Objective To explore the effects of various location methods on the successful rate of placement nails by the entrance spot of lumbar vertebra pedicle. Methods The clinical data of 105 patients with 462 times of internal nail fixation of lumbar vertebra pedicle were analyzed, and the successful rates of placement nails one time were compared among 5 location methods. Results 462 times of internal nail fixation of lumbar vertebral pedicle were performed safely. Postoperative X-ray imagining showed that 322 nails were located in the middle of pedicle of lumbar vertebra, 58 nails in its inferior part, and 82 nails in its superior part. The successful rate of placement nails one time by the location method of four quadrants technique was 86.9%, which was significantly different compared with the other 4 location methods(P

Objective To explore effects and mechanism of inactivation of vitamin D receptor (VDR) in intestinal tumor growth of APCmin/+ mice. Methods To generate APCmin/+VDR -/- mice through breeding, the number and size of small intestinal and colonic tumors were assessed and compared between APCmin/+ and APCmin/+ VDR -/- mice. The intestinal tumors were diagnosed with HE stain. The expressions of BCL-2,vimentin-1,Stat-1 and MSH-2 proteins of tumors were determined by immanohistocbemistry and compared be-tween APCmin/+ and APCmin/+VDR -/- mice. Results A comparison between APCmin/+ and APCmin/+ VDR -/- mice revealed that the number of the tumors, which were larger than 3mm, was significantly increased in APCmin/+ VDR -/- mice at 4 months of age (P< 0.01). HE staining indicated fistulous adenomas from small intestine and colon of two groups, Immunostaining showed Stat - 1 level in APC-min/+ tumors were increased and MSH-2 and vimentin-1 levels in APCmin/+ VDR-/- mice were increased, compared to APCmin/+tumors. Conclusion These observations suggested that inactivation of VDR promoted the intestinal tumor growth of APCmin/+ mice.

Objective To investigate the effect of transforming growth factor-?1 (TGF-?1) on cell cycle,cell proliferation,and invasive capacity of human colon cancer cells of the line SW480,for its role in colon carcinogenesis and development,as well as its application in gene therapy for colon cancer with RNA interference.Methods The recombinant expressing plasmids pEGFP-N1-TGF-?1 was constructed and transfected into SW480 cells by Lipofectamine 2000.The expression of TGF-?1 mRNA and protein in the transfected SW480 cells were detected by fluorescent microscopy,RT-PCR and Western blot analysis respectively.The cell proliferation of SW480 cells was tested by MTT assay,the cell cycle was analyzed by flow cytometry,and the invasion ability of SW480 cells were investigated by Transwell-matrigel invasion chambers.Results After transfected into SW480 cells,both the mRNA and protein levels of TGF-?1 were effectively increased (P

Objective To explore the relationship between respiratory viruses infection and the episode of steroid responsive simple nephrotic syndrome(SRSNS).Methods Thirty-eight children with SRSNS were selected,including the active stage group(n=28)and the remission group(n=10).The urine from 18 cases of nephritic nephrosis,16 cases of bronchiolitis,15 cases of secondary glomerular diseases and 15 cases of healthy children were served as controls.By using the method of reverse transcriptase-polymerase chain reaction(RT-PCR)and alkaline phosphoesterase-anti alkaline phosphoesterase enzyme-linked assay(APAAP),viral genes and antigens in urine were assayed,respectively.Results The positive rate of detecting viruses in the active stage group of SRSNS children was higher than that in the remission group and the other control groups(Pa

Objective To evaluate the safety and efficacy of three types of anesthesia methods in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.Methods Totally 65 patients with coronary heart disease of cardiac function Ⅰ-Ⅱ (NYHA),scheduled for undergoing unilateral lower limb surgery were randomly divided into three groups:local nerve block anesthesia of lumbar plexus plus the sciatic nerve (21 cases),general anesthesia (19 cases),epidural anesthesia (25 cases).Systolic blood pressure (SBP),heart rate (HR),pulse rate and blood oxygen saturation (SPO2) at 0 min,10 min,20 min,30 min,40 min after surgery at the end of the surgery were observed and recorded.The change of troponin Ⅰ (cTnI) at 3 day after surgery was observed.Visual analoguc scales (VAS) scores.movement reaction,the infortnation of muscle relax and corresponding management were recorded in order to detect anesthesia efficacy.Results The excellent and satisfactory rate of anesthesia efficacy of three groups were 17 cases (81.0％) and 4 cases (19.0％),17 eases (89.5％) and 2 cases (10.5％),22 cases (88.0％) and 3 cases (12.0％) (all P＞0.05).In epiduralgroup compared with other groups,SBP were decreased (both P＜0.05).cTnI in nerve stimulator group was decreased (all P＜0.05) at 1 and 3 day after surgery compared with general anesthesia group,and at 3 day after surgery,cTnI level in nerve stimulator group was lower than other two groups(all P＜0.05).Conclusions The nerve stimulator guided nerve block is the most safe method among general anesthesia and epidural anesthesia in elderly patients with coronary heart disease scheduled for lower extremity surgery.

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.

Objective To investigate the impact of anesthetization and manipulation on neurotransmitters glutamate and dopamine during cell transplantation. Methods Neural stem cells cultured in vitro from postnatal rats were implanted into the striatum of normal adult rats. Brain microdialysis combined with high-performance liquid chromatography (HPLC) was applied to dynamically detect the impact of microdialysis probe implantation, anesthetics ketamine and pentobarbital and implanted cells etc on glutamate and dopamine levels. Results After 15 min probe implantation into the rat striatum, glutamate and dopamine levels in the striatum increased, evidently higher than the baseline value and declined to the baseline level within about 5-6 h. Ketamine and pentobarbital anesthetization for 15 rain resulted in a transient increase in glutamate and dopamine levels in the rat striamm;there were no significant effects on in vivo glutamate and dopamine levels by cell implantation itself. Conclusion Routine doses of intraperitoneal ketamine or pentobarbital anesthetization may result in a transient increase in glutamate and dopamine levels within the brain extracellular space. Based on these data, the optimal time for commencing brain microdialysis on glutamate and dopamine should be at least 6 h after probe implantation.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.