Adrenomedullin (AM) is a novel vasoactive peptide. The actions of AM include vasodilatation, reduction of arterial pressure, inhibition of vascular smooth muscle cell transference and proliferation, diuretic and natriuretic, inhibition of aldsterone secretion. Furthermore AM modulates extra cellular matrix deposition. So adrenomedullin plays an important role in the regulation of cardiovascular remodeling. This paper reviews the relationship between AM and cardiovascular remodeling.

BACKGROUND:Due to different pathogenesis of degenerative and isthmic lumbar spondylolisthesis, the differences in sagittal spino-pelvic morphology and life quality between them are stil unclear.
OBJECTIVE:To investigate the differences in sagittal spino-pelvic morphology and life quality between degenerative and adult isthmic lumbar spondylolisis patients.
METHODS:From May 2012 to February 2015, 169 lumbar spondylolisthesis patients with complete imaging data were included in the study. Degenerative group contained 83 patients, and isthmic group contained 86 patients. The folowing radiographical parameters were measured on standard standing lateral radiographs of the entire spine, including thoracic kyphosis, lumbar lordosis, sagittal vertical axis, pelvic incidence, pelvic tilt and sacral slope. Meanwhile, slippage angle, slippage percentage and slippage distance ofal patients were also measured. SF-36 scale was employed to evaluate life quality, which was compared between groups.
RESULTS AND CONCLUSION:(1)Lumbar lordosis, thoracic kyphosis and slippage angle were significantly lower in the degenerative group than those in the isthmic group (P< 0.05-0.01). The sagittal vertical axis in degenerative group was higher than that in isthmic group (P< 0.01). (2) With respect to the domains of SF-36 scale, degenerative group had lower physical functioning score and social functioning score compared with the isthmic group (P< 0.01). (3) Pelvic incidence, pelvic tilt, sacral slope, slippage percentage and slippage distance showed no significant difference between two groups (P> 0.05). (4) Results suggested that pelvicmorphology between the degenerative and isthmic lumbar spondylolisthesis was similar. Compared with degenerative lumbar spondylolisthesis, isthmic spondylolisthesis patients have higher thoracic kyphosis, lumbar lordosis and slippage angle. In addition, notable limitations of physical functioning and social functioning were found in degenerative lumbar spondylolisthesis patients.

Objective To investigate the effect of low sound pressure level infrasound on che-mokine-mediated inflammatory response in spinal cord in rats with neuropathic pain.Methods Seven-ty-two healthy male SD rats were randomly divided into sham operation group (group Sham),neuro-pathic pain group (group NP)and low sound pressure level infrasound intervention group (group LNP),24 in each.The sciatic nerve injury models were established.3 d after the model constructed, the rats in group LNP started to receive low sound pressure level infrasound therapy,4 h per day, continued for 21 d.1 d before surgery (T0 )and 3 d after surgery (T1 ),all rats were detected me-chanical paw withdrawal threshold (MWT).Respectively,after treated for 7 d (T2 ),14 d (T3 )and 21 d (T4 ),eight rats were randomly selected from each group and their MWT was measured.The ex-pressions of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord in rats were detected using quantitative PCR,the expressions of MCP-1 protein and CCR2 protein in spinal cord in rats were detected by using Western blot.Results MWT in groups NP and LNP at T1-T4 was lower than that of group Sham,and that in group LNP at T3-T4 were higher than that of group NP,respectively (P <0.05).Compared with group Sham,the relative expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord tis-sues in groups NP and LNP at T2-T4 were increased (P <0.05);compared with group NP,the rela-tive expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mR-NA in spinal cord were decreased in group LNP at T3-T4 (P <0.05 ).Western blot analysis showedthat the relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in groups NP and LNP at T2-T4 were higher than that of group Sham,while relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in group LNP at T3-T4 were lower than that of group NP. Conclusion The low sound pressure level infrasound could effectively reduce neuropathic pain in rats, possibly via inhibiting chemokine-mediated cascade inflammatory reaction.

Objective To investigate the effects of propofol on mesenteric artery in SD rats and to observe whether the effect of propofol on the mesenteric artery relaxation is related to the gap. Methods Pressure myograph was used to examine the effect of 18β-GA and 2-APB on the relaxation induced by propofol 1×10 -7 ,3×10 -7 ,1×10 -6 ,3×10 -6 ,1 ×10 -5 ,3 ×10 -5 ,1 ×10 -4 and 3 ×10 -4 mol/L in acutely separated mesenteric arterioles of SD rat.Results The diameter of mesenteric arteri-oles were increased from (208.6±13.4)to (213.5±13.6),(21 9.7±13.2),(226.4±12.5),(234.9 ±12.3),(245.5±13.0),(267.4±1 5.2),(336.2±18.3)and (385.9 ±14.2)μm after application of 1×10 -7 ,3×10 -7 ,1 × 10 -6 ,3 × 10 -6 ,1 × 10 -5 ,3 × 10 -5 ,1 × 10 -4 and 3 × 10 -4 mol/L propofol,re-spectively.Propofol induced dilation of the rat mesenteric arterioles in a concentration-dependent man-ner (P < 0.01 ).After pretreatment with 18β-GA and 2-APB,1 × 10 -4 mol/L propofol induced dilation was absolutely decreased (P <0.01).Conclusion These results suggest that propofol relaxes mesenteric arterioles via gap junction.

