Objective To investigate the technique and effectiveness of CT-guided collagenase injection into prominence of herniated lumbar disc and the surface of prominence in the treatment of lumbar disc herniation. Methods One hundred and fifty-five patients with lumbar disc herniation diagnosed by clinic and CT received CT-guided collagenase injection, with the approaches via intervertebral foramen in L3-4 and L4-5, and the approaches via margo medialis of joint processus articularis in L5-S1. Results Injection was done successfully in all patients (100%), the clinical rate of excellent and good results were 94.2%. The herniation disappeared or significantly reduced as demonstrated by CT scan in 32 of 34 patients (94.1%), the rate of excellent and good results were 100%. No changes existed in 2 cases. There were 2 cases of disc inflammation in our group. Conclusions CT-guided collagenase injection into the prominence of herniated lumbar disc and its surface is a safe and efficient method in the treatment of herniated lumbar disc.

Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.

Objective　To compare the effects of early and long-term treatment with captopril on clinical outcome between elder patients (65-75 years old) and younger patients (＜ 64 years old) suffering from acute myocardial infarction (AMI). 　Methods　In a randomized trial, 822 patients with a first AMI were treated with captopril at initial dosage of 6.25 mg and adjusted to 25 mg t.i.d according to blood pressure (209 younger patients, 269 elder patients) and conventional treatment (131 younger patients, 213 elder patients). Survival rate of the four groups was calculated with Kaplan-Meier method. 　Results　The survival of treatment group was correlated significantly with age during hospitalization (P=0.0002). Eight patients in younger treatment group and 10 patients in younger control group (3.83% vs 7.63%, P＞0.05), 25 patients in elder treatment group and 52 patients in elder control group (9.29% vs 24.41%, relative risk = 0.37, 95% CI 0.29-0.48, P＜0.0001) were died. During follow-up period, the survival was however not related to the age (P＞0.05), and both the elder and younger patients had better survival (all P＜0.01 ) and lower cardiac events (all P＜0.01) during captopril treatment. 　Conclusions　 Captopril exerts less effect on the younger patients but more effect on the elder patients during hospitalization after AMI. Long-term captopril had no difference between the youngers and the elders in prognosis.

Chronic inflammation has been demonstrated closely related to the tumor progression.Tumorassociated macrophage,as the most abundant immune cells in the tumor microenvironment,is a key element that links inflammation and cancer.Recently,studies found that the phenomenon and function of tumor-associated macrophage almost tend to M2 type macrophage.As an important indicator,tumor-associated macrophage usually predicts the poor progress with the cancer development.In China,Most of patients with hepatocellular carcinoma are associated with chronic viral infection.A large number of macrophages in the liver infiltrated in chronic inflammation,which are differentiated by variety of mechanisms under the chronic inflammatory stimulation,promote the development of liver cancer.In this paper,we will review the tumor-associated macrophages and the development of liver cancer.

Objective To compare the effects of early and long term treatment with captopril on clinical outcome between elder patients (65 75 years old) and younger patients (0 05), 25 patients in elder treatment group and 52 patients in elder control group (9 29% vs 24 41%, relative risk = 0 37, 95% CI 0 29 0 48, P 0 05), and both the elder and younger patients had better survival (all P

Objective To observe how the ACC transmits nociceptive information and how it regulates spinal noceciption.Methods A total of 32 male SD rats were randomly divided into four groups:Sham group,CCI group,ACC group,and AP-5 group.After light-dark transition test, forced swimming test (FST),paw withdrawal mechanical threshold (PWMT),paw withdrawal ther-mal latency (PWTL)had been measured,the rats were finally anesthetized,then ACC and the spinal cord was rapidly removed,the expression of cAMP-response element binding protein (pCREB)and extracellular regulated protein kinases (pERK)were measured by Western blot.Results Compared with the sham group,the PWMT of the CCI rats were significantly decreased,rats spent less time in the light compartment and number of transition were decreased (P <0.01 ).The immobility time in FST were also significantly prolonged (P <0.01).After AP-5 injected in bilateral ACC 13 days after CCI operation,the PWMT of the CCI rats were significantly increased,rats spent more time in the light compartment and number of transition were increased (P <0.01).The immobility time in FST were also significantly shortened (P <0.01).Compared with sham group,the expression of pCREB, pERK increased significantly in ACC in CCI group (P <0.01).The expression of pCREB,pERK in spinal cord was increased in CCI group and decreased in AP-5 group (P <0.01 ).Conclusion ACC facilitate the spinal nociception in a descending mode.

