Objective To study the mechanism and the nomenclature of the lumbar disk herniation associated with posterior bony edge separation of the vertebral body, based on its CT findings in transverse and sagittal planes. Methods 18 patients with lumbar disk herniation were evaluated with the CT scan and sagittal reconstruction. Results There were 19 lumbar herniated disks associated with separated posterior bony edge of the vertebral body which protruded into the spinal canal. There was bony defect filled with disk material. In the sagittal plane, the bony separation and the posterior edge of the vertebral body formed the “V” type defect at 15 levels, and 4 were irregular or triangular. 15 cases of the disc herniation had bony separations and 4 had bone connection with the vertebral body. There were bony defect and sclerosis on the vertebral body edge. Conclusion The main mechanism was the separation compression of the herniated disk on the posterior vertebral body. The bony separation was the secondary change. So the authors suggest that such anatomical pathologic changes be named as intervertebral disk herniation associated with posterior bony separation of the lumbar vertebrae.

Objective Hypotension can be induced by sodium nitroprusside(SNP) combined with propofol more easily and with less amount of each drug. But both SNP and propofol were reported to inhibit platelet aggregation. The purpose of present study was to investigate the effect of controlled hypotension induced by SNP alone or in combination with propofol on human platelet aggregation. Methods Fifty-six ASA Ⅰ -Ⅱ patients (30 male, 26 female), aged 20-54 (36.0 ? 11.2) years and weighing 42-79 (67.6?14.3)kg, undergoing elective neurosurgery were randomly assigned to one of four groups: A control group ( n = 14) ; B propofol group ( n = 14) ; C SNP group( n = 14) and D SNP + propofol group ( n = 14) . The patients were premedicated with luminal 0.lg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.2 mg ?kg-1 , fentanyl 5 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation and intermittent boluses of fentanyl and vecuronium. In group A and B no hypotension was induced. In group C and D hypotension was induced by 0.01 % SNP infusion (0.5-5 ?g?kg-1?min-1 ) alone or combined with propofol infusion(2-3 mg?kg-1?h-1 ) . As soon as the dura was cut, hypotension was induced. MAP was reduced by 30 % and maintained at ( 67.80 ? 9.64 ) mm Hg on average. Radial artery was cannulated for continuous BP monitoring. In order to avoid the effect of colloid and homologous transfusion on platelet function, only Ringer' s lactate was infused during operation in the four groups. Blood samples were taken from peripheral vein before skin incision, 30min and 1h after hypotension was induced and 2h after surgery for determination of platelet aggregation, prothrombin time and plasma level of NO2 -/NO3- .Results Platelet aggregation was significantly inhibited in group C and D at 30 min and Ih after induction of hypotension as compared with the baseline (before operation) . There was significant difference in the inhibition of platelet aggregation among the four groups. The inhibition was greatest in group D. There was no significant change in prothrombin time after induction of hypotension in the four groups. Plasma level of NO2-/NO3 - increased significantly at 30 min and 1h after induction of hypotension in group C and D. Conclusions SNP combined with propofol has inhibitory effect on human platelet aggregation during controlled hypotension and increased in plasma NO2 -/NO3-level may be the mechanism.

Objective:To explore the protective effect of vitexin on retinal ganglion stem cells (RGCs) from oxidative stress caused by retinal ischemia-reperfusion (RIR) in rats and its possible mechanism.Methods:Sixty male SD rats were randomly divided into the model group, vitexin group and normal control group by random number table, with 20 rats in each group.The right eyes were taken as experimental eyes.Rats in the model group and the vitexin group were treated with anterior chamber perfusion to establish RIR models.Rats in the vitexin group were given intraperitoneal injection of vitexin at a dose of 25 mg/(kg·d) for 7 days.Rats in the model group were intraperitoneally injected with the same volume of normal saline.For the normal control group, the experimental eyes underwent anterior chamber puncture without increasing the intraocular pressure, and were intraperitoneally injected with the same volume of normal saline.On the 7th day following modeling, the rats were sacrificed by overdose anesthesia.Histopathology staining was used to detect the thickness of retina and the number of RGCs.Retrograde tracing with Fluoro-Gold was used to detect the density of RGCs.TUNEL staining was used to detect the apoptosis of RGCs.Colorimetric method was used to detected superoxidate dismutase (SOD) activity and concentration of malondialdehyde (MDA) and nitric oxide (NO). Western blot method was used to detect the relative expression levels of cytoplasmic Nrf2, HO-1, NQO1, nuclear Nrf2 proteins in rat retina.The use and care of animals followed the ARVO Statement.This study protocol was approved by the Experimental Animal Ethics Committee of Henan Eye Hospital (No.HNEECA-2019-04).Results:The retinal thickness was (90.21±3.55)μm in the model group, which was significantly lower than (128.20±5.31)μm in the normal control group and (119.65±6.14)μm in the vitexin group, and the differences were statistically significant (both at P<0.05). The average density of RGCs was (1 300.85±14.00)/mm 2 in the model group, which was significantly lower than(2 330.12±15.05)/mm 2 in the normal control group and (1 921.64±11.78)/mm 2 in the vitexin group, and the differences were statistically significant (both at P<0.05). The rate of TUNEL positive RGCs was (68.34±5.04)% in the model group, which was significantly higher than (3.01±0.18)% in the normal control group and (35.51±2.04)% in the vitexin group, and the differences were statistically significant (both at P<0.05). Compared with the normal control group and the vitexin group, the SOD activity in the retinal tissue of the rats was lower and the concentrations of MDA and NO were higher in the model group, and the differences were statistically significant (all at P<0.05). The expression level of cytoplasmic Nrf2 protein was the lowest in the vitexin group, then following the model group and the normal control group, and the relative expression levels of HO-1, NQO1 and nuclear Nrf2 protein were the highest in the vitexin group, then followed the model group and normal control group, and the differences were statistically significant (all at P<0.05). Conclusions:Vitexin can reduce the apoptosis of RGCs and alleviate oxidative stress damage of retina in RIR rat model.This protective effect may be achieved by activating Nrf2-related signaling pathway.

Objective The purpose of this study was to analyze the alterations of T_1、T_2 lymphocyte subsets in the peripheral blood of patients with colorectal cancer. MethodsTwenty patients with primary colorectal cancer were enrolled into this study, T_1 and T_2 in the peripheral blood were evaluated by detecting the intracellular interferon-? and interleukin-4 production with 4-color flow cytometry. ResultsThe percentage of T_1 and T_2 in the peripheral blood of cancer patients was lower significantly than healthy controls [(36?11)% and 3.3(1.9)% vs. (46?12)% and 4.1(3.1)%](P

Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.

OBJECTIVE:To investigate the clinical efficacy and safety of mirtazapine combined with citalopram in the treat-ment of sleep disorder in depressive patients. METHODS:One hundred and sixty-five depressive patients with sleep disorder were selected and divided into control group (82 cases) and treatment group (83 cases) according to random number table. Control group took Escitalopram oxalate tablet 10 mg,once every night,increasing to 20 mg according to disease condition;treatment group was additionally given Mirtazapine tablet 15 mg,once every night,increasing to 30 mg one week later. Both groups re-ceived treatment for consecutive 6 months. HAMD-17 and MADRS were observed in 2 groups before and after treatment,and the sleep quality of 2 groups were evaluated by PSQI before and after treatment;the sleep structure was measured by using polysom-nography before and after treatment;clinical efficacies and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in HAMD-17,MADRS and PSQI score,sleep structure between 2 groups (P>0.05);after treatment,above scores and indexes of 2 groups were all improved significantly,and the treatment group was sig-nificantly better than the control group,with statistical significance(P<0.05). Total response rate of treatment group was 97.47%, which was significantly higher than 78.95%of control group,with statistical significance(P<0.05). There was no statistical signif-icance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Citalopram combined with mirtazapine shows sig-nificant therapeutic efficacy for sleep disorder of depressive patients,and can significantly improve sleep structure,adjust sleep cy-cle and improve sleep quality with good safety.

AIM:To investigate the role of miR-125b in regulating the sensitivity of CD133+ colorectal cancer cells to cisplatin.METHODS:The expression of miR-125b was detected by RT-qPCR in the routine SW480 cells and CD133+ SW480 cells.Flow cytometry analysis was performed to measure the percentage of CD133+ cell population in the SW480 cell line treated with miR-125b and cisplatin.MTT assay was performed to evaluate the effect of miR-125b on the cisplatin-induced cell death in the CD133+ SW480 cells.Bioinformatics and Western blot were performed to determine whether the expression of HAX-1 was regulated by miR-125b.JC-1 staining, Annexin V staining and Western blot analysis were used to study the pathway of apoptosis in the CD133+ SW480 cells co-treated with miR-125b and cisplatin.RESULTS:The expression of miR-125b was significantly lower in the CD133+ SW480 cells than that in the routine SW480 cells and normal colonic epithelial FHC cells.Treatment with cisplatin alone increased the percentage of CD133+ SW480 cell population.However, miR-125b significantly inhibited the enrichment of CD133+ cell population induced by cisplatin.In addition, the results of MTT assay showed that the anti-tumor effect of cisplatin was significantly enhanced when the miR-125b was transfected into the CD133+ SW480 cells.The results of Western blot indicated that the HAX-1 gene was the target of miR-125b.Furthermore, the apoptosis induced by the combination of miR-125b and cisplatin was dependent on the dysfunction of mitochondrial membrane, leading to the release of cytochrome C into the cytoplasm and the subsequently activation of apoptosis in the CD133+ SW480 cells.CONCLUSION:miR-125b increased the sensitivity of CD133+ colo-rectal cancer cells to cisplatin by down-regulating the expression of HAX-1.

