BACKGROUND: In recent years, percutaneous laser disc decompression (PLDD) has been developed gradually in China. But there have been fewer further studies on the indications and contraindications for the use of the therapy.OBJECTIVE: To analyze the therapeutic effect after the choice of the indications for PLDD.DESIGN: A case-paired observational analysis with the patients as the subjects.SETTING: The Department of Radiology and Department of Soft Injuries of the 474 Hospital of Chinese PLA.PARTICIPANTS: We recruited inpatients of the 474 Hospital of Chinese PLA after PLDD between August 1998 and December 2004 as subjects for this research. Totally 68 cases were involved. According to the same gender, the closeness in age, the cases were matched and divided into 2 groups (eg. If there were 2 or more than 2 cases with the same age, the case whose disease course is the closest one was chosen): poor indication group (n=34) and good indication group (n=34).METHODS: A pillow was put under the belly of the patient who lay face down on the angiographic bed with the side with serious symptoms near the outside of the bed (the side where doctor operated). Symbols were marked on the body surface under the fluoroscopy. The waist was subjected to conventional sterilization and was paved with a piece of sterile cloth. 5 Ml of lydocaine was used for anesthesia. 8-12 cm to the posterior central midline of the diseased side, an incision was made to insert the needle according to the fat and thinness of the patients, and attention to the angle adjustment was needed to enter the intervertebral disc through "the secure triangle"beneath the nerve root so that 5 mm of the exposed front segment covered the needle end completely. Cautery was made with 15 W laser for every 1s after an interval of 4 s. The total output power of laser was adjusted according to the area of intervertebral disc, which was usually 1 200-1 700joules. The gas produced should be drawn out during the cautery, and this was done at least for 3 times. If the patient felt the distending pain, drawing out gas should be performed at any time. The puncturing needle and fiberoptics were pulled out after the operation, and band-aid was applied to the local area. The patients lay at the supine position to let the doctor examine the remission and functional recovery. When the patients were discharged, modified Macnab standard was used to evaluate the therapeutic effect. Evaluation criteria: According to the modified Macnab standard, the therapeutic effect can be classified into the following types: excellent means disappearance of pain, no limitation in motor function, with complete recovery of normal working and movement; good means that the patients showed occasional pain, but were able to do light job; passable means that the patients showed partial improvement, but still felt pain, and were not able to work and move; poor means that the patients showed signs of nerve compression that further operation was needed. The therapeutic effect of being excellent and good was combined as good therapeutic effect,and that of being passable and poor was combined as poor therapeutic effect. X2test was performed to the paired numerative data by the author.MAIN OUTCOME MEASURES: ① General evaluation of the therapeutic effect of the poor indication group and good indication group according to modified Macnab standard when the patients were discharged from the hospital; ② Comparison of the curative effect between the group with intervertebral disc herniation ≥ 0.6 cm and the group with intervertebral disc herniation ＜ 0.6 cm; ③ Comparison of the therapeutic effect of the group complicated with spinal canal stenosis and the group with normal spinal canal; ④ Comparison of the therapeutic effect between the group with good indications and other groups with poor indications.RESULTS: All the 68 patients entered the result analysis. ①The therapeutic effect in the good indication group was obviously better than that in the poor indication group, with a significant difference [85%(29/34),56%(19/34) ,χ2=5.06,P ＜ 0.05]. ② The therapeutic effect was significantly better in the group with intervertevbral disc herniation ＜ 0.6 cm than in the group with intervertevbral discs herniation ≥ 0.6 cm, but without significant difference [75 % (6/8), 50% (4/8),χ2=0.25, P ＞ 0.05]. ③The therapeutic effects were close in the group complicated with spinal canal stenosis and the group with normal spinal canal, but without significant difference [80% ( 12/15 ), 73 ( 11/15 ) ,χ2=0,P ＞ 0.05].④ The therapeutic effect in the group with good indications was obviously better than that in other groups with poor indications, with a significant difference [100%( 11/11 ), 36%(4/11), χ2=5.14,P ＜ 0.05].CONCLUSION: It could improve the therapeutic effects of PLDD when indications were properly chosen.

