BACKGROUND:Cervical spondylosis refers to cervical intervertebral spondylotic myelopathy and secondary degenerative changes, as wel as pathological changes in surrounding tissue structures. Establishing animal model of cervical instability and vertebral-basilar artery ischemia is the key in the studies addressing cervical spondylosis pathophysiology and treatment.
OBJECTIVE:To establish animal model of unstable cervical spine and vertebral-basilar artery ischemia, and explore new progress of animal model imitation study.
METHODS:A computer-based retrieval of PubMed database and CNKI database was performed for articles published from 1979 to 2012. The key words were“cervical instability, basal-vertebral artery ischemia, animal model”in English and Chinese. The articles about cervical instability, basal-vertebral artery ischemia, and animal model were screened, and those published recently or in authorized journals were preferred in the same field. Final y 43 articles were included in this study.
RESULTS AND CONCLUSION:An ideal animal model of cervical disease is needed. Animal model of cervical diseases is often used for the study of disease causes, onset mechanism and biochemistry. As the causes and mechanism of cervical diseases remain unclear, the existing modeling method cannot duplicate human cervical diseases, so further studies are needed to explore the establishment of models, positive rate and modeling time.

Objective To investigate the clinical significance of serun procalcitonin (PCT) and adrenomedullin(ADM) levels in elderly patients with pneumonia diagnosis.Methods Thirty-eight elderly patients with pneumonia who were admitted to our hospital were collected as the study group.Thirty-two cases of non-pneumonic patients hospitalized in respiratory department at the same period for lung tumor,non-infective interstitial lung diseases and pulmonary edema were chosen as the control group.According to CURB-65 score,the study group was divided into three subgroups as mild,moderate and severe group.Levels of serum PCT and ADM at the 1st day,3rd day and 7th day were measured by ELISA,and data were statistically analyzed.Results Serum PCT ((1.98 ± 0.32) μg/L vs.(1.63 ± 0.44) μg/L,t =3.989,P =0.040) and ADM levels ((0.92±0.31) μg/L vs.(0.52±0.12) μg/L,t =5.987,P ＜0.001) on the first day of the treatment was significantly higher than in the control group.Serum PCT and ADM levels in the three subgroups decreased after treatment,and at each time point serum PCT (1st day:(2.19 ±:0.36) μg/L vs.(1.80 ± 0.28) μg/L vs.(1.83 ±0.22) μg/L;3rd day:(2.08 ±0.34) μg/L vs.(1.73 ±0.35) μg/L vs.(1.75 ±0.24) μg/L;7th day:(2.05 ±0.32) μg/L vs.(1.65 ±0.30) μg/L vs.(1.61 ±0.31) μg/L) and ADM levels (1st day:(1.08 ± 0.31) μg/L vs.(0.80 ± 0.25) μg/L vs.(0.77 ± 0.22) μg/L; 3rd day:(1.09 ± 0.32) μg/L vs.(0.77 ±0.23) μg/L vs.(0.75 ±0.21) μg/L;7th day:(1.08 ±0.33) μg/L vs.(0.66 ±0.18) μg/L vs.(0.72 ±0.25) μg/L) in the severe group were significantly higher than in the other two subgroups (P ＜0.05).Serum PCT and ADM levels in survived patients on the 1 st day,3rd day,and 7th day after treatment were significantly lower than in patients who were deceased (PCT:1 st day:(1.82 ± 0.26) μg/L vs.(2.16 ± 0.37)μg/L;3rd day:(1.74 ± 0.29) ~L vs.(2.06 ±0.31) μg/L;7th day:(1.62 ± 0.30) μg/L vs.(2.03 ±0.30) μg/L;P ＜0.05 ;ADM:1st day:(0.78 ± 0.23) μg/L vs.(1.06 ± 0.29) μg/L;3rd day:(076 ± 0.21)μg/L vs.(1.08 ± 0.30) μg/L; 7 th day:(0.70 ± 0.20) μg/L vs.(1.09 ± 0.35) μg/L; P ＜ 0.05),and serum PCT and ADM levels did not change significantly in deceased patients after treatment.Conclusion Serum PCT and ADM levels can serve as serum markers in early diagnosis,the severity of pneumonia and estimating prognosis in elderly patients.

