Objective Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi method. Methods Use document retrieval method to review information and articles about the treatment guidelines and articles of cervical radiculopathy including domestic and international areas, established a protocol about clini?cal consensus of the treatments for cervical radiculopathy. This protocol included 23 questions (the effective proportion of non?operating therapy, neck immobilization, physiotherapy, pharmacologic treatment, surgical indications, contraindications, anteri?or surgical decompression, anterior surgical implants). We performed a modified Delphi survey in which current professional opinions from experienced experts, representing from almost all of the Chinese provinces, were gathered. And then we modi?fied the protocol according to those professional opinions. Three rounds were performed and finally we established consensus. Consensus was achieved with ≥70% agreement. Results The panel included 30 experienced experts. The recycling question?naire's quantity of three rounds were 30(100%), 24(80%) and 16(53.3%) respectively. After three expert assessments, there were 18 questions which achieved with≥70%agreement and these questions accounted for 64.3%(18/28) of all the questions. Consen?sus of the treatments for cervical radiculopathy was reached on 7 aspects, including:the effective proportion of non?operating thera?py (1 question), neck immobilization (1 question), physiotherapy (1 question), pharmacologic treatment (5 questions), surgical indi?cations (3 questions), contraindications (4 questions), surgery (3 questions). Conclusion This modified Delphi study had reached a consensus concerning several treatment issues on cervical radiculopathy which had strong representativeness of experts and good convergence of opinions. In the absence of high?level evidence, at present, these experts' opinion findings will guide health care providers to define appropriate treatment in their regions. Areas with no consensus provide excellent insight for future research.

The study was aimed to evaluate if the modified in situ cryopreservation could affect the biological function of mesenchymal stem cells (MSC) in vitro. Mesenchymal stem cells from human bone marrow were isolated by standard method and characterized with their morphology, cell-surface antigen profile and differentiation repertoire in vitro. The culture-expanded MSC were cryopreserved in situ with culture medium (DMEM-LG) containing 10% D MSO and 30% selected FCS in -70 degrees C. Following recovery of cryopreservation, differentiation to adipocytes, chondrocytes, and osteoblast in vitro and cell cycle analysis were performed to investigate whether the cryopreservation would change the differentiation potential of MSC. The results showed that after recovery of cryopreservation, there was no changes detected as compared with the culture-expanded MSC in both differentiation potency and growth pattern at 12 weeks. In conclusions: this optimized short term in situ cryopreservation at -70 degrees C could retain biological characteristics of human MSC for at least 3 months, and this method may be useful for cryopreservation of hum an bone marrow MSCs.
Bone Marrow Cells ; cytology ; Cell Cycle ; Cell Differentiation ; Cell Separation ; Cell Survival ; Cryopreservation ; Humans ; Mesenchymal Stromal Cells ; cytology

Scoliosis is a complex spinal three-dimensional malformation with complicated pathogenesis, often associated with complications as thoracic deformity and shoulder imbalance. Because the acquisition of specimen or animal models are difficult, the biomechanical study of scoliosis is limited. In recent years, along with the development of the computer technology, software and image, the technology of establishing a finite element model of human spine is maturing and it has been providing strong support for the research of pathogenesis of scoliosis, the design and application of brace, and the selection of surgical methods. The finite element model method is gradually becoming an important tool in the biomechanical study of scoliosis. Establishing a high quality finite element model is the basis of analysis and future study. However, the finite element modeling process can be complex and modeling methods are greatly varied. Choosing the appropriate modeling method according to research objectives has become researchers' primary task. In this paper, the author reviews the national and international literature in recent years and concludes the finite element modeling methods in scoliosis, including data acquisition, establishment of the geometric model, the material properties, parameters setting, the validity of the finite element model validation and so on.
Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Humans ; Scoliosis ; physiopathology ; surgery ; Spine ; pathology

OBJECTIVETo observe different effects of moxibustion on extracellular potassium ion in acupoint under physiological and pathological status and provide experimental evidence for exploring action mechanism of moxibustion on acupoint local.

METHODSForty female SD rats were randomly divided into a blank group, a blank-moxibustion group, a model group and a model-moxibustion group, 10 cases in each one. The complete Freund's adjuvant(CFA) was adopted to establish model of adjuvant arthritis (AA) in the model group and model-moxibustion group. No treatment was given in the blank group and model group while moxibustion was applied at "Zusan-li" (ST 36) for 30 min in the blank-moxibustion group and model-moxibustion group. The tissue fluid in "Zusanli" (ST 36) was collected with microdialysis and real-time analyzed by electrolytic analyzer. The change of concentration of potassium ion in "Zusanli" (ST 36) was observed.

