BACKGROUND:The pathogenesis and risk factors for lumbar disc herniation are significantly different between adults and teenagers Previous studies seldomly refer to risk factors for lumbar disc herniation in adolescents by using logistic regression analysis.OBJECTIVE:To investigate the risk factors for lumbar disc herniation in adolescents in Jinzhou by using logistic regression analysis.METHODS:A total of 94 patients with lumbar disc herniation,including 56 males and 38 females,aging 9-18 years,were considered as the experimental group.A total of 1 00 patients suffering from other diseases were considered as the control group.Logistic regression analysis was employed to analyze risk factors for lumbar disc herniation onset,suggesting that OR>1 was taken as the risk factor for lumbar disc herniation,whereas OR<1 as the protective factor for lumbar disc herniation RESULTS AND CONCLUSION:All the 1 94 patients were involved in the final analysis.The result of logistic regression analysis showed that compared with control groups,the patients with lumbar disc herniation were statistically associated with familial Dredisposition(OR=6.427,P=0 015),trauma(OR=17.196,P=0.011),congenitalmalformations(OR=31.429,P=0 002),and over-exercise(OR=12.644,P=0.027)Trauma,congenital malformations,familial predisposition,and over-exercise were the risk factors for lumbar disc herniation in children and adolescents in Jinzhou.So it is necessary to implement a comprehensive prevention program,such as lifestyle and dietary habit modification,and proper activity.

BACKGROUND: Anterior and dorsal root nerve tracts should be separated to small tracts in high selective dorsal rhizotomy, because detailed tract separation will benefit electrostimulation, thereby helping correctly cutting the lower-threshold Ia nerve fibers that cause convulsion, and meanwhile sensory nerve fibers in dorsal nerve root can be reserved as many as possible.OBJECTIVE: To meet the needs of limited and high selective spinal dorsal rhizotomy, anterior and dorsal root of spinal nerve were microanatomized to be certain of the separation standard and the number of small nerve tracts, so as to provide reliable basis and novel operative standard for clinical operation.DESIGN: Single sample experiment with adult corpses as subjects.SETTING: Orthopedic Department of the First Affiliated Hospital and Department of Anatomy, Jinzhou Medical College.PARTICIPANTS: This study was carried out at the Anatomical Laboratory of Jinzhou Medical College in December 1999. Fifteen adult corpses, 11 males and 4 males, were donated, and the donators signed informed consent when alive.tained from the 15 adult spinal cords (30 sides) and subjected to morphoanterior and dorsal roots of L5 spinal cord were obtained from a fresh corpse for immunohistochemical staining. The starting part, middle part and the exterior of intervertebral foremen was cut into slices, and the total number of nerve fibers, the number of Ia nerve fibers responsible for convulsion, and their percentage in the total fibers were counted. Meanwhile the distribution and the number of Ia nerve fibers in the three parts were compared.ber of nerve fibers per 100 μm2, the percentage of Ia nerve fibers in the total nerve fibers at the starting part, middle part and exterior of intervertebral foremen of spinal nerve dorsal root.root filaments. Microsurgical observation proved that dorsal root could be divided into 10-18 small tracts and anterior root 6-11 tracts; the diameter number of nerve fibers in the three parts of spinal nerve dorsal root was (3 243±143) fibers per 100 μm2, including (1 702±85) Ia nerve fibers that constituted about 52.5% of the total nerve fibers. Ia nerve fibers were found to be evenly distributed in dorsal root and no gathering could be observed.CONCLUSION: The tracts in anterior and dorsal roots of spinal cord should be separated as minutely as possible during improved dorsal rhizotomy, which is beneficial for cutting off Ia nerve fibers correctly. Generally,the anterior root consists of 6-11 small tracts and dorsal roots of 10-18small tracts, and nerve tracts should not be cut off over 1/2 of total dorsal nerve fibers.

Objective To evaluate the effect of ischemic preconditioning(IPC) on ischemia-reperfusion-injury of myocardium and phosphorylated Akt(p-Akt) during the disease course of diabetes in rats.Methods The rat model of diabetes mellitus was reprodused by streptozocin(40mg/kg,i.v.).Myocardial ischemia was then created by temporary ligation of a branch of the left anterior descending(LAD) coronary artery after 2 and 9 weeks,respectively.Thirty six SD rats were randomly divided into six groups(6 each):non-diabetic IPC(NDMIP) group,non-diabetic I/R(NDMIR) group,2-week diabetic IPC(2DMIP) group,2-week diabetic I/R(2DMIR) group,9-week diabetic IPC(9DMIP) group and 9-week diabetic I/R(9DMIR) group.Ischemic/reperfusion was induced by temporary occlusion of LAD coronary artery.After the experiment,creatine kinase-MB(CK-MB) isoenzyme and myocardial infarct size were measured,and the expression of p-Akt was detected by Western-blotting,the arrhythmia score was then evaluated.Results CK-MB level in NDMIP group was significantly lower than that in NDMIR group and 9DMIP group(P0.05);the arrhythmia score in 9DMIP group was significantly higher than that in 2DMIP group(P0.05);the expression of p-Akt in 9DMIP group was significantly lower than that in 2DMIP group(P0.05);the myocardial infarct size in 9DMIP group was larger than that in 2DMIP group.Conclusions IPC can provide significant microvascular protection against prolonged ischemia/reperfusion in acute diabetic rats,but not in chronic diabetic rats.The attenuation of myocardial protection by IPC may be associated with a decrease in p-Akt activation.

Objective To explore the potential diferentiation of insulin-secreting cells from muscle derived stem cells.Methods SD rat muscle derived stem cells(MDSCs)were isolated and then induced for 7～12 days with combination inductor.Morphological changes of the induced cells were observed under an inveted microscope.DTZ staining,immunocytochemical staining were conducted to examine the production of insulin.Glucose challenge and radio immunoassay were perfomed to evaluate the function of the aggregates,and RT-PCR was conducted to detect the expression of endocrine gene.Results Typical insulin-producing cells were observed at the end of the protocol(12 days).Ditizone staining and immunohistochemistry for insulin were both positive.Insulin was secreted by these cells in response to different concentrations of glucose stimulation(P

BACKGROUND:As the incidence of spinal cord injury increases with the years and axon regeneration after spinal cord injury was very difficult.How to promote the recovery from spinal cord injury and improve the transplantation efficiency of stem cells and other therapeutic cells after spinal cord injury has been the focus of clinical and scientific research. OBJECTIVE:To establish the efficient transplantation and replacement of mouse spinal cord microglia in the spinal cord injury model. METHODS:CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice,CX3CR1+/GFP mice,β-actin GFP mice and C57 BL/6J wild-type mice at 8-10 weeks of age were selected.According to the requirements of the experiment,they were randomly divided into six groups.(1)Sham operation group:eight C57 BL/6J wild-type mice were used when only the lamina was removed without injury.(2)Spinal cord contusion injury group:eight C57 BL/6J wild-type mice were used.(3)Spinal cord crush injury group:eight C57 BL/6J wild-type mice were used.(4)Conjoined symbiotic spinal cord strike injury group:β-actin GFP mice with green fluorescent blood were surgically stitched together with C57 BL/6J wild-type mice,using eight β-actin GFP mice and eight C57 BL/6J wild-type mice.(5)Mr BMT-X Ray group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with X-ray radiation):Bone marrow cells from four CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice were extracted and transplanted into eight C57 BL/6J wild-type mice for spinal cord injury modeling.(6)Mr BMT-Busulfan group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with Busulfan):Bone marrow cells from four CX3CR1+/GFP mice were transplanted into eight C57 BL/6J wild-type mice.The percentage of cell transplantation replacement in this group was observed,and the spinal cord injury model was not established in this group.The sham operation group,spinal cord contusion injury group and spinal cord crush injury group were sampled by perfusion on day 14 after spinal cord injury.The conjoined symbiotic spinal cord strike injury group was sampled by perfusion on day 7 after spinal cord injury.Mr BMT-X Ray group was sampled by perfusion on day 28 after spinal cord injury.Mr BMT-Busulfan group was sampled by perfusion on day 28 after transplantation.The sampling site was a 1.2 cm long spinal cord with the T10 segment as the center.In the Mr BMT-X Ray group and Mr BMT-Busulfan group,additional mouse brain tissue was retained to see if it would lead to brain transplantation and replacement.The number and proportion of transplanted and replaced cells in the damaged area were measured using transgenic mice,symbiosis and immunofluorescence. RESULTS AND CONCLUSION:Compared with the traditional peripheral blood transplantation(9.8%)of mice in the conjoined symbiotic spinal cord strike injury group,the new transplantation methods,Mr BMT-X Ray and Mr BMT-Busulfan,could greatly improve the proportion of spinal microglia transplantation and replacement,which could reach 84.8%and 95.6%,respectively.The difference was significant(P<0.05).The results showed that Mr BMT-X Ray and Mr BMT-Busulfan could achieve efficient replacement of spinal microglia cells,and could improve the problems of low cell transplantation efficiency,few survival numbers and unclear differentiation of the traditional cell transplantation methods.In addition,Mr BMT-X Ray can only replace the microglia in the spinal cord,while Mr BMT-Busulfan could avoid brain inflammation and injury caused by X-ray radiation transplantation.

Objective:To compare the efficacy between deep continuous irrigation combined with vacuum sealing drainage (VSD) and routine dressing change in treating multidrug-resistant bacterial infections at the surgical wound site in patients with major vascular injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 28 patients with surgical wound infections by multidrug-resistant bacteria after major vascular injury treated at the First Affiliated Hospital of Henan University of Science and Technology from March 2015 to December 2021. There were 15 males and 13 females, aged 15-65 years [(41.8±12.9)years]. All patients received vascular graft surgery after major vascular injury. Postoperative microbiological culture indicated that the wound infections were caused by Carbapenem-resistant organisms (CRO) or vancomycin- resistant Enterococci (VRE), with no available sensitive antibiotics for treatment. The patients received surgical debridement every five days after vascular graft surgery and were divided into two groups to receive the subsequent treatments including a routine dressing change (routine dressing group, 14 patients) or a deep continuous irrigation combined with VSD (irrigation combined with VSD group, 14 patients). On the first day post-operation and then every 3 days, inflammatory indicators [white blood cell count, neutrophils, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin] were observed in the two groups (repeat tests when a patient′s condition changed). Microbiological cultures were applied with patient samples every 5 days to observe the wound and infection control. Comparisons were made between the two groups regarding the duration to normal levels of inflammatory indicators, duration to negative CRO or VRE cultures, visual analogue score (VAS) before and at 1, 2 and 3 hours after changing the irrigation fluid (changing the dressing), conditions of wound skin grafting or flap repair, and incidences of anastomotic fistula.Results:All patients were followed up for 12-24 months [(14.3±2.4)months], during which no wound redness, rupture, purulent discharge or infection recurrence was noted. The duration to normal levels was (9.4±2.4)days for white blood cells, (9.6±2.8)days for neutrophils, (9.8±3.1)days for CRP, (12.2±3.6)days for ESR, and (7.6±1.9)days for procalcitonin in the irrigation combined with VSD group, significantly shorter than those in the routine dressing group [(15.2±3.1)days, (13.6±3.4)days, (14.2±3.9)days, (19.9±3.3)days, and (12.9±4.1)days, respectively] (all P<0.01). The duration to negative CRO or VRE cultures was (13.9±3.1)days in the irrigation combined with VSD group, significantly shorter than that in the routine dressing group [(19.2±6.9)days] ( P<0.05). The VAS before and at 1, 2 and 3 hours after changing the irrigation fluid was (4.2±0.7)points, (4.1±0.9)points, (4.2±0.9)points and (4.1±0.8)points in the irrigation combined with VSD group, respectively, and was (4.3±0.6)points, (6.9±0.7)points, (5.4±0.9)points and (4.5±0.9)points in the routine dressing group, respectively. The VAS score in the irrigation combined with VSD group was significantly lower than that in the routine dressing group at 1 hour and 2 hours after changing the irrigation fluid (all P<0.01), while no significant differences were found before and at 3 hours after changing the irrigation fluid (all P>0.05). After infection control, 5 patients (35.7%) in the irrigation combined with VSD group required skin grafting or flap repair at the wound site, lower than 11 patients (78.6%) in the routine dressing group ( P<0.01). The incidence of anastomotic fistula was 7.1% (1/14) in the irrigation combined with VSD group, lower than 42.9% (6/14) in the routine dressing group ( P<0.05). Conclusion:When multidrug-resistant bacterial infections occur at the surgical wound site after major vascular injury, deep continuous irrigation combined with VSD performs better than routine dressing change in controlling infection as well as in reducing pain, rate of wound skin grafting or flap repair and incidence of anastomotic fistula, without reliance on antibiotics.

BACKGROUNDThe objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.

METHODSLiterature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.

RESULTSA total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.

CONCLUSIONSThe best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.