BACKGROUND:Percutaneous vertebroplasty for vertebral fractures can effectively relieve acute pain and has the advantages of smal trauma, good curative effect and less complications, but for patients with osteoporotic compression fractures, there were varying degrees of osteoporosis after surgery, which have a longer course of disease and cannot be easy to cure. So the effectiveness of percutaneous vertebroplasty cannot be ful y evaluated based on the pain relief. OBJECTIVE:To study the curative effect of percutaneous vertebroplasty for patients with fresh osteoporotic thoracolumbar vertebral compression fractures. METHODS:We selected 24 patients undergoing percutaneous vertebroplasty and 24 patients receiving conservative treatment at the same time who had fresh osteoporotic compression fractures as research objects;and compared pain degree, vertebral body height and the kyphosis Cobb angle, function activity of the lower lumbar before and after treatment, the quality of life and clinical incidence of complications within 6 months after treatment in the two groups. RESULTS AND CONCLUSION:The degree of pain, the vertebral body height, kyphosis Cobb angle, function activity of the lower lumbar were al improved in the two groups after treatment (P<0.05), and these indexes in the percutaneous vertebroplasty group were better than those in the conservative treatment group (P<0.05). The quality of life and incidence of complications within 6 months after treatment were improved better in the percutaneous vertebroplasty group than the conservative treatment group (both P<0.05). These results suggest that the percutaneous vertebroplasty for fresh osteoporotic thoracolumbar vertebral compression fractures can effectively reduce the pain of patients, improve vertebral deformity and activities of the lower lumbar, and has obvious role in promoting the postoperative quality of life of patients.

Objective: In order to solve the problem of moisture absorption for Biantong Capsule, the extract granule of Chinese medicine is covered with HPMC for Biantong Capsule. Methods: Taking moisture absorption rate as measure index, various facters effected the moisture absorption rate, and the optimal coating process can be selected with well disturbed uniform design and computer analog test. Results: Under the condition of 25℃, relative moisture 75% and 100% respectively, the moisture absorption rate is lower than uncovered granules, the critic relative moisture of covered granules is greater than that of uncovered granules. Conclusion: Chinese medicine of Biantong Capsule covered with HPCM can be served as a good anti moisture method.

Objective To explore the hospitalization costs of patients with diabetic foot ulcer and analyze key influencing factors.Methods A total of 570 diabetic foot inpatients were recruited from January 2008 to March 2012 for analysis of the relationship between their hospitalization costs and clinical symptoms.The multifactor regression analysis model was used to identify main influencing factors for their hospitalization costs.Results The medical costs of such inpatients amounted to 1 9 825.6 yuan (12 476.6~32 745.9)yuan,while average hospitalization costs of the 3 401 diabetic patients admitted over the same period were but 9 757.1 yuan (6 282.1 ~ 1 5 723.7 )yuan,a difference of statistic significance.The single-factor analysis found statistical differences from the differences of hospitalization among various age,occupation,dorsal artery of foot,B ultrasound of lower extremity arteries,wagner classification,amputation,transfer,leucocyte,hemoglobin,serum albumin,serum creatinine and high density lipoprotein.Multifactor analysis found that the significant factors influencing the medical costs of inpatients were days of stay,albumin,wagner classification,dorsal artery of foot,leucocyte and age. Conclusion Hypoalbuminemia,high stage of wagner classification,weak or absent pulsation of foot dorsal artery,severe infection and aging were significant factors contributing to higher medical costs of hospitalization for patients with diabetic foot ulcer.

BACKGROUND:WIF-1 is a tumor suppressor gene. Promoter hypermethylation causes WIF-1 down-regulationin most tumors. DNA methylation inhibitor can lead to gene demethylation and restore its expression. OBJECTIVE:To observe the differences of tumor pathology and, WIF-1 mRNAand proteinchanges using WIF-1 or 5-aza-2'-deoxycytidine demethylation in animalmodels of osteosarcoma.
METHODS:Murine osteosarcoma models were established and divided into three groups. In the control group, no treatment was given. In the 5-aza-2'-deoxycytidine group, an appropriate amount of 5-aza-2'-deoxycytidine was injected ineach mouse daily. In the WIF-1 group, an appropriate amount of Wnt/β-catenin signal transduction pathway inhibitor WIF-1 was injected in each mouse daily. Seven days after medication, the weight of nude mouse was weighed every 7 days. Short tumor diameter (a) and the long diameter (b) were measured. Therelative tumor volume was calculated. The relative growth rate of tumor was calculated at 7, 14, 21, 28 and 56 days. Four nude mice from ach group were sacrificed by puling the neck at 7, 14, 21, 28 and 56 days after medication. Tumor tissues were stripped and the weight of them was weighed. Pathological analysis of the tumor was conducted. The expression of WIF-1protein and WIF-1 mRNA was detected in osteosarcoma at 56 days after medication in the three groups.
RESULTS AND CONCLUSION:(1) Compared withthe medication and control groups, the weight of nude mice was increased at 7, 14, 21, 28 and 56 days in the treatment group. No significant difference was found between the medication and control groups. (2) The tumor size was significantly smaler in themedication group than in the control group. WIF-1 mRNA and WIF-1 protein expression was increased in the medication group compared with the control group to different degrees. (3) Results suggested that WIF-1 gene promoter methylation is one of the mechanisms of the development of osteosarcoma. Use of WIF-1 or 5-aza-2'-deoxycytidine demethylation can inhibit tumor growth in animal models of osteosarcoma.

