Objective: To investigate the efficacy of acupuncture and point injection in cooperation with Tuina and reposition for treating lumbar intervertebral disc protrusion.Methods: Treatment was given by first acupuncture, then point injection and last Tuina and reposition. It was administered once daily, 6 times as a course and compared with simple Tuina and reposition. Results: Both the effective rate in the clinical treatment and the cure rate in the same period were significantly higher in the treatment group than in the control group. Conclusion: A composite treatment by acupuncture and point injection in cooperation with Tuina and reposition is better in curative effect and shorter in the course of treatment than simple Tuina and reposition.

Objective To investigate the changes and the significance of the contents in matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in plasm of patients with intracerebral hemorrhage (ICH). Methods The contents of MMP-2 and MMP-9 in plasm of 50 patients with ICH and 50 healthy people (control group) were measured respectively through ELISA methods. Results Compared with the control group,the increase of the contents of MMP-2 and MMP-9 had obvious statistic significance in plasm of patients with ICH (P0.05),but they had obvious statistic significance in the comparison among other time groups (P

Objective To observe the relationship between dynamic expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 protein and water contents in perihematoma, and the effect of sodium aescine in rats with intracerebral hemorrhage(ICH). Methods 250 Wistar rats were assigned randomly to four groups: normal control group (10 rats), sham operation group (80 rats), ICH group (80 rats) and sodium aescine treating group (80 rats). The water contents in perihematom and the expressions of MMP-2 and MMP-9 protein were measured respectively at 6 h, 12 h, 24 h, 48 h, 72 h, 120 h, 7 d and 15 d after operation in each group. Results Neurological function deficit in sodium aescine treating group was improved compared with ICH group in 6 h~7 d (P

Sixty barrows (Duroc × Labdrace × Yorkshine) were randomly assigned to two groups by weight of 33 kg,each of which was replicated three times with ten pigs. Half of the pigs were fed with diets containing 10 mg/kg lead and 0.5% particulate montmorillonite,the other half pigs were fed only with diets supplemented 10 mg/kg lead as control groups for 100 days.The results showed that the addition of particulate montmorillonite to the diet significantly decreased lead concentration in tissues such as blood,brain,liver,bone,kidney and hair and enhanced the erythropoiesis as measured by increasing numbers of RBC,hemoglobin and hematocrit values ,and elevated ALA-D activity in liver. The damage of lead to the liver was evident in the increases in hepatic concentration of malondialdehyde (+ 17.08% );decreases in the antioxidant enzymes catalase(-85.73 % ),superoxide dismutase ( - 52.17% ) and glutathione peroxidase ( - 47.56% ). Concomitant use of particulate montmorillonite in the diets completely ameliorated the lead-induced oxidative damage. It indicated that particulate montmorillonite is possessed of the potential therapeutic activity against lead poison.

Objective To introduce a safe and practical approach for the treatment of severe muscular torticollis. Methods In an axis of the spasmodic sternocleidomastoid muscle, the author designed a five-valve flap with two valvae inside, which ended at the mastoid point and inferior clavicular part of sternocleidomastoid muscle, respectively. The arm length of each valve was approximately half of its axis. Each valve was separated bluntly in naked eyes in order not to detach the platysma myoides from the skin, and to release the webbed neck. Under the flap, the thinned and fibrosed sternocleidomastoid muscle and spasmodic neck sheath and superficial cervical vein were easily found. The sternocleidomastoid muscle was disconnected at the median point, and the two ends were retracted, the superficial cervical vein was cut and ligated, the neck sheath was released to uncover the spasmodic cervical artery and nerve. The head was right positioned, and then the surrounded fascial tissues were released under the protection of the arteries and veins. The flap was sutured to cover the arteries, veins and muscles. Results Reasonably good effect was achieved in one case and intermediate effects in other 4 cases. Surgical results were satisfactory. All the flaps were survival with insignificant scar formation. Conclusions Webbed skin deformity in the neck can be corrected by using five-valve plastic surgery of platysma myoides, which is able to cover the exposed nerves and vessels. This procedure prevents the adhesion of the operated area, ensures the blood supply of the distal portion of the flap, and also avoids the damage of other tissues in the flap area.

