ObjectiveTo investigate the pathogenesy and operation method in patients with ossification of thoracic ligamentum flavum.MethodsThe imaging and clinical data of 56 patients who underwent laminectomy combined with posterolateral fusion were studied retrospectively.The method of laminectomy included enbloc laminectomy and decomposed laminectomy.Postoperative outcomes were evaluated according to a recovery scale in terms of JOA score.ResultsThe patients were followed up for 18-70 (25.00 ± 11.56) months.There were a total of 237 ossified segments in this series,57.4％(136/237)located in lower thoracic segments.According to the configuration of ossification on CT scans,lateral type occurred in 6 patients,diffuse type in 17 patients and thickened nodular type in 33 patients.All patients with lateral type and majority of patients with diffuse type were treated with enbloc laminectomy,and the rate of fineness of postoperative outcome was 83.3％ (5/6),82.4％ ( 14/17 ) respectively.Most of the patients with thickened nodular type were treated with decomposed laminectomy,and the rate of fineness of postoperative outcome was 78.8％ (26/33).Four patients withthickened nodular type were performed with enbloc laminectomy,2 of them resulted in deteriorated myelopathy.Twenty-nine patients with thickened nodular type were performed with decomposed laminectomy,however,only 2 of them resulted in worse outcomes.ConclusionsThe pathogenesis of ossification of thoracic ligamentum flavum is mainly due to the localizedmechanical stress.Laminectomy combining with lateral fusion may be the ideal method for the treatment ofthis condition.Furthermore,enbloc laminectomy is suitable for the patients in lateral type and diffuse type according to the configuration of ossifications.For the thickened nodular type,decomposed laminectomy is favorable.

BACKGROUND:Transformation growth factor-β(TGF-β) and brain-derived neurotrophic factor (BDNF) are the main regulatory factors in the process of spinal cord injury. There are many researches for TGF-βand BDNF pathogenesis in the spinal cord injury, but the regulation of Ginsenoside Rg1 intervention on TGF-βand BDNF in the spinal cord injury is rarely reported.
OBJECTIVE:To observe the effect of Ginsenoside Rg1 intervention on TGF-βand BDNF expression at themolecular protein levels, and to study the protection effect of Ginsenoside Rg1 on the spinal cord and nerve function after spinal cord injury.
METHODS:Experimental rats were randomly divided into blank control group, model group and Ginsenoside Rg1 group. In the model and Ginsenoside Rg1 groups, spinal cord injury model was established with the impact method in rats. In the Ginsenoside Rg1 group, rats were intraperitoneal y injected with 10 mg/kg Ginsenoside Rg1 24 hours after modeling, once per day, for 14 days. Rats in the blank control and model groups were injected with equal saline.
RESULTS AND CONCLUSION:Compared with the control group, serum malondialdehyde levels increased, the content of superoxide dismutase decreased, TGF-βexpression levels in spinal cord tissue increased, and BDNF expression levels decreased in the model and Ginsenoside Rg1 groups. Compared with the model group, serum malondialdehyde levels decreased, the content of superoxide dismutase increased, TGF-βexpression levels in spinal cord tissue decreased, and BDNF expression levels increased in the Ginsenoside Rg1 group. Ginsenoside Rg1 can protect the injury spinal cord in rats after spinal cord injury.

BACKGROUND:Chinese herb extracts can restore and protect the nervous system of rats through intervention of neural stem cels. OBJECTIVE:To explore the role of ginsenosides Rg1 in the proliferation and protection of neural stem cels. METHOD:Sprague-Dawley rats at pregnant 19 days were dissected to take out fetal rats, and then the hippocampal tissues from fetal rats were isolated to extract neural stem cels. Neural stem cels were co-cultured with DMEM/F12 medium containing 50 g/L ginsenosides Rg1 as intervention group, with DMEM/F12 medium as blank control group, and with DMEM/F12 containing 0.64% phenol as positive control group, respectively. MTT assay was used to detect the proliferation of neural stem cels in each group, and western blot method to detect the protein expression of brain-derived neurotrophic factor and transforming growth factor-β in neural stem cels. RESULTS AND CONCLUSION:Rat neural stem cels were round single cels with clear border at early period after isolation but at 2 days after inoculation, the cels were adherent and aggregated into smal cel spheres. Compared with the blank control group, the proliferative rate of neural stem cels was significantly increased in the ginsenosides Rg1 group (P < 0.05), but decreased in the positive control group (P < 0.05). Compared with the blank control group, in the ginsenosides Rg1 group, the expression of brain-derived neurotrophic factor was elevated, and the expression of transforming growth factor-β was reduced, indicating ginsenosides Rg1 has a certain effect to promote the proliferation of neural stem cels as wel as to protect the neural stem cels.

