Objective A two-stage renovation has nowadays been considered as the optimal mode for the treatment of infected total hip joint.Extensive bone defects were often found during the subsequent operation,and they should be repaired by using allograft to attain stability of the implants.The purpose of present study is to investigate the efficacy and safety of employing bone allograft in repairing the femoral defect caused by post-operation infection of hip arthroplasty in the second stage operation.Method From Mar.2001 to Dec. 2006,a total of 20 patients(20 hips)with infected total hip arthroplasty were treated with bone allograft on the femoral side in the second operation.Impaction bone grafting technique was performed for 16 patients using bone allograft combined with cemented stems,and un-ce- mented prosthesis combined with bone strut allograft were used in the other 4 cases.A regular follow-up was done and the outcomes were evaluated using the Harris Hip Score System and radiography.Result All patients were followed-up clinically and radiographically for an average of 20.3 months(4-61 months).No re-infection was found at the last time of follow-up.The mean Harris Hip Score was in- creased from 34.2 before operation to 87.7 after operation.90% of the patients were satisfactory with the results.Conclusion The bone allograft can be used for reconstructing bone defects in the patients after infection of total hip arthroplasty,either with combined with ce- mented stems or non-cemented stems.It is an effective and safe way in dealing with femoral bone defect after infection of total hip arthro- plasty.

[Objective]To evaluate clinical results of videoassisted thoracoscopic anterior spine release combined with anterior or posterior correction of adolescent idiopathic scoliosis(AIS).[Method]Eleven cases of received video-assisted thoracoscopic anterior spine release followed by anterior or posterior instrumentation from July 2003 to December 2005 were reviewed.The average age at surgery was 14.6 years(ranged from 12 to 16 years).There were nine cases of Lenke type Ⅰ with average preoperative Cobb's angle of 59.7?(ranged from 54? to 68?),and two cases of Lenke type Ⅲ,with average preoperative Cobb's angle of 64.5?(ranged from 58?to 71?).The correction rate of thoracic curves in bending film averaged 26.4%(ranged from 21.8% to 32.4%).All 11 patients underwent release via endoscopic anterior resection of intervertebra disc through radiofrequency,and anterior or posterior correction.The coronal and sagittal Cobb's angle after surgery,and at follow-up were measured.The operative time,intraoperational blood loss,peri-operative complications and loss of carrection were analyzed.[Result]The average operation time was 4 hours and 50 min.The blood loss during surgery averaged 171 ml.The average number of released levels was 4.4(ranged from 5 to 7).The average postoperative Cobb's angle of 9 cases of Lenke type Ⅰ was 20.4? with curve correction rate of 65.5%.Postoperative Cobb's angles of 2 cases of Lenke type Ⅲ were 20? and 25?,the correction rate of thoracic curve averaged 65.1%.One patient developed thoracic effusion.The average follow-up period was 18.6 months,only one of them with loss correction of 14?.No neurologic or vascular complication occurred.[Conclusion]Compared to the open anterior surgery,video-assisted thoracoscopic anterior spinal release is a safe and effective treatment for idiopathic scoliosis.It can avoid complications incurred by traditional thoracic surgery.It has satisfactory clinical results compared to conventional thoracotomic release for AlS.

Objective To investigate the effect of corpectomy decompression by subtotal vertebrectomy and fusion of adjacent segmental artificial disc replacement through anterior intervertenral spance (Hybrid Surgery) in the anteriorcervical spondylotic myelopathy treatment . Methods Hybrid Surgery were operated on 18 patients who suffered from anterior cervi?cal spondylotic myelopathy . Follow up of 1-50 months. Patient’s conditions were assessed according to the Japanese Associ?ation for Department of orthopedics assessment score (JOA score) before and after operation. Effects of Hybrid operation were assessed by the improvement of JOA score, Odom’s follow-up grade and cervical mobility . Results The JOA scores of all 18 operated patients were improved from 10.6 ± 1.7 before operation to 13.5 ± 2.4 after operation. And the difference is statistically significant (t=1.314, P < 0.05). Among all the operated patients, 16 were cured and 2 were effective. As to Odom’s follow up grades, 6 cases were excellent, 11 cases were good and 1 case was acceptable. The postoperative move?ment range of cervical spine (40.1° ± 8.4°) show no statistically difference compared with that in preoperation (42.6° ± 11.9°) (t=0.68, P > 0.05). Conclusion Hybrid Surgery of anterior cervical decompression and fusion can both improve the nerve function and preserve cervical mobility.

