Early effectiveness of oblique lateral interbody fusion combined with pedicle screw fixation via small incision Wiltse approach for lumbar spondylolisthesis / 中国修复重建外科杂志

Objective: To investigate the early effctiveness of oblique lateral interbody fusion (OLIF) combined with pedicle screw fixation via small incision Wiltse approach for the treatment of lumbar spondylolisthesis. Methods: Between January 2016 and December 2016, 21 patients with lumbar spondylolisthesis were treated with OLIF and pedicle screw fixation via small incision Wiltse approach. There were 9 males and 12 females, aged 57-73 years, with an average age of 64.5 years. The disease duration was 24-60 months, with an average of 34.6 months. All cases were spondylolisthesis at L 4 (15 cases of degreeⅠ, 6 cases of degreeⅡ); 1 case had vertebral arch isthmus, and 20 cases had spinal stenosis. Japanese Orthopaedic Association (JOA) scoring system was used to evaluate the effectiveness before operation and at last follow-up. Before operation and at 2 days after operation, anteroposterior and lateral X-ray films and CT were taken to measure the sagittal diameter and cross-sectional area of the spinal canal, and calculate the intervertebral height and degree of spondylolisthesis. At 6 months after operation, the intervertebral fusion was evaluated by CT. Results: The operation time was 120-180 minutes, with an average of 155 minutes; the intraoperative blood loss was 100-340 mL, with an average of 225.5 mL. One patient had slight injury of lower endplate, 1 patient had numbness of thigh and weakness of hip flexion after operation, 1 patient had sympathetic nerve trunk injury. All the cases were followed up 12-18 months, with an average of 14.3 months. The symptoms of low back pain, leg pain, and numbness of lower limbs significantly relieved after operation, and there was no complication such as protrusion of fusion cage, screw breakage, and endplate collapse. At 2 days after operation, the intervertebral height, degree of spondylolisthesis, sagittal diameter of spinal canal, and cross-sectional area of spinal canal significantly improved compared with preoperative ones ( P<0.05). At 6 months after operation, CT showed that 1 patient had poor interbody fusion (grade Ⅲ), the other 20 patients had good interbody fusion (grade Ⅰ and Ⅱ), and the interbody fusion rate was 95.2%. At last follow-up, JOA score of lumbar spine significantly increased compared with that before operation ( t=24.980, P=0.000). Conclusion: OLIF combined with pedicle screw fixation via small incision Wiltse approach for the lumbar spondylolisthesis has minimally invasive features, such as less trauma, fewer complications, and higher intervertebral fusion rate. It is a safe and effective method.

Survey of radiation baseline level in Ninghai areas adjacent to the Sanmen Nuclear Power Station / 上海预防医学

Objective To obtain the environmental gamma radiation dose and the radioactivity level of environment medium in the Ninghai areas adjacent to Sanmen Nuclear Power Station before the Station running, and to establish the baseline data for environmental background radiation. Methods The environmental gamma radiation rate and cumulative dose was measured by sodium iodide scintillation detection and cumulative dose of thermoluminescence method.The total αand total βof water source in the monitoring areas was detected by low background αor βdetector, and the radionuclide in the food samples was detected byγ-ray spectrometer. Results Annual effective dose per residents in surveillance areas was 0.928 mSv.γ-ray of field external radiation dose rate was (98.32 ±21.08) nGy/h, and the annual cumulative environmental radiation dose was ( 1.040 ±0.044 ) mSv.There were seasonal differences in theγ-ray of field external radiation dose rate and cumulative environmental radiation dose.γ-ray of external radiation dose rate and the annual environmental cumulative dose in the range of 20 km was higher than in the range of 10 km and 30 km, but there were no statistical significance.Radioactive detection value of food samples were much less than the national standards, and the total radioactivity index of water source samples can be up to the national standard of drinking water. Conclusion Radioactive background in Ninghai areas adjacent to the Sanmen Nuclear Power Station was in the normal range, and there was seasonal variations.The study established baseline data for environmental background radiation before the Sanmen Nuclear Power Station running.In the future, the food sample monitoring should be focused on the artificial radionuclide 90 Sr, 137 Cs, 131 I , etc.

