Objective To investigate the clinical outcomes of interbody fusion with transpedicular screw fixation in the reoperation for lumbar spinal instability secondary to lumbar discectomy.Methods From May 1997 to Aug 2002, 23 patients underwent reoperation with posterior lumbar spinal decompression, removal of residual disc, transpedicular screw instrumentation and interbody fusion because of lumbar spinal instability after previous lumbar discectomy. There were 14 males and 9 females. The age of patients ranged from 28 to 64 years with an average age of 48.5 years. The time between the onset of the symptoms and the diagnosis was 18 months on average (range, 6 months to 36 years). The mean interval between the primary and revision surgery was 68 months (range, 24 months to 10 years). Lumbar discectomy had been performed in all patients as the primary surgery. All patients were evaluated by the conventional radiography, and CT or MRI if necessary. The low back pain was predominant in 8, and associated with radicular leg pain in 15. The instability of one segment was found in 17, and two segments in 6. The average follow-up was 3.6 years (range, 1 to 6.4 years). Results The lateral, AP, flexion and extension X-ray films were taken at 1, 3, 6 months and 1 year to evaluate the fusion, sliding between two vertebral bodies and internal fixation, and McGill pain questionnaire was adopted to determine the satisfaction of the patients. The intraoperative blood loss ranged from 550 to 800 ml (mean, 650 ml), and the total operative time ranged from 120 to 210 min (mean, 180 min). Based on Oswestry low back pain and disability scores, the clinical successful rate was 86.9%. The rate of patient satisfaction was 82.6%. 20 patients showed radiographic bony fusion. Pedicle screw breakage and loosening were found in 3 out of the 102 screws. 5 patients had nerve root irritation and recovered within 2 to 3 weeks. 5 patients had dural laceration. Bony nonunion was found in 3 patients. Conclusion Transpedicular screw instrumentation and interbody fusion is proved helpful in management of spinal instability secondary to decompression surgery, providing successful interbody fusion and restoration of the intervertebral stability.

Objective To introduce the operative procedure of prosthetic disc nucleus(PDN)re-placement and investigate its clinical effectiveness in the treatment of lumbar disc herniation.Methods Nine cases of lumbar disc herniation were treated with PDN replacement from March2002to April2002.There were6males and3females,the average age of the patients was33.4years ranging from22to48years.The interval between the onset of the symptoms and the diagnosis was averagely18.4months,ranging from8months to3.6years.All of the patients were evaluated by anteroposterior and lateral radiography,computer-ized tomography and,if necessary,magnetic resonance imaging.The low back pain was predomi nant in two patients,the low back pain associated with radicular leg pain in6patients.The height of disc space became narrowed in varying grade.The operated level was at L 4-5 in6patients,L 5 S 1 in3patients.The standard pos-terior approach was used in8patients;the anterior lateral retroperitoneal approach was adopted in1patient.8cases were implanted with a single PDN,and1case with a couple of PDNs.Results All patients were followed up12to13months(average12.3months).The estimated intraoperative blood loss ranged from50to150ml (mean120ml ),and the total operation time ranged from45to120min(mean60min).The patients wore a brace for the first6weeks.Based on Oswestry low back pain and dis ability scores,the clinical successful rate was88.9%.The average percentage of the postoperative to preoperative disc height was128%.The slight displacement of PDN was observed in2patients,however there was no change of lumbar spinal mo bility.1patient had a bad recovery of back and leg pain.Conclusion PDN re placement can improve clinic symptoms,increase disc height and restore the normal lumbar motion as well.Its clinical effectiveness is excellent in short-term observation.

Objective To study the expression of insulin like growth factor binding proteins 3 (IGFBP-3) during inhi-bition of resveratrol (Res) on cell proliferation. Methods The inhibitory effect of Res on BGC-823 cells was determined by MTT method; Real-time qRT-PCR and western blot were applied to detect the expression of IGFBP-3 in Res-treated BGC-823 cells. In addition, cytometry was used to determine the proliferation and apoptosis of Res-treated BGC-823 after knockdown of IG-FBP-3 by siRNA. Results Upon Res (20,40, 80 and 160 μmol · L-1 ) treatment,the viability of BGC-823 cells was (82. 35±10. 65)% ,(74. 30±12. 36)% ,(62. 80±14. 66)% and (50. 75±11. 14)% , respectively. The mRNA and protein ex-pression of IGFBP-3 elevated as high as 2. 96-fold compared to the control group (P<0. 05). The cell viability of BGC-823 cells with IGFBP-3 knockdown was significantly higher than that of the wild type ( P < 0. 05 ) only at high Res concentration (160 μmol·L-1 ). Meanwhile,IGFBP-3 knockdown led to a significant decrease on cell apoptotic rate by Res (160 μmol·L-1 ) [(20. 13±9. 12)% vs (35. 48±11. 12)% ,P<0. 05)]. Conclusion Res can inhibit BGC-823 cell proliferation and promote cell apoptosis, the underlying mechanism of which may be related to the overexpression of IGFBP-3 in BGC-823 cells.

Objective To explore the feasibility of 7.0T MR scanner in mouse aorta atherosclerosis models.Visualising the TN-C in atherosclerotic plaque by immunohistochemistry and its correlation with CD68 to provide experimental basis for the feasibility of TN-C in targeted MRI.Methods ApoE-/- mice and wild type C57 mice were fed on high fat diet to establish aorta atherosclerosis model (n=10),the aorta were observed by MRI after 14 weeks.The aorta specimens were taken to stain with HE to observe the pathological changes.The plaque was stained with oil red O,anti-TNC and TN-C antibody respectively to observe the fat,CD68 and TN-C in plaque.Results 7.0 MRI showed the aortic wall of the experimental group was thicker,high signal on T1 WI and PDWI,and low signal on T2 WI after 14 weeks.The histopathlogic examination showed the intima was obviously thicker,and the lumen was ir-regulary narrow.Both of CD68 and TN-C were highly expressed in plaque,and the distribution of TN-C correlated with CD68.In the control group,no case showed hyper-signal in the vessel wall of aorta or narrow lumen by MRI,and the histopathlogy showed no for-mation of atherosclerotic plaque in the aorta.Conclusion Aorta atherosclerotic plaque can be established through high fat diet on ApoE-/- mouse,and 7.0 MR can successfully detect it.TN-C is high expressed in AS plaque and the expression is correlated with CD68,which may suggest that they may collaborate in the development of AS.Detecting TN-C could be useful for the further study of atherosclerotic plaque.

Objective To investigate the relationship between serum prealbumin (PA) and inflammation in acute myocardial infarction (AMI) patients. Methods A prospective observational study was conducted. AMI patients hospitalized in the cardiovascular department of the General Hospital of Chinese People's Armed Police Forces from June 2014 to June 2016 were enrolled in the study. At the same time, healthy cases were enrolled as control. Venous blood was taken from patients at admission. Serum PA was detected by immune projection turbidimetry method and high-sensitivity C-reactive protein (hs-CRP) was measured by latex enhanced immune turbidimetry. High-sensitivity cardiac troponin T (hs-cTnT), and interleukin (IL-6, IL-8) was measured by electrochemical luminescence method. Creatine kinase-MB isoenzyme (CK-MB) was detected by rate method. PA, inflammatory factor and myocardial enzyme were compared between two groups. The correlation between PA and inflammatory factors was analyzed by Pearson linear correlation; The diagnostic value of PA was analyzed by receiver operating characteristic (ROC) curve. Results 173 AMI patients and 86 healthy controls were enrolled in the study. There were no significant differences in gender, age, history of smoking, hypertension and diabetes. Compared with the control, the levels of serum PA in AMI patients was lower [PA (g/L): 0.215±0.056 vs. 0.280±0.057], hs-CRP, IL-6, IL-8, hs-cTnT and CK-MB were higher [hs-CRP (mg/L): 6.63±3.52 vs. 2.25±1.45, IL-6 (ng/L): 38.03±22.43 vs. 6.13±3.38, IL-8 (ng/L): 295.61±98.70 vs. 17.24±7.31, hs-cTnT (μg/L): 4.789±2.874 vs. 0.009±0.008, CK-MB (U/L): 244.48±165.54 vs. 12.20±5.24], the difference was statistical significant (all P < 0.01). It was shown by Pearson correlation analysis that the levels of PA were negatively related to hs-CRP, IL-6 and IL-8 (r = -0.562, -0.591, -0.548, all P <0.05). The PA level had no correlation with hs-cTnT and CK-MB (r = -0.018, -0.149, both P > 0.05). It was shown by ROC curve analysis that area under ROC curve (AUC) of PA for diagnosis of AMI was 0.783±0.039, and the 95% confidence interval (95%CI) was 0.706-0.860 (P < 0.05). When the cut-off value was 0.190 g/L, the sensitivity was 29.63%, and the specificity was 62.22%. Conclusion PA may be involved in the inflammatory process of AMI and had a diagnostic value for AMI.

OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.

