Objective To study the biological characteristics of dendritic cells (DCs) derived from peripheral blood mononuclear cells (PBMCs) of patients diagnosed with syphilis. Methods PBMCs were isolated from 16 patients clinically and serologically diagnosed with syphilis, and from 16 healthy human controls, then cultured with GM-CSF and IL-4. On day 10, the monocyte-derived dendritic cells (MoDCs)of the patients and controls were collected and subjected to the detection of surface molecules by flow cytometry; TpN17 was used to stimulate MoDCs from the controls, the expression of phosphorylated ERK was detected by Westem blotting 20 minutes following the stimulation. Results The positivity rate of CD80 was significantly increased in the patients with syphilis than that in the controls (51.90% vs 33.67,P ＜ 0.05), while no significant difference was observed in the expressions of CD83, CD86 or HLA-DR be tween the two groups (16.53% vs 15.99%, 66.13% vs 59.32%, 91.29% vs 90.51%, all P 0.05). The ex pressions of CD80 and CD83 on the surface of MoDCs were enhanced in a dose-dependent manner after ex-posure to TpN17. The expression of cytoplasmic phosphorylated ERK was observed in MoDC stimulated by TpN17, but not in those without the treatment. Conclusions Antigenic stimulation with Treponema pal-lidum may be a reason for phenotypic abnormality of MoDCs derived from patients with syphilis. TpN17 may stimulate the maturation of DCs through the ERK signal transduction pathway.

ObjectiveTo analysis the subsets of the lymphocyte and dendritic cells (DC) in peripheral blood in patients with neurosyphilis and investigate the relationship between these cells and onset of neurosyphilis.MethodsThe subsets of CD4+T cells as well as DCs and the counts of CD4+T and CD8+T were analyzed by flow cytometry with immunofluorescent staining in 8 patients with neurosyphilis and 10 healthy controls.ResultsIn peripheral blood of neurosyphilis patients the proportion of CD4+T cell was significantly higher than that in the normal controls ( P<0.01); the proportion of CD8+T cell was significantly lower than that in the normal controls ( P<0.05). The proportion of Th1, Th2 and the ratio of Th1/Th2 in neurosyphilis patients was (14.12±5.12)%, (1.52±0.88)% and (12.05±5.62), respectively. In normal controls, it was (26.10±4.98)%, (0.99±0.35)% and (31.62±16.62) respectively. The expression of Th1 and the ratio of Th1/Th2 in neurosyphilis patients was significantly lower than the normal controls (P<0.05). The proportion of DC1 and DC2 in neurosyphilis patients was not significantly different from that in normal controls ( P>0.05). There was a significant correlation between DC1 and Th1, DC2 and Th2 in the neurosyphilis patients ( P<0.051), but no correlation between the proportion of DCs and the ratio of Th1/Th2 ( P>0.05).ConclusionThe cellular immune function of neurosyphilis patients may be inhibited, and there is no relationship between the proportion of DCs subset and unbalance of Th1/Th2.

ABSTRACT:Objective To compare the clinical effects of Zero-P and traditional titanium plate with cage in treating single level cervical spondylosis.Methods We retrospectively analyzed the clinical data of 28 patients with single level cervical spondylosis who underwent anterior cervical discectomy and fusion (ACDF)by traditional titanium plate with cage (group A,n=16)or Zero-P implant (group B,n=16)in our department between January 2012 and January 2014.The intraoperative blood loss,operation time,postoperative JOA scores,JOA recovery rate,NDI scores,and dysphagia incidence in both groups were measured and compared.The changes of the midpoint interbody height (IBH),the cervical Cobb angle of the surgical segment and the cervical Cobb angle of C2 and C7 vertebral body were measured on the standing lateral cervical spine X-ray.Results The operation time was significantly longer in group A than in group B (P < 0 .0 1 ), but there were no significant differences in intraoperative blood loss between the two groups (P>0 .0 5 ).The incidence of dysphagia was lower in group B than in group A.The two groups did not significantly differ in JOA score or JOA improvement rate during the same period after operation (P>0.05).The NDI score in group B was significantly lower than that in group A (P<0 .0 5 )at 1 month and 6 months after operation,but showed no significant difference in preoperative and 1 2 months after operation (P>0 .0 5 ).The midpoint interbody height in group B was significantly greater than that in group A (P<0 .0 5 )1 2 months after operation,but showed no significant difference one month after operation.The cervical Cobb angle of the surgical segment was significantly greater in group B than in group A (P<0 .0 5 )after operation, but there was no significant difference in cervical Cobb angle of C2 and C7 vertebral body between the two groups at various time points (P>0.05).Conclusion Zero-p and traditional titanium plate with cage have similar effects in treating single level cervical spondylotic myelopathy,and Zero-P system has the advantages of lower incidence of dysphagia after operation,shorter operation time and better recovery of postoperative cervical physiological structure.

Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.

Objective To compare the modified expanding suspended laminoplasty and posterior pedicle screw fixation applied in lumbar intraspinal tumors and evaluate operation,complications,postoperative neurofunctional improvement and lumbar lumbar stability in the two groups.Methods We made a retrospective analysis of the clinical data of 1 14 cases of lumbar intraspinal tumors, including 66 cases of modified expanding suspended laminoplasty and 48 cases of posterior pedicle screw fixation.We compared the operation time,operation bleeding volume,and incidence of postoperative cerebrospinal fluid leakage in the two groups.We also analyzed the lumbar instability and spinal cord injury score standard by the Japanese Orthopedic Association (JOA)between the two groups at 3,6, 12,and 24 months after operation.Results The results of modified expanding suspended laminoplasty group were significantly better than those of posterior pedicle screw fixation group in operation time, operation bleeding volume and incidence of postoperative cerebrospinal fluid leakage (P < 0.01 ).The lumbar instability did not significantly differ between the two groups (P >0.05).At 3,6 or 12 months after the operation, changes in the increase of JOA score of the two groups had no significant difference (P > 0.05 ).However,24 mouths after the operation,the group of posterior pedicle screw fixation had significantly improved JOA score compared with that in the modified expanding suspended laminoplasty group.Conclusion Both the modified expanding suspended laminoplasty and posterior pedicle screw fixation have a favorable outcome of postoperative lumbar instability and neurofunction.And posterior pedicle screw fixation is superior to modified expanding suspended laminoplasty in improving neurofunction.

Objective To investigate the indications,surgical principles and advantages and disadvantages of microsurgery of intra-spinal tumor via the quadrant pathway.Methods We made a retrospective analysis of the clinical data of patients with spinal canal tumors treated via the quadrant pathway from October 2014 to July 201 5. Results Totally 1 6 patients were included.Their tumors were fully removed by microscopic resection,in which there were three epidural cases,twelve subdural extra-medullar cases,and one intra-medullar case.In terms of stage,there were three cases of cervical segment (C3 - C7 ),four cases of thoracic (T1 - T10 ),nine cases of thoracic and lumbar ones (T1 1 - S2 ). In pathology, there were nine cases of neurilemmoma, two cases of neurofibroma,four cases of meningeal tumor and one case of neuroepithelial cyst.The postoperative symptoms and signs of the patients were significantly improved,and no recurrence or complications occurred in the follow-up 2-10 months.Conclusion Quadrant pathway can be used in removing spinal epidural and subdural tumor,which is shorter than two vertebral segments in length,and the cross-sectional area is less than 2/3 of the spinal cord. However,surgery with extensive adhesion and intra-medullary lesions should be performed carefully,and the surgical techniques are more demanding and a longer learning curve is needed.

OBJECTIVETo observe the clinical effects of free musculo-cutaneous flap bridging with contralateral posterior tibial vessel on repair of lower extremity soft tissue defect.

METHODSFrom February 2006 to June 2013, 10 patients with soft tissue defect on lower shank and foot were included. The posterior tibial vessel on healthy lower extremity was chosen as recipient vessel and anastomosed with free latissimus dorsi musculo-cutaneous flap, or free latissimus dorsi musculo-cutaneous flap combined with thoracic-umbilical skin flap or anterolateral femoral musculo-cutaneous flap. The retrograde bridged flap was transposed to repair defect on contralateral lower shank and foot. The wound area ranged from 40 cm x 21 cm to 22 cm x 15 cm, with flap size from 48 cm x 26 cm to 25 cm x 18 cm. Meanwhile the defects on donor sites were covered with skin graft and both lower extremities were fixed with kirschner wires at middle tibia and calcaneus. The kirschner wires were removed at 4 weeks and pedicles were cut off 5-8 weeks postoperatively. Six patients received posterior tibial vessel reanastomosis at the same time of pedicle cutting.

RESULTSAll the 10 flaps survived and 3 patients received thinning of flaps due to excessive thickness. During the follow-up period of 3 months to 2 years follow up, the ambulatory function of injured legs recovered gradually with satisfactory appearance. The reanastomosed posterior tibial vessel on the healthy side was recovered.

