The optimized cultural medium of fermentation for Candida sp.mutant strain YQ5 to produce S-adenosylmethionine was studied.The results of single factor experiment showed that the most favorable pH value,carbon source,nitrogen source organic nutrient is 6.0,8% sucrose,1.5% tryptone and 2% yeast extract,respectively.As to inorganic salts,MgSO4?7H2O,CaCl2,FeSO4?7H2O,CoCl2,CuSO4?5H2O,H3BO3 could improve accumulation of the intercellular SAM.The ingredients of the culture medium are also opti-mized by the orthogonal experiment.Fermentation for 48 h under the optimal condition resulted in AdoMet production at 1740.0 mg/L.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.
Animals ; Body Weight ; drug effects ; Dose-Response Relationship, Drug ; Dyslipidemias ; metabolism ; Energy Metabolism ; drug effects ; Fatty Liver ; chemically induced ; complications ; Female ; Fibroblast Growth Factors ; administration & dosage ; pharmacology ; therapeutic use ; Insulin Resistance ; Lipolysis ; drug effects ; Liver ; metabolism ; pathology ; Male ; Mice ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Sodium Glutamate

OBJECTIVETo analyze the causes of the complications associated with the pedicle screw fixation during and after operation, as well as the methods for prevention and treatment.

METHODSFrom January 1988 to December 1999, 475 patients who underwent pedicle screw fixation for various spinal disorders were reviewed retrospectively with statistical analysis.

RESULTSFour hundred and twenty-eight patients (90.1% of all) were followed up for (6.0 +/- 3.7) years. Complications of CD, DRFS, Dick, RF and steffee among 72 cases (80% of all) occurred during the operation of pedical screw fixation in 26 cases with the incidence of 5.5% and after the operation in 64 cases with the incidence of 15%. The incidence of operative/postoperative complications were 0-12.9% in CD, 6.8%-11.9% in DRFS, 7.3%-12.7% in Dick, 2.4%-19.5% in RF, and 10.1%-21.5% in Steffee respectively. The main complications included pseudoarthrosis, pedicle screw broken, pedicle screw malposition and so on. The complications were mainly due to unskilled technique of pedicle screw fixation, implant defect in design and so on.

CONCLUSIONSThe complications associated with the technique of pedicle screw fixation must not be neglected. The main causes are laid on unskilled technique of pedicle screw fixation and implant defect in design.

Equipment Failure ; statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Incidence ; Internal Fixators ; Male ; Postoperative Complications ; epidemiology ; etiology ; Pseudarthrosis ; epidemiology ; etiology ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fusion ; methods

Objective To summarize the experience of long-term survival in patients after simulta- neous kidney-pancreas transplantation(SKPT)with modified enteric drainage(ED).Methods From October 2001 to July 2004,6 patients with end-stage renal disease due to Type 1 diabetes underwent SKPT with modified ED,ie,side-to-side anastomosis between the duodenum of donors and jejunum of recipients. The medication regimen included:mycophenolic acid 500 mg and tacrolimus 2 mg before operation;methyl- prednisolone(MP)1.0 during operation;and 2-dose anti-IL-2 receptor monoclonal antibody(2 cases)or antihuman thymocyte globulin(ATG)(4 cases)for immune induction therapy;MP was used on the first 3 d after transplantation,triple immunosuppressive therapy(tacrotimus,mycophenolic acid and prednisone)was used on the second d after transplantation.Anticoagulants such as low molecular heparin or alprostadil were used for 7-10 d to prevent thrombosis in pancreas graft.Somatostatin was used as prophylaxis for graft pan- creatitis.Ganciclovir was used to prevent cytomegalovirus infection when renal graft gradually recovered 3 to 5 d after transplantation.The follow-up was from 1 year and 3 months to 4 years and 1 month.Results Transplantation was successful in all 6 cases.The blood sugar levels were 6-16 mmol/L.Low-dose insulin was used for 5-10 d,then the blood sugar levels returned to normal range.One of 6 patients experienced nephrotoxicity because of high tacrolimus blood concentration at 7 d after operation;after 3 dialyses and re- duction of tacrolimus dose,the renal allograft regained normal function.Three cases experienced alimentary tract hemorrhage at 14,20 and 22 d,respectively,after operation;the bleeding was stopped after treatment. There were no complications such as pancreatic fistula,intestinal fistula and thrombosis early after operation. All the patients are now alive,specifically,1 survived over 4 years,3 over 3 years,1 over 2 years,and 1 over 1 year.All had normal blood sugar free of insulin use.Five cases had normal renal graft function,with normal sCr,and 1 had sCr＞400?mol/L. Two cases were admitted to hospital due to upper respiratory infection and furuncles in the skin of head 6 months and 2 years,respectively,after operation.They were both cured.No complications such as urinary infection,metabolic acidosis and dehydration occurred.Conclusions SKPT is effective for the treatment of end-stage renal disease due to Type 1 diabetes.SKPT with modified ED are relatively simple with physiological compatibility and fewer complications.High quality of donated organs, HLA matching,pancreatic drainage pattern,rational periopcrative medications and infection late after trans- plantation are important factors affecting the long-term survival of the patients.

