Effect of Compound Phylanthus urinaria Ⅱ in Regulating Expression of lncRNA CCAT1 in Hepatocellular Carcinoma HepG2 Cells / 中国实验方剂学杂志

Objective:To explore the anti-hepatoma effect of compound <italic>Phylanthus urinaria</italic> Ⅱ （ CPU Ⅱ） by inhibiting the expression of the long non-coding RNA （lncRNA） colon cancer associated transcript-1 （CCAT1） and restoring the expression of microRNA let-7a. Method:Real-time fluorescence quantitative polymerase chain reaction （PCR） was used to detect the expression of lncRNA CCAT1 in normal liver cells （LO2 cells） and hepatocellular carcinoma HepG2 cells， and the differences in expression between these two types of cells were compared. The methylthiazolyl tetrazolium（MTT） assay was used to detect the proliferation of HepG2 cells after treatment with different concentrations of CPU Ⅱ and 5-fluorouracil（5-FU） for 24， 48 and 72 h. Hepatocellular carcinoma HepG2 cells were cultured <italic>in vitro </italic>and set into three gropes： cell control group， CPU Ⅱ low-dose group （0.8 g·L^-1） and high-dose group （1.6 g·L^-1）. Real-time PCR was used to detect the mRNA expression of lncRNA CCAT1， microRNA let-7a and its target genes high mobility group protein A2（HMGA2）， and N-RAS in each grope. Western blot was used to detect the protein expression of HMGA2， and Cyclin D₁ in each grope. Result:As compared with LO2 cells， expression of lncRNA CCAT1 in HepG2 cells was significantly up-regulated （<italic>P</italic><0.05）. Results of MTT assay showed that the 50% inhibiting concentration（IC₅₀）of CPU Ⅱ and 5-FU on hepatocellular carcinoma HepG2 cells was 1.649， 0.044 648 g·L^-1respectively. As compared with the control group， CPU Ⅱ high-and low-dose groups （1.6， 0.8 g·L^-1） significantly inhibited the proliferation of HepG2 cells （<italic>P</italic><0.05）， and the effect was most remarkable in CPU Ⅱ high-dose group （<italic>P</italic><0.05）. The results of Real-time PCR showed that as compared with control group， the expression of lncRNA CCAT1 mRNA was significantly inhibited in CPU Ⅱ high-and low-dose groups （<italic>P</italic><0.05）， and the expression of microRNA let-7a mRNA was obviously up-regulated in high-dose group （<italic>P</italic><0.05）， but the expression of HMGA2 mRNA in CPU Ⅱ high-and low-dose groups as well as the expression of N-RAS mRNA in CPU Ⅱ low-dose group were down-regulated （<italic>P</italic><0.05）. Western blot results showed that as compared with the cell control group， the protein expression of HMGA2 and Cyclin D₁ in CPU Ⅱ high-and low-dose groups （1.6， 0.8 g·L^-1） was significantly down-regulated （<italic>P</italic><0.05）. Conclusion:CPU Ⅱ can inhibit the expression of lncRNA CCAT1， recover the expression of microRNA let-7a， and suppress the mRNA and protein expression of related downstream target genes in hepatoma cells line HepG2， thereby inhibiting the proliferation of hepatocellular carcinoma cells and exerting anti-hepatocellular carcinoma effect.

Effect of Compound Phyllanthus urinaria Ⅱ(CPU Ⅱ) on Proliferation, Apoptosis and Autophagy of Hepatocellular Carcinoma Huh7 Cells / 中国实验方剂学杂志

