[Objective]To investigate the diagnostic methods and clinical effects of the management of spondylolithesis with adjacent segment degeneration.[Method]Between October 2000 and October 2005,16 consecutive patients(3 males and 13 females) aging 42 to 76 years(mean 59.1 years) received instrumented lumbar interbody fusion procedure using traditional posterior approaches for spondylolithesis with adjacent segment degeneration.Lumbar functions were assessed using Prolo system.Preoperative and follow-up lateral lumbar radiographs were studied for reduction of spondylolithesis,disc heights,lumbar lordosis,fusion rates and complications.[Result]Fourteen patients were followed up,with an average duration of 28(16–53) months.Clinical outcomes in terms of Prolo system was 7 points in 3 patients,8 in 7 patients,9 in 2 patients,and 4 in 2 patients at 3 months after operation with 85.7% being graded as good or excellent.Seven points in 4 patients,8 in 6 patients,and 9 in 4 patients at last follow-up(graded as 100% good or excellent).Fusion rate was 66.7%(8/14)at 6 months and 92.9%(13/14)at 12 months after operation.Ten patients(71.4%) fully recovered from spondylolithesis,4 had partial reduction,and their reduction status was unchanged according to plain radiographs at 12 months and last follow-up.The operative wound healed without complications in all patients.The mean Lordosis was 26.64??6.67?,33.29??3.39?and 32.71??2.80?before and at 3-month,or last follow-up after operation.The mean of fused Lordosis was 15.64??6.21?,28.29??3.28?and 32.36??3.91?before at 6 months or at last time follow-up after operation.The disc heights were 6.54?1.13mm and 9.62?0.81mm before and after operation.Statistics showed significant difference(P

Objective To compare the biomechanical stability of the multiaxial inter-vertebral and vertebral pedicle screw fixation in vertebral fracture fixation of the spinal fracture model. Methods Six lumbar fracture models were made on fresh calf lumbar spine specimens at L1 -L5 to compare the stability of four transpedicular multiaxial screws and six transpedicular multiaxial screws by examining the range of motion (ROM) in flexion, extension, lateral bending and torsion. Results Biomechanical experiment found that four multiaxial screws transpedicular fixation specimen exhibited a significantly larger ROM in flexion and extension than the intact specimens; while six multiaxial transpedicular screw fixation specimen exhibited a smaller ROM than the intact specimens (t =4. 844,P ＜0. 01 ;t =3. 722,P ＜0.05 ). The ROM of six multiaxial transpedicular screw fixation specimen was significantly smaller than that of four multiaxial transpedicular screw fixation specimen in flexion, extension, lateral bending and rotation ( P ＜ 0. 01 ). Conclusions Compared with four multiaxial transpedicular screw fixation, six multiaxial transpedicular screw fixation exhibits a significantly larger stability in flexion, extension, lateral bending and rotation, as provides theoretical basis for treatment of thoracolumbar fractures with pedicular screw fixation.

ObjectiveTo investigate the protective effects of epigallocatechin gallate (EGCG) in a mouse model of Parkinson's disease induced by 1-Methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP).Methods32 C57BL/ 6 male mice were randomly divided into 4 groups: Model group was administrated with 16 mg/kg MPTP (i.p., four times, 2 h interval); Sham group was treated with saline; EGCG treatment group was given EGCG (5 mg/kg) after MPTP administration; normal group was just given EGCG (5 mg/kg) as treatment group. After given EGCG for 3 weeks, behavioral tests, tyrosine hydroxylase (TH) immunohistochemistry staining and the HPLC for dopamine (DA) and its metabolites were used.ResultsThe present results indicated that oral administration of EGCG significantly improved the behavioral impairement in mice induced by MPTP (P<0.05). And in the EGCG treatment group, there were more TH-positive neurons than in model group. In addition, levels of DA and its metabolites in striatum decreased significantly in MPTP group (P<0.05). Though the concentration of DA and its metabolites in EGCG treatment group tended to increase, however, there was no significance between EGCG treatment and model group.ConclusionEGCG could improve the behavioral impairment in a mouse model of Parkinson's disease induced by MPTP and protect against the loss of the dopamine neurons in the substantia nigra (SN).

Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides (MF).
Methods From January 2008 to January 2013, a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital. The median age of these patients was 53.36±14.45 years. Female-male ratio was 1:1.2. The average course of disease was 10.82±3.37 years. All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51 (40-74) Gy in an average of 24.55±5.57 (20-40) fractions, 5 fractions per week.
Results The median follow-up time was 55.27±29.3 (13-103) months. No severe acute or chronic side effects of irradiation were observed. Complete clinical response (CR) rate of the radiated sites was 54.5%(6/11), partial response (PR) rate was 36.4%(4/11), and the overall response rate (CR+PR) was 90.9%. One patient showed no response.
Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.

