OBJECTIVETo evaluate the clinical outcomes of percutaneous intervertebral foramina endoscopic lumbar discectomy for elder patients with lumbar spinal stenosis syndrome.

METHODSFrom July 2006 to July 2011, 60 elder patients with lumbar spinal stenosis syndrome were treated with surgical operation, including 32 males and 28 females with an average age of (66.7 +/- 2.5) years old ranging from 72 to 83 years. These patients were divided into the traditional surgery group and percutaneous intervertebral foramina endoscopic discectomy groups (PTED group), 30 cases in each group. The index of the preoperative and postoperative, operative incision visual analogue scale (VAS) of two groups were compared. The Oswestry disability index (ODI) of two groups at 6, 24 months of the follow-up were also evaluated on activity of daily living.

RESULTSThe average operative time, the average blood loss, the number of cases using analgesic drug, hospitalization time of PTED group were better than those of the traditional surgery group (P < 0.05). The improvement of incision VAS in PTED group was better than that in the traditional surgery group (P < 0.05). All patients were followed up for 24 months at least. The ODI at 1, 24 month after operation were better than that of preoperative in two group respectively (P < 0.05), but the improvement of PTED group was better than that of the traditional surgery group (P < 0.05).

CONCLUSIONPTED has the advantages of smaller incision, less bleeding, less postoperative stay and hospitalization time, tissue trauma and quicker recovery. It is a safe and efficacious minimally invasive surgical technique for elder patients with lumbar spinal stenosis syndrome.

Aged ; Aged, 80 and over ; Decompression, Surgical ; Diskectomy, Percutaneous ; Endoscopy ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Spinal Stenosis ; surgery ; Treatment Outcome

BACKGROUNDNeoadjuvant chemotherapy provides an excellent model for evaluation of potential predictive factors. The objective of this study was to evaluate the predictive value of different biological factors in breast cancer patients treated with neoadjuvant taxane and anthracycline chemotherapy.

METHODSOne hundred and thirty-five patients treated with 4 cycles of neoadjuvant taxanes and anthracycline were included in this retrospective study. Using pretreatment biopsy materials, immunohistochemical studies were performed for estrogen receptor (ER), progesterone receptor (PgR), HER-2, Ki-67 and p53 protein expression. The associations among biological markers and clinical and pathological complete response (pCR) were analyzed.

RESULTSThe overall clinical response was 86%, including 33% clinical complete response (cCR) and 53% clinical partial response. The pCR was just 17%. In the univariate analysis, only HER-2 overexpression was predictive of cCR to neoadjuvant chemotherapy (P=0.018). No significant associations between other biological factors and cCR were found. Absence of ER, PgR expression and overexpression of HER-2 were predictive of the pCR (P=0.002, 0.001, 0.01, respectively). Ki-67 and p53 failed to show an association with pCR. In multivariate analysis, overexpression of HER-2 remained as an independent variable in predicting the cCR (P=0.021). However, negative ER was the only parameter that maintained statistical significance in predicting the pCR (P=0.001).

CONCLUSIONSPatients with overexpression of HER-2 and negative hormonal receptor status are much more likely to respond to neoadjuvant taxane and anthracycline chemotherapy than those with the opposite characteristics. These factors could serve as predictive markers for this regimen.

Adult ; Aged ; Anthracyclines ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; analysis ; Breast Neoplasms ; chemistry ; drug therapy ; Chemotherapy, Adjuvant ; Female ; Humans ; Ki-67 Antigen ; analysis ; Middle Aged ; Receptor, ErbB-2 ; analysis ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Taxoids ; administration & dosage ; Tumor Suppressor Protein p53 ; analysis

Objective To investigate the correlation of serum interleukin-6 (IL-6) and IL-18levels to carotid artery intimal-medial thickness (IMT) in patients with acute cerebral infarction (ACI).Methods In 64 patients with ACI and 30 healthy volunteers, serum IL-6 and IL-18 levels were detectedusing radioimmunoassay and enzyme-linked immunosorbent assay (ELISA), respectively. Carotid arteryIMT were measured in the two groups using color Doppler ultrasound, and the ACI patients were dividedinto two groups with carotid IMT greater or lower than 1.0 mm. Results The ACI patients and thehealthy volunteers showed significant differences in serum IL-6 (P<0.05) and IL-18 levels (P<0.05),which were also significantly different between ACI patients with carotid IMT ≥ 1.0 mm and those withIMT<1.0 mm (P<0.05). The ACI patients with IMT<1.0 mm had comparable serum IL-6 and IL-18 levelsto those in the healthy volunteers. In patients with carotid IMT ≥ 1.0 mm, the serum IL-18 level waspositively correlated to IMT (r=0.549, P=0.001), but the IL-6 level was not related to IMT (P>0.05).Conclusion The serum levels of IL-6 and IL-18 are elevated in ACI patients with increased carotid IMT.

