Volume 91  ·   Issue 31  ·  2011

Cervical spondylosis has gradually become a high-incidence and common disease in modern society, and this concept is widely used by doctors and patients. Traditional methods divide cervical spondylosis into nerve root type, myeloid type, sympathetic type and mixed type. Surgical classification of diseases is to make a clear diagnosis and choose the best treatment mode. However, with the deepening of understanding of cervical disease imaging and causes, this traditional classification is somewhat general, and it is often impossible to determine the surgical mode according to the diagnosis. In recent years, some scholars have tried to put forward some new classification methods of cervical spondylosis, in order to achieve the clear diagnosis and better selection of surgical mode according to the classification. We put forward the diagnostic classification of cervical degenerative diseases, which include: cervical disc herniation, cervical ligament ossification, cervical ligament flavum calcification, degenerative cervical spinal stenosis, degenerative neck pain, degenerative cervical instability and degenerative cervical kyphosis, among which there are sub-classifications, Basically all cervical degenerative diseases are covered.

Objective To explore the relationship between endogenous transforming growth factor (TGF) -β1 and calcification-related genes through an in vitro degeneration model by propagating rat endplate chondrocytes during a natural degeneration process. Methods Endplate chondrocytes were extracted from rat lumbar vertebrae, isolated by enzyme digestion and P2 and P4 generations selected for a 6-day in vitro culture. The specimens were photographed microscopically to observe the cellular differences by alizarin red staining. Type Ⅱ collagen marker gene, transcription factor SOX-9 gene and metabolism-related genes proteoglycan. matrix metalloproteinase (MMP)-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4 and ADAMTS-5 were detected by RT-PCR to verify the degeneration model. Based on this model, the changes of growth factor TGF-β1 and calcification-related genes ankyrin (ANK), ectonucleotide pyrophosphatase (ENPP), tissue-nonspecific alkaline phosphatase (TNAP) were continuously tested. Results Compared with P2 cells, P4 cells tended to assume a spindle-shaped morphology. And alizarin red staining showed no change between them. The level of transcription factor SOX-9 of P4 cells( P4/P2 =0. 0690, P =0. 0489 ) was significantly lower than that of P2 cells. Type Ⅱ collagen ( P4/P2 = 0. 0535, P = 0. 009 ) and proteoglycan ( P4/P2 = 0. 2672, P = 0. 0343 ) were also significantly lower than those of P2 cells. No significant changes were observed in other metabolism-related genes. TGF-β1 ( P4/P2 = 0. 5934, P =0.0482) was significantly lower. The expressions of TNAP( P4/P2 = 0.0385, P =0.0139) and ANK (P4/P2 =0. 2121, P =0. 0009) were significantly lower. But ENPP showed no significant change. Conclusion P4 endplate chondrocytes undergo natural degeneration in vitro with the rising passage number. Type Ⅱ collagen, SOX-9 and proteoglycan are significantly reduced. Endogenous TGF-β1 gene and calcificationrelated genes are down-regulated. The decrease of ANK gene may be caused by the down-regulation of endogenous TGF-β1. Modulating the expression of endogenous TGF-β1 gene in endplate chondrocytes may become a new therapeutic approach for the degeneration of intervertebral disc.

