[Objective]To investigate the etioloty of the early nerve root lesion(RNRL) after collagenase chemonucleolyoio(CC) and its prevention and treatment.[Method]Twelve-hundred and eighty case of lumbar disc herniation undergoint cc were reviewed and analyzed.From January,2000 to December,2004 with follow-up time of 4~30 months,in which 12 cases(0.94%)had obvious ENRL after CC.Eighteen rabbits were randomly divided into three groups of six each:Group A,posterior longitudinal ligament intepated+intradisca injection;group B,parterior longitudinal ligamen+booteen+intradiscal injection,and group C,extradiscae injection.The disc and the nerve roots at the inject side were removed,fixed and examined by microscope,and the changes of the discs end nerve roots were analyzed in different inject side and different time after CC.[Result]As the collagenase dose was large in groups of intradiscal+intradiscal injections case of ENRL in this group were more than that in other groups.In the 12 ENRL cases,ten cases of ENRL appeared in about 7 days after CC,8 cases without nerve root compression and all cases were improved in different degree,but no one reeovered completely at follow-up with excellent and good rate of efficiency in the cases operated in 3 days than that in cases operated after 8 days.In the experiment rabbits,there lowed obvious lyeis of nucleus.Pulpus in group A and group B,with severe damage of nerve roots in group B,while in group C,there was no obvious lipis of nucleuss pulpus and damage of nerve roots[Conclusion](1)As the larger collagenas dose in the cases with intradiscal and extradiscal injections can raise.The incidence of ENRL,it is suggested that CC used in cases with broken posterior longitudenal ligament of and brous anmulus and,with nucleus pulpuses herniated into spinal canal,CC should be prudent to apply.(2)The prognoseo of the ENRL after CC is poor and is related to operation time.(3)The incidence of ENRL after CC can be lowered with absolute bed rest and changing body position after CC.

OBJECTIVETo observe the changes in the adhesive function of vascular endothelial cells (VEC) and rat monocytes induced by lipopolysaccharide (LPS) and co-cultured with smooth muscle cells (SMC) and the intervention effect of paeonol (Pae).

METHODPrimary rat vascular endothelial cells (VECs) and rat vascular smooth muscle cells (VSMCs) were cultured by predigesting and adhering tissue blocks. The VEC-VSMC co-culture model was established by Transwell chamber. LPS was used to induce VEC injury. MTT assay and LDH assay were used to determine the VEC activity. ELISA assay was used to detect IL-1beta and TNF-alpha secreted by the VEC. The immunocytochemistry assay was carried out to detect the expression of ICAM-1. The Rose Bengal Staining was used to test adhesive function between VECs and monocytes.

RESULTThe concentration of LPS-induced VEC injury was 100 microg x L(-1), and the time was 7 h. after the intervention on the above cell model for 24 h, Paeonol (15, 30, 60 micromol x L(-1)) could effectively inhibit LPS-induced VEC injury and VEC injury, significantly enhance the survival rate of LPS-injured VECs, decrease IL-1beta and TNF-alpha secreted by the injured VEC, and reduce the expression of ICAM-1, so as to inhibit the adhesion of LPS-induced VECs and monocytes.

CONCLUSIONPaeonol could inhibit IL-1beta and TNF-alpha expression to protect VECs from being injured by LPS, and reduce ICAM-1 expression to inhibit the adhesion between VECs and monocytes.

Acetophenones ; pharmacology ; Animals ; Cell Adhesion ; drug effects ; Coculture Techniques ; Endothelial Cells ; cytology ; drug effects ; metabolism ; secretion ; Gene Expression Regulation ; drug effects ; Intercellular Adhesion Molecule-1 ; metabolism ; Interleukin-1beta ; metabolism ; Lipopolysaccharides ; pharmacology ; Male ; Monocytes ; cytology ; drug effects ; Myocytes, Smooth Muscle ; cytology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; secretion

0.05). The median duration of survival was 11.5 months for TEP gr oup versus 8.5 months for EP group (P0.05,no statistical difference). The main toxicity wa s myelosuppression for the two groups.The incidence rate of Ⅲ～Ⅳ degree neutro p enia and thrombocytopenia was higher in the TEP group than that in the EP group( P

Objective To study the preoperative self-efficacy of patients with lumbar disc herniation(LDH) and its influential factors. Methods Seventy-six patients with LDH underwent operation from June 2008 to March 2009 were enrolled in the current study. The patients were investigated with GSES,SAS,SDS and self-made general characteristics before operation. The data were analyzed with SPSS 11.5. Results The score of preoperative self-efficacy was 25. 84 ±6. 76. The course of disease, education level, patients' hobbits could affect self-efficacy (F = 15. 371,P<0.01;F = 18.078,P<0.01;t =2. 368,P<0. 05). Preoperative self-efficacy correlated negatively with the course of disease (r = - 0.541, P < 0. 01). And preoperative self-efficacy correlated with education level and hobbits(r = 0. 589, P < 0. 01; r = 0. 226, P < 0.05) . The score of preoperative dysphoria and depression was significantly higher than norm (P < 0. 01) . Preoperative self-efficacy correlated negatively with dysphoria and depression (r = -0. 494, P < 0.01; r = - 0. 443, P < 0. 01). Conclusions The score of preoperative self-efficacy with LDH is low; the score of preoperative dysphoria and depression is high. Preoperative self-efficacy correlated negatively with the course of disease. And preoperative self-efficacy correlated with education level and hobbits; Preoperative self-efficacy correlated negatively with preoperative dysphoria and depression.

