BACKGROUND:Operation is an important measure to improve the function of spinal cord and to stop the pathological progress of multilevel cervical spondylotic myelopathy. There are controversies how to select the optimum operation mode, to reduce postoperative complications and to elevate clinical curative effects.
OBJECTIVE:To systematical y review patients’ profiles of multilevel cervical spondylotic myelopathy, and to evaluate the effects of simple anterior approach, simple posterior approach and one stage posterior anterior combined approach on cervical spinal curvature index and functional recovery in patients.
METHOD148 sample profiles of patients, who received multilevel cervical spondylotic myelopathy operation in The Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital from February 2000 to February 2008, and met the inclusion and exclusion criteria, were selected. They were divided into simple anterior approach group, simple posterior approach group and one stage posterior anterior combined approach group. The differences in the functional recovery were assessed after treatment using different therapeutic methods.
RESULTS AND CONCLUSION:Cervical spinal curvature index was highest in the simple posterior approach group before treatment (P<0.01). Cervical spinal curvature index was highest in the one stage posterior anterior combined approach group after treatment (P<0.01). Changes in cervical spinal curvature index were most obvious in the simple anterior approach group before and after treatment (P<0.01). No significant difference in Japanese Orthopaedic Association Scores was detected among three groups after treatment (P>0.05).
Significant differences in improvement rate of Japanese Orthopaedic Association Scores were detectable after treatment between the one stage posterior anterior combined approach group and simple anterior approach and simple posterior approach groups (P<0.001). Significant differences in cervical dysfunction index and SF-36 scores were detectable among the three groups before and after treatment (P<0.05). Results indicated that compared with the simple anterior approach and simple posterior approach, decompression through one stage posterior anterior combined approach is a reliable and effective operative procedure for treatment of multilevel cervical spondylotic myelopathy.

Objective To study the changes of insulin-like growth factor-1(IGF-1) in serum of patients with obstructive jaundice.Methods The clinical data of 20 patients with obstructive jaundice were collected and the measurement of serum TNF-?,ALT, ALP, endotoxin and IGF-1 were performed. Results The serum IGF-1 in obstructive jaundice was significantly lower than that in gallbladder stone(P

Objective To investigate the effect of butylphthalide (NBP) on H2S content and the expression of NR2B in the hippocampus of alcohol dependence rats. Methods A total of 84 SD male rats were randomly divided into 6 groups. Except for the normal group, other groups were subjected to alcohol solution with concentration of 6% ( V/V) for 28 d. Drug intervention began at the 14th day,and rats in the low,medium,high dose group were treated with NBP with a different concentration. Erden abstinence scoring was used to evaluate the rats withdrawal symptom. H2S content was measured in one side of hippocampus and CBS activity was tested in the other side of hippocampus. Hippocampus of 3 rats from each group was used to investigate NR2B mRNA level. Results Withdrawal symptom score ( 12.27 ± 1. 19),H2S content(30. 25 ±8.82), CBS activity (72. 44 ±7. 46) and NR2B mRNA expression( 19. 47 ±0. 86) in medium dose NBP group rats were lower than withdrawal symptom score(14.09 ±2.21) ,H2S content(44. 50 ±6. 65) , CBS activity(79. 06 ±4. 57) and NR2B mRNA expression (29. 13 ±1.39) in experimental control group (P<0.05). Withdrawal symptom score(12. 18 ±1.08) ,H2S content(33.00 ±5.38) ,CBS activity(67. 81 ±9. 37) and NR2B mRNA expression(23. 12 ± 1. 86) in high dose NBP group rats were lower than experimental control group (P < 0. 05). Conclusion NBP can reduce withdrawal symptoms of alcohol dependence rats,may be related to decreased expression of H2S/CBS system, and NR2B mRNA expression.

