BACKGROUND: Long-term follow-up of the patients undergoing anterior cervical discectomy and fusion (ACDF) shows some incidence of degeneration at the segments adjacent to the fusion level. Cervical total disc replacement may resolve this problem. OBJECTIVE: To compare the effects of cervical total disc replacement versus ACDF on the biomechanics of the segment adjacent to the operation level. DESIGN, TIME AND SETTING: The randomized controlled trial was performed at biomechanical laboratory in Beijng Trauma and Orthopaedic Institute from August 2007 to February 2008. MATERIALS: Eighteen samples of fresh goat cervical spine; Bryan artificial cervical disk (Medtronic); CSLP-VA cervical plate (Synthes); coral bone (Beijing Yihuajian Science And Trade Co., Ltd.). METHODS: The goat spines were divided into 3 groups: control group with no specific treatment; total disc replacement group, in which C5/6 segment underwent Bryan artificial cervical disk replacement and fusion; internal fixation group, in which the C5/6 segment underwent cervical discectomy, coral bone implantation and internal fixation with CSLP-VA cervical plate. MAIN OUTCOME MEASURES: The adjacent intervertebral disk pressure (IDP) was measured in flexion, extension, rotation and lateral bending under certain loading, and the pressure changes were compared among three groups. RESULTS: At level C4/5, the IDP between total disk replacement group and the control group had no statistical significances in flexion (P 0.05) but internal fixation group was significantly higher than control group (P=0.014). There were no significant differences among the three groups in IDP in extension, rotation and lateral bending. CONCLUSION: Compared with ACDF, the total disk replacement can reduce the adjacent segment IDP and may avoid the degeneration in adjacent cervical segment.

