[Objective]To discuss the basic principles and methods of surgical protocols in treating multilevel cervical disc herniation.[Method]The surgical protocols patients underwent operation based on patient's changes in radiology.Protocols varied from anterior approach discectomy,partial corpectomy with bone grafting and plate fixing;titanium mesh+plate;titanium mesh+plate in major segment and decompression with trepan+cage in secondary segment;combined anterior and posterior surgical procedure.[Result]Totally 96 cases of cervical spondylosis in different types were observed.After average 32 months of follow-up,an overall excellent and good rate in 90% of the cases was obtained.[Conclusion]To choose the appropriate surgical protocol for different multilevel cervical disc herniaion or degenerative myelopathy patients,every treatment should rely on patient's symptoms and changes in radiology.We must check out which vertebra is major segment or secondary segment,generalized or localized,with or without developmental stenosis of cervical spinal canal.Most patients can achieve satisfied prognosis by anterior approach decompression with bone grafting and plate fixing.Intervertebral bone grafting and plate fixing is preferred to single level degenerative.Anterior decompression with approach discectomy,partial corpectomy with bone grafting and plate fixing is preferred to 2 or 3 level degenerative.Combined anterior and posterior surgical procedure is the best method to treat generalized degenerative or obvious stenosis of cervical spinal canal,and continuous type OPLL.In conclusion,the key to excellent prognosis of cervical spondylosis is choosing the right operation for the right patient.

OBJECTIVE: Because of the widely origin, easily isolation and cultivation, the powerful multiplication ability and some other characteristics, endothelial progenitor cells have become the most important seeding cells in tissue-engineered vascular, but the condition to become a vascular in vitro, characteristics of endothelial progenitor cells and their progress in research and application in the tissue-engineered vascular deserve further study. DATA SOURCES: A computer-based online search of PUBMED database was undertaken to identify articles about endothelial progenitor cells being seeding cells in tissue-engineered vascular application published from January 1997 to July 2006 by using the keywords of "Endothelial progenitor cells,Tissue-engineered vascular,Tissue Engineering Blood Vessel" in English. STUDY SELECTION: The data were selected firstly, and quotation of each articles were read. Inclusive criteria: all articles related to the characteristics of endothelial progenitor cells and their progress in research and application in the tissue-engineered vascular were selected. Exclusive criteria: repetitive research or Meta articles were excluded. DATA EXTRACTION:Totally 136 articles were collected, of which 30 articles were associated with inclusive criteria. The 106 excluded articles were with old content or repetitive research. The 30 articles contained 8 articles on characteristics of endothelial progenitor cells, 14 articles about the advantages of endothelial progenitor cells as seeding cells in tissue-engineered vascular application, 8 articles on the application of endothelial progenitor cells construction in tissue-engineered vascular. DATA SYNTHESIS: ① Endothelial progenitor cells could be isolated from bone-marrow, peripheral blood, spleen and so on. They expressed CD133 and distinction from endothelial cells by CD133. Endothelial progenitor cells could transform to endothelial cells and smooth muscles, too. ② Endothelial progenitor cells could raise the density of capillary and the number of angiovascular. There were many research indicated that endothelial progenitor cells could improve ischemic, repair the injure of endocardium; Endothelial progenitor cells could improve reendothelialization, protect endomembrane, and hold the integrity of endomembrane; when incorporated with ischemic vascular, endothelial progenitor cells could improve patency rate and prevent restenosis. ③ With smooth muscle cells and some other materials, endothelial progenitor cells could widely applied in constructing tissue-engineered vascular and have a brilliant prospect in the tissue-engineering blood vessel. CONCLUSION: The research of endothelial progenitor cells will have a breakthrough in the expression of its vessel and the function in the organization remodeling. As one of the seeding cells, endothelial progenitor cells have widely origin and the powerful multiplication ability, and they have a brilliant prospect in the tissue-engineering blood vessel.

Objective To investigate the recent studies about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm. Methods The current literatures about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm were reviewed. Results Chlamydia pneumoniae is one of the most important factors for the formation of abdominal aortic aneurysm since Chlamydia pneumoniae can cause abdominal aortic aneurysm through the metabolism of matrix metalloproteinases, the apoptosis of smooth muscle cells in the vessels and the chronic infection of the wall of the aneurysm. Conclusion There maybe a distinguishingly close relationship between Chlamydia pneumoniae and abdominal aortic aneurysm, and Chlamydia pneumoiae may take an important role in the development and progress of the abdominal aortic aneurysm.