Phloroglucinol combined with parecoxib for cystospasm after transurethral resection of the prostate / 中华男科学杂志

<p><b>Objective</b>To evaluate the effect and safety of phloroglucinol combined with parecoxib on cystospasm after transurethral resection of the prostate (TURP).</p><p><b>METHODS</b>We conducted a prospective randomized case-control study on 98 patients treated by TURP. After operation, the patients were randomly assigned to a treatment (n=50) and a control group (n=48), the former treated by intravenous injection of 80 mg phloroglucinol qd plus 40 mg parecoxib bid while the latter given 80 mg phloroglucinol only, both for 3 successive days. Then we recorded the frequency and duration of cystospasm, visual analogue scales (VAS), adverse reactions, post-operative bladder irrigation time, catheter-indwelling time, and hospital stay and compared them between the two groups of patients.</p><p><b>RESULTS</b>Compared with the controls, the patients in the treatment group showed a significantly lower frequency of cystospasm (［1.95±0.14］ vs ［0.70±0.65］ times, P<0.01), duration of cystospasm (［0.44±0.21］ vs ［0.12±0.14］ min, P<0.01), and VAS score (2.70±1.80 vs 1.90±1.30, P<0.01) at 48－72 hours after TURP, but no statistically significant differences were found between the control and treatment groups in the post-operative bladder irrigation time (［2.75±0.87］ vs ［2.64±0.83］ d, P>0.05), catheter-indwelling time (［3.52±0.32］ vs ［3.44±0.42］ d, P>0.05), and hospital stay (［5.23±0.81］ vs ［5.10±0.73］ d, P>0.05), and no obvious adverse reactions were observed in either of the two groups.</p><p><b>CONCLUSIONS</b>Phloroglucinol combined with parecoxib is more effective and safer than phloroglucinol alone in relieving postoperative cystospasm after TURP.</p>

Treatment of depression fractures of posterolateral tibial plateau through a modified anterolateral approach / 中国骨伤

<p><b>OBJECTIVE</b>To study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.</p><p><b>METHODS</b>From February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).</p><p><b>CONCLUSION</b>Treatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.</p>

Safety and effectiveness of GreenLight 120-W laser photoselective vaporization of the prostate for benign prostatic hyperplasia: A meta-analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and effectiveness of GreenLight 120-W laser photoselective vaporization of the prostate (PVP) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We searched PubMed, Medline, Embase, Cochrane Library, Wanfang, CNKI, and VIP for randomized control trials and their references addressing 120-W PVP versus TURP in the treatment of BPH. Based on the inclusion and exclusion criteria, two reviewers independently accomplished the screening, quality assessment, and data extraction of the identified studies and performed meta-analyses using RevMan 5.2.</p><p><b>RESULTS</b>Totally, 6 randomized control trials were included in this analysis, involving 703 cases, 351 treated by PVP and 352 by TURP. Compared with TURP, PVP showed significantly decreased time of catheterization (by 32. 55 hours, 95% CI 15.3 -49.8, P < 0.01), hospital stay (by 1.85 days, 95% CI 1.2-2.5, P < 0.01), and intraoperative blood loss (by 15.6 g/L, 95% CI 10.0-21.2, P < 0.01), but increased time of operation (by 9.37 minutes, 95% CI 5. 1-13.6, P < 0.01). There was also a significant reduction in blood transfusion, TUR syndrome, and capsular perforation in the PVP group. At 12 months after surgery, no statistically significant differences were found between the two groups in the improvement of maximum urinary flow rate, IPSS, postvoid residual, and sexual function.</p><p><b>CONCLUSION</b>GreenLight 120-W laser PVP is a safe and effective procedure for the treatment of BPH, with similar effectiveness to TURP but less blood loss, shorter time of catheterization and hospital stay, and lower incidences of blood transfusion, TUR syndrome and capsular perforation.</p>

