Objective To probe the validity and security of cervical dorsal rand nerve block in posterior approach of cervical vertebra surgery.Methods Eighty-six adults ASA class I-II patients undergohag posterior approach of cervical spine operation randomized equally to cervical dorsal rami nerve block group (group I )and partial infiltration anesthesia group (group II ).In group I ,according to regional anatomy characteristic of the nerve and by means of preopomtively measuring the cervical vertebra X -ray,the body surface projection of articular process joint waist of cervical vertebra were calibrated.Away 3 cm from latter median line,percutaneous puncture via 45° angle relative into sagittal plane ,adopting long 8 cm 7# needle and anesthetic to block ~e surgical incision corresponding bilateral dorsal rami nerves.In group II,using traditional local infiltration anesthesia.The effect and response time of anesthesia,influence on breathing and hemodynamics or pulse oxygen saturation,visual analogue score( VAS ) and calmed grade postoperatively and adverse reaction were observed and recorded.Results The anesthesia excellent rate (74%) in group I was obviously higher than that(42%) in group II (P ＜ 0.05 ).The surgeries average time in group I was less than that in group II,but no statistical significance (P＞ 0.05).The average dose of anesthetic in group I was obviously lower than that in group II (P ＜ 0.01 ).The mean arterial pressure elevated after anesthesia in both groups,and in group I was significantly lower than that in group lI (P ＜ 0.05 ).The SpO2 of both ＞ 95%.Calmed grade and VAS at 24 and 48 h postoperatively were significantly lower in group I than that in group II (P＜ 0.05).There was no adverse reactions.Conclusions Compared to other anesthesia methods in posterior approach of cervical vertebra surgery,the method of cervical dorsal rami nerve block has so undermentioned dominances: simple,less anesthetic,exact effect of anesthesia,light influence on breathing and hemeodynamies and lower injury of spinal cord or spinal nerve root that the method is safe and feasible.

It has been over two decades from the discovery of extracorporeal shock wave(ESW).The therapy of ESW has been proved effective in improving fracture healing,and has been developed quickly both in the choice of indications and in the medical equipments research.The status quo of ESW research,application in orthpedic trauma and treatment mechanism are summarized in this paper.Successful cases are reviewd in treating post-traumatic nonunion,renovation of artificial joints,and traumatic osteonecrosis of the femoral head.Common complications and its preventive measures are given.Detailed description of ESW operating principles and selection of working parameters are also described,with the expectation of wider range of clinical applications of ESW.

Objective To evaluate biodistribution and pharmacokinetics pattern of ~(131)I-labeled rch24which is the region-grafted (humanized) anti-carcinoembryonic antigen (CEA) monoclonal antibody in nude mice. Methods Nude mice bearing cancer xenografts received intravenous injections of ~(131)I- rch24, then blood, plasma, heart, liver, spleen, lung, kidney, tumor and other tissues were taken at different time point for determination the concentration of radioactivity and calculate the T/NT value. Nude mice were packeted randomly to four group of high, medium, low dose and continuous administration, blood drug concentration was detected by ELISA method at the different intervals. Then, draw the concentration-time curve and calculate the pharmacokinetics paramete. Results After administration, radioactivity of the tumour was significantly enhanced whereas radioactivity of normal tissues decreased gradually. For single administration, at the dose of low to medium, pharmacokinetics pattern was linearity -kinetics whereas for high dose group,pharmacokinetics paramete shown some behavior of non-linearity-kinetics. Conclusion Our results suggest that the ~(131)I-labeled region-grafted (humanized) anti-CEA monoclonal antibody rch24 exhibit a considerable targeting activity so as to ~(131)I radioisotopes can be concentrated specifically in tumor. The pharmacokinetics pattern of this medicine was different at different dose.

