Obejective To explore the diagnostic and curative evaluation value of gastrin-releasing pep-tide precursor (ProGRP) and neuron specific enolization enzyme (NSE) in small cell lung cancer (SCLC). Methods Sixty SCLC patients, sixty non-small cell lung cancer (NSCLC) patients and forty patients with be-nign pulmonary disease were collected fromJanuary 2014 to October 2015. The levels of serum ProGRP and NSE in all patients were determined by ELISA method and radioimmunoassay respectively then the clinical value of ProGRP and NSE on SCLC was evaluated. Results The levels of ProGRP and NSE in SCLC group were signif-icantly higher than those in NSCLC group and those in lung benign disease group (P < 0.05). The levels of Pro-GRP and NSE in extensive stage were higher than those in limited stage in SCLC group (P < 0.05). The bound-ary value of SCLC through ProGRP identified through ROC curve was 64.68 pg/mL. The diagnostic sensitivity , specific degree and Youdenindex of ProGRP in SCLC were 86.7%, 97.5% and 0.842 respectively, which were significantly higher than NSE (P < 0.05). After 2 cycles of chemotherapy, serum ProGRP in SCLC disease con-trol groupwere significantly decreased(P < 0.05) but on difference of serum ProGRP was found in SCLC progres-siongroup (P > 0.05). Conclusion ProGRP and NSE can be used as markers for the diagnostic and curative evaluation of SCLC. And ProGRP has higher sensitivity and specificity than NSE and can be promoted in clinic.

Objective:To investigate the neuroprotective effect and possible mechanism on rats with low dose Lipopoly -saccharide ( LPS) preconditioning after spinal cord injury.Methods:120 female SD rats were randomly divided into the empty virus (EV) group,LPS+empty virus (LPS+EV) group,Nrf2 interference virus (NIV) group,LPS+Nrf2 interference virus (LPS+NIV) group.The model of traumatic spinal cord injury ( TSCI) was established by the modified Allen′s method,motor function of the rat hind limb was assessed by the Basso Beattie and Bresnahan (BBB) score at 1,3,7,14 and 28 d after the operation.The injured spinal cord tissue samples were harvested at each time ,and the pathological changes of rat spinal cord were observed by HE staining ,the Nissl body and neuron survival index were observed by Nissl staining ,the expressions of Nrf2 and GCLC protein level were detected by immunohis-tochemical staining and Western blot.Results:The rat BBB score of LPS+EV group increased significantly than EV group at 7,14,28 d after operation ( P<0.05 ,P<0.01 );The NIV group between LPS+NIV group have no statistical significance at each time.As compared with EV group:the Nrf2 protein of LPS+EV group was expression increased significantly and Nissl staining showed that the neurons survival index was increased at 1,3 and 7 d(P<0.05,P<0.01);The GCLC protein of LPS+EV group was expression increased significantly at 1-14 d( P<0.05 );HE staining showed that the injured spinal cord pathological changes of LPS +EV group was obviously improved.Conclusion:Low dose lipopolysaccharide preconditioning can accelerate the nerve function recovery on rats with traumatic spinal cord injury ,the mechanism may be regulated by activating the Nrf 2 antioxidant stress pathway.

Objective To establish the UPLC fingerprint of Shuanghuanglian powder-injection. Methods Acquity UPLCTM BEH C18 Column (2.1 mm × 50 mm, 1.7 μm) was established;mobile phase was acetonitrile and 0.1%formic acid with gradient elution;the flow rate was 0.3 mL/min;the column temperature was 40 ℃. Characteristic spectrum cluster of 13 batches of Shuanghuanglian powder-injection were analyzed, and Chinese Medicine Chromatographic Fingerprint Evaluation System (2004 A) was used to evaluate their quality. Results UPLC fingerprint common mode of 13 batches of Shuanghuanglian powder-injection was established. There were total 16 common spectrum peaks in the reference for comparison, and three main peaks were identified with better separation. The 13 batchs had good consistency, and the process was stable. Conclusion The method is rapid, efficient and can be used for full control of the quality of Shuanghuanglian powder-injection.

