Macrovascular complications are the main death or disabling causes of diabetic patients.In recent years,the results of a number of clinical trials aimed at preventing diabetic macrovascular complications have been unveiled.Comprehensive and systemic analysis of these results may give great enlightenment to the clinicans,as well as promote the work in preventing diabetic macroangiopathy in China.

[Objective]To evaluate the posterior approach treatment of old traumatic lumbar spinal stenosis,lumbar kyphosis,intervertebral space stenosis using vertebral plate decompression,nucleus pulposus removal,intervertebral fusion and CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.[Method]Twenty patients with low lumbar spinal canal and intervertebral space stenosis,lumbar kyphosis caused by trauma were enrolled in this study.There were 13 males and 7 females,with an average age of 31.4 years (range 22-49).Four had lesions of L3、4,10 of L4、5 and 6 of L5S1.One patient was treated at 4 years after injury,3 within 9-15 months,6 within 3-6 months and 10 within 1-3 months after injury.All patients were treated with vertebral plate decompression,some serious patients underwent laminectomy decompression,nucleus pulposus removal,intervertebral fusion,CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.One week after surgery,patients could wear thoracic waist-iliac orthosis and take out-of-bed activity.[Result]All the patients lumbodynia,lower limb pain,muscle strength and hypoesthesia improved within one week after operation.X-rays showed that both the intervertebral space and the physiological curvature improved to some degrees.Twenty patients were followed up(ranged,1 to 3 years)and the clinical outcomes were good.The average Franke1 grade was 1.4.Re-X-rays showed that interbody fusion was achieved in all 20 patients.No loss was found about the altitude of the intervertebral space and the physiological curvature.[Conclusion]For patients with old traumatic lumbar spinal stenosis,the recovery of body altitude is almost impossible.This method is simple and has less complications.It can be widely used in the clinical practice.

Objective To determine the biological effectiveness of 125I radioactive seeds with continuous low dose rate radiation on the human esophageal cancer cell line KYSE150 in vitro and explore the underlying cellular mechanisms.Methods The cells were divided into three cell groups:control group,single dose radiation group (SDR) and 125I radioactive seeds with continuous low dose rate radiation group (125 I-CLDR).The KYSE150 cells were exposed to radiation of X-ray at a high dose rate of 1.052 Gy/min or 125I radioactive seeds at a low dose rate of 2.77 cGy/h.The responses of KYSE150 cells to two modes of irradiation were evaluated by the colony-forming assay,cell apoptosis as well as cell cycle analysis.Furthermore,the expression levels of γ-H2AX and Bax were detected by Western blot.Results KYSE150 cells were more radiosensitive to 125I-CLDR than SDR.The relative biological effectiveness (RBE) for 125I-CLDR related to SDR was 1.56.Compared with SDR,125I-CLDR yielded more proportions of the early and late apoptosis rate (t =4.07,11.08,P ＜0.05) as well as cells at G2/M phase (t =11.25,P ＜0.05).Moreover,γ-H2AX and Bax expression levels in 125I-CLDR significantly increased compared with SDR.Conclusions Compared with the high dose rate X-ray radiation,the continuous low dose rate radiation of 125I radioactive seeds had stronger inhibition effect on KYSE150 esophageal cancer cells by impairing clonogenic capacity,inducing apoptosis and G2/M cell cycle arrest,and increasing radiosensitivity.

Objective: To investigate the mechanism of Glytan lowering portal pressure induced by biliary liver fibrosis. Methods: SD male rats, 240-260g weight around, were randomly divided into sham-operation group, model group, propranolol group, Glytan high-dose, middle-dose and low-dose group according to the weight. Portal hypertension was induced by common bile duct ligation in rats. After two and four weeks, measured the portal pressure(PP) of each group, observed the histological changes of liver by HE staining, tested liver function and the concentration of endothelin-1 in systemic circulation and mesenteric circulation radioimmnuoassay. Results: After two and four weeks, portal pressure of model group rats increased significantly. Both Glytan and propranolol can decrease PP after two and four weeks, and the pressure-relief effect was similar between the two drugs. HE staining showed that Glytan can significantly inhibit the formation of collagen, promote the recovery of liver tissue structure; liver function indicated a significant decrease in serum AST, ALT, TBIL and Na+ concentration. In addition, Glytan decreased the concentration of endothelin -1 in systemic circulation, increased it in mesenteric circulation after two weeks. Conclusion: Glytan decrease PP by improving liver function and microcirculation, inhibiting collagen formation and water-sodium retention after long-term therapy, ameliorating hyperdynamic circulation at the early stage.

Objective To reveal the difference between the standards for genu varum and genu valgum in the medical standard directory PLA Air Force( PLAAF) for recruitment of flying cadets and those adopted in the United States Air Force ( USAF) , and suggest a method for the reform of our flying cadets recruitment.Methods The rejection rate and comprehe nsive assessment qualification rate of genu varum and genu valgum during physical examinations for recruitment of flying cadets between 2012 and 2015 were analyzed.The different standards for genu varum and genu valgum in PLAAF and USAF flying cadets recruitment were compared and subjected to an empirical study.Results During the final physical examination for selection of flying cadets between 2012 and 2015, only 18 candidates were eliminated because of genu varum and genu valgum, accounting 9.1% of the total eliminated candidates because of orthopadics diseases.Four candidates with genu varum and genu valgum passed the comprehensive assessment in 2014 and 31 in 2015, which accounted for 15%of the candidates with orthopaedics diseases approved by comprehensive assessment.The standards for genu varum and genu valgum in PLAAF were based on morphology while those in the USAF based on the function of knees.According to the USAF medical standard directory, 9 of the candidates rejected because of genu varum and genu valgum were qualified and 9 disqualified.Among the candidates with genu varum and genu valgum approved by comprehensive assessment, 32 were qualified and 3 disqualified.Conclusion The standards for genu varum and genu valgum in PLAAF medical standard directory are of lower accuracy.The standards of USAF should be referred to and the function of knees should be considered in selection of flying cadets.Femur-tibia angle should be measured to improve the morphological standards.