BACKGROUND: As indicated by previous researches, aluminium (Al) could affect learning and memory of animals through many approaches in cluding affecting the stable status of intracellular calcium, decreasing protein kinase C(PKC) activity, and affecting the release of glutamic acid(Glu) . The formation of long-term potentiation(LTP) weakens in hip pocampal CA3 region of rats fed by forage containing Al. It could be found that Al would weaken evoked potential(EP) in hippocampal CA3 region and inhibit LTP formation, which might be related with the damaging effect of Al on L-Arg-NO approach through further application of acute Al administration, i.e., AlCl3 is directly injected into hippocampal CA3 region by microinjection.OBJECTIVE: To investigate the damaging effect of Al on learning and memory, and its correlation with cholinergic system and gamma-aminobutyric acid (GABA) system.DESIGN: A completelyrandomized controlled verifying study based on the experimental animals.SETTING: Department of psychology in a university and the medical college of an occupational technology college.MATERIALS: The study was conducted in the Laboratory of Neuro-Electrophysiology, the Faculty of Physiology, Tongji Medical College,Huazhong University of Science and Technology between September 2000 and April 2001. Totally 68 SD rats of ordinary grade in either gender with a body mass between 150 g and 250 g were obtained from the Department of Experimental Animals of Tongji Medical College, Huazhong University of Science and echnology.INTERVENTIONS: SD rats were randomly divided into 9 groups including normal NS ( NS ) control group ( n = 6): 1 μL of NS was injected twice ( 1 minute interval) into hippocampal CA3 region by microinjection; NS + AlCl3 group( n = 6): 1 μL of NS and 0.5 mol/L of AlCl3 were injected(1 minute interval) into hippocampal CA3 region by microinjection;NS + Tac group( n = 6): 1 μLof NS and 1 × 10-9 mol/L of Tacrine were injected in turn into hippocampal CA3 region by microinjection; NS + Bic group(n=6): 1 μL of NS and 1 × 10-3 mol/L of Bicuculline were injected in turn into hippocampal CA3 region by microinjection; Tac +AlCl3 group: 1 μL of 1 × 10-9 mol/L( n =8),1 × 10-10 mol/L ( n = 6) and 1 × 10-8 mol/L of Tacrine were firsdy injected into hippocampal CA3 region by microinjection, and 1 μL of 0. 5 mol/L AlCl3was injected 1 minute later; Bic + AlCl3 group: 1 μL of 1 × 10-3 mol/L( n = 9) and 1 × 10 -4 mol/L( n = 7) of Bicuculline were firstly injected into hippocampal CA3 region by microinjection, and 1 μL of 0.5 mol/L AlCl3 was injected 1 minute later. Population spike(PS) in hippocampal CA3 region was recorded after using single pulse to stimulate perforating fiber(PF). When PS became stable, medication was injected into hippocampal CA3 region to observe the impacts of Al on EP in hippocampal CA3 region and the impacts of some central transmitters on the effect of Al in in hibiting PS.MAIN OUTCOME MEASURES: PS evoked in hippocampal CA3 region;the impacts of Al on EP in CA3 region and the impacts of some central transmitters on the effect of Al in inhibiting PS. RESULTS: ① After the application of 0.5 mol/L of AlCl3 in hippocampalCA3 region by microinjection, the recorded amplitude of PS reduced to peakat 1 minute, which accounted for(33.8 ± 11. 0) % of the level beforemedication( n = 6). The inhibitive effect of AlCl3 lasted for 120 minutes. ② After the pre-application of 1 × 10-9 mol/L of Tacrine(cholinesterase in hibitor) into CA3 region by microinjection and the application of AlCl3 at oneminute later, it was found that Tacrine antagonized the inhibitive effects ofAlCl3 on PS within 1 to 30 minutes( n = 8) . Its antagonism would extend to60 minutes if 1 × 10-8 mol/L of Tacrine was administrated( n = 6) . How ever, the antagonism of 1 × 10-10 mol/L of Tacrine was weaker than that of 1×10-9 mol/L group within 3-5 minutes(n=6) ③ After thepre-application of 1 × 10-3 mol/L of Bicuculline into CA3 region by mi croinjection and the application of AlCl3 at one minute later, Bicucullinecould partially weaken the effects of AlCl3 within 1 to 20 minutes( n = 9). CONCLUSION: Al of certain concentration can inhibit the evoked PS am plitude in hippocampal CA3 region; Tacrine can antagonize Al' s effects andits antagonism might be related with dose. Hence, the inhibitive effects of Almight be related with the damage in Ach transmitter system. The applicationof Bicuculline, a GABAA inhibitor, also can weaken the PS inhibitive effectsof Al, which indicates that the inhibitive effect of Al also might be effective through GABA approach.

ve To explore the levels of boood lead of preschool children in Harbin and their impacts on the growth and development of children. Methods 310 preschool children aged 4~7 years were selected for measurement of height and weight, and for collection of fasting blood samples, determined for concentrations of lead by ICP/ MS assay. The state of lead poisoning in selected subjects was defined based on the blood lead level of ?100?g/L ruled by the standard of children's lead poisoning established by CDC in 1991 and Health Assessment Scale for Growth and Development of Children set by Academy of Preventive Medicine. Results The prevalance rate of lead poisoning a-mong selected preschool children was 14.9%. Significantly negative correlation was observed between the blood lead levels and heights (H), body weights(BW) in children aged 4~5 years (rBw = -0.158, P

Objective To investigate the effect of non-hazard treatment of feces on control of intestinal infectious diseases and parasitosis. Methods During Nov, 2003-May, 2004, we selected 6 counties as observational points by the character of geographical position and the types of non-hazard treatment in Hunan province. The number of fecal coliform and the sedimentation rate of parasite ova were measured, the methods of questionnaire and retrospective study were used and the prevalance rate of intestinal infectious diseases, the incident rate of infectious diarrhea and infectious rate of parasite were analyzed. Results Among three types of non-hazard treatment, the eligibility rates of fecal coliform were 95.0%, 93.5%and 91.7% respectively,and the sedimentation rates of parasite ova were 90.0%, 90.3% and 87.5% respectively. Compared with the villages where the latrines had not been improved, the infectious rates of parasite decreased by 67.0%,the prevalance rate of intestinal infectious diseases decreased by 58.3%, and the incidence rates of infectious diarrhea decreased by 56.3% in villages where the latrines had been improved. Conclusion Non-hazard treatment of feces will play an important role in preventing of intestinal infectious diseases, infectious diarrhea and parasitosis.

