OBJECTIVE:To observe the efficacy and safety of valsartan combined with prednisone in the treatment of idiopath-ic pulmonary fibrosis. METHODS:50 patients with idiopathic pulmonary fibrosis were randomly divided into control group and ob-servation group. Control group was orally given 0.5 mg/(kg·d)Prednisone acetate tablet in 1-4 weeks,then maintained with 0.125 mg/(kg·d)in 5-12 neeks,2-3 times a day;observation group was additionally given 80 mg Valsartan capsule,orally,once a day. The treatment course for both groups was 6 months. Pulmonary function indicators [forced vital capacity(FVC),peak expiratory flow rate (PEFR),and forced expiratory volume in one second (FEV1)],serum inflammatory factor indicators [interleukin-13(IL-13), IL-18,transforming growth factor-β1(TGF-β1)] level,matrix metalloproteinase-9(MMP-9),MMP-2 contents and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in the pulmonary function indicators,serum inflammatory factor indicators,MMP-9 and MMP-2 contents between 2 groups(P>0.05);af-ter treatment,pulmonary function indicators in 2 groups were significantly higher than before,and observation group was higher than control group,MMP-9 and MMP-2 contents were significantly lower than before,and observation group was lower than con-trol group(P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Valsartan combined with prednisone can significantly improve the pulmonary function of patients with idiopathic pulmonary fibrosis,and reduce the contents of serum inflammatory cytokines and matrix metalloproteinases,with good safety.

Objective: To observe the clinical efficacy of Zhi Shen Tiao Sui (regulating the mind and marrow) needling in treating depression after ischemic stroke. Methods: A total of 145 patients with depression after ischemic stroke were recruited between January 2016 and January 2018 and divided into two groups using random number table method, with 72 cases in the control group and 73 cases in the observation group. The control group received conventional treatment for ischemic stroke and medication, while the observation group was given additional Zhi Shen Tiao Sui acupuncture. The two groups were treated for 4 successive weeks. Clinical efficacy was analyzed after treatment. The neurological function pertinent scores [Hamilton depression scale (HAMD), clinical neurological deficit score (CNDS), activities of daily living (ADL), Fugl-Meyer assessment scale (FMA) and Barthel index (BI) scores], as well as the levels of cortisol (CORT) and adrenocorticotropic hormone (ACTH) were recorded in the two groups. Adverse reactions that occurred during treatment were also observed. Results: The clinical total effective rate was 82.2％ in the observation group, significantly higher than 66.7％ in the control group (P<0.05). After treatment, the HAMD and CNDS scores were markedly reduced in both groups (all P<0.05), and the ADL, FMA and BI scores were markedly increased (all P<0.05). The HAMD and CNDS scores were significantly lower in the observation group than in the control group after treatment (both P<0.05), and the ADL, FMA and BI scores were significantly higher in the observation group than in the control group (all P<0.05). The levels of CORT and ACTH declined significantly after treatment in the two groups (all P<0.05), and were markedly lower in the observation group than in the control group (both P<0.05). The adverse reaction rate was 2.7％ in the observation group, versus 4.2％ in the control group, and the between-group difference was statistically insignificant (P>0.05). Conclusion: Compared with sole use of Western medication, medication combined with Zhi Shen Tiao Sui acupuncture can promote the recovery of neurological function, down-regulate the levels of CORT and ACTH and enhance the clinical efficacy in treating patients with depression after ischemic stroke, with a relatively high safety rating.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on spinal cord injured rats.Methods Weight-drop spinal cord injury model was made at thoracic 10 segments with NYU impactor device.Stimulated group received daily superthreshold rTMS continued for 4 weeks.BBB locomotor scores were recorded weekly.Growth associated protein 43(GAP43)and 5-hydroxytryptamine(5-HT)were detected with immunofluorescence staining in the area of rostral and caudal to the lesion.Results The BBB scores in stimulation group improved compared with that in the control(P<0.01).GAP43 and 5-HT markers increased in the stimulation group(P<0.01),and they increased in the rostral than in the caudal areas(P<0.01).Conclusion rTMS can improve the locomotor function of incomplete spinal cord injury rats,which may result from the increase of expression of GAP43 and 5-HT.

Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on the spinal segmental excitability after spinal cord injury in adult rats.MethodsT 10 spinal cord injury models were made with weight-drop method.8 weeks later,rTMS were applied to the experimental group at 0.5 Hz suprathreshold stimulation,500 pulses daily for 4 weeks.Spinal cord injury rats without stimulation and normal rats were used as controls.At different time points,electronic evoked F-wave were measured.The ratio of F-wave amplitude to M-wave amplitude(F/M)were compared among these groups.Immunohistochemistry was used to detect the expression of 5-hydroxytryptamine(5-HT)in the rostral and caudal lesion segments.ResultsThe ratio of F/M increased significantly(P<0.01)8 weeks after spinal cord injury compared with baseline ratio and regressed significantly(P<0.01)after 4 weeks of rTMS.Expression of 5-HT in grey matter around lesion was decreased after spinal cord injury and increased significantly(P<0.01)both in the rostral and caudal lesion segments in rTMS treatment group.ConclusionThe increased spinal segmental excitability after spinal cord injury can be regressed by rTMS,which may be resulted in increased expression of 5-HT.

To make a portable apparatus for the patient self-doing joint voluntarily exercise that is keeping with the training demand of human body potential and muscle strong. Different kinds of spring belts are used for joint exercise apparatus according to the needs of joint exercise. Though active joint extension and flexion by using the method of Chinese physical and breathing exercises, the exercise was done by drawing the spring belt. The extremity multifunctional training box is easy for carrying and sutble for each mussel be trained. Because of the wide range of back spring power, it is easy to reach the best training mount and to do the continually training under the biggest training mount. It is beneficial to the joint active function improvement. From June 2006 to February 2008, this kind of apparatus was used in 30 patients with footdrop at the Beijing Tongren Hospital, Capital Medical University. The design of the extremity multifunctional training box is reasonable, and it is easy for carrying and operating. It is also helpful for the patient to do muscle exercise themselves, and the joint function can be persisted and improved by continual exercise using this apparatus.

Objective To construct the pseudovirus containing nucleic acid(NA)fragments of Marburg virus,Zaire Ebola virus,Sudan Ebola virus,Lassa fever virus and Yellow fever virus by using a lentiviral vector system in order to provide a reference standard for the detection of the five viruses.Methods The gene fragments of the above five viruses were synthesized in vitro,connected into a single gene by fusion PCR technique,and cloned into lentiviral vectors with its auxiliary vector.After co-transfecting into 293T cells,the supernatants were collected on 48 h and 72 h post transfection. The naked NA was cleaned from the supernatants using DNase and RNase digestion before pseudotype virus was purified and concentrated.After the NA of the pseudotype virus,were extracted normal PCR and real-time PCR were conducted. Results Sequence analysis showed that the five target genes in vitro synthesis were properly connected and inserted into lentivirus vectors.Using the NA of the pseudotype virus as the template,both normal PCR and real-time PCR could sensitively amplify the target gene with the primers and probes of the above five,viruses respectively.The result indicated that the pseudovirus particles containing the five kinds of hemorrhagic fever virus target genes were successfully packaged. Conclusion The pseudovirus particles containing gene fragments of five viruses are constructed,which can be used as a common reference standard for NA detection.

BACKGROUND:Due to the importance of pedicle adjacent structures, once the screw replacement appears a deviation, adjacent structures may be damaged, leading to extremely serious consequences. Although the security of screw placement in thoracic vertebral pedicle-rib complex is significantly greater than that of pedicle screws, the mechanics of the pedicle-rib complex at different cross-sectional areas of the screw are rarely reported.
OBJECTIVE:To observe mechanical property of different cross-sectional area screws in the middle and upper thoracic vertebral pedicle-rib complex.
METHODS:Five specimens of adult cadaveric thoracic spine (T 1-T 10 ) and adjacent rib segment (50-60 mm long) were used. The bone density of specimens was measured using difunctional bone density testing machine, and osteoporotic vertebral body was excluded. The position of the screws was detected with CT images. The maximal withdrawal force of the pedicle screw was measured with biomechanical force test machine.
RESULTS AND CONCLUSION:Thirty-eight specimens at normal bone density were implanted with 25 screws (5.5 mm), 25 screws (6.0 mm) and 26 screws (6.5 mm). Because the pedicle screws destroyed the pedicle-rib complex and perforated the vertebral body, we final y obtained the withdrawal force of 68 screws. The axial withdrawal force of pedicle screws at different diameters was (812.36±147.22) N, (868.64±160.48) N and (946.48±157.58) N, respectively. There were significant differences between the 5.5 mm screws and the 6.5 mm screws (P<0.05). Experimental findings indicate that, the pedicle screws (diameter>5.5 mm) are suitable in the middle and upper thoracic vertebral pedicle-rib complex due to strong internal fixation and clinical requirement.

