BACKGROUND:Due to complicated and special lumbar spinal stenosis disease and different degrees of lumbar degeneration in the elderly, it requires very careful choice of repair methods and repair technology.
OBJECTIVE:To investigate the indications and prognosis effect of the treatments of elderly lumbar spinal stenosis by selective decompression of lumbar root canal under direct vision and laminectomy.
METHODS:Clinical data of 167 elderly patients with lumbar spinal stenosis were retrospectively analyzed. A total of 82 patients were treated with selective decompression of lumbar root canal as the selective decompression group, with a clear nerve root compression but without central canal stenosis. A total of 85 patients were treated with laminectom and treated with pedicle screw fixation as the whole lamina cut group, with distinct central canal stenosis. The indications were analyzed between the two groups. Clinical effects were assessed using Japanese Orthopaedic Association and Oswestry Disability Index before and after surgery.
RESULTS AND CONCLUSION:(1) Al patients were operated successful y. There was no serious
complication during treatment. (2) Japanese Orthopaedic Association and Oswestry Disability Index were significantly improved at last fol ow-up in two groups compared with preoperation (P<0.05). No significant difference in Japanese Orthopaedic Association and Oswestry Disability Index was detected between the two groups at various time points (P>0.05). Clinical symptoms disappeared or relieved at last fol ow-up in two groups. The prognosis in two groups had significantly improved. (3) Results indicated that laminectomy and pedicle screw fixation in elderly patients with lumbar spinal stenosis and central canal stenosis obtained significant effects. For elderly patients with lumbar spinal stenosis but without central canal stenosis, selective decompression of lumbar root canal under direct vision was given, and it is effective and reliable. The two methods are suitable for different patients, and are effective and reliable way to repair.

[Objective]To compare the effects of topical different concentration mitomycin C(MMC)in preventing postlaminectomy peridural adhesion.[Method]Laminectomies were performed at L1 in 40 rats.Cotton pads soaked either with 0.01 mg / ml(group L),0.05 mg /ml(group M),0.1 mg / ml(group H) MMC or saline(group C) were applied to the operative sites.The rats were killed 4 weeks after surgery.The specimens were prepared for determination of the degree of scar adhesion according to Rydell method,the content of Hydroxyproline(HOP),the area of peridural fibrosis and the count of fibroblasts.[Result]Dense peridural fibrosis with marked peridural adhesion showed in group C.No obvious adhesion formed in group H.In group M and L,peridural adhesion wasn't avoided.The content of HOP,the area of peridural fibrosis and the count of fibroblasts showed various degrees decrease in all MMC-treated groups.[Conclusion]Local application of 0.1 mg/ ml MMC may be a successful method of reducing postlaminectomy peridural fibrosis and completely avoided peridural adhesion.

Objective To investigate the efficacy of emodin in the treatment of acute pancreatitis in rats.Methods Forty-five SD rats were divided into control group,pancreatitis group and treatment group.The apoptotic index of pancreatic acinar cells.the expression of NF-κB mRNA and Bax mRNA,the apoptosis rate of peripheral polymorphonuclear neutrophil(PMN),and the expression of PMN caspase-3 and PMN caspase-8 were detected.Results Compared with the panereatitis group,the apoptotic index of pancreatic acinax cells and PMN,and the expressions of NF-κB mRNA,Bax mRNA.PMN caspase-3 and PMN caspase-8 in pancreas tissue were significantly increased in the treatment group(F=853.199,327.126,143.586,48.857,231.750,96.552,P＜0.05).The histopathologic score of panereatitis Was negatively correlated with the apoptotic index of the pancreatic acinar cells and PMN(r=-0.96,-0.94,P＜0.05).The apeptotic index ofthe pancreatic acinar cells Was positively correlated with the expression of NF-κB mRNA,Bax mRNA in pancreas tissue(r=0.73,0.76,P＜0.05).The expression of NF-κB mRNA was positively correlated withthat of Bax mRNA(r=0.94,P＜0.05).The apoptotie index of PMN was positively correlated with the expression of PMN caspase-3 and PMN caspase-8 (r=0.99,0.99.P＜0.05).Conclusions Emodin alleviates acute pancreatitis via regulating the apoptosis of pancreatic acinar cells through Bax pathway,and regulating the PMN apoptosis through caspase pathway.

BACKGROUND: It has been demonstrated that pedicle screw internal fixation influencing factors involve screw structural morphology, thread parameter, bone density, moment size for tightening screw during operation, and depth of screw placement. There is little known about the correlation of pullout strength of spinal pedicle screw with device for transverse traction to extraversion angle. OBJECTIVE: To assess effect of the spinal pedicle screw with device for transverse traction on pullout strength at different extraversion angles. DESIGN: Repeated measurement. SETTING: Center for Bone Joint, the First Affiliated Hospital of Nanjing Medical University. PARTICIPANTS: This study was performed at Laboratory for Material Mechanics, Hehai University between June and November 2003. A total of 18 adult dried lumbar vertebrae (L1-5) were provided by Department of Anatomy, Nanjing Medical University, and recruited for this study. The protocol was approved by the hospital's Ethics Committee. The pedicle screw was made of stainless steel. Each pedicle screw had a diameter of 5.5 nun, total length of 150 nun (thread part 50 into included), and the same thread parameter. Electrical universal material machine (EW type) was provided by Laboratory for Material Mechanics of Hehai University. METHODS: Bone density was measured with a single photon bone density determinator. According to the bone density, the lumbar vertebrae were numbered and randomly divided into 3 groups with 6 lumbar vertebrae in each: extraversion angle 5 ° group, extraversion angle 15° group, and extraversion angle 30° group. ① Installation of pedicle screw and clamping apparatus: According to Wein-Stein method, one entry-point was selected at each side of lumbar vertebra, and at the sametime, extraversion angle 5°, 15° ,and 30° were respectively defined for extraversion angle 5° , 15° ,and 30° groups. A 50 mm-depth pinhole was drilled with a drill bit with a diameter of 3.0 nun. Pedicle screw was screwed into 50 nun, and its end part was connected to the device for transverse traction. Spinal vertebrae and the device for transverse traction were fixed with a specially made clamping apparatus. ② Determination of pullout strength and observation of pedicle and vertebral injury: Spinal vertebrae, on which pedicle screw and device for transverse traction were installed, was placed on a EW electrical universal material machine together with clamping apparatus for determining the pullout strength of pedicle screw. Sensor was connected to a computer to draw strength-displacement curve. The wave crest of the curve was considered the maximum pullout strength. At the same time, injuries to pedicle and vertebra caused by pullout of pedicle screw were observed. MAIN OUTCOME MEASURES: Pullout strength and injuries to pedicle and vertebra. RESULTS:①The mean maximum pullout strength of pedicle screw was respectively 0.878 167, 1.420 333, and 2.154 167 KN for extraversion angle 5° , 15 ° , and 30° groups. There was significant difference among the 3 groups (F = 12.554 22, P < 0.01). ② In the extraversion angle 5° group, 4 patients presented with cortical bone fracture which occurred at the entrance for pedicle screw, and 2 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge; In the extraversion angle 15° group, 1 patient presented with cortical bone fracture which occurred at the entrance for pedicle screw, 4 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge, and 1 patient presented with vertebral posterior coronal fragmentation; In the extraversion angle 30° group, 1 patient presented with cortical bone fracture which occurred at the entrance for pedicle screw, 2 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge, and 3 patients presented with vertebral posterior coronal fragmentation. There was statistical significance in the intergroup rank-sum test (P < 0.01).CONCLUSION: During application of pedicle screw with device for transverse traction, proper accrescence of extraversion angle can increase pullout strength of the screw and enhance fixative strength, and excessive extraversion angle easily injures vertebra.

Objective To know the impact of nursing intervention mode of parent-child interactive on the adaption of postpartum family roles.Methods One hundred families (maternal,husbands,baby at birth) were divided into the intervention group and the control group.The intervention group was cared by the responsibility nurses who were trained to master the parent-child interactive nursing intervention.The control group was cared by conventional nursing methods.The role adaptation of the fathers and the mothers of the two groups,and self-confidence of the parents to take care of newborns were observed.Results In the intervention group,the role adaptation of the fathers and the mothers was better than the control group; self-confidence of taking care of the newborn was better than the control group.The sleep time of the newborns was prolonged and the crying times were less than the control group.Conclusions The parent-child interactive nursing intervention model can help the family to adapt to the father and the mother role as soon as possible; teach the parents to comprehensively understand newborns,give stimulation of touch,sight,hearing,smell,so as to achieve positive response of newborns and increase the confidence of rearing newborns of the parents.

BACKGROUND: Nerve growth factor (NGF) is characterized by poor stability both in vitro and in vivo, and liable to lose its bioactivity.OBJECTIVE: To study the stability of liposome-encapsulated NGF injection preserved under various conditions.DESIGN: A controlled study of liposome-encapsulated NGF.SETTING: Department of Surgery of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: This study was carried out at the Central Laboratory of the First Affiliated Hospital of Nanjing Medical University between July 2002and March 2004. NGF from rat submaxillary gland was purified, encapsulated by liposome, and prepared into lyophilized dosage form before preserved under different conditions (at 4 ℃, room temperature, 40 ℃ or 40 ℃ with saturated humidity, respectively).METHODS: Chicken embryo dorsal root ganglion cultured in serum-free medium was used to evaluation the bioactivity of NGF in vitro. The dorsal root ganglion from 8-day-old chicken embryo was inoculated in a polylysine-coated 24-well culture plate and cultured in Dulbecco modified Ea-gle medium (DMEM) containing different testing samples. Only DMEM was used for culture in the negative control group, while DMEM containing NGF at different concentrations used in the positive control group. The ganglion was cultured at 37 ℃ with 50 mL/L CO2 and saturated humidity for 24 hours, and the growth of the nerve fibers was observed under an inverted microscope. The bioactivity of NGF was also evaluated in simulated condition in vivo by adding lyophilized liposome-encapsulated NGF and positive control NGF specimen into 0.5 mL rat serum, which, along with the blank control serum, was added into 2.5 mL DMEM at 0.5, 1, 2, 3, 4,6 hours and thoroughly mixed. The bioactivity of NGF was assessed accord-ing to the length and density of the dorsal root ganglion and graded the prominences (recorded as "++" or "+++ "), and very long and dense growth of the prominences (++++).MAIN OUTCOME MEASURES: In vitro bioactivity of NGF preserved for 10, 30, 60, and 90 days by testing the growth of cultured chick embryo dorsal root ganglion in serum-free DMEM and in test of rats serum containing NGF added at 0, 0.5, 1, 2, 3, 4, and 6 hours into DMEM.RESULTS: Lyophilized liposome-encapsulated NGF exhibited stable bioactivity (+++) after preservation at 4℃ and room temperature for 10-90days; at 40 ℃ for 10-60 days, the it retained its the bioactivity (+++),which, however, slightly decreased by 90 days (++); its bioactivity was preserved (+++) at 40 ℃ with saturated humidity for 10 days (+++), slightly decreased at 30-60 days (++) and noticeably lowered (+) at 90 days. When preserved for 0, 0.5, 1, 2, and 3 hours in rat seum, the NGF preparation retained stable bioactivity (++++ or +++), which slightly decreased at 4 hours and 6 hours (++).CONCLUSION: Liposome-encapsulated NGF has stable bioactivity but its preservation at relatively high temperature with high humidity is difficult.Lyophilized liposome-encapsulated NGF exhibits better bioactivity than NGF-liposome suspension after preservation under various conditions.

AIM　The purpose is to study the anti-arrhythmic effects of extracts from cultured Cordyceps sinensis. METHODS　Aconitine and barium chloride were used to induce experimental arrhythmia models in rats. RESULTS　The results showed that PE was more potent than other ingredients. Pretreatment with PE by oral administration significantly antagonized arrhythmia induced by aconitine. PE significantly prolonged the onset of arrhythmia, decreased the duration and diminished the degree of severity. And in barium chloride-induced arrhythmia model, PE had some anti-arrhythmia effect，which could diminish the degree of severity effectively to some extent. CONCLUSION　PE is an active component to antagonize arrhythmia induced by aconitine and barium chloride.

BACKGROUND:The human telomerase reverse transcriptase gene (hTERT) transfected into target cel s can play an important role in target cel proliferation and differentiation by increasing telomerase activity and maintaining telomere length. OBJECTIVE:To explore the effect of hTERT transfection on telomerase activity and biological characteristics of precartilage stem cel s culured in vitro. METHODS:Precartilage stem cel s cultured in vitro were subjected to hTERT gene transfection via a retrovirus vector pLXSN. Meanwhile, control and negative control groups were set up. After transfection, TRAP-ELISA assay was used to detect telomerase activity;RT-PCR and western blot employed to detect hTERT mRNA and protein expressions;cel counting kit-8 used to detect cel proliferaiton based on cel growth curve;and flow cytometry adopted to detect cel cycle and distribution. RESULTS AND CONCLUSION:The telomerase activity was significantly increased at 48 hours after hTERT gene was transfected into the precartilage stem cel s. After transfection of hTERT, hTERT mRNA and protein levels were significantly increased, the cel growth rate was significantly increased, the proportion of cel s at G 0/G 1 phase was decreased, and the number of S-phased cel s increased compared with the control group and negative control group. There were significant differences among the groups (P<0.05). In conclusion, hTERT transfection via retrovirus vector pLXSN can promote the proliferation of precartilage stem cel s in rats by increasing the telomerase activity.

Objective:To investigate the changes of macular region structure before and after operation in patients with macular epiretinal membrane,and its relationship with the visual function of patients.Methods:The clinical data of 60 patients with macular epiretinal membrane (60 eyes) in our hospital from February 2014 to August 2016 were retrospectively analyzed.All patients were examined with optical coherence tomography (OCT) examination,and observed the changes ofmacula central fovea and retinal each azimuth thickness,and the best corrected visual acuity (BCVA) was recorded before and after operation,and the correlations of them were analysised.Results:The visual acuity was improved in 53 patients (53 eyes) after operation,accounting for 88.33％,and the visual acuity was unchanged in 7 patients (7 eyes),accounting for 11.67％.The preoperative BCVA of patients was (0.18± 0.07),and it was (0.38± 0.12) at 3 months after operation,which was significantly higher than before operation (P＜0.05).Postoperative macular central thickness,inner side of the inner ring thickness,nasal side of the inner ring thickness,above the inner ring thickness,below the inner ring thickness,outer ringtemporal side thickness,external ring nasal side thickness,above the outer ring thickness,below the outer ring thickness in patients compared with the preoperative were significantly lower,the difference was statistically significant (P＜0.05).The Pearson correlation analysis showed that preoperative macular central thickness,preoperative inner side of the inner ring thickness,preoperative outer ring temporal side thickness,the difference of macular fovea thickness before and after operation,the difference of the medial temporal before and after operationwas,the difference of outer ring temporal side before and after operation were negatively correlated with postoperative BCVA (P＜0.05).Conclusion:Vitrectomy can significantly reduce macular retinal thickness in patients with macular epiretinal membrane,and it can improve the visual function of patients,and the shape ofmacular region before operation had some influence on postoperative visual acuity.

OBJECTIVETo explore the effects of the nerve growth factor (NGF) on N-methyl-D-asparate receptor 1 (NMDAR 1) after spinal cord injury.

METHODSSpinal cord injury of Wistar rats was performed with Allen's method by a 10 gx2.5 cm impact on the posterior T8 spinal cord. NGF was given to the rats of the treatment group via subarachnoid space tube at once, 2, 4, 8, 12 and 24 hours after spinal cord injury, respectively. The expression of NMDAR1 mRNA in spinal cord was detected by in situ hybridization.

RESULTSRare expression sequence of NMDAR1 mRNA was found in rat spinal cord of the normal group. A strong expression sequence of NMDAR1 mRNA was found in rat spinal cord of the normal saline group. The expression of NMDAR1 mRNA in the NGF group was significantly decreased as compared with that in the normal saline group (P=0.01).

CONCLUSIONSNGF can relieve damage of injured spinal cord by prohibiting the expression of NMDAR1 mRNA.

Animals ; In Situ Hybridization ; Nerve Growth Factor ; pharmacology ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Spinal Cord Injuries ; physiopathology