Objective To analyze the results of inhaled allergens detection in children with allergic rhinitis(AR)in Changzhou ar-ea and the distribution situation of allergens in different age groups.Methods The levels of serum allergen specific IgE antibodies in 473 children cases(aged 1-12 years)of allergic rhinitis(AR)were detected by the Allergy Screen allergen screen system.The children cases were divided into the infants group(0-3 years old),preschool children(4-6 years old)and school age children(7 -12 years old)according to age.The allergen positive rates and the change tendency were compared among different age groups.Re-sults Among 473 children cases of allergic rhinitis,340 cases(71.9%)were positive.The top three allergens were house dust mite (55.6%),mixed fungi(25.8%)and house dust(18.8%).The positive rate of allergen showed the upward trend with the age in-crease.The distribution of house dust mite(χ2 =21.061,P =0.000),house dust (χ2 =15.111,P =0.000)and the cat and dog dan-der(χ2 = 7.597,P = 0.022 )was statistically significant among the three groups.Single allergen positive rate was the highest (38.5%)and the secand was double allergens(23.7%).The top three positive in single allergens was consistent with sort of total allergen positive rate.The most common double allergen was the combination of house dust mites and house dust.The multiple al-lergen positive rate had statistical significance in the distribution among groups(χ2 =13.399,P =0.001).Conclusion The inhaled allergens of AR children in Changzhou area are dominated by house dust mite,mixed fungi and house dust.The positive rate shows the increasing trend with age increase.The allergen constituents are different in different age groups.The positive single allergen is most common,followed by positive double allergens.

Objective To find the effect of Rhodiola herb on the phenotypic transfer of epithelial cell in renal tubule of adriamycin-induced nephropathy rats.Methods The rat nephropathy model is established by adriamycin.For Rhodiola herb treated group,feed with Rhodiola herb 0.672 g/kg?d from the 4th week,for the control group and neohropathy group,feed with water [3 mL/(kg?d)].Kill the rats per batch at the week of 4th,8th,12th,16thand 20th week,observe the pathological change of nephridial tissue,test the expression of ?-SMA-protein of myofibroblast in the tuhulointerstitial.Results A semi-quantitative analysis of ?-SMA of rats at the 16th week in the nephropathy group is 6.24?0.57,which is obviously higher than that of Rhodiola herb treated group,3.84?0.28(P

Objective To assess the value of implanting remedial or prophylactic cardioverter defibrillator in patients with Brugada syndrome for protecting from malignant ventricular arrhythmias and to estimate the initial outcomes in one-month follow-up. Methods Implantable cardioverter defibrillators (ICDs) were implanted in 21 consecutive patients (9 symptomatic and 12 asymptomatic) with Brugada syndrome using standard procedure under general anesthesia. Patients presented the typical ECG changes of Brugada syndrome with or without sodium channel blockers but without structural heart disease in all the cases. Electrophysiological examinations were performed in all patients. Eight asymptomatic patients had spontaneous or induced malignant ventricular arrhythmias and 4 asymptomatic patients had single positive family history. Results Sixteen single chamber ICDs (VVI) and 5 double chamber ICDs (DDD or DDDR) were implanted. The DDD- or DDDR-ICDs were applied for patients with sinus node dysfunction and/or atrioventricular conduction disturbances. Battery/lead status measurements of ICDs were good and met with standards of implantation during the procedure. No complications occurred after ICD implantation and also no changes of various electrophysiological parameters during re-hospitalization in one-month follow-up. There were no events' record of anti-tachycardia pacing or cardiovertion or defibrillation for ventricular arrhythmias in the memory of treatment by ICDs. Conclusions ICDs were implanted successfully with safety in patients with Brugada syndrome showing good function for the initial outcomes in one-month follow-up.