Objective To explore the efficacy and safety of coflex interspinous dynamic fixation device implantation in the lumbar spinal stenosis. Methods Eighty-three patients with lumbar spinal stenosis were randomly divided into two groups, and 80 cases were followed up. Coflex group (38 patients) received coflex implantation,posterior lumbar interbody fusion (PLIF) group(42 patients) received PLIF treatment. Indicators of surgical trauma degree (operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time),indicators of clinical effect (waist and leg pain VAS scores,Japan Orthopaedic Association JOA score,Oswestry functional disability index ODI score),intervertebral space height and median sagittal diameter (MSO) were measured and compared between the two groups. Results In the Coflex group, the operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time were (104.3 ±9.5) min,(230. 7 ±29.6) ml,(110. 6 ±34. 5)ml,3. 2 ±1.3, (13. 6 ±2.0) d,which were significantly lower than those of (174. 6 ±24. 2) min,(536. 8 ±163.3) ml, (319. 2 ± 142. 8) ml,4. 8 ±2. 7, (15. 7 ±2. 6) d in the PLIF group(t= 16. 720,11. 380,8. 771,3. 320,4.018,Ps <0. 01). In the back and leg pain VAS score,JOA score,ODI score,intervertebral height and MSD,indicators after surgery were significantly improved than before surgery in both groups(Ps <0. 01). There were no significant difference before and after treatment 12 months in both groups (Ps >0. 05) on severe complications such as internal fixation loosening and spinous process fractures.Conclusion The two surgical methods both can effectively increase the foraminal area and intervertebral height to maintain the stability of the spinal posterior colum. However, Coflex interspinous dynamic fixation device implantation had more advantages,such as shorter operation time,less bleeding,less trauma,and early functional exercises.

Objective To evaluate the prognostic value of plasma D dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. Methods The plasma D dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D dimer level in different Child pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with ? 2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.Results In Child Pugh’s A, B and C patients, the difference of plasma D dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant ( P 0.05). The differences of plasma D dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant ( P 0.05). Conclusion Plasma D dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child pugh’s classification.

Objective To study the relationship between the serum level of matrix metalloproteinases-9 (MMP-9),carotid plaque and human cytomegalovirus (HCMV) infection in the patients with carotid atherosclerosis (CAS). Methods The antigen of HCMV-PP65, serum level of MMP-9 and the results of coloured doppler sonography from 90 cases with CAS were analyzed and compared. Results (1)The contents of MMP-9 in antigen of HCMV-PP65 positive (A) group, negative (B) group and normal control (C) group was (260.25?89.03)pg/ml, (157.47?78.28) pg/ml and (138.65?80.73)pg/ml, respectively. Group A was significant higher than groups B and C (all P

0.05).Conclusion Retropubic DVC control before laparoscopic radical prostatectomy is beneficial for both the surgical procedure and postoperative recovery of physiological functions,owing to minimal blood loss,clear surgical field,and less injury to the urinary continence system.

Objective To investigate the effects and the possible mechanisms of berberine in human cervical cancer Hela cell line in vitro. Methods Cell growth rate was determined with MTT assay. TUNEL was used to examine cell apoptos rate. The expression of COX-2 and Bcl-2 proteins were detected by immunocytochemistry method. Results Berberine induced cytotoxicity and apoptosis in human cervical carcinoma Hela cells in time-dependent and dose-dependent manner. Berberine could down-regulated the Bcl-2 protein expression of Hela cells,but had no significant influence in the expression of COX-2 protein. Conclusion Berberine can inhibit Hela cell growth of cervical carcinoma and induce apoptosis in vitro. Down-regulation of the Bcl-2 protein expression may be involved in berberine-induced apoptosis of HeLa cells.

The strong administrative system of Chinese public hospitals seriously affects the hospital reputa-tion evaluation .This paper is to discusses the practical significance of the construction of third -party reputation eval-uation system for public hospitals and put forward the tentative idea based on the present reputation management of do -mestic and overseas hospitals .

