目的观察中药熏蒸加电动牵引治疗腰椎间盘突出症的疗效。方法120例腰椎间盘突出症患者采取中药熏蒸加电动牵引。中药熏蒸每次30min,每日1次,10次为1个疗程。牵引每次30min,每日1次,10次为1个疗程。依据临床疾病诊断依据治愈好转标准评价疗效。结果 120例患者优84例(70%)、良21例(17.5%)、可12例(10%)、差3例(2.5%)。结论中药熏蒸加电动牵引是一种有效的治疗腰椎间盘突出症的方法。

At present,peripherally inserted central catheter (PICC) and totally implantable access port (TIAP) are most commonly used for the medium-term and long-term ccntral vcnous infusion in China,which is mainly adopted for long-term repeated chemotherapy,nutritional support and other clinical treatments.As an advanced infusion route,this technique needs to be further popularized in clinical practice to benifit the majority of patients.However,in aspect of the implantation,use,maintenance,and the diagnosis and treatment of complications of long-term central venous access,there are still a lot of problems,to which sufficient attention should be paid.Standard implantation and maintenance are of great importance for the safe implantation of central venous access and long-term safe use.This paper aims to make a comprehensive review concerning the problems of long-term indwelling of central venous access,the basic solutions,and the whole course management of central venous access.In order to promote the technique of central venous access to continually develop,the multidisciplinary collaborative team with tacit cooperation,standardized system and regulatory process should be emphasized.

Objective To evaluate specific clinical and imaging features of osteogenesis imperfecta V and to improve diagnostic accuracy of this disease. Methods Data of 15 patients with osteogenesis imperfecta type V were retrospectively analyzed for their clinical and imaging features. There were 10 males and 5 females, aged from 1 year and 30 years old (median age,12.5 years ). All 15 patients had plain X-ray, and 4 of 15 had CT. All data were analyzed by 3 experienced deputy chief doctors in OI according to OI V standard. Results X-ray:calcification of the interosseous membrane between radius-ulna was detected in all patients and calcification of the interosseous membrane between tibia-fibula was detected in 2 of 15 patients. Dislocation of the radial head was seen in 13 of 15 patients,bilateral in 9 and utilateral in 4.All patients showed restriction in the pronation and supination of the forearm and restricton in the flexion and extention of the elbow joint. Patients with dislocation of raidal head were associated with large coronoid process and olecranon of the ulna. Hyperplastic callus of the extremities were detected in 7 of 15 patients (7 at femur , 3 at humerus, 1 at tibia.In early stage, hyperplastic callus showed thin cortice, and clear boundares with the diaphysis showing and low density, irregular, mesh-like lamellation inside. In the later stage, there were dense calcification inside hyperplastic callus, and no difference in density with the diaphysis. Diaphysis surrounded by hyperplastic callus had clear boundaries with the hyperplastic callus. No cortical destruction was detected. CT:there were sparse needle-dot calcification inside hyperplastic callus, with the patterns of granular, ring-and-arch,irregular streaky mineralization. The cross section of proximal femoral shaft showed irregular shape , flat square shape and tiny medullary cavity, with no calcification on the edge of hyperplastic callus. CT value:-91 HU inside hyperplastic callus; 283 HU in femoral shaft. Conclusions Interosseous membrane between radius-ulna or tibia-fibula, hyperplastic callus ,dislocation of the radial head are specific features in osteogenesis imperfecta V. X-ray can make a definitive diagnosis of osteogenesis imperfecta V. CT scan is helpful in the differential diagnosis of osteogenesis imperfecta V from osteosarcoma.

0.05).However,the effect on decreasing mean yearly incidence of RRTI and duration of each onset in group A was superior to that in group B(P0.05).【Conclusion】JY can reduce the mean yearly incidence of RRTI and duration of each onset in preschool children with RRTI,and its mechanism may be related to the regualtion of cellular immune function by improving the parameters of subgroups of T lymphocytes.