BACKGROUNDPulmonary problems often occur in patients with early-onset scoliosis (EOS). However, lung function in patients with EOS after growing rod surgery has not been documented. The aim of this study was to investigate lung function after the treatment for EOS with growing rod and its possible correlative factors.

METHODSEight patients with EOS were treated with growing rod surgery at Peking Union Medical College Hospital from September 2002 to September 2009. Four patients had finished the final fusion surgery (group 1), and the other 4 (group 2) were in the process of periodic lengthening. Preoperative forced vital capacity (FVC), ratio of FVC to predicted FVC, forced expiratory volume in 1 second (FEV1), ratio of FEV1 to predicted FEV1, and radiographic measurements of Cobb's angle and C7-S1 distance were recorded. Lung function changes and correlations between lung function changes and radiographic changes (Cobb's angle and C7-S1 distance) were analyzed.

RESULTSIn group 1, FVC and FEV1 both increased. FVC showed a significant difference (P = 0.01), but FEV1 did not (P = 0.05). In group 2, FVC and FEV1 also increased, and both showed a significant difference (P = 0.04 and P = 0.02, respectively). Ratio of FVC to predicted FVC and ratio of FEV1 to predicted FEV1 changed similarly and did not show statistical differences in the 2 groups. There were no significant correlations between lung function changes and radiographic changes (Cobb's angle and C7-S1 distance) (P = 0.10 and P = 0.41, respectively).

CONCLUSIONSLung function increases after growing rod surgery in patients with EOS. Lung function changes do not correlate with Cobb's angle changes or C7-S1 distance changes.

Child ; Female ; Forced Expiratory Volume ; physiology ; Humans ; Male ; Orthopedic Procedures ; adverse effects ; Scoliosis ; physiopathology ; surgery ; Vital Capacity ; physiology

OBJECTIVETo evaluate the biomechanical stability of Shen's instrumentation in the management of thoracolumbar fractures.

METHODSThe ranges of movement (ROM) in three dimensions of twelve T(12) - S(3) specimen of fresh adult cadavers were measured sequentially in the states of normal, injured, GSS and SOCON fixation, fatigued GSS and SOCON fixation. Data were then compared.

RESULTSFor the L(2 - 3) segment, the average normal ROM in flexion was 8.3 degrees. In the established spondylolisthesis models, the ROM was 14.7 degrees. After fixation with SOCON, the ROM was decreased to 3.0 degrees, indicating that SOCON fixation can produce good stability. The ROM after fatigue test was 3.6 degrees, significantly lower than that of the normal state, indicating that SOCON still produces good stability after fatigue. For the L(4 - 5) segment, the average normal ROM in flexion was 8.6 degrees. In the established spondylolisthesis models, the ROM was 13.7 degrees. After GSS fixation, the ROM was decreased to 3.2 degrees, significantly lower than that in the normal state, indicating that GSS fixation can produce good stability. ROM after fatigue test was 3.7 degrees, significantly lower than that of the normal state, indicating that GSS can produce good stability after fatigue. The ROM measurements in the other five directions were similar to those for flexion described above.

CONCLUSIONGSS produces good stability for spondylolisthesis, good fatigue resistance, and can be used in pedicle screw revision surgery. There were no significant differences between GSS and SOCON.

