BACKGROUND:Lumbar fusion is a conventional effective measure to treat spondylolisthesis, spinal stenosis or with deformity. Bilateral pedicle screw fixation is recognized as the standard treatment for various spinal disorders, and has biomechanical and clinical advantages. OBJECTIVE:To evaluate the effects of bilateral pedicle screw fixation in the repair of lumbar disc herniation to restore disc height from the angle of imaging. METHODS: Clinical data of 42 patients with lumbar disc herniation were retrospectively analyzed. They al received bilateral pedicle screw fixation. Pain was evaluated before implantation, immediately and 1 month after implantation using Japanese Orthopaedic Association score of lower back pain and visual analog scale score. X-ray including anteriorposterior and lateral films of lumbar spine and MRI were used. CT was utilized to verify screw placement conditions and complications. RESULTS AND CONCLUSION:A total of 42 patients were folowed up for 3-6 months. Compared with pre-implantation, Japanese Orthopaedic Association score and visual analog scale score were significantly improved immediately after implantation (P < 0.01). There was no significant difference in Japanese Orthopaedic Association score between 1 month and immediately after implantation (P > 0.05). The height of intervertebral discs was significantly higher immediately and 1 month after implantation than pre-implantation (P < 0.01). The symptoms were lessened after fixation in al cases, and their qualities of life elevated. At 1 month, X-ray films and CT images revealed that no screw loosening, breakage or displacement occurred. The height of intervertebral discs was perfectly restored. No adverse events appeared in patients. These data indicate that bilateral pedicle screw fixation for lumbar intervertebral disc herniation can effectively restore the height of intervertebral discs, improve clinical symptoms and have biological and clinical superiority.

Infection by the human immunodeficiency virus (HIV) is characterized by a progressive depletion of CD4 T lymphocytes, which leads to dysfunction of the immune system. Although a variety of mechanisms may contribute to the gradual T cell decline that occurs in HIV-infected patients, abnormal apoptosis of infected or bystander T lymphocytes is an important event leading to immunodeficiency. The HIV envelope glycoprotein plays a crucial role in HIV associated apoptosis through both death receptor-mediated and mitochondria-dependent pathways. This review summarizes current knowledge of Env-mediated T lymphocyte apoptosis.

Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

BACKGROUND:Human umbilical cord blood-derived mesenchymal stem cels can be induced through the co-culture to differentiate into other cels, but how to get more seed cels for tissue engineering is one of the most difficult problems. OBJECTIVE: To investigate the role of the different concentrations of thyroxine in chondrogenic differentiation of human umbilical cord blood-derived mesenchymal stem cels by co-culture with rabbit chondrocytes. METHODS:Human umbilical cord blood-derived mesenchymal stem cels were co-cultured with rabbit chondrocytes at 2:1, and stimulated by medium containing different concentrations of thyroxine (0, 0.01, 0.1 and 1, 10 μmol/L). Co-cultured cels with no thyroxine served as control group. After 14 days of co-culture, the cel RNA and protein were extracted, mRNA expressions of aggrecan and colagen type II were detected by real-time PCR, and protein expression of aggrecan and colagen type II were detected by western blot assay. RESULTS AND CONCLUSION:After intervention with 0.01, 0.1, 1, 10 μmol/L thyroxine, the mRNA and protein expressions of aggrecan and colagen type II were enhanced with the increase of thyroxine concentration, which were significantly different from those in the control group (P < 0.05). Experimental findings indicate that high levels of thyroxine can enhance the chondrogenic ability of human umbilical cord blood-derived mesenchymal stem cels co-cultured with rabbit chondrocytes.

Objective To investigate the effects of sevoflurane anesthesia on learning and memory functions and S100β protein in anaplasis in the 7-day-old rat.Methods 48 SD rats of both sexes aged 7-day-old weighing 1 2-1 6 g were randomly divided into 3 groups (1 6 rats in each group):group A and group B inhaled 3 ％ sevoflurane in oxygen(1L/min) for 6h and 2h respectively; group C inhaled oxygen(1L/min) only.After inhalation,the effects of sevoflurane anesthesia on learning and memory function were assessed by Morris water-maze test and Y-maze test from 16d to 24d.The rats were killed in the day of 8d and 25d respectively,and the blood were collected for the expression of serum concentration S100β protein by enzyme-linked immunosorbent assay.Results (1) Results of Morris water-maze test:Compared with group C,escape latency prolonged in group A and group B in 17-20d(P ＜ 0.05 or 0.01) ;escape latency prolonged in group A compared with group B in 19-20d(P ＜ 0.01) ;but there were no significant differences in the probe time in original platform quadrant and the frequency of crossing original platform among three groups(P ＞0.05).(2) Result of Y-maze test:In 22d,the total reaction time of group A and B were longer than group C (P ＜0.05 or 0.01),and the error number was increased in group A and B compared with group C(P ＜ 0.01) ; while in 23-24d,there were no significant differences between every index of each groups (P ＞ 0.05).(3) Results of the blood serum index:In 8d,serum concentration of S100β protein was significantly increased in group A and B compared with group C (P ＜0.01),and serum concentration of S100β protein was significantly increased in group A compared with group B (P ＜ 0.05) ; But there were no significant differences in serum concentration of S100β protein of each groups in 25d(P ＞ 0.05).Conclusion Sevoflurane anesthesia in the 7-day-old rat can temporarily decrease the ability of learning and memory functions in the length of inhalation time dependent manner,and the mechanism may be related to the increased expression of serum concentration of S100β protein transiently.

