Objective To discuss bilateral percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) using inside and outside intravertebral vacuum cleft (IVC) respectively with bone cement injection for the treatment of Kümmell disease.Methods From January 2008 to October 2015,16 cases of Kümmell disease patients were treated with bilateral PVP or PKP with inside and outside IVC perfusion of bone cement respectively.Of 16 cases,6 were male and 10 were female,aged from 63 to 94 years,with a disease duration from 2 to 15 months.The bone mineral density of every patient was measured by dual-energy X-rayabsorptiometry.The T value ranged from-4.3 to-2.6.Fractures located from T10 to L4,including 2 cases of multiple fractures.Postoperative X-ray was used to observe the vertebral bone cement leakage and anterior height changes of affected vertebrae.Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pain status and functional activity.Results All cases were followed up for 12-96 months.Cement leakage occurred in 4 patients without nerve complications.The anterior height of affected vertebrae before operation,2 d after operation and at the last follow-up was (50.3 ± 8.3)％,(67.1 ± 8.1)％ and (65.2 ± 6.4)％.The anterior height of affected vertebrae 2 d after operation and at the last follow-up were significantly improved compared with those before operation (P ＜ 0.05),but there were no significant differences between 2 d after operation and at the last follow-up (P ＞ 0.05).The scores of VAS before operation,2 d after operation and at the last followup was (8.63-± 1.23),(2.56 ± 3.48) and (1.38 ± 0.92) scores,and the scores of ODI was (82.1 ± 6.7)％,(28.5 ± 7.3)％ and (22.1 ± 8.2)％.The scores of VAS and ODI 2 d after operation and at the last follow-up were significantly decreased compared with those before operation (P ＜ 0.05),but there were no significant difference between 2 d after operation and at the last follow-up (P ＞ 0.05).There was no postoperative in situ or adjacent vertebral fracture.Conclusions Using internal and external IVC bone cement injection for treatment of Kümmell disease has a good clinical curative effect.It can effectively relieve back pain symptoms,reduce intraoperative and postoperative bone cement leakage and recurrent adjacent or in situ vertebral fracture.

Objective　To introduce the management experience in the first cause of living-related small bowel transplantation in China. Methods　An 18-year-old male patient with short gut syndrome received a living-related small bowel transplantation with the graft taken from his father(44-year-old). A segment of 150?!cm distal ileum was resected from the donor. Treatment of immunosuppression, antibiotics, antithrombosis and nutrition support were given posttransplantatively. Results　Recently the recipient has a good life quality for 19 months. Conclusions　Living-related small bowel trnasplantation can be effectively used to treat short gut syndrome, and the posttransplantative management is the key to the successful transplantation.