Vascular birthmarks are the most common disease.The morbidity is about 2.5%,most of the lesions occur in oral and maxillofacial regions which accounts for 40%-60% of the total lesions.In 1982,Mulliken and Glowacki proposed a biologic classification of vascular birthmarks on the basis of their clinical manifestations,histopathological features,and natural history.They defined hemangiomas as vascular tumors with a growth phase,marked by endothelial proliferation and hypercellularity,and an involutional phase.They recognized that many entities referred to as hemangiomas are actually structural malformations of the vasculature,derived from capillaries,veins,lymph vessels,or arteries or from a combination of these sources.The classification was confirmed and issued by International Society for the study of vascular anomality(ISSVA) in 1988.Waner and Suen amended the above category in 1995.This paper presents the new classification of vascular birthmarks and the developments in this field in re-cent years,including the pathology,clinical features and the therapy.For example,the classification of venular malformation categorized by Waner in 1989;the classification of lymphous malformation by Waner and Suen in 1995;and the treatments according to above classifications.

Objective To explore the biomechanical properties of posterior occipital condyle screws compared with common occipitocervical fusion internal fixation and it's impacts upon stress of hypoglossal canals.Methods Finite element models based on the occipitocervical CT data of one 28-year-old male healthy volunteer were built,including normal model,instability model,internal fixation model by occipital condyle screws,internal fixation model by occipital plate screws,and internal fixation model by transarticular screws.Fifty N gravity and 1.5 N · m torque were exerted upon the surface of occipital bone so that the models could perform lateral bending,flexion,extension,and rotational motions.The motion range and stress distribution of internal fixation were compared under varying conditions among different occipitocervical fusion models.In addition,the impact of occipital condyle screw upon hypoglossal canals was examined.Results Compared with instability model,the motion range in the internal fixation model by occipital condyle screws declined by 96.8％,95.6％,95.0％ and 98.5％ respectively in lateral bending,flexion,extension and rotation.In the internal fixation by occipital plate screws,the motion range decreased by 96.3％,95.7％,98.4％ and 99.6％ respectively.In the internal fixation by transarticular screws,the motion range exhibited a decline of 95.7％,94.0％,94.3％ and 98.9％,respectively.The stress peaks in the occipital condyle screw were 192.4 MPa,201.6 MPa and 187.6 MPa under lateral bending,flexion,and rotation conditions,respectively.The stress peaks in the occipital plate screw were 279.6 MPa,213.7 MPa,and 154.1 MPa,respectively.The stress peaks in the transarticular screw were 232.4 MPa,220.9 MPa,and 224.5 MPa,respectively.The stress impact peak of occipital condyle screw on the hypoglossal canals wall was 12.96 MPa,and the content deformationunder the hypoglossal canal was 0.64％.Conclusions The occipital condyle screw internal fixation has similar stability with common occipitocervical fusion fixations.The occipital condyle screw has more uniform stress distribution and less effect on the hypoglossal canals,and hence is safe and reliable as anchor point on the cranial side in occipitocervical fusion.

