BACKGROUND:Posterior lumbar interbody fusion is a typical therapeutic method of lumbar degenerative disease. Present studies suggested that adjacent segment degeneration occurs after fusion. Recently, more and more scholars paid attention to the development of non-fusion of the spine. ＜br> OBJECTIVE:To compare clinical effects of Dynesys dynamic stabilization system fixation and posterior lumbar interbody fusion in treatment of lumbar degenerative disease. ＜br> METHODS:From July 2009 to July 2011, clinical data of 56 patients with lumbar degenerative disease were retrospectively analyzed. There were 28 cases of Dynesys dynamic stabilization system fixation, and 28 cases of posterior lumbar interbody fusion. Operation time, bleeding volume, and postoperative hospitalization time were compared in both groups. Visual analog scale was used to assess pain. Oswestry disability index was utilized to evaluate clinical effects. ＜br> RESULTS AND CONCLUSION:A total of 56 patients were fol owed up for 18-24 months. Visual analog scale and Oswestry disability index scores were significantly improved at 12 months after treatment in both groups (P＜0.01). Significant differences in operation time, bleeding volume, and postoperative hospitalization time were detected between both groups (P＜0.01). Dynesys dynamic stabilization system group was better than posterior lumbar interbody fusion group. Range of motion was better in the Dynesys dynamic stabilization system group than in the posterior lumbar interbody fusion group (P＜0.01). During fol ow-up, nail rope system and polyester sleeve loose were not detectable in the Dynesys dynamic stabilization system group. These results verified that compared with posterior lumbar interbody fusion, Dynesys dynamic stabilization system for lumbar degenerative diseases has a high safety and smal trauma, and can keep advantages of a fixed segment, and exert a certain effect on degeneration of intervertebral disc in the adjacent segment.

Educational Measurement ; Humans ; Inservice Training ; Pneumoconiosis ; diagnosis ; Reference Standards

BACKGROUND: The application of mesenchymal stem cells derived from umbilical cord cultured in serum-containing medium has some obstacles. OBJECTIVE: To establish serum free medium system for primary culture of umbilical cord-derived mesenchymal stem cells. METHODS: Wharton’s Jel y was isolated from umbilical cord, minced, 1-3 mm3, and subsequently incubated in either serum containing medium or serum free medium. Some cells were harvested on days 11, 14 and 17 for some detection. Based on the minimal criteria established by the International Society for Cel ular Therapy in 2006, mesenchymal stem cells were assayed with colony forming unit-fibroblast. RESULTS AND CONCLUSION: The mesenchymal stem cells grew rapidly in serum free medium condition compared with serum containing medium. On day 11, the number of colonies was larger in serum free medium condition than that in serum containing medium. Thus, serum free medium could maintain properties of mesenchymal stem cells and provide possibility a credible alternative to serum containing medium for primary culture of umbilical cord-derived mesenchymal stem cells.

New scientific hypotheses detected by mining the potential indirect association inliterature according to the studies on literature-based knowledge discovery are increasinglyapplied in biomedical field and evaluation of literature-based indirect association discovery is a hot spot in recent studies on literature-based knowledge discovery . The role of network characteristics in evaluation of literature-based indirect association discovery during the litera-ture-based knowledge discovery was thus studied.The new indexes for evaluaing the literature-based indirect asso-ciation discovery were esatablished by integrating the co-ocurrent statistic information and the network charateris-tics, which are of greatimportance for improving literature-based knowledge discovery and constructing knowledge discovery system .

OBJECTIVEEndothelial apoptosis plays an important role in the initiation of atherosclerosis. It would be useful to clarify whether activation of non-neuronal muscarinic receptor (NNMR) could prevent endothelial apoptosis and atherosclerosis. We investigated the effects of NNMR activation on regulating rat aortic endothelial cells (RAECs) apoptosis induced by homocysteine, an independent risk factor of atherosclerosis, and further studied its molecular mechanism.

METHODSRAECs were incubated using homocysteine at the concentration of 2.7 mmol/L for 36 h. RAECs were also pre-treated with carbachol or arecoline to examine their effects. RT-PCR was used to assess changes in the gene expression related to cell apoptosis.

