0.05). ③The entrance point of screw was designed based on the obtained data. Sixty screws were all inserted into pedicles successfully. CONCLUSION: L1-5 superior margin root of spinous process locates in superior and inferior planes of vertebral pedicle with stable anatomic relationship; in addition, there are no significant differences between plain tomography and CT films. It provides anatomic data for pedicular operation.

Objective To evaluate the feasibility,safety and efficacy of laparoscopic appendectomy for acute appendicitis with previous abdominal surgery.Methods The clinical data of 253 patients with acute appendicitis undergoing laparoscopic surgery was retrospectively studied from Feb.2009 to Jun.2012,including 177 patients without previous abdominal surgery (no previous abdominal surgery group,NPAS group),76 patients with previous abdominal surgery (previous abdominal surgery group,PAS group).Parameters studied were conversion rates,operation time,blood loss,complications rate,length of hospital stay and the intestine function recovery time between two groups.Results The conversion rates were no significant difference between NPAS group and PAS group.The operation time of NPAS group and PAS group was (40.5 ± 12.3) minutes and (62.6 ± 14.2) minutes (P ＜0.05).The blood loss,intestine function recovery time,complications rate,and length of hospital stay were no significant minutes between NPAS group and PAS group after operation (P ＞ 0.05).Conclusions Previous abdominal surgery prolongs the operation time of laparoscopic appendectomy,but history of abdominal surgery has no significant effect on laparoscopic surgical outcome,which may indicate that laparoscopic surgery for acute appendicitis with previous abdominal surgery is safe and effective and still has the adventages of less trauma,faster recovery.

Objective To explore the clinical effect and feasibility of cold cycle microwave ablation combined with laparoscopic hepatectomy for hepatic hemangioma.Methods Thirteen cases of hepatic hemangiomas were treated with cold cycle microwave ablation combined with laparoscopic hepatictomy,and their clinical data were analyzed retrospectively from March 2015 to October 2017 in the First People's Hospital of Jiangxia District of Wuhan City,including 5 males and 8 females with an average age of 52 years and age range of 45-68 years.The course of disease was 18 months to 8 years,with an average of 4.2 years.The clinical data were retrospectively analyzed and the operation time,intraoperative blood loss,postoperative hospital stay,liver function changes and complications were recorded.The data were analyzed using SPSS 17.0 statistical software,and measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD).Results The operations of the 13 cases were successful,including 7 cases of single hepatic hemangioma (the lesions were located in segments 11,111 and Ⅳ) and 6 cases of multiple hepatic hemangioma (the lesions were located in segments Ⅱ,Ⅲ,Ⅳ,Ⅶ and Ⅷ).No hepatic portal occlusion was performed during the operation.The operation time was (135.4 ± 35.8) min,intraoperative blood loss was (95.2 ± 22.7) ml,the postoperative hospital stay was (6.4 ± 0.8) d.On the first postoperative day,alanine aminotransferase was (354.2 ± 75.4) IU/L,and aspartate aminotransferase was (382.7 ± 68.5) IU/L,during the first week after surgery,alanine aminotransferase and aspartate aminotransferase both decreased to the normal range,and no serious complications such as bile leakage or hemorrhage occurred after surgery.No recurrence was observed after 6 to 12 months of follow-up.Conclusions Under the premise of strict control of surgical indications,laparoscopic cold-circulation microwave ablation combined with hepatectomy for hepatic hemangioma is safe and feasible.It can simultaneously treat multiple lesions,and cold-cycle microwave ablation can effectively reduce intraoperative bleeding with a minimally invasive effect.

Objective To explore the clinical characteristics of and surgical strategies for distal tibiofibular syndesmosis separation based on ankle axial CT scan.Methods From January 2009 to January 2016,63 patients with injury to the distal tibiofibular syndesmosis were treated.Their injuries were characterized according to the anatomic characteristics on their ankle axial CT scan images as pronation-extorsion type (28 cases),supination-extorsion type (11 cases) and abduction type (24 cases).Specific strategies of reduction and fixation depended on the specific characteristics of distal tibiofibular syndesmosis separation.After 12 months postoperatively,the reduction quality was assessed by Burwell-Charnley's radiological evaluation system and the function of ankle joint was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score system.Results The patients were followed up for 6 to 48 months (average,19.3 months).Anatomical reduction was achieved in 19 cases,good reduction in 7 and fair reduction in 2 in the pronation-extorsion type,yielding an excellent to good rate of 92.8％;anatomical reduction was achieved in 6 cases,good reduction in 4 and fair reduction in one in the supination-extorsion type,yielding an excellent to good rate of 90.9％;anatomical reduction was achieved in 17 cases,good reduction in 6 and fair reduction in one in the abduction type,yielding an excellent to good rate of 95.8％.By the AOFAS system,the pronation-extorsion type scored 88.6 points,the supination-extorsion type 89.4 points and the abduction type 86.6 points.Conclusion In the treatment of distal tibiofibular syndesmosis separation,reduction and fixation strategies should depend on analysis of the characteristics on the ankle axial CT scan,so as to achieve positive outcomes.

