Objective:To investigate the surgical outcome of one-stage combined anterior and posterior ap-proach for severe thoracolumbar and lumbar spine fracture.Method:A total of 62 cases suffered from severe thoracolumbar and lumbar spine fracture undergoing surgery from Jan 2003 to Jan 2008 were reviewed retro-spectively.Of these,there were T11 involved in 2 cases,T12 in 13 cases,L1 in 28 cases,L2 in 10 cases,L3 in 6 cases and L4 in 3 cases.There were 58 fresh fractures and 4 old fractures.Based on Dennis classifica-tion,12 were compression fracture,33 were burst fracture and 17 fracture dislocation.All cases had spine load score≥7 and TLICS score≥5.Of 19 cases with neurological deficit according to Frankel grade,there were 7 A,5 B and 7 C.Combined anterior and posterior approach was performed in all cases,anterior bony graft plus posterior pedicle instrumentation were performed either,of these,52 cases had additional anterior decompres-sion.Result:All operations were performed successfully,with the mean surgical time of 170min (range, 150-210min) ,the average blood loss was 819ml(range,400-2900ml).No iatrogenic neuroinjury,skin infection, dural matter tearing and graft displacement were noted.The preoperative Cobb's angle was 8°-40°(mean, 23.9°), while the postoperative counterpart returning to normal with 5 cases having 2°-10° kyphosis.The preoperative compression rate was 20%-95%(mean,54.5%),while the postoperative counterpart returning to normal in 47 cases,with 15 cases having 2%-30%.The preoperative canal stenosis rate was 5%-90%(mean,51.1%) while the postoperative counterpart was 0-30%(mean,4.7%),which showed significant difference with regarding to these 3 parameters (P<0.05).All cases were followed up for an average of 31 months (range,12-72 months). Bony fusion was evidenced in cases undergoing anterior bony graft.At 10-12 months, the Cobb's angle was 0°-15°(mean,0.62°) ,the vertebral compression rate was 0-30%(mean,4.6%),no significant difference were noted between them and their postoperative counterparts(P>0.05).At final foUow-up,15 of 19 cases with neu-rological deficit had neurofunction improved,while 4 remained unchanged.According to our hospital criteria,of 43 cases with no neurological deficit,there were 30 excellent,9 good,3 fair and 1 bad with the total excel-lent to good rate of 90.6%.Cage subsidence and pedicle screw breaking was noted in 1 case,who developed severe kyphosis presenting with irreducible back pain.Conclusion:One-stage combined anterior and posterior approach for severe thoracolumbar and lumbar spine fracture can ensure three column stability as well as complete decompression,which has good early outcome.

Objective To transfect a recombinant pcDNA3.1-DCN into HepG2 cells and detect the expressions of decorin(DCN) and p21WAF1/CIP1 so as to investigate the mechanism of tumor suppression of DCN.Methods HepG2 cells were divided into pcDNA3.1-dec-HepG2 group(transfected group) and pcDNA3.1-HepG2 group(control group).After the recombinant pcDNA3.1-DCN and pcDNA3.1 were transfected into HepG2 hepatoma cells by liposome,the stably transfected cell lines were established using G418 screening.RT-PCR method was used to detect the expressions of DCN and p21WAF1/ CIP1 mRNA;Western blotting method was used to detect the expressions of DCN and p21WAF1/CIP1 protein;immunohistochemistry was performed to detect the expression of DCN protein.Results Compared with control group,the expressions of DCN and p21WAF1/CIP1 mRNA were significantly increased in transfected group by RT-PCR(P

