[Objective] To evaluate the early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease.[Methods]The clinical outcomes of 31 patients with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion were retrospectively studied,and assessed with visual analogue scale(VAS)and spinal operative standard of Chinese Medical Association.The early effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded.[Results]The operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive.The VAS scores were 7.9?2.0,2.6?1.2 and 1.7?0.8 at one day preoperatively,two week postoperatively and final follow-up,respectively.The good to excellent result was 94.4% at the lastest follow-up.No compliction related with Wallis posterior dynamic lumbar stabilization was found.[Conclusion]It is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease,and the early effect is good.The Wallis system provides an alternative for treatment of lumbar degenerative disease.

OBJECTIVETo investigate the clinical outcomes of the posterior C1,2 screw-rod combined with C2 unilateral translaminar screw and contralateral pedicle screw fixation and autogenous bicortical iliac crest graft fusion in treating upper cervical instability with vertebral artery variations.

METHODSFrom June 2008 to December 2012, the clinical data of 12 patients with upper cervical instability underwent C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion were analyzed retrospectively. There were 8 males and 4 females with a mean age of 47.5 years (ranged, 16 to 77 years). Patients suffered from occipitocervical activity limitation of motion with pain or not, VAS was 0-7 points with an average of (3.50 +/- 2.71) points. Unilateral vertebral artery hypoplasia was demonstrated by vertebral arteriography (VAG) or CTA in all patients. Cervical X-ray and CT scans were done within 7 days after surgery in order to confirm internal fixation position. Internal fixation loosening and breakage, reduction losing, bone fusion ratio were observed during follow-up.

RESULTSNo nerves and vertebral artery injuries occurred during operation. Cervical pain obviously decreased and VAS was (0.92 +/- 0.90) points. Cervical alignment of 12 patients had well-recovered by X-ray while Atlantoaxial ventral lamina cortex of 1 case was encroached by CT scan without neurological symptom. All patients were followed up for 6 months to 3 years, no internal fixation loosening and breakage, reduction losing were found. All patients obtained bone fusion in 6-12 months after operation.

CONCLUSIONPosterior C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion can achieve biomechanical stability and raise the successful rate of bone fusion, while avoiding the risk of vertebral artery injury and overcoming the insufficient of bone fusion during bilateral laminar screws placement as well. Posterior C1 lateral mass screws fixation is a safe and effective additional method in treating upper cervical instability with vertebral artery variations.

Adolescent ; Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Internal Fixators ; Joint Instability ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; pathology

Objective To investigate the effect of the courses of image diagnostics on clinical pro-bation period via the combination of PBL and multimedia network teaching model. Methods 126 under-graduates from the department of medical image (Grade 2011 and 2012) were selected as teaching subjects, and PBL combined with multimedia network teaching was adopted in the teaching of the course of medical imaging diagnosis. After class we implemented a questionnaire survey, and let the students write learning experience. Statistical analysis was conducted by using SSPS 13.0 to reflect the teaching participation in the students' questionnaire and a. summary analysis of the learning experience of the students was also made. Results 123 valid questionnaires were collected. 94.31%(116 people) of students were active participants in these courses, 90.25%(111 people) of the students thought they could actively communicate in teaching, and 43% (110 people) of the students thought they got fully prepared before class. 123 articles in accor-dance with the requirements of experience were received; most students took positive attitude to the active influence the teaching methods had brought; some student pointed out that the teaching method had the disadvantages such as too much time to prepare, too much information, and so on. Conclusions The com-bination of PBL and multimedia network teaching has preliminary results. It is a novel model that is available for teaching image diagnostics on clinical probation period.

MAIN OUTCOME MEASURES: Free running EMG and stimulus triggered EMG, including time, frequency, amplitude, muscle group were observed and recorded simultaneously. Never root functional injury and restoration after surgery were detected.RESULTS: 378 pedicle screws in 74 patients were monitored intraoperatively, and only 3 pedicle screw malposition (2 of L_4, 1 of L_5) was detected and then replaced with the help of C-arm fluoroscopic examination. Myoelectricity appeared when the current intensity was less than 10 mA. The correct rate of implantation was 99.2%. Nerve root impingement was found in two cases during laminectomy for L_5 and S_1 decompression and never root solution, which alerted the surgical team of critical neural structures. Nerve symptoms of the lower limb were aggravated after surgery and restored following 2-4 weeks of conventional treatment. The error injury rate of nerve root was 2.7%. In all reported cases, no irreversible neurological deficit was observed 2-4 weeks after operation.CONCLUSION: Intraoperative EMG monitoring can find improperly placed screws and detect impending nerve root injury promptly. Combined EMG and 3-D imaging modality monitoring is a reliable and practicable method that can be used to protect neural structures during complex lumbosacral surgery.

OBJECTIVETo observe the clinical therapeutic effect of acupuncture massage for primary dysmenorrhea and its influence on prostaglandin F2alpha level in menstrual fluid.

METHODSNinety patients with primary dysmenorrhea were assigned equally to the acupuncture group, the massage group and the control group (oral administrated with Somiton tablet). The treatment course was 3 menstrual cycles. The effect in relieving menalgia was evaluated using numerical rating scale (NRS) before and after treatment and change of PGF2alpha content in menstrual fluid was tested as well.

