AIM: To investigate the changes of alkaloid in Rhizorrm Coptidis and Fructus Evodiae before and after combination. METHODS: The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS : After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochioride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION: In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.

AIM:To investigate the changes of alkaloid in Rhizoma Coptidis and Fructus Evodiae before and after combination.METHODS:The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS:After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION:In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.

OBJECTIVETo evaluate the clinical results and the value of the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation for the treatment of ossifying thoracic disc herniation.

METHODSThirty nine cases of ossifying thoracic disc herniation who accepted the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation were included in this study. There were 21 male and 18 female patients. The age ranged from 33 to 69 years, with an average of 53 years. The course of disease ranged from 1 month to 18 months, with an average of 6.5 months. The lesion locations were T7-8 for 1 case, T8-9 for 4 cases, T9-10 for 9 cases, T10-11 for 7 cases, T11-12 for 10 cases, T12-L1 for 6 cases, and both T11-12 and T12-L1 for 2 cases. The clinical results were evaluated by Otani scored system.

RESULTSThe operative time was from 2.5 to 5.0 hours, with average of 3.3 hours. The blood loss was from 400 to 2 000 ml, with average of 850 ml. All patients were successfully operated without neurological symptoms aggravation and accidents. The followed-up period was 24 to 60 months, mean 40.5 months. According to Otani scored system, there were excellent results in 16 cases and good results in 18 cases. The clinical satisfaction rate was 87.2%. All obtained bony fusion without instrument failure.

CONCLUSIONPosterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation is a safe and effective surgical procedure for the treatment of ossifying thoracic disc herniation.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; Treatment Outcome

Objective To investigate the clinical effect of anterior and posterior decompression internal fixation in the treatment of spinal cord injury without fracture and dislocation(CSCIWFD).Methods The clinical data of sixty-five patients with CSCIWFD in Worker's Hospital and Handan Central Hospital from December 2013 to May 2015 was analyzed.According to the surgical methods,the patients were divided into two groups,31 cases in the anterior group,accepted the anterior cervical decompression and internal fixation,34 cases in the posterior group,treated with posterior cervical open-door laminoplasty fixation.The operation time, intraoperative blood loss,neurological function recovery and complications of each group were recorded.Results The operative time in the anterior group was(63.2 ± 15.1)min and in the posterior group was(113.8 ±21.5)min,there was significant difference between the two groups(P<0.05).The intraoperative blood loss in the anterior group was lower than that in the posterior group((116.3 ± 18.9)ml vs.(236.3 ± 41.0)ml,t=55.837,P<0.05).In the anterior group,the JOA score was(6.9±1.6)points before operation,(9.6±1.9) points at 2 weeks after operation,(11.7±2.6)points at 3 months after operation and(13.5±3.1)points at the last follow-up,there were significant differences between the preoperative level and postoperative level(F between groups=33.759,P<0.05;F grouP=5.213,P<0.05;F interaction=6.769,P<0.05).In the posterior group,the JOA score was(6.7 ± 1.5)points before operation,(8.7 ± 1.8)points at 2 weeks after operation, (10.9±2.5)points at 3 months after operation and(13.1±3.4)points at the last follow-up,the differences were all statistically significant(P<0.05).Based on the JOA scores,there was significant difference between the two groups at 2 weeks after operation(P<0.05).The anterior group had 1 case of recurrent laryngeal nerve injury and 1 case of cerebrospinal fluid leakage,while the posterior group had 1 case of wound infection,1 case of liquefaction necrosis and 1 case of epidural hematoma.There was no significant difference in the complication rate between the two groups(X2= 0.000,P= 1.000).Conclusion The anterior decompression has the advantages of less operative trauma,shorter operation time,less intraoperative blood loss and quick recovery of nerve function.The selection of surgical method should be based on the compression section of the spinal cord.