Objeetive To investigate the clinical efficacy of treating stomach cance belonging to spleen and stomach deficient cold type with self-designed formula and chemotherapy.Methods 100 patients of stomach cancer belonging to stomach and spleen deficient cold were randomly grouped into a control group and a treatment group,with 50 cases in each group.The control group was only treated with chemotherapy,and the treatment group was additionally treated with self-designed Chinese formula on the basis of the control group.After 3 months' treatment,the curative effect,the improvement of life quality,the changes of body weight,the improvement of peripheral blood and immune function,and the occurrence of adverse reaction were observed.The survival rate of patients after 1,3 and 5 years' treatment was investigated.Results ① Short term curative effect:the total effectiveness of the control group and the treatment group was 60.0％ (30/50) and 30.0％ (15/50) respectively,with the treatment group being better than the control group(Z=-2.100,P＜0.05);② life quality:theimprovement rate of life quality in the treatment group and the control group was 64.0％ (32/50) and 20.0％ (10/50) respectively,with the treatment group being better than the control group (Z=-3.259,P＜0.05); ③ body weight:the improvement rate of body weight in the treatment group and the control group was 24.0％ and 16.0％ respectively,and there was no significant difference (Z=-1.815,P＞0.05) ; ④ peripheral blood:the peripheral blood abnormality rates of treatment group was obviously lower than the control group (Z=-4.286,P＜0.05) ;⑤ immune function changes:CD4+、CD8+、and the activity of NK cell of two groups after the treatment [the treatment group was (40.8 ± 4.1)％,(26.1-3.2)％,(83.57-2.52)％ respectively; the control group was (31.7±2.9)％、(33.8±3.0)％、(92.88±3.83)％ respectively] wasobviously improved compared with the same group before the treatment [the treatment group was (34.2±3.5)％,(31.0±2.0)％,(85.01±2.92)％ respectively; the control group was (34.0±3.2)％,(30.9±2.2)％,(85.02± 3.48) ％ respectively].The immune indexes (CD4+、CD8++、CD4+/CDg+and the activity of NK cell)in the treatment group presented significant difference (P＜0.01) than the control group after the treatment.⑥adverse reaction:compared with the control group,the occurrence rate of adverse reaction of the treatment group was obviously lower than the control group,and there was significant difference (Z=-5.297,P＜0.05).⑦survival rate:the survival rate of patients after 1,3 and 5 years' treatment in the treatment group was better than the control group,and there was significant difference (x2=5.263,12.96,7.895,P＜0.05).Conclusion The combination of self-designed Chinese formula and chemotherapy could effectively relieve the clinical symptoms,improve the immunity,reduce the occurrence of adverse reaction,and improve the life quality of patients with stomach cancer belonging to stomach and spleen deficient cold type.

Objective:To observe the effect of electromyographic biofeedback on the wrist dirsiflexion function of the patients with cerebral infarction at different Brunnstrom stages, and to clarify the treatment of electromyographic biofeedback,and to provide basis for its clinical application.Methods:A total of 100 cerebral infarction patients were selected.Among them 54 BrunnstromⅠ-Ⅱ patients were randomly divided into treatment group (n= 32)and control group (n = 22),and another 46 Brunnstrom Ⅲ patients were randomly divided into treatment group (n=23)and control group (n=23).The patients in four groups were treated with the same routine stroke rehabilitation therapy while the patients in treatment groups still received the electromyographic biofeedback therapy additionally.The maximum electromyographic contraction of muscle,active range of movement (AROM) and Fugl-Meyers Assessment (FMA)of the extension of wrist joint were evaluated before treatment and 4 and 8 weeks after treatment,respectively.Results:The maximum electromyographic contraction values of muscle of the patients in BrunnstromⅠ-Ⅱ treatment group and control group were significantly improved 8 weeks after treatment (P <0.05),and the value in treatment group was higher than that in control group (P <0.05).The maximum electromyographic contraction value of muscle in Brunnstrom Ⅲ treatment group began to improve 4 weeks after treatment compared with before treatment (P < 0.05) and it was significantly higher than that in control group (P <0.05).The maximum electromyographic contraction value of muscle in Brunnstrom Ⅲ control group began to improve 8 weeks after treatment (P <0.05).The AROM in Brunnstrom Ⅰ-Ⅱ treatment group began to improve 8 weeks after treatment (P <0.05)and it was significantly higher than that in control group (P <0.05)while the AROM in control group had no significant change (P >0.05).The AROM in Brunnstrom Ⅲ treatment group and control group were significantly improved 4 weeks after treatment (P < 0.05 or P < 0.01 ), and the value in treatment group was significantly higher than that in control group (P < 0.05).The FMA in BrunnstromⅠ-Ⅱtreatment group and control group were significantly improved 8 weeks after treatment (P <0.05),while the value in treatment group was higher than that in control group (P <0.05);the FMA in Brunnstrom Ⅲ treatment group began to improve 4 weeks after treatment (P < 0.05)and it was significantly higher than that in control group (P <0.05). The FMA in control group began to improve 8 weeks after treatment (P <0.05). Conclusion:Electromyographic biofeedback can increase the strength and improve the body function of the patients with cerebral infaction.

