Objective To study the effect of acupuncturing at Jiaji points plus cervical traction in treating unsteady lower cervical vertebrae.Methods The 90 outpatients willing to accept our treatment were randomized into 3 groups with 30 in each.Acupuncture group:acupuncture at the cervical Jiaji points.Traction group:traction at the cervical vertebrae.Acupuncture + traction group:acupuncture at the cervical Jiaji points plus cervical traction.Total effect,symptom scoring and X-ray examination were evaluated after 3 course of treatment.Results The total effective rate of acupuncture group,traction group and acupuncture + traction group was 47.67%,73.33% and 90.00% respectively.In total effect,symptoms of unsteady lower cervical vertebrae and the changes of X-ray examination,acupuncture + traction group was better than that of acupuncture group(P

0.05). But the CaO2-CjO2 and jugular vein Glu level at D in group I were significantly lower than those at D in group C. In group C CaO2-CjO2 and jugular vein glutamate level at D were significantly higher than those at B (P

Objective To investigate the changes in TNF? content of sciatic nerve induced by chronic constriction injury (CCI) of sciatic nerve to determine the role of TNFa in the development of neuropathic pain. Methods Eight-four female health SD rats weighing 250-300g were anesthetized with sodium barbiturate. Unilateral sciatic nerve was exposed and ligated at the middle of thigh. Three ligatures (chromic catgut 4.0) were placed around the sciatic nerve and tied. The distance between the two ligatures was about 1 mm. Sham operation was performed on the contralateral thigh. The sciatic nerve was exposed and mobilized but not ligated. The thermal nociceptive threshold was determined by measuring the withdrawal latency of hindpaw placed on a 58℃ hot plate on days 0.5, 1, 3, 5, 7, 9, 11, 13 and 14 after surgery. Animals were sacrificed on days 0.5, 1, 3, 7, 10 and 14 after surgery. Sciatic nerves were removed from both thighs and frozen at - 80℃ for determination of TNF? content. Sciatic nerve from healthy animals was used as control. The percentage of maximal possible response (% MPR) , was determined for each group (CCI, sham operation, control) % MPR= (new withdrawal latency- average baseline latency)/( 15-average baseline latency) . The distribution of TNF? between supernatant and sediment was also determined. Results The average baseline nociceptive threshold (withdrawal latency) was (7.9?0.2)s. There was significant different in %MPR between the two hindpaws on days 1, 3, 5, 7, 9 and 11 after surgery. The TNF? content of sciatic nerve from healthy rats was (40.62? 0.24) pg/mg protein. The TNF? content of the ligated sciatic nerve was elevated abruptly in 12h after ligation, then abruptly declined to a plateau but was still significantly higher than that of sham-operated side on days 1 and 3. There was no significant difference in TNF? content of sciatic nerve between control group and sham-operation group. The relative content of TNF? content in the sediment of ligated sciatic nerve gradually increased and reached the peak on day 7 and then gradually decreased. Conclusion The TNF? content of peripheral nerves plays an important role in the development of neuropathic pain. Membrane-combined TNF? is involved in the process of nerve repairing.

Objective To investigate the efficacy of percutaneous laser disc decompression(PLDD)combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion.Methods Ninety patients with lumbar intervertebral disc protrusion scheduled for discolysis,aged 31-52 yr,weighing 58-70 kg,were randomly divided into 3 groups: PLDD group(group P,n = 29),collagenase injection group(group C,n = 31),PLDD combined with injection of collagenase through a target location group(group PC,n = 30).The puncture was performed under the guidance of CT.Group P was treated using PLDD.Group C was treated with collagenase injection.Group PC was treated with injection of collagenase after PLDD was completed.The therapeutic effect was assessed before operation and on day 7,30,60 and 90 after operation using M-JOA score.Results M-JOA grade was significantly higher at the each time point after operation in group P and PC,and on day 30,60 and 90 after operation in group C than that before operation(P ＜ 0.05).M-JOA grade was significantly lower on day 30 after operation in group P,while higher on day 30,60 and 90 after operation in group C and PC than that on day 7 after operation(P ＜ 0.05).M-JOA grade was significantly lower at the each time point after operation in group P and C than in group PC.Conclusion The therapeutic effect of PLDD combined with collagenase injection through a target location is stable for treatment of lumbar intervertebral disc herniation and better than that of PLDD or collagenase injection alone.

Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9％) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5％) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7％) with femoral neck fracture and 38 patients (51.40％) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.