Objective: To evaluate the prevention and treatment effects of acupuncture-moxibustion for Alzheimer disease (AD) based on various AD mouse models.Methods: Several representative types of mouse models were selected according to the pathophysiological causes of AD, including senescence accelerated mouse/prone (SAMP) mice, soluble amyloid-β protein (Aβ) injection mice/rats, amyloid precursor protein (APP) transgenic mice, and APP/PS1 double transgenic mice. Through the observation of behavioral changes and analysis of core items, the possible mechanisms of acupuncture-moxibustion in preventing and treating AD were explored. Results: Acupuncture-moxibusiton therapy can improve AD mice's cognitive dysfunction; the major action mechanisms including increasing cerebral blood flow, improving the expressions of vital proteins in the hippocampus, preventing neuron cell apoptosis, promoting the clearance of Aβ deposition, activating autophagy pathway to reduce memory deficits and regulating the metabolisms of brain-derived neurotrophic factor, tyrosine kinase receptor B, N- acetylaspartate and glutamic acid. Conclusion: Although the optimal mouse model is not determined, it is sure that acupuncture-moxibustion therapy can improve cognitive function. A more suitable AD animal model should be duplicated in order to better explore the inherent action mechanism of acupuncture-moxibustion in preventing and treating AD.

AIM: To explore the effect of early posterior approach vitrectomy in the treatment of penetrating ocular trauma with intraocular foreign body.METHODS: Totally 10 cases of penetrating ocular trauma with intraocular foreign bodies(IOFB) in the past two years were included.Emergency vitrectomy, intraocular foreign body removal and silicone oil tamponade were performed by the same surgeon.Antibiotics and steroids were given after surgeries.Retinal photocoagulation was done according to fundus conditions after surgeries.RESULTS: One patient combined with preoperation endophthalmitis and severely damaged retina failed to recover, eventually came to phthisis bulbi.Vitrectomy and IOFB removal were all successfully performed in the other patients.The postoperation follow-up time was 3-18mo.Two of the patients received secondary vitrectomy and silicone replacement surgeries due to recurrent retinal detachment.The remaining patients had no further bleeding with intraoclar pressure(IOP) 8-21mmHg.At the last follow-up, three of them gained best corrected visual acuity better than 0.1, two patients had visual acuity of 0.01 to 0.1 and four patients had poor visual acuity of light perception to FC/50cm because of macular damage.The patient with phthisis bulbi had no light perception.CONCLUSION: Early vitrectomy, foreign body removal and silicone oil tamponade is an effective treatment for patients with penetrating eyeball injury with IOFB.

Objective To find out the physical state of the human papillomavirus ( HPV) genome in hepatoma cell line HepG2 cells and the regulation of HPV late capsid protein 1 ( L1) expression and to explore the nature of the cytoryctes in HepG2 cells.Methods E2 and E6 in HPV18 were detected by PCR to evaluate the physical state of HPV18 genome .HepG2 L1 expression was detected by ELISA , light microscropy and electron microscrope immu-nohistochemistry assays , Western blot assay using HPV L 1 mice monoclonal antibody .L1 mRNA in HepG2 cells was detected by reverse transcriptional PCR ( RT-PCR) .Results PCR assay displayed that HPV DNA was inte-grated with HepG2 genome.ELISA assay showed that HPV L1 was present in lysate of HepG2 cells.Light micros-cropy demonstrated strong positive reaction in HepG2 cells.In microscopy, in the cytoplasm of partial HepG2 cells, there were lumpish cytorrhyctes materials which consists of very small and uniform particles and these parti -cles were marked by HPV L1 antibody labeled by colloidal gold .Western blot analysis showed a band at 56 ku dis-trict and it was L1 specific strap which demonstrated HPV 18 L1 was present in HepG2 cells.RT-PCR assay demon-strated the presence of L1 mRNA in HepG2 cells.Conclusions HepG2 cells are HPV18-positive HPV DNA ge-nome is integrated with HepG2 cells.HepG2 cells can express L1.The cytorrhyctes in HepG2 cells are composed of HPV18 L1 indicating that L1 can be expressed in HepG2.

