Objective To investigate the relationship and mechanism between the serum level of high mobility group box protein-1(HMGB1)and the mortality rate in patients with sepsis.Methods The serum levels of HMGB1,superoxide dismutase(SOD)and malondialdehyde(MDA)in 48 patients with sepsis were determined.The clinical outcomes in those patients were recorded and anlyzed.Results After the onset of sepsis,the serum HMGB1 levels of both death group and survival group were increased gradually and peaked at 72h after the onset of the disease.The semm HMGB1 levels of death group were much higher than those of survival group except at 24h(t=6.07,6.20,24.43,all P＜0.05).The activity of serum SOD of death group was markedly lower than that of survival group at 12h,24h,48h and 72h(t=10.24,20.61,11.67,33.33,all P＜0.05),and the level of serum MDA of death group was significantly higher than those of survival group at all time points(t=26.06,22.17,23.86,9.49,5.95,all P＜0.05).There was a significantly positive correlation between the serum HMGB1 and MDA level.Conlusioa The increase in serum HMGB1 level may be the important reasoll for the increased mortality rate in patients with sepsis;Oxidant/antioxidant imbalance may be olle reason for the increase in serum HMGB1 level.

Objective To establish L4 vertebrae burst fractures and take a biomechanical test of different internal fixations so as to discuss the significance of internal fixation using short-segment plus Index-level screws in treatment of low lumbar burst fractures.Methods Ten fresh human lumbosacral vertebrae specimens were used to establish models of L4 vertebrae burst fractures by corpectomy and partial removal of ligament.Thereafter,the biomechanical test was performed in order as below:longsegment fixation,short-segment fixation and short-segment construction plus Index-level screw fixation.Differences of range of motion (ROM) of the lumbar after three different internal fixations were compared.Results Compared with short-segment fixation,short-segment plus Index-level screw fixation showed that ROM of the lumbar was decreased in front flexion,axial rotation and lateral bending (P ＜ 0.05),but stability was improved and ROM of lumbar was decreased by 32.7％ in back extension (P ＞ 0.05).Conclusions Compared with short-segment fixation,the short-segment plus Index-level screw fixation can increase initial lumbar stability by average 32.5％ in treatment of low lumbar burst fractures.In the meantime,short-segment plus Index-level screw fixation provides larger ROM of the lumbar than the long-segment fixation.