RESULTSIncubation of RAECs with homocysteine at the concentration of 2.7 mmol/L resulted in morphologic changes, such as cellular shrinkage, membrane blebbing, chromatin condensation and margination. These could be attenuated by pretreatment with carbachol and arecoline at the concentration of 10 micromol/L for 12 h. Homocysteine induced apoptosis in RAECs and the molecular mechanisms were associated with the regulation of fas, fas-L and caspase-8 in the death receptor pathway, bcl-2, bcl-xL and bax in the mitochondrial pathway, caspase-12 in the endoplasmic reticulum pathway and caspase-3, caspase-6 and p53 as downstream effectors. Carbachol and arecoline attenuated the effects of homocysteine on genes in the death receptor pathway, in the mitochondrial pathway and in the downstream pathway. Atropine could reverse all of the effects of arecoline.

CONCLUSIONActivation of NNMR by carbacol and arecoline inhibits homocysteine-induced endothelial cell apoptosis mainly through regulation of death receptor pathway, mitochondrial pathway and downstream effectors.

Animals ; Aorta ; cytology ; Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Arecoline ; Carbachol ; Cell Cycle ; Endoplasmic Reticulum ; metabolism ; Endothelial Cells ; cytology ; drug effects ; Homocysteine ; adverse effects ; Mitochondria ; metabolism ; Rats ; Receptors, Muscarinic ; metabolism

BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective.
OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis.
METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software.
RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.

Objective To review the effect of exposed and buried Kirschner wire fixation of lateral humeral condyle fracture in children.Methods Randomized control trials (RCTs) about exposed versus buried Kirschner wire fixation of lateral humeral condyle fracture in children were identified through electronic search using the Cochrane Collaboration search strategies and manual search.Electronic database included Cochrane Library,Medline,PubMed,CBM,VIP,CNKI,Wanfang database and other Chinese and English database.Manual research included related journals and conference proceedings.Quality analysis of the included literatures was performed using the methodological index for non-randomized studies (MINORS).RevMan 5.3 software was used for Meta analysis.Results Four studies involving exposed Kirschner in 150 cases and buried Kirschner in 351 cases were included.The two techniques were similar with respect to postoperative infection (OR =1.10,95％ CI 0.52 ～ 2.33,P ＞ 0.05),superficial infection (OR =1.45,95 ％ CI 0.66 ～ 3.18,P ＞ 0.05),reoperation rate (OR =2.29,95％CI 0.51 ～ 10.25,P ＞0.05),delayed union rate (OR =1.57,95％ CI 0.76 ～ 3.21,P ＞0.05) and total complications (OR =1.57,95％ CI 0.76 ～ 3.21,P ＞ 0.05).However,Kirschner wire exposure shortened the time of pulling out Kirschner wire (MD =-13.28,95％ CI-16.42 ～-10.14,P ＜0.05).Conclusion Applied for lateral humeral condyle fracture in children,exposed versus buried Kirschner wire fixation results in short Kirschner wire stabilization time that avoids local anesthetic and cost while pulling out Kirschner wire in the late stage.

Objective To increase the awareness of virus-associated hemophagocytic syndrome.Methods Sixteen cases of virus-associated hemophagocytic syndrome were retrospectively analyzed.Results All presented with persistent high fever,cytopenia,hepato-splenomegaly,hepatic dysfunction,hypertriglyceridemia,hyperferritinemia,coagulopathy,hypofibrinogenemia,cytokine storm and a low natural killer cell activity.All patients had lymphohistiocytic accumulation in bone marrow.Treatment with high-dose gamma-globulin and high-dose methylprednisolone.Clinical symptoms and laboratory improved,and five patients died.Conclusion Aggressive early diagnosis and treatment are critical to improve survival.

China ; Competency-Based Education ; Education, Medical ; methods ; trends

Objective The study was designed to compare the ultrasound-guided technique for the cannulation of subclavian vein with the traditional technique using anatomic landmarks.Methods One hundred and twenty ASA Ⅱ or Ⅲ patients undergoing cannulation of subclavian vein before gastrp-intestinal tumor resection were randomly divided into 2 groups (n=60 each) according to the technique used for cannulation:ultrasound-guided group (group US) and anatomic landmark group (group AL).The puncture time,successful puncture and complications were recorded.Resulls The success rate was 100% in group US;while the cannulation failed in one patient in group AL.The rate of successful puncture at 1st attempt was 100% in group US but ouly 90% in group AL.The cannulation time was significantly shorter in group US than in group AL.The incidence of accidental puncture of subclavian artery,hematoma and pneumothorax was significantly higher in group AL than in group US.Conclusion The ultrasound-guided catheterization of the subclavian vein is superior to the landmark technique.