Objective To investigate the effects of preconditioning and postconditioning with isoflurane on pro-inflammatory cytokines and lipid peroxidation in focal cerebral ischemic/reperfusion (I/R) injury in rats.Methods Thirty-two Sprague-Dawley (SD) rats were randomly divided into four groups:control group,model group,isoflurane preconditioning group and isoflurane postconditioning group,with 8 rats in each group.Rats in control group did not receive any challenge.In rats of model group right middle cerebral artery occlusion (MCAO) was conducted for 90 minutes.Rats in isoflurane preconditioning group received 2％ isoflurane exposure for 30 minutes 24 hours before MCAO for 90 minutes.Rats in isoflurane postconditioning group were given 60-minute 2％ isoflurane exposure after reperfusion of right MCAO.Twenty-four hours after the procedure,all rats were anesthetized with isoflurane,and blood sample taken from the heart was centrifuged,and the pro-inflammatory cytokines,including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α),and lipid peroxidation products such as malonaldehyde (MDA) and superoxide dismutase (SOD) were determined.The mRNA and protein expression levels of matrix metalloproteinase (MMP-2,MMP-9),tight junction protein Calaudin-5 and Occludin were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results Compared with control group,serum levels of IL-1 β (ng/L),TNF-α (ng/L) and MDA (μmol/L) were elevated and activity of SOD (U/L) decreased in rats of model group (IL-1β:76.81 ± 11.14 vs.52.43 ± 8.86,TNF-α:64.93 ± 10.81 vs.33.64 ± 7.94,MDA:8.63 ± 1.42 vs.4.14 ± 0.98,SOD:0.95 ± 0.21 vs.2.36 ± 0.80,all P＜0.05).After isoflurane preconditioning and postconditioning,compared with model group,the levels of IL-1 β,TNF-α and MDA were lowered,while activity of SOD was increased (IL-1 β:54.37 ± 9.06,56.82 ± 8.67 vs.76.81 ± 1 1.14,TNF-α:43.72 ± 6.16,39.49 ± 9.34 vs.64.93 ± 10.81,MDA:5.65 ± 0.83,5.82 ± 0.78 vs.8.63 ± 1.42,SOD:1.64 ± 0.47,1.71 ± 0.52 vs.0.95 ± 0.21,all P＜0.05).Focal cerebral I/R injury could lead to an increased expression of MMP accompanied with a decreased expression of tight junction protein.Compared with model group,after isoflurane preconditioning and postconditioning,it was found that there were decreased mRNA and protein expression of MMP-2 and MMP-9 (MMP-2 mRNA:1.25 ± 0.08,1.32 ± 0.12 vs.2.48 ± 0.26,MMP-2 protein:1.56 ± 0.09,1.50 ± 0.08 vs.2.12 ± 0.11 ; MMP-9 mRNA:1.26 ± 0.13,1.20 ± 0.12 vs.2.74 ± 0.28,MMP-9 protein:1.53 ± 0.04,1.51 ± 0.05 vs.2.23 ± 0.09,all P＜0.05) and increased levels of Calaudin-5 and Occludin (Claudin-5 mRNA:0.40 ± 0.08,0.38 ± 0.06 vs.0.28 ± 0.03,Claudin-5 protein:0.80 ± 0.06,0.81 ± 0.07 vs.0.39 ± 0.02; Occludin mRNA:0.54 ± 0.07,0.50 ± 0.08 vs.0.26 ± 0.06,Occludin protein:0.64 ± 0.06,0.69 ± 0.05 vs.0.49 ± 0.02,all P＜0.05).Conclusion Preconditioning and postconditioning with isoflurane can lower the levels of pro-inflammatory cytokines and the degree of lipid peroxidation,and lower the hydrolytic activity of MMP to the tight junction protein in cerebral tissue,thereby decrease the loss of tight junction protein and alleviate I/R injury.