Objective:To observe the effect and investigate the mechanism of compound Phyllanthus urinaria Ⅱ(CPU Ⅱ)on proliferation, apoptosis and autophagy of human hepatoma cell line Huh7. Method:Huh7 cells were cultured in vitro and divided into blank control group, high-dose CPU Ⅱ group (40 g·L-1),low-dose CPU Ⅱ group (20 g·L-1), and 5-FU group (0.04 g·L-1). Methye thiazolye telrazlium(MTT) assay was used to detect the inhibitory effect of CPU Ⅱ on proliferation of human hepatoma Huh7 cells. The apoptosis rate was observed by Annexin V-FITC/PI flow cytometry; the changes of autophagosomes in each group were observed by monodansylcadaverin (MDC) staining; Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR)was used to detect the mRNA expression of phosphatidylinositol 3-kinase (PI3K), Serine-threonine protein kinase 2(Akt2), B-cell lympoma-2(Bcl-2) and Microtubule-associated protein 1 light chian 3(LC3Ⅱ) and Western blot was used to detect the protein expression of Akt2 and LC3Ⅱ. Result:CPU Ⅱ(40, 20 g·L-1) significantly inhibited the hepatoma cell line Huh7 and induced apoptosis, with an apoptosis rate of 51.72% and 19.74% respectively, significantly higher than that of control group (PPPPConclusion:CPUⅡ had obvious inhibitory effect on the proliferation of hepatoma cell line Huh7, and the mechanism may be related to inhibiting the activation of PI3K/Akt signaling pathway to induce apoptosis and autophagy.

Application of 3.0 T Multimodal Intestinal MRI in Quantitative Evaluation of Ulcerative Colitis / 中山大学学报(医学科学版)

@#【Objective】To investigate the diagnostic value of multimodal intestinal MRI with routine MRI ，diffusion- weighted imaging（DWI）and multi-phase dynamic enhanced MR scanning by 3D-VIBE sequence in patients with ulcerative colitis（UC）.【Methods】Twenty-five patients with UC confirmed by endoscopic biopsy were enrolled. According to the modified Truelove-Witt′s criteria，patients were divided into remission group and active group，and the active group was divided into three subgroups as mild，moderate，and severe. The intestinal wall edema，comb sign，enlarged mesenteric lymph nodes，enhanced degree of intestinal wall，the maximum thickness of intestinal wall and the ADC value of the intestinal wall were observed and measured. The patient′ s C-reactive protein（CRP）and erythrocyte sedimentation rate （ESR）results were collected to evaluate the diagnostic value.【Results】The sensitivity and specificity in diagnosing the UC activity were not high by using CRP and ESR. There were significant differences in the stratification of intestinal wall edema ，comb sign ，intestinal wall thickness ，and ADC value between the four groups in the UC remission period and active period（P<0.05）. There were no significant differences between the four groups in mesenteric lymph nodes enlargement. ADC value had higher diagnostic efficiency for identification the activity group and remission group. Cutoff ADC values for differentiating the activity group and the remission group was calculated as（1.52 ± 0.16）× 10- 3 mm2/s，with 70.8% sensitivity and 79.8% specificity，respectively.【Conclusions】The diagnostic value of multimodal MRI for UC is higher than that of routine MRI，and multimodal MRI has high clinical value.

Significance of 6-minute walk test for patients with heart failure / 心血管康复医学杂志

The present article addressed method, indications, contraindications of 6 min walk test (6MWT), and its correlation with plasma level of brain natriuretic peptide (BNP) and NYHA class. 6MWT can be used for rehabilitation guidance, improve exercise tolerance and assess their cardiac function and prognosis, etc. in patients with heart failure.

Clinical efficacy of three different minimally invasive procedures for far lateral lumbar disc herniation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Far lateral lumbar disc herniation (FLLDH) accounts for 2.6% to 11.7% of all lumbar herniated discs. Numerous surgical approaches have been described for treating this condition. The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH.</p><p><b>METHODS</b>From June 2000 to March 2006, 52 patients with FLLDH were treated with minimally invasive procedures. All patients were assessed by anteroposterior and lateral roentgenography and computed tomography (CT). Some patients underwent myelography, discography, and magnetic resonance imaging. Procedures performed included Yeung Endoscopy Spine System (YESS) (n = 25), METRx MicroDiscectomy System (n = 13), and X-tube (n = 14). Patients were followed up for a mean of 13.5 months. Clinical outcomes were assessed using a visual analog scale (VAS) and Nakai criteria.</p><p><b>RESULTS</b>All 3 procedures significantly improved radiating leg symptoms (P < 0.005). After surgery, 84.0%, 84.6%, and 92.8% of patients in the YESS, METRx, and X-tube groups had excellent or good outcomes. There were no statistically significant differences of VAS scores between the groups. The YESS procedure was associated with the shortest operation time, simplest anesthesia, and least trauma compared with the other 2 procedures, especially for type I herniations. The METRx procedure was the most suitable for type II herniations and posterior endoscopic facetectomy. Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability (type III).</p><p><b>CONCLUSION</b>Minimally invasive strategies and options should be determined with reference to the type of FLLDH.</p>