Adult ; Biomechanical Phenomena ; Cadaver ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Lumbar Vertebrae ; injuries ; Male ; Range of Motion, Articular ; Spinal Fusion ; instrumentation ; methods ; Spinal Injuries ; physiopathology ; surgery ; Thoracic Vertebrae ; injuries ; Young Adult

OBJECTIVETo investigate the mid-term radiological outcome of sagittal alignment of overall cervical spine and the functional spinal unit after replacement surgery with Bryan cervical disc prosthesis.

METHODSEighteen patients with cervical disc disorder were performed cervical disc replacement with 20 Bryan discs from November 2005 to May 2010, including single-level 16 cases and bi-level 2 cases. The patient consisted of 13 males and 5 females with age ranging from 38 to 59 years (average, (47 ± 6) years). Fourteen cases with overall cervical lordotic alignment and segmental lordotic alignment per-operatively (group 1) and 4 others with segmental kyphotic alignment and overall cervical kyphotic alignment per-operatively (group 2). The overall sagittal alignment (C(2-7)) and segmental sagittal alignment were measured pre-operatively, post-operatively and at final follow-up to evaluate the outcome.

RESULTSAll cases obtained the follow-up with an average of (24 ± 5) months (range 12 to 53 months). To the mean overall cervical alignment, there were 9.9° ± 1.9° per-operatively, 12.8° ± 2.1° post-operatively and 11.6° ± 1.8° at final follow-up in group 1 and -1.8° ± 0.8° per-operatively, 7.3° ± 1.3° post-operatively and 5.0° ± 2.1° at final follow-up in group 2. There were statistical significance between per-operatively and post-operatively (t = -2.987 and -5.058, P < 0.05) and no statistical significance between post-operatively and final follow-up (P > 0.05) in both groups. To the mean segmental alignment there were 2.6° ± 0.8° per-operatively, 5.4° ± 1.0° post-operatively and 4.3° ± 0.9° at final follow-up in group 1 and -3.0° ± 0.8° per-operatively, 3.8° ± 1.3° post-operatively and 0.3° ± 2.8° at final follow-up in group 2. There were statistical significance between per-operatively and post-operatively in both groups (t = -3.829 and -4.086, P < 0.05) and between post-operatively and final follow-up in group 1 (t = 2.630, P < 0.05)but not in group 2 (P > 0.05).

CONCLUSIONSThe Bryan cervical disc prosthesis has a good mid-term outcome for maintaining sagittal alignment of overall cervical spine and the functional spinal unit. Long-term follow-up should be needed to assess the long-term functionality of the prosthesis.

Adult ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; surgery ; Joint Prosthesis ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; Spinal Osteophytosis ; surgery ; Treatment Outcome

OBJECTIVETo compare and evaluate instrumented posterior fusion with instrumented circumferential lumbar fusion in the treatment of lumbar stenosis with low degree lumbar spondylolisthesis.

METHODSFrom April 1998 to April 2003, 45 patients who suffered from lumbar stenosis with low degree lumbar spondylolisthesis were divided into 2 groups (A and B) at random. The patients in group A (n = 24, average age 54 years old) were performed decompressive laminectomy, intertransverse process arthrodesis with bone grafting and transpedicle instrumentation of solid connection (SOCON) system. The patients in group B (n = 21, average age 53 years old) were performed the same procedure as group A except adding posterior lumbar interbody fusion (PROSPACE). The main levels of lumbar spondylolisthesis in 2 groups was L(4 - 5) or L(5)-S(1). All cases were classified as degree 1 to degree 2. All patients in the two groups received preoperative myelography or CTM, and were diagnosed lateral recess stenosis and(or) central lumbar canal stenosis.

RESULTSAll the patients were followed up from 12 to 72 months. In group A, the results showed that the preoperative clinical symptoms disappeared completely in 12 of 24 patients, pain relief was seen in 91.7% (22/24), anatomical reduction rate was 91.7%. No infection or neurologic complication occurred in this series. In group B, the results showed that the preoperative clinical symptoms disappeared completely in 13 of 21 patients, pain relief was seen in 90.5% (19/21), anatomical reduction rate was 95.2%. Four cases of infection or neurologic complication occurred in this series. Two groups had no significant difference in follow-up clinical outcome and anatomical reduction rate. But group A had better intraoperative circumstances and postoperative outcome than group B, group B had better postoperative parameters in X-ray of angle of slipping and disc index than group A.