Objective: Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue. Method:Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A. Result:The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls(P<0.05), and there was no remarkable difference in the expression of SP-A between allergic rhinitis and polyp(P>0.05). The result demonstrated that SP-A was positivly correlated with eosinophils within the basement membrane of epitheli-um(R=0.81,0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group(P<0.05). Conclusion:SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

Objective:To evaluate the prognosis of non-small cell lung cancer (NSCLC) patients with pleural dissemination after differ-ent surgical interventions. Methods:We retrospectively reviewed clinical and survival data of 153 NSCLC patients with pleural dissemi-nation who were diagnosed and treated in our hospital from May 2002 to May 2011. Results:The overall 3-and 5-year survival rates of all the patients are 38.5%and 24.2%, respectively, with a median survival time (MST) of 29.0 months. A total of 122 patients accept-ed primary tumor resection whereas the remaining 31 received pleural biopsy. The 5-year survival rate of the primary tumor resection group was 26.2%with a MST of 29.0 months and 16.1%for the pleural biopsy group with a MST of 24.0 months. The survival analysis showed no significant differences in the prognosis between the primary tumor resection and pleural biopsy groups (P>0.05). In the pri-mary tumor resection group, different surgical interventions (with or without lymph nodes dissection, with or without metastatic nod-ules resection, lobe, or partial lobe resection) had no effect on prognosis (P>0.05). Conclusion:Patients with pleural dissemination had poor prognosis. Different surgical interventions showed no survival benefits for patients with NSCLC regarding pleural dissemination. The role of surgery was to rule out or confirm pleural dissemination. The definite value of surgery still needs further exploration.

Objective To compare the prognosis of sentinel node-positive breast cancer patients forgoing axillary lymph node dissection.Methods A systematic literature search (Medline,Embase,Cochrane Library)ended in April 2014 was performed to identify all eligible articles.Two reviewers independently screened and extracted data.RevMan5 was used for statistical analysis.Results A total of 1026 abstracts were retrieved and 18 clinical controlled studies finally included,the total number of patients were 47 894,7389 had micrometastases in sentinel lymph node,35 217 had macrometastases in sentinel lymph node and 5288 had positive sentinel lymph node regardless of micrometastases or macrometastases.For patients with MIC,the 5-year axillary recurrence rate,5-year disease free survival and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.78;95％ CI:0.72-4.39,P=0.21),(OR =0.76,95％CI:0.56-1.04,P=0.08),(OR=0.77,95％CI:0.43-1.40,P=0.39).For patients with MAC,the 5-year axillary recurrence rate had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.21;95％ CI:O.76-1.91,P =0.42).For patients with positive sentinel lymph node regardless of micrometastases or macrometastases,the 5-year axillary recurrence rate and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.29;95％ CI:0.92-1.80,P =0.14),(OR =0.96,95％ CI:0.64-1.45,P =0.84).Conclusions Among patients with limited positive SLN of breast cancer,patients forgoing ALND compared with ALND did not have obvious affect on long-term survival.

Objective To explore the effects of angelica naphtha on the withdrawal signs and norepinephrine neurotransmitter in uorphine-dependent rats.Methods 72 SD rats were randomly divided into control group,model group,clonidine group and three angelica naphtha groups (80,40 and 20 mg/kg).Rats were received gradualy increasing doses of morphine to produce physical dependence.Withdrawal symptoms were evaluated by Ryuta Tomoji score.The level of norepinephrine and normetanephrine(NMN) were tested by enzyme-linked immunosorbent assay(ELISA).Results The scores of withdrawal signs were (4.00± 3.29),(30.13±4.41),(18.96± 4.43),26.04±4.13),(22.33±4.60) and (19.00±3.47),respectively.The morphine withdrawal signs were reduced by angelica naphtha in a dose-dependent manner(P＜0.01),also significantly reduced the level of NE and NMN and the ratio of NMN/NE in the nucleus ceruleus and prefrontal cortex(all P＜0.01).Conclusion Angelica naphtha alleviates the withdrawal synlptons in morphine-dependent rats,which may be related to the inhibition of excessive turnover of norepinephrine neurotransmitters in the nucleus ceruleus and prefrontal cortex.