Carbon monoxide has been proved to be an important signal molecule in body. Transition metal carbonyl compounds are solidified form of carbon monoxide. Numerous studies have shown that Ruthenium carbonyl carbon monoxide releasing molecules have a strong pharmacological activity. In this paper, five Ruthenium (II) carbonyl CORMs 1-5 were synthesized and their toxicology, tissue distribution and interaction with blood endogenous substances were investigated. The results showed CORMs' IC50 to fibroblasts are ranged from 212.9 to 2089.2 micromol x L(-1). Their oral LD50 to mouse is between 800 to 1600 mg x kg(-1). After repeated administration, CORMs 1 and CORMs 5 haven't shown an obvious influence to rats' liver and kidney function, but caused the injury to liver and kidney cells. The in vivo distribution result revealed the majority of CORMs were distributed in blood, liver and kidney, only a small part of CORMs distributed in lung, heart and spleen. They could scarcely cross the blood-brain barrier and distribute to brain. The non-CO ligands in structure have an obvious relevance to their in vivo absorption and distribution. Interestingly, CORMs could enhance the fluorescence of bovine serum albumin, and this enhancement was in direct proportion with the concentration of CORMs. Under different conditions, interaction of CORMs with glutathione got different type of products, one is Ruthenium (II) tricarbonyl complexes, and Ruthenium (II) dicarbonyl complexes.

Objective To understand the coronary characteristic of acute coronary syndrome patients with ischemic J wave. Methods Comparison was made between 60 acute coronary syndrome patients with ischemic J wave and 60 acute coronary syndrome patients without ischemic J wave. All patients were examined by Holter monitoring electrocardiogram and coronary arteriongraphy. To distinguish the stenosis degree was defined in three degree based on Genisini score of 0, 1-80, and 81-160. Plaque types were divided into Ⅰ,Ⅱ, Ⅲ by Ambrose classification,the coronary and plaque characteristics of acute coronary patients were observed with ischemic J wave. Results There were no significant difference of stenosis degree between the two groups ( U = 3. 0686, P = 0. 0022), whereas there were significant difference of plaque types (x2 =16. 0890, P = 0. 0003) and coronary vessel numbers(x2 =12. 1045, P = 0. 0024). The degree of stenosis, the plaque types, and number of stent in coronary vessel were positively correlated with ischemic J wave(r =0. 44,0. 34,0. 31 ;P <0. 05). Conclusions The acute coronary syndrome with ischemic J wave patients is often not only accompanied with serious coronary stenosis and high incidence rate of multivessel disease,but also high probability of unstabilized plaque. Ischemic J wave can be a predictor of super-acute ischemic of myocardium.

Objective To analyze the correlation between emphysema extent measured by high resolution computed tomography (HRCT) and pulmonary function tests, symptom score in patients with chronic obstructive pulmonary disease ( COPD ) , and to study the value of HRCT in the emphysema quantification in the clinical evaluation of COPD patients. Methods 78 patients with stable COPD were recruited to take the HRCT scan , and emphysema extent was qualified by measuring the proportion of low attenuation area in the whole lung (LAA%). Correlations between LAA% and indices of pulmonary function test, bronchial dilation test, mMRC scale, CAT score and six minutes walking distance (6MWD) were assessed. Results LAA% was negatively correlated with FEV1/FVC and DLCO%pred, and the correlation coefficients were -0.759 and -0.589 (P <0.01), respectively. LAA% was positively related to mMRC score (r = 0.342, P < 0.01), and negatively asso-ciated with 6MWD (r = -0.365,P< 0.01). There was no association between LAA% and indices of bronchodila-tion test (⊿FVC, ⊿FVC%, ⊿FEV1, ⊿FEV1%) (P > 0.05). Conclusions The severity of emphysema measured by HRCT is well correlated with the clinical symptoms , pulmonary function tests and exercise capacity in COPD patients. It can be used to diagnose emphysema early and to evaluate the severity of the disease com-prehensively. Thus, the risk factors of COPD can be controlled and the prognosis of the patients can be im-proved.

