BACKGROUND:Due to the importance of pedicle adjacent structures, once the screw replacement appears a deviation, adjacent structures may be damaged, leading to extremely serious consequences. Although the security of screw placement in thoracic vertebral pedicle-rib complex is significantly greater than that of pedicle screws, the mechanics of the pedicle-rib complex at different cross-sectional areas of the screw are rarely reported.
OBJECTIVE:To observe mechanical property of different cross-sectional area screws in the middle and upper thoracic vertebral pedicle-rib complex.
METHODS:Five specimens of adult cadaveric thoracic spine (T 1-T 10 ) and adjacent rib segment (50-60 mm long) were used. The bone density of specimens was measured using difunctional bone density testing machine, and osteoporotic vertebral body was excluded. The position of the screws was detected with CT images. The maximal withdrawal force of the pedicle screw was measured with biomechanical force test machine.
RESULTS AND CONCLUSION:Thirty-eight specimens at normal bone density were implanted with 25 screws (5.5 mm), 25 screws (6.0 mm) and 26 screws (6.5 mm). Because the pedicle screws destroyed the pedicle-rib complex and perforated the vertebral body, we final y obtained the withdrawal force of 68 screws. The axial withdrawal force of pedicle screws at different diameters was (812.36±147.22) N, (868.64±160.48) N and (946.48±157.58) N, respectively. There were significant differences between the 5.5 mm screws and the 6.5 mm screws (P<0.05). Experimental findings indicate that, the pedicle screws (diameter>5.5 mm) are suitable in the middle and upper thoracic vertebral pedicle-rib complex due to strong internal fixation and clinical requirement.

Objective To explore the related factors and diagnostic criteria of perioperative myocardial infarction (PMI) after on-pump coronary artery bypass grafting(CABG).Methods 258 CABG patients were selected.The cardiac troponin-I in immediately,6,12,24,and 48 hours after surgery were measured.95 percentile (P95) was used as the boundary,any measured value greater than P95 was identified PMI,as group I(13 cases),the rest as group II(245 cases).The age,sex,cardiopulmonary bypass time,aortic corss-clamp time,LV ejection fraction,left ventricular end diastolic diameter,grafted vessels,left anterior descending coronary artery occlusion,recent myocardial infarction (<3 months),severe complex coronary artery disease and other risk factors that may lead to PMI were analyzed.The data were analyzed using Student's test for continuous variables and the χ2 test for discontinuous variables.Results P95 value was 3.47,the cardiopulmonary bypass time(t=3.268,P<0.05),aortic corss-clamp time(t=2.047,P<0.05),severe complex coronary artery disease between the two groups had statistically significant difference (χ2=19.846,P<0.05).Conclusion cTnI>P95 (3.47) indicates that the myocardium injury is serious,cardiopulmonary bypass time,aortic corss-clamp time and severe complex coronary artery disease are associated with PMI in patients undergoing CABG.

BACKGROUND:Thoracic lumbar segment is prone to spinal tuberculosis, caseous necrosis tissue, dead bone compression of spinal cord and nerve root may cause neurological symptoms, and the majority of them is accompanied with mild and moderate spinal kyphosis deformity. Surgical treatment of spinal tuberculosis has been frequently reported in recent years, the commonly used treatment includes lesion clearance, bone graft fusion and internal fixation. OBJECTIVE:To investigate the principle of choosing different internal fixation treatment for thoracolumbar spinal tuberculosis. METHODS:42 patients with thoracolumbar spinal tuberculosis were involved in this study from January 2001 to December 2011. Al patients suffered from waist and back pains, with the disease course range of 1 month to 7 years. Four cases showed neurological deficit before surgery. According to the Frankel classification, 1 case was graded as Frankel C and 3 cases as Frankel D. The preoperative average Cobb angle of kyphosis was 27° (range 12°-45°). The internal fixation approaches were chosen according to the tuberculose focus and vertebral fracture extent. Thoraco-abdominal approach for thoracolumbar spine via diaphragm with the removal of 11 rib and(or) 12 rib was performed for al patients. Among these protocols, 25 cases underwent anterior focal debridement and bone grafting. 17 cases had anterior focal debridement and posterior pedicle screw internal fixation (one-stage surgery in 7 cases and second-stage surgery in 10 cases). Al patients received anti-tuberculosis chemotherapy before and after operation. 36 cases used rib and 6 cases used iliac bone as bone graft. Al patients were fol owed up from 17 months to 9 years. The correction of spinal deformity, spinal stability and spinal functional recovery were observed. RESULTS AND CONCLUSION:30 patients were fol owed up after operations and the back pains disappeared. X-ray examination showed that, al patients were fixed wel without no loosening and rupture, and achieved bony fusion (the mean time were 5.4 months). No tuberculosis recurred. Four cases complicated with spinal cord injury were E grade according to the Frankel classification. The Cobb angle was 0-26° (mean 14°) at 12 months after operation. On the premise of standard anti-tuberculosis chemotherapy, various internal fixation methods can be determined according to general conditions of patients and tuberculose focus site.