Objective To observe the serum betatrophin levels in patients with type 2 diabetes mellitus (T2DM) and to explore the role of betatrophin in the pathogenesis of diabetic retinopathy (DR).Methods A total of 59 patients with T2DM (DM group) and 14 healthy controls (NC group) were enrolled in the study.Vision,slit lamp microscope,indirect ophthalmoscope,fluorescein fundus angiography were performed on all the subjects.According to the results of the examination combined with the international DR clinical staging criteria,the patients were divided into no DR (Non-DR) group,non-proliferative DR (NPDR) group,and proliferative DR (PDR) group,with 30,20 and 9 patients in each,respectively.The fasting blood glucose (FPG),insulin (FIN),C-peptide,glycated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),high-density lipoprotein (HDL-C),low-density lipid Protein (LDL-C) levels were detected.The level of betatrophin in serum was determined by enzyme-linked immunosorbent assay.The correlation between betatrophin and other indicators was analyzed by Spearman correlation.The influencing factors of PDR were analyzed by logistic regression.Results Compared with subjects in the NC group,the level of FPG (F=-4.316,P＜0.001),FIN (F=2.142,P=0.001),HbA1c (F=-5.726,P＜0.001),TC (t=3.609,P=-0.010),LDL-C (t=0.000,P=0.003),and betatrophin (F=-2.263,P=0.024) were significantly increased and HDL-C level (F=-3.924,P＜0.001) was decreases in the DM group.The difference of TG level between two groups was not statistically significant (F=-1.422,P=0.155).Compared with the Non-DR group and the NPDR group,the serum C-peptide (F=7.818,P=0.020) and betatrophin levels (F=1 2.141,P=0.002) were significantly increased in the PDR group.Spearman correlation analysis showed that the levels of betatrophin in the DM group was positively correlated to TC (r=0.304,P=0.019).The serum levels of betatrophin was positively correlated to body mass index in the Non-DR group (r=0.513,P=0.004).Furthermore,in the PDR group,a significant positive correlation was observed between the serum betatrophin levels and diastolic blood pressure (r=0.685,P=0.042).Logistic regression analysis showed that the duration of diabetes,serum C-peptide and betatrophin levels were risk factors for PDR.After controlling for the duration and serum C-peptide,the PDR risk for betatrophin levels great than or equal to 1.0 ng/ml was 12 times as much as betatrophin levels less than 1.0 ng/ml in T2DM patients.Conclusions The serum betatrophin content of patients with T2DM is abnormal.Betatrophin may be involved in the occurrence and development of PDR.

Objective To observe the effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery??Methods From September 2014 to February 2016, 112 patients with multi?segment cervical spondylotic myelopathy underwent surgical treatment in Handan Central Hospital of Hebei Province??According to the lamina fixation methods,they were divided into groups A,B and C??There were 35 cases in group A,using suture suspension method to fix lamina; 34 cases in group B,using anchor suspension to fix lamina;and 43 cases in group C,using mini?titanium plate to fix lamina The operation time,intraoperative blood loss,laminae open angle,spinal drift distance,postoperative neurological recovery,cervical curvature index ( CCI ) and occurrence of axonal symptoms were compared in each group??Results All patients underwent surgery successfully??There were no significant differences in operation time,intraoperative blood loss,laminae open angle and spinal drift distance between the 3 groups (all P＞0??05)??The JOA score of group A was (7??9± 2??2) preoperatively,(9??3± 2??8) at 3 months after surgery,and (13??9±3??4) at the final follow?up??In Group B was (7??7±2??0) preoperatively,(9??1±2??7) at 3 months after surgery,and (13??6±3??7) at the final follow?up??In Group C was (7??8±2??1),( 9??0±2??6) and (13??8 ± 3??5 ), respectively, there were significant differences before and after operation ( Fintra?grouP＝7??271, Pintra?grouP ＜ 0??001; Finter?grouP ＝ 11??372, Pinter?grouP ＜ 0??001; Finteraction ＝ 9??831, Pinteraction＜0??001)??The CCI of group A was ( 22??7± 5??6)% preoperatively,(20??5± 4??4)% at 3 months after surgery,and (16??6± 3??0)% at the final follow?up??The CCI of group B was ( 21??4 ± 5??2)%,( 19??7 ±4??1)% and (17??8±2??9)% respectively??The CCI of group C was ( 21??1 ± 5??0)%,( 20??8 ± 4??6)% and (19??8 ± 4??0)% respectively??There were significant differences between group A and group B in the last follow?up and the three months before and after operation??( all P＜0??05),there was no significant difference between groups C at different time points ( P＞0??05)??According to the visual analogue scoring system,the distribution of axial symptoms in group C was significantly better than that in group A and group B ( Z＝6??678;P＝0??035)??Conclusion Posterior single?door mini?titanium plate fixation can not only improve nerve function,but also prevent cervical curvature loss and reduce the occurrence of axonal symptoms??

Objective To observe the therapeutic effects of posterior laminectomy and lateral bone fusion on multi-segments thoracic disk herniation. Methods 18 patients with multi-segments thoracic disk herniation accepted the posterior laminectomy and lateral bone fusion. They were followed up with JOA score and Frankel system. Results The mean of operative time was 190.6 min with a mean of blood loss of 806.3 ml. Cerebrospinal fluid leakage happened in 3 patients, and recovered after treatment. Wound infection occurred in 1 case and recovered after applied sensitive antibiotics. The Cobb's angle decreased after surgery (P<0.05). Compared with the preoperative, the JOA score improved 3 months later and at the last follow-up (P<0.05). During the follow-up, there was no fixation loosen, displacement and spinal instability happened. Conclusion Patients with multi-segments thoracic disk herniation may benefit full spinal decompression and a stable spinal sagittal alignment from posterior laminectomy and lateral bone fusion.