In this paper the causes of deficiency of public welfare were analyzed in medical research,and some strategies were proposed to enhance the public welfare of public health care services according to the cardinal principles of new healthcare reform package in 2009.These were benefit to maintain the public welfare of public medical and health care services,and to reach the goal of medical research served as the clinic and the patients.

Objective To study the efficacy and safety of treating Parkinson disease(PD) by repetitive transcranial magnetic stimulation (rTMS). Methods 45 patients with PD were randomly divided into two groups. 30 patients received rTMS therapy and 15 patients were given sham stimulation. Stimuli were delivered at an intensity of 110% of resting threshold (RT) and a frequency of 1Hz once a day for 10 days. All the patients were followed-up at 1 month and 3 months after treatment. The efficacy was assessed by UPDRS score, grooved pegboard test, timed motor test and 10m turned back test. All the patients stopped using dopaminergic drugs for at least 12h before each assessment. Results In rTMS treatment group, the UPDRS total scores, UPDRSⅠ-Ⅲ, the mean times of grooved pegboard and 10m turned back test were significantly decreased 10 days after treatment compared with pre-treatment (all (P)0.05), and PDQ scores significantly decreased 3 months after treatment. In sham treatment group, there was no difference of each index between pre- and post-sham treatment.Conclusion Low frequency rTMS may improve the symptoms of the patients with PD and raise their quality of life.

Objective: To compare the effects of seasonal autoregressive integrated moving average (SARIMA) , seasonal autoregressive integrated moving average with exogenous regressors (SARIMAX) and long short-term memory neural network (LSTM) models in predicting the incidence of hand, foot, and mouth disease (HFMD). Methods: Monthly incidence data of HFMD in Kunming City from 2010 to 2019 were collected. SARIMA, SARIMAX and LSTM models were established using the monthly incidence of HFMD from 2010 to 2018 to predict the monthly incidence of HFMD from January to December 2019. The prediction performance of the three models was compared using mean squared error (MSE), root mean squared error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). The optimal prediction model was selected based on the principle of minimizing MSE, RMSE, MAE and MAPE. Results: The HFMD cases were reported every month in Kunming City from 2010 to 2019, with the incidence fluctuating between 188.27/105 and 363.15/105. The disease exhibited a biennial high-incidence bimodal distribution. Among the four evaluation indicators for the training and testing sets, the LSTM model had the smaller values: MSE was 63.182 and 102.745, RMSE was 7.949 and 10.136, MAE was 6.535 and 7.620, and MAPE was 46.726% and 31.138%. The LSTM model performed the better, followed by the SARIMA model, while the SARIMAX model had the relatively poorest performance. Conclusion The LSTM model outperforms the SARIMA and SARIMAX models in predicting the incidence of HFMD.

Objective:To observe the clinical efficacy of calcium dobesilate combined with valsartan in the treatment of IgA ne-phropathy. Methods:Totally 58 cases of IgA nephropathy were randomly divided into the treatment group and the control group. The control group enrolled 29 cases given valsartan 160 mg · d-1 . The treatment group included 29 cases treated with calcium dobesilate 500 mg·time-1 ,tid,and valsartan 160 mg·d-1 . After 6 months, the following indicators were observed, such as blood pressure,fi-brinogen,urea nitrogen,serum creatinine,blood uric acid,and 24-hour urinary ( Upro) . Results: After 6 months, UA and Upro of the two groups were significantly declined than those before the treatment(the control group P<0. 05,the treatment group P<0. 01). Upro of the treatment group was declined from (1. 48 ± 0. 84) g/24h to (0. 41 ± 0. 22) g/24h,and there was statistical significance com-pared with the control group (P<0.05). BUN, Scr and FIB were decreased significantly(P <0.05),while no significant change showed in those in the control group after the treatment. Conclusion:Calcium dobesilate combined valsartan can effectively reduce Up-ro and improve renal function in IgA nephropathy.

Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P ＜ 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P ＜ 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.

Objective To evaluation the efficacy of ketamine on the expression of adhension molecular CR3and intracellular cAMP, cGMP in neutrephils in patients associated with cardiopulmonary bypass (CPB), as well as the cardiovascular function of the CPB patients. Method Sixty patients operated on with prosthetic valve replace-rnent under CPB were randomly divided into 4 groups: placebo, ketamine 0.1 mg/kg ( ketamine Ⅰ) ,ketamine 0.5 mg/kg ( ketamine Ⅱ) ,ketamine 1 mg/kg( ketamine Ⅲ). Each group included 15 eases. Venous blood sam-pies were obtained during anesthesia induction (T1), 10 min before CPB (T2), end of CPB (T3) and 24 hoursafter operation (T4). The expression of CR3 was measured by Flow cytometry and the concentration of cAMP/cGMP by HPLC. Results Ketamine with various dosages decreased the expression of CR3 at the T3 and T4 inpatients of ketamine groups compared with patients of placebo group (P<0.05). The dosages of ketamine Ⅱgroup and ketamine Ⅲ group had more significant effect than that of ketamine Ⅰ group. The dosages of ketamineⅡ and ketamine Ⅲ group increased the intracellular cAMP at the T3 and T4 compared with ketamine Ⅰ groupand placebo (p<0.05), respectively. However,cGMP was lower in ketamine Ⅱ and ketamine Ⅲ group thanthat in ketamine Ⅰ group and placebo (P<0.05) at the T3.Morever,the mean arterial blood pressure was higherin ketamine Ⅱ and ketamine Ⅲ group at T4. Only the patients of ketamine Ⅲ group required less inotropic drugsafter operation. Conclusions Ketamine can reduce the expression of adhhension molecular CB3 and intracellularcAMP, cGMP in neutrophils from patients associated with CPB.