Objective To explore the clinical outcomes of the removal of nucleus pulposus with vertebral lamia fenestration in the treatment of lumbar disc herniation.Methods A total of 5482 patients with lumbar disc herniation were performed to remove nucleus pulposus with vertebral lamia fenestration.The follow-up study was conducted in 4329 cases for the duration varying from 6 months to 20 years,averaging 6.7 years,and the therapeutic effect of the operation was evaluated.Results After operation,the patients could walk in(3?2) days,resumed their daily activities in (15?6) days and went back to work in(28?9) days.According to the Nakai scale,excellent results were achieved in 3374 cases(77.9%),good in 652 cases(15.2%),improved in 249 cases(5.8%) and poor in 54 cases(1.1%).The rate of excellent and good results was 93.1%.Conclusion The advantages of the removal of nucleus pulposus with vertebral lamia fenestration are the removal of the annulus fibrosus,the calcified ligamentum flavum and osteophyte under direct vision.The operation may preserve the utmost integrity of the posterior lumbar structures,and the operative treatment has shown its good results.

Virtual reality is a technology to simulate the real world by computer, with 3 characteristics of immersion, interaction and imagination. It is a new method applied to gait rehabilitation after stroke. This article briefly introduced the characteristics of virtual reality, and the value for rehabilitation in stroke patients. The recent development of the studies on virtual reality in gait rehabilitation for stroke was summarized, mainly included the advantages of virtual reality technology, virtual reality hardware devices applied to the gait rehabilitation, and its therapeutic effect.

The synaptic organization of monoaminergic and peptidergic fibers in the lateral horn of the rat spinal cord was studied under electron microscopy by immunocytochemistry ABC method. TH, 5-HT, SP and L-ENK immunoreactive fibers in the lateral horn were unmyelinated. In the cell clusters of the lateral horn these fibers appeared in the space between cell bodies and some pressed on the soma, but axosomatic synapses were seldom found. Many immunoreactive fibers ran along the dendrites, especially in the dendritic bundle. Occasionally a small bundle of unmyelinated fibers all contained the same kind of substance. Majority of the immunoreactive boutons formed axodendritic synapses. All the four kinds of neuroactive substancecontaining boutons or varicosities contained almost round clear vesicles or plus a few large granular vesicles. The SP and L-ENK varicosities included more large granular vesicles than the boutons did. Both symmetrical and asymmetical contacts were encountered in TH, 5-HT, SP and L-ENK boutons.

The ultrastructural characteristics of the lateral horn of the cat and rat revea-led by present study included:(1)The neurons of cell clusters in the lateral hornwere fusiform or oval,oriented rostrocaudally and possessed similar fine structures.The dendrites often protruded from the rostral and caudal poles of the cell bodies.The synapses on neuronal somata were sparse,for usually only 0-5 buttons contac-ted the plasmalemma in each neuronal profile.A little amount of neuropil existedbetween cell bodies in the cell clusters,even sometimes the plasma membranes ofadjacent cell bodies apposited directly.(2)Most dendrites in the lateral horn ranlongitudinally and paralleled with one another.Numerous dendrites aggregated inthe ventral part of the cell clusters,constituting a dendrite bundle in which adja-cent dendrites apposited directly and were surrounded by glial processes.(3)Manyunmyelinated fibers and fiber bundles ran longitudinally in the lateral horn.Theywere parallel with the neuronal and dendritic profiles.Unmyelinated fiber bundlesconsisted of the fibers with diameter less than one micron,and their terminal bottonsoften compacted together.(4)The majority of the synapses in the lateral horn wereaxodendritic synapses.A small number of axosomatic and axoaxonic synapses werefound,occasionally synaptic glomeruli and serial synapses were observed.Most ofthe buttons contained round clear vesicles and some plus a few granular vesicles.

Objective To investigate the cosmetic results of endoscopic thyroidectomy via areola of breasts approach.Methods The incision was chosen to be along the areolar margin.One 12 mm incision was made at 3-clock position of the right areolar to introduce a 30? flexible laparoscope.Another 7 mm incision was made at 9-clock position of the right areolar for a grasping forceps.An additional 12 mm incision for the performance of ultrasonic scalpel was made at 11-clock position of the left areolar.Subcutaneous tissues were separated to create enough space for partial or subtotal thyroidectomy according to patient's conditions.Results The surgery was finished successfully in all 10 cases.The operation time ranged 110~230 min(mean,140 min).The estimated blood loss ranged 3~15 ml(mean,9 ml).There were no surgical complications after operation.Follow-up checkups for 3~5 months(mean,3.5 months) in 10 cases showed inconspicuous scars and no recurrence.Conclusions Endoscopic thyroidectomy via areola of breasts approach is a feasible and safe procedure with satisfactory cosmetic results.

Objective To establish a method for the isolation and culture of bone marrow derived mesenchymal stem cells (MSCs) from patients with coronary artery disease and investigated its biological characteristics. Methods Bone marrow was extracted from patients' sternum when they were operated for coronary artery bypass graft. MSCs were separated from bone marrow by density gradient centrifugation in Percoll solution and seeded in culture medium supplemented with 10% fetal bovine serum. The morphology and growth characteristic of MSCs were observed in primary and passage generation culture with inverted microscope. The cell phenotype and cell cycle of MSCs were analyzed by flow cytometry. The growth curves were compared between different passages and ages. Results Most adherent MSCs showed spindle morphology whatever passages they were. The MSCs could be expanded for 15 passages. The proliferative potential of MSCs over the fifth passage or from old patients decreased gradually. The MSCs in primary and passage were positive for CD29 and CD44, but negative for CD34 and CD45. Analysis for cell cycle showed most MSCs in G_0/G_1 phase. Conclusion The method of isolation and culture of sternum bone marrow derived MSCs from patients with coronary artery disease is feasible, the MSCs have self-renewal capacity and might be ideal for cellular cardiomyoplasty.