Objective To build an effective nonlinear three-dimensional finite-element (FE) model of T11 - L3 segments for a further biomechanical study of thoracolumbar spine. Methods The CT ( computed tomography) scan images of healthy adult T11 - L3 segments were imported into software Simpleware 2. 0 to generate a triangular mesh model. Using software Geomagic 8 for model repair and optimization, a solid model was generated into the finite element software Abaqus 6. 9. The reasonable element C3D8 was selected for bone structures. Created between bony endplates, the intervertebral disc was subdivided into nucleus pulposus and annulus fibrosus (44% nucleus, 56% annulus). The nucleus was filled with 5 layers of 8-node solid elements and annulus reinforced by 8 crisscross collagenous fiber layers. The nucleus and annulus were meshed by C3D8RH while the collagen fibers meshed by two node-truss elements. The anterior (ALL) and posterior (PLL) longitudinal ligaments, flavum (FL), supraspinous (SSL), interspinous (ISL) and intertransverse (ITL) ligaments were modeled with S4R shell elements while capsular ligament (GL) was modeled with 3-node shell element. All surrounding ligaments were represented by envelops of 1 mm uniform thickness. The discs and bone structures were modeled with hyper-elastic and elasto-plastic material laws respectively while the ligaments governed by visco-elastic material law. The nonlinear three-dimensional finite-element model of T11 - L3 segments was generated and its efficacy verified through validating the geometric similarity and disc load-displacement and stress distribution under the impact of violence. Using ABAQUS/EXPLICIT 6. 9 the explicit dynamic finite element solver, the impact test was simulated in vitro. Results In this study, a 3-demensional, nonlinear FE model including 5 vertebrae, 4 intervertebral discs and 7 ligaments consisted of 78 887 elements and 71 939 nodes. The model had good geometric similarity under the same conditions. The results of FEM intervertebral disc load-displacement curve were similar to those of in vitro test. The stress distribution results of vertebral cortical bone, posterior complex and cancellous bone were similar to those of other static experiments in a dynamic impact test under the observation of stress cloud. Conclusion With the advantages of high geometric and mechanical similarity and complete thoracolumbar, hexahedral meshes, nonlinear finite element model may facilitate the impact loading test for a further dynamic analysis of injury mechanism for thoracolumbar burst fracture.

Objective To explore the clinical feasibility, approach, efficacy and indications of posterior fusion plus pedicle screw fixation in the treatment of combination atlantoaxial fractures. Methods A retrospective analysis was conducted for 26 cases of Jefferson and dens fracture treated with atlantoaxial pedicle screw from June 2008 to May 2010. Results The postoperative radiographs verified an excellent position of all screws with a satisfactory atlantoaxial reduction. Operative time was (126 ± 26) min, and blood loss was (350 ± 107) ml. During an average follow-up period of 14 months (range:6 -28), it showed no spine cord and vertebral artery injury or interfixation failure. Atlantoaxial alignment and stability were restored without any instrumentation-related complication. Conclusion Posterior atlantoaxial pedicle screw and rod fixation may provide immediate three-dimensional rigid fixation of atlantoaxial joint. This technique is more effective than other previously reported approaches.

Objective To investigate the feasibility of a one-stage combined posterioanterior approaches for the treatment of lumbosacral tuberculous spondylitis with the patients lying in a lateral position. Methods A retrospective review was conducted for 15 patients with lumbosacral tuberculosis undergoing one-stage combined posterioanterior approaches for radical lesion resection and reconstruction. All patients were observed and evaluated by clinical and imaging studies. Results Operative posture: 11 cases for right side and 4 cases for left side. The mean operative duration was 280 min ( range :230 - 380 min) and the mean estimated volume of blood loss 1720 ml (range: 1100 -3000 ml). Imaging results: No recurrence of tuberculose focus was found until the last follow-up. Upon image reviewing, it showed no loosening or displacement except for two cases of slightly collapsed titanium mesh. Preoperative and postoperative changes in the degree of lumbar lordosis were statistically significant [( 20 ± 5 ) ° vs ( 31 ± 5 ) °, P ＜ 0. 05]. The Kirkaldy-Willis classification rating yielded satisfactory results for 13 cases. Conclusion The patients with lumbosacral tuberculosis undergoing one-stage combined posterioanterior approaches may achieve radical lesion resection, posterioanterior collaboration and reconstruction. It avoids a 2-stage operation, eliminates the need of changing a patient's body position with secondary sterilization and shortens the operative duration. Lumbosacral surgery for tuberculosis combines the respective advantages of anterior, posterior and combined posterioanterior approaches and yet makes up for their deficiencies.

