[Objective]To explore the therapeutic effect of three surgical procedures(anterior approach,posterior approach and posterior-anterior approach) for cervical spondylotic myelopathy(CSM). [Methods]A total of 111 patients with cervical spondylotic myelopathy treated with three surgical procedures from June 2002 to December 2007 were retrospectively analyzed.Group A(anterior approach) comprised 54 patients with a mean age of 57.1 years(ranged,44~75 years).Group B(posterior approach,Laminoplasty) comprised 33 patients with a mean age of 61 years(ranged,41~73 years).Group C(posterior-anterior approach) comprised 24 patients with a mean age of 62 years(ranged,48-78 years).All patients were followed-up,neural function and cervical sagittal alignment were recorded.According to JOA score,preoperative and postoperative follow-up scores were compared,improvement rates were calculated,respectively.[Results]Patients were followed up for 3 months to 5 years with an average of 2 years.JOA scores of the three groups at 3,6,12 months and at the last follow-up after operation were compared with those of preoperation(P0.05).Cervical sagittal alignment(D numerical value) had no statistical difference at the postoperative and the final follow-up between group A and group C(P=0.434,P=0.492,P=0.569).There was significant difference between group B and group A/C(P

[Objective]To evaluate the curative effects of the posterior or anterior lumbar interbody fusion for the treatment of superior position intervertebral disc herniation. [Method] Forty-seven patients with superior position intervertebral disc herniation were followed up.There were 29 males and 18 females with mean age of 53.3 years(from 35 to 67 years).Twewty-five patients were treated with posterior lumbar interbody fusion(PLIF)using facet joint autograft and cage additional of pedicle screw internal fixation(posterior way group),and 22 patients were treated with anterior disckectomy,bone graft and plates internal fixation(anterior way group).The mean follow-up time was 53.5?5 months(from 24 to 78 months).The clinical results were compared between two groups.Clinical functional assessment standard was used to evaluate the clinical curative effect.The changes of the therapeutic effects,the radiographic findings and complications were evaluated.[Result]In regard to the operation time and bleeding,the posterior way group was superior to anterior way group.There was no difference between the two groups in clinical recovery rates and nerve root injury rates.Complications included dural tear(n=3),and pedicle screw deviating(n=1) in the posterior way group;and dural tear(n=2),unilateral transient lower extremity paresthesia(n=3),and hard controlled singultation(n=1) in the anterior way group.The rates of bone fusion were 96.00% and 95.45% in the posterior and anterior way groups. [Conclusion] Operation for the superior position intervertebral disc herniation is effective.The posterior lumbar interbody fusion using facet joint autograft and cage additional of pedicle screw internal fixation to shorten the operation time and decrease bleeding is recommend for the treatment of superior position intervertebral disc herniation.

Objective To analyze the influencing factors of extra uterine growth retardation (EUGR) in premature very low birth weight infants.Methods A total of 61 EUGR premature very low birth weight infants survived in intensive care unit of our hospital were enrolled into EUGR group,and at the same time another 50 non-EUGR premature very low birth weight infants were selected into non-EUGR group.The clinical related medical records in the two groups were compared and analyzed,and the influencing factors of EUGR was analyzed by Logistic regression analysis.Results The birth gestational age of EUGR group was (31.29±1.56)weeks,which was significantly lower than (33.98±1.35)weeks of the non-EUGR group (t=9.60,P<0.05).The birth weight of the EUGR group was (1 206.76±212.14)g,which was significantly lower than (1 341.55±103.26)g of the non-EUGR group (t=4.11,P<0.05).The hospital stay,return to birth weight time,start enteral nutrition time and total parenteral nutrition time in the EUGR group were (27.77±5.00)d,(15.36±5.91)d,(3.36±1.91)d,(16.93±4.02)d respectively,which were significantly longer than those in the non-EUGR group[22.69±3.97)d,(10.61±4.57)d,(2.61±1.37)d,(9.43±3.11)d](t=3.53,4.65,2.33,10.80,all P<0.05).The incidence rates of complications such as respiratory system,digestive system and metabolic disorder in the EUGR group were 26.23%,19.67% and 67.21%,respectively,which were significantly higher than those of the non-EUGR group(8.00%,6.00% and 40.00%)(x2=6.18,4.39,8.22,all P<0.05).Logistic regression analysis showed that low birth gestational age and birth weight,long hospital stay,later return to birth weight and total parenteral nutrition time,intrauterine growth retardation,and respiratory system,digestive system and metabolic disorder were independent risk factors for the occurrence of EUGR(all P<0.05).Conclusion The influencing factors of EUGR in very low birth weight infants were mainly low gestational age and birth weight,long hospital stay,later return to birth weight and total parenteral nutrition time,intrauterine growth retardation,and respiratory system,digestive system and metabolic disorder.Therefore,in order to prevent EUGR,active symptomatic measures should be given in clinic.

