Objective:To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS).Methods: From July 2011 to April 2016,96 cases of single segment DLSS were involved.All the patients had unilateral lower extremity neurological symptoms,signs,neurogenic intermittent claudication of less than 500 m.Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration.The mean age was (71.6±5.4) years,male: 55 cases,female: 41 cases.Their intraoperative blood loss,operation time,complications,ambulation time and discharge time were recorded.Leg pain VAS,ODI were used to evaluate the pain and lumbar function of the patients.The clinical efficacy was evaluated by Nakai evaluation.Results: All the patients were performed endoscopic decompression of the lateral recess and nerve root by removing the ventral part of the superior facet joint,the ligamentum flavum and the intervertebral disc.The decompression range was from the inferior edge of the upper pedicle to the superior edge of the lower pedicle.The nerve root was detected to have no compression and the pulse of nerve root returned to normal.The patient got ambulant on the operation day and discharged if he had no discomfort symptom.In the study,68 cases got follow up.The mean follow-up time was 12.1 months (6-63 months).The VAS at dif-ferent follow-up time points was improved relative to the baseline,and the difference was statistically significant (F=491.60,P<0.001).The ODI at different follow-up time points was improved relative to the baseline,and the difference was statistically significant (F=189.91,P<0.001).The excellent and good rates of Nakai evaluation were 79.4％ (excellent in 42 cases,good in 12 cases,fair in 10 cases and poor in 4 cases).The mean intraoperative blood loss was (49.29±11.86) mL.The mean operation time was (92.46±21.34) min.The mean ambulation time was 1.8 h.The mean discharge time was 2.3 days.Postoperative epidural hematoma was found in 1 case.Foot drop was found in 1 case.Second stage open surgery was performed in 6 cases.Conclusion: We can apply transforaminal endoscopic decompression for the patients of lumbar spinal stenosis who have unilateral nerve root irritation.Patients with transforaminal endoscopic decompression can get less surgical trauma,quick recovery and obtain good short-term outcome.

BACKGROUND:Chinese herb Cape Jasmine Fruit can activate the chondrocytes and geniposide is an important component in this herb.
OBJECTIVE:To investigate the effect of geniposide on col agen II synthesis in rat chondrocytes cultured in vitro. METHODS:Rat chondrocytes were separated and cultured in vitro. The chondrocytes were then interfered with 25, 50 and 100 mmol/L geniposide. Normal control group was also set. Col agen II mRNA and protein expression was detected with semi-quantitative RT-PCR and western blot analysis, respectively.
RESULTS AND CONCLUSION:RT-PCR and western blot analysis results showed that, geniposide at 25, 50 and 100 mmol/L increased the col agen II mRNA and protein expression (P<0.01). Geniposide can promote the synthesis of col agen II in rat chondrocytes cultured in vitro.

Background: Isolated systolic hypertension (ISH) is a common disease in elderly people, threatening their health. Traditional Chinese medicine (TCM) treatment or integrative treatment had advantages in improving quality of life and protecting target organs, but need to be proved by large evidence-based researches. Objective: To observe the effects of TCM treatment (Jiangya Capsule) or integrative treatment (combination of Jiangya Capsule and nimodipine) on blood pressure and vasoactive agents, and their safety in elderly ISH patients. Design, setting, participants and interventions: A multicenter, randomized, double-blind controlled trial was adopted. A total of 270 elderly ISH patients recruited from Xiyuan Hospital, and TCM Hospital and Community Health Service Centers of Yanqing County of Beijing were randomly divided into 3 groups: TCM group (Jiangya Capsule plus nimodipine simulation, 90 cases), integrative group (Jiangya Capsule plus nimodipine, 90 cases) and Western medicine (WM) group (nimodipine plus Jiangya Capsule simulation, 90 cases). They were all treated for 4 weeks. Main outcome measures: Before and after 4-week treatment, office blood pressure, 24-hour ambulatory blood pressure, serum nitric oxide (NO), and plasma endothelin-1 (ET-1), thromboxane B2 (TXB2) and 6-keto-prostaglandin 1alpha (6-keto-PGF1alpha) were detected, and safety evaluation was conducted. Results: After 4-week treatment, 5 patients in TCM group were lost to follow-up and another 5 patients were excluded, and 80 patients finished the trial; 7 patients in integrative group were lost to follow-up and another 7 patients were excluded, and 76 patients finished the trial; 2 patients in WM group were lost to follow-up and another 3 patients were excluded, and 85 patients finished the trial. After treatment, systolic blood pressure (SBP) decreased in each group (P<0.05), and integrative treatment was superior to TCM or WM treatment in decreasing SBP (P<0.05). Twenty-four hour average SBP and day average SBP decreased significantly in each group, and night average SBP decreased in integrative group, and integrative treatment was superior to TCM or WM treatment in decreasing day average SBP. Serum NO and plasma 6-keto-PGF1alpha levels were elevated and plasma ET-1 and TXB(2) levels were reduced after treatment, and integrative treatment was superior to TCM or WM treatment in reducing plasma TXB(2) level. Conclusion: TCM treatment or integrative treatment has affirmative effects and safety in treating elderly ISH patients, and integrative treatment has superiority in improving some indexes, and deserves further study.

Scoliosis is a common deformity in neuromuscular disease, which usually has the characteristics of early onset age, severe degree of deformity, and rapid progression.Neuromuscular scoliosis often leads to serious damages to the quality of life, and results in the loss of walking, standing and sitting, and cardiopulmonary insufficiency.Surgical treatment can improve the quality of life for children with neuromuscular scoliosis, but surgical treatment is still challenging due to the complex surgery and many complicated diseases.The complications are much higher than those of idiopathic scoliosis.A multidisciplinary team is necessary in the surgical treatment of neuromuscular scoliosis to promptly and effectively reduce the complications.

Objective:To determine the content of albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol in Huaiqin Salve with high performance liquid chromatography-quantitative analysis of multi-components by single-marker (HPLC-QAMS) method. Methods:The samples were separated with ZORBAX Eclipse XDB-C18 column by a gradient elution using methanol-acetonitrile (1:2) (A)-0.1% phosphoric acid solution (B) as mobile phase and the flow rate was 1.0 ml/min. The detection wavelength was 230 nm for albiflorin, paeoniflorin and benzoylpaeoniflorin, and 254 nm for sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol. The column temperature was 30 ℃. Using sophoricoside as an internal standard, the relative correction factors (RCFs) of albiflorin, paeoniflorin, benzoylpaeoniflorin, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol were calculated. The method was validated by comparison of the quantitative results between external standard method (ESM) and HPLC-QAMS method.Results:Albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol showed good linear relationship within the range of 0.034 7-0.867 5, 0.063 6-1.590 0, 0.006 9-0.172 5, 0.198 6-4.965 0, 0.092 8-2.320 0, 0.026 6-0.665 0, 0.042 7-1.067 5, 0.020 9-0.522 5 μg ( r ≥ 0.999 1); whose average recoveries ( RSDs) were 98.85% (1.02%), 100.04% (0.67%), 96.92% (1.14%), 100.06% (0.85%), 99.31% (1.39%), 99.16% (1.22%), 98.59% (1.33%) and 97.58% (1.41%), respectively. No significant differences were found in the quantitative analysis of the components with ESM and HPLC-QAMS method. Conclusion:The HPLC-QAMS method could provide the reference for themulti-index component evaluation for Huaiqin Salve.