Objective To determine the lumbar anatomical structure parameters of the lumbar spine posterior column and its sample data of three-dimensional conformation,and based on these data to design the lumber laminar screw dynamic fixation system.Methods 20 human L3 ～ S1 bone specimens,the thickness of the lumber laminar region were measured to obtain the normal anatomical parameters of the lumbar laminar.And 20 healthy lumbar vertebrae L3-S1 for three-dimensional reconstruction were detected by CT scan,which could obtain the structure data of the normal lumbar posterior three-dimensional conformation,and to obtain conformational sample data of three-dimensional space of the posterior structure.Results Lumbar lamina medial 1/3 could serve as a spine laminar screw setting area by anatomical observations and measurements.Lamina thickness of L3-4 on average (6.6 ±0.9) mm,L5 ～ S1average (6.0 ± 0.6) mm.Lumber laminar screw length 6.5 ～ 8.0mm could meet the requirements of bilateral cortical fixation.Conclusion Lower lumbar spinal lamina area can serve as the region to fix the bilateral cortical bone screw,and the optimal length of the laminar screw is 6.5 ～ 8.0rmm.

Objective: To explore the feasibility and clinical effect of single bundle anatomic intrathecal reconstruction of proximal injury of anterior cruciate ligament (ACL) using dissociate peroneus longus tendon combined with semitendinosus tendon. Methods: From January 2015 to September 2016, a total of 24 patients with proximal injury of ACL, confirmed by arthroscopy, were admitted to the sports medicine department of our hospital. The ACL was completely ruptured from the proximal footprint and the tibial side residual remained intact. There were 19 males and 5 females; 16 cases on the right side and 8 cases on the left side. The mean age was 27.88±7.13 years old; The interval between injury and surgery was 14.83±9.09 d; The dissociate peroneus longus tendon and semitendinosus tendonfrom the injured extremity were folded in half, then braided and trimmed into ACL graft for use. The ACL remnant was preserved and the graft was pulled through the stump for single bundle anatomic intrathecal reconstruction. The ACL graft was fixed with Endobutton on the femoral side and interference screw on the tibial side. The results of Lachman test, Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) subjective scores of knee before operation and at final visit were recorded to evaluate the stability and function of the knee. Visual analogue score (VAS) was used to record the changes of pain at the site where the peroneal longus tendon was harvested. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scores were recorded before injury and at the final visit to assess the effect of ankle function after peroneal longus tendon resection. Results: The diameter of the ACL graft made of dissociate peroneus longus tendon and semitendinosus tendon is 8.88±0.30 mm. All patients were followed up at the outpatient clinic, with an average of 34.38±5.40 months, and no serious complications such as rerupture and joint infection were found. There were 16 grade B, 6 grade C and 2 grade D for preoperative Lachman test, none with hard end point. At last vist, there were 23 cases of grade A and 1 grade B, all with hard end points for Lachman test. At the preoperative and final visit, the Lysholm scores of the knee joint were 35.20±11.92 and 94.29±2.92 (t=23.850, P=0.000). Tegner scores were 3.46±0.93 and 8.04±1.00 (t=16.653, P=0.000). The subjective IKDC scores of knee joint were 47.63±13.06 and 91.71±3.75 (t=15.972, P=0.000). At the final visit, all the indicators of the knee were improved compared with those before surgery, and the difference was statistically significant.The AOFAS scores before injury and at the final visit were 98.83 (2.78) and 98.17 (4.01), respectively, with no statistically significant difference (t=1.850, P=0.076) . The VAS scores for the harvest of theperoneus longus tendon were 4.50±1.41, 0.54±0.65 and 0.29±0.55 immediately and 6 months after the operation and at the last visit.There was statistically significant difference between the scores immediately and 6 months after the operation (t=14.900, P=0.001).There was statistically significant differences between the scores at 6 months after the operation and the final visit (t=2.770, P=0.011). Conclusion Single bundle anatomic intrathecal reconstruction of proximal injury of ACL using dissociate peroneus longus tendon and semitendinosus tendon is feasible with good clinical effect.

The aim of the present study was to investigate the effects and possible mechanism of tetramethylpyrazine(TMP)on morphine-induced microglia activation and tolerance. The antinociception and morphine tolerance were assessed in mice using hot-water tail flick test. IBA-1(ionized calcium binding adapter molecule 1), the marker of microglia, was detected by immumofluorescence method. The expression of p-p38 MAPK and total p38 MAPK(mitogen-activated protein kinase, MAPK)was analyzed by Western blot; real-time polymerase chain reaction(RT-PCR)was used to detect the expression level of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β). Results showed that TMP(15, 30, 60 mg/kg, ip)inhibited morphine-induced up-regulation of IBA-1, p-p38, TNF-α and IL-1β in a dose-dependent manner, yet with no effect on the expression of total p38 MAPK. In conclusion, TMP significantly inhibited the activation of microglia evoked by morphine via p38 MAPK signaling pathway, thus attenuating morphine antinociception tolerance.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children and adolescents, and it is commonly accompanied with other developmental and psychological disorders.The prevalence of obesity in children continues to rise, and it is also a major social public concern that threatens human health.As a somatic comorbidity with ADHD, obesity is characterized by a high incidence.In this paper, the focus would be placed on the underlying mechanisms of ADHD accompanied with obesity from the aspects of genetics, perinatal period, environmental and neurobiological factors, which could provide a theoretical basis and intervention strategies for the early identification, rational treatment and long-term comprehensive management, as well as prevention and treatment effects of ADHD and its comorbidities.