Objective A meta-analysis is to be performed to compare the entire efficacy on decompression (D) alone and decompression with fusion (F) for patients with 1-2 level lumbar stenosis (LSS) regardless of degenerative spandylolisthesis (DS) based on published RCTs.Methods The databases include Pubmed,Embase,Cochrane Library and Web of Science from January 1970 to March 2018 with a certain search strategy and inclusion criteria.Two reviewers assessed eligible trials,evaluated articles quality and extracted information independently and the information included basic characteristics of demographic information,primary and secondary measures,then data synthesis and meta-analysis was progressed as well as subgroup analysis by DS and follow-up time (36 months).Continuous variables were reported as weighted mean difference (WMD) and dichotomous variables were reported as odds ratios (ORs).Finally the strength of evidence and grade of recommendation was evaluated by the grades of recommendation,assessment,development and evaluation (GRADE) system for the overall outcome.Results A total of 9 RCTs with a low to moderate risk of bias met inclusion criteria with a total of 857 patients (367 were in D group and 490 were in F group) in 1-2 level operation and the average age,sex ratio and preoperative visual analogue scale (VAS) were of no significance.In primary measures,there were no statistical difference in VAS changes on back and leg pain between D and F group [MD=-0.03,95％ CI (--0.38,0.76),Z=0.08,P=0.94;MD=0.1 1,95％CI (-1.08,1.30),Z=0.18,P=0.86,respectively];Patients' satisfaction was of no difference between the two groups (OR=0.74,P=0.48),together with the change of Oswestry disability index (ODI,P=0.29) and European quality of life-5 dimensions (EQ-SD,P=0.41).As to the secondary measures,there were no difference in the rate of complication (OR=0.75,P=0.50) and reoperation (OR=1.93,P=0.11) while a statistical significance of longer operation duration (P=0.000),more blood loss (P=0.004),longer hospital stays (P=0.000) but amazing lower rate of ASD (OR=2.35,P=0.02) in F group.The subgroup analysis on whether combined with DS showed that basically all of the compared measures were in consistency with the whole meta-analysis;As to the follow-up,there was a higher reoperation rate in middle-to-long term (＞ 36months) in D group while the other measures were in line with the overall meta-analysis and adjacent segment degeneration/disease (ASD) was the most seasons of reoperation yet no matter the follow-up time.According to the GRADE system,the grade of this meta-analysis is of "High" quality.Conclusion F group has no better clinical results than D alone in short-segment LSS,regardless of DS,and even further,no significant change with shot-term or middle-to-long term follow-up.F approach has a longer duration of operation,more hospital stays and more blood loss,even perhaps a lager cost.According to the GRADE,the grade of this meta-analysis is of "High" quality,the grade strength of recommendation was "Strong".

Objective: To review and compare radiological parameters between degenerative lumbar kyphoscoliosis (DLKS) and degenerative lumbar kyphosis (DLK), and analyze the relationships between coronal and sagittal deformities and compensatory mechanisms of sagittal balance. Methods: A total of 82 patients with lumbar degenerative deformities were enrolled for our radiographic study at Department of Spinal Surgery, Peking University People′s Hospital from January 2016 to May 2017. These patients were divided into two groups: DLKS group (39 patients) with lumbar coronal and sagittal deformities, and DLK group (43 patients) just with lumbar sagittal deformity. Complete spinopelvic radiographic parameters were compared. Results: The Cobb angle and lumbar lordosis of DLKS group were (23.0±11.8)° and (18.2±12.1)°, while the lumbar lordosis of DLK group was (20.4±10.2)°. In DLKS group, Cobb angle had correlations with lumbar lordosis(r=-0.338, P=0.035), and central sacral vertical line distance had significant correlations with thoracolumbar junctional angle (r=0.488, P=0.002) . Moreover, no significant differences of all sagittal spinopelvic parameters were found between two groups (P>0.05). In DLKS group, significant correlations between lumbar lordosis and sacral slope (r=0.617, P=0.000), and correlations between lumbar lordosis and thoracic kyphosis(r=-0.363, P=0.023) were observed. In DLK group, lumbar lordosis showed significant correlations with thoracic kyphosis(r=-0.341, P=0.025) and sacral slope (r=0.772, P=0.000). According to Nash-Moe grading scale of apical vertebral rotation, 10 patients were with Ⅰ-Ⅱ grade while 29 patients with Ⅲ-Ⅴ grade in DLKS group. Conclusions Both as typical lumbar degenerative deformities, there are some correlations between scoliosis and kyphosis. However, coronal scoliosis may not influent sagittal morphological parameters for DLKS patients. Thoracic curve changes and pelvic backtilt are both important for maintaining the sagittal balance in patients with degenerative lumbar kyphoscoliosis.