Objective To evaluate the clinical therapeutic outcomes for severe burst fracture of lumbar vertebrae via a posterior approach for one-stage spinal "three-column" reconstruction. Methods An retrospective analysis of data was performed for 21 patients with severe burst fracture of lumbar vertebrae undergoing a posterior approach for one-stage spinal "three-column" reconstruction from 2005 to 2010. It was compared with previous 15 cases undergoing a staged anteroposterior approach. The operative duration,volume of blood loss, pre- and post-operative imaging measurements of kyphosis and vertebral height and nerve function recovery were evaluated. Results The values of operative duration and volume of blood loss in the one-stage posterior approach group were significantly less than those of the two-stage anteroposterior approach group [(263 ±72) min vs (439±75) min, t = -5.303, P＜0.01; (1143 ±296) ml vs (1471 ±399) ml, t = -2. 169, P = 0. 042 )]. Statistical significance existed in postoperative kyphosis between two groups [(0.5 ±2.0)°vs (3.9 ±2.6)°, t = -3.336, P =0.003]. Vertebral height had no statistical significance pre- and post-operatively between two groups while restoration of vertebral height did [(0.47±0.19) mm vs (0.26±0.15) mm, t=2.669, P=0.015].Conclusion Posterior approach for one-stage vertebral resection, mesh implantation, pedicle screws and rod internal fixation for reconstructing spinal "three-column" structures offers excellent feasibility and safety. And it may avoid complications associated with an anteroposterior approach for two-stage procedures. The median length of hospital stay is also reduced.

Objective To investigate the transfer strategy of low-quality embryo in in vitro fertilization and embryo transfer (IVF-ET) cycle. Methods A retrospective analysis was performed for the clinical data of 621 IVF-ET cycles under controlled ovarian hyperstimulation, including 574 fresh embryo transfer (ET) cycles (Group T1 ) and 47 frozen-thawed embryo transfer (FET) as the first ET cycles (Group C1 ). Logistic regression was used to model the probability of clinical pregnancy rate based on the cycle-specific factors. Results The clinical pregnancy rate was significantly higher in Group C1 than Group T1 [38. 3% ( 18/47 ) vs 22. 1% ( 127/574), P ＜ 0. 05]. Multivariate logistic regression analysis revealed that patient age and ET method were significantly associated with the clinical pregnancy rate. After adjusting for patient age, the clinical pregnancy rate remained significantly higher in Group C1 than Group T1 (OR:2. 107, 95% CI: 1. 128 - 3.939, P ＜0.05 ). Conclusion The use of FET instead of fresh ET may improve the clinical pregnancy rate in low-quality embryo cycles.

Objective To evaluate the efficacy and safety of argon-helium cryoablation as a salvage therapy for the failure cases of non-small cell lung cancer (NSCLC) after radiochemotherapy. Methods A total of 12 NSCLC patients ( stage Ⅲ ) with a diagnosis of recurrence after radiochemotherapy received cryoablation. The endpoint objectives were overall response rate ( RR), clinical benefit rate ( CBR), 1-year survival rate, quality of life (QOL) and safety profile. Results Among them, the overall response rate was 6/12 cases and the clinical benefit rate 7/12 cases at 12 months post-cryoablation. The 1-year survival rate was 10/12 cases. No significant complications or adverse reactions occurred during the process of cryoablation. As shown by the QOL score, the quality of life was satisfactory. Conclusion As a salvage treatment for the recurrence NSCLC cases after radiochemotherapy, cryoablation may achieve a high response rate, a favorable 1-year survival rate and a high safety profile. It has excellent prospects for clinical applications.