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation
( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Objective To evaluate efficacy of rotigaptide ZP123 on prevention of negative chronotropic effect caused by dexmedetomidine lengthening repolarization duration of the isolated rat hearts.Methods Eighteen healthy adult SD rats of either gender,weighing (300±30) g,were prepared isolated heart perfusion model by Langendorff.After 15 min perfusion and balance of K-H fluid,the isolated hearts were randomly divided into 3 groups (n=6 each): The hearts were continuously pefused for 30 min with 37℃ K-H solution in control group (group C),with dexmedetomidine 50 ng/ml in dexmedetomidine group (group D),or with rotigaptide 80 nmol/L combined with dexmedetomidine 50 ng/ml in rotigaptide combined with dexmedetomidine group (group ZD).In the whole Langendorff-perfused hearts,at the end of balanced infusion for 15 min (T0) and at 15(T1),30(T2) min of continued perfusion with K-H solution,the monophasic action potential (MAP) and heart rate (HR) were recorded from left anterior free wall,MAP duration at 50% repolarization (MAPD50) and at 90% repolarization (MAPD90),monophasic action potential amplitude (MAPA) and maximal velocity (Vmax) were calculated.Results Compared with T0,HR in group D was significantly declined at T1,T2;MAPD90 and MAPD50 in group D were significantly increased at T1,T2 (P<0.05).Compared with groups C and ZD,HR in group D was significantly declined at T1,T2;MAPD90 and MAPD50 in group D were significantly increased at T1,T2 (P<0.05).There was no significant difference in MAPA and Vmax between the three groups.Conclusion Rotigaptide antagonizes negative chronotropic effect induced by dexmedetomidine through shortening monophasic action potential duration in the myocardium of left ventricle of the isolated rat hearts.

Objective To investigate the dosimetric performance of COMPASS system,a novel 3D quality assurance system for the verification of nasopharyngeal carcinoma volumetric modulated therapy (VMAT) treatment plan.Methods Eight VMAT treatment plans of nasopharyngeal carcinoma patients were performed with MasterPlan,a treatment planning system (TPS),and then these treatment plans were sent to the COMPASS and MOSAIQ system,a coherent control system,respectively.Comparison of the COMPASS reconstructed dose versus TPS dose was conducted by using the dose volume-based indices:dose received by 95％ volume of target ( D95％ ),mean dose ( Dmean ) and γ pass rate,dose to the 1％ of the spinal cord and brain stem volume ( D1％ ),mean dose of leaf and right parotid ( Dmean ),and the volume received 30 Gy for left and right parotid (V30).COMPASS can reconstruct dose with the real measured delivery fluence after detector commissioning.Results The average dose difference for the target volumes was within 1％,the difference for D95 was within 3％ for most treatment plans,and the γ pass rate was higher than 95％ for all target volumes.The average differences for the D1％ values of spinal cord and brain stem were ( 4.3 ± 3.0) ％ and ( 5.9± 2.9 ) ％ respectively,and the average differences for the Dmean values of spinal cord and brain stem were ( 5.3 ± 3.0 ) ％ and ( 8.0 ± 3.5 ) ％ respectively.In general the COMPASS measured doses were all smaller than the TPS calculated doses for these two organs.The average differences of the Dmean values of the left and right parotids were( 6.1± 3.1 ) ％ and ( 4.7 ± 4.4 ) ％ respectively,and the average differences of the V30 values of the left and right parotids were (9.4 ± 7.5 ) ％ and (9.4 ± 9.9)％ respectively.Conclusions An ideal tool for the VMAT verification,the patient anatomy based COMPASS 3D dose verification system can check the dose difference between the real delivery and TPS calculation directly for each individual organ,either target volumes or critical organs.

Objective To investigate change of the volume and the epicenter of target volume under different scan speed of the three-dimensional (3D) simulation computed tomography (CT) and determine the scan speed which close to ITV.Methods A dynamic phantom-QUASAR,with a 3 cm × 3 cm × 3 cm target cubic simulating respiratory motion was used.The phantom was set with three different amplitudes and breathing frequencies under different scan speed.The dynamic phantom was also scanned using simulation 4DCT as ITV was the standard.The length of the phantom was 12 cm,the scan time were 6.6 s,12.8 s,31.7 s.The volume and epicenter of the target identified from 3DCT images were calculated and compared to 4DCT images.The number of times of target length (30 ± 2) mm/total scan times was used to assese the accuracy.Results The total accuracy was 6.8％.For different scan speed,the accuracy were 13％,4％ and 2％,respectively.The length of the epicenter of the target volume was (318.9 ±0.37) mm,(683.2 ±0.44) mm,(682.9 ± 0.66) mm under the 0.5 cm,1.0 cm and 2.0 cm,respectively.When the scan time was 31.7 s,the volume of the target from the 3DCT were close to ITV-10 mm,the frequency were 50％,78％,56％ for three different amplitude.Conclusions This study shows that the images from the 3D simulation CT were the partial image of the breathing cycle,and the epicenters were diversed with the breathing amplitude and scan speed.The accuracy rate of the 3DCT reflects the real target is low.In addition,the epicenter of the target changed randomly.