Objective To explore the influences of Dexmedetomidine for laparoscopic cholecystectomy on stress reaction and hepatic/renal functions. Methods Totally 100 cases with laparoscopic cholecystectomy were divided into two groups:Dexmedetormidine group and Propofol control group (n=50 for each group) according to the different anesthetic methods.The hemodynamic change,stress reaction and hepatic/renal function were measured and analyzed. Results Heart rate [(85.7±13.4)times /min vs.(62.7±9.9) times/min; (81.3±14.9) times/min vs.(60.3±8.8)times/min,t=2.296,2.714,P=0.045,0.022] and mean artery pressure(MAP )[(86.3±11.9)mm Hg vs.(66.5+11.7) mm Hg; (88.6±15.6) mm Hg vs.(68.7± 12.3) mm Hg,t=2.653,2.240,P=0.024,0.049] immediately at trachea cannula and 1 min after trachea cannula were significantly increased in Propofol control group as compared with Dexmedetomidine group.In contrast to Propofol control group,epinephrine[(680.1±112.3) pmol/L vs.(576.1±83.1)pmol/L; (705.4±127.6)pmol/L vs.648.8±105.3) pmol/L,(689.6±123.4) pmol/L vs.(628.2±94.3) pmol/L,t=2.628,2.242,2.224,P=0.019,0.039,0.040],norepinephrine[(3953.6±514.6) pmol/L vs.(3695.1±196.2) pmol/L; (3967.2=514.9) pmol/L vs.(4367.1±565.7) pmol/L; (4095.8±415.1) pmol/L vs.(3813.4 ± 513.7) pmol/L, t =2.454, 2.500, 2.255, P =0.032, 0.030,0.045] and hydrocortisone [(796.6±198.7) nmol/L vs.(698.7±176.3) nmol/L; (835.5+217.2) nmol/L vs.(783.7±201.9) nmol/L; (822.4±203.3) nmol/L vs.(720.6±188.1) nmol/L,t=2.334,2.167,2.189,P=0.033,0.044,0.043] immediately at trachea cannula,1 min and 5 min after trachea cannula were decreased in Dexmedetomidine group.There were not significantly differences in hepatic/renal function between the two groups (P＞ 0.05). Conclusions Dexmedetomidine is safe and effective for laparoscopic cholecystectomy in view of more stable hemodynamics,less stress reaction,and non influence on hepatic/renal function.

BACKGROUND: Percutaneous laser disc decompression(PLDD) is a new technology developed to treat lumbar herniated disk inrecent years; however,only limited literature has been reported about cohort study on its indications.OBJECTIVE: To treat patients with lumbar disc herniations by PLDD and evaluate the effects of PLDD in releasing painandimproving lumbar function after operation.DESIGN: Non-randomized concurrent controlled trial based on thepatients.SETTING: Department of Radiology of the 474 Hospital of Chinese PLA.PTICIPANTS: This study recruited totally 173 patients ( 101 males and 72 females aged from 18 to 75 years) who received PLDD in the Department of Radiology of the 474 Hospital of Chinese PLA from July 1998 to August 2002 and were followed up for over one year.METHODS:The 173 patients were divided into good indication group (Group A, n = 139) and poor indication group(Group B, n =34). Group B was further divided into extrusion group(Group B1 of 8 patients),lumbar canal stenosis group(Group B2 of 15 patients) and other conditions group (Group B3 of 11 patients). VAS scoring criteria and modified Macnab criteria were used to evaluate the curative effects.MAIN OUTCOME MEASURES: Primary results: the degree of pain and lumbar function. Secondary results:the success rate of puncture as well as adverse events and side effects.RESULTS: The success rate of puncture was 96. 3％ for performing through L5 - S1 and 100％ through L3-4 and L4-5. In Group A, excellent postoperative effects were seen in 63 cases, good in 51 cases, fair in 20 cases and poor in 5 cases, with 82.0％ excellent and good rates. The excellent and good rate in Group B was 55.9％. Postoperative back pain could be relieved several days later. Other complications such as disc infection,psoas hematoma,rupture of colon,injuries of nerve roots and bloodvessels did not occur. There was a significant difference between Group A and Group B(x2=10.38, P ＜0.05).CONCLUSION: (① PLDD is a convenient, safe and reliable procedure in treating lumbar disc herniation because of its high success rate, satisfactory results and fewer complications.② Proper selection of indications helps improve the curative effects of lumbar disc herniation.