Objective To study the simple preparation method and structure of nano-hydroxyapatite/collagen composite, to investigate new substitute of repairing bone for using in tissue engineering. Methods Porous nano-hydroxyapatite was made of Ca (OH)2 and H3PO4. Collagen was drawn from fresh adult bovine tendon. The two materials were prepared into biomembrane through the glutaraldehyde and freeze-drying. The crystallite phase, micro-morphology, structure, crystallite size of the composite were examined by XRD and scanning electronic microscop (SEM). Results The results showed that the composite structure was porous and consisted of nano-hydroxyapatite (10 nm ? 50 nm - 20 nm ? 80 nm) and collagen fiber. The crystallite phases and size of the composite was similar to that of natural bone. Conclusion The porous nano-hydroxyapatite /collagen composite is expected to be an ideal substitute of repairing bone.

Objective To study the effect of sub-chronic exposure to dehamethrin(DM) on the behavior of mice in learning and memory.Methods 60 Female SPF Kunming mice were randomly divided into 4 groups and given DM by gavaging for 60 days.Morris water maze (MWM) was used to evaluate spatial memory in mice.Results After exposure to DM,the escape latency of the solvent control group and the treatment groups were (12.20±6.5)s,(14.99±5.4) s,(15.64±8.3)s,(22.71±6.2)s on the fifth day.The escape latency of the high-dose group was higher than those of the low-dose group (P=0.0041) and the solvent control group (P=0.019) in the navigation test.The number of crossing position of the platform in the high-dose group ((2.93± 1.53)times) and the middle-dose group ((3.40± 1.12) times) were lower than that in the solvent control group ((5.87 ± 1.55) times) and the low-dose group ((4.90± 1.41)times)(P＜0.05).Conclusion Sub-chronic exposure to DM can damage the spatial learning and memory of mice.

Objective To investigate the clinical application of wave intensity (WI) technique in assessing the short-term effects of cardiac resynchronization therapy(CRT). Methods Sixteen patients with congestive heart failure treated with CRT were chosen. Before the implantation of CRT pacemaker and 1 week, 1 month,3 month after it,the diameters and volumes of left ventricle(LV) in the end-diastole and the end-systole were measured by echocardiography. LV ejection fractions(LVEF) were calculated by Simpson's way,and the variation ratio of left ventricular end-systolic volume(△ESV) was assessed each time after the CRT. The maximal rate of LV pressure rise (LVdP/dtmax) was assessed in the continuous-wave Doppler spectrum of mitral regurgitation. The magnitude of W1, and the length of R-W1 interval as well as W1-W2interval were recorded by WI technique applied on the left carotid artery of each patient. Results Compared to the data before CRT,W1 and W1-W2 interval were significantly higher in different period after CRT (P ＜0. 01). This result was conformed with echocardiographic remodeling data and LV systolic function.Conclusions WI provides a potential usage in conveniently and effectively assessing the CRT effects in short-term.

Objective To investigate the effects of ischemic preconditioning on pneumocyte apoptosis and the expression of HSFT0 after lung isehemia-reperfusion(I/R) in rats and discuss its possible mechanism of extenu-ating ischemia-repedusion injury. Method Thirtysix male Sprague-Dawley rats were randomly divided into three groups [ sham operation(SO ) group, ischemia-teperfusion(L/R) group, and ischemic preconditioning(IP) group],twelve in each group. Lung croas-clamping was used to build the L/R model. In IP group, three cycles of 5-minute-ischemia + 5-minute-reperfusion were given to the pulmonary artery before the procedure. Sham operation rats had a thoracotomy only. Two hours(or five hours) reperfusion was given to both L/R and IP group. Tenninal-deoxynucleotidyl Transferase Mediated d-UTP Nick End Labeiing(TUNEL) was used to evaluate apoptosis. Expression of HSP/0 in lung was observed by immunohistochemical stain and image analysis. Index of quantitative assessment of histologic lung injury(IQA), wet to dry weight ratio(W/D) were measured. The pathological change of lung tissue was observed under both hght and electron microscopy. Statistical analysis was carried out by One-way Anova. Scheffe test was used for intragroup comparison. Results The apoptosis index and expression of HSP70、W/D,IQA of hng tissue in I/R group were higher than those in the sham operation group (P<0.01). Compared with the L/R group, the apoptosis index and expression of HSP70, W/D, IQA of lung tissue significantly decreased (P<0.01), the levels of expression of HSPTO increased significantly in IP group ( P<0.01 ). The pathological and ultrastructure change of lung tissue was better in IP group than those in I/R group. Condusions Ischemic preconditioning can extenuate lung I/R injury by the possible mechanism of increasing the expression of HSPT0 which inhibits the apoptosis during lung I/R injury.