Objective To investigate whether cochlear hair cells occur apoptosis following kanamycin treatment in guinea pigs. Methods It was comprised of two groups of six animals each. Experiment group and control group were subjected to administration of kanamycin,im,400 mg?kg -1 ?d -1 ,and saline respectively for successive 10 days. One week later, animals were sacrificed. Left cochlea and right cochlea were taken for cochlea preparation and cochlea section respectively. Apoptosis was detected by terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(d-UTP) nick end-labling(TUNEL) method.Results Apoptosis was present in cochlear hair cells, supporting cells as well as marginal cells of stria vascularis except for the spiral ganglion cells in kanamycin treatment guinea pigs. No apoptosis was detected in control animals. Conclusion Apoptosis of cochlear cells play important role in kanamycin ototoxicity.

Objective To observe the intervention effect of Wuxing-Jiangu exercise for different syndrome types of elderly patients with chronic low back pain.Methods A total of 199 patients who met the criteria of chronic low back pain (CLBP) were divided into a Wuxing-Jiangu exercise group (86 cases), a control group (85 cases) and a health education group (28 cases). On the basis of health education, theWuxing-Jiangu exercise group was given Wuxing-Jiangu exercise; the control group was treated with the warm type frequency therapeutic instrument; health education group was only given health education guide. The changes of the score of CLBP patients before and after treatment with different syndrome types were observed.Results After 3 months of treatment, the score of the kidney deficiency syndrome and spleen deficiency syndrome in the Wuxing-Jiangu exercise group, the control group and the health education group had significant differences (H were12.554, 8.014, respectively;all P<0.01); After 3 months of treatment, the score of kidney deficiency syndrome and spleen deficiency syndrome in the Wuxing-Jiangu exercise group reduced than before the treatment (Z were -5.975,-5.025, respectively)and 1 month after the treatment(Z were -5.976,-5.026, respectively) (all P<0.01).Conclusion Wuxing-Jiangu exercise can reduce the score of the kidney deficiency syndrome and spleen deficiency syndrome and improve clinical syndrome.

Objective To study the clinical value of plasma BNP level in evaluation cardiac function of children with left-to-right shunt congenital heart disease.Methods 32 children with left-to-right shunt congenital heart disease were selected as the observation group.Then according to the heart load capacity,the observation group children were further divided into right ventricular group(14 cases) and left ventricular group(18 cases).20 cases of normal children were selected as the control group.Then plasma BNP level was determined by ELISA and the left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),right ventricular end diastolic diameter(RVEDD),pulmonary blood flow/systemic blood flow ratio (Qp/Qs) and left heart Tei indices were determined by echocardiography.Results In the right ventricular group,the BNP level was (360.21 ± 56.78) ng/L,LVEDD was (35.71 ± 6.98) mm,RVEDD was (25.04 ± 5.52) mm,Qp/Qs was (1.74 ± 0.24) and left heart Tei index was (0.34 ±0.12).And in the left ventricular group,the BNP level was (384.57 ±55.18) ng/L,LVEDD was (45.27 ±7.26)mm,RVEDD was (12.34 ±2.18)mm,Qp/Qs was (1.78 ±0.19) and left heart Tei index was (0.36 ±0.11),which were significantly higher than those in the control group (F =307.00,18.92,84.24,91.47,3.44,all P ＜ 0.05).LVEF of the observation group had no obvious difference compared with the control group (F =1.51,P ＞0.05).The plasma BNP level of the right ventricular group was positively correlated with RVEDD,Qp/Qs and left heart Tei index (r =0.634,0.721,0.647,all P ＜ 0.05).The plasma BNP level of the left ventricular group was positively correlated with LVEDD,Qp/Qs and left heart Tei index(r =0.547,0.794,0.745,all P ＜ 0.05).There was no correlation between the plasma BNP level and LVEF of the observation group.Conclusion The plasma BNP level can help evaluation the early cardiac function of children with left-to-right shunt congenital heart disease,and combined with echocardiography can accurately reflect the early cardiac function of the left-to-right shunt congenital heart disease,which can provide basis for the clinical diagnosis and treatment.

