Many reasons cause low back pain, such as muscles and ligaments injury, vertebral joints retrogression, spinal canal stenosis, lumbar disc herniation, lumbar spondylolisthesis, spondyloarthritis, infection, tumor and metabolic bone disease. It is in recent years that discogenic low back pain be recognised, especially after the MRI widely applied in clinics. This article makes a summary on discogenic low back pain of recent years from etiology, pathogenesis, diagnosis and therapy.

There is a lot of drug to cure the osteoporosis.The drug effect feature is different,and clinicle choice and application is complicated,too.This paper will review the advancement of drugs and their mechanism for treating osteoporosis,including calcium and vitamin-D,estrogen,selective estrogen receptor modulators,caicitonin,bisphosphonates,parathormone and fluoride etc.

Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

AIM: Anterior cervical discectomy and Cage bone graft fusion followed by steel plate internal fixation can decompress the vertebral canal and then spinal cord in patients with multilevel cervical spondylotic myelopathy. Complete decompression is very important for such patients. This study is to investigate the effect of this technique on reconstruction of spinal function.METHODS:①Thirty-eight inpatients with multilevel cervical spondylotic myelopathy admitted to Department of Spine Surgery, Tianjin Hospital between April 2003 and February 2006 were involved in this study. The involved patients, 35 male and 3 female, were aged 43-72 years, with disease course of 0.5 to 5 years. Informed consents of therapeutic regimen were obtained from all the patients.②All the patients underwent anterior cervical discectomy and cage placement operation. The patients with destabilized combination underwent titanium-plate fixation, and those with stabilized combination underwent cage implantation alone. The cage used in the experiment was made of tetragonal polyether ether ketone (Intromed Company), and titatium-plate was Zephir plate (sofarmor Danek Company). The elastic modulus of tetragonal polyether ether ketone Cage was similar to bone tissue and could allow X-ray pass through, which was easy for postoperative fusion of implanted bone. The outer design of Cage bone graft with certain angle could allow cervical physiological antecurvature well recover; Surface radian was the same as end plate, and good fitness contributed to the good fusion rate of bone graft; The sawtooth antiskid design on the surface provided good stability immediately after implantation; Elastic modulus was between os integumentale and cancellous bone that made stress-shielding and subsidence of fusion cage reduced, and had good anticausticity and biocompatibility. ③ The clinical results were evaluated with Japanese Orthopaedic. Association (JOA) scoring system before, 2,8 and 24 weeks after operation: upper limb motor function (4 points), lower limb motor function (4 points), sensation (6 points) and bladder function (3 points). Higher scores indicated better function. Postoperatively, body examination and X-ray and MRI scanning of anteroposterior cervical vertebra were performed.RESULTS: Thirty-eight patients with multilevel cervical spondylotic myelopathy participated in the final analysis. Within postoperative several days, nervous symptoms improved obviously, muscle strength of lower limb was increased, limbs were more flexible after operation than before operation, and paresthesia of two upper limbs recovered in 38 patients. JOA was a score of (9.25±1.85) before operation, and it was (12.4±2.08) at postoperative 2 weeks, (13.2±2.07) at postoperative 8 weeks and (13.8±1.67) at postoperative 24 weeks.CONCLUSION: Multilevel discectomy and Cage implantation obviously improve sensorimotor function and lessen symptoms of patients with multilevel cervical spondylotic myelopathy.

An automated on-line solid phase extraction-liquid chromatography-tandem mass spectrometry ( on-line SPE-LC-MS/MS ) method for the simultaneous quantification of six endogenous phytohormones including abscisic acid ( ABA ) , indole-3-acetic acid ( IAA ) , salicylic acid ( SA ) , jasmonic acid ( JA ) , indole-3-propionic acid ( IPA) and indole-3-butyric acid ( IBA) in rice tissues was described. Plant samples were extracted with methanol and on-line SPE procedure was performed with C18 SPE cartridges. Analytes were eluted to C18 analytical column with mobile phase and further analyzed by LC-MS/MS. The performance of the method was fully validated. Linearity showed good correlation (R2≥0. 99). Limits of detections (S/N=3) were in the range of 0. 1-0. 8 μg/kg. Recoveries varied between 71. 2% and 126%. The method was rapid and sensitive to determine multiple phytohormones in rice young panicles and the results were cross-validated with the off-line SPE-LC-MS/MS phytohormone analytical method. Finally, the method was applied to monitor the changes of ABA, IAA, SA and JA in wounded rice leaves. The trends were in accord with plant physiological processes.

