Acupuncture Therapy ; Analgesia ; Animals ; Brain Chemistry ; Morphine ; pharmacology ; Opium ; analogs & derivatives ; antagonists & inhibitors ; Rats

Objective To evaluate the clinical effect of the free-hand cervical pedicle screw fixation in treatment of the upper cervical fracture and instability.Methods A retrospective review was performed on 15 patients with upper cervical fracture and instability treated with cervical pedicle screw fixation and fusion from September 2006 to January 2009.There were 11 males and 4 females,at average age of 41.2 years(range,18-60 years).Of all,there were five patients with atlas fracture and dislocation(including three simple anterior arch fractures and two Jefferson fractures),three with axis fracture and dislocation,one with dens fractures plus nonunion,two with C2,3 fracture and dislocation and four with atlantoaxial instability without fracture.The main clinical complaints included local neck pain and/or tetraplegia.Halo traction was recommended to restore the cervical sequence preoperatively in all patients.All 15 patients were treated by cervical pedicle screw-rods internal fixation and bone graft fusion.During the operation,the point and angle of the implanted pedicle screws were determined by preoperative X-ray and CT scan and the bony channel drilled with free-hand before implantation of the Summit or Vertex pedicle screws(22-26 mm long)and posterior interlaminar autologous or allogeneic bone fusion.Patients could get out of bed with neck collar at days 1-2 after operation.Results A total of 64 cervical pedicle screws were implanted in all 15 patients,with no vertebral artery injury,spinal cord injury or cerebrospinal fluid leakage.Postoperative X-ray and CT scan confirmed satisfactory internal fixation.The clinical symptoms were improved significantly.Fourteen patients were followed up for 12-36 months,which showed bony fusion,with no looseness or breakage of the screws.Neurologic impairment was improved in all patients,with no complications associated with the cervical pedicle screw.Conclusions Cervical pedicle screw internal fixation can reestablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function and hence is a reliable method for upper cervical fracture and/or instability.

The manipulation and direct mechanical measurement of single DNA molecule could give much information about its elastic properties. Single stranded DNA (ssDNA) of 100 bases was adsorbed onto flat gold surface fabricated by depositing gold onto mica surface. Atomic force microscope (AFM) was used to observe the surface topography with different ssDNA concentration. Then the ssDNAs were stretched by AFM tip and in 50% cases ssDNAs could be stretched.Various kinds of force curves have been observed due to the different interaction between AFM tip and ssDNAs.

Objective To discuss the value of thoracolumbar injury classification and severity score (TLICS) and load-sharing scores in guiding selection of the indications of combined anteroposterior surgery for thoracolumbar fractures. Methods A total of 216 patients with thoracolumbar fractures treated surgically from January 2006 to January 2008 were involved in the study. Combined anterior and posterior surgery was carried out in 48 patients including 32 males and 16 females (at average age of 39 years, range 18-55 years). Segments involved T11 in two patients, T12 in eight, L1 in 20 and L2 in 18. According to the classification of Magerl, there were 20 patients with type B1 fractures, 15 with type B2, four with type C1 and nine with type C2. Neurologic status based on ASIA classification was at grade A in five patients, grade B in 16, grade C in 16, grade D in nine and grade E in two. All patients were operated in lateral position at one stage within 14 days after injury, with posterior laminectomy and pedicle fixation, anterior corpectomy, reduction and strut graft. Forty-five patients were followed up for 14-38 months. Plain X-ray radiographs and reconstruction CT were taken to observe the bone healing. Local kyphosis and vertebral canal were also measured. All the patients were evaluated with TLICS and load-sharing scores. Results Lumbar physical lordosis was reconstructed, with no evident correction loss,pseudoarthrosis or implant failure noted during follow-up. The patients treated with combined surgery had TLICS score ≥5 points, load-sharing scores ≥7 points and were combined with posterior ligamentous complex injury, so the fracture could not be sufficiently decompressed and reconstructed with single anterior or posterior surgery. Of all, 45 patients were followed up for 14-38 months (mean 25 months), which showed that all the combined surgeries were performed successfully, with bone fusion and neurological status improved for at least one ASIA grade. No complications like implant breakage, loosening, titanium mesh displacement or subsidence were observed. Conclusions LICS is basically helpful for guiding selection of combined surgery, but does not well evaluate the canal compromise, to which the load-sharing scores can supplement. These two evaluation systems should be applied together. The anteroposterior surgery can be recommended when the patients are with TLICS≥5 points, load-sharing score ≥7 points and combined with ligament complex injury.