Objective To observe the effectiveness of injecting mouse nerve growth factor ( mNGF) on the recovery of hand motor function among patients with cubital tunnel syndrome. Methods A total of 138 patients with moderate to severe cubital tunnel syndrome were randomly divided into groups designated as A, B and C, each of 46. Twenty micrograms of mNGF was injected daily 1 mm from the ulnar nerve at the cubital tunnel for the patients of group A and the injection site was moved 1 mm distally everyday along the nerve , but injected intramuscularly for those in group B. Those in group C received 500 μg of mecobalamin injected intramuscularly 3 times a week. The whole intervention consisted of two 4-week phases, with an interval of 2 months. Before and after the intervention, the function of internal hand muscles, hand function recovery rates and any electrophysiological changes in the ulnar nerve were measured and compared between the two groups. Results All of the patients showed significant improve-ment in hand muscle function and neuroelectrophysiology. The incidence of had muscle atrophy, Tinel′s sign, posi-tiveness in the paper clamping test and claw hand all significantly improved compared with before the treatment in all three groups. The average Disability of Arm Shoulder and Hand score in group A after the treatment was significantly higher than the group B and group C averages. The average ulnar nerve conduction velocity, incubation period and amplitude of group A after the treatment were all significantly better than before the treatment and better than the other groups′averages. After the treatment, the average hand function recovery in group A reached 91％, significantly high-er than in groups B ( 76％) and C ( 59％) . Conclusion Injecting mNGF next to the ulnar nerve is superior to in-jecting it intramuscularly in promoting the recovery of the ulnar nerve and hand function for patients with moderate to severe cubital tunnel syndrome.

Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.

Objective: To investigate the correlation between takeaway food consumption and poor sleep status of college students in Jiangxi Province, to provide a theoretical basis for poor sleep prevention and intervention among college students. Methods: A total of 2 610 college students were selected from a university in Shangrao City, Jiangxi Province by cluster stratified random sampling in May of 2018. The frequency and type of takeaway food consumption, sleep quality and drowsiness were investigated. Results: The detection rate of takeaway food consumption behavior(≥4 times in a week) for college students was 74.8%. The detection rates of poor sleep quality and drowsiness were 17.0% and 18.3%, respectively. The difference of sleep quality was statistically significant with sex, college, different self rated family conditions, study burden, physical activity level, depression and daily smoking ( χ 2=4.33，8.67，23.14，39.03，12.89，313.37，15.23， P <0.05). There were statistically significant differences between drowsiness and college, grade, learning burden, physical activity and depression ( χ 2=12.81，6.57，20.61，8.42，228.06， P <0.05). Logistic regression analysis showed that takeaway consumption (≥4 times in a week) had statistical significance with poor sleep quality and drowsiness ( P <0.05). Conclusion College students takeaway consumption (≥4 times in a week) of rice noodles, malatang, fragrant pot hot pot increase the risk of poor sleep. It is suggested that schools should strengthen nutrition and health education for college students.

BACKGROUNDAllergic asthma is a chronic airway inflammatory disease partly characterised by high concentration of T help 2 (Th2) cytokines in bronchoalveolar lavage fluid (BALF). There is no report on the relation of peripherally circulating blood lymphocytes and asthma. We explored the balance of Th2/Th1 cytokines in asthmatic mice. Exogenous recombinant interleukin (IL) 33 acted on murine peripheral circulating blood lymphocytes, IL-5 cytokine was selected for assessing Th2 cytokines and interferon-gamma (IFN-γ) for Th1 cytokines.

METHODSFemale specific pathogen free BABL/c mice were sensitised by intraperitoneal injection of 20 µg of ovalbumin emulsified in 1 mg of aluminium hydroxide gel in a total volume of 200 µl, and challenged for 30 minutes in 7 consecutive days with an aerosol of 2 g ovalbumin in 100 ml of PBS. Then we collected BALF and isolated lymphocytes from the peripheral blood. The lymphocytes were divided into two groups: asthmatic group and normal group. Th1/Th2 cytokines was detected by enzyme-linked immunosorbent assay (ELISA) kits.

RESULTSIn the asthma group, we found numerous eosinophils and lymphocytes on the glass slides. We then confirmed that the optimal concentration of IL-33 was 10 ng/ml and time of IL-33 stimulating lymphocytes was 24 hours. In the asthma group, the production of IL-5 was significantly increased over normal group after stimulation with IL-33 (P < 0.05) and the production of IFNγ was supressed from IL-33 stimulated lymphocytes (P < 0.05).

CONCLUSIONIL-33 acts on lymphocytes of peripheral blood increasing secretion of Th2 cytokines and inhibiting secretion of Th1 cytokines.

Animals ; Asthma ; chemically induced ; immunology ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Interferon-gamma ; immunology ; metabolism ; Interleukin-33 ; Interleukin-5 ; immunology ; metabolism ; Interleukins ; immunology ; metabolism ; Lymphocytes ; immunology ; metabolism ; Mice ; Mice, Inbred BALB C

Obeticholic acid (OCA), the first FXR-targeting drug, has been claimed effective in the therapy of liver fibrosis. However, recent clinical trials indicated that OCA might not be effective against liver fibrosis, possibly due to the lower dosage to reduce the incidence of the side-effect of pruritus. Here we propose a combinatory therapeutic strategy of OCA and apoptosis inhibitor for combating against liver fibrosis. CCl-injured mice, d-galactosamine/LPS (GalN/LPS)-treated mice and cycloheximide/TNF (CHX/TNF)-treated HepG2 cells were employed to assess the effects of OCA, or together with IDN-6556, an apoptosis inhibitor. OCA treatment significantly inhibited hepatic stellate cell (HSC) activation/proliferation and prevented fibrosis. Elevated bile acid (BA) levels and hepatocyte apoptosis triggered the activation and proliferation of HSCs. OCA treatment reduced BA levels but could not inhibit hepatocellular apoptosis. An enhanced anti-fibrotic effect was observed when OCA was co-administrated with IDN-6556. Our study demonstrated that OCA inhibits HSCs activation/proliferation partially by regulating BA homeostasis and thereby inhibiting activation of HSCs. The findings in this study suggest that combined use of apoptosis inhibitor and OCA at lower dosage represents a novel therapeutic strategy for liver fibrosis.