BACKGROUND:The basic idea of artificial disc replacement is the intension to minimize the impact on adjacent segments based on the premise of stabilizing index segment, then prevent and reduce the incidence of adjacent segment degeneration.
OBJECTIVE:To explore the indications and contraindications of artificial disc replacement, peri-operative
economics considerations, long-term complications, as wel as the effect of artificial lumbar disc replacement combined with fusion surgery.
METHODS:The PubMed database, CNKI database and SinoMed database over the past decade were searched for the related articles. The retrospective and prospective clinical trials of artificial lumbar disc replacement were included. Repetitive studies and stale perspectives were excluded. A total of 34 articles were summarized and analyzed in the end.
RESULTS AND CONCLUSION:Since the first artificial lumbar disc prosthesis designed to be commercial y
distributed in 1982, there have been a plenty of clinical trials on lumbar disc replacement. However, there is no
answer to many problems that encountered in clinical trials. The effect of the number of replaced segment on the clinical outcomes, the effect of facet joint degeneration on the clinical outcomes, selection of the patients with the history of lumbar disc surgery, age of the patients and the rest time before disc replacement should be taken into consideration in the researches on indications and contraindications of artificial disc replacement. The
intraoperative blood loss, operation time and hospital stay after replacement can be used to evaluate whether lumbar disc replacement is better than the traditional lumbar fusion surgery or not. The complications after lumbar disc
replacement include heterotopic ossification, implants mechanical failure, and facet joint and adjacent segment
degeneration. The combination of lumbar disc replacement and fusion surgery for the treatment of multi-segmental lumbar disc diseases can achieve complement and thus obtaining the efficacy that better than the application of one surgery alone.

BACKGROUND:Artificial Lumbar disc replacement as a new choice for the treatment of degenerative disc disease has aroused widespread concern by clinicians because of the preservation of lumbar vertebra’s biomechanical characteristics during pain eliminating. While the design of the prosthesis structure and material needs further study and validation.
OBJECTIVE:To review the structure and material types of several newly designed artificial lumbar discs, then to discuss the trends in the optimization design of prosthesis, in order to provide instruction for the design and assessment of new lumbar artificial disc prosthesis.
METHODS:The PubMed database, CNKI database and SinoMed database were searched for related articles. New articles related to artificial lumbar disc structure, material, in vivo and in vitro biomechanics were included. Repetitive studies and stale perspectives were excluded. A total of 46 articles were summarized and discussed in the end.
RESULTS AND CONCLUSION:Artificial lumbar disc has developed for nearly 30 years, the design of structure and biological material has been in continuous improvement. At first, we summarized the principle and current situation in the design of movement reservation, movement constraint, instant fixation, base material, weight-bearing material and coating material of artificial lumbar disc prosthesis, then combined with the exist newly in vivo and in vitro biomechanical results to evaluate different kinds of design with the recent research trend to prospect the development of biomimetic design, material improvement, the optimization design of prosthesis and assisted devices.

Objective:To isolate and culture the pulp cells from human young permanent teeth (pDPC),and to observe their biological characteristics and the expression of some specific markers,and to induce these pulp cells to differentiate into osteoblast, adipocyte, neuron and chondrocyte lineages. Methods:Pulp cells were isolated and cultured from orthodontic extracted premolars of children. The attached cells after at least 3 passages were used for the following experiments:1. Morphology and ultrastructure analysis; 2. Cell cycle and phenotype were analyzed by flowcytometry; 3. Growth curve were recorded;4. pDPC were induced to differentiate into osteoblast,adipocyte,neuron in vitro,and were identified by histochemical methods and RT-PCR. Results: 1. Attached pDPCs were fibrablast-like cells,which were distinguished from BMSC. 2. The cell organs in dDPCs were well developed. 3. pDPCs were highly positive for CD90, CD44, CD147,which are mesenchymal stem-cell markers,but were negative for other markers including CD34, CD38, CD45, HLA-DR. 4. pDPCs showed high growth rate. 5. pDPCs could be induced to differentiate into osteoblast, adipocyte, and neuron lineages,but not chondrocyte lineages. Conclusion:pDPCs were characterized by their ability to proliferate with high growth rate in vitro. The expression of some BMSC markers in these cells were observed. They showed the potential to differentiate into multiple mesenchymal lineages such as osteoblst,adipocyte, neuron lineages under specific conditions in vitro.

Objective To evaluate the performance of a kind of military health service rescue vest. Methods The author studied the structure analysis, basic performance experiments and ergonomics tests. Results The vest was scientifically designed, easy to use, in line with the ergonomics and can fulfill the requirements of military health service secure in different environment. Conclusion The secure vest can fulfill medical first aid at scene and military health service rescue. It can be used for soldiers.