Objectives:To compare the clinical efficacy between robot-assisted cortical bone trajectory screw(RCBTS)and robot-assisted pedicle screw(RPS)for patients with lumbar spinal stenosis(LSS)undergoing sin-gle-level decompression and fusion.Methods:In this retrospective cohort study,LSS patients who underwent robot-assisted single-level decompression and fusion in Beijing Shijitan Hospital between June 2020 and June 2022 were reviewed.A total of 99 patients were included and divided into RCBTS group of 41 patients and RPS group of 58 patients.There were 59 males and 40 females,with an average age of 67.07±4.65 years old.The incision length,operative time,intraoperative blood loss,24h postoperative drainage,and postopera-tive hospital stay were compared between groups.The Japanese Orthopaedic Association(JOA)score and visual analogue scale(VAS)of low back pain were compared at 3d,3 months and 6 months after operation,and the fixed effects of JOA score and VAS score changes were tested.The screw positions were graded according to the Gertzbein-Robbins method.The accuracy of screw placement of the two surgical methods was evaluated by reviewing the postoperative imaging data.The perioperative and postoperative 3 months of complications were compared between the two groups.Results:There were no significant differences in baseline data be-tween the two groups(P＜0.05).Comparing with the RPS group,the RCBTS group was shorter in operative time(134.39±22.23min vs 152.93±19.10min,P＜0.001),smaller in incision length(64.93±3.71mm vs 78.84±3.82mm,P＜0.001),less in intraoperative blood loss(155.61±37.15mL vs 172.41±43.22mL,P=0.001)and postoperative drainage within 24h(83.66±21.54mL vs 101.21±29.80mL,P=0.002),and shorter in postoperative hospital stay(4.90±1.26d vs 6.26±1.66d,P＜0.001),with statistical significance.There was no significant difference in JOA score and VAS score changes between the two groups at each time point(P＞0.05).The fixed effect test showed that time was a fixed effect of JOA and VAS score changes(P＜0.001).The RCBTS group was no sig-nificantly different from the RPS group in the accuracy of screw placement(grade A:152/164 vs 211/232,P=0.538;grade B:9/164 vs 15/232,P=0.688;grade C:3/164 vs 6/232,P=0.619),the rate of clinically accept-able screw placement(161/164 vs 226/232,P=0.619),the rate of bad screw placement(3/164 vs 6/232,P=0.619),and the incidence of postoperative complications(only 1 patient in the RCBTS group developed delayed wound healing)(P＞0.05).Conclusions:Compared with RPS,RCBTS has significant advantages in operative time,incision length,intraoperative blood loss,volume of postoperative drainage,and postoperative hospital stay.However,there is no significant difference between the two groups in terms of postoperative functional recovery and alleviation in low back pain.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids(ω-3PUFAs)and ω-6 polyunsaturated fatty acids(ω-6PUFAs)on Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway,and the expressions of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β and IL-6 in neonatal rats with brain injury induced by lipopolysaccharide (LPS). Methods Ninety-six neonatal rats were divided into control group,ω-3PUFAs group,ω-6PUFAs group,and LPS group by using random number table method. Intraperitoneal injection of LPS was performed in LPS group,ω-6PUFAs group and ω-3PUFAs group to establish models of rat brain injury. The rats in control group received 9 g/L saline. Twelve newborn rats were killed at 1 d or 5 d after intraperito-neal injection in each group for hippocampus selection. Real -time PCR and Western blot were used to detect the mRNA and protein expression levels of TLR4,NF-κB,TNF-α,IL-1β and IL-6. Results One day after mode-ling,TLR4,NF-κB,TNF-α,IL-1β and IL-6 mRNA expressions in ω-3PUFAs group (10. 63 ± 0. 07,5. 86 ± 1. 05,7. 65 ± 2. 29,5. 23 ± 1. 31,3. 36 ± 0. 72)were lower than those in ω-6PUFAs group (18. 83 ± 2. 10,8. 79 ± 2. 08,11. 95 ± 3. 23,10. 97 ± 2. 24,6. 37 ± 1. 17)and LPS group (15. 76 ± 1. 59,7. 13 ± 1. 10,9. 71 ± 2. 14,7. 83 ± 0. 85,4. 78 ± 0. 51),and the differences were all statistically significant(all P＜0. 05);which in ω-6PUFAs group were higher than those in LPS group,and the differences were all significant (all P＜0. 05). TLR4,NF-κB,TNF-α, IL-1β and IL-6 protein levels in ω-3PUFAs group (1. 57 ± 0. 11,1. 58 ± 0. 09,1. 55 ± 0. 09,1. 63 ± 0. 31,1. 36 ± 0. 12)were lower than those in ω-6PUFAs group (1. 96 ± 0. 17,2. 21 ± 0. 12,1. 95 ± 0. 23,1. 97 ± 0. 24,1. 77 ± 0. 17)and LPS group (1. 73 ± 0. 15,1. 87 ± 0. 10,1. 79 ± 0. 14,1. 83 ± 0. 15,1. 58 ± 0. 11)in 1 d,and the diffe-rences were all significant (all P＜0. 05),and those in ω-6PUFAs group were higher than those in LPS group (all P＜0. 05). Similarly,TLR,NF-κB,TNF-α,IL-1β and IL-6 mRNA and protein expression levels in ω-3PUFAs group (3. 78 ± 0. 88,3. 86 ± 0. 62,6. 26 ± 1. 94,3. 65 ± 1. 44,2. 11 ± 0. 87;1. 15 ± 0. 08,1. 32 ± 0. 10,1. 46 ± 0. 04, 1. 38 ± 0. 14,1. 21 ± 0. 09)were lower than those in ω-6PUFAs group (7. 76 ± 1. 65,5. 51 ± 0. 88,7. 96 ± 2. 13,5. 35 ± 1. 75,4. 88 ± 1. 35;1. 42 ± 0. 15,1. 51 ± 0. 36,1. 65 ± 0. 13,1. 72 ± 0. 23,1. 48 ± 0. 10)and LPS group (6. 21 ± 1. 87, 4. 98 ± 0. 73,7. 11 ± 2. 10,4. 84 ± 1. 75,4. 25 ± 0. 64;1. 35 ± 0. 13,1. 44 ± 0. 22,1. 59 ± 0. 10,1. 61 ± 0. 18,1. 35 ± 0. 07) in 5 d (all P＜0. 05),and which in ω-6PUFAs group were higher than those in LPS group,and the differences were sig-nificant (all P＜0. 05). Conclusion ω-6PUFAs can up-regulate the activity of TLR4,NF-κB,and reduce the re-lease of TNF-α,IL-1β and IL-6;and ω-3PUFAs can down-regulate the activity of TLR4,NF-κB,and reduce the release of TNF-α,IL-1β and IL-6,so it has a neural protective effect in brain injury induced by LPS.