CONCLUSIONSThe best surgical treatment method of lumbar stenosis with low degree lumbar spondylolisthesis is complete intraoperative decompressive laminectomy, reduction with excellent transpedicle system instrumentation and solid fusion after bone grafting. The use of cage should be conformed to strict indications.

Adolescent ; Adult ; Aged ; Female ; Humans ; Laminectomy ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Stenosis ; complications ; surgery ; Spondylolysis ; complications ; surgery ; Treatment Outcome

Objective By using resting-state fMRI (r-fMRI), to observe the effect of electroacupuncture at Quchi (LI 11) and Shangjuxu (ST 37) in changing brain activity pattern in functional bowel disorders (FBD), and to provide imaging evidence for seeking the central mechanism of Quchi (LI 11) and Shangjuxu (ST 37) in treating FBD.Method Twenty patients with functional constipation were taken as the constipation group, and 20 patients with functional diarrhea were taken as the diarrhea group. The constipation group was intervened by electroacupuncture at Shangjuxu (ST 37), while the diarrhea group was intervened by electroacupuncture at Quchi (LI 11). On the next day, the two groups both received electroacupuncture at the corresponding non-meridian point. The r-fMRI data of the two groups were collected before and after the interventions. With the functional connectivity taken as the observation index and right insular lobe as the seed point, MTLAB, DPARSF and REST were adopted to obtain the brain images functionally connected with the seed point, to further analyze the difference in brain functional connectivity before and after electroacupuncture.Result After electroacupuncture at Shangjuxu (ST 37), functional constipation patients presented positive activation in left cerebellar declive, left lingual gyrus, left middle occipital gyrus, right occipital lobe, right supramarginal gyrus, right gyrus cingula and left precuneus; the right subgyrus, right insular lobe and left insular lobe were negatively evoked. After electroacupuncture at Quchi (LI 11), patients with functional diarrhea showed significant differences in left cerebellar culmen and left posterior cingulate.Conclusion Electroacupuncture at Quchi (LI 11) and Shangjuxu (ST 37) can induce changes in brain functional connectivity related to visceral hypersensitivity in FBD patients, which is possibly associated with the effect of acupuncture in improving FBD.

AIM:To investigate the distribution characteristics of interleukin-22(IL-22)gene rs2227485C/T and rs2227491A/G polymorphisms in Guangxi people and the distribution differences with other ethnic groups ,and to ex-plore the difference levels of common lipid indexes in different genotypes.METHODS:SNaPshot technique and DNA se-quencing were used in 280 Guangxi persons to examine IL-22 genotypes and to analyzed the distribution frequencies of allele and genotype in these sites.The distribution frequencies in different sexes ,and the differences between groups and diffe-rence levels of common lipid indexes in different genotypes were analyzed statistically.RESULTS:Three genotypes of CC ,CT and TT were found in rs2227485C/T with the frequency distribution of 17.1％,49.3％and 33.6％,respectively.No significant difference between different sexes of each genotype and allele frequency in the Guangxi population was observed(P>0.05).Compared with the distribution frequencies of genotype and allele in HapMap -TSI,HapMap-HCB,HapMap-JPT and HapMap-MEX,those in Guangxi population showed statistically significant differences(P<0.05).Three geno-types of AA,AG and GG were found in rs2227491A/G with the frequency distribution of 16.1％,52.8％and 31.1％,re-spectively.There was no significant difference between different sexes of each genotype and allele frequency in the Guangxi population(P>0.05).The significant differences of genotype frequencies among Guangxi population ,HapMap-TSI,Hap- Map-JPT and HapMap-MEX were detected(P <0.05 ).Compared with the other 4 populations ,allele frequencies in Guangxi population had significant difference(P <0.05).There were significant differences in the levels of HDL-C and LDL-C among the 3 genotypes of rs2227491A/G.The level of HDL-C had difference between AG/AA genotype and GG genotype.In addition,the level of LDL-C had difference between AG/GG genotype and AA genotype(P<0.05).CON-CLUSION:rs2227485C/T and rs2227491A/G polymorphisms of IL-22 gene have differences in different populations.The rs2227491A/G polymorphism may be associated with serum lipid levels.