Objective To explore the diagnosis and treatment of clinical possible organizing pneumonia.Methods The medical records of 31 patients with clinical probable organizing pneumonia were retrospectively analyzed.The clinical presentation,radiographic results and treatment were collected and analyzed.Results Thirty-one patients with non-response to antibiotics were preliminary diagnosed as organizing pneumonia.By percutaneous lung biopsy or transbronchial lung biopsy the tuberculosis,fungi,suppurative inflammation,lung cancer and other diseases were ruled out in 24 patients,and 7 patients were diagnosed by perfect effect of corticosteroids treatment.Twenty-one patients had typical CT findings.All the patients responded rapidly and completely to the administration of corticosteroids.Six patients relapsed after the reduction or stop of corticosteroid in a follow-up time of 6-25 months.Conclusions Non-response to antibiotics,the typical imaging findings and lung biopsy ruling out other diseases are important for diagnosing organizing pneumonia.Rapid response to administration of corticosteroids may be helpful to the diagnosis.Decreasing the dose of corticosteroid too early may cause recurrence of organizing pneumonia.

After the development of different medical social media in China was summarized , the advantages and trend of social media in medical field of China were analyzed , the challenges facing medical social media were pointed out and their countermeasures were proposed .

Objective To investigate prevalence and risk factors of pelvic organ prolapse in women underwent routine gynecologic health care in Peking Union Medical College Hospital (PUMCH).Methods From Jan.2008 to Aug.2009,972 women underwent gynecological health care in PUMCH Were enrolled in this study.Questionnaires and pelfic examinations were given.The pelvic organ prolapse quantitive examination(POP-Q)system was used as the assessment tool.Results (1)Among all participants,the mean ages were(42±10)years(range 22 to 78 years),the mean height were(162±5)cm(range 142 to 180 cm),and the mean weight were(59±8)kg(range 42 to 91 kg).83.8%(815/972)of women were multipara.The mean total vagihal length(TVL)of 972 women was 8.20 cm.No women met the standard of pelvic organ prolapse, while 35.5% (345/972) of women presented mild posterior vaginal descent and 96. 7% (940/972) presented mild anterior vaginal descent, all of them were asymptomatic. (2) The length of genital hiatus (gh), TVL and C, D proximal to the hymen in nullipara were (2.26 ±0. 32), (8.08 ±0. 30), ( - 7.08 ± 0. 24) and ( - 8. 08 ± 0. 30) cm, which were significantly less than ( 2. 33 ± 0. 39 ),( 8. 22 ± 0. 35 ), ( - 7. 14 ± 0. 28 ) and ( - 8. 22 ± 0. 35 ) cm in multipara ( P < 0. 05 ). Ap and Pb proximal to the hymen of ( - 2. 87 ± 0. 22) and ( - 2. 87 ± 0. 22 ) cm in nullipara were significantly larger than ( -2.81 ±0.25) and ( -2.81 ±0.25) cm in multipara (P<0.05). When compared with nullipara, the incidence of posterior and anterior vaginal wall protrusion were increased ( OR = 1. 819). (3) The index of POP-P were compared among women at groups of 22 -34 years, 35 -49 years and more than 50 years (P <0. 05 ). Those index did not show statistical difference between women at group of 22 - 34 years and group of 35 -49 years (P >0. 05). However, those in women at group of 22 -34 years and 35 -49 years showed statistical difference when compared with women at group of more than 50 years ( P < 0. 05 ). When compared with women at group of 22 - 34 years, the incidence of posterior and anterior vaginal wall protrusion were increased ( OR = 1. 713, 3. 765). (4) Menopause status was associated with severities of all kinds of descent ( P < 0. 05 ) and presence of posterior vaginal protrusion ( OR = 3. 354 ). Conclusions Mild anterior and posterior vaginal descent by POP-Q were common among women in China. The risk of anterior vaginal descent is relatively higher than posterior vaginal descent. However, most of the women with descent are asymptomatic and need no treatment. The most important factors associated with the severity and detectable ratio of descent is parity and age.

Objective To investigate the mechanism of different HLA-G isoform mRNA patterns in different cells alters its cell membrane expression.Methods RT-PCR was used to analyze HLA-G isoform mRNA(HLA-Gl-6)of ovarian cancer cell lines HO-8910,HO-8910PM and OVCAR-3,leukemia cell lines Jurkat,K562,HIJ60,MUTIZ-1,and the chorioeareinoma cell lines JEG-3,JAR.HLA-G between cellular membrane and intracellular expression were analyzed by flow cytometry.Results All HLA-G mRNA isoforms were observed in the positive control cell line JEG-3,but none in the negative control cell line JAR.HLA-G1 isoform mRNA was expressed in HO-8910,HO-8910PM,OVCAR-3,MUTZ-1 and Jurkat cells.HLA-G2 mRNA was not detected in any cell line but JEG-3.HLA-G3 mRNA was found in HO-8910,HO-8910PM,K562,HIJ60,MUTZ-1,OVCAR-3 and Jurkat cells.HO-8910,HO-8910PM,HIJ60,Jurkat cells expre8sed HLA-G4 mRNA.Only the Jurkat cells expressed HLA-G5 mRNA.FACS results showed that JEG3 and HO-8910PM cells membrane expressed HLA-G,however,the intraeellular HLA-G expression was detected in all tested cells except the negative control cell JAR.Conclusion Only the HLA-G1 isoform could be exDressed on cell membrane in particular cell lines. Other isoforms including HLA-C2,-G3,-G4,-G5 and HLA-G6 could not reach cell snrface.

A certain amount of image noise is increased in low-dese protocols, but image quality is still acceptable without problem in CT localization. The reduction of radiation dose and the radiation harm to patients are the superiority.