Objective To explore the characteristic clinical profiles and treatment modalities of Fetal rhabdomyomatous nephroblastoma(FRN).Methods A retrospective study was conducted for 14 FRN patients from Jan.2000 to Oct.2015.Their clinical data were collected including clinical presentations,pathology and treatment modalities.There were 8 males and 6 females with a mean age of 23 months.There were 3 cases at left side and right side 5 cases,bilateral 6 cases.2 patients were classified as stage Ⅰ,1 stage Ⅱ,5 stageⅢ and 6 stageⅤ.Abdominal mass was the main clinical presentation in 11 patients,and 1 case with hematuria,1 with abdominal pain,and 1 with vomit.Most tumors showed cysts or completely solid from the ultrasonography.Computed tomographic scan revealed a large inhomogeneous enhancement tumor from the kidney pole with necrotic,cystic,bleeding or calcification.Ultrasonography and Computed tomography (CT) had no different performance from Wilms' tumor.9 patients received preoperative chemotherapy,and the response was none in all of them.8 unilateral patients underwent tumor nephrectomy and another 4 had nephron-sparing surgery.Results Pathology showed that FRN contained more than 70％ of fetal rhabdomyomatous tissue.Immunohistochemistry had no specificity,most FRN shows Desmin (+) and Myogenin(+).Bilateral FRN tumors were seen in 2,one side with FRN and another side with nephroblastomatosis were seen in 3,one side with FRN and another side with Wilm's tumor was seen in 1 patient.Postoperative pathology confirmed FRN in all 14 cases.All patients received postoperative chemotheraphy:Act-D and VCR for 6 month(stage Ⅰ),Act-D and VCR for 15 month(stage Ⅱ),Act-D +VCR + ADR and radiotherapy for 15 month(stageⅢ).During follow-up of 6 months to 15 years,10 of them were alive without tumor and no evidence of recurrence.Conclusions FRN is a rare histologic variant of Wilm's tumor with less aggressive behavior.FRN usually has a huge volume and is bilateral with a poor responder to preoperative chemotherapy,but it is associated with a generally favorable outcome.Surgery and chemically treatment appears the effective measure.

0.05). The mean ADC value obtained in poor group was significantly lower than that obtained in satisfactory group (t = 4.81,P

Objective To construct the vector for ?-galactosidase (?-gal) gene expression regulation with tetracycline-regulated gene expression system,and to control ?-galactosidase gene expression in hepG2 cells with the vector.So that offer a experimental base for regulating gene expression for liver cancer gene therpy with this system.Methods The primers for explanding two tetracycline operator (TetO2) gene according to the gene nucleotide sequences of TetO2 gene and pcDNA3.1 vector were designed.TetO2 gene was amplified by PCR with pcDNA3.1 plasmid as template.The TetO2 PCR products were cloned into pcDNA3.1 and the vector was named as pcDNA3.1-TetO2.The pcDNA3.1-Teto2 with TetO2 PCR products sequence was analyzed by ABI3130 sequencing analysis.Then ?-gal gene was cloned into pcDNA3.1-TetO2,the vector was named as pcDNA3.1-TetO2-?-gal.The pcDNA6/TR plasmid vector with tetracycline repressor(TR) was transfected into HepG2 cells by Lipotap,and the stable transfection cells were screened by blasticidin.TR gene expression was detected by RT-PCR in HepG-2 cells with and without pcDNA6/TR plasmid transfection.The pcDNA3.1-TetO2-?-gal plasmid vector was transfected into HepG2 cells with and without pcDNA6/TR plasmid transfection,and 3 to 4 d later, these transfected gene cells were treated with doxycline(4 mg?L-1).After 48 h,?-gal gene expression was detected with ?-gal cell staining.Results The pcDNA3.1-TetO2 sequencing analysis results showed that a cassette was made for a cytomegalovirus-type 2 tetracycline operator (TetO2)-TetO2 promoter in pcDNA3.1-Teto2.The double digestion reslut of pcDNA3.1-TetO2-?-gal plasmid vector demonstrated that ?-gal gene was successfully cloned into pcDNA3.1-TetO2 vector .The RT-PCR result of TR gene showed TR gene could be expressed in HepG2 cells with pcDNA6/TR plasmid transfection and TR gene didn’t express in HepG2 cells without pcDNA6/TR plasmid transfection.?-gal gene expressed in HepG2 cells without pcDNA6/TR plasmid transfection,but didn’t express in HepG2 cells with pcDNA6/TR plasmid transfection.However,?-gal gene expression could be induced with doxycline in HepG2 cells with pcDNA6/TR plasmid transfection.Conclusion The tetracycline-regulated gene expression system vector for regulating ?-gal gene expression is successfully constructed and the vector system can control ?-gal gene expression in HepG2 cells.

