Objective To evaluate retrospectively whether posterior longitudinal ligament(PLL)adhere to dura mater in the patients with cervical spondylotie myelopathy(CSM)or not before the anterior cervical operation.Methods From December 2005 to January 2007,of 18 patients with CSM the adhesion between PLL and dura mater was found in the anterior cervical operation.The patients included of 11 males and 7 females,with mean age of 65.4 years (range 55-72 years).All the patients were measured by CT and MRI before operation.There were 12 cases of dual-segmental cervical intervertebral disc herniation,6 of tri-segmental disc herniation.The former cases were treated with one level corpectomy and titanium mesh or iliac grafting and cervical anterior plate,and the latter with an additional cervical cage in the intervertebralspace.The floatation method was used to deal with the adhesion.The fitness between the two radiological methods was analyzed by matched-pairs Kappa eoemcient test.Results The nerve functions of all the patients were improved after anterior cervieal decompression.The mean score of JOA was increased from 9.6 of pre-operation to 12.1 of post-operation.There were 4 cases with injury in dura mater,which healed after appropriate dealing with the leakage of cerebrospinal fluid.None of lacerated dura was directly repaired during the operation.The condition of the coarse touch and bur between intervertebral disc and dura mater were found in CT transverse scanning.The thickening of the PLL and the unsymmetrical space between inferior and superior subdural cavity was found in MRI.The coefficient test proved that the difference of the CT and MRI was significant in finding the adhesion.Conclusion MRI iS better than CT in finding the adhesion between the PLL and dura mater in CSM before operation,besides the floatation method should be good to deal with the adhesion.

[Objective]To evaluate the restoration of the cervical curvature after segmental anterior cervical decompression.[Method]Thirty-seven patients(male 31,female 6,mean age 57.8)with cervical spondylotic myelopathy were treated by segmentai anterior decompression,JOA(17 scores)was used to evaluate the improvement of nerve function of the patients.The measurement of the lordosis was according to the Harrion posterior tangent angle which is presented on the tangent of posterior vertebral body margins of C2 and C7 in the cervical spine.E-film software was used to measure the tangent angles which were obtained by pre operation and post operation.All patients were divided into two groups in terms of the fifteen degree of lordosis of the cervical spine before the operation.[Result]All of the cases were obtained the improvement of the nerve function of the extremities.The mean JOA scores was 10.6 in pre-operation,and was 12.8 in post-operation(P

DSS group,although without statistical significance.JOA score of two groups before and after surgery without statistical significance.[Conclusion]Developmental spinal stenosis is pathology found,which influences course of ossification of cervical posterior longitudinal ligament.The principal factor is trauma,which induces ossification of cervical posterior longitudinal ligament.Decompressed from a posterior approach is a reasonable treatment way.

Objective To approach the treatment principle of lumbar spondylolisthesis with spina bifida occulta. Methods Twenty-six patients(male19,female 7,average 23.2 years old)with spondylolisthesis and spina bifida occulta were analyzed retrospectively.All cases were evaluated by radiological examinations including X-rays,computed tomography,magnetic resonance image.Based on the radiological results,the degeneration of intervertebual disc were varied by Ⅰ~Ⅴ types.Meyerdin’s score was used to evaluate the severe slip of the body of spondylolysis.At same time spina bifida occulta was divided into 4 models as follows,type A meant that the semi-lamina of sacrum was hypoplasia and still linked with spinous process;type B meant that the both sides of the lamina of sacrum was hypoplasia and the spinous process was free;type C meant that the lamina of sacrum was absent;type D meant that the spina bifida occulta was companied by other deformities such as the round formation of the end-plate of sacrum,the deformity of the transverse process of L5. Results The modality of the operations included 9 cases in single-vertabra fixation,13 cases in single-segment fixation,4 cases in two-segment fixation.All patients had been follow-up for 6~37 months(average 11.2 months).The effect of treatment was also obtained(8 in excellent,13 in good,5 in fair). Conclusions As for how to do with spondylolisthesis with spina bifida occulta(SBO),the type of SBO,degeneration scores of the disc and the degree of the slip of spondylolysis should be taken into consideration.

Objective:To observe the effect of etanercept on bleomycin-induced pulmonary fibrosis in mice and its possible mechanisms.Methods:Thirty male SPF Kun ming mice were randomly assigned to control group ( intratracheal saline injection ) or model group ( intratracheal injection of bleomycin 5 mg/kg ) or intervention group ( intratracheal bleomycin injection followed by etanercept 3 mg/kg intraperitoneal administration twice a week )(n=10 group).Lung tissue were taken after the sacrifice of the mice with 28 days of molding.The content of hydroxyproline of the right lung samples was measured by alkaline hydrolysis method ,while the left lungs were fixed in 4%paraformaldehyde and embedded in paraffin with the sections stained with hematoxylin -eosin or Masson′s trichrome for pathological examination .Total tissue protein was extracted from lung homogenates to detect the expression of NF -κB and phosphorylation of NF-κB( P-NF-κB) by Western blot.Results:The content of hydroxyproline in lung tissue of mice of intervention arm was decreased significantly compared with the model arm ( P<0.01 ).The alveolar structure of the intervention arm maintained integrity with alveolar septum slightly thickened.The inflammation and fibrosis scores were decreased significantly with noticeable greater improvement of pulmonary fibrosis than the model arm (P<0.01).In addition,the protein phosphorylation of NF-κB in the lung tissues was remarkably decreased in the intervention arm ( P<0.01 ).Conclusion: Etanercept can inhibit the phosphorylation of NF-κB and reduce lung inflammation and fibrosis caused by bleomycin in mice ,which may be useful in the treatment of pulmonary fibrosis.

Objective:To investigate the iodine nutrition level of pregnant women in Shanxi Province, and to provide basis for guiding pregnant women to supplement iodine scientifically.Methods:From 2016 to 2018, 40, 80 and 118 counties were selected in Shanxi Province. In each county, 5 townships were selected according to the east, west, south, north and middle orientation, 20 pregnant women were selected from each township. Urine and salt samples of pregnant women were collected, and urinary iodine and salt iodine contents were determined, respectively.Results:From 2016 to 2018, 3 590, 7 907, and 11 750 salt samples were collected from pregnant women's homes. The medians salt iodine were 23.80, 23.70, 23.25 mg/kg, and the qualified iodized salt consumption rates were 91.06% (3 269/3 590), 90.06% (7 121/7 907), 92.21% (10 835/11 750), and the coverage rate of iodized salts were 97.72% (3 508/3 590), 97.00% (7 670/7 907), 98.53% (11 577/11 750), and the qualified rate of iodized salts was 93.19% (3 269/3 508), 92.84% (7 121/7 670), 93.59% (10 835/11 577), respectively. There were statistically significant differences in the median salt iodine and qualified iodized salt consumption rate among pregnant women in different years ( H = 99.915, χ 2 = 27.988, P < 0.05). Totally 3 902, 7 892 and 11 745 urine samples of pregnant women were tested, and the medians (quartiles) urinary iodine were 174.20 (114.00, 251.08), 180.70 (117.13, 258.58) and 179.40 (115.90, 249.00) μg/L, respectively. There was statistically significant difference in the median urinary iodine among pregnant women in different years ( H = 12.368, P < 0.05). From 2016 to 2018, counties with appropriate levels of iodine accounted for 70.00% (28/40), 73.75% (59/80) and 70.34% (83/118), respectively. The medians (quartiles) urinary iodine levels of pregnant women in the early, middle and late stages of pregnancy ( n = 2 225, 5 727, 3 793) in 2018 were 177.62 (117.28, 257.23), 178.21 (117.40, 248.40) and 172.70 (112.98, 245.70) μg/L, respectively, and there was statistical by significant difference in urinary iodine levels among pregnant women in different pregnancy periods ( H = 11.077, P < 0.05). Conclusions:From 2016 to 2018, the iodine nutrition level of pregnant women in Shanxi Province is generally in an appropriate state, iodine deficiency or more than appropriate still exists in some areas. We should continue to carry out monitoring work, and focus on strengthening health education for pregnant women, and guide them to supplement iodine scientifically and accurately.

BACKGROUND:Autologous hamstring Rigidfix and Intrafix has been frequently used to fix and reconstruct anterior cruciate ligament. However, it lacks of evaluation of middle and long period of clinical outcomes. OBJECTIVE:To retrospectively evaluate the medium term clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. METHODS:The 39 cases of anterior cruciate ligament injury were subjected to anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix under arthroscope. They were fol owed up for 2 years or more. The clinical outcomes were evaluated using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:In the fol ow-up, IKDC2000 score and Lyshlom score were significantly increased fol owing Rigidfix and Intrafix fixation than before treatment (P<0.01). Results indicate satisfactory clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. However, long-term fol ow up is needed to verify the feasibility of extensive application.

ObjectiveTo determine the effect of multi-criteria decision analysis (MCDA) on the effect of bundle treatment for severe pneumonia.Methods A prospective historical control observation was conducted. Seventy-five patients with severe pneumonia having received MCDA (from January 2013 to August 2014) were assigned as intervention group. MCDA group was set up by the medical staff. Bundled treatment plan was composed of the MCDA evaluation results, anti-infection, phlegm and other conventional treatment measures which was adjust on time until the patient was transferred out of the respiratory intensive care unit (RICU) or died. Seventy patients with severe pneumonia before receiving MCDA (from August 2010 to December 2012) were set as historical control group. Comparison of general condition before treatment and the incidence of hospital infection, average hospitalization cost, duration of RICU stay and mortality between these two groups were performed.Results There were no statistically significant differences in gender, age, past history, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score at admission between two groups. Compared with control group, the incidence of hospital infection [1.33% (1/75) vs. 11.43% (8/70),χ2 = 4.723,P = 0.030], mean hospitalization cost in RICU (10 thousand Yuan: 3.44±0.79 vs. 3.76±0.91,t = 2.265, P = 0.025), length of RICU stay (days: 15.01±4.22 vs. 16.92±4.79,t = 2.552,P = 0.012) and mortality in RICU [8.0% (6/75) vs. 21.4% (15/70),χ2 = 5.272,P = 0.032] in intervention group was significantly decreased. Conclusions Application of MCDA in the bundle treatment of severe pneumonia could elevate the scientificalness of decision, and reduce the medical cost. Additionally, MCDA is worth to be generalized because the implementation of guidelines can improve the clinical outcome and prognosis of the patients.

Objective To observe effects of different extracts of Jianpi Huogu Formula (JPHGF) on proliferation and differentiation of bone marrow mesenchymal stem cell (BMSCs). Methods Whole bone marrow adherent was used to screen, culture, and isolate BMSCs. Extracts from different parts (water, chloroform, ethyl acetate and n-butanol parts) of JPHGF were administrated for a certain time. MTS was used to detent cell proliferation;ALP staining was used to detect ALP activity;ARS staining was used to detect the formation of calcium nodules;oil red O staining was used to detect fat cell formation. Results Extracts from different parts of JPHGF could promote cell proliferation of BMSCs in different levels, followed by its strength in water, chloroform, ethyl acetate, and n-butanol parts;ALP staining results showed that the intensity of ALP expression of the order is water, acetic acid ethyl, chloroform and n-butanol parts;in promoting the formation of calcium nodules, ARS staining results showed that its intensity were water, chloroform, ethyl acetate, and n-butanol parts;oil red O staining results showed that inhibition intensity of fat cells interaction strength was formed from ethyl acetate, water, chloroform to n-butanol parts. Conclusion Extracts from different parts of JPHGF have different effects on BMSCs proliferation and differentiation. Water extraction has the strongest osteogenic differentiation and proliferation, and ethyl acetate has the best effect on the inhibition of cell formation.

Objective To research the influenza virus infection on rat vascular smooth cells number,proliferation,apoptosis,the amount of IL-6,sFas,platelet-derived growth factor(PDGF) and the mechanism of atherosclerosis.Methods Flow cytometry,enzyme-linked immunosorbent assay and cell count experiments were used to detect these indicators at 0 h,6 h,12 h,24 h,48 h.Results After influenza virus infected at 0 h,proliferation,apoptosis condition were 10.39％,0.44％,respectively; at 6 h,proliferation,apoptosis respectively increased to 12.68％,0.73％ ; proliferation reached the peak at 12 h (18.01％),instead apoptosis decreased to 0.14％ ; at 24 h,proliferation decreased to 12.89％ and apoptosis markedly increased to 1.09％ ; at 48 h,proliferation further reduced to 7.07％ and apoptosis reached the peak(4.61％).The number of cells and the cytokine secretion were statistically significant to control group (P＜0.05).Conclusion Influenza virus infection might lead to change of cell proliferation and apoptosis and involve the atherosclerosis form and development,and cytokines played an important role in them.