Objective To evaluate the effectiveness of rehabilitative treatment after extended open-doorlaminoplasty of the cervical spine for cervical spondylotic myelopathy.Methods Sixty patients(mean age 61.7 ±12 years)who had undergone extended open-door laminoplasty of the cervical spine for cervical spondylotic myelopa-thy were studied for an average of 40.7 months.They are divided into a rehabilitation group and a control group with 30 patients in each.The patients in the rehabilitation group received systematic rehabilitation therapy pre-and post-operation.In both groups,the neurological recovery rate,the cross-sectional areas of the cervical posterior muscles,and the incidence of axial symptoms and post-operative complications were recorded and compared. Results The wounds of patients in the rehabilitation treatment group healed with no complicating infections,but the wounds of three patients in the control group became infected.There was no statistically significant difference in neurological recovery between the two groups.In the rehabilitation treatment group,the rate of atrophy and the cross-sectional areas of the cervical posterior muscles were significantly lower than in the control group.At the same time,the rate of neck axial symptoms was 23% in the rehabilitation group but 60%in the control group.a difference which was statistically significant. Conclusions Although rehabilitation treatment pre-and post-operation may not speed up neurological recovery,it may prevent postoperative atrophy of the cervical extensors and lower the incidence of neck axial symptoms.

This study was aimed to optimize the extraction process of double-marker components for Arctium lappa L. The central composite design and response surface methodology was used. According to 3 main factors, the extraction rates of arctiin and arctigenin was used as evaluation indexes. Multiple linear regression and two-order polynomial equation were used. The binomial fitting model was performed in the optimization of arctiin and arctigenin extraction technology. The results showed that the indentified optimized extraction technology of arctiin and arctigenin was 70% ethanol, 24-fold, ultrasonic solvent extraction for 15 minutes. It was concluded that this technology was able to extract large amount of arctiin and arctigenin, which provided experiment evidences for arctiin and arctigenin preparation. It also provided references for the development and utilization of arctiin and arctigenin.

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

BACKGROUND: Degenerative lumbar spinal stenosis could be treated by laminectomy internal fixation placement,unilateral or bilateral decompression,posterior laminectomy and so on.However,whether laminectomy internal fixation placement can be used remains unclear.OBJECTIVE: To evaluate the efficacy of interbody fusion cage implantation of pedicle screw fixation,in combination with posterior lumbar laminectomy,bilateral resection and decompression of the inferior articular process,autologous facet joint bone transplantation in the treatment of degenerative lumbar spinal stenosis.METHODS: A total of 41 patients of degenerative lumbar spinal stenosis,who failed after 3 months of conservative therapy,including 23 males and 18 females,at a mean of 60.3 years,Received posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autologous facet joint bone and cage interbody fusion implant pedicle fixation.They were followed up for 24 months,preoperative and postoperative Japanese Orthopedic Association(JOA)score evaluations were performed to assess the therapeutic efficacy of the patients,radiological examination was done to investigate the graft fusion and vertebral stability of surgical segments in patients.RESULTS AND CONCLUSION: During the follow-up,JOA score significantly increased compared with the preoperative score(P＜0.01)and clinical excellence rate was 90%; 40 cases obtained bony fusion,with a fusion rate of 98%,1 patient exhibited signs of lumbar instability.There was no loosening,fracture and other complications after internal fixation,but 2 cases appeared dural tear,1 case pedicle position deviation,1 case pseudoarticulation formation.The results suggest that the posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autogenous facet joint bone and cage interbody fusion implanted pedicle screw fixation show good clinical effects for the treatment of degenerative lumbar spinal stenosis.