The article reviewed the situation of warming kidney and strengthen spleen treatment for ulcerative colitis (UC) in recent 15 years from three aspects: Yang deficiency in spleen and kidney syndrome is one of the most important syndromes in UC; common prescriptions, medicine and efficacy of warming kidney and strengthening spleen treatment for treating UC; the mechanism of the treatment for UC is related to immunity enhancement, inhibition of gastrointestinal smooth muscle, promoting gastrointestinal function, antibiosis, improving plant nerve function, and release of enzymes. It also proposed the problems about warming kidney and strengthening spleen treatment for UC, and prospect for relevant problems.

Objective:To study the biological characteristics of new retrograde filling materials iRoot BP plus and iRoot FS.Methods:(1 )The roots were cut into 3 mm in length,and the root canals were pre-pared to 1 mm in diameter,followed by being filled with iRoot BP plus,iRoot FS,or mineral trioxide ag-gregate (MTA).The specimens were immersed in simulated body fluid (SBF).The ability of minerali-zation in vitro was detected through three studies.First,the mineralization of specimens was analyzed through scanning electron microscope observations and energy dispersive X-ray spectrometer.Then,the pH of SBF was monitored using pH meter.(2)The extracts were gained by immersing blocks of iRoot BP plus,iRoot FS,and MTA (8 mm diameter and 2 mm height)into dulbecco’s modified eagle medium (DMEM).The effects of the extracts on proliferation of MG63 cells were detected through MTT assay. The gene expression level of alkaline phosphatase (ALP)was analyzed by quantitative real-time PCR, and the expression of ALP activity was observed by ALP activity staining.Results:(1 )The formation of minerals could be observed on the surfaces of iRoot BP plus,iRoot FS,and MTA at the end of 24 h,and there were more amounts of apatite aggregated after 14 days.The values of Ca/P ratios of apatites were 1.43,1.39,and 1.51,respectively.(2)The pH of SBF could be raised to 8.09 ±0.07,7.91 ± 0.06,and 8.1 1 ±0.06,respectively,significantly higher than the blank.(3)The extracts of iRoot BP plus,iRoot FS,and MTA of dilutions of 1∶5 and 1∶10 presented no effect of proliferation of MG63 cells. (4)iRoot BP plus and iRoot FS could significantly up-regulated the levels of ALP messenger RNA ex-pression,while there was no obvious difference in ALP staining among the iRoot BP plus,iRoot FS, MTA,and the blank.Conclusion:The present study shows that iRoot has displayed good mineralization capability in vitro and capability to promote differentiation and mineralization of MG63 cells,inferring that iRoot may have good bioactivity.

Objective To study the transcriptional regulation of type Ⅰ procollagen gene in systemic scleroderma(SS)-derived high collagen-producing fibroblast clones by Radix Salviae Miltiorrhizae(RSM).Methods Fibroblast clones with different collagen-producing capacity were previously obtained from patients with SS and normal human controls,and divided into 5 groups to be treated with RSM(1 g/L)injection,its water-soluble active monomers including sodium danshensu(20 mg/L),salvianolic acid B(5 mg/L)and protocatechuic aldehyde(5 mg/L),and lipid-soluble active monomer(tanshinone Ⅱ A,5mg/L)respectively.The fibroblast clones incubated with no drugs served as the water soluble negative control group,and those with dimethyl sulfoxide(DMSO)as the lipid soluble negative control group.MTT assay was performed to evaluate the proliferation of the fibroblast clones after 1-,3-,5-,and 7-day treatment,transient transfection and dualluciferase reporter assay system to quantify the relative activity of collagen type Ⅰ,alpha 1(COL1A1)proximal promoter in these fibroblast clones.Results The inhibitory effect of RSM and its active monomers on the proliferation of fibroblast clones was inapparent within the initial 3 days(P ＞ 0.05),but was enhanced with incubation time.A significant difference was observed in the proliferation level of fibroblast clones between RSM group and water-soluble negative control group on day 5(q′ =3.22,P ＜ 0.01),between RSM,salvianolic acid B,protocatechuic aldehyde groups and the water-soluble negative control group(q′ =4.74,3.03,2.56,all P ＜0.05)on day 7,and between tanshinone Ⅱ A and lipid-soluble negative control group on day 5 and 7(t =2.22,2.15,both P ＜ 0.05).RSM injection,tanshinone Ⅱ A and protocatechuic aldehyde significantly inhibited COL1A1 proximal promoter activity in SS-derived and normal control fibroblast clones(all P ＜ 0.01),and the former two drugs preferentially downregulated COL1A1 proximal promoter activity in SS-derived high collagenproducing fibroblast clones.Significantly different COL1A1 proximal promoter activity was observed in SS-derived high and low collagen-producing fibroblast clones between water-soluble negative control group and RSM injection group(12.019 ± 0.830 vs.4.445 ± 1.061,5.388 ± 0.480 vs.2.856 ± 0.597,F=31.78,P＜ 0.01),and between lipid-soluable negative control group and tanshinone Ⅱ A group(14.155 ± 0.672 vs.9.638 ±0.854,4.299 ± 0.252 vs.3.192 ± 0.450,F=24.10,P＜ 0.01).Conclusions RSM inhibits the transcription of COL1A1 gene in SS-derived high collagen-producing fibroblast clones,which may be mainly attributed to tanshinone Ⅱ A and protocatechuic aldehyde.

