Reprt of the short-term efficacy of a new type of ileal orthotopic cystectomy / 中华泌尿外科杂志

In this study, a new ileal orthotopic bladder (Urumqi Bladder) modified by our center based on the ileal "W" type orthotopic bladder and Studer bladder was used on 8 patients with invasive bladder cancer. All of patients were male and aged between 54 and 66 years. The history of disease ranged from 1 month to 3 years, including 5 patients with initial onset, 3 patients with ≥2 TURBT history. 6 patients had multiple tumors, tumor size from 0.5 cm to 2.5cm. There were 2 patients with single tumor. Preoperative PET-CT examination showed no distant metastasis and pelvic lymph node enlargement, no urinary tract hydronephrosis, and cystoscopy showed no suspected tumor in the urethra. Preoperative pathological results: high-grade invasive urothelial carcinoma was found in 6 cases and muscular invasive urothelial carcinoma in 2 cases. In 8 patients, 50cm ileum was taken from 15cm away from ileocecum after radical cystectomy, which was crimped clockwise inward from the right end into a nearly circular shape, with 10cm left at the left end. The remaining 40cm ileum was formed into 3 sections of about 13cm each, which were decanted to form a storage capsule. The last 10cm intestinal tube was crossed from the front of sigmoid colon. The end of intestine was anastomosed with the left ureter. The right ureter was anastomosed with the top of the right intestine pouch, and the urethra was anastomosed with the pouch to complete the diversion of urine flow. During 3-12 months of postoperative follow-up, 4 patients had short-term mild urinary incontinence. All had complete urinary control at 12 months. 1 patient still had mild left ureter reflux 12 months after surgery, and the other 7 patients had no ureter reflux. In this group of 8 patients, postoperative excretory cystography showed satisfactory effect of bladder voiding, residual, and bladder capacity. Follow-up review of chest CT, urinary CT and abdominal ultrasound showed no hydronephrosis, and no tumor recurrence or distant metastasis.

The relationship between lumbar disc degeneration of lumbar spinal stenosis and the dural sac cross-sec-tional area by MRI measurement / 实用医学杂志

Objective To explore the relationship between lumbar disc degeneration (LDD) of lumbar spinal stenosis(LSS)and the dural sac cross-sectional area(DSCA)by MRI measurement. Methods 91 patients with central degenerative LSS were randomly selected and 91 age-and sex-matched people without LSS were select-ed as a control group. LDD was classified into five grades by MRI detection according to the method proposed by Pfirrmann and DSCA were measured. Results LDD was not associated with age in LSS. The proportion of severe degenerated disc in lower lumbar levels were higher than that of L2/3 in the two groups;DSCA in severe degenerat-ed disc group was significantly smaller than that in light degenerated group only in L2/3 and L3/4 in LSS. There were no statistical differences in every lumbar level in the control group. Conclusions LDD in L4/5 and L5/S1 of LSS is more severe than that of the normal people. DSCA and LDD are positively correlated in L2/3 and L3/4,but not in L4/5 and L5/S1 for LSS.

Management of laboratory animals of new drug safety evaluation in GLP and AAALACi certification systems / 药物评价研究

With the global development of the research of medicine,more and more new drug safety evaluation institutions have been certified by Good Laboratory Practices (GLP) and Association for Assessment and Accreditation of Laboratory Animal Care International (AAALACi).Laboratory animal,which is the carrier of drug safety evaluation,its survival condition and animal welfare will directly effect the experimental results.Dealing with laboratory animal husbandry by scientific methods in two systems is the requirement to make sure the accuracy of experimental data of animal experiments.With the certification processes and practical experiences in two certification systems of Tianjin Institute of Pharmaceutical Research New Drug Evaluation Co.,Ltd.,also accompanied by experience exchangement with peers,the relationship of practices in two certification systems will be preliminarily discussed;Through strengthening the management of laboratory animal,it can help the institutions get the certificates.