Objective:To compare the efficacy of pars plana vitrectomy (PPV) and nonvitrectomizing vitreous surgery (NVS) in the treatment of idiopathic epimacular membrane (IMEM).Methods:A prospective , randomized and comparative clinical study. From April 2019 to May 2020, 21 eyes of 21 patients with IMEM diagnosed in Chongqing Aier Eye Hospital were included in the study. Among them, 11 males had 11 eyes, and 10 females had 10 eyes. Best-corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA), and corneal, intraocular, and global aberration measurements were performed in all eyes. The international standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted into logarithm of minimum angle of resolution (logMAR) during statistics. The iTrace visual function analyzer was used to measure the corneal, intraocular and whole ocular aberrations, and the dysfunction lens index (DLI) was calculated. Lens density in Scheimpflug images was calculated using Pentacam three-dimensional anterior segment analysis and diagnosis system. The 6 mm×6 mm area of the macular area was scanned by OCTA, which was divided by the software automatically into three concentric circles with the fovea as the center, namely the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, The outer ring area of 3-6 mm was used to measure the superficial vessel density (SVD) and superficial perfusion density (SPD) of the entire macular area, the central area, the inner ring area, and the outer ring area. The patients were divided into PPV combined with epimacular membrane (MEM) peeling group (PPV group) and NVS direct peeling MEM group (NVS group) by random number table method, 10 cases with 10 eyes and 11 cases with 11 eyes, respectively. The age of the two groups ( t=-0.72), logMAR BCVA ( t=-0.98), lens density ( t=-1.10), DLI ( t=1.15), SVD ( t=0.82) and SPD ( t=1.19) of entire macular area, corneal aberration ( t=0.45), intraocular aberration ( t=-0.22), and whole eye aberration ( t=0.83), there was no significant difference ( P>0.05). All eyes were operated on with a 27G vitrectomy system. The MEM was removed from the eyes of the NVS group under NVS condition, and the MEM was removed from the eyes of the PPV group under the condition of PPV, and the operation time was recorded at the same time. The follow-up period after surgery was 12 months. Relevant examinations were performed using the same equipment and methods before surgery. Taking the last follow-up as the time point for efficacy judgment, the BCVA, lens opacity, DLI, visual quality, SVD, SPD and MEM recurrence in the macula were compared between the two groups. The two groups were compared by paired t test. Results:The operation time of eyes in PPV group and NVS group was 20.81±3.52 and 5.70±1.30 min, respectively, and the difference was statistically significant ( t=7.23, P<0.001). At the last follow-up, the logMAR BCVA of PPV group and NVS group were 0.65±0.25 and 0.44±0.20, respectively, and the difference was statistically significant ( t=-2.16, P=0.04); compared with before operation, the BCVA of eyes of the two groups was significantly improved, and the difference was statistically significant. ( t=2.52, 4.41; P=0.033, P<0.001). The lens density and DLI of the affected eyes in the PPV group and NVS group were 10.64±1.58, 6.24±3.99 and 5.77±1.63, 7.74±1.55, respectively, and the differences were statistically significant ( t=-3.90, 2.85; P<0.05). The macular area SVD ( t=1.03), SPD ( t=1.77), corneal aberration ( t=-0.42), intraocular aberration ( t=-1.10), and whole-eye aberration ( t=-1.17) of eyes of the two groups, the difference was not statistically significant ( P>0.05). During the follow-up period, there were 2 eyes with MEM recurrence, 1 eye in the PPV group and 1 eye in the NVS group; there was no significant difference in the recurrence rate of MEM between the two groups ( χ2=0.005, P=0.94). Conclusion:Compared with PPV combined with MEM stripping, the BCVA after NVS surgery increases more, has a better protective effect on the lens, and has a shorter operation time.

Tooth enamel is prone to be attacked by injurious factors, leading to a de/remineralization imbalance. To repair demineralized enamel and prevent pulp inflammation caused by biofilm accumulation, measures are needed to promote remineralization and inhibit bacterial adhesion on the tooth surface. An innovative material, poly (aspartic acid)-polyethylene glycol (PASP-PEG), was designed and synthesized to construct a mineralizing and anti-adhesive surface that could be applied to repair demineralized enamel. A cytotoxicity assay revealed the low cytotoxicity of synthesized PASP-PEG. Adsorption results demonstrated that PASP-PEG possesses a high binding affinity to the hydroxyapatite (HA)/tooth surface. In vitro experiments and scanning electron microscopy (SEM) demonstrated a strong capacity of PASP-PEG to induce in situ remineralization and direct the oriented growth of apatite nanocrystals. Energy dispersive X-ray spectroscopy (EDS), X-ray diffraction analysis (XRD) and Vickers hardness tests demonstrated that minerals induced by PASP-PEG were consistent with healthy enamel in Ca/P ratio, crystal form and surface micro-hardness. Contact angle tests and bacterial adhesion experiments demonstrated that PASP-PEG yielded a strong anti-adhesive effect. In summary, PASP-PEG could achieve dual effects for enamel repair and anti-adhesion of bacteria, thereby widening its application in enamel repair.