The biomechanical and clinical study of the percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures / 中华骨科杂志

ObjectiveTo evaluate the biomechanical stability and the clinical efficacy of the percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures. Methods Twelve lumbar fracture models were made on fresh calf lumbar spine specimens to compare the stability of the 4 monoaxial screws and 4 muhiaxial screws transpedicular fixation by examining the range of motion(ROM) in flexion,extension, lateral bending, and torsion. Sixty cases of thoracolumbar fractures without neuro-deficiency were treated surgically, 11 of the minimally invasive group(monoaxial screw group) and 18 of the open surgery group(multiaxial screw group) were followed up more than 12 months. ResultsThe 4 monoaxial screws transpedicular fixation specimen exhibited a smaller ROM significantly in flexion, extension compared withthe 4 multiaxial screws transpedicular fixation specimen. The 4 monoaxial screws transpedicular fixationspecimen exhibited a significantly smaller ROM in flexion and extension than the intact specimens. TheROM in the 4 multiaxial screws transpedicular fixation specimen and the intact showed on significant differences. There were no significant differences between the two groups in the preoperative and postoperative anterior fractured vertebral height (AVH) and the Cobb's angle (CA), but there were significant differences in the AVH and the CA between preoperative and postoperative in the two groups. There were significant differences in the correction loss of the AVH between the two groups at final follow-up.ConclusionThe percutaneous pedicle screw fixation using Sextant system is a good minimally invasive surgical choice for patients with thoracolumbar fractures without neuro-deficiency, but which has a loss of the AVH and worse flexion-extension stiffness in follow-up compared with the open monoaxial screws fixation.

Clinical study on lumbar spondylolisthesis treated by minimally invasive transforaminal lumbar interbody fusion / 中华外科杂志

<p><b>OBJECTIVES</b>To retrospectively analyze the treatment of lumbar spondylolisthesis using minimally invasive and open transforaminal lumbar interbody fusion (TLIF), and compare the clinical results of two techniques.</p><p><b>METHODS</b>From June 2006 to May 2010, 371 patients with lumbar spondylolisthesis grade 1 and 2 were treated with TLIF, pedicle screw fixation and followed up. The mean age was 50.4 years (range, 37 - 85 years). There were 172 patients who underwent minimally invasive TLIF and percutaneous pedicle screw fixation were set as the MIS-TLIF group, 199 patients who underwent open TLIF and pedicle screw fixation were set as the OTLIF group. The operative time, blood loss, X-ray exposure time and complications were compared between the two groups. Clinical outcome was assessed using the visual analog scale (VAS) and the Oswestry disability index (ODI). Fusion rates were determined by using CT scan reconstruction and dynamic lumbar radiography in last fellow-up.</p><p><b>RESULTS</b>The average follow-up duration was 32.7 months with a range of 12-58 months. The gender, age, classification of spondylolisthesis and level of fusion showed a identical pattern in both groups. The mean intra-operative blood loss (310 ± 75) ml and postoperative blood loss (38 ± 13) ml in MIS-TLIF group were significantly superior to the intra-operative blood loss (623 ± 156) ml and postoperative blood loss (184 ± 72) ml in OTLIF group (t = 2.836 and 3.274, P < 0.01). Comparing with the OTLIF group (20 ± 10) s, the MIS-TLIF group had a significantly longer radiation time (51 ± 19) s (t = 2.738, P < 0.01). There was no statistical difference in operating time, lower back pain VAS scores, ODI scores and incidence of complication between the two groups.</p><p><b>CONCLUSIONS</b>Comparing with open TLIF, minimally invasive TLIF is a safe and reliable procedure for treatment of lumbar spondylolisthesis grade 1 and 2 with potential advantages.</p>