MRI tracking of superparamagnetic iron oxide-labeled rabbit bone marrow mesenchymal stem cells for treatment of femoral head avascular necrosis / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cell(BMSC) transplantation is one of the developmental directions in the treatment of femoral head necrosis. In recent years, the use of superparamagnetic iron oxide (SPIO) nanoparticles labeled target cells traced by MRI imaging method has become the focus of the study. OBJECTIVE:To observe the in vivo MRI tracking and the curative effects of SPIO-labeled BMSC transplantation on rabbit femoral head necrosis. METHODS:SPIO-labeled BMSCs, unlabeled BMSCs, and normal saline were injected in situ into the necrotic femoral head of rabbits. Fol owing MRI dectection, the image changes of transplanted BMSCs marked by SPIO were observed among the three scanning sequences of SE T2WI, FSE T2WI and GRE T2*WI. Meanwhile, the area percentage of newly formed bone trabecula in the defect samples under high power lens were observed and calculated for statistical analysis. RESULTS AND CONCLUSION:In situ celltransplantation group showed the emerging and extinctive time of the decreased-signal region was different among the three scanning sequences of SE T2WI, FSE T2WI and GRE T2*WI. It was found that the decreased-signal region of the MRI scanning sequences was the target of the present experiment. No obvious signal change occurred in the control side. After 6 weeks of transplantation, the area percentage of newly formed bone trabecula in the defect samples showed no difference in SPIO-labeled and unlabeled BMSC transplantation groups (P>0.05), but it was higher than that in the control side (P<0.01). The SPIO-labeled BMSCs and unlabeled BMSCs are shown to have the same effects in the treatment of femoral head necrosis. The SPIO-labeled BMSCs can be observed obviously by MRI detection in vitro.

Frozen shoulder due to cold damp treated with acupuncture and moxibustion on tender points / 中国针灸

<p><b>OBJECTIVE</b>To search for a better method for frozen shoulder due to cold damp.</p><p><b>METHODS</b>Sixty cases of frozen shoulder were randomly divided into an acupuncture-moxibustion group (32 cases) and an acupuncture group (28 cases). Acupuncture was applied mainly at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) in either group. In acupuncture-moxibustion group, moxibustion on tender points was supplemented.</p><p><b>RESULTS</b>In acupuncture-moxibustion group, 7 cases were cured, 15 cases markedly effective, 9 cases improved and 1 case failed. The cured and markedly effective rate was 68.8% and the effective rate was 96.9%. In acupuncture group, 2 cases were cured, 9 cases markedly effective, 13 cases improved and 4 cases failed. The cured and markedly effective rate was 39.3% and the effective rate was 85.7%. The cured and markedly effective rate in acupuncture-moxibustion group was superior to that in acupuncture group (P < 0.05) and there was no significant difference in the effective rate statistically between two groups (P > 0.05).</p><p><b>CONCLUSION</b>The clinical efficacy of acupuncture combined with moxibustion on tender points is superior to that of simple acupuncture on frozen shoulder due to cold damp.</p>

Analysis the relation of adults HBV vicinal failure and T cell subset, HLA-DR rang gene phenotype / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study and explore the relativity of adults HBV vicinal failure and HLA-DR, T cell subset, trace viruses infection. To accumulate date for formulating preventing adult HBV infection prophylactic-therapeutic measures.</p><p><b>METHODS</b>Select 20 adults randomly who had vaccinated with 10 microgYDV and produced anti-HBS successfully, and another 20 hadn't produced anti-HBs to form two groups-defeated group and contral group. Blood samples from two groups were taken for detecting the level of DR range gene phenotype: T cell subset, white blood cell HLA-DR, HLA-B27, HLA DRB1 * 07, DRB1* 04, DRB1 * 1001, DQB1 * 0401 and so on.</p><p><b>RESULTS</b>The level of CD4(-)/CD8(-) is lower in the infection group than in healthy group. But the average level of HLA-DR and HLA-B27 is higher in the infection group. The differences of HLA DRB1 * 07 gene frequency between two groups were significant (P <0.05), but the levels of CD3, CD4, CD8, CD7, CD4/CD8 and HLA DRB1 * 04, DRB1 * 1001, DQB1 * 0401 were not significant.</p><p><b>CONCLUSION</b>The failure of HBV vaccination on adults may have relation to HLA-DR, HLA-B27, HLA DRB1 * 07, CD4(-)/CD8(-), etc.</p>

