BACKGROUND: There have been reports at home and abroad about effects of estrogen upon the dopamine amount in substantia nigra in the midbrains while the neuroprotective effects of estrogen are still being studied.OBJECTIVE: To observe the effects of estrogen on dopaminergic neurons and explore the feasibility of preventing and treating Parkinson disease with estrogen.DESIGN: A randomized controlled study based on the experimental animals.SETTING: General neurosurgery institute in a hospital of a military medical university of Chinese PLA.MATERIALS: The trial was conducted in the General Neurosurgery Institute of Xijing Hospital,the Fourth Military Medical University of Chinese PLA from October 2003 to February 2004 with 50 healthy,first-grade Wistar rats as subjects. INTERVENTIONS: The rats were randomly assigned into 5 groups with 10in each group. Group 1 was normal control,group 2 sham-operation group,and groups 3,4,5 were ovariectomy groups. In group 3,10 μg of estradiol was administered twice a day ineach rat after ovariectomy. Each rat in group 4 was administered with estrogen antagonist,5 μg tamoxifen twice a day as well as estrogen. In group 5,only ovariectomy was performed. After stereotaxic injection of 6-hydroxydopamin into substantia nigra in the midbrains,the TH positive neurons were labeled and counted with immunohistochemic method and the rat's behavior was observed.MIAN OUTCOME MEASURES:①the circles of rat's rotation provoked by apomorphine.②the TH positive neuron count in the middrains of rat's substantia nigra 30 days after ovariectomy.RESULTS: Baseline characteristics among the groups were no difference ( P ＞ 0.05). The result of group 3 was different from that of group 5 ( P＜ 0.05 ). The result of group 4 was also different from that of group 3 and group 5 (P ＜ 0.05) . The TH positive neuron count in the midbrains ingroup 3 also differed from that in other groups( P ＜ 0.05).CONCLUSION: Estrogen acts as a neuroprotectant of the nigral dopaminergic neurons in the midbrains not only through estrogen receptor-dependent pathways but probably also through others.

BACKGROUND: The most commonly used rod-screw posterior spinal fixation system has some biomechanical drawbacks. The screw-plate system is more preferred for patients.OBJECTIVE: To prepare a new posterior spinal fixation system based on imaging results of distance between two pedicles,radian of spine flexion, extension and the height of intervertebral space of Chinese population.METHODS: The thoracolumbar data of 129 normal people were measured. According to the imaging measurements and relative documents, a device of gear-distraction plate (GDP) for spine reduction and fixation was designed. Eighteen fresh calf lumbar specimens were randomly divided into 3 groups, the test group was fixed by GDP and the other groups were fixed by CD and Steffee plate, respectively. The results of the displacement, strain, strength, stiffness and ultimate strength were measured under the states of vertical compression, flexion, extension and lateral bending respectively, and the results were statistically analyzed.RESULTS AND CONCLUSION: GDP could meet the need of strength and stiffness of human bodies. It showed superior to the CD and Steffee plate groups in strength and stiffness (P ＜ 0.05), with 13% or 14% torsion intensity greater than that of the CD or Steffee plate groups. The ultimate mechanical performance test showed that, the load bearing of the GDP group was greater than that of the CD and Steffee plate groups (P ＜ 0.05). The findings demonstrated that GDP for Chinese human presented with good biomechanical stability, which can promote vertebrae fracture union and prevent kyphosis relapses or vertebral height loses.

BACKGROUND: Amnion has been widely used in ophthalmology. Numerous studies have suggested that amnion transplantation did not induce acute immunologic rejection. These indicated that amnion transplantation can be used as a safe material for repair of dural defects.OBJECTIVE: To study the probability of freeze-dried amniotic membrane (FDAM) as a dural substitue. METHODS: Each of the guinea pigs underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura. On the right side, a piece of dura mater was removed. The dural defect was covered with a piece of FDAM. The exposed dura on the left was cut and sutured itself as control. The animals in each group were sacrificed at 15, 30, 60 and 90 days after operation, respectively. The implants were harvested and stained with hematoxylin-eosin, and histologically analyzed. RESULTS AND CONCLUSION: After operation, the behavior of all guinea pigs remained completely normal. The wound healing was achieved in all cases. No wound infection, subcutaneous effusion or cerebrospinal fluid (CSF) leakage occurred. The graft was degraded gradually and covered with a sheet of connective tissue. Dural defects repaired with FDAM showed no adhesions to the brain surface. 15 days after operation, plenty of scattered fibroblasts appeared in the dural substitute. 30 days alter dural graft implantation, parts of the implant disappeared; meanwhile the hyperplasia of fibrous connective tissue took place in the center part of the dural substitute, without the infiltration of inflammatory cells. 60 days after implantation, a majority of the dural graft was degraded, substituted by fibrous connective tissue which was of hyperplasia and low-grade degeneration, surrounded by a small quantity of giant cells. 90 days after operation, colloidal degeneration happened in the dural substitute, surrounded by ossification tissue and the degenerated fibrous connective tissue. The inflammatory cells were not discovered. The animal experiment proves FDAM to be a safe and applicable dural substitute.