Inhibitory effect of anluohuaxianwan on experimental hepatic fibrosis in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of anluohuaqianwan on experimental hepatic fibrosis induced by dimethyl nitrosamine (DMN) in rats.</p><p><b>METHODS</b>36 male SD rats were randomly dividied into three groups: model group, normal group, anluohuaqianwan group. The rats in the three groups were treated with DMN daily for 4 weeks. The liver function was detected using auto biochemistry analyzer, the serum HA, LN, IV-C, PIIIP were detected by immunoradiometry, the histopathology was observed in the left liver lobe after HE staining, the expression of matrix metalloproteinase-2 (MMP-2) in liver tissue were detected by immunohistochemistry.</p><p><b>RESULTS</b>The serum levels of ALT, AST, ALP, TP, ALB and the contents of HA, LN, IV-C in model group were significantly increased compared to these in the normal group (P less than 0.01). The serum levels of ALT, AST and the contents of HA in anluohuaqianwan group were significantly lower than those in the model group (P less than 0.01). The liver MMP-2 in the model group was significantly increased compared to that in the normal group (P less than 0.05). The expression of MMP-2 in liver tissue of model group was lower than that in the anluohuaqianwan group (P less than 0.05).</p><p><b>CONCLUSION</b>Anluohuaqianwan can inhibit liver fibrosis in rats induced by DMN.</p>

Percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system: an analysis of 38 cases / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To prospectively evaluate the feasibility, safety and efficacy of the percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system in the retrospective non-randomized case-control study.</p><p><b>METHODS</b>A total of 38 consecutive non-randomized patients with type A thoracolumbar fractures, which had been stabilized posteriorly from December 2006 to March 2009, were examined retrospectively more than 9 months after surgery. Twenty-one patients had been treated conventionally with open pedicle screw fixation (OPSF) and 17 patients received minimally invasive treatment with Sextant percutaneous pedicle screw fixation (SPPSF). As a method of evaluation, the incision size, the intraoperation and postoperative volume of blood loss, operation time, postoperative hospital stay, blood transfusion, the radiological assessment of the sagittal Cobb;s angle, vertebral body angle and vertebral body height were recorded and compared.</p><p><b>RESULTS</b>All patients were followed up for 8-24 months (average 11.6 months). There were significant differences in the incision size, surgical blood loss, surgical draining loss, operation time, hospital stay after operation, blood transfusion, the proportion of antalgic supplement and postoperative incisional VAS between the two groups (P less than 0.05). Mean preoperative kyphotic deformity was 16.0 degree and improved by 9.3 degree after surgery in OPSF group, but 15.2 degree and 10.3 degree respectively in SPPSF group. Mean preoperative angle of the fractured vertebral body was 15.9 degree and improved by 7.9 degree after surgery in OPSF group, but 14.9 degree and 6.6 degree respectively in SPPSF group. Mean anterior vertebral body height (% of normal) was 67.3% before surgery and 95.8% after surgery, but 69.1% and 90.1% respectively in SPPSF group. Mean posterior vertebral body height (% of normal) was 93.3% before surgery and 99.5% after surgery, but 88.9% and 93.3% respectively in SPPSF group. Among the patients whose 9-month follow-up films were available, 3.0 degree of kyphosis correction was lost in OPSF group, but 3.2 degree in SPPSF group. And 1.0 degree of the angle of the fractured vertebral body correction was lost in OPSF group, but 1.5 degree in SPPSF group. Then 3.0% of the anterior vertebral body height correction was lost in OPSF group, but 2.2% in SPPSF group. And 3.0% of the posterior vertebral body height correction was lost in OPSF group, but 2.5% in SPPSF group. The sagittal Cobb's angle, vertebral body angle and anterior height of the fractured vertebra were all significantly different in each group before and after operation (P less than 0.05). There were no significant differences in the postoperative sagittal Cobb's angle, vertebral body angle and the improvement of the vertebral body height and the kyphotic deformity correction between OPSF and SPPSF groups (P larger than 0.05), but there was significant difference in the postoperative anterior height of the fractured vertebra between the two groups (P less than 0.05).</p><p><b>CONCLUSION</b>The percutaneous pedicle screw fixation through the pedicle of fractured vertebra using Sextant system is a good minimally-invasive surgical therapeutic choice for patients with type A thoracolumbar fracture except for that the SPPSF has a little insufficiency in resuming the anterior height of the fractured vertebra compared with OPSF.</p>

Design and biomechanical study of a modified pedicle screw / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>In pedicle screw fixation, the heads of monoaxial screws need to be directed in the same straight line to accommodate the rod placement by backing out during operation, which decreases the insertional torque and internal fixation strength. While polyaxial screws facilitate the assembly of the connecting rod, but its ball-in-cup locking mechanism reduces the static compressive bending yield strength as compared with monoaxial screws. Our study aimed to assess the mechanical performance of a modified pedicle screw.</p><p><b>METHODS</b>In this study, the tail of the screw body of the modified pedicle screw was designed to be a cylinder-shaped structure that well matched the inner wall of the screw head and the screw head only rotated around the cyclinder. Monoaxial screws, modified screws and polyaxial screws were respectively assembled into 3 groups of vertebrectomy models simulated by ultra high molecular weight polyethylene (UHMWPE) blocks. This model was developed according to a standard for destructive mechanical testing published by the American Society for Testing Materials (ASTM F1717-04). Each screw design had 6 subgroups, including 3 for static tension, load compression and torsion tests, and the rest for dynamic compression tests. In dynamic tests, the cyclic loads were 25%, 50%, and 75% of the compressive bending ultimate loads respectively. Yield load, yield ultimate load, yield stiffness, torsional stiffness, cycles to failure and modes of failure for the 3 types of screws were recorded. The results of modified screws were compared with those of monoaxial and polyaxial screws.</p><p><b>RESULTS</b>In static tests, results of bending stiffness, yield load, yield torque and torsional stiffness indicated no significant differences between the modified and monoaxial screws (P > 0.05), but both differed significantly from those of polyaxial screws (P < 0.05). In dynamic compression tests, both modified and monoaxial screws showed failures that occurred at the insertion point of screw body into the UHMWPE block, while the polyaxial screw group showed screw body swung up and down the screw head because of loosening of the ball-in-cup mechanism.</p><p><b>CONCLUSIONS</b>The modified screw is well-designed and biomechanically improved. And it can provide sufficient stability for segment fixation as monoaxial screws.</p>

Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.</p><p><b>METHODS</b>This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF) magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.</p><p><b>RESULTS</b>There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.</p><p><b>CONCLUSIONS</b>Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.</p>

Micro-endoscopic strategies and options for recurrent lumbar disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the results of micro-endoscopic revision surgery for recurrent disc herniation, and compare the results of disc excision with and without interbody fusion.</p><p><b>METHODS</b>A total of 32 patients included who had undergone micro-endoscopic revision discectomy for recurrent disc herniation with or without interbody fusion has been surveyed to assess their clinical outcome. The 27 patients who had been followed were divided into two groups; the micro-endoscopic discectomy alone 14 cases, the micro-endoscopic discectomy with interbody fusion 13 cases. With an average follow-up of 25.5 months. Clinical symptoms were assessed based on the VAS scores and Nakai criteria. All medical and surgical records were examined and analyzed, including intraoperative blood loss, length of surgery, and postsurgery hospital stay et al.</p><p><b>RESULTS</b>The statistical difference in the postoperative back pain and leg pain score compared with preoperative score were significant (P < 0.05) or very significant (P < 0.01). Clinical outcomes were excellent or good in 92.8% of patients undergoing a micro-endoscopic discectomy alone, and in 85.5% of patients with interbody fusion. The statistical difference between the fusion and non-fusion groups was insignificant (P = 0.793). But the two groups intraoperative blood loss, length of surgery, length of hospitalization and expenses were significantly less in patients undergoing discectomy alone than in patients with interbody fusion.</p><p><b>CONCLUSIONS</b>Micro-endoscopic revision surgery for recurrent disc herniation is very effective and safety. Micro-endoscopic discectomy alone is first choice for managing recurrent disc herniation.</p>

The initial approach of two sides hypogastric artery ligation and isolation with laparoscope before excision of presacral tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the significance of excision of presacral tumor after two sides hypogastric artery ligation and tissue dissociation with laparoscope.</p><p><b>METHODS</b>Twenty-one patients with sacral tumor were performed excision of presacral tumor after two sides hypogastric artery ligation and tissue dissociation with laparoscope.</p><p><b>RESULTS</b>All sacral tumor were removed successfully, the mean volume of operative blood was 800 ml (range 500-1900 ml), and all the patients were followed up 3-25 months, averaged time 11 months. One patient was recurred after 2 months of operation (the patient was Ewing's sarcoma, and refused to accept radiotherapy and chemotherapy after operation), 1 patents died of brain metastases after 9 months of operations. There were no recurrence in the others patients.</p><p><b>CONCLUSIONS</b>The excision of presacral tumor after two sides hypogastric artery ligation and tissue dissociation with laparoscope is an effective operation method, with the advantages of decreasing the operative blood and difficulty of sacral tumor excision, and diminishing the operation wound.</p>

Endoscopic transforaminal lumbar decompression, interbody fusion and pedicle screw fixation-a report of 42 cases / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the surgical procedure of endoscopic transforminal discectomy, bone grafting and Dynalok pedicle screw fixation under X-Tube operation system in the treatment of lumbar disc herniation combined with segmental instability and/or pars defected spondylolithesis.</p><p><b>METHODS</b>From June 2004 to May 2006, 42 patients with classic features of lumbar disc herniation combined with segmental instability and/or pars defected spondylolithesis underwent endoscopic transforminal lumbar interbody fusion (TLIF). Under the guidance of fluoroscopy, a 2.8 to 3.0 cm incision with 4.5 to 5.0 cm apart from the posterior middle line was made on the symptomatic side and the working portal (X-Tube) was docked unilaterally on the facet joint. A total facetectomy was then performed to expose neural foramina and nerve root. Discectomy and endplate preparation were completed through the tube. A Telamon cage was placed obliquely into the intervertebral space after interbody grafting, and then the Dynalok pedicle screw fixation system was performed. This procedure was accomplished on the lateral side when it is necessary.</p><p><b>RESULTS</b>Clinical outcomes were determined using the Oswestry Disability Index (ODI) which revealed that 62.2% of patients got excellent results, 29.2% good and 8.6% fair. The average hospital stay was 12.5 days (5-25 days). Operation time averaged 240 min (110-320 min), blood loss averaged 140 ml (80-420 ml) and incision length averaged 3 cm (2.8-3.2 cm). Five patients had complications including wound infection in 1 case, incision dehiscence and focal skin necrosis in 1, progressive radicular pain of contralateral leg in 1 and residual radicular numbness after transient radicular pain in 2.</p><p><b>CONCLUSIONS</b>This surgical procedure of endoscopic transforminal diskectomy, bone grafting, cage placement and pedicle screw fixation can be effectively accomplished under X-Tube operation system with predominant benefits such as small incision, less stripping of paraspinal muscles, minimal blood loss and rapid postoperative recovery.</p>

