Objective To explore the diagnostic value of nerve root sedimentation disease to symptomatic lumbar spinal stenosis (LSS) and nonspecific low back pain(LBP).Methods One hundred and eighty lumbocrural pain patients in the People's Hospital of Binzhou from Jan.2010 to Jun.2013 were divided into LSS group and LBP group,and 90 patients in each group.The rate of nerve root sedimentation in two groups was recorded.Results There were 84 cases(93.3％) with positive nerve root sedimentation in group LSS,while 0 case in LBP group,and the difference was significant (P =0.000).The pain visual analogue score (VAS) between the two groups were no significant difference (P ＞ 0.05).The Oswestry disability index (ODI) in LSS group was (60.3 ± 5.1) ％,lower than that in LBP group (66.4 ± 6.3) ％,and the difference was statistically significant (P =0.021).Cross-sectional area (CSA) of the LSS group was (68.9 ± 7.0) mm2,lower than that in LBP group ((168.2 ± 13.8) mm2),and the difference was statistically significant (t =26.173,P =0.000).There was no significant correlation between ODI and CSA (r =0.18,P =0.098).Conclusion The nerve root sedimentation disease is higher in LSS patients and positive of sedimentation disease can serve as a diagnosed marker of LSS.

[ Objective ] To investigate the mechanism of Zhenchan Ning (ZN) for Parkinson's Disease ( PD). [Methods] Rat models of PD were established by striatal infusion of 6-hydroxy dopamine (6-OHDA) . Effect of ZN on rat rotating behavior was observed, and the contents of dopamine ( DA), homovanillic acid (HVA), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH) and glutathione peroxidase (GSH-PX) in blood and corpus striatum were also detected. [Results] As compared with those before treatment, high-dose ZN could improve the rotating behavior and decrease the rotating frequency ( P 0.05), but could decrease serum MDA content (P

Objective To establish a novel method for the determination of betaine in serum by high performance liquid chromatography with UV detection.Methods Pre-column derivatization of serum was performed directly in acetonitrile without extraction with p-bromophenacyl bromide and 18-crown-6 ether as catalyst.The p-bromophenacyl ester derivatives were then separated by Supelcosil LC-SCX, using an was 0.8 ml/min and the effluent was monitored at 259 nm. Betaine was used for preparation of standard curve and quantification with external standards.Results The linearity of this method was 6.25-200.00 μmol/L,the regression was 0.999 8.The detection limit was 3.0 μmol/L.The within-day imprecision was 1.88%-3.79% ( average 3.24% ), the between-day imprecision was 3.14%-6.76% ( average 4.39% ), the recovery rates were 95.89%-102.86% (average 99.16% ).Conclusion This method is sensitive, rapid, accurate and suitable for the research and routine clinical practice.

ObjectiveTo explore puncture point and angle of skin for unipedicular vertebroplasty by imaging measurement and combining clinical practice in order to pr vide reference for clinical work.MethodsCT images of thoracic and lumbar vertebrae of imaged with multislice helical CT were random chosen.From high to low position vertebrae of easy fracture T6 to -L5,its angle between vertebraI pedfcle stalk line and 1/3 of vertebraI body stalk line fore and median of point of intersection was measured.The angle of sternocostal joints route was also measured.At the same time the distance between site of skin puncture and spinous process was measured.ResultsThe angle between the thoracic vertebraI pedicle and sagittal section was (28.2 ± 3.8) °,the lateral distance of the spinous process was ( 31.6 ± 5.4) mm.The angle of thoracic vertebraI pedicle lateral route was (35 ± 3.4) °,the distance was ( 55.2 ± 5.3 ) mm.In the lumbar vertebrae pedicle route,the angle of L1 -L4 was (29.3 ± 5.6 ) °,the distance was (38.4 ± 4.5 )mm.Ls was (39.2 ± 3.3) °,the distance was ( 71.6 ± 6.2) mm.Combining clinical practice,the lateral distance of the spinous process in thoracic vertebraIpedicle route,the best puncture point was 30 mm,in thoracic vertebraI pedicle lateral route it was 40 mm,in L1-L4 it was 45 mm,in L5 it was 60 mm.ConclusionsThe unipedicular vertebroplasty can be performed rapidly,accurately and safely,and it reduces complications,cost and time.