Correlation of vertebral osteophyte and lumbar disc degeneration in the elderly people / 实用医学杂志

Objective To analyze the correlation of vertebral osteophyte and lumbar disc degeneration in the elderly people and explore the possible mechanism of osteophyte formation. Methods X-ray and MRI data of 120 elderly people with backache or leg pain were retrospectively analyzed. Osteophyte was classified into four grades by X-ray according to the method proposed by Nathan. Discs with osteophyte were defined as occurring when osteophyte of grade II or greater were present. Lumbar disc degeneration was classified into five grades by MRI according to the method proposed by Pfirrmann. The obtained parameters were statistically treated and analyzed. Results Osteophyte and age were positively correlated at every lumbar disc level (P < 0.05). The proportion of osteophyte in L3/4 (76.7%) and L4/5 (70.08%) were more severe than that in L1/2 (31.7%) and L2/3 (46.7%). Osteophyte and lumbar disc degeneration were positively correlated at every lumbar disc level (P < 0.01). Conclusion Osteophyte becomes more severe with the increasing of lumbar disc degeneration. The vertebral stress after lumbar disc degeneration may be the main cause of osteophyte.

Clinical efficacy of unipedicular versus bipedicular percutaneous vertebroplasty for Kummell's disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the clinical efficacy and safety of percutaneous vertebroplasty by unipedicular and bipedicular approach for treatment of Kummell's disease.</p><p><b>METHODS</b>The clinical data of patients with Kummell's disease undergoing percutaneous vertebroplasty via unilateral or bilateral approach between January, 2006 and January, 2011 were reviewed. The clinical efficacy, operation time, bone cement injection volume, incidence of cement leakage, degree of vertebral height restoration, and degree of kyphosis correction were compared between the patients receiving surgery via the two approaches.</p><p><b>RESULTS</b>The operation time was shorter in the unipedicular group than in the bipedicular group (P<0.05), but bone cement injection volume, incidence of cement leakage, degree of anterior vertebral height restoration, degree of middle vertebral height restoration, degree of kyphosis correction, and VAS scores were all comparable between the two groups (P>0.05). In both groups, the VAS scores at 24 h, 3 months and at the last follow-up after the surgery were lowered compared to the preoperative scores (P<0.05).</p><p><b>CONCLUSION</b>Both unipedicular and bipedicular percutaneous vertebroplasty can achieve satisfactory analgesia in the treatment of Kummell's disease with similar clinical efficacy. The unipedicular approach is sufficient for treatment of Kummell's disease.</p>

Causes and prevention of postoperative spinal cord injury after anterior approach surgery for cervical spondylotic myelopathy / 中华创伤杂志

Objective To investigate the causes and prevention strategies of postoperative spinal cord injury after anterior approach surgery for cervical spondylotic myelopathy. Methods The clinical data of 749 patients with cervical spondylotic myelopathy treated with anterior approach surgery from 2001 to 2009 were retrospectively studied.There were five patients with spinal cord dysfunction instantly or early after operation,including three males and two females at average age of 52 years (range,48-62 years).Two patients were combined with ossification of the posterior longitudinal ligament.The Japanese Orthopaedic Association (JOA) score was average 12.4(9-16)preoperatively.The surgeries included anterior cervical diskectomy(or corpectomy)and interbody fusion(iliac bone graft or cage or titanium mesh)and locking plates fixation.The blood loss was 50-200 ml.The symptoms included instant spinal cord injury in two patients,loss of the motor and feeling of both legs at 6 h after surgery in one,paralysis of one side limbs at 24 h after surgery in one and numbness of limbs at 5 days after surgery in one.Four patients were treated by large dose of methylprednisolone.Five patients underwent anterior exploration surgery,of which one patient received posterior cervical one-door expansive laminoplasty. Results The patients were followed up for average 16 months(12-24 months).The JOA score of four patients was recovered at three months and WaS better than preoperation after surgery.The function of spinal cord of one patient showed no improvement at one year after surgery.The causes for spinal cord injury included inappropriate surgical manipulation in decompression and haemostasis in two patients,insufficient decompression in one,epidural hematoma in one and absorbable hemostatic gauze in one. Conclusions The major causes of postoperative spinal cord injury in anterior approach surgery for cervical spondylofic myelopathy are the delayed postoperative injury.The spinal cord can recover to normal and has satisfactory prognosis if discovered promptly.We must avoid the spinal cord injury by surgical Manipulation that may result in permanent neurological deficits.