BACKGROUND: The development of safe and powerful antidepressant agents from traditional Chinese herbs has become a hotspot in studies on anti-depression therapy. OBJECTIVE: To investigate the anti-depressive effect and possible mechanism of curcumin by behavioral and neurochemical procedures. DESIGN: Randomized grouping design and controlled experiment. SETTING: Depart, ment of Pharmacology, School of Basic Medical Sciences of Peking University.MATERIALS: This study was carried out in the laboratory of the Department of Pharmacology, School of Basic Medical Sciences of Peking University, between November 2003 and October 2004. A total of 240 male ICR mice were recruited. METHODS: The whole experiment was divided into 4 tests. ① Antagonism of reserpine-induced hypothermia: Totally 60 mice were randomly chosen and divided into 6 groups: normal control group, groups of various doses of curcumin (1.25, 2.50, 5.00 and 10.00 mg/kg), and positive control group (imipramine 10 mg/kg). Normal temperature of the mice was measured before experiment. The animals were given a single injection of reserpine (2.5 mg/kg). The mice were administered with drugs 18 hours later, namely, curcumin of different concentrations by gastric perfusion, groundnut oil (0.1 mL/10g by gastric perfusion) as well as imipramine (10 mg/kg by intraperitoneal injection). Rectal temperature was measured 60, 90, 120,150 and 180 minutes after administration, respectively. ② Potentiation of 5-hydroxytryptophan (5-HTP)-induced head twitches: animal grouping was the same as above, and the drug in positive control group was replaced by fluoxetine. The mice received gastric perfusion and the dose of curcumin given was the same as above. Groundnut oil and fluoxetine (10 mg/kg) and 5-HTP (70 mg/kg) were injected into the vein of the tail one hour later.The number of head twitches was counted within 5-10 minutes after 5-HTP treatment. ③ Antagonism of apomorphine-induced hypothermia: Mice grouping was the same as above; the drug in positive control group was replaced by imipramine. Curcumin was give as above at 4 doses, and groundnut oil and imipramine were also given. Large-dose apomorphine was injected subcutaneously (16 mg/kg). Rectal temperature was measured before injection, as well as 30 minutes and 60 minutes after injection. ④Determination of monoamine and metabolites: Mice grouping was the same as above. The drug in positive control group was replaced by imipramine.Curcumin was give as above at 4 doses, and groundnut oil and imipramine were also given. The content of monoamine and metabolites in the mice was measured with high performance liquid chromatography. ⑤ Dunnett's t test was used for comparison between groups.MAIN OUTCOME MEASURES: ① In reserpine-induced hypothermia test, the change of body temperature before and after administration. ② In 5-HTP-induced head twitches test, whether the times of head twitches were increased. ③ In apomorphine-induced hypothermia test, the change of body temperature after administration. ④ Effect of drugs on the content of monoamine.RESULTS: Totally 240 mice entered the result analysis. ① Experiment results of reserpine-induced hypothermia: Curcumin (5 mg/kg and 10 mg/kg)produced an antagonism against reserpine-induced hypothermia, and the results were significantly different from those in control group (P ＜ 0.05,P＜0.01). Curcumin of 10.00 mg/kg produced the similar effect compared as that of imipramine in positive control group. ② Results of 5-HTPinduced head twitches: Curcumin (5 and 10 mg/kg) could significantly increase the times of 5-HTP-induced head twitches (P ＜0.05, P＜0.01). ③Results of apomorphine-induced hypothermia test: 2.50, 5.00 mg/kg and 10.00 mg/kg of curcumin could significantly increase the content of 5-HTP, and 10 mg/kg of curcumin could significantly increase the content of norepinephrine and dopamine. There was significant difference from that in control group (P ＜ 0.05). By contrast, curcumin had no obvious effect on the content of metabolite 5-hydroxyindol acetic acid and 3,4-dihydroxyphenylacetic acid. Imipramine of 10 mg/kg as the positive control drug could significantly increase the content of 5-hydroxyindol acetic acid and norepinephrine (P＜0.05).CONCLUSION: Curcumin has an antidepressant effect and the effect exerted may be related to monoaminergic neurotransmitter system.

Objective To investigate the feasibility of construction of tissue engineering nucleus pulposus by com?bining the novel silk fibroin porous scaffold with PKH26 labeled rabbit nucleus pulposus cells. Methods Rabbit nucleus pulposus cells were isolated and cultured, then the passage 1 nucleus pulposus cells were stained with safranin O and typeⅡcollagen immunohistochemical staining. The isolated rabbit nucleus pulposus cells were labeled with PKH26. MTT assay was used for examining the proliferation of the nucleus pulposus cells before and after labeling. Labeled cells were inoculat?ed in the scaffold, cultured for 4 days and then the cell-scaffold complexes were implanted subcutaneously into nude mice. After 12 weeks of in vivo culture, the cell-scaffold complexes were detected by in vivo imaging technology, H&E staining, toluidine blue staining, safranin O staining and collagen typeⅡimmunohistochemical staining. Results Safranin O stain?ing and typeⅡcollagen immunohistochemical staining of the passage 1 nucleus pulposus cells were positive. The fluores?cence intensity of labeled cell was distributed, and the difference of OD value of nucleus pulposus cells was not statistically significant before and after labeling (P>0.05). The in vivo imaging technique showed a strong fluorescencea in porous scaf?fold. H&E staining of cell-scaffold complexes showed that the scaffolds were filled with a large number of nucleus pulposus cells and large amount of extracellular matrix. Toluidine blue staining, safranin O staining and typeⅡcollagen immunohisto?chemical staining were positive, and large amount of extracellular matrix was secreted around the cells. Conclusion The new silk fibroin porous scaffold with rabbit nucleus pulposus cells in vivo culture formed nucleus pulposus like tissue, which can be used for construction of tissue engineering nucleus.