Objective To investigate the interseed dose attenuation for multiple 125I seeds.Methods Monte Carlo simulation was done by Geant 4 to investigate the dose distribution of single seed and multiple seeds.The results were compared with the dose calculation method from TG43-U1 and examined by experiments.Results The difference of single seed dose distribution between Monte Carlo method and line source model was ± 3％.The difference between Monte Carlo method and experiment result was ± 5％.The interseed dose attenuation of multiple seeds at the interesting points was 3.8％ to 13.2％ and the average interseed dose attenuation was 7.2％.The difference of experiment result and Monte Carlo result was less than 6％.Conclusions The interseed attenuation is about 7％ and the maximum value may be larger than 13％ for multiple seeds.The interseed dose attenuation may be larger in tissue.So it is not accurate to calculate the dose distribution by using TG43-U1.

Hypertension is classified to fire-heat constitution,yang deficiency constitution,phlegm-wet constitution and yin deficiency causing predominant yang constitution on base of consititutional theory. The therapeutic method of TCM is to modify the unbalance of constitution of hypertension patient.

Objective To investigate the effect of medical rescue of the Maritime Medical Team (Corps) for mass sick and wounded in maritime disaster so as to improve the medical rescue capacity for maritime disasters.Method The construction of maritime medical teams (corps) constituted with various numbers of 10, 15,50 and 120 team members, and the development of algorithm in practice were reviewed. In 68 maritime disasters from January 2003 to December 2009, 937 wounded were rescued by first-aid at sea. The patients were classified and given cardiopulmonary cerebral resuscitation, emergency operation, complication prevention, comprehensive treatment for seawater immersion wound and rapidly referred to hospitals. Results Of 937 patients, 872 survived (93%) and 65 died (7%). Of the dead, 16 died in one hour (25%), 43 died in 24 hours after injury (66%),andofthem, 61died of trauma (94% ) , 2 died of drowning and 1 died of poisoning. Conclusions Besides a good command of the features of mass sick and wounded, organization and program, treatment strategies and measures, the timely and effective assignment for on-site first aid at sea and safe transfer were very important for medical rescue of mass patients in maritime disaster. After the practice of maritime medical team (corps) in medical rescue during maritime disaster, the rapid response capability, cooperation and the quality of rescue were improved, and the experience of medical service of marine medical team (corps) was enriched.

Objective To investigate the diagnostic value of prenatal ultrasonography and magnatic resonance imaging in the fetal intracranial hemorrhage. Methods The 20 antenatal diagnosed ICH cases was collected from 31 200 prenatal diagnosis units in Guangzhou Women and Children′s Medical Center from July 2012 to June 2014. Maternal characteristics, ultrasound, and magnetic resonance imaging findings, clinical course, and postnatal outcome were reviewed. Results Twenty consecutive cases of fetal ICH were evaluated. All cases were diagnosed at mid or third trimester. Transabdominal ultrasound showed 9 cases of hyper echoic lesions in the lateral ventricle, 2 cases of hypoechonic lesions, 2 cases of irregular mixed echo in the parenchyma, 1 case of hyperechoic cerebellar hemisphere with infarction, and 1 case of abnormal choroid plexus. Seventeen cases were associated with ventriculomegaly, brain compression or brain midline displacement. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. Some cases were combined with cortex lesions or abnormal parenchyma. ICH was complicated with other structural abnormalities:1 case of cleft palate, 2 cases of spinal deformity and 3 cases of other cerebral cortical malformations. Prenatal diagnosis results were:2 cases diagnosed as positive cytomegalovirus infection and no chromosome abnormalities found in all cases. The follow up results were:1 case was lost, 16 cases were terminated after prenatal diagnosis. Among the 3 survival cases, 1 case has the neurological complication and the other two were normal till now. Conclusions Fetal intracranial hemorrhage has some image features on ultrasound and magnetic resonance. Ultrasound showed hyper echoic lesions with ventriculomegaly. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. MRI may contribute to the accuracy of diagnosis, particularly in bleeding site. The regular ultrasonic monitoring is helpful to improve the detection rate.

Objective:To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 60 patients with LDH admitted to the Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, were enrolled as the research objects between September 2020 and September 2021. According to the random number table, they were randomly divided into the treatment group and control group, 30 in each group. Both groups were given routine basic treatments (strengthening tendons-waist exercise and three-position six-step manipulation). On this basis, the treatment group was treated with modified Shishi Niubangzi Decoction, while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsive rates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbar function by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) were compared between the two groups.Results:The response rate of treatment group was significantly higher than that of control group (93.3% vs. 73.3%; χ2=4.32, P=0.038). After treatment, scores of JOA (subjective symptoms, signs, activities of daily living) in the treatment group were significantly higher than those in the control group ( t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of back pain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limb numbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower than those in the control group ( P<0.01). At 1 week and 1 month after treatment, ODI scores in treatment group were significantly lower than those in control group ( t=10.22, 5.59; P<0.05). Conclusion:The modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise can improve responsive rates, improve lumbar pain and function in LDH patients.