Objective To evaluate the midterm efficacy of prosthetic disc nucleus ( PDN) replacement for the treatment of lumbar disc herniation. Methods Twenty cases of lumbar disc herniation( including one case of recurrent lumbar disc herniation) were treated with PDN. The twenty cases were followed-up 5.4 ～6.2 years( mean 5.7 years). Functional,and radiographic follow-up examinations,MRI and follow-up records of all patients were reviewed carefully. Results Clinical evaluation at the end of follow-up,there were 10 cases in excellent,6 cases in good,2 cases in fair and 2 cases in poor,and good rate was 80%. One patient accepted the revision operation to remove the PDN because of device migration. One patient accepted the fusion because of adjacent segment disease. The others experienced pain relief, and resumed their normal life and work. The average Oswestry score and VAS get better significantly. Conclusion The PDN was effective in treating patients with lumbar disc herniation. However, the medium term complications of device subsidence should be taken seriously.

Objective:To investigate the role of monocyte chemoattractant protein-1 in the progress that isometric exercise training improves arteriogenesis.Method:Twenty-four male Sprague-Dawley rats were used,weighing (200±20)g.The rats were randomized into control group (CG),myocardial ischemia group (MI),exercise training group (ET),MCP-1 inhibitor group (LG).There were 6 rats in each group.Rats were continuously administered 10mg/kg subcutaneously isoproterenol for successive 2 weeks to establish the myocardial ischemia model.Successfully modeled rats were in groups MI,ET and LG.Isometric exercise training were performed in group ET and LG.The rats in group LG were given MCP-1 inhibitor leflunomide by gavage.After 8 weeks of training,the left ventricular myocardium was extracted and relative collateral blood flow (RCBF) was measured by microspheres.Artery density (AD) and monocytes were measured by immunohistochemistry analysis.Western blot analysis and real-time quantitative PCR were performed to assay protein and mRNA of MCP-1.Result:RCBF and AD increased significantly in group ET as compared to the rest groups.RCBF and AD in group LG showed higher than that in group MI but not significant.The number of monocytes,MCP-1 mRNA and MCP-1 expression were significantly elevated in ischemic myocardium of group ET.Interestingly,the number of monocytes,MCP-1 mRNA and MCP-1 expression showed lower than that in group MI but also not significant.Conclusion:Eight weeks of isometric exercise training can increase the expression of MCP-1 in ischemic myocardium and promote the arteriogenesis.

Objective To investigate whether functional electrical stimulation (FES) can improve the expression of proteins in the NMDAR1-pGLuR1 pathway so as to promote the recovery of motor function and sensation after stroke.Methods Eighty-one Wistar rats were used to make a photochemical brain model of local ischemia.Rats were randomly assigned into a sham, placebo stimulation or FES group.Rats in the placebo and FES groups had local ischemia induced in the M1 zone of the brain using the photosensitive dye Bengal rose.It was administered intravenously and a laser beam was then stereotactically positioned on the skull.The rats in the FES groups were stimulated for 30 minutes (10 minutes on, 10 minutes off, then 10 minutes on).The placebo group's treatment was similar, but without the electric current.The rats in the sham group received no intervention.The cylinder test and the adhesive-removal test were used to test the rats' motor function and sensation before the operation and before they were sacrificed.Cohorts were sacrificed after 3, 7 and 14 days of intervention.NMDA receptor and AMPA receptor were detected in the peri-ischemic cortex using western blotting.Results After 7 and 14 days the index of forelimb motor function in the cylinder test of the FES group was significantly better than that of the placebo group.The average adhesive-removal time of the FES group was also significantly faster compared with the placebo group.After 7 days the average expression of NMDAR1 in the FES group was significantly higher than in the placebo group.The average expression of GluR1 and pGluR1 in the FES group was significantly higher than in the placebo group after 14 days.Conclusion Functional electrical stimulation can improve motor function after ischemia through the NMDARAMPAR signal pathway, at least in rats.

ObjectiveTo investigate the prevalence of preoperative malnutrition and nutrition support among gastrointestinal cancer patients.MethodsA retrospective study was conducted based on the nutritional status and nutrition support of 336 gastrointestinal cancer patients who received elective radical surgery in Peking Union Medical College Hospital from April to December 2009.ResultsMalnutrition was found in 34.6％ gastric cancer patients,23.8 ％ colorectal cancer patients,and 23 ％ esophageal and cardiac cancer patients.The patients with worse nutritional status were given longer duration of nutrition support and higher energy intake.Conclusion Malnutrition occurs in gastrointestinal cancer patients,yet sometimes treated with inappropriate nutrition support.

Objective To explore the change in nutritional status of perioperative gastrointestinal cancer patients. Methods The nutritional status of 207 gastrointestinal cancer patients who were to undergo elective radical surgery was evaluated by SGA within 48h of admission and 7 days after operation. The investigation results went through analysis. Results Body weight was significantly decreased 7 days after operation compared with 48h of admission, the prevalence of malnutrition 7 days after operation was higher than 48h of admission; weight loss, change of food intake and decreased functional activity were the related factors of change in nutritional status of perioperative gastrointestinal cancer patients. Conclusions There was a decreased nutritional status among perioperative gastrointestinal cancer patients, and appropriate nutrition intervention program and treatment should be taken to improve clinical outcomes according to the risk factors.