The effect of transpedicular vertebral intervertebral spinal shortening osteotomy in treatment of kyphosis / 中国基层医药

ObjectiveTo improve the correction rate of clinical, understand transpedicular vertebral intervertebral spinal shortening osteotomy for treatment of clinical efficacy of kyphosis. Methods40 patients with kyphosis,were selected as research objects. beffore and after the kyphosis correction surgery, pain improvement, efficacy and complications were retrospectively studied. ResultsBefore and after surgical correction of spinal kyphosis angle control study showed significant differences. Before and after surgical correction of grading oral pain control study showed significant differences.40 patients,the effects of surgical correction achieved grade Ⅰ ,35 cases(87.5％ ) ,grade Ⅱ in 5 cases ( 12.5％ ), grade Ⅲ and Ⅳ 0. ConclusionIntervertebral vertebral pedicle shortening osteotomy surgery could effectively correct spinal kyphosis, relieve pain and discomfort of patients, and safe, and it was worth to promote in the clinical use.

A new classification of spinal tuberculosis:based on MRI findings (Southern Medical University classification) / 中华骨科杂志

Objective To outline the classification of spinal tuberculosis based on MRI findings (Southern Medical University classification,SMU classification) and explore its use in the diagnosis,surgical protocols.Methods The MRI data from 230 cases with spinal tuberculosis were analyzed retrospectively.Our classification system was based on clinical and radiological criteria (abscess formation,disc degeneration,vertebral collapse,kyphosis,sagittal index,instability and neurological problems).The surgical strategies were made according with this classification.Results Two hundred and thirty cases with spinal tuberculosis were classified into the 5 types.There were signal change type (type Ⅰ) in 28 cases,abscess formation type (type Ⅱ) in 39,vertebral collapse type (type Ⅲ) in 78,canal compression type (type Ⅳ) in 46 and kyphosis type (type Ⅴ) in 39 respectively.In type I lesion,25 patients had been followed up.Twenty patients were treated medically.Recurrence of tuberculosis was found in 2 cases.Surgical meticulous debridements were done in 5 cases without recurrence.In type Ⅱa lesion,6 patients were treated medically.The other 6 patients underwent surgical meticulous debridement with recurrence occurred in one patient.There was no difference between medical and surgical treatment regarding outcomes in patients with type Ⅰ and Ⅱa lesion.In type Ⅱb-Ⅴ,surgical treatments were carried out according to the pathological changes.There was no difference between medical and surgical treatment regarding outcomes in the patients with type Ⅱb-Ⅴ.Conclusion The SMU classification helps in differentiating the various manifestations of spinal tuberculosis and appears to correlate with the surgical treatment of spinal tuberculosis.We believe that this new classification system can be used as a practical guide in the treatment of spinal tuberculosis.

Effects of nitric-oxide synthase inhibitor on matrix metalloproteinase's expression in osteoarthritls cartilage by Luminex analysis / 中华风湿病学杂志