To explore the effect of proton pump inhibitors (PPI) on the micro-structure of bone in older men. A retrospective study was conducted on data of patients over the age of 60 who were admitted to the Geriatric Department of Jiangsu People′s Hospital from June 2018 to January 2019. Patients were divided into control group (taking PPI for less than 1 week, 50 cases) and PPI treatment group (taking PPI for more than 3 months, 30 cases). Biochemical indexes, bone mineral density (BMD)and trabecular bone score (TBS) were analyzed. Compared with control group, the weight and albumin level in the PPI treatment group were lower, and the thyrotropin level was higher ( P<0.05). There was no statistical difference in the BMD of femur or lumbar vertebrae between the two groups ( P>0.05), but the TBS of lumbar vertebrae in the PPI treatment group was significantly decreased ( P<0.05). Correlation analysis found that TBS was positively correlated with alkaline phosphatase (ALP) ( r=0.45, P=0.002) and body mass index ( r=0.164, P=0.045), and negatively correlated with age ( r=-0.291, P=0.025). Multiple linear regression model analysis showed that there was still a positive correlation between TBS and ALP ( β=0.437, P=0.023). In the elderly men, the use of PPI for more than 3 months can significantly affect the bone micro-structure, and the bone micro-structure can better reflect the adverse effect of PPI on bone than BMD.

Objective:To observe the clinical efficacy of endoscopic submucosal dissection (ESD) in the treatment of superficial esophageal cancer (SEC), and to explore the application value of ESD in the treatment of SEC.Methods:From January 2016 to December 2019, at The First Affiliated Hospital With Nanjing Medical University, the clinical data of 368 patients with SEC and receiving ESD treatment were retrospectively analyzed, induding the general condition, the circumferential proportion of lesions, effectiveness of ESD treatment (en bloc resection rate, complete resection rate, curative resection rate, operation time and resected lesion area), incidence of complications and follow-up. 368 patients were divided into stenosis group (94 cases) and non-stenosis group (274 cases) according to the occurrence of esophageal stenosis after ESD. The circumferential proportion of lesions, operation time and resected lesion area were compared between stenosis group and non-stenosis group, and the independent risk factors of esophageal stenosis after ESD were analyzed. Independent sample t test, chi-square test and binary logistic regression analysis were used for statistical analysis. Results:Among 368 patients, 270(73.4%) were male and 98 (26.6%) were female; the age was (64.4±7.6) years old. The circumferential proportion of lesions of 231 cases (62.8%) was <1/2 circle, 49 cases (13.3%) was 1/2 to <2/3 circle, and 88 cases (23.9%) was ≥2/3 circle. The en bloc resection rate of the lesion was 98.6%(363/368), the complete resection rate and curative resection rate were both 97.8% (360/368). The operation time was (89.4±47.9) min. The area of resected lesion was (12.5±8.9) cm 2. The incidence of perforation during operation, delayed bleeding and stenosis was 0.3% (1/368), 0.5% (2/368) and 25.5% (94/368), respectively. The followed-up period was 8 to 53 months, and the median follow-up period was 25 months. During the follow-up period, no recurrence or new lesion was found, and no lymph node or distant metastasis occurred. The circumferential proportion of lesions of 38 cases (40.4%) of stenosis group and 193 cases (70.4%) of non-stenosis group was <1/2 circle, respectively, the circumferential proportion of lesions of 9 cases (9.6%) and 40 cases (14.6%) was 1/2 to <2/3 circle, respectively, the circumferential proportion of lesions of 47 cases (50.0%) and 41 cases (15.0%) was ≥2/3 circle, respectively, and the difference was statistically significant ( χ2=47.30, P<0.01). The operation time of stenosis group was longer than that of non-stenosis group, the resected lesion area was larger than that of non-stenosis group ((126.1±56.3) min vs. (76.8±37.2) min, (17.5±10.7) cm 2 vs. (10.8±7.4) cm 2), and the differences were statistically significant ( t=9.57 and 5.41, both P<0.01). The results of binary logistic regression analysis showed that circumferential proportion of lesions ≥2/3 circle, operation time and the resected lesion area were independent risk factors for the occurrence of esophageal stenosis after ESD (odds ratio=0.253, 1.018 and 1.041, 95% confidence interval 0.116 to 0.551, 1.011 to 1.025, 1.007 to 1.076, all P<0.05). Conclusions:ESD is a safe and effective way to treat SEC, with low local recurrence rate and few complications, which is worthy of further clinical promotion.