Exosomes are nanosized membrane microvesicles secreted by various living cells.They contain proteins,lipids,RNA,and a variety of other biological macromolecules.Exosomes play an important role in many pathological and physiological processes,such as antigen presentation in the immune system,repair of damaged tissues,and growth and migration of tumors.Tumor-derived or tumor-associated exosomes play a vital role in regulating the occurrence and development of tumors.The analysis and detection of exosomes in tumors is helpful for the early diagnosis of tumors and provide new treatment methods.This article reviews exosomes' origin,composition,and functions in the development,migration,diagnosis,and treatment of tumors and provides new ideas for the treatment of tumors.

Objective To discuss prevention and treatment of the late complications of deteniaceacal-colon continent urinary reservoir. Methods 105 patients who underwent detenia ceacal-colon con-tinent urinary reservoir were followed up for 9 -82 months(mean 40.5 months).Clinical data of these wereretrospectively analyzed. Results Late complications occurred in 25.7%(27/105) of the cases and 9were treated with operations,including difficulty with catheterization in 4 cases(3.8%),3 treated with dila-tion and 1 with efferent limb reconstruction with ileal,urinary pouch stones in 5(4.8%),4 treated with li-thotomy,urinary pouch perfotation in 1 (0.95%),treated with repair,urinary pouch superdistention in 1(0.95%),treated with reduction, single or double lateral hydronephrosis in 8(7.6%),caused by strictureof single or double lateral lower ureters in 4 (2 treated with excision lesion and anastomosis ) and by refluxin 1,1 case suffering from azotemia preoperatively worsened to uraemia treated with regular haemodialysis,hyperchloremia in 7 (6.7%),only 1 needed drugs treatment,repeated urinary infection in 11,amomg them,10 were complicated by the other complications,all treated with sensitive antibiotic. Conclusions Most ofpatients underwent detenia ceacal-colon continent urinary reservoir had good curative effects. Late complica-tions afflicting these patients mostly had immediate or mediate relations with symptomatic urinary infection.Prevention and treatment of symptomatic urinary infection can reduce the occurrence of late complications ofthis operative method,regular and adequant pouch washing and catheterization is efficient to prevention oflate complications of this operative method.

Objective:To analyze the current situation of sulfur dioxide residues in Chinese herb pieces through determining the residues in Chinese herb pieces purchased by our hospital to provide the information for the quality control of Chinese herb pieces in our hospital and ensure the clinical medication safety. Methods:The methods for the detection of sulfur dioxide residues described in Chi-nese Pharmacopoeia 2010 edition and the relative literatures were adopted. Totally 100 batches of Chinese herb pieces were selected randomly from the storage waiting products, including 10 categories of 36 batches with the limitation of 400 mg·kg-1 and the other categories of 64 batches with the limitation of 150 mg·kg-1 . Results: The sulfur dioxide residues in 14 batches were out of limits, and among them, 7 batches were over 400 mg·kg-1 and the other 7 ones were over 150 mg·kg-1 . The unqualified rate was 19. 4%and 10. 9% for the samples with the limitation of 400 mg·kg-1 and 150 mg·kg-1 , respectively. Conclusion:The detection method is simple, reproducible and rapid in determining sulfur dioxide residues in Chinese herb pieces. The exceeding standard situation of sulfur dioxide residues in Chinese herb pieces is serious, and the management on Chinese herb medicines with sulphur fumigation should be strengthened by manufacturers. Hospitals should implement the determination of sulfur dioxide residues before storage to en-sure drug safety.

Hypertension is one of main risk factors for the occurrence and death of stroke and coronary heart disease. Its prevalence rate is rising year by year. It severely threatens the health of the human beings. The acupuncture method of "activating blood and dispersing wind, harmonizing Gan-Pi" for treating hypertension launched by Academician SHI Xue-min has aroused great attention due to good cur- ative effect and less adverse reactions. In this paper principles of the circular motion covered by the acupuncture method of "activating blood and dispersing wind, harmonizing Gan-Pi" were clarified.
Acupuncture ; Acupuncture Therapy ; methods ; Coronary Artery Disease ; Humans ; Hypertension ; therapy ; Medicine, Chinese Traditional ; Risk Factors ; Stroke ; Wind