Objective To study the expression of suppressor gene PTEN in gastric cancer tissues and its relationship with tumor biologic characteristics. Methods Using EnVision immunohistochemical methods, we examined the suppressor gene PTEN expression in 116 cases of gastric cancer, 35 cases dysplasia and 56 cases normal gastric mucosa specimens. Results The positive rate of PTEN (53.4 %, 62/116) was lower in gastric cancer tissue than in dysplasia (71.4 %, 25/35) and normal gastric mucosa specimens(100 %, 56/56) (P

OBJECTIVE:To excavate and evaluate the security alert signals of linezolid after marketing,and to provide refer-ence for rational drug use in clinic. METHODS:The reporting odds ratio(ROR)method was used to excavate the security alert signals from the adverse drug events(ADE)data in the OpenFDA platform of FDA during second quarter of 2004-2016. The low-er limit of 95%CI >1 was regarded as suggestive of ADE alert signal. RESULTS:A total of 6828534 reports were extracted, among which there were 7224 reports mainly induced by linezolid. Top 10 ADE reports were thrombocytopenia,drug interac-tion,thrombocytopenia,nausea,anaemia,serotonin syndrome,diarrhoea,pyrexia,drug ineffective,vomiting. After the detec-tion of top 200 ADE reports by ROR method,120 signals related to 18 system organ class(SOC)were identified. Top 5 ADE sig-nals in turn by SOC were medical examination,nervous system disorders,blood and lymphatic system disorders,metabolism and nutrition disorders,cardiac disorders. The high risk signals with clinical reference value included 42 cases of optic neuropathy (ROR=56.33),350 cases of serotonin syndrome(ROR=52.86),162 cases of lactic acidosis(ROR=18.30),31 cases of endo-carditis (ROR=15.38),566 cases of thrombocytopenia (ROR=14.29),122 cases of bone marrow failure (ROR=14.20),261 cases of panhematopenia (ROR=11.92),86 cases of disseminated intravascular coagulation (ROR=10.91),58 cases of toxic epidermal necrolysis(ROR=9.06),etc. As for ADE reports,male was slightly higher than female,and the patients in age group of ≥45 reported evidently more compared to younger age group. CONCLUSIONS:By detecting and evaluating alert signals of li-nezolid through OpenFDA platform,we could effectively lay the foundation for further research of pharmacovigilance.

ObjectiveTo analyze the relationship between pancreatic cancer (PC) and diabetes mellitus (DM),and the clinical and pathological features of pancreatic cancer in patients with DM.MethodsFrom January,2008 to December,2010,151 patients with PC and 195 comparable patients without PC were enrolled in a case-control study to analyze the relationship between PC and DM.ResultsThe OR was 5.91 (95％ CI 3.03-8.00,P＜0.05) in PC patients with DM for less than 2 years,and 1.308 (95％ CI 0.37-4.60,P＞0.05) in patients with DM for 2 to 5 years,and 1.16(95％ CI 0.44-3.19,P＞0.05) for patients with DM for more than 5 years.There was no significant difference between PC patients with and without DM in gender,age,body-mass index (BMD,obstructive jaundice,tumour location and tumour metastases (P＞0.05).ConclusionsThere was a significant correlation between PC and DM.De novo DM may be a clinical manifestation in patients with PC.PC patients with concurrent DM have no particular clinical and pathological features.

BACKGROUND:Once lumbar degenerative diseases merge with lumbar spinal stenosis, lumbar instability and degenerative scoliosis, surgical therapy is required for corresponding clinical symptoms, and the usage of internal fixators cannot be inevitable. Osteoporosis is rather common in the elderly. Therefore, how to implant stable pedicle screw fixation system in serious osteoporosis patients wil be a big difficulty. In recent years, some studies have proven the biomechanical stability of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw in the vertebral body, so it becomes very hot in the spine surgery. OBJECTIVE: To explore the clinical efficacy of the use of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis. METHODS:Thirty-one patients with lumbar degenerative disease accompanied with osteoporosis from Jun 2008 to Jan 2013 were selected, including 11 males and 20 females with an average age of 73.5 years (range, 65-86 years). There were 14 cases of lumbar degenerative stenosis, 9 of lumbar intervertebral disc herniation combined with segmental instability, 6 of lumbar degenerative spondylolisthesis, and 2 of lumbar degenerative scoliosis. The patients were treated with lumbar canal decompression, fusion and polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation according to their clinical features and imaging data. Visual analog scale for pain evaluation was used before and after fixation, the Japanese Orthopaedic Association (JOA) scale was used for assessment of neurological function and life skils before internal fixation and during folow-up. RESULTS AND CONCLUSION:Al cases were folowed up for 40 months (range, 36-48months). No screw breakage, rod breakage, screw extraction, loosening, pseudoarticulation formation, or incision infection was found. The postoperative visual analog scale score and the JOA score was remarkably improved (P < 0.05). For patients suffering from lumbar degenerative disease accompanied with osteoporosis, polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation is helpful for increasing the stabilization of screw and preventing from loosening and dislocation of the screws, and thereby beneficial for improvement and maintenance of clinical efficacy.

Objective To establish the clinical pharmacokinetics research method for Bawei Jiangu Tablet.Methods Drug blood concentration was estimated through analyzing the ingredients and preclinical pharmaceutical research results of Bawei Jiangu Tablet.Results Corresponding cardiac glycoside value in serum of animals treated with oral use of Bawei Jiangu Tablets and cortex periplocae extracts can be detected by drug monitor system of digoxin immunoreaction, which was similar to that in animals treated with digoxin.Corresponding cardiac glycoside value had also been detetected in serum of subjects in phaseⅠclinical tolerance trial,which was related to the time and dosage of administration.Clini- cal negative control trial showed that the reaction was specific.Conclusion Pharmacokinetics study on target of toxic components with cross-reaction of periplocoside is feasible through drug monitor system of digoxin immunoreaction.

OBJECTIVE: To explore the clinical effects of using custom-made tumor prosthesis replacement to treat malignant tumor located in the distal femur or proximal tibia. METHODS: A retrospective study of 29 cases malignant tumors around knee treated surgically from June 2001 to October 2008. In the study there were 19 males and 10 females, aging from 17 to 65 years, with an average of 38.5 years. The location of tumors was at distal femur in 22 cases and 7 cases at proximal tibia. After the tumor was extensively resected or radically resected, custom-made tumor prosthesis replacement was performed for reconstruction, simultaneously, neoadjuvant chemotherapy and radioactive-therapy were used in treating the tumor according the pathology. RESULTS: All patients were followed-up for 18-84 months, with average follow-up period of 54.2 months. The 3 year survival rate was 79.8%, and the 5 year survival rate was 63%. As for the complications, prosthesis breakage occurred in 2 patients, aseptic loosening in 1 patients, 2 had a recurrence of the soft tissue tumor for which the diseased limb amputation was performed. The mean MSTS score showed excellent limb function in 15 patients, good in 8 patients, fair in 5 patients and poor in 1 patient. The overall excellent and good function was obtained in 79% of the patients. No superficial or deep infection occurred. Two patients suffered common peroneal nerve injury, but were cured by symptomatic treatments. CONCLUSION: Application of tumor prosthesis can give a satisfactory functional outcome, which is an effect method in limb salvage treatment of malignant tumor around the knee.

OBJECTIVE:To investigate the general regularity and characteristics of propylthiouracil (PTU)-associated small vasculitis (ASV),and to provide reference for rational drug use in the clinic. METHODS:ADR/ADE case reports of PTU-ASV published during 1990-2016 were retrieved. The data of 118 ADR cases were analyzed statistically. RESULTS:The incidence of PTU-ASV was higher in female and was highest in 18-59 age group. Drug dose of 87 patients were within 600 mg/d,and the inci-dence of PTU-ASV was the highest within 1-5 years after medication. Main clinical manifestations were renal and lung function in-jury. After drug withdrawal,59 patients received hormone therapy,and 30 patients received hormone combined immunosuppressive agent. Finally,115 patients were recovered and 3 patients died. CONCLUSIONS:In older to reduce or avoid the occurrence of ADR,it is necessary to regularly check antineutrophil cytoplasmic antibody related indexes and evaluate the symptoms of ADR.