To study the significance of the levels of plasma inflammatory cytokines (IL-6,IL-8,IL-10 and TNF-?) in patients with acute deep venous thrombosis (DVT) of lower extremity. Methods Forty untreated DVT cases were selected as the subjects in the DVT group, while thirty healthy subjects, whose ages and genders showed no significant difference with the DVT patients, were collected as the control group. The plasma levels of IL-6, IL-8 and TNF-? were detected by radioimmunoassay (RIA), and the plasma level of IL-10 was measured by enzyme-linked immunosorbent assay (ELISA). Correlation analysis was used to investigate the relationships between the levels of different inflammatory cytokines within DVT group. Results The levels of plasma cytokines in the DVT group were all significantly higher than those in control group (P

Objective:To investigate the effects of nitric oxide(NO) and inducible nitric oxide synthase (iNOS) in the experimental abdominal aortic aneurysm (AAA) rat model.Methods:An intra-aortic elastase infusion model was used.Control rats received intra-aortic saline infusion.In the remaining groups,intra-aortic elastase infusion was used to induce aneurysm formation.These rats were treated with intraperitoneal injections of saline postoperatively(experimental group),aminoguanidine postoperatively(medicine group).Serum NO and aortic diameter were measured,Changes of histology,iNOS and MMP-9 were observed in the aortic wall.Results:Experimental group produced AAAs with significant production of iNOS,MMPs and serum NO compared with controls.In medicine group reduced aneurysm size and displayed suppression of MMPs expression,inflammatory infiltrates and serum NO production were detected.Conclusion:Expression of iNOS and MMP-9 are induced and serum NO levels are increased in experimental AAA,iNOS and NO production by iNOS play an important role with detrimental effects during experimental aneurysm development.

BACKGROUND: Angiogenesis attracts much attention in tissue engineering field. Previous research has proved that a two-dimensional culture of vascular endothelial growth factor (VEGF) promotes angiogenesis.OBJECTIVE: To evaluate the effect of VEGF on three-dimensional angiogenesis.METHODS: Endothelial progenitor cells were separated from the SD rat bone marrow. At about 70%-80% fusion, rat tail collagen gel was added to establish three-dimensional models. Samples in the experimental group were incubated in complete culture solution containing M199 culture media, fetal bovine serum, VEGF, and double antibody. The samples in the control group were incubated with VEGF-free culture media. In vitro culture and amplification of bone marrow-derived endothelial progenitor cells were determined at 1, 4, 7, and-20 days after incubation. Morphology and quantitative analysis were performed at 3, 6, 9, and 12 days after three-dimensional model establishment.RESULTS AND CONCLUSION: Endothelial progenitor cells grew from three-dimensional matrix into collagen matrix in the experimental group. Budding and infiltration were observed in the collagen within 24 hours, and branching-like structure was then gradually formed. Cells in the control group grew slowly, with slowing budding, small tubiform structure, superficial infiltration into COllagen, sparse network structure, and non-intact. Numbers of newborn vessels in the expedmental group were significantly greater than control group (P<0.01). A detection on gel block showed positive expressions of endothelin-1 and endothelial nitric oxide synthase-3 on the 3~(rd), 6~(th), 9~(th), and 12~(th) days. The results demonstrated that VEGF mobilized and induced endothelial progenitor cells in order to promote angiogenesis. Rat tail collagen gel induced endothelial progenitor cells which behaved migration, proliferation, and pullulation of angiogenesis.