BACKGROUND:Establishment of high-quality finite element model is an important basis of biomechanical analysis. The reports on three-dimensional finite element model of complete adolescent idiopathic scoliosis are less. OBJECTIVE:To set up three-dimensional finite element model of PUMCIId1 adolescent idiopathic scoliosis for building ideal digitization platform for further biomechanical study. METHODS:A 14-year-old female patient with PUMCIId1 adolescent idiopathic scoliosis was included as volunteer for the current study. CT images obtained from CT transverse scanning from T 1 to sacrococcyx were imported into Mimics 16.0 software to form qualified three-dimensional geometric model, including thoracic cage, which was further delivered to Geomagic Studio 11.0 software to build three-dimensional finite element model by a series of modules and optimization of cleaning. The geometric model was imported to ANSYS 14.0 software to build complete three-dimensional finite element adolescent idiopathic scoliosis model by adding ligaments, setting unit type, and defining material properties. RESULTS AND CONCLUSION:A complete three-dimensional finite element model of PUMCIId1 adolescent idiopathic scoliosis was built successful y, consisting of 522 887 tetrahedron elements and 730 rod elements, a total of 523 617 units and 159 008 nodes. Three-dimensional finite element model of PUMCIId1 adolescent idiopathic scoliosis was lifelike, and can be used as the reliable digital model for further biomechanical analysis.

BACKGROUND:Studies have shown that posterior orthopedic internal fixation and anterior orthopedic internal fixation al can get good clinical outcomes for treatment of adult idiopathic scoliosis, however, it has not been reported on what kind of methods could achieve a better clinical outcome for treatment of Lenke3 type adult idiopathic scoliosis, have less risk of pedicle screws breakage and more reliable long-term efficacy. OBJECTIVE:To establish the Lenke 3 type adult idiopathic scoliosis finite element model and thoracic screw guide target 3D model using finite element analysis software, so as to provide scientific basis for biomechanical analysis and scientific pedicle screw implantation. METHODS:The CT scan image from T 1 to sacrum of one 28 years old volunteer with Lenke 3 type adult idiopathic scoliosis was imported into Mimics 16.0 software by Dicom form. Integral idiopathic scoliosis three dimensional model was established by geometry clear technology. Nail guide target of thoracic vertebra was established on vertebral model by design module in Mimics 16.0 software. The point cloud form of three dimensional model was imported into Geomagic Studio 11.0 software. Series of image processing of model were conducted. At last, three dimensional model was imported into ANSYS 14.0 finite element analysis software in order to build finite element model with biological properties. RESULTS AND CONCLUSION:Complete Lenke 3 type adult idiopathic scoliosis three dimensional finite element model was established successful y. It concluded 440 975 tetrahedron units and 580 bar units, total y 441 555 units and 1 077 318 nodes. Total y 12 nail guide target models of thoracic vertebra were established, including 4 682 tetrahedron units and 7 390 nodes. Lenke 3 type adult idiopathic scoliosis three dimensional finite element model and nail guide target of thoracic vertebral model with a realistic appearance were established successful y in this experiment. These results confirm that Lenke 3 type adult idiopathic scoliosis three dimensional finite element model provides scientific basis for further biomechanical experiments. Meanwhile, the construction of nail guide target model of thoracic vertebra provide a new scientific method for thoracic pedicle screw placement.

BACKGROUND:Anular repair after discectomy in intervertebral disc degeneration obtains good clinical outcomes and reduces the recurrent rate, but there is little report on the effective suturing method and reliable instrument. OBJECTIVE: To investigate the clinical effectiveness of annulus repair after discectomy under Mast Quadrant system for lumbar disc herniation. METHODS: Fifty patients with lumbar disc herniation admitted in the Hubei Provincial Hospital of TCM from August 2013 to August 2015 were selected, followed by divided into experimental and control groups (n=25 per group), and then received annulus repair after discectomy and simple discectomy, respectively. The length of incision, operation time and intraoperative blood loss were compared between two groups, and the Oswestry disability index and visual analogue scale scores for lumbago and lower limb pain before and after surgery were detected, as well as the incidence of complications and recurrence were recorded. RESULTS AND CONCLUSION:All patients in the experimental group completed the follow-up, while only 23 in the control group finished the follow-up. There were no significant differences in the baseline data between two groups (P > 0.05). The postoperative Oswestry disability index and visual analogue scale scores in both two groups were significantly lower than those before surgery (P < 0.05). There was a significant difference in the visual analog scale score at 1 month postoperatively between two groups (P < 0.05), while the scores at other time points showed insignificant difference between two groups (P > 0.05). There were two cases of recurrence in the control group, one of which received secondary treatment, and the recurrent rate was 9%. In the experimental group, there was only one case of recurrence receiving no treatment, and the recurrent rate was 4%. There were no cerebrospinal fluid leakage, infection, never root injury or other serious complications in both two groups. These results indicate that annulus repair after discectomy is minimally invasive, achieves the reconstruction of disc, and reduces the recurrence rate, which is available for lumbar disc herniation.