Objective To fabricate a silk fibroin scaffold with biomimetic oriented microstructure using the directional crystallization technology, and to evaluate the possibility of application to the cartilage tissue engineering. Methods The silk fibroin scaffold with biomimetic oriented microstructure was made by the directional crystallization technology. The structure of scaffold was observed by the scanning electron microscope, and the pore size, porosity and mechanical properties were calculated. Adipose-derived stem cells were isolated from rabbit, and the passage 3 was seeded into the scaffold. The cell proliferation was detected by CCK8 method. The cell adhesion ability was observed by HE staining and scanning electron microscope. The cell viability was observed by LIVE/DEAD staining. Results The scanning electron microscopy showed that the parallel microtubule-like structure can be seen arranged in longitudinal section of the scaffold, which had a uniform directivity, and also the elliptical or circular pore structure in cross-section. The scaffold had a good pore interconnectivity with (112.43±12.65) μm pore diameter of the cross-section, (90.25±2.05)%porosity and (52.48±5.78) kPa the compression modulus. HE staining and scanning electron microscopy demonstrated that the cells uniformly adhered to the surface and inner pore, and which secreted lots extracellular matrix distributed in the oriented microstructure. Results of CCK8 showed that the good cell proliferation on the scaffold, and the LIVE/DEAD staining indicated that the cells were maintained good viability. Conclusion The silk fibroin scaffolds have a biomimetic oriented microstructure, and show good pore diameter, porosity, biocompatibility and biomechanical properties, which made it a suitable candidate as an alternative scaffold for cartilage tissue engineering.

Objective To evaluate the clinical efficacy of treatment of severe thoracolumbar burst fractures by posterior short-segment instrumentation without spinal fusion and assess radiographic imaging and function recovery after surgery.Methods Thirty-eight patients with severe monosegmental thoracolumbar burst fractures treated between July 2011 and March 2013 were analyzed retrospectively.Operation procedures were posterior short-segment pedicle screw distraction reduction and fixation combined with screw insertion to the injured vertebrae and calcium sulphate augmentation.In addition,there was no need for posterolateral interbody fusion.X-ray and CT were performed before and after operation to evaluate local kyphotic angle,anterior fractured vertebral body height and canal encroachment.Visual analogue scale (VAS) and Oswestry disability index (ODI) were assessed before and after operation as well as in follow-up.Results All patients were followed up for average 14 months (range,3-20 months).Local kyphotic angle was (21.2 ±4.3)° before operation,(3.5 ± 1.8)°immediately after operation,and (4.8 ± 2.7) ° in final follow-up.Relative anterior vertebral height was (54.8 ± 14.6)％ before operation,(91.7 ± 8.0)％ after operation,and (87.2 ± 6.0)％ in final follow-up.Mean canal encroachment was (48.0 ± 4.5)％ preoperatively,(23.8 ± 7.8)％postoperatively,and (8.8 ± 4.6) ％ in final follow-up.In final follow-up,six patients with American Spinal Injury Association (ASIA) grade C on admission showed improvement to grade D (n =2) and grade E (n =4) ; 10 patients with ASIA grade E on admission showed improvement to grade E; 22 patients with grade E had no changes.ODI and VAS scored 15.5 ±8.8 and 2.3 ±0.8 in final follow-up with substantial improvement from those before operation (P ＜ 0.01).Complications from internal fixation were not found during follow-up.Conclusion Posterior short-segment fixation without fusion is one of the foremost effective methods for severe thoracolumbar burst fractures,for it can effectively restore the sagittal spinal alignment and the fractured vertebral body height.

Objective To study the role of the transforming growth factor-β-activating kinase 1 (TAK1) poly-ubiquitination in radiation-induced NF-κB activation.Methods FLAG-TAK1 and HA-UbK63 plasmids were transiently transfected into HEK-293T cells.The radiation effect on TAK1 ubiquitination was detected by immunoprecipitation and Western blot,which was further confirmed in FLAG-TAK1 HeLa stable cell line.Results At 1 h after irradiation,Lys 63-1ink TAK1 ubiquitination was induced in the HEK-293T cells with plasmids transfection.This result was further confirmed by using a FLAG-TAK1 stably expressed HeLa cell line.Radiation-induced IKKs and p38 phosphorylation were greatly impaired in MEFs reconstituted with TAK1 K158R mutant compared to ones with wild-type TAK1.Conclusions Lys63-1inked TAK1 poly-ubiquitination at Lys-58 plays a key role in the process of radiation-induced NF-κB activation.