Objective To evaluate the curative effect of endovascular treatment for Leriche syndrome.Methods The clinical data of 57 patients with Leriche syndrome,who were admitted to authors' hospital during the period from September 2010 to October 2014,were retrospectively analyzed.The curative effect of percutaneous transluminal angioplasty (PTA) was analyzed.Results Among the 57 patients (65 diseased limbs in total),simple PTA was employed in 2,catheter directed thrombolysis (CDT) with subsequent PTA and stenting in 5,and PTA plus stenting in 50.A total of 97 stents were implanted,the technical success rate was 100％.After the treatment,the ankle brachial index (ABI) increased from preoperative (0.42±0.22) to postoperative (0.83±0.15),the difference between the two data was statistically significant (P＜0.01).Thepatients were followed up for (9.8±2.8) months.The 6-month and 12-month primary patency rates were 95.4％ and 90.7％ respectively,the postoperative secondary patency rate was 96.4％.After the treatment,the symptoms of lower limb ischemia were improved in all patients.During perioperative period,iliac artery rupture due to balloon dilatation occurred in 2 patients,pseudoaneurysm at brachial aaery puncture point in one patient,hematoma at puncture point in 3 patients,cerebral infarction in 2 patients and myocardial infarction in one patient.One patient developed contrast-induced nephropathy and finally died of multiple organ dysfunction syndrome.The perioperative mortality was 1.75％.One patient developed in-stent obstruction in 3 months after two stage treatment,and artificial vascular bypass grafting had to be carried out.Conclusion For the treatment of Leriche syndrome,PTA is safe and reliable,it carries less complications and lower perioperative mortality with satisfactory short-term patency rate.(J Intervent Radiol,2017,26:221-224)

Objective To understand health seeking behaviors and influencing factors among freshmen before enrollment in Kunming Medical University in Yunnan Province and to find out the existing medical problems and provide advice to guarantee undergraduates' seeking proper treatment. Methods We used cluster sampling method to select 1044 freshmen whose last digit of student number was singular and questionnaire was used to do the survey which was conducted within 3 months of admission. Statistical methods were descriptive statistics and multivariate logistic regression analysis. Results The main reasons for students to see the doctor were acute diseases (29.4%) and common disease dominated by cold and fever (34.9%), most of the students went to the medical institutions because of mild medication which can be treated by taking pills. Family location for rural areas had small number of students to see the doctors, the number of students seek medical services with low income families were larger than the high counterparts;students had poor perceived health status tended to seek medical services. Conclusions Family location, incomes and perceived health status are important factors influencing health seeking behavior. The current medical insurance system for college students could be further improved, and colleges and universities should take appropriate measures to provide the conditions for students to seek proper treatment.

Objective To explore the suitable range of PT-INR for Chinese people with acute deep venous thrombosis (DVT) treated by warfarin anticoagulation therapy. Methods Eighty seven DVT patients with indications to warfarin anticoagulation therapy were enrolled into the study and divide into two groups randomly. Patients from group A (n=47) took warfarin to adjust the PT-INR to range 1.7-2. 5,and patients from group B (n =40) took warfarin to adjust the PT-INR to range 2. 0-3. 0. The therapeutic effectiveness and the incidence of bleeding complications were compared between two groups. Results Forty-six patients (46/47,98%) had limb swelling symptoms relief in group A with one exception,which was diagnosed as pelvic tumor by ultrasonography,CT and tumor markers examination later. No patient underwent bleeding in group A Thirty eight patients (38/40,93%) had limb swelling symptoms relief in group group B with two exceptions,of which one case had Cockett syndrome and the other one had unknown aetiology. The total effective rate of group B was 95% . As to the complications of this group,3 patients had slight gum and nasal mucous membrane bleeding, 1 patient developed gastrointestinal bleeding. No patients had pulmonary embolism in both groups. Conclusion For Chinese people,anticoagulation therapy of acute deep venous thrombosis to adjust the range of PT-INR to 1.7-2. 5, shows good effectiveness and significantly reduced bleeding complications.

Objective To explore the methods and the effect of the surgical treatment of patients with chronic ischemia of extremities.Methods In recent 6 years,the clinical data of 75 patients,including 7 upper(extremities) and 71 lower extremities with chronic ischemia,treated surgically were reviewed retrospectively.The surgical treatment included: traditional operation in 65 cases,interventional surgery in 4 cases and stem cell transplantation in 6 cases.Results Sixty-three patients(66 extremities) were followed up from 2 to 56 months after the surgical treatment,and the result showed that 9 extremities of 8 patients were amputated(within) 1 year(13.6%).In the other cases(83.3%),the ischemic symptoms were relieved or(disappeared),the ulcer healed or the amputating level had lowered(3.0%).The effective rate of the surgical treatment was 86.3%.Conclusions The appropriate surgical treatment of chronic ischemia limbs should be choiced based on the ischemic state of the limb,and a satisfactory result can be obtained in most patients.