[Objective]To discuss incidence of nerve root stretch injury and threshold value of traction injury in lumbar interbody fusion from posterior rout approach. [Method]Totally patients were treated by lumbar interbody fusion performed with posterior approach using the safe nerve root retractor,the force of dragging nerve root and the retracting time were showed on the display device,while the latency and amplitude of the DSEP wave were measured with Keypoint to monitor the status of the neural function.JOA scores were followed up 10 days,1 month,3 months and 12 months after operation respectively.[Result]Nineteen cases occurred latency prolongation and wave amplitude digression during the operation,when the tensile strength to nerve root was(4.1? 0.45) N and accumulating strength was(42.89?2.96) N*min.The tensile force of aggravation groups exceed stable and improvement groups obviously,incidence of FBSS was higher than the other two groups.[Conclusion]Stretch injury of nerve root during operation is the main cause of earlier period FBSS after interbody fusion.Master single tensile force less than(4.1? 0.45) N or accumulating strength less than(42.89?2.96) N*min is presumed safety.

[Objective]To evaluate the incidence of postoperative residual numbness and the factors that influenced numbness in lumbar canal stenosis(LCS).[Method]Eighty patients with LCS including 24 males and 32 females,who were 27～78 years of age with an average age of 61.3,were operated by posterior decompression,and followed 10 days,1 month,3 months,1 year and 2 years after operation.All patients were examined by neurological findings and residual symptoms.[Result]In LCS,there were 82.1% of patients who complained numbness preoperativety.The incidence of residual numbness was 43.6%,39.1%,36.6%,35.3% and 35.7% after 10 days,1 month,3 months,12 months and 24 months,respectively.The factors that influenced residual numbness were related to stenosis types;JOA score before operation and the type of spinal canal stenosis were independent of age and nerve root diameter.[Conclusion]The lower limbs numbness recovered within 1 month postoperatlvely.The incidence of postoperative residual numbness was 35.3% and 35.7% in LCS after 1 year and 2 years.It is speculated that the potential of recovery of neural tissue is important for lower limbs residual numbness.

Objective No reports has been found to date on whether frequency compounding can improve elastographic image signal to noise ratio (SNRe) and how it affects elastogram performance.In this paper simulations investigation was carried out on transmit-side frequency compounding (TSFC)for elastography.Methods 50 mm×50 mm tissue model was simulated with two round hard inclusions of 10mm diameter uniformly distributed along the tissue central axial line,and their elasticity modulus were 10 times of the background.Then simulation of 3.5 MHz、5 MHz and 7.5 MHz probes were introduced to form compression elastography of the double-lesion model by quasi-static compression method (applied strain 1%).Then,sub-elastograms obtained by the combination of 3.5 MHz and 5 MHz,3.5 MHz and 5 MHz,3.5 MHz and 7.5 MHz were compounded,respectively.Results Before compounding,signal to noise ratio (SNRe) of the various sub-elastograms were 8.42,9.62,10.73,respectively,contrast to noise ratio (CNRe) were 11.35,14.82,18.37,respectively and axial resolutions were 9.83,9.82,9.81.After compounding elastograms,the SNRe were 11.82,13.05,19.45,CNRe were 22.31,27.63,56.12,while axial resolutions were 9.83,9.83,9.83.Conclusion Frequency compounding elastograms have higher SNRe and CNRe than any sub-elastogram before compounding and have no axial resolution loss.The TSFC can improve elastogram performance efficiently and frequency compounding for elastography enhancement is feasible.

Proposed in this paper are expanding the access channels of information resources, providing knowledge service needed by the users, and constructing a complex subjects-oriented information service team in order to keep close to the scientific research work and realize the sustainable development of information service according to the positioned function of logistic service institute and understanding of changed information needs in scientific research on logistic service in Chinese People's Police Armed Forces.