OBJECTIVETo search for a new method of screening for molecular targets for androgen-dependent prostate cancer.

METHODSWe collected tissue samples and paired serum samples from 3 cases of androgen-dependent prostate cancer (ADPC) treated by surgical resection, and included another 3 samples of benign prostatic hyperplasia (BPH) tissue and normal human serum in the control group. The total proteins extracted were separated and transmembrane by two-dimensional gel electrophoresis, followed by hybridization with the sera of the patients with ADPC and those with hormone-independent prostate cancer (HIPC) as the primary antibodies. The differentially expressed proteins were compared by Western blot, analyzed by MALDI-TOF-MS mass spectrography, and verified by RT-PCR and Western blot following bioinformatic identification.

RESULTSThis modified method exhibited a significantly better effect in displaying differentially expressed proteins, by which 12 differentially expressed protein spots were identified, including Beclin1, glutathione S-transferase P (GSTP1-1), ZBTB7, dihydrodiol dehydrogenase 2 (DDH), enolase (ENO1), glucose-dependent insulin-releasing peptide receptor (GIPR), Mn-superoxide dismutase (MnSOD), phosphoglycerate mutase 1 (PGAM1), amino-peptidyl-prolyl cistrons isomerase (PPIA), and phospholipid-PE-binding protein (PEBP). The mRNA and protein expressions of Beclin1 were significantly down-regulated in androgen-dependent prostate cancer tissues.

CONCLUSIONThis modified serum-guided immunoblotting technique has provided a new method for clarifying the molecular mechanisms of the occurrence and progression of HIPC, in which Beclin1-mediated autophagy may play a key role.

Biomarkers, Tumor ; blood ; Blotting, Western ; Humans ; Immunoblotting ; methods ; Male ; Mass Spectrometry ; Prostatic Neoplasms ; genetics ; metabolism ; Proteomics

OBJECTIVETo study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture.

METHODSTwenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm.

RESULTSThe incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good.

CONCLUSIONThe application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

Adolescent ; Adult ; Bone Plates ; Collateral Ligaments ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Thumb ; injuries ; surgery ; Young Adult

Objective To investigate the curative effect of YU Yun pulse-feeling-based acupuncture therapy for the treatment of middle-late liver cancer. Methods A total of 60 middle-late liver cancer patients were divided into control group and treatment group by stratified randomization method,30 cases in each group. The control group was given integrated Chinese and western medicine therapy according to the clinical pathway, including anti-cancer treatment such as vascular interrention,molecular targeted therapy,chemotherapy,radio therapy, and focal ablation therapy,as well as chinese medicine treatment based on disease differentiation and syndrome differentiation. And the treatment group was given YU Yun pulse-feeling-based acupuncture therapy on the basis of treatment for the control group. The two groups received 12-week treatment, and then their curative effects were compared. Results The treatment group had better effect on increasing the survival rate, prolonging survival time, improving the scores of clinical symptoms, stabilizing tumor size, and increasing the scores of Karnofsky Performance Status (KPS)than the control group,the difference being significant (P < 0.05 or P <0.01). Conclusion YU Yun pulse-feeling-based acupuncture therapy exerts certain curative effect for the treatment of middle-late liver cancer.