【Objective】 To establish and verify the vacuum decay method for the tightness inspection of blood products. 【Methods】 The method for inspecting the tightness of blood product was established, and the detection limit, linearity, range, accuracy, precision and durability were verified according to the requirements of methodological verification.The validated method was used to check the tightness of blood product packaging. 【Results】 The detection limit of this method was 2.5 μm, linear correlation coefficient was r=1, the differential pressure of positive sample was within the allowable range of accuracy, and the durability met the requirements.The RSD of results of 6 repeatability tests and 12 intermediate precision tests were both less than 10%, and all validation items met the verification standards. 【Conclusion】 Vacuum decay method can be used to check the tightness of blood products.

【Objective】 To establish gas chromatography for the determination of tributyl phosphate(TBP) residues in human prothrombin complex and then verify it. 【Methods】 Acid modified polyethylene glycol(PEG)(20M) capillary column was used with n-hexane as solvent. The chromatographic parameters were as follows: gasification chamber temperature at 220 ℃, column temperature at 155 ℃, detector temperature at 220 ℃, column flow rate at 2.0 mL/min, carrier gas as N2, detector as FID, and collection time for 10min. The accuracy, repeatability, linearity, specificity, intermediate precision, detection limit, quantitative limit, range and durability were verified. 【Results】 The verification results showed that the method had good specificity. The linear regression correlation coefficient of standard curve was 0.999 90. The recovery rate were 98.4%, 97.5% and 95.7% when the concentration at 50%, 100%(30μg/mL) and 150%, respectively, with an average recovery of 97.2% and a relative deviation of 2.15%. When the concentration was 100%, the repeatability was 2.08%, and the relative deviation of intermediate precision was 1.63%. The detection limit was 0.255 μg/mL, and the quantitative limit was 0.511 μg/mL. After changing capillary chromatographic columns with different batch numbers but the same types and manufacturer, the applicability test of the system met the requirements, and the method had good durability. 【Conclusion】 This method can be used for the determination of TBP residues of human prothrombin complex in laboratory.

The development of famous classical formula compound preparations has been a research hotspot in recent years， carrying great expectations from the government， academia and industry. During the process of its research and development， it reflects many problems related to traditional Chinese medicine （TCM） industry and deserves deep consideration by the academic community. Based on the current status of development of famous classical formulas， this paper summarizes the key problems and made an in-depth analysis. The results show that three key issues should be paid attention. The first is the weakness of basic research in TCM， which affect the healthy development of TCM. The second is the understanding of development of famous classical formula compound preparations is not in-depth， and the formulation of relevant policies needs to be more reasonable. Thirdly， the expectation for the development of famous classical formula compound preparations is too high， which affects the research and development process of the compound preparations. It is hoped that the TCM industry can take this opportunity to face the problems， propose solutions， and form new breakthroughs to promote the development and progress of TCM.