BACKGROUND: An ideal repairing material characterizes by both great biocompatibility and osteogenesis ability. Any biomaterials should meet excellent biological security and biocompatibility prior to clinical application.OBJECTIVE: To evaluate the biocompatibility and the biological security of the TiO_2-Ag-nano-hydroxyapatite/polyamide66 (TiO_2-Ag-nHA/PA66) composite.DESIGN, TIME AND SETTING: A randomized controlled duplicated design was performed in Chongqing Medical University from July 2008 to July 2009.MATERIALS: A total of 40 Kunming mice aged 3 weeks and of clean grade and 32 healthy adult New Zealand rabbits were provided by Experimental Animal Center of Chongqing Medical University. TiO_2-Ag-nHA/PA66 composite powder (10 g),TiO_2-Ag-nHA/PA66 composites (n=32, 5 mm ×25 mm), and TiO_2-Ag-nHA/PA66 composites (n=32, 3 mm × 5 mm) were provided by Research Center of Nano-Biomaterials of Sichuan University.METHODS: General toxicity test: Forty mice were randomly divided into experimental and control groups. Composite powder was used to prepare leaching liquor which was treated on experimental mice by an intraperitoneal injection. While, an equal amount saline was inserted into the control mice. Intramuscular implanting test: The 16 rabbits were randomly divided into experimental and control groups. Two TiO_2-Ag-nHA/PA66 composite (5 mm × 25 mm) were implanted into left and right erector spinae, respectively. A similar surgery with the exception of implantation was performed on the control rabbits. Intrabony implanting test: The resting 16 rabbits were implanted one TiO_2-Ag-nHA/PA66 composite (3 mm × 5 mm) into left and right lateral epicondyle, respectively. Hemolytic test: A 8-mL anti-coagulation blood was obtained and added with composite powder (0.1,0.15, and 0.2 g).MAIN OUTCOME MEASURES: Biocompatibility and biological security of TiO_2-Ag-nHA/PA66 composite.RESULTS: General toxicity test demonstrated that mice in the two groups had good activity and eating, normal breathing, stable body mass, no paralysis, convulsion, and death. Intramuscular implanting test and intrabony implanting test showed that there was no significant difference in levels of alanine aminotransferase, aspartate transaminase, urea nitrogen, and creatinine and leukocyte numbers between the two groups before implantation and at day 4,1 week, and 2 weeks after implantation (P> 0.05).In particular, there was no significant difference in the experimental group at varying time points (P> 0.05). Intramuscular implanting test indicated that tissue sections in the experimental group displayed coated tissue of materials. The inflammatory variation in the experimental group was generally similar to that in the control group. Intrabony implanting test indicated that tissue sections in the experimental group displayed new bone formation. Hemolytic test suggested that hemolytic ratio of three varying concentrations of TiOrAg-nHA/PA66 composites was less than 5%, which met the normal criterion.CONCLUSION: TiO_2-Ag-nHA/PA66 composite has a good biocompatibility and biological security.

The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P < 0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P < 0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.
Back ; Decompression, Surgical ; Durapatite ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; Nanostructures ; Nylons ; Spinal Fusion ; Treatment Outcome

Objective To detect the effect of a new bioactive bone screws composed of nanohydroxyapatite/polyamid 66/glass fiber (n-HA/PA66/GF) biomaterial on biological behavior of osteoblasts with a view to a later clinical application of the screws.Methods Mice osteoblasts were co-cultured with n-HA/PA66/GF biomaterial or its extract.Cell growth was detected under a microscope,cell proliferation using MTT assay,apoptosis by flow cytometry,osteocalcin by ELISA method,cell migration using Transwell invasion assay,cell adhesion and growth by scanning electron microscope,and cytoskeleton and actin filament distribution using immunofluorescene.Results Direct contact test demonstrated n-HA/PA66/GF material had no obvious cytotoxicity to osteoblasts.Extract of n-HA/PA66/GF material stimulated osteoblast proliferative activity over time with absorbance value of 0.96 ± 0.14,1.54 ± 0.15,and 2.39 ±0.27 respectively after 2,4,and 6 hours of coculture (P ＜ 0.05).The n-HA/PA66/GF material induced more osteoblasts to entering S period without obvious influence on apoptosis rate and promoted osteocalcin secretion.Migrated cells in medium supplied with n-HA/PA66/GF material or FBS was 8.73 ± 3.26 and 9.47 ± 3.29 in each visual field,but there was no significant difference (P ＞ 0.05).Osteoblasts had a regular form on the surface of n-HA/PA66/GF material,closely adhered to the surface,and reproduced and aggregated with each other to form stratified cell layers.However,nHA/PA66/GF material exhibited no obvious influence on distribution of cytoskeleton and actin filament.Conclusion The new n-HA/PA66/GF screws has excellent cytocompatibility with positive regulatory effect on cell growth,proliferation,secretion,adhesion,cycle,and osteocalcin secretion.

Objective To investigate the intestinal pathophysiological mechanism of bacterial translocation and endotoxemia in rabbits with acute spinal cord injury (SCI). Methods Paraplegia was induced by injuring the spinal cord of 30 rabbits by the method of Fehlings. Twelve rabbits were used for recording the changes of gastrointestinal (GI) electrophysiology and colon pressure. The left 18 rabbits were experimental group and were killed in 24, 48 and 72 h after injury. The other 6 rabbits served as normal group. Under aseptic condition, samples of blood and mesenteric lymph node were collected for bacterial cultures and endotoxin detection. The small intestines were observed by light and electron microscopy. The colons were inspected by light microscopy. Results After SCI, the electrophysiology of the GI tract was changed especially at the middle and distal colon. The peristalsis of the middle and distal colon was reduced and sometimes even disappeared. In the early stage, the main pathology was hyperemia of blood vessel and infiltration of inflammatory cells. The interepithelial tight junctions became wider and the columnar epithelium was disintegrated. All of the pathological changes may lead to the destruction of the intestinal barrier. The endotoxin level were increased since 24 h after SCI and had statistically significant difference compared with that at 72 h (P0.05). Conclusion After SCI, the middle and distal colon dysfunction induces constipation, bacterial overgrowth, and blood flow congestion. These factors may accelerate the destruction of the intestinal barrier and lead to bacterial translocation and endotoxemia.