Objective To establish a key technological system for spider fibroin gene code tandem connection , vector construction , prokaryotic expression and purification using genetic engineering in order to achieve MaSp 1 heterologous ex-pression in Escherichia coli and its separation and purification .Methods Isocaudarner ligation method was used to connect synthetic spider fibroin gene monomer code in tandem , and a recombinant clone concatemer was obtained .The identified recombinant clones were connected with prokaryotic expression vector pET 28a(+), and then transformed into E.coli BL21 (DE3).After being induced by IPTG for 6 hours, the expression product was identified by SDS-PAGE and Western blot-ting.Engineering bacteria were fermented in high density , and the obtained protein was purified through ammonium sulfate fractionation.Results and Conclusion The expression plasmids of MaSp1concatemers were successfully constructed , and the induced expression genetic engineering MaSp 1 protein was of the expected relative molecular mass .In addition, the pu-rity of the purified protein was above 80%.This study has developed crucial technologies for mass production of genetic en-gineering spider silk proteins .

Objective To evaluate the clinical efficacy of transpedicular intracorporeal bone graft with allogenic bone in treatment of thoracolumbar osteoporotic compression fracture. Methods A total of 45 patients with thoracolumbar osteoporotic compression fractures were treated with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone. Anteroposte-rior and lateral X-ray photographs were taken before and after operation and at follow up period to determine the ratio of anterior and middle compressed body height to the normal height, the vertebral angle and the superior-inferior endplate angle. The extent of local pain was measured by VAS score. The implant failure was also recorded during follow-up. Results The operative reduction and interbody bone grafting exerted a satisfactory effect on the ratio of anterior and middle body height to the normal height, the vertebral angle and the superior-inferior endplate angle. Local back pain disappeared immediately after surgery in 34 patients out of 38 patients followed up for more than two years. No implant failure was found during follow-up. Conclusions Early treatment with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone can effectively correct local deformity, prevent late vertebral collapse and implant failure and is an ideal treatment method for thoracolumbar osteoporotic compression fracture.

Objective To study the impairment and the expression of receptor of advanced glycation endproduct (RAGE) in cultured rat glomerular mesangial cells ( GMC ) induced by constant and intermittent high glucose, and to investigate the pathogenesis of diabetic nephropathy. Methods After being cultured under constant and intermittent high glucose with different concentrations for 24 and 48 hours, the morphological changes of rat mesangial cells were observed, the proliferation of GMC was detected by MTT assay, the activity of superoxide dismutase (SOD)and the level of malondialdehyde (MDA)in supernatant were measured by spectrophotometer,and the expressions of RAGE mRNA were evaluated by RT-PCR. Results ( 1 ) Compared with the control group,the cellular morphology was changed in case of constant and intermittent high glucose. The damage of GMC with intermittent high glucose concentrations was more serious. (2)The activity of SOD was decreased and the level of MDA was raised in case of intermittent high glucose concentrations compared with the constant high glucose concentrations (P＜0.05). (3)The expression of RAGE mRNA with intermittent high glucose concentrations was significantly higher than that with constant high glucose concentrations ( P＜0. 01 ). Conclusions The damaging effects and increased expression of RAGE in cultured rat GMC induced by blood glucose fluctuation was much worse than that with constant high glucose. The blood glucose fluctuation may be one of the causes that induce diabetic nephropathy.

ct curative effect and prognosis of multiple myeloma.

Objective To investigate the influence of sodium fluoride(NaF)on alkaline phosphatase (ALP)activity and bone gla protein(BGP)synthesis in yellow ligament cells from different surgical simples in vitro.Methods The human ligament cells were divided into three groups according to its sources,including normal yellow ligament cells(NLF)group(from acute traumatic thoracolumbar fractures with paraplegia in 7 patients),degenerative yellow ligament cells(DLF)group(from degenerative lumbar stenosis in 9 cases)and ossified ligament cells(OLF)group(thoracic yellow ligament from 8 patients).Twenty-four groups of cells were obtained under vitro cell culture by the method of tissue adherence.Different concentrations of NaF were added into the medium when the cells spread to the fifth generation.Then,the morphological changes were observed and ALP activity and BGP synthesis were tested.Results Human yellow ligament cells from different samples can proliferate and be passaged in vitro.The cell in ossific groups and degenerative groups were pleomorphic and could form calcium nodules.High concentration of NaF(1.0 mmol/L)can lead to cytotoxic reaction in all 24 groups.Low concentrations of(0.01-0.125 mmol/L)NaF can enhance the ALP activity and BGP synthesis in DLF groups while no effect was found in OLF and NLF groups cells under the same concentration of NaF.Conclusion The fact that fluoride can promote ALP activity and BGP synthesis in degenerative yellow ligament cells in vitro indicates fluoride may play an important role in inducing further ossification of human ligament cells.