Objective To explore and evaluate the clinical significance of pressure-controlled discography in diagnosis of discogenic low back pain.Methods From July 2008 to October 2009,pressurecontrolled discography under C-arm guidance was taken in 52 patients with suspected discogenic low back pain,including 83 degenerative discs and 52 good discs.Based on the pressure of discography inducing pain,the discs were divided into 4 groups:pressure ≤ 30 psi,30 psi＜pressure ≤50 psi,50 psi＜pressure≤70psi,and pressure＞70 psi.By using SPSS 11.0 statistical software,the correlation of pressure of discography and morphologic representation was analyzed.Results Among 83 degenerative discs,positive discography was detected in 46 discs.During discography,the pressure of positive degenerative discs was (36.5±15.7)psi; the pressure of negative degenerative discs was (50.5±26.2) psi,and the normal discs’ pressure was (98.6±3.7) psi.A significant difference could be found between the mentioned three groups.Among different pressure groups,the positive rate were analyzed by x2 test,and a significant difference was found as well.But no significant difference was found between the group of less than 30 psi and group of 30 to 50 psi.According to Adams’ morphological classification of discography,the pressure of disc varied from 30 to 50 psi in grade Ⅲ,while less than 30 psi in grade Ⅳ.There was a significant difference of discography pressure between discography positive grade Ⅲ and grade Ⅳ.Conclusion The pressure-controlled discography is valuable for clinical diagnosis of discogenic low back pain.The morphological classification of discs could indicate the degree of the disruption of annular fibrosus.

Objective To evaluate the mid-term clinical and radiographic results of artificial disc replacement (ADR) for discogenic low back pain.Methods From July 2004 to July 2007,21 patients with discogenic low back pain,aged from 26 to 67 years,underwent lumbar ADR with the Charité Ⅲ artificial disc at 22 levels and Activ L prosthesis at 2 levels:L4-5 5 cases,L5S1 13 cases,L4-5 and L5S1 3 cases.The diagnosis was proved by discography in all the patients.The clinical and radiographic results were evaluated and compared between pre-,post-operation and finial follow-up.Results All patients were followed up for 4to 7 years (average,5.1 years).There were statistical differences between pre-operation and final follow-up in Oswestry disability index and Visual Analogue Scale for back pain and leg pain.All the prostheses were mobile without dislocation,breakage,subsidence or spontaneous fusion,only a slight scoliosis was noted in one patient.At the ADR levels,the anterior and posterior intervertebral height increased averagely 6.3 mm and 1.9 mm respectively,the lordosis increased 2.9°,and the mean range of motion (ROM) was 4.6°.At the adjacent level proximal to ADR,the intervertebral height and lordosis decreased slightly,and the ROM decreased 2.5°.The total lumbar lordosis increased 7.8°,and the total lumbar ROM increased 2.4°.According to MRI and CT scans,the degeneration of proximal adjacent disc and facet were not evident,however the degeneration of facets at the ADR levels was evident.Conclusion The 5 years results of ADR for discogenic low back pain were satisfactory,with preserved motion at the ADR level,and the degeneration of adjacent level was not evident.However,there was obvious degeneration in facet joints of the ADR level.