CONCLUSIONSAppropriate bridged musculo-cutaneous flaps is suitable for extensive soft tissue defect of lower shank and foot. It is a safe and effective method for limb salvage.

To investigate the curative effect of electroacupuncture on luteinized unruptured follicle syndrome(LUFS) and its mechanism. Methods:Sixty LUFS patients were randomly allocated to treatment (electroacupuncture) group and control (hCG) group. The follicular condition and ovarian arterial flow under color Doppler ultrasonogaphy and a change in reproductive endocrine level were observed in the patients before and after treatments. The ovulation rates and pregnancy rates were compared between the two groups,and the mechanism was investigated. Results:Both ovulation rate and pregnancy rate were significantly higher in the treatment group than in the control group (P＜0.01). There was a significant difference in the improvement in ovarian arterial flow between the treatment and control groups (P＜0.01). The improvement in endocrine level was significantly more marked in the treatment group than in the control group(P＜0.01). Conclusion:Electroacupuncture has a good effect on luteinized unrupture follicle syndrome. Its mechanism may be related to the improvement in ovarian arterial blood supply and the regulation of endocrine level.

【Objective】 To explore the application of multi-mode electrophysiological monitoring technology in highly selective posterior rhizotomy (SPR) of patients with spastic cerebral palsy. 【Methods】 We retrospectively collected data on patients with systolic cerebral palsy who underwent SPR in our hospital from January 2019 to December 2019. Bispectral index (BIS), somatosensory evoked potentials (SEP) and electromyography during surgery of all the patients were measured. We used EMG to monitor the depth of the anus, spinal cord function, and the stimulation response of multiple muscle groups, and recorded and summarized abnormal intraoperative electrophysiological monitoring, surgical treatment and complications during displacement and discharge, and relief and exercise functional recovery six months after the surgery. 【Results】 The intraoperative BIS parameters of 18 patients were 60-75, the EMG amplitude was abnormal in 1 case (5.6%), and the SEP amplitude decreased in 1 case (5.6%). The preoperative muscle tension of both lower extremities was 3.6 on average, and the postoperative muscle tension was 1.4, with a decrease by 2.2 grades. There were 16 cases (88.9%) in long-term follow-up, among which 12 cases (75%) had complete relief of spasm, 4 cases (25%) had significant improvement, gait function improvement rate was 100%, and no complications occurred. 【Conclusion】 Multi-mode electrophysiological monitoring technology is an effective method for SPR to increase the success rate of surgery. It can increase the accuracy of the ratio of posterior root resection of spinal nerves, reduce the risk of spinal cord damage, and improve the poor prognosis.

【Objective】 To explore the application of multi-mode electrophysiological monitoring technology in cervical spine surgery. 【Methods】 We retrospectively collected data of patients who received cervical spine surgery in Department of Neurosurgery of our hospital in January 2018 to December 2019. All patients were guided by the bispectral index (BIS) to control the depth of anesthesia. High cervical spine lesions were treated with somatosensory evoked potentials (SEP), motor evoked potentials (MEP), brainstem auditory evoked potentials(BAEP)and electromyography (EMG) monitoring. We selected SEP, MEP and EMG combined monitoring for low cervical nerve and spinal cord injury, recorded and summarized the abnormalities of intraoperative electrophysiological monitoring, surgical efficacy and complications at the time of discharge and 6 months after surgery. 【Results】 The intraoperative BIS parameters of 112 patients were 45-60, the MEP amplitude decreased in 9 cases (8.0%), the SEP amplitude decreased in 4 cases (3.6%), the EMG amplitude was abnormal in 5 cases (4.5%), and the BAEP amplitude decreased in 4 cases (3.6%); no operation was terminated due to significant abnormalities in monitoring. Compared with 44 cases (39.3%) before operation, 112 patients had little change in SEP and MEP amplitudes, 35 cases (31.3%) had a slight increase in SEP amplitude, 2 cases (1.8%) had a slight decrease, 24 cases (21.4%) had slightly increased MEP amplitude, while 7 cases (6.3%) had slightly decreased one. There were no new neurological disorders at the time of postoperative discharge and 6 months after surgery. 【Conclusion】 Multi-mode electrophysiological monitoring shows the recovery of damaged nerve electrophysiological activity immediately after the operation, which provides an objective basis for the recovery of nerve function, and can effectively prevent and reduce iatrogenic spinal cord and nerve function damage, and improve the efficacy of surgery.