RESULTS(1) Under physiological status, the concentration of extracellular potassium ion in the blank group was not changed within 150 min (P > 0.05); before the moxibustion, the concentration of extracellular potassium ion in the blank-moxibustion group was (1.21 +/- 0.31) mmol/L, and after treatment it was gradually increased and reached its peak at (2.38 +/- 0.42) mmol/L after 60 min (P < 0.05), then it was reduced. 150 min after the treatment, concentration of potassium ion was slightly higher than that before moxibustion as well as that in the blank group. The concentration in the blank-moxibustion group at 60 min was statistically significant compared with that in the blank group (P < 0.05). (2) Under pathological status, the concentration of extracellular potassium ion in the model group was not changed within 150 min, differences of which at each time point was not statistically significant (all P > 0.05). Before the moxibustion, the concentration of extracellular potassium ion was (1.09 +/- 0.12) mmol/L in the model-moxibustion group, and it was immediately increased to (1.96 +/- 0.18) mmol/L after moxibustion. 60 min and 90 min after the moxibustion, it still maintained a higher level, which was (1.87 +/- 0.29) mmol/L and (1.59 +/- 0.16) mmol/L respectively (both P < 0.05). The differences of each time point after moxibustion in the model-moxibustion group were statistically significant compared with those in the model group (all P < 0.05).

CONCLUSIONThe moxibustion could increase the concentration of potassium ion in rat's acupoint local under physiological status but time of effect is short; with moxibustion at "Zusanli" (ST 36) under pathological status, the concentration of local potassium ion is obviously increased and maintains for a long time.

Acupuncture Points ; Animals ; Arthritis, Experimental ; metabolism ; therapy ; Disease Models, Animal ; Female ; Humans ; Moxibustion ; Potassium ; metabolism ; Rats ; Rats, Sprague-Dawley

Action Potentials ; Animals ; Electromyography ; Environmental Exposure ; Hypothermia ; Rats ; Rats, Wistar ; Seawater ; Thigh ; physiology ; physiopathology

Objective To analyze clinical characteristics of patients suffered from nervous system involved severe fever with thrombocytopenia syndrome (SFTS).Methods Clinical data of SFTS patients who were admitted to Qingdao Sixth People’s Hospital between January 2016 and December 2017 were retrospectively analyzed.Accor-ding to whether there was nervous system involvement,they were divided into two groups,clinical data of two groups of patients were compared and analyzed;SFTS patients with nervous system involvement were subdivided in-to death group and survival group according to the final outcome,clinical data of two groups were compared and ana-lyzed.Results The median date of occurrence of neurological symptoms in SFTS patients was at day 6 of disease process. There were statistical differences in age,skin ecchymosis/severe bleeding tendency,C-reactive protein,procalcitonin,Ca2+on admission,CD4+cell count,myocardial enzymes (LDH,CK,CKMB,HBDH),pulmonary inflammation,liver func-tion (ALT,Alb,AST),and activated partial thromboplastin time (APTT)between nervous system involvement group and non-nervous system involvement group(all P＜0.05).Among patients with nervous system involvement,there were statistical differences in skin ecchymosis,the lowest value of PLT,positive rate of SFTSV-IgM antibody,CD3+cell count, CD4+cell count,LDH,Alb,and APTT between death group and survival group (all P＜0.05).Conclusion Most SFTS patients with nervous system involvement are elderly patients with seriously damaged coagulation function, liver function,myocardial enzymes and immune system,proportion of pulmonary infection is high.Among SFTS patients with nervous system involvement,impairment of coagulation function,immune function,liver function, and myocardial enzymes in deceased patients are more serious than those in survivors.