Objective To launch systematic research on long-term asymptomatic hyperuricemia (HUA) from hemorheological viewpoint,so as to provide references for clinical treatment of asymptomatic HUA.Methods Twenty rats were randomly and evenly divided into normal control group and model group.The rats were intraperitoneally injected with 250 mg/(kg · d) oxonate for 8 weeks to induce the model of asymptomatic HUA.The blood samples were obtained to measure the serum uric acid,hemorheological parameters,oxidative and anti-oxidative indices.Results The aggregation index,haemolysis rate,serum xanthine oxidase (XOD),plasma fibrinogen and blood viscosity significantly increased,while the orientation index,electrophoresis rate,serum superoxide dismutase (SOD),activated partial thromboplastin time (APTT) and prothrombin time (PT) significantly induced.Conclusions The asymptomatic HUA can lead to more serious oxidative stress,deteriorate the hemorheological parameters of red blood cells in rats,and induce higher blood viscosity and coagulation status.The research findings indicate that asymptomatic HUA should be correctly understood and timely intervened in clinical diagnosis.

OBJECTIVEThe increasing number of aged patients with severe ascending aorta atherosclerosis who are undergoing coronary artery bypass graft (CABG) present high risk for ascending aortic cannulation, cross-clamping or partial occluding and proximal anastomosis. We reviewed the surgical experience in 22 patients of CABG with ascending aorta atherosclerosis and tried to find the way to minimize the complications.

METHODSTwenty-two patients with severe atherosclerotic and calcified ascending aorta underwent CABG in our hospital. Thirteen of them received CABG on beating heart. Nine patients had their CABG with extracorporeal circulation. With deep hypothermia, we reduced the flow rate and intermittently arrested the circulation for the proximal anastomosis on ascending aorta in 5 patients with neither cross-clamping nor partial occluding. The sequential grafts and "Y" type anastomosis between reversed saphenous venous grafts were employed.

RESULTSTwenty of the patients survived after surgery. One died of inhalation pneumonia in two weeks after surgery. Another died of right hemothorax in ten days after surgery. The complications include: pneumonia 4 patients (18%), angina 2 patients (9%), ventricular fibrillation 1 patients (5%), post-CABG myocardium infarction 1 case (5%) and hemothorax 1 case (5%). There is no neurologic complications or aortic dissection after CABG.

CONCLUSIONCABG on beating heart with pedicel arterial grafts is the best approach to performing the surgery without touching the diseased ascending aorta. Ventricular fibrillation under mild hypothermia cardiopulmonary bypass and left ventricular suction were employed for quiet and bloodless field while distal anastomosis had no cross-clamping the ascending aorta. Also deep hypothermia and intermittently circulatory arrest offer quiet and bloodless field for the proximal anastomosis on ascending aorta without cross-clamping or partial-occluding. Distal sequential anastomosis and proximal "Y" type anastomosis are the effective approach to minimizing the proximal anastomosis on the ascending aorta.

Aged ; Aged, 80 and over ; Aortic Diseases ; complications ; surgery ; Atherosclerosis ; complications ; surgery ; Coronary Artery Bypass ; methods ; Coronary Artery Disease ; complications ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the association between SCN1A rs3812718 polymorphism and generalized epilepsy with febrile seizures plus (GEFS+), and to provide potential molecular targets for the diagnosis and treatment of GEFS+.

METHODSThe iPLEX technique in the MassARRAY system was used to determine SCN1A rs3812718 polymorphism, genotype frequency, and allele frequency in 50 patients with GEFS+ and 50 healthy controls.

RESULTSAs for the frequencies of CC, CT, and TT genotypes in SCN1A rs3812718, there was a significant difference in the frequency of TT genotype between the GEFS+ group and the control group (P<0.05). There was also a significant difference in the frequency of T allele between the two groups (P<0.05). Compared with those carrying CC genotype or C allele, the individuals with CT genotype , TT genotype or T allele had a higher risk of developing GEFS+ (CT/CC: OR=4.05, 95%CI: 1.04-15.69; TT/CC: OR=30.60, 95%CI: 6.46-144.85; T/C: OR=4.64, 95%CI: 2.54-8.48).

CONCLUSIONSSCN1A rs3812718 polymorphism is a risk factor for GEFS+, and the population carrying T allele may have an increased risk of GEFS.

AIMTo compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi.

METHODSFrom August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5 approximately 9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence.

RESULTSThe stone clearance rate was 78.1 % with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<0.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant.

CONCLUSIONThough the selection of these two options depends on equipments available and the expertise of the operator, we recommend URS as the optimal treatment for distal ureteral calculi.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureteral Calculi ; therapy