RESULTSThe NRS score was 0.60 +/- 0.67 in the acupuncture group and 0.53 +/- 0.63 in the massage group respectively, significantly lower than that in the control group, which was 2.30 +/- 1.73 (P < 0.01). The PGF2alpha level after treatment was significantly lower in the acupuncture group (176.58 +/- 17.85 ng/L) and the massage group (171.32 +/- 17.15 ng/L) than that in the control group (220.56 +/- 54.47 ng/L), respectively (P <0.01). There showed no difference in the two aspects between the acupuncture group and the massage group (P >0.05).

CONCLUSIONAcupuncture and massage has a reliable therapeutic effect on primary dysmenorrhea, which is superior to that of Somiton tablet, and its mechanism might be exerted by regulating PGF2alpha level in menstrual fluid.

Acupuncture Therapy ; Decidua ; metabolism ; Dinoprost ; metabolism ; Dysmenorrhea ; therapy ; Female ; Humans ; Massage

OBJECTIVETo evaluate the two-tier system for the grading of ovarian serous carcinomas, and to analyze Pax2, p53, Ki-67 protein expression and their prognostic values for low- and high-grade ovarian serous carcinomas.

METHODSA total of 38 cases of low-grade and 100 cases of high-grade ovarian serous carcinomas were selected based on the two-tier grading system. Immunohistochemistry was used to detect Pax2, p53 and Ki-67 protein expression in all cases. Correlation of the two-tier system with immunohistochemical results and prognostic parameters were performed.

RESULTS(1) The overall survival, disease-free survival and 5-year survival rates were significantly higher in the low-grade serous carcinoma cases than in the high-grade cases (P < 0.05). (2) Significant differences in protein expressions were found between the low- and high-grade serous carcinomas. The high-grade serous carcinomas had a significantly higher expression level of p53 (55.0% vs 13.2%, P < 0.05) and Ki-67 (42.1% vs 13.7%, P < 0.05), while low-grade carcinomas had a significantly higher expression level of Pax2 (65.8% vs 13.0%, P < 0.05). (3) Pax2 positive cases had a significantly better overall survival and 5-year survival rates than Pax2 negative cases (P < 0.05). The expressions of p53 and Ki-67 were found to have little correlation with overall survival and disease-free survival (P > 0.05).

CONCLUSIONSThe two-tier system for the grading of ovarian serous carcinomas has a good prognostic value. There are significantly differences in expressions of Pax2, p53 and Ki-67 between low- and high-grade ovarian serous carcinomas. Compared with p53 and Ki-67, Pax2 is likely a better prognostic indicator for ovarian serous carcinoma.

CA-125 Antigen ; metabolism ; Cystadenocarcinoma, Serous ; classification ; metabolism ; mortality ; pathology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Membrane Proteins ; metabolism ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Ovarian Neoplasms ; classification ; metabolism ; mortality ; pathology ; Ovary ; pathology ; PAX2 Transcription Factor ; metabolism ; Survival Rate ; Tumor Suppressor Protein p53 ; metabolism

Objective· To investigate the association between neck circumference (NC) and cardiovascular risk factors among middle-aged and elderly people without diabetes in Jiading District in Shanghai.Methods· A cross-sectional study was conducted among 4 657 nondiabetic inhabitants aged 40 and above in Jiading District,Shanghai from August 2014 to July 2015.Clinical information collection,anthropometric measurements,and biochemical analyses were performed.The objects were divided into 4 groups according to the quartiles of NC in order to analyze association between NC and cardiovascular risk factors.Results· With increase of NC,the prevalences of abdominal obesity,insulin resistance,hypertension,and dyslipidemia all increased as well as waist circumference,body mass index (BMI),blood pressure,lipid profile,fast blood glucose,and HOMA-IR level (all Ptrend ＜0.01).Multiple Logistic regression analysis showed that individuals in Q2,Q3 and Q4 group had significantly higher risk of abdominal obesity,insulin resistance,hypertension,and dyslipidemia compared with those in Q1 group after age,sex,smoking,drinking,physical activity,BMI,waist circumference,systolic blood pressure,C-reactive protein,fast blood glucose,and lipid profile were corrected (all Ptrend ＜0.01).Conclusion· NC is positively and independently correlated with cardiovascular risk factors in middle-aged and elderly nondiabetic people in Jiading District in Shanghai.

OBJECTIVETo study the occupational exposure limit of dimethoxymethane (DMM) in workplace air.

METHODSLiterature research was conducted on DMM; information on its physicochemical properties, toxicology, and occupational epidemiology was collected. Upon analyzing these data, an occupational exposure limit of DMM in workplace air was proposed according to the guidelines and principles of developing occupational exposure limits for harmful factors in workplaces.

RESULTSA total of 165 air samples were collected from DMM manufacturers, 14 of which had a DMM concentration over 3000 mg/m(3), accounting for 8.48% of all samples. Compared with the control group, the exposed employees had a significantly increased incidence of discomfort symptoms when exposed to more than 6000 mg/m(3) DMN (P < 0.01).No significant differences in the constituent ratios of abnormal results in physical examinations were found between the exposure groups and control group (P > 0.05).

