BACKGROUND: Posttraumatic kyphosis and neurologic compromise secondary to osteoporotic fractures, which needs surgery treatment. However, the choice of approach method is an argument. OBJECTIVE: To explore the therapeutic effect of transpedicular decompression and pedicle fixation for the treatment of obsolete thoracolumbar vertebral fractures combined with kyphosis deformity.METHODS: A total of 23 cases with obsolete thoracolumbar fractures combined with kyphosis admitted at the Department of Spinal Surgery, First Affiliated Hospital, University of South China were selected, including 14 males and 9 females, aged 18-60 years, mean aged 36 years; The JOA scores of patients were (11.02±1.24) points prior to operation, with (37.43±3.76)° Cobbangel. All patients were treated by transpedicular decompression and pedicle fixation. The functional recovery of lumbar vertebra,bone healing, as well as the complications was compared before and after operation.RESULTS AND CONCLUSION: All patients were followed-up for 6-28 months with an average of 12.5 months. The lumbar vertebra function and kyphosis deformity was notably improved postoperatively. After treatment, the JOA score and Cobb angle was (14.04±2.12) points and (11.02±3.58)°, which was obviously different than that of preoperative (P<0.05). The surfaces of cut bone were healed at 6 months after operation, without complications of pseudoarticulation formation or correction loss. The results suggested that transpedicular decompression and pedicle fixation can achieve a satisfactory result in deformity correction and neurological decompression, which can precipitate the functional recovery.

OBJECTIVE: To study the possible pathway of the effect of musk on brain disorder, distributing into the brain through blood brain barrier. METHODS: We used the musk ketone (muscone), a main composition of musk, to inject through the tail vein of the rats into the blood and took the brain and other organs at different times to make samples. Then gas chromatography was used to measure the distribution of muscone in the brain and other organs. RESULTS: Muscone could pass through the normal rat's blood brain barrier into the brain and soon reached the highest peak and remained in higher concentration, and more slowly metabolized as compared with other organs. CONCLUSION: Musk distributing into the brain through blood brain barrier provides the basis for its effect in treating brain disorders. Chromatography is an effective method to study the active composition of Chinese herbal medicine distributing through the blood brain barrier into the brain.

In recent years,the humanistic quality education in vast number of medical colleges and universities shows a low level of wandering state.This in not only related with the poor condition of current humanistic quality course,but also related with the diametrically opposed humanistic quality education and medical professional education and lack of organic integration.To improve the medical colleges' educational level is urgent to establish the concept of holographic education of great medicine,great education and great culture,improve the teaching quality of current humanistic quality education,actively explore the deep integration of humanistic quality education and medical professional education,improve the humanistic quality and nurturing ability of teachers staff in medical universities and colleges,and so on.

Objective:To detect anti-LKM-1 antibody with enzyme-linked immunosorbent assay (ELISA) using a recombinant fusion peptide which comprises 257-351 amino acid fragment of CYP2D6 as antigen.Methods:We obtained CYP2D6 cDNA fragment by means of PCR,using total liver cDNA library as the template.The PCR products were ligated into pEGH expressing vector to construct the recombinant expressing vector with high efficiency in Saccharomyces Cerevisiae Y258.The positive clones were identified by PCR reaction and then induced by galactose.Glutathione-Sepharose 4B was used for purification of recombinant CYP2D6 protein.After affinity purification,the antigenicity was identified with Western blot.Serum samples from 26 patients who were positive for anti-LKM-1 antibody,20 patients with other connective tissue disorder(CTD) and 30 normal controls were retrospectively tested with ELISA.Results:A fusion peptide was expressed and purified.The antigenicity was confirmed with Western blot using standard of anti-LKM-1 antibody-positive serum.Of the 26 serum samples which are positive for anti-LKM-1 antibody,5 of 6 samples positive for anti-HCV antibody also recognized the recombinant fusion peptide with ELISA,only one serum sample which was showed positive anti-HCV antibody displayed a negative result in ELISA assay.All other 20 patients with positiv anti-LKM-1 antibody were shown positive in ELISA assay using this recombinant peptide.All the serum samples from patients with other CTD were negative in ELISA assay.Conclusion:The recombinant antigen fragment contains major epitope regions in natural CYP2D6 antigen.Detection of anti-LKM-1 antibody with ELISA using the recombinant peptide can improve the sensitivity and has a potential role in determining its clinical association.