Objective: To understand the epidemic status and influencing factors of Mongolian children with ASD in central and eastern Inner Mongolia, so as to provide data support for formulating prevention and intervention strategies and improving the overall epidemiological investigation of ASD in Inner Mongolia. Methods: Sixteen kindergartens and primary schools were selected from Chifeng City, Ulanqab City, Tongliao City, Hulunbuir City and Xilingol League cities in Inner Mongolia by means of random cluster sampling. Firstly, 7 108 children aged 3-14 were initially screened with the Kirschner Autism Behavior Scale(CABS), and then the children with ASD positive were given the autism behavior test scale (ABC). According to the diagnostic criteria, the professionals, including chief physicians and associate chief physicians from the major of child psychiatry, diagnosed ASD with the total score of ABC scale ≥62. Univariate and Logistic regression multivariate analysis were carried out among Mongolian children to find out the influencing factors related to the occurrence of Mongolian ASD in Inner Mongolia. Results: The prevalence of Mongolian children was 0.37%. Mongolian ASD group and Mongolian normal children series in the household register, habitual twitch, hyperactivity, bite lips, families have extreme introverts, mothers age, father s cultural level, cultural degree of mother, father mother mild character, irritable, neonatal diseases, fetal gestational age distribution had statistical significance( χ 2/Z= 12.58 , 16.68, 14.93, 64.43, -3.76, -2.86, 4.57, 11.12, 12.33, 16.66, P <0.05). Conclusion Measures such as shaping a healthy growth environment, adjusting parental style, paying attention to the level of early childhood language development, and preventing neonatal diseases might lower the risk of ASD in children.

AlM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds ( CMBs) and discuss its clinical significance.
METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76. 3 ± 11. 2 years old. For all patients, functions of liver and kidney, blood - lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent ( RAE) , retinal venular equivalent ( RVE) , retinal vein diameter ratio ( AVR) and arteriovenous crossing sign ( AVN ) were identified, CMBs were classified with cerebral MRl. All the data were processed by SPSS statistical software.
RESULTS: The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and AVR values in the eyes were found no statistical difference (P<0. 05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation ( P<0. 01). The higher CMBs classification, the more obvious retinal microvascular changes were found. ln respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification.
COCLUSlON: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

Objective To evaluate the condition of rebuilding stove for preventing coal-buming fluorosis in Ankang City of Shaanxi Province in 2006.Methods Guided by local health administration department in Shaanxi.five counties-Zhengping,Langao,Hanyin,Ziyang,Shiquan-were chosen as rebuilding stove regions in Ankang City.Fifteen housewives were chosen randomly in each village in each county,they were quizzed for the knowledge of health.Fifty students were chosen randomly in each school in each county,they were quizzed for the knowledge of health too.Data of rebuilding stove were refferred.Results Ninty-seven point two per cent(243/250)of the ovens were appropriately sealed,96.8%(242/250)were efficiently exhausted,the rate of oven correctly used was 97.2%(243/250),the awareness rates of healthful knowledge were 85.6%(214/250)in adults and 97.8%(485/496)in children.Data of rebuilding stove were documented systemically,completely and precisely.ConelusionFive model counties in Ankang City have fulfilled the demand.

Objective To investigate the frequency of CD4~+CD25~+FoxP3~+regulatory T cells (Treg)and the expression of the functional protein,FoxP3,in patients with active tuberculosis and the relationship between Treg and the pathogenesis of tuberculosis.Methods Forty-five patients with active tuberculosis(including 25 cases of pulmonary tuberculosis and 20 tuberculous lymphadenitis), 20 healthy controls,20 recovered tuberculosis patients and 6 patients with reactive hyperplasia in cer- vical lymph node were enrolled.The frequency of CD4~+ CD25~+ FoxP3~+ Treg in the peripheral blood was measured by flow cytometry.FoxP3 mRNA expression was determined by real-time reverse transcriptase-polymerase chain reaction(RT-PCR)and the expression of FoxP3 protein in lymphoid tissues was measured by immunohistochemistry.Results The frequency of natural Treg in the peripheral blood from the patients with active tuberculosis was 2.91%?0.23%,which was signifi- cantly higher than that of healthy control group(1.22%?0.18%)and recovered tuberculosis patients(1.50%?0.17%,P

Objective: To understand the prevalence and influencing factors of children with ASD in central and eastern Inner Mongolia, and to provide theoretical basis for disease prevention and prevalence of ASD. Methods: Sixteen primary schools and kindergartens were selected from 5 cities in central and eastern Inner Mongolia through random cluster sampling. A total of 15 817 children aged 3-14 years were selected. Children who were positive using Clancy Autism Behavior Scale were further diagnosed according to the teacher s nomination form and the Autism Behavior Checklist, as well as the diagnostic criteria of the fifth edition of the American Diagnostic & Statistical Manual of Mental Disorders by 2 professionals. Results: The prevalence of ASD was 0.27% (42/15 817), with prevalence in urban areas (0.16%, 15/9 231) higher than that of rural areas (0.41%, 27/6 586) ( χ 2=8.89, P <0.01). Logistic regression analysis showed that maternal education and language development were negatively associated with ASD in urban children [ OR =0.29(95% CI =0.12-0.69) and 0.18(95% CI =0.05-0.60), P <0.05]. ASD in rural children were positively associated with enuresis and introverted family members [ OR =7.09(95% CI =1.60-32.27) and 8.63(95% CI =3.10- 24.01 ), P <0.05]. Conclusion High prevalence of ASD is found in urban area of central and eastern Inner Mongolia. Unhealthy habits, neonatal diseases, low parental education, delayed language development and poor exercise performance are primary factors associated with ASD in both urban and rural areas.