Minimally invasive strategies and options for far-lateral lumbar disc herniation / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the surgical procedures, options and surgical indications for far-lateral lumbar disc herniation between three different minimally invasive procedures.</p><p><b>METHODS</b>From January 2000 to October 2006, 52 patients with far-lateral lumbar disc herniation (29 males and 23 females, with the average age of 41.5 years) were treated with minimally invasive procedures. All the patients were assessed by X-ray and CT. Some were given additional myeography, discography, Computerized tomography mye-lography (CTM) and MRI examination. Yeung Endoscopy Spine System (YESS), METRx and X-tube procedures were performed in 25, 13 and 14 cases, respectively. All patients were followed up for a mean period of 13.5 months. Clinical outcomes were assessed by visual analog score (VAS) and Nakai criteria.</p><p><b>RESULTS</b>The results indicated that the three procedures could significantly improve the radiating leg symptoms (P less than 0.05). The postoperative overall excellent and good rates of YESS, METRx and X-tube procedures were 84.0%, 84.6% and 92.8% respectively, with no statistical difference among three groups (P larger than 0.05). The YESS procedure had several advantages including shortest operation time, simplest anesthesia and least trauma as compared with the other two procedures, especially for simple type I far-lateral lumbar disc herniation. METRx procedure was specially suitable for simple type II. And the procedure of posterior endoscopic facetectomy, posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was designed for far-lateral disc herniation combined with degenerative lumbar instability.</p><p><b>CONCLUSION</b>Minimally invasive strategies and options should be determined by different types of far-lateral lumbar disc herniation.</p>

Endoscopic transforaminal lumbar decompression, bone graft fusion and pedicle screw fixation under X-tube system: report of 42 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the surgical procedure of unilateral transforaminal discectomy, bone grafting, cage (Telamon) insertion and Dylanok pedicle screw fixation using X-tube operation system for the treatment of lumbar disc herniation combined with segmental instability and Spondylolysis with pars defect.</p><p><b>METHODS</b>From 2004 to 2006, 42 patients including 17 male and 25 female were treated in our department. The age range from 22 to 77 (mean: 51.6). Etiologies including lumbar disc herniation combined with segmental instability and Spondylolysis with pars defect.</p><p><b>RESULT</b>Of these 42 patients, the mean operation time was 240 min (110 - 320 min), the average blood loss was 140 ml (80 - 420 ml), the average incision length was 3 cm (2.8 - 3.2 cm) and the average hospitalization time was 12.5 days (5 - 25 days). Nakai criteria, Excellent in 23 cases (62.2%), good in 11 cases (29.2%) and fair in 3 cases (8.6%). 5 patients had postoperative complication (complication rate: 16.3%).</p><p><b>CONCLUSIONS</b>The surgical procedure has shown predominant benefits: small incision, less stripping of paraspinal muscles, minimal blood loss and rapid postoperative recovery which makes it a valuable alternative to conventional surgical procedures.</p>

Endoscopic transnasal reconstruction of skull base defects with titanium mesh / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of endoscopic transnasal reconstruction of skull base defect with titanium mesh.</p><p><b>METHODS</b>Eight cases were selected to reconstruct their anterior skull base defects by endoscopic transnasal approach with titanium mesh between April, 2006 and January, 2007.</p><p><b>RESULTS</b>Pathologies of these cases included two esthesioneuroblastomas, one squamous cell carcinoma, one chondrosarcoma, one malignant fibroma, two meningiomas, and one chordoma. The defects involved anterior-medial skull base in 2 cases, anterior skull base-sellar turcica in 2 cases, and anterior skull base sellar turcica-clivus in 4 cases. All patients were followed up for 2 to 10 months after operation and were monitored with endoscopic examinations and imaging. Replacement of titanium mesh was found in one case and other seven cases were successfully reconstructed without replacement of titanium mesh.</p><p><b>CONCLUSIONS</b>Endoscopic transnasal reconstruction with titanium mesh is a feasible technique for defects of the anterior skull base. This procedure is simple and safe. Result of this protocol is desirable.</p>

