OBJECTIVETo explore the operative skills and effect of unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation in treating degenerative low lumbar disease.

METHODSFrom January 2009 to December 2011,22 patients with degenerative low lumbar disease were treated with transforaminal lumbar interbody fusion, during the operations, unilateral pedicle screw and contralateral percutaneous transfacet screw fixation were performed. There were 16 males and 6 females, aged from 32 to 71 years old with an average of (51.1 ± 10.6) years, including single segment in 20 cases and two segments in 2 cases. Clinical effects were evaluated according to visual analogue score (VAS) and Oswestry Disability Index (ODI).

RESULTSAll patients were followed up from 1 to 2.5 years with an average of 18 months. One case complicated with leakage of cerebrospinal fluid after operation and 1 case with lower limb pain of decompression-side on the 3rd day after operation. Twenty-two patients got bony fusion. There were no instability and evidence of instrument failure during follow-up. The VAS and ODI score decreased from preoperative 8.24 ± 0.72, 36.72 ± 6.84 respectively to 3.18 ± 0.66, 4.36 ± 1.12 at the final follow-up (P < 0.05).

CONCLUSIONUnilateral pedicle screw combined with contralateral percutaneous transfacet screw fixation is safe and feasible surgical technique in treating low lumbar degenerative disease. It has advantages of little trauma, rigid fixation, high fusion rate, and less complication. etc.

Adult ; Aged ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fusion ; methods

Aim To observe the effect of hemodialysis on pharmacokinetics of sparfloxacin in thepatients contracting chronic renal failure. Methods Sparfloxacin concentrations inserum and urine of hemodialysis and non-dialysis patients were measured with a highperformance liquid chromatography method after administration a single oral dose of 200mg sparfloxacin. The pharmacokinetic parameters were computed with the programPKBP-N1.Results The main pharmacokinetic parameters in hemodialysis group wereT1/2(ka) - (1. 25 ?0. 57) h, T1/2(?) = (11. 88?4. 13) h, Tpeak = (4. 18 ? 0. 78) h,Cmax = (0.80 ? 0. 17) mg? L-1 and AUC0-= (6. 90 ? 3. 25) mg?h?L-1, while innon-dialysis group were T1/ 2(ka) = (1. 12 ? 0. 42) h, T1/ 2(?) = (15. 93 ? 5. 20) h, Tpeak =(3. 88 ? 0. 75) h, Cmax = (0. 69 ? 0. 37) mg?L -1, AUC0-= (10.05 ? 4. 13) mg?h?L-l. The original sparfloxacin discharge rats in urine within 24 h were (8. 98 ? 3. 92) % and(10. 58 ? 5. 64) % separately. T1/2(?) and AUC in hemodialysis group were markedly lowerthan in non-dialysis group (P

OBJECTIVETo explore the etiological factors of benign paroxysmal positional vertigo (BP-PV).

METHODSThe clinical data of 145 patients with BPPV were retrospectively reviewed. The impacts of gender and age on BPPV were analyzed. The relationship between the onset of BPPV and the internal ear ischemia was also explored.

RESULTSThe abnormality rate of auditory brainstem response (ABR) under high stimulus rate was 59.3% (86/145) in all the patients with, including 22.1% (32/145) in male and 37.2% (54/ 145) in female (P > 0.05). The abnormality rate of ABR under high stimulus rate were 37.9% (55/145) and 21.4% (31/145) in middle-aged (30-55 years) and old ( > 55 years) patients, respectively (P > 0.05).

CONCLUSIONThe onset of BPPV may relate to ischemic internal ear but is not relevant with gender and age.