AIM:To establish a specific method for the identification of 26 chemical drugs added illegally into analgesic-antipyretic traditional Chinese medicines and health food. METHODS: The liquid chromatography-ion trap mass spectrometry method was used.Comparing with retention time and spectrums of references in library set up by ourselves,the target compounds in sample were screened and identified. RESULTS: Sixty samples were tested and Naproxen,Ibuprofen and Aspirin were detected out. CONCLUSION: The method is accurate,sensitive and easy to operate, which is first reported in China and so many compounds could be detected at the same time.

Background Proliferative vitreoretinopathy (PVR) is one of the major causes of retinal detachment surgery failure.Based on proteomic studies of PVR vitreous,the insulin-like growth factor binding protein-6 (IGFBP-6) protein was specifically expressed in the vitreous and serum of PVR patients.Furthermore,its expression level is higher in the vitreous and serum in severe PVR patients than that in mild PVR patients.Objective This experiment was to detect the expression of IGFBP-6 in a PVR rat model.Methods Seventy 7-week old male SPF Wistar rats were included and were randomized into the PVR model group and control group.A mixture of RPE-J cell suspension(5 μl) and platelet-rich plasma (5 μl) was intravitreally injected in the left eyes of adult Wistar rats to establish the PVR model,and normal saline solution was administered in the same way in the control group.The rat eyes were clinically examined 1 week,2,3 and 4 weeks after injection,and PVR was graded based on the criteria of Francine.The animals were sacrificed after 1 week,2,4 or 8 weeks for the preparation of retinal sections and liver extraction.Expression levels of IGFBP-6 mRNA in the rat retina and liver were assayed by real-time Q-PCR.The expression of IGFBP-6 protein in the rat serum and vitreous was detected by ELISA.The use of animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Purified IGFBP-6 RNA was extracted from the liver and retina of Wistar rat and quantified by real-time Q-PCR.The expression level of IGFBP-6 mRNA in retina was (3.79± 1.33) × 10-4 in the PVR model rats,showing a significant decline in comparison with the control rats with a level of(8.32±2.96) × 10 4,4 weeks after injection (t =3.42,P＜0.01).The expression of IGFBP-6 mRNA in the 4th week was significantly lower than that of 1 week,2 or 8 weeks after the establishment of the PVR model(P＜0.05).No significant difference was found in the IGFBP-6 mRNA level in the liver between the PVR group and control group(27.60± 14.01 × 10 4 vs.25.01 ± 12.04 ×10-4,respectively),as well as among the different time points(P＞0.05).IGFBP-6 mRNA content in the retina was significantly reduced in grades 1,2 or 3 of the PVR groups compared with the control group(P＞0.05),but there was no significant difference among the different grades of PVR groups (P＞0.05).Concentrations of IGFBP-6 protein in grades 1,2 and 3 of the PVR model group were (221.00 ± 19.32),(229.63 ± 18.89) and (225.70 ± 26.71) μg/L,with a significant elevation in comparison with (173.25 ±21.11) μg/L of the control group (t =2.14,P＜0.05).However,there was no significant change among the different grades of PVR groups(t=1.24,1.46,P＞0.05).The concentrations of IGFBP-6 protein in the vitreous and serum were higher in PVR rat samples (vitreous:225.44±19.36 μg/L;serum:108.48 ± 15.78 μg/L) than in control rats (vitreous:173.25 ± 21.11 μg/L,serum:95.96 ±17.40 μg/L)(P＜0.05).Conclusions The concentrations of IGFBP-6 protein in the vitreous and serum increase in PVR rats.The results indicate that the increased IGFBP-6 in the vitreous might be a localized autocrine secretion of the eye.

Objective The purpose of this study was to evaluate the outcome of autogenous bone grafts in unilateral cleft lip and palate patients following early orthodontic tooth movement,and to determine the volume of new bone formation in the bone grafted region with spiral computed tomography.Methods Computed tomography scans of 12 patients were taken immediately preoperatively and at 6 months postoperatively.The patients underwent bone grafting between 9 and 13 years of age were divided into two groups based on whether postoperative orthodontic tooth movement were initiated or not.Three-dimensional models were created in each period,and the defect of alveolar cleft and volume of the newly formed bone were calculated in each patient.The roots of the moved teeth and their positions to the alveolar bone were also observed.Results The preoperative cleft width and cleft volume were not significantly different between both groups.The volume of the newly formed bone in group A was (0.98±0.23) mm3,significantly higher than that in group B,which was (0.73± 0.15) mm3.The rate of newly formed bone in group A was (72.5 ± 11.9)％,significantly higher than that in group B,which was (53.2±9.7)％.The cleft adjacent teeth could move smoothly into the bone grated area,with no root resorption observed in the computed tomography scans.Conclusions Early orthodontic tooth movement can reduce bone resorption in autogenous bone grafted unilateral cleft lip and palate patients through the observation of spiral computed tomography.It plays an active role in the bone remolding process after bone grafting.