Objective To investigate the preventive effect research of dezocine in the treatment of hyperpathia caused by remifentanil and sevoflurane. Methods A total of 84 epigastric operation patients were collected into this study. Both of them were anesthetized by the therapy of remifentanil and sevoflurane. Patients of observation group were treated with dezocine before the end of the operation. Patients in control group were treated with fentanyl before the end of the operation. The six behavioral pain score (BRS6) and VAS score were used to evaluate the degree of pain in patients before and after surgery, and recovery time, extubation time and leave PACU time as well as anesthesia ad-verse reactions in the two groups were recorded. Results The differences of preoperative BRS6 and VAS score were not statistically significant (P>0.05), BRS6 and VAS scores at 1 h after surgery in the observation group were significantly lower than the control group; recovery time, extubation time and leave PACU time in observation group were (28.96±5.54) min, (21.08±7.45) min and (58.05±10.32) min, while (38.62±5.05) min, (57.08±5.36) min and (69.05±9.52) min in the control group, the differences were statistically significant (P<0.05); 1d after anesthesia, incidence of vomiting in the observation group was significantly lower than the control group (P<0.05). Conclusion Dezocine has perfect preven-tive effect in the treatment of hyperpathia caused by remifentanil and sevoflurane.

Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.

Uncut Roux-en-Y anastomosis is widely used in gastrointestinal reconstruction procedure after radical gastrectomy for distal gastric cancer. However, the proximal jejunal closure point recanalization of the input loop is an important complication of postoperative patients with prolonged time, resulting in pancreatic juice or bile reflux, which can lead to inflammatory lesions of the remnant stomach or esophagus. Poor selection of the location of the closure point during anastomosis causes a large amount of food deposited in the blind loop to be pushed and impacted, resulting in loosened threads or failed U-shaped staples, which may cause recanalization complications. Most scholars believe that the shortening of the jejunal tube closure point to the optimal position of 2 to 3 cm from the residual gastrojejunostomy can significantly reduce food retention, decrease the pressure of the closure point and the incidence of recanalization. At present, the application of new anastomotic techniques and materials such as four-row and six-row U-shaped staples and 7# wire ligation under laparoscopy can prevent the occurrence of recanalization of the closure point. Uncut Roux-en-Y anastomosis is safe and has few complications, and is expected to become one of the best ways of digestive tract reconstruction.

Uncut Roux-en-Y anastomosis is widely used in gastrointestinal reconstruction procedure after radical gastrectomy for distal gastric cancer. However, the proximal jejunal closure point recanalization of the input loop is an important complication of postoperative patients with prolonged time, resulting in pancreatic juice or bile reflux, which can lead to inflammatory lesions of the remnant stomach or esophagus. Poor selection of the location of the closure point during anastomosis causes a large amount of food deposited in the blind loop to be pushed and impacted, resulting in loosened threads or failed U-shaped staples, which may cause recanalization complications. Most scholars believe that the shortening of the jejunal tube closure point to the optimal position of 2 to 3 cm from the residual gastrojejunostomy can significantly reduce food retention, decrease the pressure of the closure point and the incidence of recanalization. At present, the application of new anastomotic techniques and materials such as four-row and six-row U-shaped staples and 7# wire ligation under laparoscopy can prevent the occurrence of recanalization of the closure point. Uncut Roux-en-Y anastomosis is safe and has few complications, and is expected to become one of the best ways of digestive tract reconstruction.