Objective To determine the best method of revision for failed pedicle screw by investigating the change in maximum insertional torque and axial pullout strength after placing a larger diameter and/or longer screw or augmenting the failed hole with bone shims or PMMA. Methods Six fresh male adult cadaveric spines from T10-L5 were harvested. These specimens, aging from 23 to 51 years with an average of 36.7 years, were divided into six groups: 1)Using a larger diameter screw; 2)Using a longer screw; 3)Using a larger and longer screw; 4)Augmenting with bone shims; 5)Augmenting with PMMA; and 6)Reinsertion after being backed out. The first three groups were subdivided into two groups. Maximum insertional torque and axial pullout strength of each original screw were recorded as control data. Change of maximum insertional torque and axial pullout strength between original and corresponding revision screws were noted. Measurements were analyzed using one-way ANOVA statistically by SPSS10.0. Insertional torque change after simply removing and replacing a 5.0 mm?40 mm screw was also measured. Results Among the changes in pedicle dimensions, the greatest improvement in peak insertional torque and axial pullout strength occurred when using a 2 mm larger and 10 mm longer screw, with an increase of 37.06% and 18.22%; a 2 mm larger screw increased peak insertional torque and axial pullout strength by 20.15% and 19.99% respectively, while a 1 mm larger and 5 mm longer screw increased by 19.23% and 10.07% respectively; use of a 5 mm or 10 mm longer screw decreased peak insertional torque by 32.80% and 14.02% respectively, with axial pullout strength down by 27.36% and up by 43.25% respectively. Use of bone shims caused a decrease of the insertional torque and axial pullout strength by 14.99% and 29.34% respectively. Hole augmentation with PMMA lead to a significant increase in insertional torque but a decrease in axial pullout strength by 37.40%. Simply removing and replacing an original screw resulted in a decrease in insertional torque by 34.22%. Conclusion Revision for pedicle screw is most effective when using a 2 mm larger diameter screw, next by using a 1 mm larger diameter and 5 mm longer screw. Use of a bone shim should be avoided. The efficacy of hole augmentation with PMMA need to be further investigated.

Objective To evaluated the acccuracy of the two quantitative electroencephalographic parameters-bispectral index (BIS) and 95% specrral edge frequency (95% SEF) for measuring the depth of sedation induced by propofol, midazolam and ketamine. Methods Forty-five ASA Ⅰ - Ⅱ patients aged 30-59 yr weighing 46-80 kg scheduled for elective general thoracic or abdominal surgery were randomized to receive an infusion of propofol at a rate of 8 mg?kg-1?h-1 (group P , n = 15) or midazolam at 0.5 mg?kg-1?h-1 (group M, n = 15) or ketamine at 4 mg?kg-1? h-1 (group K, n = 15) . The patients were unpremedicated. The depth of sedation was assessed using OAAS scale (5 = wide awake , 1 = no response to prodding or shaking ) at 3 min intervals. BIS and 95 % SEF were continuously monitored. The BIS and 95% SEF values at each OAAS score (5-1) were recorded. The relations between BIS, 95 % SEF and sedation scores were determined in each group. The ED50 values of BIS and 95% SEF50 for loss of consciousness and their 95% confidence internals were calculated. Prediction probability(Pk) values for BIS and 95% SEF were compared among the drugs. Results There were no significant differences among the 3 groups with respect to age, body weight, sex and duration of drug infusion. With increasing sedation there was a progressive decrease in BIS and 95 % SEF values in group P and M but no significant changes in BIS and 95 % SEF values were seen in group K. The BIS and 95 % SEF positively correlated with OAAS score in group P and M but not in group K. The BIS50 was 65.9 in group P and 70.7 in group M,but inestimable in group K.The 95% SEF50 was 20.4 in group P and inestimable in group M and K. The Pk values for BIS and 95 % SEF were higher in P group than in M group and were not significantly different from 0.5 indicating a very poor predictive performance . Conclusion The accuracy of BIS and 95 % SEF for assessing the depth of sedation is greater with propofol. BIS is more sensitive than 95% SEF for the same anesthesia.