Objective:To examine the changes of mimecan protein expression in development of atherosclerosis induced by sinoaortic denervation,and to explore the effects of mimecan knock down on the proliferation and migration of vascular smooth muscle cells.Methods:The animals were randomly divided into a sham group and a model group (n=8 in each group).The rat model of blood pressure variability was established by sinoaortic denervation,and the hemodynamic indexes were recorded 20 weeks after the surgery to confirm the success of the model.The thoracic aorta was excised and stained with immunohistochemistry to observe the pathological changes of smooth muscle tissues and the changes of mimecan expression.The mice vascular smooth muscle cells were isolated,and which were treated with mimecan siRNA to knock down the mimecan expression,The cell proliferation was observed by 5-ethynyl-2'-deoxyuridine (Edu) in corporation test and the changes of cell migration was observed by wound healing test.Results:Twenty weeks after sinoaortic denervation,the blood pressure variability in the model group was significantly increased compared with that in the sham group,suggesting the model was successfully established.In addition,the increased blood pressure variability in the model group promoted the proliferation and migration of the vascular smooth muscle cells in thoracic aorta,while the expression of mimecan protein was significantly decreased.In in vitro assays,the knock down of mimecan in mice vascular smooth muscle cells could promote the cell proliferation and migration.Conclusion:Mimecan plays a protective role in the development of sinoaortic denervation induced atherosclerosis through amechanism involving suppression of the proliferation and migration of vascular smooth muscle cells.

Objective To evaluate the application effect of telemedicine robot on the postoperative follow-up of liver transplantation recipients from donation after cardiac death (DCD). Methods A total of 100 recipients undergoing liver transplantation from DCD in the First Affiliated Hospital of Xi 'an Jiaotong University from January 2014 to December 2017 were recruited in this investigation. According to differnt follow-up patterns, all recipients were divided into the research group (n=50, follow-up by telemedicine robot) and control group (n=50, follow-up by traditional telephone). The compliance (medication compliance, self-monitoring, life compliance and follow-up compliance), follow-up time and follow-up satisfaction at postoperative 3 months of all DCD liver transplantation recipients were analyzed and statistically compared between research group and control group. Results The scores of medication compliance, self-monitoring, life compliance, follow-up compliance and the total score of compliance in the research group were significantly higher than those in the control group (all P < 0.05). The each follow-up time of liver transplantation recipients in the research group was (9±4) min, significantly shorter than (13±4) min in the control group (t=-4.452, P < 0.001). The score of satisfaction during postoperative follow-up in the research group was 19.8±2.6, significantly higher than 16.2±3.1 in the control group (t=6.234, P < 0.001). Conclusions The application effect of telemedicine robot on the postoperative follow-up of liver transplantation recipients from DCD is satisfactory, deserves widespread application in clinical practice. It is expected to become an indispensable part of the postoperative follow-up of liver transplantation recipients from DCD.

Objective To systematically review the predictive factors associated with reversibility of post-transplantation diabetes mellitus in adults using Meta-analysis,and to provide a theoretical basis for clinical prevention and treatment of diabetes after transplantation.Methods Pub Med,Web of Science,Cochrane Library (Issue 5,2017),CNKI,VIP and WanFang Data were searched from inception until May 2017.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer.Publication biases were evaluated,and the Meta-analyses were conducted with RevMan5.3.Results A total of 7 studies were analyzed which involved 979 adults.Metaanalysis showed the following significant predictive factors:male (OR =1.73,95％ CI 1.19 to 2.50,P ＜0.05),advanced age (MD =1.73,95％ CI 0.07 to 10.39,P =0.05),high FPG before transplantation (MD=5.66,95％CI 0.11 to 11.31,P=0.05),hepatitis C virus (HCV) infection (OR=1.52,95％CI 1.08 to 2.14,P ＜ 0.05),high frequency of combination therapy with MMF (OR =0.26,95％ CI 0.11 to 0.61,P ＜ 0.05),and short time before development of PTDM (MD =-19.08,95％ CI-37.08 to -1.07,P ＜ 0.05).There was no correlation with preoperative BMI,family history of diabetes and acute rejection.Conclusion The study showed that male,advanced age,high FPG before transplantation,hepatitis C virus infection,high frequency combination therapy with MMF,short time before development of posttransplantation diabetes mellitus were the predictive factors associated with reversibility of post-transplantation diabetes mellitus.

Objective To assess the value of cardiac magnetic resonance (CMR) imaging in left ventricular structure and function in patients with end stage renal disease (ESRD).Methods Twenty-five patients with ESRD and 10 healthy subjects underwent CMR.Left ventricular end diastolic volume(EDV),end-diastolic diameter(EDD),end-systolic volume(ESV),end-systolic diameter(ESD),stroke volume(SV),ejection fraction(EF),LVM and interventricular septum (IVS) thickness were measured and compared.The parameters from CMR and 2DTTE were compared.Results The EF in patients with ESRD was significantly lower than that in controls (P＜0.001),while ESV,ESD,IVS and LVM were respectively higher than these in controls (P＜0.05).There was no significant difference (P＞0.05) in ESV between CMR and 2DTTE,but EF of CMR was significantly higher than this of 2DTTE (P＜0.05).There was no significant difference (P =0.296) in left ventricular systolic functional category.Bland-Altman plots showed a good agreement between the two methods.Conclusion CMR is a helpful tool to assess left ventricular structure and function in patients with ESRD.