Objective To evaluate the effects of posterior segmental pedicle screw instrumentation and augmentation using calcium sulphate cement in treatment of Denis type B thoracolumbar burst fractures.Methods Forty patients with Denis type B thoracolumbar burst fracture treated between January 2011 and December 2012 were reviewed retrospectively.Twenty patients received posterior short-segment pedicle screw fixation in conjunction with screw placement at the level of fracture and calcium sulphate augmentation without posterolateral fusion (combined treatment group),but 20 patients underwent traditional short-segment pedicle screw fixation (conventional treatment group).Radiographs and CT scans evaluated local kyphotic angle on the spot of injury,anterior height of the injured vertebra,and canal encroachment before and after operation and at final follow-up.Meanwhile,visual analogue score (VAS),Oswestry disability index (ODI),and neurologic status based upon ASIA 2000 were assessed.Results Mean follow-up period was 15 months (range,12-24 months).Vertebral height restoration was equivalent of the two groups immediately after operation,but better result of kyphosis correction was found in treatment group than in control group (P ＜ 0.05).Anterior vertebral height and kyphotic angle significantly improved in treatment group compared to control group at final follow-up (P ＜ 0.05).Clinical and neurologic outcome evaluation were similar between the two groups.No implant failure occurred at follow-up.Conclusion For Denis type B thoracolumbar burst fractures,posterior segmental pedicle screw fixation augmented with calcium sulphate is effective for reducing correction loss and implant failure,compensating for the deficiencies of conventional fixation.

Objective To evaluate the prognostic value of China Classification System and TNM staging in patients with liver cancer undergoing resection. Methods From Jan 1986 to Dec 2000, 246 patients underwent resection of liver cancer. At least three years of follow-up was made in these 246 cases. Results The 1, 3, 5, 7, and 10-year disease-free survival rates were 55%, 30%, 25%, 20% and 18%, respectively. The 1,3,5,7,and 10-year disease-free survival rates predicted by China Classification System and TNM staging were statistically different and positively correlated with each other. Differences of survival rate between stageⅠa、Ⅰb、Ⅱa 、Ⅱb and Ⅲ by China Classification System were all statistically significant. Conclusions Based both on tumor extension and liver function, China Classification System was more accurate in than TNM stage predicting the prognosis of liver cancer patients undergoing resection.

Objective To evaluate the feasibility and clinical efficacy of microendoscopic discectomy-lumbar interbody fusion (MED-LIF) with mobile microendoscopic discectomy (MMED) technique. Methods The MMED includes outer working canal and inner operating canal, and large working canals (12 mm and 14 mm) are fabricated for this operation. The operation was designed as follow:an incision was made between pedicle projection sites and spinous process on the side with prominent symptom. Working canal was inserted along spinous process and a fenestration was performed. After discectomy and ipsilateral decompression, contralateral nerve was decompressed in case of contralateral stenosis. Then the intervertebral space was prepared and grafted. The inner operating canal was removed and the suitable cage was inserted, followed by percutaneous pedicles screws installation, reduction and fixation. A total of 102 patients with lumbar degenerative disc disease were treated by this technique. The index levels included L34 (n=11), L45 (n=64), L5S1 (n=21), L3-5 (n=3), and L4-S1(n=3). The operative data and follow-up results were recorded and evaluated. Results Surgery was successful in all patients, with no nerve injury or conversion to open surgery. The mean operative time was ( 120 ± 30) min (range, 90-200 min), with a mean blood loss of (120 ± 80) mL (range, 50-300 mL). The post-operative X-ray and CT scans showed improvement of spinal alignment with sufficient decompression. Patients were followed up for 6 to 36 months. The Oswestry disability index (ODI) score decreased from the pre-operative 44.2%±16.3%to the last follow-up 4.9%±4.7%. The visual analog pain score (VAS) of lumbar decreased from the pre-operative 5.3±4.1 to the last follow-up 2.1±1.7, and VAS of leg decreased from the pre-operative 6.7 ± 3.5 to 1.0 ± 0.8 at final follow-up. The clinical results were excellent in 46 cases, good in 50 cases and fair in 6 cases according to the Macnab standard. Conclusion MED-LIF can be easily performed with MMED technique, with sufficient decompression and reduction, providing satisfactory results with less invasive procedure.