OBJECTIVE To explore the genotype and distribution of humam papilloma viruses(HPV) among rural women with cervical lesion.METHODS The cervical exfoliated cell specimens were collected and divided into two groups,the experimental group with 340 rural women finally diagnosed as cervical intra-epithelial neoplasm(CIN) or higher grade pathological changes in healthy examination,and the health control group with 230 rural women randomly selected from the crowd taken healthy examination.DNA was extracted and the genotypes of HPV-DNA were monitored by traditional nested PCR,flow-through hybridization and gene chip technique.RESULTS One-hundred and ninety-five cases(57.4%) in experimental group and the 58 cases(25.2%) in control group were confirmed to be HPV-DNA positive.There was significant difference between the two groups(P

Objective To establish chronic sleep deprivation mouse model,evaluate the learning and memory ability of mice and observe autophagy and apoptosis levels in mouse brain.Methods C57BL/6 mice (n =20) were randomly separated into sleep deprivation group and control group.After 2-month sleep deprivation by using an adapted multiple platform method,the behavioral performance of mice was measured by IntelliCage system.The expression of microtubule associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ) and Beclin-1 was detected by Western blotting.Confocol microscopy was used to observe autophagosome.In addition,terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining was performed to detect neuronal apoptosis level in mouse brain.Results The results of behavioral test showed that the incorrect visit ratio was much higher in sleep deprivation group than that in control group.Moreover,the expression of LC3-Ⅱ (sleep deprivation group 1.681 ± 0.186,control group 1.125 ±0.048,t =2.892,P =0.027 6) and Beclin-1 (sleep deprivation group 1.144 ±0.048,control group 1.006 ± 0.017,t =2.721,P =0.018 6) in mouse hippocampus and cortex was significantly elevated in sleep deprivation group than those in control group.Accordingly,the confocal microscopy observation also revealed an increased nuclear LC3-positive puncta in hippocampus and cortex of sleep deprived mice (hippocampus in sleep deprivation group 1.665 ± 0.153,in control group 0.819 ± 0.072,t =5.024,P =0.002 4;cortex in sleep deprivation group 1.925 ± 0.175,in control group 1.195 ± 0.111,t =3.521,P =0.012 5).In addition,TUNEL staining showed a much higher percentage of TUNEL-positive nuclei in these brain regions (hippocampus in sleep deprivation group 47.24 ± 4.15,in control group 19.26 ± 3.72,t =5.025,P =0.007 4;cortex in sleep deprivation group 42.25 ± 1.25,in control group 27.50 ± 3.23,t =4.262,P =0.005 3).Conclusions Chronic sleep deprivation can impair the learning and memory,increase the expression of LC3-Ⅱ and Beclin-1,elevate the formation of autophagosome,and promote apoptosis in mouse brain.These findings suggest that autophagy and apoptosis might be involved in the cognitive impairment induced by chronic sleep deprivation.

Objective To investigate the changes in the expression of acid-sensing ion channel 3(ASIC3)in the dorsal root ganglion(DRG)in a rat model of bone cancer pain.Methods Twenty-four female SD rats,aged 3-4 yr,weighing 180-220 g,were randomly divided into 2 groups:sham operation group(group S,n =8)and bone cancer pain group(group P,n =16).Bone cancer pain was induced by intra-tibial inoculation of 10 μl Walker 256 cancer cell suspension in group P,while group S received intra-tibial inoculation of 5 μl normal saline.Body weight and paw withdrawal threshold to mechanical stimulation with yon Frey filaments(MWT)were measured at 0,1,3,5,7,9,1 1 and 14 d after cancer cell inoculation.The tibia was removed at 14 d after cancer cell inoculation in group S and at 7 and 14 d after cancer cell inoculation in group P for pathological and imaging examinations.The tumor cell growth and bony destruction were observed.The expression of ASIC3 in the DRG was determined by immunolluorescence.Results Pathological damage occurred at 14 d after cancer cell inoculation,bony destruction was observed obviously,ant cortical bone was missing in many places.Compared with group S,body weight at T3-7 and MWT al T2-7:were significantly decreaed,and the expression of ASIC3 was up-regulated at 14 d after cancer cell inoculation in group P(P ＜ 0.05).Conclusion Up-regulation of the expression of ASIC3 in the DRG is involved in the developntent and maiutenence ot bone cancer pain in rars.