ObjectiveTo investigate the clinical features and treatment of ascending paralysis after thoracolumbar fracture.MethodsThree male patients with 2 fracture levels at T12 and one at L1 were retrospectively studied.Their mean age was 41.3 years(range,39-42 years).All 3 cases were undertaken open decompression,reduction and internal fixation.Paralysis level began to ascend at 2-5 days after injury,with 2 cases up to C2,3 and 1 case up to T7.Two patients suffered irritating pain over the paralysis level before onset of ascending.Postoperative MRI images demonstrated well reduction and no compression of spinal cord.In the early phase after ascending,MRI obviously showed swelling in spinal cord and long T1 and long T2 signals shaped patchy and stripy distribution in the central area.One patient's MRI displayed that the spinal cord shrinked 16 days after trauma with abnormal high signal in the central area.ResultsTwo cases died of respiratory muscle paralysis and 1 case suffered paraplegia with no recovery 5 years after surgery.ConclusionAscending paralysis after thoracolumbar fracture is a rare complication with very poor prognosis.MRI is available for evaluating operational effects and affected level.The exact mechanism and effective treatment are still unclear and need further investigated.

BACKGROUND:Anatomic medul ary locking (AML) femoral prosthesis is circular cylinder and has satisfactory efficacy. However, some scholars found the complications such as thigh pain, loss of bone at the proximal end of the femur, and wearing-related osteolysis. F2L femoral prosthesis is cone-shaped and also has satisfactory efficacy, but the thigh pain incidence is relatively low. ＜br> OBJECTIVE:To compare the intermediate-long term results of AML versus F2L in total hip arthroplasty. ＜br> METHODS:Between November 1997 and January 2005, we retrospectively reviewed 60 patients (66 hips) undergoing total hip arthroplasty using biological femoral prosthesis. At fol ow-up examination, 58 hips in 52 patients were available for clinical and roentgenographic review. 26 AML devices were placed in 24 patients, and 32 F2L devices were placed in 28 patients. The AML group were reviewed with an average of 12.7 years fol ow-up (range 10 years and 3 months to 15 years and 5 months), while the F2L group were reviewed with an average of 9.5 years fol ow-up (range 8 years and 3 months to 11 years and 1 month). The clinical results were evaluated with Harris methods and X-ray examination. Kaplan-Meier analysis was performed to evaluate the survival of femoral component. End point was radiographical loosening or revision of the femoral component for any reason. ＜br> RESULTS AND CONCLUSION:There were no significant difference between AML and F2L about Harris score in the latest fol ow-up (P>0.05). After surgery, the incidence of thigh pain was significantly lower in F2L group than that in AML group (P＜0.05). In AMKL group, the stress-shielding 1 level was observed in 21 hips (81%), and 2 level in five hips (19%);in F2L group, the stress shielding 0 level was observed in 20 hips (62%) and 1 level in 12 hips (38%). There were significant differences between the two groups (P＜0.05). The stress shielding showed significant differences between the two groups (P＜0.05). The incidence of osteolysis in F2L group was significantly lower than that in AML group (P＜0.05). Kaplan-Meier analysis showed that, the survival rate of both AML and F2L components were 1.0 (95%confidence interval:0.98-1.00). Experimental findings indicate that, both AML and F2L femoral prosthesis have a satisfactory long-term efficacy after total hip arthroplasty, and the incidence of thigh pain and osteolysis is significantly lower in F2L group.

Objective To explore the technique and significance of intraoperative neuromonitoring (IONM) for scarless in the neck endoscopic thyroidectomy (SET) via breast approach.Methods From Apr.2015 to Oct.2015,101 consecutive patients undergoing SET with IONM were included.During the operation,patients received radical resection of the thyroid cancer by Wang's seven-step method.The lymph nodes in the central area were dissected and Wang's multi-functional separation forceps were implemented for recurrent laryngeal nerve (RLN) positioning,monitoring and protection.Also,time required for RLN positioning and exposure,postoperative transient and permanent RLN damage incidence were calculated to assess the feasibility of IONM under SET.Results Among 101 patients,130 RLNs in total were exposed.The average time required for RLN positioning under IONM was (3.26 ± 1.08)min,with round-nerve management time of (13.95 ± 4.58)min.Nerve signal change happened in 16.9％(22/130) patients.Positive predictive value was 13.6％ and negative predictive value was 100％.The overall accuracy rate was 85.4％.Conclusion IONM during SET is feasible,and can be helpful for the localization and functional protection of RLN and was useful to predict vocal cord paralysis.