Objective To summarize and analyze the intraoperative and postoperative complications arising from the Anderson-Hynes transperitoneal laparoscopic pyeloplasty (LP) procedure in the treatment of patients with ureteropelvic junction obstruction (UPJO).Methods There were 154 consecutive patients who underwent transperitoneal LP between November 2011 and December 2015.These patients' data were retrospectively analyzed for intraoperative and postoperative complications.All the 154 patients were primary UPJO.Of the 154 patients,124 (80.7％) were males and 30 (19.3％) were females,114(74.0％) were found in the left side,32(21.0％)were found in the right side,while 8 (5.0％)were found in bilateral.The mean age was 3.9 years old(ranged 8-180 months).28 patients(18.2％) have the history of urological infection or flank pain.Results Mean operative time was 89 minutes (ranged 42-330 min).The mean blood loss was 7.5ml (ranged 2-50 ml),and no blood transfusions were necessary intra-and post-operatively.The mean postoperative hospital stay was 5.7 days (ranged 3-28 days).The mean follow-up duration was 28 months (ranged 6-54 months).2 laparoscopic surgeries were converted into open surgeries.One patient suffered with repeated infection after removing the double J stent two months postoperatively.The ultrasound and intravenous urography showed the more severe obstruction compared to that before surgery.The second operation was performed and resolved this problem.The overall success rate was 98％.All 28 patients,who has preoperative symptoms,reported a complete resolution of symptoms after the procedure.Intraoperative complication occurred in 11 (7.1％) patients,including injury of parapyelic vessel while in 3 (1.9％),the misplacement of the Double-J stent in 6 (3.8％),conversion to laparotomy in 2(1.3％).The postoperative complications occurred in 24(15.6％) patients,including urine leakage in 10(6.5％),infectious urinoma in 7 (4.5％),infection after removing the Double-J in 4 (2.6％),temporary intestinal obstruction,recurrent UPJO were in 1 (0.6％)respectively.Conclusions Our retrospective analysis confirmed that LP is an effective and safe procedure.The most common intraoperative complications are difficulty in double-J stent insertion.The most common postoperative complication is urine leakage.

Enhanced green fluorescent protein( EGFP), myc epitope and polyhistidine metal-binding tag are often used as a marker for recombinant fusion protein in many gene expression vectors, each marker has its own function, EGFP emits green fluorescence for direct detection, myc epitope facilitates recombinant fusion protein detection using its antibodies, polyhistidine tag allows purification of recombinant fusion protein using resin.Hitherto, no a plasmid vector can integrate all of these functions. In this study we constructed a novel eukaryotic expressive plasmid, designated as pcDNA6/myc-his-EGFP B, which integrated the functions of EGFP, myc epitope and polyhistidine tag. Importantly, a linker octo - peptide in N terminal of EGFP was designed using LINKER program. A DNA fragment encoding a putative protein containing a signal peptide of human interleukin 2(IL-2) in N terminal was cloned into pcDNA6/myc-his-EGFP B in frame with the C-terminal peptide to construct pMHES. 2.2.15 Cells were transfected with pcDNA6/myc-his-EGFP B and pMHES, and Balb/c mice were intravenously injected with pcDNA6/myc-his-EGFP B by tails, results revealed that both of the plasmids worked in 2.2.15 Cells and livers of Balb/c mice. Assuming gene of the IL-2 was inserted into pcDNA6/myc-his -EGFP B in frame with EGFP, myc and 6 × His, three-dimensional structure for this putative expression product was simulated using Modeller8V2, results revealed that IL-2, EGFP, myc and 6 × his did not interfere each other and octo- peptide linker owned certain flexibility. The results suggest that pcDNA6/myc-his-EGFP B may be useful as a genetic tool for mammalian cells and a vector for gene therapy.