Objective To investigate the application value of perioperative enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of choledocholithiasis.Methods The clinical data of 84 patients with choledocholithiasis who were admitted to the Yijishan Hospital from January 2011 to December 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the 75 patients who were allocated into the control group and the enhanced recovery after surgery group (ERAS group) based on a random number table.All the patients underwent LCBDE,the patients in the control group received conventional perioperative management and the patients in the ERAS group received perioperative management according to enhanced recovery rehabilitation program.All the patients were followed up by outpatient interview till postoperative month 6.The clinical features,liver function and residual stones in the patients were observed.The operation time,postoperative complications,postoperative intestinal function recovery,duration of hospital stay and hospital expenses in the two groups were compared.Measurement data with normal distribution were presented as x ± s.Comparison between groups were evaluated with an independant sample t test.Count data were analyzed using the chi-square test.Results All the 75 eligible patients undergoing successful operation were randomly divided into the control group (35 patients) and the ERAS group (40 patients).The operation time and volume of intraoperative blood loss in the control group and the ERAS group were (185 ±46)minutes and (124 ±28)mL,(178 ±37) minutes and (114 ±32)mL,respectively,with no significant difference (t =0.729,1.431,P ＞ 0.05).There were 12,14 and 10 patients in the control group and 5,6 and 4 patients in the ERAS group with postoperative incision pain,vomit and infection,showing a significant difference (x2=5.054,5.966,4.241,P ＜ 0.05).The level of white blood cell,alanine aminotrausferase and direct bilirubin in the control group and in the ERAS group were (11.4 ± 3.5) × 109/L,(128 ± 33)U/L,(38 ±14) μmol/L and (10.6 ± 3.0) × 109/L,(135 ± 35) U/L,(44 ± 16) μmol/L at postoperative day 1,compared with (7.8 ±2.9) × 109/L,(48 ± 14) U/L,(21 ± 8) μmol/L and (6.9 ±2.1) × 109/L,(43 ± 13) U/L,(20 ±7) μmol/L in the 2 groups at postoperative day 4,respectively,showing no significant difference between the 2 groups (t =1.018,-0.872,-1.767,1.553,1.836,1.044,P ＞ 0.05).The postoperative first flatus day,time of food intake,time of postoperative infusion and duration of hospital stay were (42 ± 13)hour,(45 ±14) hours,(6.8 ±2.3)days and (11.3 ±4.5)days in the control group,and (35± 11)hours,(19 ±7)hours,(4.2 ± 1.8) days and (9.6 ± 2.4) days in the ERAS group,with a significant difference between the 2 groups (t =2.741,10.524,5.485,2.077,P ＜ 0.05).The total hospital expenses was (18 729 ± 3 127) yuan in the control group,which was significantly greater than (16 981 ±2 756) yuan in the ERAS group (t =2.574,P ＜ 0.05).The liver function of all the patients was recovered at the postoperative month 1.Four patients with residual stones in the 2 groups were detected by T-tube cholangiography,and were cured by removal of gallstones by choledochoscopy.There were no complications of the abdominal pain,jaundice and fever in all the patients till the end of follow-up.Conclusion ERAS combined with LCBDE for the treatment of choledocholithiasis is safe and feasible,with the advantages of low morbidity,quick recovery,short duration of hospital stay and less hospital expenses.

Objective To compare the operative results of removing large olfactory groove meningiomas(diameter≥3 cm)using either a unilat?eral or bilateral subfrontal approach ,and to determine whether there is an advantage in the unilateral approach. Methods Sixty?nine cases of large olfactory groove meningioma,treated in our department,by either a unilateral or bilateral subfrontal approach microsurgery were retrospec?tively reviewed. Removal grading,post?operative complications,and other clinical indices were evaluated. Results Total resection(Simpson Ⅰ or Ⅱ)was achieved in all the cases. There were lesser complications with use of the unilateral subfrontal approach. Conclusion Patients with ol?factory groove meningioma have a good prognosis when a unilateral subfrontal approach is used for surgery.

Objective To investigate the expression of CD26 (dipeptidyl peptidase 4) in the kidney tissues of diabetic rats and the effects of mycophenolate mofetil (MMF) on the renal CD26 expression.Methods Wistar rats were randomly divided into three groups:normal control group (NC group,n=7),diabetic model group (DM group,n=7) and MMF-treated group (MMF group,n=7).Wistar rats were fed with high-sucrose-high-fat diet and injected with streptozotocin into abdominal cavity to induce diabetes.Sixteen weeks later,blood glucose (BG),blood urea nitrogen (BUN),serum creatinine (Scr),renal hypertrophy index (kidney weight]body weight) and 24 hour urinary protein (24Upro) were measured.The number of CD37CD4+ T cells in renal tissues were measured through flow cytometry.The expression of CD26 in kidney was examined by using Western blotting and immunohistochemistry.Results Compared with NC group,BG,BUN,Scr,kidney weight/body weight,24Upro were significantly increased in DM group (P ＜ 0.05).Except BG and kidney weight] body weight,the above-mentioned parameters were lower in MMF group compared with that in DM group (P ＜ 0.05).Intrarenal CD37CD4+ T cells were significantly up-regulated in DM group compared with that in NC group (P ＜ 0.01).CD26 in renal tissue was mainly expressed in T lymphocytes of renal interstitium.CD26 expression in DM group was significantly higher than that in NC group,and also higher than that in MMF group (P ＜ 0.05).In DM group,CD26+ T lymphocytes infiltration of renal interstitium was positively correlated with 24Upro (r2=0.770,P ＜ 0.05).Conclusions CD26 is related with diabetic nephropathy.MMF maybe inhibit T lymphocytes infiltration to reduce the expression of CD26 in renal interstitium,thus protecting the kidney function.