To explore the effect of different doses of thrombopoietin on proliferation of bone marrow mesenchymal stem cells (MSCs) in mice, 20 Kunming mice (35 +/- 5 g) were divided randomly into 4 groups: low-dose TPO group, moderate-dose TPO group, high-dose TPO group and normal control group (n = 5). The experimental groups were subjected to intraperitoneal injections of TPO at a dose of 25, 50, 100 microg/kg, respectively, and normal control group were treated with saline at a dose of 0.1 ml/g per day for 5 days. The bone marrow was harvested on 12 hours after the final administration. The bone marrow nucleated cells (BMNCs) were counted and seeded at a density of 10(6) cells/cm(2). The colony-forming unit-fibroblast (CFU-F) of MSCs was cultured and evaluated. The CFU-F of MSCs underwent osteo-genic induction and adipogenic induction, and cytochemical and immunocytochemical staining were performed to verify their multipotential. CFU-F and the cell percentage of CD90(+), CD105(+), CD34(+) in BMNCs were analyzed by flow cytometry. The results showed that the number of BMNCs and the cell percentage of CD90(+), CD105(+), CD34(+) and CFU-F increased obviously in TPO groups as compared with the normal control group (p < 0.05). The number of BMNCs increased most obviously in the 50 microg/kg TPO group. However, there was no significant difference in number of CFU-F between 50 microg/kg and 100 microg/kg TPO group (p > 0.05). The CFU-F of MSCs in bone marrow had their osteogenic and adipogenic differentiation potentials in vitro. It is concluded that the number of BMNCs and the cell percentage of CD90(+), CD105(+) and CFU-F increased after administration with TPO. It means that TPO can enhance MSCs to proliferate in bone marrow. However, the number of BMNCs and CFU-F can not increase with the increase of TPO dose.
Animals ; Bone Marrow Cells ; cytology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Dose-Response Relationship, Drug ; Mesenchymal Stromal Cells ; cytology ; Mice ; Thrombopoietin ; pharmacology

Delphi Technique ; Humans ; Radiculopathy ; drug therapy ; surgery ; therapy

OBJECTIVETo explore the clinical significance of multiple radiography of the pelvis in the evaluation of surgical outcomes for patients with slow transit constipation complicated with outlet obstruction.

METHODSPatients with slow transit constipation complicated with outlet obstruction were diagnosed by multiple radiography of the pelvis after screening using colon transit study. Surgery was performed according to the cause of the obstruction. Anorectal angle and the locations of perineum, pelvic peritoneum, and bladder were assessed by multiple radiography of the pelvis one month after surgery. The changes in locations of pelvic organs were assessed and the imaging appearance after the release of obstruction was observed.

RESULTSA total of 48 patients were included. Rectocele repair, partial mucosectomy with rectopexy, and hysteropexy were performed. All the patients were followed up with a mean length of 19(6-58) months. Excluding 2 patients who had no symptomatic improvement, the mean bowel movements was 1.9 times per day in the remaining 46 patients(95.8%). Preoperative anorectal angle at the squeezing phase was(128.09±13.82) degree and the difference between squeezing and resting phase was (11.14±12.58) degree, while the postoperative angle was (180.26±9.98) degree and the difference(20.01±13.11) degree(P<0.05). Preoperative location of the perineum at the squeezing phase was(-2.05±0.83) cm and the difference was(2.23±0.78) cm, while postoperative location was (-0.50±1.13) cm and the difference was (2.18±1.04) cm(P<0.05). Preoperative location of the pelvic peritoneum at the squeezing phase was(4.91±1.32) cm and the difference was (1.32±0.89) cm, while postoperative location was (2.62±2.53) cm and the difference was (3.28±0.68) cm (P<0.05). Preoperative bladder location at the squeezing phase in patients with urological symptoms was (3.92±2.51) cm and the difference was(1.39±1.27) cm, while postoperative location was (2.15±1.55) cm and the difference was (1.98±1.54) cm(P<0.05).

CONCLUSIONMultiple imaging of the pelvis provides objective evidence in the evaluation of surgical outcomes for patients with chronic slow transit constipation complicated with outlet obstruction.

Adult ; Aged ; Constipation ; complications ; diagnosis ; surgery ; Diagnostic Techniques, Digestive System ; Female ; Humans ; Intestinal Obstruction ; complications ; diagnosis ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To assess the prevalence rates of intra-and extraeranial large-artery stenosis in the rural community population and its related risk to the development of stroke.Methods The study subjects included 1337 residents in the rural community of Beijing.Transcranial Doppler Was carried our to examine the relation between intra-and extracranial large-artery stenosis and subsequent cerebrovascular events, with a meall follow-up period of 16.7 months.Results The incidence densities of cerebral infarction and cerebral hemorrhage in persons without cerebral large-artery stenosis were 410.6 and 351.9/100-thousand person-years,respectively.In the group wlth large-artery stenosis,the incidence density of cerebral infarction was 3303.7/100-thousand person-years.Data from The Fisher's Exact test showed a significant difference in the two groups (P=0.004).Cerebral large-artery stenosis(OR=6.593,95%CI:1.712-25.390)and smoking (OR=8.437,95% CI:2.327-30.598)appeared to be independent risk factors to cerebral infarction.Conclusion Cerebral large-artery stenosis and smoking were independent risk factors to cerebral infarction.