Objective To investigate the effects of nitric-oxide synthase inhibitor on matrix metalloproteinases (MMPs) expression in osteoarthritis (OA) cartilage by Luminex analysis,and to explore the mechanism of nitric-oxide synthase inhibitor on modification of the metabolism of OA cartilage.Methods Fifteen specimens of articular cartilage taken from the patients with OA were cultured and divided in two groups.The control group was those with no intervention.L-NIL group was co-cultured with NOS inhibitor L-NIL.After 72 h cultivation,the release of NO and the activity of NOS on OA cartilage were measured by Griess reaction and spectrophotometric methods.MMPs (MMP-1,MMP-2,MMP-3,MMP-9,MMP-13) expression was measured by Luminex analysis.Comparisons between groups were performed with paired sampies t test.Results After cultured for 72 h,spectrophotometric analysis showed high concentration of NO release[(216±47) μmol/L ] and high level of active NOS [(5.7±1.3)U/ml]in supernatants of the control,1 mmol/L concentration L-NIL could evidently reduce NO release [(55±20)μmol/L,P<0.01] and NOS activity [(1.7±0.7)U/ml,P<0.01 ].Luminex analysis demonstrated high MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression in cartilages of the control group [respectively for (10.8±5.4)ng/ml,(9.2±3.3) ng/ml,[11.6±4.2 )ng/ml,(1.27±1.07)ng/ml,(3.6±1.3)ng/ml] and 1 mmol/L concentration L-NIL could evidently inhibit MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression [respectively for (3.6±1.8)ng/ml,(2.3±1.2)ng/ml,(3.6±1.4)ng/ml,(0.65±0.21)ng/ml,(1.8+0.5)ng/ml,P<0.05 ].Conclusion Luminex analvsis has shown that NOS inhibitor can reduce NO release and NOS activity and modify metabolism of articular cartilage by inhibiting the over-expression of MMPs.

Primary Exploration into Teaching Management Method of Clinical Practice / 浙江中医药大学学报

Pointing to the contradiction features existent in teaching of clinical practice in the beginning stage of establishing affiliated hospital of university,it primarily discusses the management method in teaching of clinical practice,which gets first achievements after 3-year trial.

Modulation of inducible nitric oxide synthase inhibitors on articular cartilage damage after intraarticular injection of interleukin-1? and lipopolysaccharides in rabbits / 中华风湿病学杂志

Objective To study the effect of nitric oxide synthase inhibitors S methylisothiorurea (SMT) on cartilage metabolism after intraarticular injection of interleukin 1? (IL 1?) and lipopolysaccharides (LPS) in rabbits.Methods The experiments were performed in three groups:normal group,control group and SMT group.The effects of SMT on IL 1? and LPS induced iNOS mRNA expression ,NO production and NOS activity in synovium,synovial fluid and cartilage were detected after 8 h.Proteoglycan synthesis was measured by ex vivo incorporation of Na 2 35 SO 4 into cartilage after 48 h.Results IL 1? and LPS induced iNOS mRNA expression and increased NO release;SMT could reduce NO release and inhibit iNOS mRNA expression in synovium,synovial fluid and cartilage,and partly restore proteoglycan synthesis of cartilage.Conclusion iNOS inhibitor SMT can protect IL 1? and LPS induced cartilage damage in high concentration.

Repair effect of articular cartilage defects by nitric oxide synthase inhibitor / 中华骨科杂志

Objective To discuss repairing effects of articular cartilage defects by nitric oxide synthase inhibitor (S-methylisothiourea, SMT), and explore the role of nitric oxide in cartilage repair. Methods Full-thickness defects of cartilage were created in the intercondylar trochlear groove of femur of thirty-six adult New Zealand white rabbits, and were divided into three groups. Twenty-four defects were untreated as the control, twenty-four were filled with fibrin glue and impregnated with rhBMP as rhBMP group, the rest twenty-four were filled with fibrin glue and impregnated with rhBMP, and hypodermic injection with SMT as SMT group. The animals were sacrified at sixteen weeks postoperatively, and the gross appearance of the defect was estimated. The repair tissue was examined histologically and was evaluated according to the grading scale of histology. The amount of released NO and the activities of nitric oxide synthase (NOS) were examined by chemical colorimetry. The distribution of type-Ⅰ,Ⅱcollagen were examined by Sirius-Red. The proteoglycan synthesis was assessed by incorporation of radio-labelled sodium sulphate Na35SO42-. RT-PCR examined the expression of iNOSmRNA and MMP9mRNA. Results The filled extent of the defect in SMT group and rhBMP group had no significant difference from the control group, and the marginal integration, cellular morphology, architecture within the defect and subchondral plate repair were better than the untreated defects (P