This study was aimed to establish the three-dimensional model of C_(3-7) segment of lower cervical spine after artificial disc implantation, to analyze the movement of lower cervical spine after artificial disc replacement. According to CT films of 1 patient at 6 months after artificial disc implantation, three-dimensional finite element model that included Bryan~(TM) artificial cervical disc prosthesis of the lower cervical spine was established using finite element method, then introduced into Ansys 9.0, the vertebral cortical bone, cancellous bone and intervertebral disc were meshed and analyzed by using under several states such as flexion/extension, lateral bending and rotation, thus understanding their motion characteristics. By comparison with previous research findings, test results nearly accorded with or exhibited identical trend with previous study. The results suggest that, cervical disc replacement can basically guarantee the stability of lower cervical spine movement.

ObjectiveTo investigate the clinical efficacy of the 3-in-1 technique of Disc-FX system,namely:discectomy,radiofrequency ablation and annuloplasty for discogenic low back pain in the early stage.MethodsFrom February 2010 to February 2011,40 patients with the discogenic low back pain underwent discectomy,radiofrequency ablation and annuloplasty using Disc-FX system were retrospectively analyzed,including 22 males and 18 females with an average age of 38.7 years(range,32-58 years).The visual analogue scale (VAS) scoring was applied to evaluate the back and low limb pain at preoperative,postoperative 1week,3 months,6 months,and last follow-up.The Macnab score was also evaluated at last follow-up.Results All the patients were followed up for average 13.8 months (range,6-18 months).The operative time averaged 26 min(range,20-40 min).No surgical complication was found during the follow-up.The VAS of preoperative low back pain was 6.60±1.47,VAS score of low back pain at postoperative 1 week,3 months,6 months,and final follow-up were 1.05±0.68,1.15±0.70,1.00±0.62,0.95±0.63,respectively.The postoperative VAS of low back pain decreased significantly compared with that preoperative.The VAS of preoperative limb pain was 3.05±1.23,VAS score of limb pain at postoperative 1 week,3 months,6 months,and final follow-up after operation were 1.10±0.74,1.15±0.70,1.10±0.72,0.95±0.54,respectively.The postoperative VAS of limb pain decreased significantly compared with that preoperative.The evaluation of Macnab score were excellent in 20 patients,good in 17,fair in 2,and poor in 1,suggesting an effective rate of 92.5％ (37/40).Conclusion Disc-FX system,which combined three surgical technique in one procedure,provides a new choice for orthopedics to treat discogenic low back pain.It can give satisfactory clinical outcomes during a short-term followup,but the long term clinical outcomes remains unknown.

Objective:Nuclear apoptosis-inducing factor 1(NAIF1) is a novel apoptosis gene cloned in laboratory. To analyze the binding proteins of NAIF1 by pulldown method, the fusion expression vector of truncated human nuclear apoptosis-inducing factor 1〔NAIF1(73-327)〕 was constructed, were expressed and purified the recombinant GST-NAIF1(73-327) fusion protein in E.coli.Methods:The cDNA encoding human NAIF1(73-327) was amplified by PCR and cloned into pGEX-KG vector. The GST-NAIF1(73-327) fusion protein was expressed in E.coli and purified by affinity chromatography. The purified protein was detected by SDS-PAGE, Western blot and ESI-Q-TOF-MS/MS.Results:A prokaryotic expression vector of GST-NAIF1(73-327) was constructed and the GST-NAIF1(73-327) fusion protein was expressed in E.coli at high level. SDS-PAGE analyses indicated that the purified protein was about 53 kD. Western blot and MS/MS analyses verified the recombinant fusion protein.Conclusion:An efficient method for obtaining recombinant GST-NAIF1(73-327) fusion protein had been established and it could be used for further studies on the structure and function of NAIF1.