Objective To explore the technique of endovascular therapy for ruptured intracranial very small aneurysms and evaluate the feasibility and safety of endovascular treatment of such aneurysms. Methods Twenty-two intracranial very small aneurysms in 22 patients with subarachnoid hemorrhage undergoing endovascular therapy were reviewed retrospectively. Their clinical, imaging,interventional and follow-up data were analyzed. Among them, there were 13 males and 9 females with a mean age of 54. 5 years old. The Hunt-Hess grade was as follows:Grades Ⅰ and Ⅱ ( n = 12) and Grades Ⅲ and Ⅳ (n = 10). The locations of aneurysms were as follows: anterior communicating artery (n = 7),middle cerebral artery ( n = 2), posterior communicating artery ( n = 8 ) and internal carotid artery ( n = 5 ).All aneurysms were embolized with coils. Among them, 7 received stent assistance and 2 balloon remodeling. Results Among 22 coiled aneurysms, complete occlusion was achieved in 17 aneurysms, neck remnant occurred in 1 patient and aneurysm remnant in 4 patients. Two aneurysms ruptured during coiling and one patient died from it. One patient had transient hemiparesis. All patients received a follow-up of 3 -36months and there was no recurrent hemorrhage. Conclusion Endovascular treatment of ruptured intracranial very small aneurysms seems to be technically feasible, relatively safe and practically effective. An appropriate selection of interventional materials and use of sophisticated techniques yield an excellent outcome.

Objective To investigate the effect of incretion hormones on growth pituitary adenoma ectomy patients and evaluate its long-term therapeutic efficacy. Methods A total of 38 growth pituitary adenoma patients were treated by adenoma ectomy between 2002 to 2009 at our hospital. The dynamic concentrations of serum prolactin (PRL), growth hormone (GH), cortisone, adrenocorticotrophic hormone (ACTH) and thyroid function (T3, T4 & thyroid-stimulating hormone) were monitored before and after microsurgery. All cases had been followed up for over one year to evaluate the long-term therapeutic efficacy.Results The level of GH decreased markedly within one week after ectomy [(2. 49 ± 0. 22 ) μg/L vs (9. 24 ±0. 56) μg/L,P ＜0. 05]and remained stable afterwards. Among 22 cases of GH-secreting pituitary adenoma with total removal, the post-operative level of GH dropped below 2. 5 μg/L in 11 cases but the other 11 cases did not. And 3 cases were recurrent within 3 years post-operation. Conclusions The GH level at Week 1 post-operation is one of the major indicators for evaluating the efficacy of surgery. And the level of GH dropping below 2. 5 μg/L at Week 1 post-operation may be used as a standard for clinical cure.

Objective To compare the different effects in fetus and puerpera with an equivalent dose of ephedrine (E) and phenylephrine ( Ph ) for maintaining maternal blood pressure near baseline during spinal anesthesia for a cesarean delivery. Methods Ninety mature parturient women with single-embryo scheduled for an elective cesarean delivery under spinal anesthesia at our hospital during January - June 2010 were randomly divided into 3 groups (E, E + Ph and Ph, n =30 each). Group E received an infusion of ephedrine (ephedrine 4 g/L), Group E + Ph ephedrine plus phenylephrine (ephedrine 2 g/L + phenylephrine 25 mg/L) and Group Ph phenylephrine (phenylephrine 50 mg/L). The blood pressure was maintained near baseline by adjusting the infusion rate during anesthesia. The maternal blood pressure, heart rate and fetal heart rate were measured at the time points of 1, 3, 5 and 10 min, skin incision and uterine incision after injecting anesthetic into subarachnoid space. Immediately after delivery, maternal arterial, umbilical arterial and umbilical venous blood samples were withdrawn for the measurements of blood gases and plasma concentrations of lactate and glucose. Results The fetal heart rate of groups E and E + Ph significantly increased after infusion[5 min: ( 150 ± 10) times/min vs( 142 ± 13) times/min, ( 146 ± 10)times/min vs( 142 ± 9 ) times/min, both P ＜ 0. 05]while those of group Ph had no significant changes [5 min: ( 143 ± 9 ) times/min vs ( 143 ± 6 ) times/min, P ＞ 0. 05]. The incidence of fetal tachycardia in groups E and E + Ph was greater than that in group Ph. In group E, umbilical arterial and umbilical venous pH and base excess were lower than those in groups E + Ph and Ph [umbilical arterial: 7. 20 ± 0. 10 vs 7.27 ± 0. 05,7. 28 ± 0. 03, ( - 3. 1 ± 3. 1 ) mmol/L vs ( - 0. 9 ± 1.7 ) mmol/L、 ( - 0. 3 ± 1.7 ) mmol/L,umbilical venous:7.29 ±0. 09 vs 7. 34 ± 0. 03,7.34 ± 0. 03, ( - 3.3 ± 2. 9 ) mmol/L vs ( - 2. 0 ± 1.7 )mmol/L,(-0.9 ±1.5) mmol/L, all P ＜ 0.05]. Umbilical arterial PCO2 and plasma concentrations of lactate and glucose in group E were greater than those in group Ph ( all P ＜ 0. 05 ). Umbilical arterial and umbilical venous plasma concentrations of lactate and glucose were greater in group E + Ph than those in group Ph( all P ＜ 0. 05 ). But base excess was lower( P ＜ 0. 05 ). Conclusion Phenylephrine may be more ideal for treating the hypotension of spinal anesthesia for a cesarean delivery. It corrects hypotension following spinal anesthesia, improves fetal oxygen supply and demand balance but induces no metabolic excitation in fetus as compared with ephedrine.

Objective To explore the technical success rate, efficacy, overall survival, recurrencefree survival and prognostic factors of transcatheter arterial chemoembolazition (TACE) plus thermal ablations of radiofrequency ablation (RFA) and microwave ablation (MWA) in the patients with large hepatocellular carcinoma (HCC). Methods Forty-five cases with Child-pugh class A, B cirrhosis and large HCC with a maximum tumor between 5.0 cm to 10. 0 cm underwent TACE and thermal ablation. Twenty-five patients received TACE plus RFA while the other 20 patients underwent TACE plus MWA. Their efficacy,long-term survival and prognostic factors were statistically analyzed. Results TACE plus thermal ablation were performed in 84 tumors with a successful rate of 100% (86/86) and a complete ablation rate of 94. 0%(79/84). The major complication rate was 6. 7% (3/45). Local and distant recurrence rates were 66. 7%(30/45) and 71.1% (32/45) respectively. The 1 and 2-year recurrence-free survival rates were 26. 7%( 12/45)and 13. 3% ( 6/45 ). And the 1, 2 and 3-year survival rates were 80. 0% ( 36/45 ), 33. 3%(15/45) and 6.7% (3/45) respectively. Univariate and Cox regression analyses indicated that tumor size ＞7. 0 cm, multi-nodularity, incomplete necrosis and pretherapy α-fetoprotein (AFP) ≥200 μg/L were 4unfavorable prognostic factors for the long-term survival. Conclusion The combined procedures of TACE and percutaneous thermal ablation are both safe and effective for the unresectable large HCC ( ＞ 5.0 cm). It represents an alleviative treatment for those patients with tumor size ＞7. 0 cm. Tumor size, tumor number,completeness of necrosis and AFP level are all significant prognostic factors.

Objective To investigate the integrity of white matters in first-episode and chronic schizophrenics. Methods For this study, 39 first-episode and 38 chronic schizophrenics, 69 healthy controls (age, gender and years of received education no significantly different from those of the patients)underwent diffusion weighted images with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. The fractional anisotropy (FA) images of three groups underwent one-way ANOVA with the methods of voxel-based morphometric (VBM) analysis. Results ( 1 ) There were three brain regions where the FA values of white matter were different among three groups: right caudate nucleus ( MNI:20, 12,14; cluster = 432 voxels; FA value :0. 36 ± 0. 18 vs 0. 35 ± 0. 24 vs 0. 38 ± 0. 17 ), left insula ( MNI: - 32,18, 2; cluster =204 voxels; FA value:0. 35 ±0.31 vs 0.33 ±0.24 vs 0.36 ±0.21) and right anterior cingulated( MNI: 16, 36, 12; cluster = 132 voxels;FA value:0. 35 ±0. 29 vs 0. 34 ±0. 31 vs 0. 37 ±0. 25).(2)The mean FA values of the three brain regions of two patients groups decreased versus those of healthy controls (P ＜0. 05 ). (3)The mean FA values of left insular region in chronic patients decreased versus those of the first-episode patients ( P ＜ 0. 05 ). Conclusion The reduced integrity of white matter may play an etiological role in schizophrenia and the changes are probably progressive.