Back-shu points were firstly discussed in(the), and various location methods of back-points had been proposed by acupuncturists until conclusive method was made indynasty. In this paper, the different location methods of back-points were reviewed; based on this, the reasons of divergences among each theory on location methods were discussed, and the theoretical background and reference of the original establishment of back-points were further explored. Therefore, it was proposed that the standardized location of back-points should be just considered as the center of possible distribution range, and adjustment should be made during clinical application according to the variability of individual combined with finger pressing.

Background Procymidone (PCM) exposure can cause damage to reproductive organs of male mice, but whether its mechanism is related to the retinoic acid (RA) signaling pathway is unclear. Objective To explore the possible mechanism of PCM-induced testes damage in adolescent mice. Methods Three-week-old ICR mice (n=64) were randomly divided into a control group and three dose groups (low, medium, and high), with 16 mice in each group. PCM was administered orally at 0, 50, 100, and 200 mg·kg⁻¹·d⁻¹ for 21 consecutive days. Serum and bilateral testes in each mouse were collected to detect content of testosterone in serum and to observe histological changes in testis section after the mice were sacrificed one week after cessation of drug administration. Real-time fluorescence quantitative PCR and Western blotting were used to detect the mRNA expression abundances of genes related to the RA signaling pathway and apoptosis genes Casp9 and Casp12, and the protein expression levels of CYP26A1, ALDH2, and CASP9 respectively. Results Compared with the control group, there was no significant change in the overall appearance and testicular appearance of mice in each dose group after the PCM exposure. According to pathological section observation, the testicular seminiferous tubules of mice in the low-dose group showed slight atrophy and reduced sperm production; the testes of mice in the medium- and the high-dose groups showed obvious pathological damage (e.g. dilated lumen of seminiferous tubules, damaged spermatogenic epithelium, decreased number of spermatogonia, and partial absence of sertoli cells); as the concentration of PCM increased, the degree of spermatogenic epithelial damage in mice gradually increased and the number of spermatozoa in the seminiferous tubules decreased. There were no significant differences in the distance between the anus and the genitals, testicular mass, testicular volume, and testicular organ coefficient among the four groups of mice (P>0.05). The body weights of the mice in the low-, medium-, and high-dose groups were (34.91±1.89), (34.88±1.75), and (32.94±1.37) g respectively, and that in the high-dose group was lower than that in the control group, (35.93±1.99) g, (P<0.05); the serum testosterone concentrations were (313.77±5.32), (305.31±3.47), and (304.80±5.28) pg·mL⁻¹ respectively, which were lower than that in the control group, (319.05±1.92) pg·mL⁻¹ (P<0.05); as the dose of PCM increased, the body weight and serum testosterone concentration showed decreasing trends. The mRNA expression levels of Stra6 and Rbp1 in the high-dose group were higher than those in the control group (P<0.05); the mRNA expression levels of Aldh2, Aldh1a1, Aldh1a3, Rarα, Rar\begin{document}$\beta $\end{document}, Rxrα and Rxr\begin{document}$\beta $\end{document} in the medium-and the high-dose groups were higher than those in the control group (P<0.05); the mRNA expression levels of Cyp26a1 and Cyp26b1 in the medium- and high-dose groups were lower than those in the control group(P<0.05); the mRNA expression levels of apoptosis genes Casp9 and Casp12 in the medium-and the high-dose groups were higher than those in the control group (P<0.05). The protein expression level of CYP26A1 in each exposure group was lower than that in the control group (P<0.05), and the expression level decreased with increasing concentration of PCM; the expression level of ALDH2 protein in the medium- and the high-dose groups and the protein expression level of CASP9 in each exposure group were higher than those in the control group (P<0.05), and the levels increased with increasing concentration of PCM. Conclusion PCM can damage the testis tissues of adolescent mice, where RA signaling pathway, Casp9 and Casp12 genes, and CASP9 protein are activated.