The role of capsule endoscopy combined with double-balloon enteroscopy in diagnosis of small bowel diseases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The diagnosis of small bowel diseases remains relatively inefficient using traditional imaging techniques. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) are two novel methods of enteroscopy for examining the entire small bowel. The aim of this study was to evaluate the detection rate and diagnostic accuracy of CE and DBE in patients with suspected small bowel diseases and to investigate the clinical significance of combined use of these two novel modalities.</p><p><b>METHODS</b>Two hundred and eighteen patients were evaluated for suspected small bowel disease, including 116 with obscure gastrointestinal bleeding and 102 with obscure abdominal pain or chronic diarrhea. One hundred and sixty-five out of these patients underwent CE first and 53 patients underwent DBE (under anesthesia with propofol) first. DBE was recommended after negative or equivocal evaluation on CE and vise versa. Introduction of the endoscope during DBE was either orally or anally and the patients were referred for a second procedure using the opposite route several days later when no abnormalities were found on the first procedure. The detection rates, diagnostic accuracy, tolerance and frequency of adverse events of these two modalities were then analyzed.</p><p><b>RESULTS</b>Failure of the procedure was seen in one patient with CE and in two patients with DBE. Sixty-four DBE procedures were carried out in 51 patients; by the oral route in 34 cases, the anal route in 4 and both routes in 13 cases. The overall detection rate of small bowel diseases using CE (72.0%, 118/164) was superior to that with DBE (41.2%, 21/51); chi(2) = 16.1218, P < 0.0001. The diagnostic rate (51.8%, 85/164) was also higher than that with the latter procedure (39.2%, 20/51), but was not significantly different (chi(2) = 2.4771, P > 0.05). Furthermore, the detection rate of small bowel diseases in patients with obscure gastrointestinal bleeding using CE (88.0%, 88/100) was superior to that of DBE (60.0%, 9/15); chi(2) = 7.7457, P = 0.0054. Lesions were detected by DBE in 1 out of 4 patients in whom CE had a negative result. Suspected findings by CE were confirmed by DBE combined with biopsy in 12 out of 15 patients. On the other hand, small bowel lesions were identified by CE in all 3 patients after negative evaluations by DBE. There were no severe complications during or after either of the two procedures.</p><p><b>CONCLUSIONS</b>The detection rate of small bowel diseases by CE is very high. CE should be selected for the initial diagnosis in patients with suspected small bowel diseases, especially in patients with obscure gastrointestinal bleeding. DBE appears to be inferior to CE in the diagnosis of small bowel diseases. However, it was shown that abnormalities could still be identified by DBE in patients with normal images or used to confirm suspected findings from CE. DBE can also serve as a good complementary approach after an initial diagnostic imaging using CE.</p>

Therapeutic effect of dietary boron supplement on retinoic acid-induced osteoporosis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the therapeutic efficacy of dietary boron supplement on retinoic acid-induced osteoporosis in rats, so as to provide experimental evidence for clinical management of osteoporosis with boron.</p><p><b>METHODS</b>Thirty-two SD rats were randomized into normal control group (8 rats) and osteoporotic group (24 rats), and osteoporosis was induced in rats of the latter group by intragastric retinoic acid administration at the daily dose of 80 mg/kg for 15 consecutive days. The osteoporotic rats were subdivided into control group (8 rats) without treatment, boron treatment group (8 rats) and estradiol treatment group (8 rats). After 30 days of treatment, the serum contents of Ca, P, boron and the activities of alkaline phosphatase (AKP) and tartrate-resistant acid phosphatase (TRAP) in the rats were assayed, the bone mineral density (BMD) of the whole body, lumbar vertebrae and tibia were determined, and the morphological changes of the femurs were observed.</p><p><b>RESULTS</b>The serum contents of Ca and P in the rats of the 4 groups differed scarcely, but the content of boron in boron treatment group was markedly higher than that in the other three groups. In the osteoporotic control group, the activities of serum AKP and TRAP, the masses of spongy bone and cortical bone of the femurs, and the quantity of the osteoclasts were increased, with the BMD of the lumbar vertebrae and tibia decreased, suggesting osteoporotic conditions. The mean trabecular plate density and thickness, trabecular bone volume and cortical bone volume of the femurs in the osteoporotic rats treated with boron or estradiol were significantly increased, but the active osteoclast quantity in the spongy bone and serum TRAP activities were obviously decreased, and the bone quality was comparable with that of the normal group. In addition, the serum AKP activity and the active osteoblast quantity in the spongy bone were obviously increased in boron treatment group.</p><p><b>CONCLUSION</b>The dietary boron supplement can increase the serum content of boron of osteoporotic rats to stimulate bone formation and inhibit bone resorption, producing therefore obvious therapeutical effect against osteoporosis.</p>

Clinical application of wireless capsule endoscopy in pediatric and adolescent patients / 中华儿科杂志