Objective:To evaluatte the high risk factors of stent occlusion in patients with acute iliofemoral vein thrombosis and Cockett syndrome.Methods:The clinical data of 178 patients of Cockett syndrome and acute lower extremity deep vein thrombosis from Jan 2014 to Dec 2016 was analyzed retrospectively. All patients underwent catheter directed thrombolysis or percutaneous mechanical thrombectomy combined with stent placement. The patency rate of stent was followed up by color Doppler ultrasound. Patients were divided into study group (stent occlusion) and control group (stent patency).Results:The stent patency rate at 6 months was 83.7%, body mass index ( OR=1.245, 95% CI: 1.097-1.413), time of thrombosis more than 2 weeks ( OR=3.899, 95% CI: 1.147-13.257), low thrombus clearance ( OR=0.238, 95% CI: 0.117-0.486) was the high risk factor of short-term stent occlusion. Stent patency rate at 3 years was 75.3%, body mass index( OR=1.225, 95% CI: 1.076-1.394), thrombosis history more than 2 weeks( OR=11.777, 95% CI: 2.576-53.832), malignant tumor( OR=4.444, 95% CI: 1.153-17.127) , compression therapy( OR=0.332, 95% CI: 0.113-0.977), low thrombus clearance( OR=0.184, 95% CI: 0.089-0.381), long stents( OR=8.427, 95% CI: 2.329-30.488) was the high risk factor for mid-term stent occlusion. Conclusions:Obesity, the duration of thrombus longer than 2 weeks and low thrombus clearance are the high risk factors of early stent occlusion, while malignant tumor, irregular compression therapy and long stents may lead to lower medium and long term patency rate of the stent.

BACKGROUND: The expanded polytetrafluoroethylene (ePTFE) vascular grafts hold promise for enhanced healing,extended suture retention, kink reduction and compression resistance. But thrombus formation still limits its use for revascularization of small-caliber vessels. It is the surface of ePTFE vascular graft that contacts with the blood. The current study focused on surface modification of ePTFE materials to improve its blood compatibility.OBJECTIVE: To characterize the heparin/alginate (H/A) gel modified ePTFE vascular graft and investigate the hemocompatibility and histocompatibility of the graft.DESIGN: Observation experiment.SETTING: Laboratory for Nanomedicine and Biosensor, Biomedicine Engineering Center, Harbin Institute of Technology.MATERIALS: The GORE-TEX ePTFE vascular grafts were 4 mm in internal diameter. Sodium alginate and 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC) were purchased from Sigma. Heparin sodium salt was obtained from Calbiochem. Nation and chitosan were purchased from Aldrich company. Human α-thrombin and AT Ⅲ were purchased from Haematologic Technologies, Inc. S-2238 was purchased from Chromogenix.METHODS: This study was performed at the Laboratory for Nanomedicine and Biosensor, Biomedicine Engineering Center, Harbin Institute of Technology between May 2006 and June 2007. The graft was first modified with Nation and then Chitosan/Nafion/Chitosan multilayer. Following the impregnation of heparin and alginate, covalent crosslinking was performed using ethylenediamine and EDC. Some characterization methods were employed: stastic water contact angle for the hydrophilicity; SEM for the surface morphology; ATR-FTIR for the surface chemical characteristics; APTT and PT,percent hemolysis and Chromogenic assay for the hemocompatibility of the ePTFE vascular graft after modification.MAIN OUTCOME MEASURES: ①Static water contact angles. ②Charactedzation of the surface morphology and platelet adhesion by SEM. ③ATR-FTIR ④APTT and PT. ⑤Percent hemolysis ⑥Chromogenic assay for heparin activity.RESULTS: ①ATR-FTIR revealed the presence of -CO-NH- at 1626 cm-1. ②The water contact angle was greatly decreased from (125±1)° to (84±2)° .③The prolonged APTT and PT, low percent hemolysis(0.065%) and low amount of platelet adhesion assay showed the H/A gel impregnated graft had good blood compatibility. ④Chromogenic assay showed the modified graft was less thrombogenic than the bare one, and the H/A coating had good stability in. PBS buffer.CONCLUSION: The H/A modified ePTFE vascular graft has great potential in applications utilizing small-diameter vascular grafts.

Objective To study the expression of basic fibroblast growth factor (bFGF),thrombospondin-1 (TSP-1) and the mi- crovessel density (MVD) and their relationship in esophageal squamous cell carcinoma.Methods Forty-six specimens of resected, paraffin embedded esophageal specious of squamous cell carcinoma were examined by immunohistochemical technique for the MVD and expression of bFGF and TSP-1.Results Of the 46 patients,the positive rate of bFGF and TSP-1 were 60.9% (28/46) and 37.0% (17/46),respectively.The mean value of MVD was (56.59?28.97)/mm~2.The depth of invasion had a significantly positive corre- lation with positive expression of bFGF and TSP-1.TNM stage had a significantly positive correlation with positive expression of TSP- 1.The value of MVD was closely associated with histological grade,lymph node metastasis and the expression of bFGF.Conclusion bFGF,TSP-1 and tumor microvessel play important roles in development and progression of esophageal squamous cell carcinoma. bFGF is a important regulator of tumor angiogenesis.

Breast cancer stem cells (CSCs) are the main causes leading to the failure of treatment of breast cancer and play important roles in the progression of breast cancer and drug resistance, which are closely related to the therapeutic resistance of radiotherapy and chemotherapy, and endocrine therapy.The metastatic potential and therapeutic resistance of CSCs are associated with epithelial mesenchymal transition and Hedgehog, Wnt, interleukin-6/signal transduction and tanscriptional activation factor 3, transforming growth factor-β and other signaling pathways.While some of the targeted drugs targeting these signaling pathways are undergoing clinical transformation, which is expected to provide new approach for the clinical treatment of breast cancer.

Adult ; Cutis Laxa ; complications ; diagnosis ; Emphysema ; diagnosis ; etiology ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors