In the field of biomechanics, there have been many discoveries concerning the cervical spine injuries in recent years. With the help of biomechanical knowledge, we can not only judge the stability of the cervical spine and have a clear idea of the factors that may affect the stability but also conduct an appropriate classification of the injuries. In this article, we summarize the effects of the stiffness and preinjury biomechanical characteristics of the cervical spine (such as alignment, mass, inertial properties) on the injury, changes of the spinal canal during injury, and the rapidly developing research on finite element models of cervical spine injuries in the past few years.

Objective To investigate the significance of the expression of endostatin and vascular endothelial growth factor(VEGF)in hepatocellular carcinoma(HCC).Methods The expression of endostatin and VEGF in 46 specimens which were collected at Second Affiliated Hospital of Fnjian Medical University from January 2000 to Apfil 2005 was detected by immunohistochemistry.The relationship between the expression of endostatin and VEGF and the progression of HCC was determined.All data were analyzed via t test,paired t test,Pearson rank correlation coefficient.LSD-t test or Tamhane's-t test.Results The expression of endostatin and VEGF was detected mainly in the cytoplasm of HCC cells and adjacent tissues.The values of mean optical density (MOD)of endostatin in HCC tissue,adjacent tissue and normal liver tissue were 0.11±0.02,0.14±0.0l and 0.09±0.01.respectively,and the values of integrated optical density(IOD)of endostatin in the above mentioned tissues were(1.8±0,2)×10~4,(3.8±2.2)×10~4 and(0.9±0.4)×10~4,respectively.The values of MOD and IOD of endostatin in HCC tissue were significantly lower than those in adjacent tissue(t=2.032,7.927,P＜0.05).The values of MOD of VEGF in HCC tissue,adjacent tissue and normal liver tissue were 0.13±0.02.0.12±0.02 and 0.11±0.02,respectively,and the values of IOD of VEGF were(5.4±3.1)×104,(3.9±2.5)×10~4 and(3.0 ±3.0)×10~4,respectively.The values of MOD and IOD of VEGF in HCC tissue were significantly hisher than those in adjacent tissue(t=5.871,8.723,P<0.05).There was positive correlation between the expression of endostatin and the recurrence of HCC(r=0.669,P<0.05),while VEGF had no influence on the recurrence of HCC(t=0.892,P>0.05).Conclusions Endostatin is mainly expressed in HCC tissue,but the level of its expression is lower in HCC tissue than in adjacent tissue.The expression of VEGF is higher in HCC tissue than in adjaneet tissue.Endostatin,rather than VEGF,may be used as a independent prognostic factor of the prognosis of patients with HCC.

Objective To investigate the correlation between ABCD2 scores and vertebrobasilar artery stenosis in patients with posterior circulation transient ischemic attack (TIA).Methods The patients with posterior circulation TIA who performed cerebral angiography were enrolled in the study,and their ABCD2 scores and imaging data were analyzed.Results A total of 108 patients with posterior circulation TIA were enrolled.There were significant differences in the main trunk stenosis degree of vertebrobasilar artery with different ABCD2 scores in patients with posterior circulation TIA (P =0.005).The overall degree of stenosis increased with the increase of ABCD2 score (P =0.000).After adjustment for other vascular risk factors,ABCD2 score had significant predictive ability for whether had posterior circulation stenosis (odds ratio [OR]1.771,95％ confidence interval [CI] 1.234-2.542; P =0.002) and moderate to severe stenosis (OR 2.083,95％ CI 1.336-3.176; P =0.001).Its receiver operating characteristic area under the curve was 0.693(95％ CI 0.586-0.800) and 0.755 (95％ CI 0.661-0.849) respectively.When the ABCD2 score was ≥3,the sensitivity and specificity of predicting posterior circulation stenosis were 62.6％ (95％ CI 53.4％-71.7％) and 70.6％ (95％ CI62.0％-79.1％) respectively,and the sensitivity and specificity of predicting posterior circulation stenosis ＞ 50％ were 78.7％ (95％ CI 70.9％-86.4％) and 67.5％ (95％ CI58.7％-76.3％) respectively.Conclusions In patients with posterior circulation TIA,the stenosis degree of vertebrobasilar arterial trunk increases with the increase of ABCD2 score.In a certain extent,ABCD2 score may predict whether the main trunk of the posterior circulation has stenosis and whether has moderate to severe stenosis.

Objective To investigate the dynamic change of serum high sensitive C-reactive protein (hsCRP) after carotid artery stenting (CAS) and its correlation with in-stent restenosis.Methods The serum hsCRP levels were determined before procedure,at 12 hours,7 days,3 and 6 months after procedure in patients who underwent CAS in the Department of Neurology,Jinling Hospital,Nanjing Their cerebral angiography was reexamined and whether there was in-stent restenosis after 6 months was observed.Results Eighty-four patients treated with CAS were included in the study.Fifteen (24％) had in-stent restenosis after CAS.The stenosis in 3 of them was ＞ 50％,and the stenosis m 12 of them was 30％ to 50％.The serum hs-CRP levels in all patients after procedure were significantly higher than those before treatment (all P ＜ 0.01 ),and they were significantly lower at 6 months after procedure than before treatment (all P ＜0.01).Univariate analysis showed that the proportion of diabetes in the restenosis group was significantly higher than that in the non-restenosis group (P＜0.01).At 7 days (8.83 ± 1.94 mg/L vs.6.77 ± 1.63 mg/L,t =14.398,P=0.044),3 months after procedure (8.26 ± 1.32 mg/L vs.4.58 ± 1.45 mg/L,t =17.569,P =0.008) and 6 months after procedure (7.04 ± i.07 mg/L vs.3.12 ± 1.28 mg/L,t =21.867,P =0.003),the serum hs-CRP levels in the restenosis group were significantly higher than those in the non-restenosis group,and the difference of the serum hs-CRP level (△ hs-CRP) before procedure and at 6 month after procedure was significantly lower than that in the nonrestenosis group (0.85 ± 0.13 mg/L vs.4.89 ± 0.94 mg/L,t =16.987,P =0.000).Multivariate logistic regression analysis showed that /hs-CRP (odds ratio [ OR] 2.392,95％ confidence interval [ CI] 1.538 -3.513; P =0.009) and diabetes (OR 1.840,95％ CI 1.372 -2.241; P =0.023) were the risk factors for instent restenosis.Conclusions The serum hs-CRP level increased significantly at 12 hours after CAS procedure,and then decreased continuously.At 6 months after procedure,the more decrease of the serum hs-CRP level,the lower risk of occurring in-stent restenosis was.

Cerebral hyperperfusion syndrome (CHS) is one of the complications after stenting in patients with carotid stenosis.Although its incidence is lower,it may result in serious disability or death in patients.Full awareness and understanding of CHS and its related risk factors may contribute to its prevention and treatment.

ObjectiveTo study the quality of life of patients with hepatolenticular degeneration (HLD)and analyze the influencing factors.Methods287 patients with HLD and 51 health people were investigated by World Health Organization quality of life assessment instrument brief version (WHOQOL-BREF),Symptom Checklist 90 (SCL-90),Life Satisfaction Index A (LSIA) and variance analysis,t-test and multiple linear regression analysis were analyzed the influencing factors.Results①Scores of WHOQOL-BREF:physical domain(54.64 ± 17.11 ),psychological domain ( 52.09 ± 15.83 ) in patients with HLD were lower than those in the health people (67.30 ± 12.66,58.90 ± 12.75 ) with statistically significant difference (P ＜ 0.01 ) ; social domain ( 51.35± 17.18),the domain of environment(53.54 ± 16.67) in patients with HLD were lower than those in the health people (57.53 ± 14.99,58.42 ± 10.55 ) with statistically significant difference (P ＜ 0.05 ).②The quality of life of the patients with HLD was influenced by LSIA,total score of SCL-90,the attitude toward the doctors,economic status,the attitude toward the disease,residence with statistically significant difference (P ＜ 0.0l ).ConclusionThe quality of life in patients with HLD is lower than that in health people and much factors influence it,so it is necessary to take multi-facet interventions to improve their quality of life.

MicroRNAs (miRNAs) are endogenous non-coding RNAs composed of 18-25 nucleotides,and they may play a role in gene regulation through completely or partially binding to target gene mRNA complementary sequences and make it degrade or prevent its translation.miRNAs play important roles in the onset and pathophysiological processes of ischemic stroke.This article reviews the roles of miRNAs in the etiology of ischemic stroke and pathophysiological mechanisms after stroke,and the potential application of miRNAs is prospected.

Objective To investigate the effect of butylphthalide on cerebrovascular reactivity (CVR) in patients with severe intracranial internal carotid stenosis.Methods The patients with severe intracranial internal carotid stenosis diagnosed by cerebral angiography in Nanjing Stroke Registry Program from January 2010 to November 2010 were randomly divided into either the butylphthalide group or the control group.All patients received the oral drugs for ischemic cerebrovascular disease that met the guideline criteria,and butylphthalide 20 mg,3 times a day orally was added in the butylphthalide group.The CVR was evaluated by transcranial Doppler and CO2 inhalation challenge test,and reexamined 3 months after treatment.Results A total of 81 patients met the inclusion criteria,11 (13.6％) were lost to follow-up,and finally 70 (n =35 in each group) were included in the analysis.The mean age of the patients was 55.2 ± 9.0 years,47 of them were male and 23 were female.The degree of vascular stenosis was 72％ to 99％ (mean 79.4％ ± 9.5％).The CVR was improved significantly after 3 months of treatment in the butylphthalide group than that in the control group (P =0.007),but it was not improvedsignificantly in the control group (P =0.330).All the patients did not have ischemic stroke events during the medication.No serious adverse reactions occurred in the butylphthalide group.Conclusions Butylphthalide may improve the CVR in patients with severe intracranial internal carotid stenosis.

We investigated the serotype,drug resistance features,molecular types,and homology of Salmonella in diarrhea in Tai'an City,and provided scientific evidences for warning,control and clinical treatment.The 31 Salmonella strains isolated from stool specimens of diarrhea in Tai'an were identified by serotyping.Broth dilution technique was used to test the sensitivity of 31 strains of Salmonella to 16 antibiotics.Pulsed field gel-electrophoresis (PFGE) was used for molecular typing and cluster analysis.Results showed that 31 strains of Salmonella were divided into 10 kinds of serotype.S.enteritidis (11/31) was the predominant serotype.All 31 strains of Salmonella were sensitive to cefoxitin and imipenem.The drug resistance rates of the 31 strains of Salmonella were 77.42 ％ (24/31) to sulfafurazole.The 31 strains of Salmonella were divided into 17 patterns by PFGE,with 100％ similarity for each pattern.All the results suggest that there are more serious problems in multiple drug resistance.The genetic variation of S.enteritidis is relatively conservative.Early warning and control on S.enteritidis are exposed to reinforce.

Objective To obtain the effective characteristic information for the standardization of diagnosis of traditional Chinese medical(TCM) syndrome in rheumatoid arthritis(RA).Methods Fifty-four items of symptoms and signs in RA patients were input into the computer,and Mahalanobis distance discriminant analysis(DDA) was used for the selection of effective indexes.Results According to the weight value and the result of T test,17 items from 54 had the highest rate of discrimination accuracy,up to 96.5%.Conclusion The results of computerized pattern recognition for the syndrome diagnosis of RA are consistent with the clinical diagnosis,which indicates that computerized pattern recognition can be used for the standardization of syndrome diagnosis of RA.