Objective To explore the clinical significance and operational methods during extended radical excision for pancreatic cancer combined with portal vein ( PV )/superior mesentery vein ( SMV ) resection,and to investigate the management of iatrogenic arterial injury. Methods Clinical date of 242 patients with pancreatic cancer undergoing extended radical excision were retrospectively analyzed. All cases were divided into three groups, patients with PV/SMV resection were in group A (n = 51 ), patients with iatrogenic arterial injury during operation were in group B(n =5) ,patients without resection of vessels werein group C (n = 186 ). Operating time、volume of intraoperative blood transfusion, time of vascular interruption、the mean hospitalization,postoperative complications and postoperative survival analysis among three groups were compared with each other. Results Operating time in group A、B and C were (442. 85 ± 102. 32 ) min, ( 348. 62 ± 92. 31 ) min and ( 315.00 ± 83.43 ) min respectively, volume of intraoperative blood transfusion were ( 1430. 83 ± 1092. 43 ) ml、( 1420. 22 ± 794. 41 ) ml and ( 928. 19 ±571.57) ml respectively,operating time and volume of intraoperative blood transfusion were of significantly difference(P <0. 05) among the 3 groups,there was no significant difference in the mean hospitalization and postoperative complications. The postoperative median survival period was 18.4 months for patients of pancreatic adenocarcinoma with PV/SMV resection, the postoperative median survival period was 16. 1 months without PV/SMV resection, there was no significant difference between these by postoperative survival analysis. In the 51 cases with vessel resection,7 cases underwent partial resection of the vascular wall,44 cases underwent segmental resection, reconstruction of the portal vein was performed by end-to-end anastomosis in 38 patients, stent graft in 6 cases, the mean length of the PV/SMV resection was (2. 92 ±1.35 ) cm; latrngenic arterial injury occurred during operation in 5 patients ( 1 in hepatic artery, 1 in superior mesenteric artery, 3 in celiac think), the artery was reconstructed by end-to-end anastomosis in 4 cases,repair in 1 case. Conclusions Active and reasonable operation for pancreatic cancer with PV/SMV resection is important for improving the rate of surgical resection and the quality of life. Because of complex topography,iatrogenic vascular injury may happened frequently.

AIM: To measure the tear film thickness when with a good fitted night wear orthokeratology lens in youth, and observe the change of corneal parameters.

METHODS: From July 2015 to August 2016, 51 eyes of 26 teenagers with myopia who would wear orthokeratology and accept regular follow-up were enrolled. The mean spherical equivalent refraction of teenagers was -2.78D±1.53D(-1.00D to-6.00D)before wearing orthokeratology, and the mean astigmatism was 1.29D±0.61D(0 to -2.68D). The tear film thickness were measured by optical coherence tomography(OCT)when the eyes wearing orthokeratology for 1mo. The surface regularity index(SRI)value was measured by corneal topography to compare its relationship with the tear film thickness and the changes of corneal anterior surface parameters during the period of wearing lens were observed.

RESULTS: At 1mo after wearing orthokeratology, the mean tear film thickness of right eyes was 230.09±10.40μm, and that was 224.38±10.57μm of left eyes. The mean tear film thickness was 228.75±9.66μm in male eyes and that was 224.80±6.74μm in female eyes. The mean tear film thickness of all eyes was 227.05±10.29μm, and the mean SRI value was 0.16±0.14. There was no correlation between tear film thickness and SRI value(P>0.05). The FK value, SK value and average K value from before wearing to after wearing for 2d and 1wk gradually decreased, the difference was statistically significant(P<0.05). There was no statistical difference among wearing for 1wk, 1, 3 and 6mo(P>0.05).

CONCLUSION: OCT can be used as a safe and reliable method for measuring the thickness of the tear film space during the wearing of orthokeratology, which may be of certain value for the safety assessment of the long term wearing of orthokeratology. Orthokeratology works very quickly, corneal curvature decreases rapidly 2d after wearing and stabilizes during the period.