[Objective]To evaluate the effects of clinical application of B-twin and cage for treatment of lumbar degenetative disease. [Methods]From June 2004 to December 2007,a total of 112 patients with lumbar degenetative disease who underwent posterior lumbar interbody fusion(PLIF) with cage and 79 patients who underwent PLIF with B-twin were enrolled. Sixty patients were selected and randomly divided into two groups(30 in each group). The clinical curative effect, the rate of bone graft fusion, the intervertebral space height and complications in both groups were analyzed and compared.[Results]In the B-twin group, the treatment was a minimally invasive technique, which offered a satisfactory effect with good bone graft fusion, fewer complications and sooner recovery, but the cost was higher than that in cage group. The cage treatment was an open sugery for fenestration operation. It had more complications but more sufficient decompression and lower cost. The rates of bone graft fusion between the 2 groups were not different in statistics.[Conclusion]The B-twin and cage techniques are two treatmens for interbody fusion of lumbar degenetative disease. Both have advantages and clinical application value. It should be choosen according to different specific conditions in the clinical practice.

Objective To investigate the correlation between microalbuminuria (MAU) and obesity and its indexes, including BMI, waist circumference(WC), and waist-to-hip ratio(WHR) , among partial community population in Beijing. Methods A total of 2080 subjects who took physical examination in Beijing, including 810 men and 1270 women with a mean age of(50. 9 ± 13. 1 )years, were enrolled. The informed consent has been achieved from each patients. BMI and WHR were calculated based on collected data of height, weight, WC, and hipline. Urine albumin-creatinine ratio(ACR) within the range of 30-300mg/g was classified as MAU. The subjects were divided into normal albuminuria ( NAU ) group and MAU group. The correlations between MAU and different obesity indexes including BMI, WC and WHR, were analyzed. Results Among the 2080 subjects, there was a positive correlation between BMI (r = 0. 1276,P＜0.01) and ACR, and WC (r = 0.0840, P ＜0.01) and ACR. WHR and ACR was irrelevant ( P ＞ 0. 05 ). In univariate analysis, there was significant difference in BMI ≥ 28 kg/m2 ( OR = 2. 02 ) and WC ≥85 cm (male) or≥80 cm (female) (OR = 1.69 ) between NAU group and MAU group (P ＜ 0. 05 ).There was no significant difference in BMI 24-＜ 28 kg/m2, and WHR ≥0. 90 (male) or ≥0. 85 (female)between NAU group and MAU group( P≥0. 05 ). Multivariate logistic regression analysis revealed that BMI ( OR = 1.06) was an isolated independent risk factor of MAU from age ( OR = 1.01 ), female ( OR = 1.42),systolic blood pressure (OR=1.01), TC (OR=1.93) and HDL-C (OR=0.54). Conclusions Obesity is an independent risk factor of MAU among partial community population in Beijing. The correlation between different obesity indexes and MAU also differs.

BACKGROUND: Through exercise and/or hypoxia to increase the body's stress level and timing of hypoxia, so as to improve the body's adaptation level to exercise and/or hypoxia. However, little was known concerning the effects of acute exercise and/or hypoxia on vascular endothelial cell growth factor (VEGF) expression in skeletal muscles.OBJECTIVE: To study the effects of acute exercise and/or hypoxia on VEGF expression in rats' gastrocnemius muscles. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Clinical Laboratory, People's Hospital of Jiangsu Province, between September 2005 and September 2006.MATERIALS: Totally 108 health male SD rats were randomly divided into 6 groups, namely, normoxia quiet, normoxia high intensity, normoxia moderate intensity, hypoxia quiet, living high-training low high intensity and living high-training low high intensity moderated intensity groups, with 12 animals in each group.METHODS: In acute normoxia exercise models, rats were performed adaptive activity at 48 hours prior to experiment. The high intensity exercise was comprised of 50 m/minx1.5 min training with 2 minutes rest. The moderate intensity exercise was 30 m/min×30 min. Hypoxia environment was produced by using low oxygen instrument to simulate hypoxia training, with hypoxia for 3 days, 22 h/d, 12.8% altitude, with 22 ℃ temperature and 55% humidity. In acute training low-living high models, rats were placed in above hypoxia environment after high intensity Or moderate intensity exercise. Four rats were sacrificed at hours 0, 2 and 4 after training, and the gastrocnemius muscles were obtained.MAIN OUTCOME MEASURES: The expression of VEGF in rats' gastrocnemius muscles was detected by using western-blot.RESULTS: Hypoxia and acute normoxia exercise enhanced the expression of VEGF, hypoxia after exercise weakened exercise-induced VEGF expression, and the exercise with long time and common intensity induced the higher level VEGF expression. The expression of VEGF was the most at the time points of instantaneousness and 2 hour after exercise, the sorting of the recovery speed of VEGF changes from fast to slow was: hypoxia or training low-living high and normoxic exercise. CONCLUSION: The expressions of VEGF in rats' skeletal muscles induced by acute exercise and/or hypoxia belong to the effect of immediate-early, with existing intensity-threshold, which recovery speed is inversely proportional to the expression amplitude;"training low-living high" may be able to enhance the adaptation of skeletal muscles to sports.

Objective To investigate the effect of calcitonin gene-related peptide ( CGRP ) in inducing os-teogenic differentiation of rat precartilaginous stem cells in vitro and the underlying mechanisms. Methods Rat pre-cartilaginous stem cells ( PSCs) were cultured in complete osteogenesis medium containing DMEM/F-12 medium and different concentrations (0, 10-8,10-9,10-10mol/L) of CGRP, the morphology changes of PSCs were observed. The proliferation of PSCs was examined at different time points by CCK-8. All the PSCs were then randomly assigned to an experimental group and a control group. The PSCs in the experimental group were cultured in complete osteogenesis medium with 10-10 mol/L CGRP , while the control group cultured merely in complete osteogenesis medium was re-ceived no special intervention. Both groups were stained by Alizarin Red and the expression of alkaline phosphatase (ALP) was detected. The osteogenic genes (RUNX2,OPN and BGP) were measured by use of RT-PCR. The activa-tion of Wnt/β-catenin signaling pathway was tested by using Western blotting to evaluate the effect of CGRP . Results Compared to the control group ( the concentration of CGRP was 0 mol/L) , the concentration of ALP was significantly higher in the experimental group, calcium deposition was significantly more obvious, and the expression of the osteogenic genes such as RUNX2,OPN and BGP as well as theβ-catenin protein expression were up-regulated significantly. However, CGRP had no effect on cell proliferation. Conclusion CGRP activated Wnt/β-catenin sig-nal pathway and induced osteogenic differentiation of precartilaginous stem cells.

Objective To compare the analgesia effect of transversus abdominis plane(TAP) block and caudal block after radical surgery of Hirschsprung’s disease.Methods Sixty pediatric pa-tients,52 males,8 females,aged 1-3 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective rad-ical surgery on Hirschsprung’s disease,were equally randomized into TAP block group(group TAP) and caudal block group (group CA).0.2% ropivacaine 1 ml/kg was used in both blocks.FLAAC scores were measured at 6,12,18 and 24 h after surgery.The requirement of sufentanil every 6 h, the first passage of flatus,the time of removing urine tube and the incidence of nausea and vomiting within 24 hours were recorded.Results Compared with group TAP,FLAAC scores and the require-ment of sufentanil were significantly decreased at 6 h after operation in group CA(P <0.05).FLAAC scores and the requirement of sufentanil were similar at 12,18 and 24 h in the two groups.The first passage of flatus,the time of removing urine tube in group TAP were significantly shorter than group CA(P < 0.05 ).The incidence of nausea and vomiting were not significantly different in the two groups.Conclusion Although both TAP block and caudal block can provide effective analgesia for the pediatric patients after radical surgery on Hirschsprung’s disease,caudal block provided superior anal-gesia at early stage after operation,however,TAP block is more beneficial for earlier recovery of bowl function.