Objective To investigate the role of sLOX?1 and leptin in metabolic syndrome ,glucose and lipid metabolism. Methods 58 patients with metabolic syndrome were included in the study ,with other 35 normal controls as control group. Fasting venous blood samples were collected. ELISA method was used to detect serum sLOX?1 and leptin levels. The related biochemical indicators were tested. Results The sLOX?1 and leptin levels in the metabolic syndrome group were significantly higher than those in the control group(P < 0.01). The levels of sLOX?1 and leptin were further compared between different genders. The differences were not statistically significant (P > 0.05). sLOX?1 and leptin levels were positively correlated. They were positively correlated with WAIST,TG,SBP,DBP,and negatively correlated with HDL?C. Leptin and age,FPG also had positive correlation,but sLOX?1 was not correlated with age and FPG. Conclusion sLOX?1 may be able to predict endothelial damage in patients with metabolic syndrome in an early stage. Combined with leptin ,the endothelial dysfunction could be reflected more accurately. They may be the important factors for early diagnosis and risk assessment of metabolic syndrome.

OBJECTIVE:To prepare Weiyoukang intragastric floating tablet,and to investigate in vitro releasing characteristics of it. METHODS:Weiyoukang intragastric floating tablet was prepared by full powder compression method using HPMC-K15M (framework material),octadecanol(low density bleaching promoter),sodium bicarbonate(foaming agent),PVP-K30(release reg-ulator)and magnesium stearate(lubricant)as excipients. The amounts of HPMC-K15M,octadecanol and PVP-K30 were optimized by orthogonal test and validated with 2 h,4 h and 8 h accumulative release rate of berberine (Y2 h,Y4 h,Y8 h) as index,start time (T1)and duration(T2)of floating as adjunctive index. The releasing regularity of berberine,tetrahydropalmatine,baicalin and glyc-yrrhizic acid in Coptis chinensis,Corydalis vanhus,Scatellaria baicalensis and Glycyrrhiza uralensis were measured by release model fitting method and Peppas equarion fitting method. Similar factor(f2)method was used to investigate the similarity of 4 com-ponents. RESULTS:The optimized formulation was as follows as HPMC-K15M 40 g,octadecanol 14 g,PVP-K30 2 g for 200 tab-lets. Y2 h,Y4 h and Y8 h of berberine of preparations were 31.94%,55.88%,93.34%(RSDs were 1.2%,1.5% and 1.5%,n=3),re-spectively. T1 and T2 were about 1 min and 13 h. The drug release of four ingredients all fitted Higuchi models,and were synergis-tic action of diffusion and matrix erode. The f2 were all more than 80,indicating that the release of four ingredients were similar. CONCLUSIONS:Weiyoukang intragastric floating tablet is prepared successfully,showing fast onset,long floating,sustained-re-lease and balanced release of multiple indigents.

