BACKGROUND:The surgical management to reconstruct the stability in lumbosacral region is very chal enging. There are many techniques to reconstruct the stability of the lumbosacral region, but the internal fixation loosening, fracture and pseudoarthosis are not uncommon. OBJECTIVE:Finite element analysis was used to analyze the stability of two types of reconstruction procedures and the stress of the internal fixation system. METHODS:A 64-slice spiral CT scan was used in a subject from L1 to pelvis. The scan data were imported into the Mimics 15.0 software to generate a three-dimensional surface model. The three-dimensional solid model was established using in the SolidWorks software. The solid geometry model of the L3, 4 pedicle screws combined with single iliac screw fixation and L3,4 pedicle screws combined with dual iliac screws and anterior titanium mesh cage support fixation were constructed by the Solidworks software. Two kinds of reconstruction procedures were simulated. The models were given material properties and analyzed by using the ABAQUS software. RESULTS AND CONCLUSION:(1) The maximum stress was 195.3 MPa in the complete model, 189.5 MPa in single iliac screw model, and 149.2 MPa in dual iliac screw+titanium cage model when constrained the roof of double acetabulum and applied a vertical load of 1 000 N. (2) The axial compression rigidity was 551.572 N/mm in the complete model, 613.87 N/mm in the single iliac screw model and 1 683.50 N/mm in the dual iliac screw+titanium cage model. (3) The bending rigidity of the dual iliac screw+titanium cage model was bigger than other models at 6 directions when applied 7 N?m bending loads. The maximum stress of single iliac screw model was bigger than other models. (4) The results suggest that the dual iliac screw+titanium mesh cage reconstruction can effectively restore the stability of the lumbosacral area. The stress of internal fixation system is smal er and more dispersed. There is obvious stress concentration in the connecting rod and the tail of the single iliac screw. The single iliac screw internal fixation system is easy to fatigue fracture and loosening.

AIM: To explore the effect of complement on the cerebral ischemia/reperfusion injury in rat and the protection by sCR1-SCR15-18. METHODS: 75 male SD rats were randomly divided into three groups: sham operation group (SO, n=15), middle cerebral artery occlusion and reperfusion (MCAO) without treatment group (I/R, n=30); MCAO treated with sCR1-SCR15-18 group (sCR1-SCR15-18, n=30). After the MCAO for 2 h, then reperfusion for 24 h, the scores of neural behavioral functional deficits were determined. Infarction area was measured by TTC staining. Activity of MPO in cerebral cortex was detected. C3b deposition and pathological change were observed by immunohistochemial staining and HE staining, respectively. RESULTS: After reperfusion for 24 h, the neurological deficits score, infarction area and activity of MPO in sCR1-SCR15-18 group were decreased compared to I/R group. In sCR1-SCR15-18 group, C3b deposition in ischemic area was decreased and pathological injury was improved compared to I/R group. CONCLUSION: Complement plays a role in cerebral ischemia-reperfusion injury and sCR1-SCR15-18 exerts a protective effect by inhibiting the excessive activation of complement.

Objective Pulmonary embolism is a common cardiovascular emergency with the characteristics of high incidence,high mortality.This study compared pulmonary artery catheter thrombolysis with peripheral intravenous thrombolysis for acute pulmonary embolism in the mid-term clinical efficacy.Methods From June 2011 to September 2015,68 patients were given pulmonary artery interventional therapy,54 cases received peripheral intravenous thrombolysis;discharged patients were followed up for 3-12 months to evaluate the curative rate,effective rate,recurrence rate and the incidence of complications.Results Follow up rate was 79.5％.The cure rate of the treatment group was higher than that of the control group (47.3 ％ vs 23.8 ％,P ＜ 0.05);The significant effective rate of the treatment group was higher than that of the control group (81.8％ vs 52.4％,P ＜ 0.05);The incidence of Chronic pulmonary hypertension (1.8％) was lower than that of the control group (16.7％);There was no significant difference in improvement rate,recurrence rate and mortality.Conclusion The medium-term efficacy of pulmonary artery catheter directed thrombolysis is superior to that of peripheral intravenous thrombolysis;it can effectively reduce the incidence of chronic thromboembolic pulmonary hypertension.

Objective To evaluate indwelling intrapulmonary artery catheter thromolysis for acute pulmonary embolism.Methods From June 2011 to June 2013 56 cases of acute pulmonary embolism were diagnosed by multi-row spiral CT and admitted at the Department of Vascular Surgery.The average age was (56 ± 11) years.Inferior vena cava filter was implanted and pulmonary angiography,catheter thrombectomy,indwelling pulmonary intraarterial thrombolytic therapy was performed.Postoperatively low molecular weight heparin and warfarin was given,dosage adjusted by prothrombin international normalized ratio at 2-3.Results Mean pulmonary arterial pressure (mPAP) decreased from (43 ± 7) mmHg to (22 ± 6) mmHg (P ＜ 0.05),arterial partial pressure of oxygen (PO2) rose from (49 ± 8) mmHg to (83 ± 9) mmHg (P ＜ 0.05).Clinical symptoms significantly relieved in 51 out of the 56 cases (91％).45 patients were followed up for an average of (15 ± 4) months,with one recurrence.There was no filter migration,vena cava thrombosis,chronic obstructive pulmonary disease and other complications.Conclusions Emergency pulmonary artery indwelling catheter thrombolysis is safe and effective therapy for acute pulmonary thromboembolism.

ABSTRACT:Objective To explore the differential expression of microRNAs (miRNAs)in steroid-induced osteonecrosis (ON).Methods Bone tissues were selected from patients with steroid-induced ON between the necrotic zone of femoral heads and its femoral neck to analyze the miRNA expression profile using the microarray. The most differentially expressed miR-125a-3p and miR-1 7-5p in microarray analysis were further confirmed by real-time quantitative PCR.Results According to the microarray screening,8 miRNAs were upregulated and 3 miRNAs were downregulated in the necrotic zone of femoral heads samples (Fold>2,P <0.05 ).Results of real-time PCR revealed that miR-125a-3p was upregulated and miR-1 7-5p was downregulated in the necrotic zone of femoral heads samples,which were in agreement with the microarray data.Conclusion MiRNA’s differential expression profile of human steroid-induced ON samples was obtained.Among the differentially expressed miRNAs, miR-125a-3p and miR-1 7-5p are the most apparently differentially expressed miRNAs,which may be related to the pathogenesis and development of steroid-induced ON.

OBJECTIVE: To explore the treatment of sudden sensorineural hearing loss with steroid from different administration routes. METHOD: One hundred and eighty-eight patients with diagnosis of sudden sensorineural hearing loss were selected, in accordance with the random number table, and all patients were divided into three groups. With different administration routes, they were devided into systemic steroid therapy group, intratympanic steroid therapy group and postauricular steroid therapy group,and the curative effects were collected and analyzed. RESULT: The total effective rate was 78.26% in systemic steroid therapy group, 80.70% in intratympanic steroid therapy group and 80.65% in postauricularsteroid therapy group,and no statistical difference was detected among these three groups (P > 0.05). CONCLUSION The treatment of sudden sensorineural hearing loss with steroid from different adminsthation routes all can achieve a relatively favorable prognosis, and there were no obvious different among those different treatments.
Administration, Oral ; Audiometry, Pure-Tone ; Dexamethasone ; administration & dosage ; Glucocorticoids ; administration & dosage ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; drug therapy ; Humans ; Prognosis ; Steroids ; Treatment Outcome ; Tympanic Membrane

Objective To observe the characteristic changes in cardiac function and to raise diagnostic accuracy and sensibility.Methods 39 silent myocardial ischemia and 58 angina and 46 age-matched healthy subjects and 62 obsolete myocardial infarction underwent myocardial tomography imaging and gated ventricular imaging.Covariance analysis was used to compare difference between SPECT imaging and parameters of function.The age was tested as covariate factor,then SNK-Q test and multiple comparison were carried on.Results The silent myocardial ischemia and angina showed reversible radioactive defect or fixed defect.Most of myocardial SMI showed single peak exempt TPFR.EF,PFR and PER showed remarkably statistical difference (P<0.01).The multiple comparison of PFR and PER was increased according by OMI,AN,SMI and negative control group (P<0.05).Conclusions The myocardial damage and PFR,PER in SMI is lower than that in AN group,which have no remarkably influence on the parameters of diastolic and retractile function in left ventricular.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

Objective To evaluate the clinical diagnosis value of 99mTc-single photon emission computed tomography(SPECT)brain blood perfusion imaging in intractable paroxysmal epilepsy and analyse the imaging character.Methods Two hundred and thirty-eight intractable paroxysmal epilepsy patients performed99mTc-SPECT,MRI,CT,and electroencephalogram(EEG).The results of examinations were ana lyzed and compared.Results The positive rate of epileptic focus in brain SPECT blood perfusion imaging in the generalized tonic-clonic seizure,absence seizure,partial seizure and complex partial seizure were 85.7%,95.7%,89.8%and 90.9%,the positive rate were much higher than those in other methods(P＜0.01).The 23 patients with SPECT focus were carried on a-γ-knife treatment with follow-up for more than one year,and the efficient rate was 78.26%.Conclusions The detection sentivity of SPECT is distinctively higher than that in others.SPECT has an important clinical value to define target region of the stereotaxic radio surgery.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.