Objective To investigate the mid-term efficacy of percutaneous laser disc decompression(PLDD) for patients with lumbar disc herniation.Methods Between May 2001 and December 2006,a total of 122 patients with simple lumbar disc herniation underwent PLDD in our hospital.Under local anesthesia,the operaiton was performed using a laser diode with the patients in supine position.A C-arm X-ray system was employed to guide the surgery.Results The patients were followed up for 6 to 60 months(mean 36.5 months).Accroding to the MacNab Criteria,60 patients achieved excellent outcomes,39 were good,15 were fair,and 8 were poor.The rate of exellent and good outcomes was 81.1%(99/122).No patient had postoperative complications.Conclusions PLDD is effective and safe for patients with simple lumbar disc herniation.The cases recover quickly after the operation,because the procedure is minimally invasive.

ObjectiveTo investigate the effect of a cervical back muscle trainer. MethodsA cervical back muscle trainer designed by ourself was used in 128 patients with different kinds of cervical spondylosis. The situation of pain and activity of daily life of the patients before and 1 month after treatment were recorded and compared. ResultsThe neck pain of all of the patients nearly completely disappeared in a month and their activity of daily life improved significantly(P<0.01). ConclusionThe cervical back muscle trainer can improve the stability of cervical vertebrae through increasing the strength of the cervical back muscle, which can be used as an assistant rehabilitation approach of all kinds of cervical spondylosis.

Objective To probe into the quantizing rule of the thoracic vertebra rotation.Methods6 healthy corpses specimen were fixed on a wooden apparatus and rotated from 0° to 90° for X-ray examination.A X-ray examination was taken at each 5° rotational point.The characteristic of the image at each examinational point was observed.ResultsThere was radiology characteristic at each rotational point.ConclusionThe thoracic vertebra rotational degree could be quantized by X-ray examinations.

Objective To investigate influence of hyperlipidemia in parents on plasma lipid level,blood pressure,body mass index(BMI) and waist circumference(WC)of their children.Methods Eighty children whose parents had been with hyperlipidemia(Group A) and 893 children whose parents had been normal plasma lipid levels(Group B) were studied.BMI,systolic pressure(SP),diastolic pressure(DP),WC,plasma triglyceride(TG),cholesterol(CH),high density lipoprotein-cholesterol(HDL-c),low density lipoprotein-cholesterol(LDL-c)of two groups were measured and compared.Results The levels of BMI,TG,TCH,LDL-c,SP,and DP had a increasing trend in group A compared to those of group B.HDL-c in group A had a decreasing trend compared to that of group B.But only the increase of BMI is significant(P

20 was lower than those whose BMI≤20(P

BACKGROUND:Emerging evidence demonstrates that low density lipoprotein receptor-related protein 1 (LRP1)isinvolved in lipid metabolism and regulation of inflammatory reaction.
OBJECTIVE:To explore the effectof lentivirus-induced knockdown of low density lipoprotein receptor-related protein 1 on cartilage damage and matrix metaloproteinase 13 in a rat model of osteoarthritis, so as to assess the role of low density lipoprotein receptor-related protein 1 in the pathogenesis of osteoarthritis.
METHODS:Sixty-fourSprague-Dawleyratswere included andramdomlydivided into four groups (n=16 for each): negative control group, no surgery; sham-surgery group, onlythearticular cavity of the knee was exposed; osteoarthritisplus shLRP1 group, rat osteoarthritis models were established by cutting anterior cruciate ligament and removing the medial meniscus partly folowed by an intra-articular injection of lentivirus-mediated siRNA at 2 days after surgery, once a week for 2 consecutive weeks; osteoarthritis group,an intra-articular injection of the negative control lentivirus was performed after surgery. Rats inthe four groups started running on theself-made electric treadmil from 5 days after modeling, 30 minutes per day,totaly 500 meters. Cartilage damage and matrix metaloproteinase 13 expression in cartilage tissues were determined at 2, 4, 6 weeks after surgery.
RESULTS AND CONCLUSION:Gross and pathological observations showed that lentivirus-induced knockdown of lowdensity lipoprotein receptor-related protein 1 aggravatedcartilage damage intherat model of osteoarthritis. At 6 weeks after surgery, Mankin’s scoreand matrix metaloproteinase 13 expression inthecartilage tissues in osteoarthritis plus shLRP1 groupweresignificantly increased compared with other three groups (P< 0.05). These findings indicate that a simulation model of osteoarthritis is developed by cutting anterior cruciate ligament and removing the medial meniscus partly combined with running onthe treadmil. Lentivirus-induced knockdown ofLRP1aggravates cartilage damage in a rat model of osteoarthritis