Objective To investigate the changes in the expression of acid-sensing ion channel 3 (ASIC3)in the dorsal root ganglion (DRG) in a rat model of bone cancer pain.Methods Twenty-four female Sprague-Dawley rats,aged 3-4 weeks,weighing 180-220 g,were randomized into 2 groups:sham operation group (group S,n =8) and bone cancer pain group (group P,n =16).Bone cancer pain was induced by inoculating Walker 256 carcinoma cells into the medullary cavity of the left tibia,while group S received normal saline instead.The pain threshold was measured after determination of body weight on the day of inoculation (T0) and on 1,3,5,7,9,11 and 14 days after inoculation (T1-7).The tibia was removed for microscopic examination of the inoculated tibia and X-ray examination.The growth of tumor cells and damage to the tibia were observed.The expression of ASIC3 in the DRG was detected using immunofluorescence.Results The tumor cell infiltration occurred in the medullary cavity and bone destruction was observed in P group.Compared with S group,the body weight was decreased at T3-T7,and the pain threshold was decreased at T4-T7,and the expression of ASIC3 in the DRG was upregulated at T7 in P group (P ＜ 0.05).Conclusion ASIC3 protein expression in DRG is significantly up-regulated in the rats with bone cancer pain,suggesting that the pathway may be involved in the mechanism of bone cancer pain.

Objective To investigate the effect and safety of duct-to-mucosa anastomosis technique for pancreaticoduodenectomy(PD).Methods The clinical data,including pancreatic fistula and other complications,of 189 patients underwent PD with end-to-side pancreaticojejunostomy at our institution from Jan 2001 to Jan 2009 were analyzed retrospectively.The definition of pancreatic fistula was threefold increase over the serum amylase level 7 days after operation,and draining volume was more than 50 ml per day.Results Totally 177 Whipple procedures were performed,while 12 pylorus-preserving pancreateduodenectomy procedures were performed.Five patients developed pancreatic fistula with a incidence of 2.65%(5/189).In which 3 were mild Cases,who fully recovered after conservative management,and the other 2 cages were cured by surgical intervention.Other complications included 9 cases of wound infection(4.76%,9/189),11 cases of empty dysfunction(5.82%,11/189),5 Cases of delayed hemorrhage(2.65%,5/189),and 4 cases of intra-abdominal infection(2.12%,4/189),and 2 patients died due to severe intra-abdominal infection and acute pulmonary infarction.Conclusions Duet-to-mucesa anastomosis technique resembles physiological state with low incidence of pancreatic fistula and delayed anastomosis hemorrhage.It may be used for different kinds of anastomosis for pancreatic stump.

Objective To determine if fetal stem cells can enter the maternal circulation during pregnancy and re-pair the injuries of maternal heart.Methods C57 female mice at the age of 6-8 weeks were randomly assigned to three groups:sham control, surgery without pregnancy, and surgery with pregnancy ( n=8,eath group) .The control sham group was developed by opening and closing of the chest.The other two groups underwent heart surgery.The myocardial infarc-tion ( MI) model was induced by ligation of the left anterior descending coronary artery.Half of the surgical mice mated with e-GFP transgenic male mice, and another half group was not.Electrocardiogram ( ECG) and echocardiographic images were recorded at pre-operation, post-operation and postpartum.The collected data were used to evaluate the heart function. The GFP expression was detected by immunohistochemistry and q-PCR.Results When compared with the sham group, both the ischemia surgery groups with and without pregnancy, the ECG ST segment was significantly increased.This meas-urement indicated that the myocardial ischemia surgery was successful, and no significant difference in the ST segments be-tween two ischemia surgery groups was found.However, when ECG was measured in the surgical mice after postpartum, their myocardial ischemia was dramatically improved when compared with that of the ischemia surgery only mice.Echocar-diographic images also indicated that both the surgery groups had myocardial ischemia, however, no significant difference was observed in the pregnant mice before and after postpartum.The order of the cardiac function indexes from high to low was the sham group, surgery with pregnancy group, and surgery with no pregnancy group;in particular, the cardiac func-tion of pregnancy group was significantly enhanced compared with that of the surgery with no pregnancy group (P<0.05). More importantly, both immunofluorescence and q-PCR results showed that the embryonic stem cell translocation through circulation system with GFP expression in the heart of pregnancy group, while negative in other two groups.Conclusions Embryonic stem cells can be transferred into the maternal circulation of pregnant mice, and play a role in the repairing of their cardiac injuries.