ObjectiveTo study transcriptional characteristics of type Ⅲ procollagen gene in systemic scleroderma (SS)-derived fibroblast clones and their regulation by Radix Salviae miltiorrhizae(RSM).Methods Eight fibroblast clones with different collagen-producing capacity were previously obtained from patients with SS and normal human controls.Recombinant plasmids containing different deletions of the human alpha 1 chain of type 3 procollagen(COL3A1) gene promoter were constructed,and transiently transfected into the fibroblast clones.Dual-luciferase reporter assay system was used to evaluate the activities of these recombinants in the fibroblast clones and to select a proximal transcriptional regulatory sequence.Then,the fibroblast clones were transfected with the plasmid containing the selected regulatory sequence(phCOLH30.1) followed by the treatment with RSM injection(1 g/L) and active monomers of RSM,including salvianolic acid B(5 mg/L),tanshinone Ⅱ A (5 mg/L),danshensu(20 mg/L) and protocatechuic aldehyde(5 mg/L),for 48 hours.The transfected fibroblast clones receiving no drug treatment served as the water-soluble control,and those treated with only dimethyl sulfoxide as the lipid-soluble control.Subsequently,the fibroblasts were lysed and subjected to the quantification of cellular proteins and determination of luciferase activity.The activity of recombinant promoters was compared by t test for the selection of proximal transcriptional regulatory sequence,and the activity of phCOLH30.1 by two-way analysis of variance in the RSM-interfering test(if there was interaction,one-way analysis of variance was conducted; and if there was no interaction,the main effect was tested after the removal of interaction item).ResultsOf the 6 recombinants,the recombinant containing COL3A1 proximal promoter from -96 bp to +16 bp(phCOLH30.1) showed the highest transcriptional activity in nearly all of the fibroblast clones,and the activity was positively correlated with the collagen-producing capacity of fibroblast clones.Compared with the water-soluble control,RSM injection significantly downregulated the activity of phCOLH30.1 in fibroblast clones with high and low collagen-producing capacity from patients with SS (2.261 ± 0.619 vs.3.879 ± 0.309,1.462 ± 0.291 vs.2.150 ± 0.262,both P ＜ 0.01) and normal human controls (1.681 ± 0.263 vs.3.039 ± 0.271,1.121 ± 0.361 vs.2.223 ± 0.247,both P ＜ 0.01),salvianolic acid B decreased the phCOLH30.1 activity in SS-derived high collagen-producing fibroblast clones (2.309 ± 0.524,P ＜ 0.01 ) and in the normal control fibroblast clones with high and low collagen-producing capacity (2.126 ± 0.320 and 1.976 ± 0.362,both P ＜ 0.05).Tanshinone Ⅱ A only downregulated the phCOLH30.1 activity in SS-derived high collagen-producing fibroblast clones compared with the lipid-soluble control(2.975 ± 0.666 vs 5.379 ± 0.238,P ＜ 0.01 ).Neither danshensu nor protocatechuic aldehyde showed inhibitory effects on phCOLH30.1 activity in SS-derived or normal control fibroblast clones.ConclusionsThe type Ⅲ procollagen gene is activated at the transcriptional level in high collagen-producing fibroblast clones from patients with SS,and the activation could be suppressed by RSM injection,salvianolic acid B and tanshinone Ⅱ A.