BACKGROUND:Tumor necrosis factor α, as a pathogenic factor, induces the inflammatory reaction mainlyvia the activation of the nuclear factor kappa B signaling pathway. Low density lipoprotein receptor-related protein 1 (LRP1) is involved in the regulation of the inflammatory reaction induced by cytokines.
OBJECTIVE:To study the effect of knockdown of LRP1 on tumor necrosis factor α-induced inflammatory reaction.
METHODS: Primary cultured rat chondrocytes were transfected with lentivirus-mediated RNA interference to knockdown LRP1 gene. Three days after lentivirus transfection, chondrocytes were pretreated with Bay 11-7082 (10 μmol/L) for 30 minutes prior to the addition of tumor necrosis factor α (30 μg/L) for 30 minutes. Signaling protein and mRNA expressions in chondrocytes were detected by western blot assay and real-time PCR analysis, respectively. Chondrocytes were pretreated with or not Bay 11-7082 (10 μmol/L) 30 minutes prior to the addition of tumor necrosis factor α (30 μg/L) for 12 hours after starvation in DMEM for overnight, and the culture medium was colected for ELISA determination of matrix metaloproteinase 13 level.
RESULTS AND CONCLUSION:Tumor necrosis factor α receptor 1 expression was upregulated in chondrocytes after lentivirus-induced knockdown of LRP1. Increased expression of inducible nitric oxide synthase and activation of the nuclear factor kappa B signaling pathway were found after the addition of tumor necrosis factor α in shLRP1 group. Moreover, increased level of matrix metaloproteinase 13 was determined by ELISA. Taken together, knockdown of LRP1 up-regulates the expression of tumor necrosis factor α-induced inducible nitric oxide synthase and matrix metaloproteinase 13 through the activation of the nuclear factor kappa B signaling pathway.

Objective To analyze the clinical characteristics and the endocrine changes in children with craniopharyngioma,and to improve the pediatrician understanding of the disease.Methods The study subjects consisted of 14 children with craniopharyngioma admitted to the Department of Endocrinology,Beijing Children's Hospital Affiliated to Capital Medical University from Jan.2004 to Dec.2012.All the patients were followed up to analyze the clinical symptoms improvement,endocrine test results and medication,et al.Results The main clinical manifestations were headache (7/14 cases,50.0％),growth retardation(4/14 cases,28.6％),vomiting (4/14 cases,28.6％),polydipsia/ polyuria (3/14 cases,21.4％) and vision diminution (3/14 cases,21.4％).Three patients didn' t undergo the surgery,and 3 cases with diabetes insipidus and 2 cases with growth hormone deficiency,and 1 case with central hypothyroidism by laboratory test.The rest 11 children received surgery and all patients had changes in endocrine after it.Five cases got polydipsia and polyuria,other 5 cases had electrolyte disturbances,and 2 cases had epilepsy.Nine patients were followed up,and the follow-up duration ranged from 5 months to 10 years [(3.29 ± 3.52) years] after surgery.Seven patients got better and 2 patients got worse.Conclusions For clinical symptoms of increased intracranial pressure,changes in endocrine,the vision and visual field,the possibility of craniopharyngioma should be taken into account.Surgery is the main treatment,but it can lead to the damage of hypothalamus and pituitary gland.Changes in endocrine,electrolyte disturbances and epilepsy are the common complications.According to the level of endocrine,longterm hormone replacement therapy for some postoperative patients should be continued.