Forty-eight men with normal glucose tolerance were divided into fatty liver disease ( NAFLD, n =23 ) and non-NAFLD (n =25 ) groups. The blood glucose excursion was evaluated by continuous glucose monitoring system. The results showed that the mean amplitude of glucose excursion[MAGE, (2. 17± 1.13 vs 1.45±0. 42 )mmol/L]and standard deviation of blood glucose[SDBG, (0. 88 ±0. 45 vs 0. 61 ±0. 21 ) mmol/L]were significantly higher in NAFLD group than in non-NAFLD group( both P＜0. 05 ). MAGE and SDBG were positively correlated with body mass index, waist circumference, and the increased value of plasma glucose 0. 5 h after glucose loading( △G30,all P＜0. 05 ). In multiple regression analysis, △G30, waist circumference, and age were significant independent predictors for MAGE( P＜0. 05 or P＜0. 01 ). △G30 and waist circumference were significant independent predictors for SDBG( P＜0. 05 or P＜0. 01 ).

Seventy-four men aged 20-50 years with normal glucose tolerance were divided into abdominal obese group(n=36),simple obese group(n=16),and normal body weight group(n=22).One-hour postload plasma glucose(1hPG)and carotid intima-media thickness(IMT)were higher in abdominal obese group than those in simple obese group and control group(all P<0.01).IMT was positively correlated with 1hPG(P<0.05).In multiple regression analysis,waist circumference and triglycerides were independent predictors for IMT.

Objective To investigate perfusion imaging and parameters of normal pancreas by dual-source CT and to evaluate the appropriate perfusion imaging scan.Methods Sixty-six subjects with normal pancreas underwent low-dose pancreatic perfusion and plain scan.CT images were sent to a separate workstation via a network.The blood flow (BF)and blood volume (BV)of pancreas head,body and tail were measured using the VPCT Body software and analyzed by one-way ANOVA.Then the time-density curve of pancreas was drawn,and the enhancement peak time and the corresponding CT value were also measured.Results The average BF values of pancreas head,body and tail were (1 1 6.09 ± 31.83)mL·100 g-1 ·min-1 ,(1 1 9.72±32.50)mL·100 g-1 ·min-1 , (1 14.65±31.42)mL·100 g-1 ·min-1 ,and the mean BV values were (29.83 ±1 9.07)mL/100 g,(30.39 ± 1 9.38)mL/100 g, (28.82±1 9.22)mL/100 g,respectively.The perfusion parameters in different pancreatic parts were not statistically different.The mean enhancement peak time was (27.92 s±4.52)s,(28.02±5.34)s in pancreas head,(27.40±4.36)s in pancreas body,(27.34±4.57)s in pancreas tail.On plain image,the average CT value of pancreas was (41.43±5.88)HU.However,on enhanced image,the mean CT value was (95.96±18.44)HU in normal pancreas [(96.73±19.71)HU in pancreas head,(98.45±17.52)HU in body,(92.69±18.1 7)HU in tail].Conclusion The perfusion parameters including blood flow and blood volume in pancreatic head,body and tail are identical. The mean enhancement peak time is (27.92±4.52)s,and the corresponding enhancement CT value is (95.96±18.44)HU.

Objective To study the effects of different types of exercise training on learning and memory, as well as on the expression of synaptophysin (SYP) and on postsynaptic density protein 95 (PSD-95) in rats in which a model of vascular dementia had been created.Methods Forty male Wistar rats were divided randomly into a voluntary exercise group (V-EX) , a forced exercise group (F-EX) , an involuntary exercise group (I-EX) , a vascular dementia group (VD) and a sham-operation group (Sham) , with 8 rats in each group.Two-vessel occlusion (2-VO) of the arteria carotis communis was used to create a model of vascular dementia in all of the rats except those in the sham-operation group.Beginning one week after the surgery, the V-Ex rats were free to run in a running wheel.The F-EX rats were forced to run 270 m a day in an electric wheel.The I-EX rats were stimulated to imitate the gait pattern of their forelimbs running at 9 m/min three times a day for l0 minutes each time.No special training was given to the rats in the other 2 groups.Three weeks after the surgery, their learning and memory were tested using a novel object recognition test.Immediately after the test, their prefrontal cortex was sampled and the expression of SYP and PSD-95 was detected using western blotting.Results The average novel object recognition indices of the rats in the V-EX, F-EX and I-EX groups were all significantly higher than that of the VD group.Average PSD-95 expression was also significandy higher than in the VD group.Conclusion Exercise, whether voluntary, forced or induced by functional electrical stimulation can improve learning and memory in vascular dementia, at least in rats.The mechanism is possibly that the training can increase the expression of PSD-95 in the prefrontal cortex, though not SYP.

Objective To observe the display and source of the artery located at anterolateral region next to pancreatic head on en-hanced CT,and to investigate its clinical value.Methods Imaging data of 200 consecutive patients who underwent abdominal CT scan were collected,and their CT images were analyzed.The reconstructed images were obtained at a post-processing workstation. After reconstruction,the display rate,source and branches of the artery located at anterolateral region next to pancreatic head were analyzed,and the diameters of these vessels were measured.Results The arterial vessel located at anterolateral region next to pan-creatic head was found on axial CT image in arterial phase with a display rate of 100%.By using post-reconstruction images,most vessels were gastroduodenal artery with mean diameter of 0.33 cm± 0.05 cm,and other ones were pancreaticoduodenal artery or right gastroomental artery.Conclusion The artery located at anterolateral region next to pancreatic head can be found on axial ab-dominal CT image in the arterial phase.Most vessels are gastroduodenal artery with a fixed position and traveling.