Human papillomaviruses infections among village women in Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of Human papillomaviruses (HPVs) among village women in Henan and to determine its relevant risk factors.</p><p><b>METHODS</b>A population based cross-sectional study on cervical cancer was conducted among village women in Xinmi, Henan. Women aged 20 - 54 who had sexual intercourse experiences were enrolled in this study. Self-sampling and direct-sampling were used in collecting women's vaginal discharge. 13 high-risk HPVs were tested with HC2 for all of the specimens. Then women with abnormal results did colposcopy and biopsy. The biopsy results were regarded as the golden standard.</p><p><b>RESULTS</b>There were 881 women enrolled in this paper and 881 self-sampling and 880 direct-sampling specimens were collected. The HPVs prevalence rates for the self-sampling and direct-sampling were 13.05% and 12.27%, respectively. Age-specific prevalence rates were 10.57% (20-), 9.60% (25-), 12.00% (30-), 9.52% (35-), 17.60% (40-), 13.74% (45-) and 12.80% (50 - 54). HPV prevalence rates were increased with progression of cervical disease (chi(2) = 200.69, P = 0.00). And HPV prevalence rates were higher in women with more advanced education background (chi(2) = 11.05, P = 0.01). HPV infection rate in women whose husbands have more than one sexual partner was 18.02% and whose husbands have only one sexual partner was 10.88% (chi(2) = 6.37, P = 0.01).</p><p><b>CONCLUSION</b>The infection rate of high-risk HPVs in this area is high. The relationship of HPV infection with age has not been observed in this study, but the the sexual activity is the major risk factor for cervical cancer.</p>

Parabiosis theory and effective stimulating amount, reinforcing-reducing, therapeutic time and course of acupuncture / 中国针灸

Parabiosis theory clearly expounds the change course of stimulatiom, namely, parabiotic equalization phase, parabiotic deregulation phase and parabiotic inhibition phase, and it can clearly explain that the effective stimulating amount is directly related to the reinforcing or reducing, and establishment of the therapeutic course. That is, the large effective stimulating amount is reducing method and the small effective stimulating amount is reinforcing method. In clinical application, for deficiency syndrome and chronic diseases, the effective intensity of acuti puncture should be smaller and the needle should be retained for 20-30 min, and for excess syndrome and acute disd eases, the effective stimulating intensity of acupuncture should be larger and the needle should be retained for longer time. In acupuncture treatment, acupoints should be grouped and used alternately, and the interval between therapeutic courses should be established.

Use of direct portal vein puncture portography with modified TIPS treatment in patients with portal hypertension and gastro-esophageal varices bleeding / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore a better procedure for transjugular intrahepatic portosystemic shunt (TIPS) in order to improve its safety and to extend its indications.</p><p><b>METHODS</b>To puncture the right portal branch under sonographic guidance in 20 patients with portal hypertension and gastro-esophageal bleeding. The Teflon sheath with gold marker was put into the portal vein; anterior and lateral portography was made, portal pressure was measured and the gastric coronal vein was embolized. The gold marker was put into the portal vein puncture site and the Rups-100 was guided under the gold marker during the TIPS puncture procedure. Anterior and lateral portography was again made to make sure the puncture site was 2 cm away from the portal vein bifurcation. In some cases a 10F sheath was used to suck the thrombosis in the portal vein, and a balloon was used to dilate the parenchyma channel and then a stent was released smoothly.</p><p><b>RESULTS</b>20 reformed TIPS were successfully performed on all patients and their gastric-esophageal bleedings were controlled immediately. 37 punctures were made in 20 of those cases; the average puncture per patient was 1.85+/-0.67, lower than that of the traditional method. The pressure of the portal vein declined from (30.5+/-1.1) mmHg to (16.9+/-0.9) mmHg, P < 0.05, showing that the difference of portal vein pressure before and after the reformed TIPS was significant. 25 stents were placed, and no complications occurred during the procedure in any of the cases.</p><p><b>CONCLUSION</b>Direct portal vein puncture portography and gold marker guided TIPS procedure is feasible and safe; the indications of TIPS could be further extended.</p>