Objective To observe the effect of epidural injection with different dose of butorphanol on the rats' neurological function.Methods A PE-530 catheter was inserted into the epidural space of all the SpragueDawley rats (male, weighting 180 ～210 g) at L1-2 level.After three days, a total of 32 rats without any motor dysfunction were randomly divided into 4 groups as follows saline(NS) group (group C, n= 8 )and butorphanol injection (B) group( B1∶ n=8;B2∶ n=8;B3∶ n=8).Rats in group C were epidurally injected NS 30 μl each ,and rats in group B1, B2 and B3 were respectively epidurally injected Butorphanol 60 μg/30μl, 120 μg/30 μl,240 μg/30 μl (all diluted with NS) ,and 1 time per day for5 days.The neurological function of rats was recorded before injection (T0) and 6h after injection on day 1 ～4(T1 ～T 4) and 6h,24h and 72h after injection on day 5 (T5 ～T7) by BBB (BASSO,BEATTIE and BRESNAHAN ) Score and the inclined plane test .Results Compared with group C ,the BBB score and the inclined plane test of group B1 showed no significant difference throughout the experimental period(P＞ 0.05 ).There was also no significant difference at T0 ～ T3 of group B2 and group B3 compared with group C (P ＞ 0.05 ), while at T4, the BBB score ( ( 18.50 ± 2.00 ) points, ( 16.38 ± 2.33 ) points) and the inclined plane test( (58.75 ± 5.17 )°, (59.38 ± 3.20) ° ) of the two groups were both obviously decreased when compared with group C( (21.00 ±0.00) points, (65.00 ±3.78)°, P＜0.05) ,and the same significant differences appeared at T5,T6 and T7 (P ＜ 0.05 ).Conclusion Repeated epidural injection of butorphanol 60 μg have no effect on neurological function of rats,while repeated epidural injection of butorphanol 120 μg and 240 μg could impaire the neurological function.

Ten glucosyloxybenzyl 2-isobutylmalates and one benzyl alcohol glycoside were isolated from the dry tuber of Pleione bulbocodioides, which is a specie of Orchidaceae family and its dry tuber is one of the main sources of traditional Chinese medicine "shanci-gu", by a combination of various column chromatographic methods, including ODS, macroporous adsorbent resin, Sepheadex LH-20, and preparative HPLC. Their structures were identified on the basis of chemical evidences and spectroscopic analysis asloroglossin (1), grammatophylloside A (2), cronupapine (3), (-)-(2R, 3S)-1-(4-β-D-glucopyranosyloxybenzyl)-4-methyl-2-isobutyltartrate (4), vandateroside II (5), grammatophylloside B (6), bis [4-(β-D-glucopyranosyloxy) -benzyl] (S) -2-isopropylmalate (7), gymnoside I (8), militarine (9), dactylorhin A (10), gastrodin (11). Compounds 1-7 were isolated from this genus for the firt time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Malates ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

This study was to investigate the chemical constituents from pseudobulbs of Pleione yunnanensis, one of the source of traditional Chinese medicine "Shancigu". The chemical constituents were isolated by various chromatography methods, including silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Fourteen compounds were isolated and identified from the EtOAc fraction of 90% ethanol extract, including five dihydrophenanthrenes, four bibenzyls, two triterpenoids, and three phenylacrylic acids. Their structures were identified on the basis of the spectral data as 4, 7-dihydroxy-2-methoxy-9,10-dihydrophenanthrene (1), 4, 7-dihydroxy-1-(p-hydroxybenzyl)-2-methoxy-9,10-dihydrophenanthrene (2), (2,3-trans)-2-(4-hydroxy-3-methoxyphenyl) -3-hydroxymethyl-10-methoxy-2,3,4,5-tetrahydro-phenanthro[2,1-b]furan-7-ol (3), pleionesin B (4), blestriarene A (5), batatasin III (6), 3, 3'-dihydroxy-2-(p-hydroxybenzyl) -5-methoxybibenzyl (7), 3', 5-dihydroxy-2-(p-hydroxybenzyl) -3-methoxybibenzyl (8), 3,3'-dihydroxy-2,6-bis(4-hydroxybenzyl) -5-methoxybibenzyl (9), triphyllol (10), pholidotin (11), (E) -p-hydroxycinnamic acid (12), (E)-ferulic acid (13), and (E)-ferulic acid hexacosyl ester (14). Compounds 5,10-14 were separated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization