Objective To analyze functional improvement of spinal cord and the prognosis of two surgical approaches for the stenosis of cervical spinal canal;to investigate the mechanisms concerning post-terior decompression,fusion with ilium graft and internal fixation and 158 cases who underwent dorsal laminectomy from January 2001 to October 2002 were follow-up for at least 24 months and examined with the evaluation systems of Japanese Orthopaedic Association Score,somatosensary evoked essential and initiative range of motion to compare preoperative,short-term and long-term efficacy.Results According to selected standard of improvement rate,therapeutic effect of 56 sufferers among ventral approach group was analyzed,14 cases(25%)excellent,29 cases(51.79%)good,10 cases(17.86%)fair,3 cases(5.36%)poor;postoperative effect of 62 sufferers from dorsal approach group was analyzed,23 cases(37.10%)excellent,31 cases(50%)good,7 cases(11.29%)fair,1 case(1.61%)poor.Concerning JOA evaluation of spinal cord function,initiative range of motion and correlated parameters of SEP,there was significant difference between two decompression approach in postoperative periods.7 cases from anterior approach and 13 patients from posterior approach disturbed by postoperative complications were gradually rehabilitated through conservative of Cervical 5 spinal root',the essence of above-mentioned symptoms may be cervical cord impairment due to decompression process,which would be alleviated by appropriate intervention;2)The efficiency of posterior decompression get the better of anterior decompression in light of fundamentally enlarging available space approach became a little smaller than normal individuals,however,the corresponding parameters after anterior approach lower than the former two groups.

Ear, Middle ; surgery ; Eustachian Tube ; Foreign Bodies ; surgery ; Humans ; Male ; Young Adult

Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial embolization,35 patients were immediately released of bleeding.Postoperative 24 h,8 patients had hemoptysis again,of which 1 case was performed with conservative treatment and subsequently had pneumonectomy,5 patients had effective conservative treatment,2 cases were performed embolization again after failed conservative treatments.Hemoptysis completely disappeared within 1 week.The total effective rate was 97.4％(37/38).Patients were followed up for 1 year,of which 13 patients relapsed again,11 patients'annual and each time's quantity of hemoptysis reduced 50％.Two patients had pneumonectomy after a number of embolization.The total effective rate was 94.7％ (36/38).After treatment,3 patients had mild chest pain in short time,2 patients had shoulder pain,3 patients had chest tightness,and 3 patients had subcutaneous passive congestion.After being treated for short-term,these symptoms disappeared eventually.Conclusion Selective bronchial arterial embolization for the treatment of acute or recurrent severe hemoptysis is very effective,and can avoid the risk of surgery.It is effective for recurrent cases and worthy of clinical application.

Objective To investigate the effect of astaxanthin on the peripheral blood endothelial progenitor cells (EPCs) apop-tosis induced by oxidative stress in vitro and to explore its underlying mechanism .Methods Human peripheral blood EPCs were in vitro cultured and divided into the control group ,model group with 100 μmol/L tert-butyl hydroperoxide(tBHP) and the astaxan-thin plus tBHP group(with 0 .10 ,1 .00 ,10 .00 nmol/L astaxanthin pretreatment for 24 h ,then adding the final concentration of 100μmol/L tBHP for 6 h continuous culture) .The cell viability was measured by the MTT method .The level of reactive oxygen spe-cies (ROS) was determined by the DCFH-DA method .The changes of mitochondrial membrane potential(MMP) and the apoptosis ratio were detected by the JC-1 method and the DAPI method ,respectively .Results Compared with control group ,100μmol/L tB-HP could obviously caused the apoptosis of EPCs(P<0 .05) ,while astaxanthin could decrease tBHP induced apoptosis ,which man-ifested by the decrease of the apoptosis ratio (P<0 .05) and MMP increase .Conclusion Astaxanthin has the protective effect on the apoptosis of EPCs ,its mechanism may be related with the protection of the mitochondrial function .

Objective To explore the genetic impact of three newly discovered single nueleotide polymorphism (SNP) sites of the transforming growth factor (TGF)-β1 gene on the susceptibility of the chronic hepatitis B virus (HBV) infection. Methods Genome DNA was extracted from the peripheral blood samples of 115 cases suffering from the chronic HBV infection (74 chronic hepatitis B, 41 cirrhosis) as well as 41 healthy volunteers. Thereafter, genotyping of rs2241715, rs2241716 and rs4803455 sites of the TGF-β1 gene was performed by genotype-specific polymerase chain reaction (PCR) analysis. The data were analyzed by the ehi square test and Fisher exact test. Results There was a significant difference of rs2241715 genotypes and allele frequencies between healthy volunteers and patients with chronic hepatitis B and cirrhosis (χ2 = 11.419, P＜0.01 and χ2 = 6.218, χ2 = 5.961,P＜0.05,respectively). Interestingly, the risk relative of subjects with T/T genotype suffered from chronic hepatitis B (OR = 2. 974, 95% CI = 1.209 - 7. 314, P = 0.018) and cirrhosis (OR = 3.228, 95%CI=1.201-8.675, P=0.020) was dramatically higher than that in patients with T/G or G/G genotypes. Conclusion The TGF-β1 rs2241715 T/T genotype appears to be associated with the chronic HBV infection.