Aim To determine the effect of exosomes from lipopolysaccharide-treated human bone marrow mesenchymal stem cells on proportion of Ly6Chigh and Ly6Clow monocytes/macrophages in inflammatory micro- environment. Methods BMSCs were obtained by gra-dient centrifugation, identified and then treated with li-popolysaccharide for 48 h. The exosomes were purified from conditional medium with or without LPS treatment and identified by CD63 protein using Western blot and transmission electron microscope. The diameters and concentration were detected by Nanoparticle Trafficking Analysis ( NTA ) . The monocytes/macrophages were sorted from bone marrow of the mice by magnetic beads. Cells were co-cultured with exosomes for 24 hours, and then treated with LPS for 48 hours. The proportion of Ly6C monocytes/macrophages was detec-ted by flow cytometry. Inflammatory cytokines in cell supernatant were investigated using ELISA. Results BMSCs surface markers CD44, CD90 were positively detected, but CD34, CD45 were not expressed. BM-SCs presented adipogenic differentiation ability. Exo-somes were positively expressing CD63 protein, and NTA showed that the diameters of exosomes were up to (82.4 ± 3.7 ) nm. BMSCs stimulated by LPS pro- duced more exosomes ( P < 0.01 ) . Exosomes from BMSCs with or without LPS treatment could increase the ratio of Ly6Chigh monocytes (P<0.01) and down-regulate the ratio of Ly6Chigh macrophages (P<0.05), and the effect of LPS treated-exosomes was more signif-icant than untreated-exosomes (P<0.05). Moreover, the concentration of IL-6 was also elevated under exo-somes treatment ( P <0.05 ) . Conclusions Human bone marrow mesenchymal stem cells-derived exosomes contribute to the regulation of Ly6Chigh monocytes/mac-rophages, indicating that they could be involved in the therapeutic treatment of inflammatory diseases.

OBJECTIVETo observe the effect of different concentration of Tamoxifen ointment on the fibroblasts and transforming growth factor (TGF-beta2) of hypertrophic scar at rabbit ears, so as to explore the possibility of treatment of hypertrophic scar with Tamoxifen.

METHODSThe hypertrophic scar model was established in 96 New Zealand rabbits' ears. The wounds were divided into four groups (A, B, C and D), with 144 wounds in each group. Different concentration of tamoxifen ointment (0.5%, 1%, 2%) was topically administered in groups A, B and C respectively, and blank ointment in group D. On postoperative day 30, 60 and 90, the scar samples were harvested. The scar thickness, scar histological change and the content of TGF-beta2 were detected.

RESULTS(1) On the 30th day after operation, the difference of scar tissue thickness among groups A, D and B, C reached statistical significance (group A, D < group B < group C). However, there was a contrary tendency in fibroblasts density and TGF-beta2 content of the scar tissue simultaneously. (2) On 60th, 90th day after injury, there was statistical difference in scar thickness, fibroblasts density and the content of TGF-beta2 in scar of four groups (P < 0.05). The content of TGF-beta2 in group A, B, C, D was (43.97 +/- 3.63) microg/L, (41.92 +/- 3.91) microg/L, (36.69 +/- 4.15) microg/L, (54.90 +/- 4.71) microg/L, respectively, on 60th day; and (45.69 +/- 2.63) microg/L, (40.43 +/- 3.87) microg/L, (38.76 +/- 3.24) microg/L, (52.59 +/- 4.92) microg/L, respectively, on 90th day. The fibroblasts density of scar in groups A, B, C, D was (4392.07 +/- 327.84) point/mm2, (4208.57 +/- 329.76) point/mm2 (4 033.44 +/- 427.91) point/mm2, (4863.03 +/- 387.98) point/mm2, respectively, on 60th day; and (4418.41 +/- 432.52) point/mm2, (4077.65 +/- 386.70) point/mm2, (3844.53 +/- 354.29) point/mm2, (4838.64 +/- 390.52) point/mm2, respectively, on 90th day. The content of TGF-beta2 and fibroblasts density of scar were lined up as group D > group A > group B > group C (P < 0.05).

CONCLUSIONSTopical Tamoxifen can reduce the content of TGF-beta2 and fibroblast, decrease fibroblasts density and the formation of hypertrophic scar at rabbit ears. It offers a new way for the treatment of the hypertrophic scar.

Animals ; Cicatrix, Hypertrophic ; drug therapy ; metabolism ; pathology ; Disease Models, Animal ; Ear Diseases ; drug therapy ; metabolism ; pathology ; Fibroblasts ; drug effects ; pathology ; Ointments ; Rabbits ; Tamoxifen ; pharmacology ; Transforming Growth Factor beta2 ; metabolism