Objective To discuss the treatment of acromioclavicular joint dislocation associated with clavicular distal end fracture and remedial means.Methods 28 cases of acromioclavicular joint dislocation associated with clavicular distal end fracture were treated with clavicular hook plate.28 patients included 4 cases of Allman's type Ⅰ,14 cases of type Ⅱ,10 cases of type Ⅲ.Classification of fracture included 9 traverse cases,14 oblique cases,3 comminuted cases,and 2 avulsion cases.There were 24 acute injury cases,4 obsolete injury cases.3 cases were open fractures.1 case was not successful by conservative management.After operation,early rehabilitation was emphasized and following-up was performed.The therapeutic effect was assessed with Karlsson standard.Results 28 patients were followed up for an average of 14.6 months(6～26 months).According to Karlsson standard:17 cases got A level,8 cases got B level,3 cases got C level.The rate of excellence was 89.3%.Conclusion Acromioclavicular joint dislocation associated with clavicular distal end fracture is not steady fracture and complicated with many ligaments avulsion often.Effective internal fixation on time and ligament repaired is necessary.

Objective To evaluate the outcome of reoperation(after I stage anterior/posterior operation)for thoracolumbar fractures combined with kyphosis and spinal cord injury. Methods A retrospective study was done on the medical records of 12 patients who underwent two-stage decompression with kyphosis and neurologic deficit due to single-stage approach(anterior or posterior) operation of thoracolumbar fractures combined with spinal cord injury between January 2005 and April 2009.There were 9 males and 3 females,at mean age of 34.6 years(range,19-57 years).According to the Denis classification,there were five patients with burst fractures,five with compression fractures and two with fracture dislocation.All the patients had couns medullaris injury.Of all the patients,five underwent one stage anterior approach surgery and the others underwent posterior approach operation.All the patients had vailous degrees of neurological symptoms.The patients treated with one stage anterior surgery were treated with two stage posterior surgery and the patients treated with one stage posterior surgery were treated with the two stage anterior operation.The mean interval from one stage operation to two stage decompression was 13.4 months(range,12-18 months).The radiologic,neurologic and functional outcomes were assessed through observation of the Cobb angle,Frankel spinal cord injury grading and Japanese Orthopaedic Association Scores(JOA). Results AIl the patients were followed up for mean 25 months (12-48months),which showed primary healing of the incisions in all the patients.The average anterior and posterior heisht of the vertebrae wers corrected from preoperative 42.6%and 70.5%to postoperative 92.5%and 95.7%and to 87.3%and 92.2%at the final follow-up respectively.Neurologic status was improved at least one Frankel grade in the patients who had preoperative incomplete paraplegia.The Cobb angle was corrected from preoperative 36.3°to postoperative 5.8°and to 5.9°at the final follow-up(P<0.05).No patient had any notable loss of correction between discharge and final follow-up.According to JOA coring,the results were excellent in nine patients,good in two and fair in one,with excellence rate of 92%. Conclusions Two stage decompression for epiconus and cauda equina syndrome resulted from one stage approach(anterior or posterior)operation of thoracolumbar fractures combined with spinal cord injury call attain satisfactory correction of the kyphosis and nerve decompression as well as various degrees of nerve function recovery.

Objective To discuss the application of nano-hydroapatic crystals and polyamide composite(n-HA/PA66) for artificial vertebrae in treating thoracic or lumbar vertebrae tumor.Methods A total of 14 cases suffering from thoracic or lumbar vertebrae tumor underwent deuto-total vertebrae resection via anterior approach,then canalis vertebralis was deboosted,artificial vertebrae was implanted and fixed with screw-stick system.Fourteen patients,9 male and 5 female were admitted by our hospital from Dec 2003 to Sep 2005,aged 32 to 68 years old(average 50).The tumor located at T_(11) in 2 cases,T_(12) in 2,L_1 in 5,L_2 in 5.Pathological diagnosis showed 3 cases were of aneurysmal bone cyst,5 of hemangioma,2 of giant cell tumor,3 of metastatic thoracic lumbar vertebra tumor. Results The follow-up lasted 3-18 months,mean 10 months.The rate of bone graft fusion reached 85.7%,with no loosened internal fixation or breakage of screw or stick.No screw breakage or spinal instability occurred during the follow-up.All cases were alive till follow-up finished.Conclusion If the thoracic vertebral tumor compresses spinal cord seriously,the patients should be recommended for surgical treatment.Total vertebrectomy followed by reconstruction could relieve the compression caused by tumor and restore the stabilization of spine effectively.Artificial vertebrae is the ideal substitute material for bone transplantation,for it has good biocompatibility,high security,high rate of bone graft fusion and firm fixation.