Objective The effect of lead exposure on children is consistently associated with intellectual and other neurologic deficits.However the exact mechanism by which Pb~(2+) exerts toxic effects on developmental central nervous system remains unknown.Our group has found by gene-chip test that the expression of metabotropic glutamate receptor subtype 5 (mGluR5) mRNA was changed by lead exposure.The present study aimed to examine the effects of different level of lead exposure on the expression of mCluR5 in gestation and lactation.Methods Sprague-Dawley rats were exposed to lead acetate during gestation and lactation.Three concentrations of 0.05%,0.2%,and 0.5% lead acetate were applied and considered as low,middle and high exposure group respectively.The Pb levels of blood and hippocampus of pups were analyzed at weaning to evaluate the actual lead content at the end of the exposure.The impact of lead exposure on the expression of mGluR5 mRNA and protein in hippocampal tissue of pups was investigated by quantitative real-time polymerase chain reaction (PCR) and Western blot.The potential role of the expression of mGluR5 mRNA and protein in lead neurotoxicity were discussed.Results The levels of lead in blood and hippocampus from lead-exposed rats were significantly higher than those in the controls and positively related to the degree of lead exposure.The results of real-time PCR and Western blot showed that exposure to lead acetate decreased the expression of mCluR5 mRNA and protein with a dose-dependent manner.Conclusions Hippocampal mGluR5 might be involved in lead-induced neurotoxicity.

Objective To analyze the etiology and surgical results through 17 cases with retrograde aortic dissection after thoracic endovascular repair.Methods From March 2009 to March 2014,17 patients were diagnosed with retrograde type A aortic dissection after thoracic endovascular repair,the mean age was 53 years,13 male and 4 female.Type B aortic dissection as the primary disease were 13 cases,aortic aneurysm and aortic ulcer were 2 cases respectively.All cases with new type A aortic dissection were diagnosed by cardiac ultrasound and aortic computed tomography.All patients were received aortic root and total aortic arch replacement plus elephant trunk procedure.All patients were followed by clinic interview or telephone.Results The interval time was from 1 to 2 200 days,5 patients were diagnosed before discharge,12 patients during clinical follow-up.The primary tear in 12 patients were located the area which were anchored by bare mental stent,in 2 cases were nearby the bare stent,the other 3 cases were located anterior part of ascending aorta.1 patient was died due to cerebral hemorrhage after operation.3 patients had renal insufficiency after operation and all were cured by hemofiltration;neurological complication occurred in 3 patients including that 1 patient stroked,1 patient cerebral hemorrhage and 1 patient had transient brain dysfunction,4 patients had pulmonary complication and 2 patients with intestinal dysfunction.There were no postoperative spinal cord deficits occurred.All patients were followed up,the mean follow up time was(35-±21) months.2 cases were died during follow-up and five-year survival rate was 87.5 ％.One patient was reoperation with total thoracic abdominal aorta replacement,five-year free from reoperation was 85.7％.Conclusion The retrograde type A dissection after thoracic endovascular repair were closely related with proximal bare mental stent,part of cases were silent symptom,the clinical fellow with aortic enhanced computed tomography were necessary to detect the serious complication.Operation scheme was safely and effectively,aortic arch replacement plus elephant trunk procedure was the preferred method to repair retrograde aortic dissection.

ObjectiveTo retrospectively analysis the role of intercostal artery reconstruction in spinal cord protection for patients with extent thoracoabdominal aotic aneurysm (TAAA) repair.MethodsFrom August 2003 to August 2010,extent Crawford Ⅱ TAAA repair were performed in 81 consecutive patients with mean age (39.4 ± 10.3) years and 61 (75.3％)were males.All the procedures were performed under profound hypothermia with interval cardiac arrest.Patientswere opened with a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10mm branches were anastomosed to iliac arteries.ResultsWith 100％ follow-up,early mortality was 7.4％ (6/81),one patient was dead result from cerebral hemorrhage,three from renal failure,one from heart failure because of myocardial infarction and one from rupture of cliac artery dissection.Postoperative spinal cord deficits was 3.7％ (3/81),temporary paraplegia were observed in 2 patients and paraparesis occurred in 1 patient,but all of them were without bladder or rectum deficits.Neo- intercostal arteries were clogged in 12 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.The mean survival time in this group is (54.22 ± 3.03 )months (95％ CI:44.37 months,59.90 months)with survival rate 92.37％ after 1 year,89.02％ after 2 years,85.54％ after 5 years.Three patient were dead with long term follow-up,one were resulted from cerebral hemorrhage at 20th month,one from rupture of ascending aorta at 23rd month and the last from rupture of aorta ulcer.ConclusionIntercostal artery reconstruction is a reliable method in spinal cord protection for patients with TAAA repair.It is a feasible method with acceptable surgical risks and satisfactory results.It can achieve long term result with less risk of spinal cord deficits and good quality of daily life.

Objective Retrospectively analyze the mid-term clinical results of single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement(T/STAR).This study describes our experience in this operation in single center of aortic disease at Fuwai Hospital.Methods From February 2004 to February 2011,21 patients with hypertension or Marfan syndrome underwent one-stage total or subtotal aortic replacement for aortic dissection or aortic aneurysms.16 male and 5 female,aged (34 ±9) years.Operations wore performed under circulatory arrest with profound hypothermia.Patients were opened with a mid-sternotomy and a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.During cooling,the ascending aorta or aortic root was replaced.At the nasopharyngeal temperature of 20 ℃,the aortic arch was replaced with selective antegrade cerebral perfusion.Staged aortic occlusions allowed for replacement of descending thoracic and abdominal aorta.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8 mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10 mm branches were anastomosed to iliac arteries.Results Early mortality was4.8％ ( 1/21 eases),the only one patient was dead result from renal failure and multiple organ failure.There were no postoperative spinal cord deficits occurred,two patients were stroked at day 5th and 7th respectively.Three patients were operated with tracheotomy because of respiratory insufficiency.Operation was undertaken on one patient with splenenctomy result of spleen rupture during first aortic aneurysms repair.All patients were follow-up,ranging from 18 to 84 months postoperatively,all 20 survivors were alive and had good functional status.One patient was reoperated with aortic valve replacement because of massive valve insufficiency after two years.Neo- intercostal arteries were clogged in 3 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.Conclusion Single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement is safely and effectively.It is feasible with acceptable surgical risks and satisfactory results.It can eliminate the risk of remnant aortic aneurysm rupture in staged total aortic replacement and has satisfactory mid-term results.

Objective Retrospectively analyze 47 cases received reoperation with aortic disease after aortic valve replacement to deepen the understanding of aortic valve disease.Methods From January 2003 to June 2012,47 patients with previous aortic valve replacement received aortic root or other aortic operation because of new aortic disease.38 male and 9 female,the interval (6.0 ± 3.8) years. All cases with new aortic disease were diagnosed by cardiac ultrasound and aortic computed tomography.Bentall's procedure were operated on 14 patients,total aortic arch replacement with elephant trunk procedure on 14 patients,aortic root and aortic arch with elephant trunk procedure on 7 patients,ascending aortic replacement on 10patients,total thoracic and abdominal aorta replacement on 2 cases.All patients were followed by clinic interview or telephone.Results Aortic dissection and aneurysmal dilatation were occurred on ascending aorta,each account for 50％,in patients with previous aortic valve replacement because of rheumatic valve disease and bicuspid aortic valve; 3 cases with Marfan syndrome occurred ascending aortic dilatation and 4 cases occurred aortic dissection.Diameter in ascending aorta increased (5.2 + 7.1)mm per year and aortic sinus (3.3 ± 3.1)mm per year.The value of ascending aortic dilatation per year in patients with rheumatic disease was higher than patients with Marfan syndrome(P ＜ 0.05).47 patients were re-operated in fuwai hospital,1 patients died in operating room because aortic dissection seriously involved right coronary artery.7 patients have renal insufficiency after operation and all were cured by hemofiltration; neurological complication occurred in 14 patients including that 7 patients stroked and 7 patients had transient brain dysfunciotn.There were no postoperative spinal cord deficits occurred.All patients were followed up,the mean follow up time were(53.49 +33.79) months.8 cases were died during follow-up and threeyear survival rate was 83％.There were no cases received operation due to aortic disease during follow-up.Conclusion Deepening the understanding of aortic valve disease combine ascending aorta changes,especially pay attention to patients with previous aortic valve replacement because of Marfan syndrome and rheumatic disease during follow-up after first operation,all efforts should decrease the occurrence of aortic adverse events in long term.