<p><b>OBJECTIVE</b>Capsule endoscopy (CE) has been demonstrated to be safe and well tolerated in adults. However, its value in pediatric patients has not been well studied. The present study aimed to evaluate the safety and effectiveness of CE in pediatric patients with suspicious small bowel disorders.</p><p><b>METHODS</b>Fifteen children and adolescents (less than 18 years) were referred to our study for suspected small bowel diseases from Aug. 2002 to May 2005. They aged from 3 to 18 years. Among them, 5 patients were less than 10 years old. The range of weight was from 17 to 83 kg and height was from 49 to 176 cm. Clinical indications included obscure gastrointestinal bleeding (n = 12) and abdominal pain (n = 3). All the patients had normal results on upper and lower gastrointestinal examinations before they underwent CE. The procedures for capsule placement, gastric transit time, small bowel transit time, the average time of the elimination of the capsule, capsule findings, and complications were recorded.</p><p><b>RESULTS</b>All the patients described that the capsule was easy to swallow except 3 youngest children. Finally the capsule was delivered via gastroscopy with overtube for these three children under intravenous anesthesia. No capsule retention occurred during the study. Median recording time was (464 +/- 40) min. In 5 patients, the capsule did not pass the ileal valve by the end of the recording time. Median gastric transit time was (85 +/- 90) min. Median small bowel transit time was (283 +/- 106) min. The average time of the elimination of the capsule was (34.3 +/- 21.8) h. The detective yield of CE was 80%. These positive findings included Crohn's disease (5), hemangioma (2), angiodysplasia (2), Meckel diverticulum (1), polyp (1), and granulomatous lesions (1).</p><p><b>CONCLUSION</b>CE was performed safely in pediatric patients after ingestion or endoscopic placement of the capsule. The high yield of abnormal findings was comparable to those of adult patients.</p>

Capsule endoscopy and push enteroscopy in the diagnosis of obscure gastrointestinal bleeding / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push enteroscopy and capsule endoscopy are currently considered to be the most effective diagnostic procedures. The aim of this study was to compare the detection rates between capsule endoscopy and push enteroscopy.</p><p><b>METHODS</b>From May 2002 through January 2003, we prospectively examined by capsule endoscopy 39 patients with suspected small bowel diseases, in particular GI bleeding of unknown origin in Renji Hospital. Among them, 32 complained of obscure recurrent GI bleeding. Between January 1993 and October 1996, we used push enteroscopy on 36 patients who suffered from unexplained GI bleeding. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy and/or angiography.</p><p><b>RESULTS</b>M2A capsule endoscopy disclosed abnormal small bowel findings in 26 (82%) out of 32 patients. Twenty-one of them had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66% (21 of 32 patients). Definite bleeding sites diagnosed by capsule endoscopy in 21 patients included angiodysplasia (8), inflammatory small-bowel (5), small-bowel polyps (4), gastrointestinal stromal tumour (2), carcinoid tumour and lipoma (1), and hemorrhagic gastritis (1). Push enteroscopy detected the definite sources of bleeding in 9 (25%) of the 36 patients. Patients with definite bleeding sources included angiodysplasias (2), leiomyosarcoma (2), leiomyoma (1), lymphoma (1), Crohn's disease (1), small-bowel polyps (1) and adenocarcinoma of ampulla (1). Suspected bleeding sources were shown by push enteroscopy in two additional patients (6%), and in other five patients (16%) by capsule endoscopy.</p><p><b>CONCLUSIONS</b>The present study of patients with obscure GI bleeding showed that capsule endoscopy significantly superior to push enteroscopy in detecting GI bleeding (P < 0.001). Capsule endoscopy is safe and painless, and should become the initial diagnostic choice for patients with obscure GI bleeding.</p>

Contamination and Control During Drinking Water Treatment and Consumption / 环境与健康杂志

The recent data on drinking water contamination suggest that pollutions caused by various treatments and consumption behaviors have been a universal public health problem. Contaminants come from materials for supply disinfections purifications secondary water supply system containers for preparation and storage. Overall management and control should be taken to prevent drinking water pollutions including replacement of hazard materials for water supply application of qualified disinfectors and purificants consumption of safety health container. The government should constitute and revise the related laws and regulations to supervise the whole process of water supply and treatment productions and distributions of disinfectors,purificants and drinking water containers.

Thickness of epicardial adipose tissue is associated with metabofic syndrome / 中华内分泌代谢杂志

The epieardial adipose tissue in 210 subjects with or without metabolic syndrome (MS) was measured by echocardiography.The thickness of epicardial adipose tissue in male with MS group was significantly greater than that in men without MS [(9.10?3.59) mm vs (6.82?3.00) mm,P