Treatment of senile lumbar spinal stenosis by unilateral approach and bilateral decompression with large channel endoscopy / 中国骨伤

OBJECTIVE@#To evaluate clinical effect of unilateral approach and bilateral decompression via large channel endoscopic system for the treatment of lumbar spinal stenosis.@*METHODS@#The clinical data of 32 patients with lumbar spinal tenosis treated by unilateral approach and bilateral decompression via large channel endoscopy from February 2018 to February 2019 were retrospectively analyzed. There were 18 males and 14 females, aged 65 to 84 years old with an average of (70.6± 8.4) years. The course of disease was from 1 to 12 years. All 32 cases were accompanied by numbness or pain in the lower limbs, of which 28 cases were accompanied by intermittent claudication. Narrow segments were L@*RESULTS@#All the patients were followed up for 12-24 (17.68±2.43) months and all operations were successfully completed with the operation time of 70-160(85.64±11.94) min. Spinal dural tear occurred in 1 case during the operation, and sensory disturbance in the other side of lower limb in a short period of time occurred in 2 cases, all improved after corresponding treatment. Postoperative imaging showed that the spinal canal was significantly enlarged and the nerve root was fully released. Before operation and 3 days, 3 months, 1 year after operation, VAS scores of low back pain were 4.62 ±1.41, 2.73 ±1.35, 1.21 ±1.17, 1.11 ±0.34, respectively;VAS scores of leg pain were 6.83 ± 1.71, 3.10±1.50, 1.08±0.19, 0.89±0.24, respectively. VAS scores of low back pain and leg pain each time point after operation were obvious improved (@*CONCLUSION@#It is a safe and effective way to treat lumbar spinal stenosis with unilateral approach and bilateral decompression via large channel endoscopic system. It has the advantages of sufficient decompression, less trauma, fast recovery, high safety and low incidence of postoperative complications. It can minimize the damage to the stable structure of the lumbar spine and is an ideal minimally invasive operation for the treatment of lumbar spinal stenosis.

Establishment and application of a mouse model for drug-induced schizophrenia / 药学学报

Schizophrenia, described as the worst disease affecting mankind, is a severe and disabling mental disorder. Schizophrenia is characterized by complicated symptoms and still lacks a diagnostic neuropathology, so developing schizophrenia animal models which have quantifiable measures tested in a similar fashion in both humans and animals will play a key role in new therapeutic approaches. According to the symptoms of cognitive impairment and emotional disorder, the N-methyl-d-aspartate (NMDA)-receptor antagonist MK-801 was applied to induce schizophrenia-like behavior in mice. Locomotor activity and prepulse inhibition (PPI) were selected as indices and the effect of clozapine was also investigated in this model. The results showed that compared with the normal group, MK-801-treated mice exhibited significantly increased locomotor activity and impaired PPI, and pre-exposure to clozapine could ameliorate the abnormality and make it back to normal level. These findings suggest that the model we established could be a useful tool for antipsychotic drug screening.

Histopathological observation of bone remodeling in rabbit sinusitis model / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the histopathological finding of bone remodeling in rabbit sinusitis model at different time and the tendency, and to discuss the effect of bone in the pathogenesis of sinusitis.</p><p><b>METHODS</b>First, the rabbit sinusitis model was made, then the experimental animals were divided into 3 groups according to the time of infection. There were 8 rabbits in each experimental group, and 4 rabbits in the control group. The sinus specimen were collected, embedded and stained. The bone in the inoculating side and noninoculating side was scored, and the bone in inoculating side was evaluated quantitatively and semiquantitatively. The parameters included the thickness of mucosa, mucoperiosteum, the density of osteoblast, the amount of osteoclast.</p><p><b>RESULTS</b>The average bone score in the inoculating side was 2.250, 2.875, 2.875; in the noninoculating side was 1.625, 2.250, 2.500. Between group A and the control group, the difference of all three parameters had statistical significance. Between group B and group A, the difference of the thickness of mucosa and the density of osteoblast had statistical significance. Between group C and group B, none of the three parameters had statistical significance.</p><p><b>CONCLUSIONS</b>Bacterial sinusitis can lead to bone remodeling, obvious bone destroy can occur at the early phase, then the bone proliferation follows. These results demonstrate that bone remodeling is one of the basic histopathological characters of CRS and might be the reason to lead CRS to a constant and chronic process of inflammation.</p>