OBJECTIVE: To summarize the clinical features of epistaxis in the posterior fornix of inferior meatus and its comprehensive treatment measures. METHOD: We collected and retrospectively analyzed the clinical data of 212 cases of epistaxis hospitalized in our department, among which 23 cases were diagnosed as epistaxis in the posterior fornix of inferior meatus. They underwent nasal endoscopic exploration and coagulation surgery with one case under general anesthesia and the other 22 under local anesthesia. The bleeding from olfactory cleft, spheno-ethmoidal recess and the middle nasal meatus were excluded for all the patients during the surgery. After shifting the inferior turbinate inward by fracture, the active bleeding was found in the posterior fornix of inferior meatus, which was stopped immediately by bipolar coagulation. The areas of coagulation and nasal mucosa erosion were packed with nasopore after operation. RESULT: For all the patients, bleeding spots were definitely located during the operation and successfully coagulated. None of them suffered from recurrent-bleeding within 1 week postoperatively. Followed up for 6 to 12 months, there was no epstaxis recurrence or nasal cavity adhesion at the bled side in all patients. CONCLUSION For intractable epistaxis patient, after excluding the bleeding in olfactory cleft, sphenoethmoidal recess and the middle nasal meatus, it should be considered that the bleeding might come from posterior fornix of inferior meatus. It is the key point to thoroughly expose the posterior fornix of inferior meatus by shifting the inferior turbinate inward by fracture and explore for the bleeding spot carefully.
Adult ; Aged ; Epistaxis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To establish the optimal extracted method for content dete rmination of naringin in Citrus grandis. Methods RP-HPLC was used to determinat e the content of naringin extracted with the above two methods from different ye ar samples of Citrus grandis. Results The average content extracted with ultraso nic extraction was 13.53 %,and the average content extracted with soxhlet extr action was 11.98 %,there being insignificant difference between the two method s. Conclusion The content of naringin extracted with ultrasonic extraction is mo re than that with the soxhlet extraction,which be receipted in Chinese pharmeco pia. And ultrasonic extraction method is more convenient and can save time.

Objective To investigate short?term clinical outcomes of XLIF through small incision approach combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis. Methods From December 2011 to June 2013, 15 pa?tients with degenerative lumbar scoliosis were treated by XLIF combined with percutaneous pedicle screw fixation (XLIF group). There were 6 males and 9 females, with an average age of 68.27±5.70 (ranging from 58 to 75) years old and Cobb angle of scoliosis 22.20°±6.66° (ranging from 14° to 35°). Meanwhile, 23 patients were treated with posterior lumber inter?body fusion (PLIF) com?bined with pedicle screw fixation (PLIF group). There were 9 males and 14 females, with an average age of 63.26 ± 6.03 (ranging from 49 to 73) years old and Cobb angle of scoliosis 23.17°±6.95° (ranging from 13° to 36°). The efficacy was assessed through cor?rection rate of Cobb angle, VAS and lumbar JOA score at the time of the latest follow?up. Results The operation time was 224.35 ± 51.53 min in the PLIF group and 197.47 ± 31.84 min in the XLIF group. No significant differences were found, but there was significantly difference in the intraoperative blood loss (PLIF group: 576.52 ± 227.89 ml, XLIF group: 181.33 ± 47.37 ml, t=-8.054, P<0.001). No patient accepted blood transfusion in the XLIF group, but in the PLIF group, 11 patients accepted blood transfusion. The Cobb angle, VAS and JOA score in two groups were improved compared with the preoperative. 38 patients were followed up for 12 to 32 months, with an average of 23 months. The correction rate of Cobb angle, VAS and JOA scores were 56.90%±11.51%, 87.97%±12.07%, 84.00%±5.59%in the XLIF group, and 62.88%±8.28%, 83.68%±12.33%, 84.79%±6.76%in the PLIF group. No significant differences were found between the two groups (P>0.05). Conclusion Treatment of degenerative lumbar scoliosis with XLIF through small incision approach combined with percutaneous pedicle screw fixation is a kind of safe and effective minimally invasive spine surgery with small trauma and less bleeding, and the recent surgery efficacy was close to PILF.