Objective Our previous studies found that 100 μg/ml oxidized low-density lipoprotein (ox-LDL) could up-regulate the autophagic level in human umbilical vein endothelial cells (HUVEC). The present study was conducted to observe the roles of oxidative stress and lectin-like oxidized low density lipoprotein-1 ( LOX-1 ) in the ox-LDL-induced up-regulation of autophagy. Methods Prior to the ox-LDL exposure, LOX-1mAb, vitamin C and vitamin E were used to study the roles of LOX-1 and oxidative stress in the activation of autophagy. The contents of total-superoxide dismutase (T-SOD) and MDA (malondialdehyde) in the culture medium were detected with enzyme linked immunosorbent assay. Western blot was employed to detect the levels of autophagic marker microtubule-associated protein light chain 3 ( MAP1-LC3 ) - Ⅱ/LC3- Ⅰ , beclinl and lysosome associated membrane protein 2a (lamp2a). Results After the ox-LDL exposure, the down-regulated level of T-SOD [0. 5 h (32. 73 ± 1.09 vs 40. 16 ± 1.28) U/ml,P ＜0. 01; 6 h ( 29. 32 ± 1.56 vs 40. 16 ± 1.28 ) U/ml, P ＜ 0. 01]and the up-regulated level of MDA [0.5 h(1.11 ±0.04 vs 0.57 ±0.05) nmol/ml, P＜0. 01; 6 h (0.69 ±0.03 vs 0.57 ±0.05) nmol/ml,P ＜0. 05]in culture medium were also significant at 0. 5 h and 6 h. The ox-LDL-induced increased ratio of LC3- Ⅱ/LC3- Ⅰ was reversed by the pretreatments of vitamin C and vitamin E (0. 5 h, vitC:3. 11 ±0. 02 vs 4.31 ±0.50, P＜0. 05; vitE: 3.46 ±0. 19 vs 4.31 ±0.50, P ＜0.05;6 h,vitC: 1.44 ±0.05 vs 2.31 ±0. 16,P ＜0. 05 ), but not LOX-1mAb. LOX-1 mAb decreased the ox-LDL-induced elevated level of lamp2a protein while vitamin C and vitamin E only inhibited the elevation of lamp2a at the timepoint of 6 h, but not 0. 5 h. Conclusion Oxidative stress, rather than LOX-1, plays an important role in the ox-LDL-induced upregulation of autophagy in HUVEC. The formation of autolysosomes is associated with the LOX-1-mediated endocytosis of ox-LDL. Oxidative stress only plays a minor role in the formation of autolysosomes induced by the engulfed ox-LDL.

Objective To investigate the mechanism of myocardialization of proximal outflow tract septum and its effect on the conotruncal anomaly in mice. Methods The C57/BL6 mice of embryonic day (E) 1 1. 5 - 16. 5 were selected. The phenotypes of connexin 43 ( Cx43 ) homozygotes ( Cx43 -/- ),heterozygotes (Cx43+/-) and wild-types (Cx43+/+) were genetically typed by polymerase chain reaction (PCR). Bone morphogenetic protein receptor 2 (Bmpr2) and α-sarcomeric acti (α-SCA) were detected by immunohistochemistry. Results The expression of α-SCA in the proximal outflow tract (OFT) septum was delayed obviously in Cx43 -/- predominantly at E13.5 and E14. 5. From E11. 5 to E13. 5, the expression of Bmpr2 was detected in cardiac atrium and epicardium of Cx43+/+ fetal heart. And Bmpr2 was slightly expressed in ventricular muscle of Cx43 +/+ fetal heart. And it was expressed slightly only in cardiac atrium and epicardium of Cx43 +/- and Cx43 -/- fetal heart. From E14. 5 to E16. 5, its expression was detected obviously in cardiac atrium, epicardium, endocardium, trabeculum, ventricular muscle and OFT septum of Cx43 +/+ fetal heart. At E14. 5, its expression was detected obviously in cardiac atrium, epicardium,endocardium and trabeculum of Cx43 +/- and Cx43 -/- fetal heart while none in ventricular muscle and OFT septum. At E15.5 and E16.5, its expression was detected obviously in cardiac atrium, epicardium,endocardium, trabeculum, ventricular muscle and OFT septum of Cx43 +/- and Cx43-/- fetal heart. Its expression was also detected obviously in OFT septum of Cx43 +/- and Cx43 -/- fetal heart with incompleted myocardialization. Conclusion Cx43KO embryonic mice exhibit delayed myocardialization. As compared with the Cx43 +/+, the expression of Bmpr2 in proximal OFT septum was delayed obviously in Cx43 +/- and Cx43 -/- mice. And the expression of Bmpr2 is abnormal in OFT septum of Cx43 +/- and Cx43 -/- fetal heart. Bmpr2 may be involved in the interaction between epicardium and myocardium. It may be a critical mechanism in the maturation process of cardiac muscles.