CONCLUSIONWe recommend to set the permissible concentration-time weighed average to 3100 mg/m(3) as the occupational exposure limit of DMM in workplace air in China. This occupational exposure limit standard meets the relevant requirements of toxicology and occupational epidemiology, as well as fits well with our country's current economical and technological levels. This standard has high applicability in China's domestic settings.

Air Pollutants, Occupational ; analysis ; China ; Humans ; Inhalation Exposure ; Methyl Ethers ; analysis ; Occupational Exposure ; analysis ; Threshold Limit Values ; Workplace

Objective To evaluate the changes in the expression of hippocampal long non-coding RNAs ( lncRNAs) and bioinformatics analysis in mice with perioperative neurocognitive disorders ( PND) . Methods Thirty clean-grade male C57BL∕6 mice, aged 12-14 weeks, weighing 25-30 g, were divided into 2 groups (n=15 each) according to the random number table method: control group (group C) and PND group. The model of PND was established by performing open tibial fracture with intramedullary fixa-tion under isoflurane anesthesia in anesthetized mice. The Morris water maze test, open field test and fear conditioning test were performed at 1, 3 and 7 days postoperatively. The animals were sacrificed after the end of behavioral testing on 3 days after operation, the hippocampus was obtained, the high-throughput gene sequencing was performed to identify the differentially expressed lncRNAs, and Gene Ontology func-tional analysis and Kyoto Encyclopedia of Genes and Genomes signaling pathway analysis were used to ana-lyze the results. Results Compared with group C, the escape latency was significantly prolonged, and the percentage of time spend in the target quadrant and percentage of freezing time in the fear conditioning test were decreased at different time points after operation in group PND ( P<0. 05) . A total of 121 differential-ly expressed lncRNAs were identified, of which 69 were up-regulated and 52 were down-regulated. The Gene Ontology functional analysis showed that there were differences in various biological processes, such as synaptic transmission, cholinergic neurotransmitters, or adiponectin secretion and regulation. The KEGG signaling pathway analysis showed that there were also differences in cholinergic synapses, MAPK signaling pathway, glucagon signaling pathway, TNF signaling pathway, NOD-like receptors, Toll-like re-ceptors, chemokine signaling pathway and etc. Conclusion There are 121 differentially expressed lncR-NAs in the hippocampus of PND mice, and lncRNAs- and the target gene-related inflammatory responses, synaptic transmission, energy metabolism and etc. may be related to the pathogenesis of PND.

OBJECTIVETo explore the effect of Scalp acupuncture on serum neuron specific enolase (NSE) and S-100β concentrations, and incidence rates of postoperative delirium (POD) and postoperative cognitive function (POCD) of elderly patients undergoing hip replacement.

METHODSEighty-four patients undergoing scheduled hip replacement under combined spinal-epidural anesthesia (CSEA) were assigned to the control group (group C) and the scalp acupuncture group (group S) according to random digit table, 42 cases in each group. In group S, scalp acupuncture was additionally performed according to International Standardized Scheme for Scalp Acupuncture. Scalp acupuncture was performed during the operation from the MS1 middle line of forehead [1 cun before Shenting (GV24), including Shenting (GV24)] and MS5 middle line of vertex [from Baihui (DU20) to Qianding (DU21), including Baihui (DU20) and Qianding (DU21)]. The operation time and post-operative length of stay were observed. The midazolam dosage, hemorrhage amount, fluid transfusion amount, urine amount, use rates of ephedrine and atropine during the operation were also observed and compared between the two groups. The occurrence rate of POD and POCD at post-operative day 3 (T₁), week 1 (T₂), month 3 (T₃), and month 6 (T₄) were measured. Eighteen patients were randomly selected to collect blood from internal jugular vein before anesthesia t₀), immediately after ending the surgery (t₁), 6 h after operation (t₂), 24 h after operation (t₃), and 48 h after operation (t₄), respectively. Serum levels of NSE and S-100β were correspondingly measured.

RESULTSThere was no statistical difference in the operation time, midazolam dosage used during the operation, hemorrhage amount, fluid transfusion amount, urine amount, use rates of ephedrine and atropine (P > 0.05). Compared with group C, the post-operative length of stay was shortened in group S (P < 0.05). The incidence rate of POD and that of POCD at each time point were lower in group S (P < 0.05). The expression level of NSE decreased at t₂, t3, and t₄, and the expression level of S100β also decreased at t₁, t₂, t₃, and t₄(P < 0.05). There was no statistical difference in expression levels of NSE or S100β between the two groups at other time points (P > 0.05).

CONCLUSIONScalp acupuncture could attenuate central nervous system lesion and improve POCD of elderly patients undergoing hip replacement.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Arthroplasty, Replacement, Hip ; Cognition ; Humans ; Length of Stay ; Phosphopyruvate Hydratase ; blood ; Postoperative Complications ; Postoperative Period ; S100 Calcium Binding Protein beta Subunit ; blood ; Scalp