Objective To investigate the resident performance on preoperative anesthetist visit in Beijing hospitals,thereby providing introduction for further training.Methods A self-designed questionnaire was distributed among the anesthesia residents who were receiving anesthesia residency training in Beijing through WeChat.The questionnaire covers geographic data of the residents,information on preoperative visit and existing training program.Results160 questionnaires were reclaimed.History-taking and physical examination were not comprehensive in many residents,the nature of surgery was not evaluated by most residents.The capacity of risk assessment and risk informing were not competent in many residents.The most desired training methods for preoperative visit were scenario simulation and bedside observation.Conclusions Scenario simulation with standard patient may have a promising prospect in preoperative anesthetist visit training.

Objective To explore the relationship between vitamin D and depression and the effects of chronic unpredictable mild stress (CUMS) plus sertraline on vitamin D metabolism in rat brain.Methods Male SD rats were randomly divided into normal control group,normal control + sertraline group,CUMS group and CUMS+sertraline group.CUMS was used to build the animal model of depression.After chronic exposure to CUMS or sertraline (8 mg·kg-1·d-1) for 6 weeks,behavioral response (sucrose preference test) and vitamin D metabolism in the prefrontal cortex were analyzed.Results Compared with normal control group,6 weeks of CUMS procedure induced the rats to a depression-like state,decreased weight and sucrose preference,and increased the expression of enzymes involved in vitamin D activation and catabolism (CYP27B1 and CYP24A1,respectively) and vitamin D receptor (VDR) in rat prefrontal cortex.As compared with CUMS group,CYP27B1,CYP24A1 and VDR were significantly decreased in CUMS+sertraline group (P<0.01 or P<0.05).Conclusion CUMS activates vitamin D signaling in the brain of the animal models of depression,while sertraline alleviates depressive behavior and relieves stress-induced activation of vitamin D signaling,indicating that vitamin D signaling may be involved in the stress-induced depression.

The ionic liquid butylamine 2,5-dihydroxybenzoate (DHB-BuN) was chosen as the matrix for improving repeatability of oligosaccharides quantitation, and imaging oligosaccharides in soybean and leaf by matrix-assisted laser desorption/ionization-mass spectrometry (MALDI-MS).Using the ionic liquid matrix methanol solution (20%, V/V) to cover sample slice, and setting MS acquisition parameters including polarity as positive and laser power as 70%, the MS imaging experiment was performed to analyze oligosaccharides and their distribution in soyben and soybean leaf.As a result, the MALDI-MS analysis of 3 kinds of oligosaccharides including sucrose, raffinose and stachyose was performed using the ionic liquid matrix and the reproducibility RSDs were less than 3% for in-spot and less than 4% for spot-to-spot.The standard curves linear correlation coefficients (R2) were all no less than 0.996 between MS peak intensity and oligosaccharides concentraions in the concentration rage of 0.062-1.00 mg/mL, which showed quantitative power in MALDI-MS analysis.The matrix was used for MALDI-MS imaging analysis of soybean chips and soybean leaf surface disaccharide, trisaccharide and tetrasaccharide to obtain the soybean mass spectrum and spatial resolution of 150 μm of the three oligosaccharides imaging.Three kinds of oligosaccharides in the soybean roughly balanced distribution, and the oligosaccharides distribution in the leave was mostly at its tip part.The contents of the 3 kinds of oligosaccharides could be estimated by their MS peak intensity and above standard curve.The result suggested that the ionic liquid DHB-BuN matrix could be well applied in MALDI-MS imaging analysis of oligosaccharides in different sample.

Objective To compare the clinical effects of treating cervical prolapse of intervertebral disc by using Solis cage, titanium cage and autogenous iliac crest graft (AICG) combined with titanium plate. Methods 64 cases of cervical prolapse of intervertebral disc were analyzed retrospectively. All the patients were followed up for about one year. Group A is composed of 20 patients (30 intervertebral spaces) treated with microdiscectomy and Solis cage fusion;group B is composed of 21 patients(22 intervertebral spaces) treated with titanium cage and group C is involved of 23patients(28 intervertebral spaces) which were dealt with AICG combined with titanium plate. The differences in the to-tal X ray exposure time, time working on iliac bone, incidence of complications, fusion rate, incidence of JOA score recovery rate more than 50 % and rehabilitation time of the three groups are analyzed. Results All indexes from group A and B were more satisfactory than those from group C (P＜0. 05). The statistic analysis results of the incidence of complications of cervical part, rehabilitation time in group A are 5.0± 1.8, 5.1 ± 1.2; and that is 14.3±2.6, 7.5 ± 1.6and 26.1±6.2, 8.6±2.3 in group B and group C respectively. There is significant difference between group A and group B on the incidence of complications of cervical part and rehabilitation time (P＜0.05). Results of the incidence of JOA score recovery rate ＞ 50 % in group A(95.8 ± 3.2) was more satisfactory than that in group B(93.6 ± 2.9),while there was no statistical difference between group A and group B (P＞0.05). Conclusion The Solis cage is better in treating the cervical prolapse of intervertebral disc than other ways. Also, it makes the operation easier, rehabilitation time shorter, and it causes fewer complications.

By using SWOT method, we analyze the strengthen, weakness, existing opportunity and challenging of applying Mini-CEX which is named Mini Clinical Evaluation Exercise in theOrgan-system-based curriculum modelclinical nursing teaching, and propose related development strategy of Mini-CEX.