Background and purpose: It has been proven that gefitinib can be safely and efficiently used to treat advanced non-small cell lung cancer (NSCLC) as a molecule targeted drug. This research was aimed to investigate the efficacy and toxicity of gefitinib as the first-line therapy for advanced NSCLC. Methods: A total of 34 pathologically-confirmed NSCLC patients who were not willing to receive or tolerate traditional cytotoxic drug chemotherapy were enrolled into the study. Gefitinib was orally administered 250 mg daily until disease progression or the occurrence of intolerable toxicity. Results: The objective response rate of gefitinib was 29.4%. The disease control rate was 61.8%. The rate of symptom relief was 47.1%. The median progression-free survival was 3.0 months. The median overall survival was 10.2 months. One-year survival rate was 35.3%. The objective response rate of nun-smoker was higher than smoker (P=0.023). The disease control rate for the patients with rash toxicity after administration of the drug were higher than those without rash (P=0.005). Logistic regression showed that rash was an independent disease control factor (P=0.003). The most common drug-related adverse events were rash and diarrhea. Conclusion: Gefitinib provided another choice to patients who are unwilling or unable to be treated by chemotherapy.

Objective To compare the efficacy and adverse effects of erlotinib versus vinorelbine naive patients with advanced non-small cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutation.Methods Totally 46 elderly patients with histologically confirmed advanced NSCLC and EGFR mutations (exon 19 dclction or L858R point mutation) were enrolled.Patients were randomly divided into two groups:erlotinib group (43 cases,150mg per day until disease progression or unacceptable toxicities) and control group (21 cases,vinorelbine-based chemotherapy,single vinorelbine chemotherapy or vinorelbine-based double chemotherapy).Results Response rates and disease control rates were significantly improved with erlotinib compared with vinorelbine (78.6％ and 88.1％ vs.38.1％ and 61.9％,respectively,P＜ 0.05).There was a significant difference in median progression-free survival (11.6 months vs.5.6 months,P＜0.05),while no statistical difference in median overall survival with erlotinib compared with vinorelbine (19.0months vs.16.5 months,P=0.193).The most frequent adverse effects were grade Ⅰ or Ⅱ and no patients stopped treatment due to adverse effects and no drug-relatcd death.The primary adverse effects were skin rash (71.4％),diarrhea (31.0％)and liver dysfunction (23.8％) in the erlotinib group and neutropenia (66.7％),nausea or vomit (47.6％),anemia (42.9％),platelet decline (33.3％),constipation (33.3％) and peripheral neuritis (23.8％) in the vinorelbine group.Vinorelbine group versus erlotinib group have more 3-4 level adverse reactions (15/21 vs.7/42)(x2=1.69,P=0.193).Conclusions Erlotinib treatment has advances in PFS,ORR and DCR and tolerability compared with vinorelbine-based chemotherapy in elderly patients with advanced NSCLC and EGFR mutation,while overall survival is in no difference.Erlotinib may be a reasonable first-line treatment option for elderly patients with advanced NSCLC and sensitive EGFR mutation.

Objective To assess the safety and feasibility of CT-guided percutaneous argon-helium cryoablation in the treatment of adrenal tumors.Methods 1 7 patients with adrenal tumors were treated with CT-guided percutaneous argon-helium cryoablation. Three of these patients were retreated second cryoablation three months later due to the lager tumor diameters.Percutaneous tran-scatheter arterial embolization was performed in four patients because of rich blood supply before cryoablation.Continuous arterial blood pressure monitoring was performed in eight pheochromocytoma patients.Results Technical success was achieved in all pa-tients.There were no serious complications.Eight pheochromocytoma patients experienced a significant increase in systolic blood pressure and diastolic pressure when compared with the basic values (P <0.05).There were no enhancement on enhanced CT and/or up-take on FDG PET-CT in the ablated zones during the follow-up period (3-24months).Conclusion It is safety and efficacy of CT-guided percutaneous argon-helium cryoablation for adrenal tumor.It might be initial treatment of choice for the patients who were not suitable for resection.