OBJECTIVE:To observe clinical efficacy and safety of nitric oxide (NO) combined with sildenafil in the treatment of neonatal pulmonary hypertension. METHODS:66 cases of neonatal pulmonary hypertension were selected and randomly divided in-to observation group and control group,with 33 cases in each group. 2 groups of patients were given Dopamine injection 5 μg/(kg· min),ivgtt. Control group was given NO 5-20 ppm;observation group received oral or nasal feeding of Citric acid sildenafil tab-lets,0.5-1.0 mg/kg,96 h,on the basis of control group. Both group received 3 d of treatment. Clinical efficacy of 2 groups were observed as well as the level of PaO2,PaCO2,SaO2,PAP,NO,ET-1,HIF-1α,EPO and Ca2+before and after treatment. The inci-dence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 96.97%,which was sig-nificantly higher than that of control group(75.76%),with statistical significance(P<0.05). There was no statistical significance in the levels of PaO2,PaCO2,SaO2,PAP,NO,ET-1,HIF-1α,EPO and Ca2+between 2 groups before treatment(P>0.05);com-pared to before treatment,PaO2,SaO2,No and Ca2+ levels of 2 groups increased significantly after treatment,while PaCO2,PAP, EPO,HIF-1,ET-1 significantly lowered and the observation group was better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Sildenafil combined with NO is effective in the treatment of neonatal pulmonary hypertension and can effectively improve pulmonary hypertension and blood gas indexes with good safety.

Objective To establish a standardized mouse myocardial infarction model,and non-invasively evaluate its cardiac function by using the echocardiography.Methods A total of 20 wild male mice were enrolled into this study.The left anterior descending coronary was ligated through the left fourth intercostal space after intubation.The echocardiographic assessment of myocardial infarction and heart function was performed 3 days preoperatively and 2 weeks postoperatively.The shortening fraction(FS),end systolic dimension(ESD),and end diastolic dimension(EDD) was recorded and analyzed.Results The acute and one-week mortality rates were 20%(4/20) and 40%(8/20),respectively.The echocardiography showed that the myocardial infarction model was successfully established in 10 mice.The heart function of the mice was markedly impaired.The FS significantly decreased from(50.23?8.36)% to(25.41?0.97)%(t=16.18,P

Objective To explore the clinical features of systemic onset of juvenile idiopathic arthritis (SoJIA) with atlantoaxial subluxation as the initial manifestation. Methods The clinical data from one SoJIA patient with atlantoaxial subluxation as the initial manifestation were retrospectively analyzed. Results A 9-year-old boy presented the head and neck movement disorder as the ifrst symptom, developed fever on the third day, then rapidly progressed on 23rd day, with a sharp decline in red blood cell, platelet, and hemoglobin, blood coagulation dysfunction, and a large number of bilateral pulmonary exudation. Ultrasonography showed excess lfuid in abdomen, chest, and pericardium. According to the 2001 version of the revised International College of Rheumatology standard, the diagnosis of SoJIA combined macrophage activation syndrome was conifrmed. Then treated with hemoperfusion, ifltration, and methylprednisolone combined with cyclosporine A, the disease was in remission. Conclusion For children with spontaneous atlantoaxial subluxation accompanied by the systemic symptoms, with no obvious skeletal deformity or acute inlfammation etc., should be alerted to the consideration of systemic juvenile idiopathic arthritis.

Objective:To explore the effect of 1,25-dihydroxyvitamin D3 on the mast cell tryptase (MCT) in asthmatic guinea pigs. Methods:A total of 60 male or female healthy guinea pigs were randomly divided into control group (group A), asthmatic group(group B), and 1,25-dihydroxyvitamin D3 group(group C), with 20 cases in each group. To establish asthmatic guinea pig models, 1ml peanut oil was filled into stomach in the morning in group A and group B , and 1ml peanut oil with 1,25-dihydroxyvitamin D3 was filled into stomach in group C. Airway resistance (Re) of asthmatic guinea pigs was detected, and the bronchoalveolar lavage fluid (BALF) cells were counted. Lung tissue with HE and MCT immunohistochemical staining were used to observe the pathological changes in lung tissue and the distribution of MCT. Results:After injection of different concentration of acetylcholine chloride, the Re in group B and group C were increased significantly compared with group A (P<0.05);compared with group B, the Re in group C were decreased significantly (t=-5.385, -5.761, -6.184,-13.574, P<0.05);the total number of BALF cells and eosinophils were increased significantly in group B and C (t=19.618, 9.598, 10.854, 5.388, P<0.05);compared with group B, the total number of BALF cells and eosinophils in group C was decreased significantly (t=-5.555,-5.392, P<0.05);the number of tryptase positive cells in group B was increased significantly than that in group A (t=21.312, P<0.05), and in addition to the alveolar septum and submucosa, the cells were also distributed around blood vessels and outside the cells; the number of tryptase positive cells in group C was decreased significantly compared with group B, and the difference was statistically significant (t=5.043, P<0.05). Conclusions:After the asthmatic guinea pigs are treated with 1,25-dihydroxyvitamin D3, their BALF, Re, infiltration degree of inflammatory cells in the trachea and lung tissue and airway inflammatory reaction are reduced significantly. 1,25-dihydroxyvitamin D3has a certain inhibiting effect on the activation of mast cells and the release of MCT granules.