Inflammatory bowel disease (IBD) occurs through an intricate interaction between genetics, immune response and environmental factors.This interaction can be reflected by altered expression levels of multiple genes in the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). Although IBD has a heterogeneous phenotype, the same pathways exist in the known pathophysiological mechanisms of UC and CD.

The survey showed that 16% of diabetic patients had painful diabetic neuropathy, of which 12.5% had not been diagnosed, and 39% had not been treated. Moreover, there has been a lack of a formal and detailed treatment guideline on how to treat it reasonably.

Smoking can cause chronic obstructive pulmonary disease (COPD), leading to emphysema and increasing the total lung volume. High-resolution CT (HRCT) examination found that smoking can also cause pulmonary interstitial abnormalities. The appearance of pulmonary interstitial abnormalities may reduce the degree of emphysema and the increase of total lung volume in patients, but the relationship between emphysema and pulmonary interstitial abnormalities is still unclear. March 10, 2011<New England Journal of Medicine published a related research article (N Engl J Med, 2011, 364: 897-906). 2508 patients aged 45-80 years with smoking index ≥10 packs per year were enrolled in 21 medical centers recruited from November 2007 to April 2010. Among them, 1867 cases (74.4%) were Caucasian and 641 cases (25.6%) were Black. According to the recommended standards of American Thoracic Association and European Respiratory Disease Association, the lung function of the patients was tested, and HRCT was performed in deep inspiration and calm expiration positions.

A 46-year-old male was admitted to the Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology on June 14, 2010 due to "abdominal distension for half a month and vomiting for half a month". On January 25, 2010, he was admitted to a provincial tertiary hospital due to "abdominal distension for half a month". The physical examination in the hospital showed obvious abdominal bulge, mobile voiced sound (+), and no abnormalities were found in the three routine examinations, large biochemistry, coagulation function, serum tumor markers, complete set of hepatitis virus, tuberculosis antibody, chip and chest radiograph. The erythrocyte sedimentation rate was 32 mm/1 h, and two ascites examinations showed yellow and slightly turbid, Li Vanta test was positive, white blood cells were 100×106/L, lymphocytes were 0.75, total protein was 40.4g/L, cholesterol was 2.31 mmol/L, adenosine deaminase (ADA) was 6 U/L, and carcinoembryonic antigen (CEA) was 14.5 mg/L.

With<The patent application for hepcidin in the treatment of osteoporosis in perimenopausal and postmenopausal women was launched in the United States [1], and the curtain of using the intervention method of iron overload to treat some osteoporosis has begun to gradually open.

Sacroiliac joint complex injury is the main cause of vertical instability of pelvic fracture, and the clinical effect of conservative treatment is not good [1]. However, there are many fixation methods for sacroiliac joint complex injury, and the effect is uneven [2]. We used minimally invasive double locking support plate to treat sacroiliac joint complex injury, with short operation time, relatively small trauma, simple operation and good fixation effect.