Objective To study the clinical and pathologic features,and endoscopic diagnosis as well as therapy and prognosis of the primary gastrointrestinal lymphoma(PGIL), and to improve its diagnosis and therapy efficiency. Methods The clinical data in 29 cases of PGIL were retrospectively reviewed. Results In these cases, the tumor was mainly located at stomach (n=21), colon(n=6) and small intestine(n=2). The type of pathology was mucosa associated lymphoid tissue lymphoma(n=8), diffuse large B-cell lymphoma(n=18), T-cell lymphoma(n=3). The commom manifestation include abdominal pain, anaemia, abdominal distention, melena or hemafecia, loss of weigh etc. The tumor appeared infilitrative in 11 cases, ulcerative in 10 cases, protruding in 6 cases, 9 cases were diagnosed by firstly routine biopsy endoscopiccally. 10 cases were treated by operation and chemotherapy, 19 cases were treated by chemotherapy. Up to now, 6 cases survival in operation group, 13 cases survival in chemotherapy group, the difference was not statistically significant . Conclusions PGIL was mainly located at stomach, which was not specific clinical manifestation; The type of pathology was mainly diffuse large B-cell lymphoma; the diagnositic rate of routine endoscopic biopsy was low. chemotherapy was the first treatment of PGIL.

Objective To assess the diagnostic value and safety of push enteroscopy in intestinal diseases. Methods From March.1998 to December 2006,345 patients were examined by push enteroscopy.Results The enteroscope bypassed the Treize ligament in 318 cases, The average examination spend 30 minutes. 144 patients were diagnosed intestinal diseases, the detection rate was 41.74%. 28 patients underwent endoscopic haemostasis treatment, 13 patients received endoscopic polypectomy. No complication of perforate, hemorrhage, abdominal pain occurred. Conclusions Push enteroscopy is an efective and safe method for diagnosing intestinal diseases, and could undertook corresponding therapy.

Objective To discuss the diagnostic and therapeutic value of duodenoscopy for chronic pancreatitis. Methods A total of 67 patients with chronic pancreatitis were treated with duodenoscopy in our hospital from January 2000 to December 2006. Among the patients, 19 patients who had duodenal papilla stenosis without obvious dilation of the pancreatic duct were treated with EST; 48 patients who had dilation of the pancreatic duct underwent EST combined with EPS. ERBD was performed on 21 patients who had stenosis of the inferior segment of the common bile duct, among which 12 received insertions of two stents into the biliary pancreatic duct. In 27 patients with stones in the pancreatic duct, the stenotic segment of the pancreatic duct was dilated after EPS, and then the stones were removed using basket or balloon. Afterwards, ERPD was performed if necessary. These patients were followed up with ERCP every 3 months, stents were used if necessary. Results Duodenoscopy was completed in 62 of the 67 patients with a success rate of 92.5% (62/67). Abdominal pain disappeared or markedly relieved in 60 cases after the treatment showing an effective rate of 96.8% (60/62). The operation was ineffective in 2 patient, who had no relief of their abdominal pain. The failure of stent insertion was due to the multiple stenosis of the pancreatic duct. Abdominal pain was markedly relieved in 21 patients who received ERBD and 38 patients who underwent ERPD. During a 39.5-month follow-up (5-70 months), no recurrence of the symptom was found. In the 27 patients with stones in the pancreatic duct, the stones were removed in 19 patients. After the treatment, 15 patients developed transient hyperamylasemia, 5 had acute pancreatitis, 3 had hemorrhage. No perforation, conversion to an open surgery, or death occurred in this series. Conclusions Duodenoscopy, which is safe, effective, and minimally invasive, is the first choice for chronic pancreatitis. The treatment outcomes can be improved by combining duodenoscopy with other therapies.