Adult ; Age Factors ; Age of Onset ; Aged ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vertigo ; etiology ; pathology ; physiopathology ; Young Adult

Background: Transarterial chemoembolization (TACE) is recommended as the standard care for unresectable hepa-tocellular carcinoma (HCC) at Barcelona Clinic Liver Cancer (BCLC) stage A–B. However, the efficacy of TACE on large (≥ 10 cm) stage A–B HCC is far from satisfactory, and it is proposed that hepatic artery infusion chemotherapy (HAIC) might be a better first-line treatment of this disease. Hence, we compared the safety and efficacy of HAIC with the modified FOLFOX (mFOLFOX) regimen and those of TACE in patients with massive unresectable HCC. Methods: A prospective, non-randomized, phase Ⅱ study was conducted on patients with massive unresectable HCC. The protocol involved HAIC with the mFOLFOX regimen (oxaliplatin, 85 mg/m2intra-arterial infusion; leucovorin, 400 mg/m2intra-arterial infusion; and fluorouracil, 400 mg/m2bolus infusion and 2400 mg/m2continuous infusion) every 3 weeks and TACE with 50 mg of epirubicin, 50 mg of lobaplatin, 6 mg of mitomycin, and lipiodol and polyvinyl alcohol particles. The tumor responses, time-to-progression (TTP), and safety were assessed. Results: A total of 79 patients were recruited for this study: 38 in the HAIC group and 41 in the TACE group. The HAIC group exhibited higher partial response and disease control rates than did the TACE group (52.6% vs. 9.8%, P < 0.001;83.8% vs. 52.5%, P = 0.004). The median TTPs for the HAIC and TACE groups were 5.87 and 3.6 months (hazard radio [HR] = 2.35, 95% confidence interval [CI] = 1.16–4.76, P = 0.015). More patients in the HAIC group than in the TACE group underwent resection (10 vs. 3, P = 0.033). The proportions of grade 3–4 adverse events (AE) and serious adverse events (SAE) were lower in the HAIC group than in the TACE group (grade 3–4 AEs: 13 vs. 27, P = 0.007; SAEs: 6 vs. 15, P = 0.044). More patients in the TACE group than in the HAIC group had the study treatment terminated early due to intolerable treatment-related adverse events or the withdrawal of consent (10 vs. 2, P = 0.026). Conclusions: HAIC with mFOLFOX yielded significantly better treatment responses and less serious toxicity than did TACE. HAIC might represent a feasible and promising first-line treatment for patients with massive unresectable HCC.

BACKGROUNDReliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research. Proton magnetic resonance spectroscopy ((1)H-MRS) has been applied with variable success in clinical application, and we hypothesize that (1)H-MRS in predictive value should perform well as a marker of TTP in patients treated with radiotherapy (RT) after surgery.

METHODS(1)H-MRS was performed before surgery on 25 patients who had undergone resection of HGGs; then the ratios of lipid/creatine (Lip/Cr) and myo-inositol/creatine (mI/Cr) were determined in the solid tumor. RT response was classified as follows: complete resolution (CR), partial response (PR), stable disease (SD), and progressive disease (PD) by comparison of pre-treatment and post-radiotherapy scans. TTP was defined at the time to radiographic progression by MacDonald criteria. Correlation was evaluated between the ratios of Lip/Cr, mI/Cr and treatment response, TTP. The chi-square test and Pearson correlation test were used for data analyses.

RESULTSMultivariate analysis revealed that the prognostic value of spectroscopic variables was independent of age, sex, WHO histologic grade, extent of surgery, and Karnofsky score (KPS). The correlation between the ratios of lipid/Cr and TTP was significant (r = 0.894, P = 0.000), and between the ratios of mI/Cr and TTP was also significant (r = 0.891, P = 0.000). As predicted, RT response correlated significantly with TTP (r = 0.59, P = 0.002): median TTP was 49.9 days for patients with PD compared with 202.7 days for SD, 208.0 days for PR, and 234.5 days for CR.

CONCLUSIONThe ratios of Lip/Cr and mI/Cr of the solid tumor region before surgery could provide important information in predicting RT response and TTP in patients with HGGs treated by radiation alone after surgery.

Glioma ; radiotherapy ; surgery ; Humans ; Magnetic Resonance Spectroscopy ; methods ; Multivariate Analysis

OBJECTIVETo explore the electrophysiological properties of differentiation of rat bone marrow-derived stromal stem cells (rBMSCs) to neuron-like cells in vitro by edaravone, a new type of free radical scavenger.

METHODSStromal stem cells were separated from rat bone marrow with Ficoll-Paque reagent and expanded in different culture medium in vitro. rBMSCs were induced by edaravone containing serum-free L-DMEM. Morphologic observation and Western blot analysis including the expression of Nav1.6, Kv1.2, Kv1.3, Cav1.2 were performed, and whole patch-clamp technique was used.