BACKGROUND:For the elderly osteoporotic thoracolumbar burst fractures without nerve root symptoms,it is difficult to choose between traditional surgical and conservative treatment,because they have their advantages and disadvantages.How to select their advantages and to discard their disadvantages? Concept of minimal invasion builds a new platform and provides a new way of thinking and therapeutic tool.OBJECTIVE:To design and develop a new thoracolumbar distraction reduction devicein vitro in the repair of elderly osteoporotic burst fractures.METHODS:We designed and developed a new type of thoracic and lumbar spinein vitrodistraction reduction device,including bracket,guide pin and two holow screws.Its characteristic is that it also contained distractor,pressurizer and wrench.In accordance with the theory of muscles as important as bones and actual anatomical condition,bone fragment in the spine canal was restored using percutaneous ligament reconstructive technique.RESULTS AND CONCLUSION:This thoracic and lumbar spinein vitro distraction reduction device combined with ligament reconstructive technique can be used in elderly osteoporotic burst fractures and elderly osteoporotic compression fractures.It is percutaneous minimaly invasive operation,can restore the height of anterior and central cylinders and correct Cobb's angle through multi angle distraction.Simultaneously,percutaneousvertebroplasty can be utilized.Bone cement was infused in the injured vertebra.According to patients' economic situation,percutaneous baloon kyphoplasty can be employed.These can provide an inexpensive,less-pain,less-invasive way to repair.

Objective To investigate the clinicopathologic features and the expression of p53,PCNA and Bcl-2in tricholemmal carcinoma.Methods Skin lesions were studied with HE staining and immunohis-tochemical markers for p53,PCNA and Bcl-2(S-P method)in22cases of skin tricholemmal carcinoma.Both morphological manifestations and immunohistochemical expression were observed.Results There were15fe-male and7male cases of tricholemmal carcinoma with the ages of40-79y,including16cases whose scalp were involved.Positive staining of p53,PCNA and Bcl-2was found in72%,100%and63%of patients,re-spectively.The positive cells of p53were diffusely distributed.PCNA-positive cells were increased along with the degree of differentiation.Significant differences of Bcl-2expression were found among the various degrees of differentiation(P

Objective To evaluate the visual function before and after photodynamic therapy(PDT) in patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Twenty-five consecutive patients (34 eyes) treated with PDT (verteporfin) for subfoveal CNV in age-related macular degeneration diagnosed by fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Visual function including best corrected visual acuity, contrast sensitivity frequency, binocular function, confusion, stereo-vision, color vision, metamorphopsis and central scotoma were examed before photodynamic therapy and 1 week, 1 month, 3 month after photodynamic therapy. The follow-up time varied from 3 months to 2 years (mean 7.6 months). Results The changes of visual function at the 3rd month after photodynamic therapy revealed improving in 13 eyes (38.24%), without any change in 17 eyes (50.00%), and decreasing in 6 eyes (17.65%). Visual acuity with logMRA improved after photodynamic therapy, but without statistic difference. All spatial contrast sensitivity improved. Contrast sensitivity for spatial frequencies 5 cycles per degree (cpd) was better after photodynamic therapy with significant difference (P=0.045).Binocular function, fusion function, stereo function and color vision were slightly improved without statistic difference. Conclusion Damage of visual function in macular degeneration is many-sided. The treatment of PDT for exudative AMD can improve part visual function.

Objective To observe the effect of scanning laser ophthalmoscope (SLO) measuring macular light sensibility on evaluating the visual function in idiopathic epiretinal membrane (IERM), and analyze the relationship among the macular light sensibility, central visual acuity, and the thickness of fovea. Methods Procedure of microperimetry of SLO was performed on 44 patients (55 eyes) with IERM diagnosed by indirect and direct ophthalmoscope and optical coherence tomography (OCT). The light sensibility at 10? macular central area was measured. The results were compared with 31 healthy control eyes which underwent the same examinations simutaneously. The correlation among the macular light sensibility, the thickness of fovea measured by OCT, and the results of logarithm visual acuity was anaylzed. Results Compared with the control eyes, macular light sensibility decreased in IERM eyes significantly (F=47.265,P

Objective To analyze the reasons and mechanisms of stereoscopic function abnormality in elder patients after the cataract extraction with intraocular lens implantation. Methods 150 cases with artificial lens implantation were randomly selected.Routine eye examinations were carried out and the associated refractive error and presbyopia were corrected.Bilateral simultaneous visual perception and fusion function were examined.The stereoscopic function was tested using "the stereoscopic function examination diagram"created by Yan Shao-ming.Ninety-seven patients who were found to have unrecover-ed or abnormal stereoscopic function were enrolled for analysis. Results In these 97 cases,53(54.6%)were found to have preexisting eye disorders that could affect visual acuity and binocular single vision before the operation.Macular problem was the most prevalent problem in this group.Twenty-seven(27.8%)patients had complicated with corneal astigmatism,after cataract,paralysing strabismus and diplopia as well as macular edema after the operation.In addition,the contralateral unoperated cataract in 17(17.5%)patients and post-operative anisometropia in 9(9.3%)patients were also the causes of stereoscopic function abnormality.There was no reason could be identified in 8 cases. Conclusions The pre-existing eye disorders before lenses implantation,complications of the operation,contralateral unoperated cataract and anisometropia are all the major factors that affect visual acuity recovery and bilateral stereoscopic function rehabilitation.