Tracheoesophageal shunt for vocal rehabilitation after laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the clinical value of functional tracheoesophageal shunt for vocal rehabilitation after laryngectomy.</p><p><b>METHODS</b>One hundred and twenty seven cases of tracheoesophageal shunt for vocal rehabilitation after laryngectomy in Cancer Hospital of Tianjin Medical University from 1981 to 2006 were analyzed retrospectively.</p><p><b>RESULTS</b>Among 127 cases, 105 cases got successful phonation and the total success rate of vocal rehabilitation was 82.7%, all successful cases were followed up from 2 to 27 years had good phonation quality and no aspiration. Analyzing the reasons of failure in phonation of the 22 cases, 9 cases were because of improper operation (7 cases for narrow fistula and 2 cases for broad fistula), 13 cases were because of postoperative infection (10 cases for narrow fistula and 3 cases for broad fistula). The key to successful phonation was the size of fistula, the main causes of the failure in phonation were related to uncorrected operative procedure and postoperative infection.</p><p><b>CONCLUSIONS</b>This method for vocal rehabilitation after laryngectomy has high success rate of vocal rehabilitation and low complications, it is relatively simple and worth popularizing in clinical treatment.</p>

Progress of clinical pathology and application of PET-CT on thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Identify the significance of variants in papillary thyroid carcinoma (PTC), the role of extracellular matrix (ECM), MMPs, cell adhesion molecular (CAM) and cytokine in lymphatic metastasis in PTC and the value of PET-CT in diagnosis of thyroid carcinoma.</p><p><b>METHODS</b>Five hundred and five cases of PTC which had complete medical records and followed up surveys were selected from the files. Clinical biological characteristic of the histological variants was investigated. Sixty cases of PTC were selected. As the important parts of micro ecosystems, ECM, MMPs, CAMs and cytokine were investigated in use of tissue chip and method of immunohistochemistry. In addition, a group of cases of thyroid carcinoma including PTC was analyzed, follicular thyroid carcinoma and medulla thyroid carcinoma (MTC) and their reports of PET-CT as the initiation.</p><p><b>RESULTS</b>The variants could be divided into three groups in terms of the rate of cervical lymph node metastasis. The high-metastases group included diffuse sclerosing variant, tall cell variant, column cell variant and diffuse follicular variant. The low-metastases group included macrofollicular variant and papillary microcarcinomas. Others are included in the moderate-metastases group. The rate of cervical lymph node metastasis of each group were 83.0% , 55.5% and 34.1% (P < 0. 05), respectively. The 10-year-survival were 75.3% , 95.8% and 100.0% , respectively. The 20-year-survival were 31.2%, 80.3% and 87.5%, respectively. The positive rate of LN, FN, MMP-2, MMP-9, TIMP-2, CD, Integrinbeta-1, ICAM-1, EGFR, TGFR-beta, VEGF-C and E-Cad in metastasis ranged from 51.6% (Integrinbeta-1) to 98.3% (CD), and that in primartumor ranged from 46.7% (FN) to 98.3% (ICAM-1). The expression of E-cad in primartumor was lower than that in normal tissues (P < 0.05). The sensitivity of PET-CT was 100% and the specificity was 85.7%.</p><p><b>CONCLUSIONS</b>The characteristic has significant difference among the variants. Individual treatment should be performed in terms of different variants. Furthermore, some molecules play an important role in the lymph node metastasis of PTC and may be considered as the focus of future study. In addition, compared with CT and Bus, PET-CT is more sensitive and has its unquestionable advantage as a whole body examination, especially for staging and detecting micro metastases, though it requires a high expense.</p>

Imaging diagnosis of lung lacerating injury / 中华放射学杂志

Objective To investigate the imaging findings of the lacerating injury of the lung. Methods Ten patients of lung lacerating injury were examined by X-ray and CT within 1—5 h after injury. X-ray(2—5 times)and CT(3—5 times)examinations were repeated for 7 patients.Results The lung lacerating injury involved 10 sides and 14 lung lobes(21 lesions in total)in the 10 cases,among which 1 case involved the right upper lobe with 1 lesion,2 cases in the right lower lobe with 2 lesions,1 case in the right upper and lower lobes with 2 lesions for each lobe,3 cases in the left lower lobe with 9 lesions,and 3 cases in both the left upper and the lower lobes with 7 lesions.The X-ray findings were cavity-like shadows with smooth margin in 9 lesions(9/21),and patchy shadows of fogging margin in 12 lesions(12/21).The CT imaging findings included 6 pulmonary hematomas(6/21),and 15 cavitary lesions with air-fluid levels (15/21).In the 15 cavitary lesions,CT revealed 14 single cavities and 2 small cavities within a big cavity. On dynamic follow-up observation,the cavity was the biggest in 1—5 h after injury,but the hematoma was the biggest in 2—3 days after injury.Hematomas tended to absorb slower than the cavities.After 16— 32 days,all lesions revolved into small patchy or stripe-like shadows with slightly increased density. Conclusion Cavitary lesion with air-fluid level is the characteristic imaging finding of lung lacerating injury.CT surpasses X-ray plain film in revealing the details of lung lacerating injury.