RESULTSCyton contraction and long processes were shown in differentiated stromal stem cells. Nav1.6, Kv1.2, Kv1.3 and Cav1.2 were expressed in both differentiated and undifferentiated cells. However, the expression of channel proteins in differentiated cells was up-regulated. Consistently, their resting potential and outward currents were also enhanced in the differentiated cells, which was especially significant in the outward rectifier potassium current.

CONCLUSIONIn vitro, neuron-like cells derived from rBMSCs, induced by edaravone, possess electrophysiological properties of neurons.

Animals ; Antipyrine ; analogs & derivatives ; pharmacology ; Blotting, Western ; Bone Marrow Cells ; cytology ; physiology ; Cell Differentiation ; drug effects ; Male ; Neurons ; cytology ; physiology ; Rats ; Rats, Sprague-Dawley ; Stromal Cells ; cytology ; physiology

OBJECTIVESTo analyze retrospectively the formation and histological changes of sclerosis rim in patients with osteonecrosis of the femoral head (ONFH), and to study the relationship between bone morphogenetic proteins (BMP4) and sclerosis rim, so as to acquire experimental and theoretical basis on individualized treatment for ONFH patients.

METHODSFrom November 2005 to November 2007, 184 hips of steroid-induced ONFH inpatients were collected. The mean age was (47 ± 7) years, the patients were divided into high (more than 54 years old), middle (40 - 54 years old) and low (less than 40 years old) age groups. Their clinical data were analyzed retrospectively according to gender and age. Parts of the femoral heads were selected for the study, including 18 hips in high age group, 11 hips in low age group and 20 hips in middle age group. Each 10 hips were selected with or without sclerosis rim. The femoral heads were cut along middle coronal plane, their weight-bearing and non-weight-bearing areas were used for the study. The specimens were processed by routine HE staining and picric acid-Sirius red staining and electron microscopy preparation and immunohistochemistry stain. The average optical density of BMP4 protein was calculated by image analysis software.

RESULTSThe trabecular of sclerosis rim was thickening and disorder. But its osteocytes were normal and with high secretion. The ratio of sclerosis rim was 71.4% (105/147) in middle age ONFH patients, which was significantly higher than the low age group patients (45.5%, 5/11) and high age group patients (38.5%, 10/26) (P < 0.01). The optical density of BMP4 in middle age ONFH patients was 0.32 ± 0.14, which was significantly higher than the low age group 0.20 ± 0.17 and high age patients 0.19 ± 0.27 (P < 0.05). The optical density was 0.16 ± 0.11 in ONFH patients without sclerosis rim, which was significantly lower than with sclerosis rim (0.28 ± 0.13) (P < 0.01). The time from hip pain to joint replacement in patients with sclerosis rim was (49 ± 11) months, and (15 ± 2) months without sclerosis rim. There was significant difference between the two groups (P < 0.01).

CONCLUSIONSThe formation of sclerosis rim is positively related to the expression of BMP4, and high expression of BMP maybe promote the formation of sclerosis rim.

Adult ; Bone Morphogenetic Protein 4 ; metabolism ; Female ; Femur Head ; metabolism ; pathology ; Femur Head Necrosis ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies

The prevalence of Lyme disease in endogenous populations in Urumqi,Xinjiang was investigated.In total,795 serum samples were collected from residents of three townships in the surrounding area of Urumqi City from 2022 to 2023,which included 383 from Lucaogou Town,145 from Shuixigou Town,and,267 from Tori Township.Serum levels of IgG and IgM antibodies were screened with an enzyme linked immunosorbent assay(ELISA)and confirmed by western blot(WB)analysis.Clinical data of WB-positive indi-viduals were collected and comprehensive analysis was con-ducted for case diagnosis.The chi square test was used for statistical analysis of the results and the P＜0.05 was consid-ered statistically significant.In total,110(13.84％)of 795 samples were positive.The positivity rates was higher in females than males[16.26％(73/449)vs.10.69％(37/346),x2=5.076,P=0.024],while there was no significant difference among age groups(x2=2.569,P=0.766).The positivity rates for serum antibodies in Shuixigou Town,Lucaogou Town,and Tuoli Township were 17.98％(48/267),14.48％(21/145),and 10.70％(41/383),respectively,with a significantly higher rate in Tuoli Township than Lucaogou Town(x2=7.041,P=0.008).Of 110 individuals who were initially positive for IgG and IgM antibodies with the ELISA,82(10.31％)were con-firmed positive by WB analysis.In total,20(2.52％)patients were diagnosed with Lyme disease based on clinical manifesta-tions.Lyme disease is epidemic among the population in Urumqi,as the infection rate is higher than the national average.Hence,continued surveillance is recommended for prevention of Lyme disease.