Objective To investigate the effects of solution-focused brief therapy on self-perceived burden and quality of life in patients with stroke.methods 60 patients with stroke recruited at the department of rehabilitation of a hospital in Chengde city from January to June 2016 were divided into control group (n=30) and experimental group (n=30).Both groups received conventional nursing care and rehabilitation treatment.In addition,the experimental group received psychological intervention of solution-focused brief therapy,2-3 times a week,30-45 minutes for each time.The self-perceived burden scale(SPBS),memorial university of Newfoundland scale of happiness(MUNSH) and short from 36 health survey questionaire(SF-36) were used to assess the patients before and after intervention.Result s(1)The differences of the scores of SPBS ((39.27±5.83) vs (22.40±4.03),t=16.248,P<0.01) and MUNSH ((4.20±4.50) vs (31.10±3.66),t=-24.136,P<0.01) for the experimental group before and after the intervention were statistically significant.There were statistically significant differences in scores of SPBS ((22.40±4.03) vs (35.30±2.63),t=-14.683,P<0.01) and MUNSH ((31.10±3.66) vs (19.67±3.64),t=12.127,P<0.01) between the experimental group and control group after the intervention.(2)The scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health for the experiment group were higher than before(t=-23.427--6.624,all P<0.01).After the intervention,the scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health in the experiment group were higher than those in control group(t=5.705-12.806,all P<0.01).Conclusion Solution-focused brief therapy can effectively reduce the self-perceived burden of stroke patients and improve their quality of life.

Objective To investigate the clinical features and prognostic factors of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in adults.Methods Clinical data of 40 adult patients with EBV-HLH admitted in the First Affiliated Hospital of Nanjing Medical University during January 2010 and September 2013 were retrospectively analyzed.The patients were divided into fatal group or survival group based on the results of 1-month follow-up.Logistic regression analysis was performed to identify risk factors of early death.Results EBV-HLH in clinic were characterized by fever,hepatosplenomegaly and lymphadenopathy.The incidences of peripheral blood cytopenias in 2 or 3 lines,hepatic dysfunction and hyperferritinemia in EBV-HLH patients were 60.0％ (24/40),95.0％ (38/40) and 94.9％ (37/39),respectively.Hemophagocytic phenomenon in bone marrow was observed in 83.8％ patients (31/37).Soluble CD25 (sCD25) was detected in 12 patients,and all were higher than 2 400 pg/mL.Nineteen patients died 1 month after fiual diagnosis with a fatality rate of 47.5％.Univariate logistic regression analysis indicated that EBV-DNA ＞ 105 copies/mL (OR =4.85,95％ CI:1.14-25.83,P ＜ 0.05),PLT ＜ 50 × 1012/L (OR =6.81,95 ％ CI:1.41-32.83,P ＜ 0.05),total bilirubin ＞ 50 μmol/L (OR =6.91,95％ CI:1.24-38.52,P ＜0.05),albumin ＜ 30 g/L (OR =7.50,95％ CI:1.80-31.28,P ＜ 0.01),serum ferritin ＞5 000 μg/L (OR =8.75,95％ CI:2.03-37.67,P ＜0.01) and polyserositis (OR =5.40,95％ CI:1.18-24.64,P ＜0.05) were risk factors of death within 1 month after final diagnosis,while chemotherapy was a protective factor of early death (OR =0.15,95％ CI:0.03-0.81,P ＜ 0.05).Conclusions EBV-HLH in adult has a poor prognosis.Significant elevated EBV-DNA,total bilirubin or serum ferritin,and notable decrease of peripheral blood platelet count or albumin level may indicate a poor prognosis,while chemotherapy may reduce the risk of early death.