To develop standard in vitro chondrosarcoma models, we synthesized three hydrogels (i. e., PDMAAm, PNaAMPS and PMETAC) and investigated the influence of Young's modulus, swelling ratio and electric charges on the behavior of chondrosarcoma cells seeded on the hydrogels, including morphology, adhesion and aggregation. Results showed that the morphology of chondrosarcoma cells at 6h was dependent on the charges of hydrogels; cells present spindle-shaped and round-shaped morphology on negative charged and neutral hydrogel, respectively, while no cells spreaded on positive charged hydrogel. Chondrosarcoma cells formed aggregates on neutral PDMAAm after further culture. The hydrogels can be synthesized easily and has the characteristics of ease at use with defined components, which holds great potential for developing standard chondrosarcoma models in vitro.
Bone Neoplasms ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Chondrosarcoma ; pathology ; Humans ; Hydrogels ; chemistry ; pharmacology ; Methacrylates ; pharmacology ; Nylons ; pharmacology ; Static Electricity

ObjectiveTo investigate the expression of lysophosphatidic acid （LPA） in patients with liver cancer， as well as its influence on malignant biological behavior of liver cancer and related regulatory mechanism. MethodsFrom January 2016 to December 2022， 26 patients with liver cancer， 28 patients with liver cirrhosis， and 28 individuals undergoing physical examination were enrolled. ELISIA was used to measure the content of LPA in plasma and peritoneal effusion of the patients with liver cancer or liver cirrhosis accompanied by peritoneal effusion， and the content of LPA was measured in plasma of the normal population at the same time， so as to clarify the difference in the expression of LPA in different populations， such as the patients with liver cancer and those with liver cirrhosis. MTT cell proliferation assay and cell migration assay were used to observe the influence of LPA and its inhibitor pertussis toxin （PTX） on the proliferation， migration， and invasion of SMMC7721 cells. In order to investigate the effect of LPA on the expression of RhoA and its upstream and downstream molecules FAK and P53 after binding to its receptor， qPCR and Western blot were used to observe the effect of LPA on the mRNA and protein expression levels of P53， FAK， and RhoA in SMMC7721 cells. A one-way analysis of variance was used for comparison of the means of continuous data between multiple groups， and the SNK-q test was used for comparison between two groups. ResultsCompared with the patients with liver cirrhosis， the patients with liver cancer had a significantly higher concentration of LPA in plasma （4.99±0.55 μmol/L vs 2.63±0.43 μmol/L， P<0.05） and peritoneal effusion （5.19±0.63 μmol/L vs 2.91±0.46 μmol/L， P<0.05）， and the patients with liver cancer also had a significantly higher level of plasma LPA than the normal population （4.99±0.55 μmol/L vs 1.61±0.39 μmol/L， P<0.05）. The cell proliferation assay showed that LPA significantly promoted the proliferation of SMMC7721 cells， and cell proliferation rate increased with the increase in dose and time； in particular， the middle-and high-dose groups had a significantly higher proliferation rate than the control group （P<0.05）. PTX inhibited the proliferative capacity of SMMC7721 cells in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The proliferation rate of the 72-hour high-dose LPA group was 3.6 times that of the control group， while the proliferation rate of the PTX group was 0.6 times that of the control group； the proliferation rate of the 72-hour high-dose LPA+PTX group was 1.2 times that of the control group. In addition， LPA increased the migration ability of hepatoma cells， while PTX inhibited their migration， in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The migration rate of the 72-hour high-dose LPA group was 3.09 times that of the control group， while the migration rate of the PTX group was 0.4 times that of the control group； the migration rate of the 72-hour high-dose LPA+PTX group was 0.99 times that of the control group. qPCR and Western blot showed that there were significant reductions in the mRNA and protein expression levels of P53 in SMMC7721 cells after LPA treatment， while there were significant increases in the mRNA and protein expression levels of FAK and RhoA； there was a significant difference between the LPA group and the control group （P<0.05）. ConclusionThere is an abnormal increase in the expression of LPA in patients with liver cancer， and LPA can promote the proliferation of liver cancer cells and increase their migration ability. At the same time， LPA changes the expression levels of P53， FAK， and RhoA， which may be associated with the promotion of tumor development and progression by LPA.