The present study was designed to evaluate the cardioprotective effect of latifolin on pituitrin(Pit) or isoproterenol(ISO)-induced myocardial injury in rats, and further investigate its underlying mechanisms. Rats were administrated sublingually with pituitrin or subcutaneously with isoproterenol to induce acute myocardial ischemia in rats, and lead II electrocardiograph was recorded. In rats with isoproterenol, ELISA assay or colorimetric method was used to detect the content or activity of myocardial injury markers in serum, and the SOD activity and MDA content in myocardium were detected by colorimetric assay; histopathological examination was conducted by HE staining; the frozen section of myocardial tissues was used for DCFH-DA fluorescent staining to detect the content of ROS in myocardium; Western blot was used to detect the protein expression levels of Nrf2, Keap1, HO-1 and NQO1 in myocardium. Results showed that latifolin significantly inhibited ST-segment changes induced by pituitrin or isoproterenol, and increased heart rate. Further mechanism study showed that latifolin reduced cardiac troponin I(cTnI) level, aspartate transaminase(AST) and lactate dehydrogenase(LDH) activities in serum, increased myocardial superoxide dismutase(SOD) activity and reduced myocardial malondialdehyde(MDA) level, and protected myocardium with less necrosis, infiltration of inflammatory cells and fracture of myocardial fibers. Furthermore, latifolin obviously reduced ROS level in myocardium, inhibited the expression of Kelch-like ECH-associated protein-1(Keap1), increased the nuclear translocation of nuclear factor erythroid 2 related factor 2(Nrf2), and promoted the expression of Heme oxygenase-1(HO-1) and NAD(P)H quinone oxidoreductase-1 (NQO1) in myocardial tissues. Our data suggest that latifolin has a potent protective effect against pituitrin or isoproterenol-induced myocardial injury, which may be related to inhibition of oxidative stress by activating Nrf2 signaling pathway.

Objective:To study the clinical medication regulation for the prevention and treatment of new coronavirus pneumonia with traditional Chinese medicine（TCM），especially prescriptions，on the basis of "treatment in accordance with seasonal conditions". Method:The guidelines and suggestions on novel coronavirus pneumonia formulated and published by national，provincial and municipal governments and experts before February 17，2020, were retrieved and summarized. Data was recorded in stages according to "prevention period，clinical observation period，pre-clinical period，middle clinical period，late clinical period and recovery period". The frequency analysis of TCM and its efficacy，prescription and proprietary Chinese medicine was carried out，and then the factor analysis and cluster analysis of TCM were carried out to obtain rational drug combinations. Result:Totally 172 suggestions on combined structure of drugs，50 suggestions on prescriptions and 31 suggestions on proprietary Chinese medicine were involved in the study，and provided by 24 official agencies and 24 medical experts， 147 kinds of herbs，44 prescriptions and 16 proprietary Chinese medicines were collected. No matter for the drug category or for the specific drug selection，the law of drug use in different stages was not the same. Huoxiang Zhengqi capsule，Shufeng Jiedu capsule，Lianhua Qingwen capsule and Jinhua Qinggan capsule can be used in the observation period. Xuanbai Chengqitang can be used in the middle of the disease. Angong Niuhuangwan，Suhexiangwan or Zixuedan, and Angong Niuhuangwan can be selected in the middle of the disease. And Qingfei Paidu decoction can be used in all stages of the disease. Conclusion:Doctors need to adjust their prescriptions along with the progress of the disease，because the law of medication in each stage of the new coronavirus pneumonia is different.