OBJECTIVETo study the correlation between hepatocellular carcinoma (HCC) and serum Golph2 protein.

METHODSGolph2 gene was cloned by RT-PCR using RNA from WBF44 cell line as template, the point mutations of the cloned sequence were corrected by PCR, then the gene (1206 bp) was cloned into pET-21 plasmid, and the resulted plasmid was transformed into E.coli DH5a. The expression of 6xHis and Golph2 fusion protein was induced by isopropylthio-beta-D-galactoside (IPTG). The expression of fusion protein was detected by SDS-PAGE and Western blot, and was purified by Ni NTA chelating agarose. The rabbit antibody against Golph2 protein was obtained by immunizing 2 rabbits with the purified Golph2 protein. The specificity and titer of the antibody was determined by Western-blot and ELISA respectively. Sandwich ELISA was used to detect the level of serum Golph2 protein.

RESULTSThere were two replacement mutation and 1 deletion mutation in the cloned sequence contrasted to NM177937 in Genbank, including 644(T-->C, L-->P) , 970 (G-->A, V-->I) and 802 G deletion. The sequence was completely reversed by PCR. The sequence of Golph2 gene cloned into expression vector was confirmed by DNA sequencing. SDS-PAGE and Western blot analysis showed that Golph2 protein was expressed in E.coli DH5a. The antiserum could bind to the 52 kD recombinant protein and serum 73 kD protein specifically. The mean A450 value of ELISA for serum Golph2 protein were significantly higher in HCC and other liver diseases than that in control groups. The sensitivity and specificity for HCC were 44.5% and 82.0%, respectively, at the cut off value is more than or equal to 0.40.

CONCLUSIONThe polyclonal antibody against Golph2 protein is specific. The level of serum Golph2 is significantly higher in patients with HCC and other liver diseases than that in healthy controls.

Animals ; Antibodies, Monoclonal ; analysis ; immunology ; Base Sequence ; Biomarkers, Tumor ; blood ; Carcinoma, Hepatocellular ; diagnosis ; metabolism ; pathology ; Cell Line, Tumor ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; methods ; Escherichia coli ; genetics ; Genetic Vectors ; genetics ; Humans ; Liver Neoplasms ; diagnosis ; metabolism ; pathology ; Male ; Membrane Proteins ; biosynthesis ; blood ; genetics ; immunology ; metabolism ; Molecular Sequence Data ; Polymerase Chain Reaction ; Rabbits

OBJECTIVEThe purpose of this study was to investigate the blood lead level of 3 - 5 year old children living in the cities in China and to provide scientific data for making policy on environmental lead pollution for children health protection.

METHODSSix thousand five hundred and two vein blood samples from 3 - 5 year old children in nineteen cities of nine provinces were sampled. Inductively coupled plasma-mass spectrometry (ICP-MS) were employed to determine lead level in whole blood after microwave digestion for sample preparation and questionnaire survey was also performed. Data were analyzed with multiple regression on factors which affecting blood lead levels.

RESULTSResults showed that mean blood lead level was 88.3 micro g/L for 3 - 5 year old children living in the cities in China and mean blood lead level of boys (91.1 micro g/L) was higher than that of girls (87.3 micro g/L). Twenty-nine point nine one per cent of the children's blood lead level exceeded 100 micro g/L. The research finding showed: (1) higher blood lead levels had negative effects on children's physical growth, language ability etc. (2) behavior of parents had certain effects on children's blood lead levels. (3) blood lead levels of children were affected by unhealthy habits.

CONCLUSIONSProblem of childhood lead poisoning in China has become more serious. During the past ten years, blood lead levels of children has been increased in China while decreasing in developed countries. Blood lead levels of children in China are higher than that of developed countries, which called for special concern by government and society.

Child, Preschool ; China ; Environmental Pollutants ; blood ; Female ; Humans ; Lead ; blood ; Male ; Mass Spectrometry ; Sex Factors ; Urban Health ; Urban Population