BACKGROUND: Endothelin(ET) -1 is a peptide with potent actions on blood vessels and nerve system. Its expression increases in the central nervous system(CNS) in a variety of pathological conditions, inducing harmful effects on the nervous tissue. However it is not clearly elucidated whether the over-expressed ET-1 can directly induce neuronal apoptosis.OBJECTIVE: To investigate whether ET-1 can directly induce apoptosis in primarily cultured brain neurons of rat, and which ET receptor subtype(s) is involved in this action.DESIGN: Completely randomized and controlled experimental study based on cells.SETTING: Neurological department in a university hospital, pathological department of a university and laboratory center of tissue transplantation and immunology, life science and technology college.MATERIALS: This study was completed in the Pathology Department, the Institute of Tissue Transplantation and Immunology, the Life Science and Technology College of Jinan University. The subjects were primarily-cultured neurons obtained from cerebral cortex of newborn rats that were provided by the Experimental Animal Center of the Medical College, Sun Yat-sen University.INTERVENTIONS: After culturing for five days, the neurons were treated with ET-1 (0. 2 nmol/L and 20 nmol/L) for 24 hours. Apoptotic neurons were semi-quantitatively measured with Annexin V and Hoechst 33258 staining respectively. ET-1(20 nmol/L), with BQ123(a selective antagonist for ET receptor A, 1 mmol/L) or with BQ788(a selective antagonist for ET receptor B, 1 mmol/L), was added respectively into the cultures simultaneously. And the apoptotic neurons were quantitatively measured with flow cytometry 24 hours later. Equal amount of PBS, instead of ET-1, waw added into the control subjects.MAIN OUTCOME MEASURES: The effect of ET-1 on apoptosis rate of cultured rat cortical neurons, and the ET receptor subtypes involved in this action.RESULTS: Twenty-four hours after treated with 0.2 nmol/L ET-1, the Annexin-V, and Hoechest 33258 positive stained cell rates[ (23.00 ± 9.96)%,(9.82 ±0.95)% ] were of no difference as compared with those of the controls[ (13.50 ± 3.35)%, (8.21 ± 2. 17)% ]. By contrast, after incubation with the higher dose of ET-1 (20 nmol/L), significant higher rate of apoptosis was measured in Annexin V staining[(50.50 ± 10.78)%, P=0.01, n=4] and Hoechest 33258 staining[(13.78±1.52)%, P= 0. 000, n = 8] . Analyzed with flow cytometry, the apoptosis rate was (0.20±0. 15)% in the control group, (26. 11 ±3.28)% in 20 nmol/LET-1 group, and(13.58 ±4. 92)% in BQ123 +ET-1 and(9.99 ±3.30)% in BQ788 +ET-1 respectively, indicating that BQ123 and BQ788 partially-blocked the apoptosis effect of ET-1 on. cultured neurons(BQ123 + ET-1 vs ET-1, P = 0. 005; BQ788 + ET-1 vs ET-1, P = 0. 001, n = 4, respectively).CONCLUSION: The higher dose of ET-1 (20 nmol/L) can directly induce apoptosis of primarily-cultured cerebral neurons of rats. The effect of ET-1 inducing neuronal apoptosis may be mediated via both ET receptors A and B.

Objective To investigate the expression of ADAM8 in patients with hepatocellular carcinoma (HCC) and its clinical significance.Methods The protein expression of ADAM8 in HCC tissues was analyzed using immunohistochemical analysis.Serum levels of ADAM8 were measured by ELISA in 126 patients with HCC,50 patients with liver cirrhosis (LC) and 50 healthy individuals.The relationship between patients' pathological features and serum ADAM8 level was analyzed.Results Immunohistochemical analysis showed that ADAM8 expression was associated closely with serum AFP elevation,tumor size,histological differentiation,and tumor stage.The ELISA assay showed that the serum levels of ADAM8 in the HCC were significantly higher than those in LC and healthy groups.Kaplan-Meier survival analysis showed that high expression of serum ADAM8 exhibited a significant correlation with poor prognosis for HCC patients.Multivariate analysis revealed that serum ADAM8 expression is an independent prognostic parameter for the overall survival rate of HCC patients.Conclusion ADAM8 expression was closely associated with tumor size,serum AFP elevation,tumor differentiation,tumor stage and prognosis in hepatocellular carcinoma.Therefore,ADAM8 expression may serve as a biomarker for predicting the prognosis of patients in hepatocellular carcinoma.

Objective To investigate the effect of local mild hypothermia on the cerebral hemodynamic parameters,plasma Endothelin-1 (ET-1s) and calcitonin gene-related peptide (CGRPs) of the subarachnoid hemorrhage patients (SAH).Methods Sixty patients were divided randomly into local mild hypothermia group and control group (n =30 patients each group).The middle cerebral artery average blood flow rates (VMCAs) and pulse index (PIs) were detected with transcranial Doppler (TCD),plasma ET-1 s and CGRPs were tested on the D1,D7,D10,and D14,respectively.Results The VMCAs in the mild hypothermia group were lower on the D7,D10,and D14 [7 d:(95.46 ±22.48)cm/s vs (110.35 ±32.38) cm/s,t =2.07,P ＜ 0.05 ; 10 d:(85.57 ± 17.47) cm/s vs (97.64 ± 20.55) cm/s,t =2.45,P＜0.05 ;14 d:(57.16 ± 14.36)cm/s vs (70.56 ± 19.42) cm/s,t =3.04,P ＜ 0.01],PIs and plasma ET-1s were lower on the D10 and D14 compared with the control group [PIs:10 d:0.76 ±0.21 vs 0.88±0.25,t =2.01,P ＜0.05;14 d:0.72±0.18 vs 0.84 ±0.19,t =2.51,P ＜0.05] [ET-1s:10 d:(71.37 ± 16.63) pg/ml vs (81.46 ±21.38)pg/ml,t =2.04,P ＜0.05 ;14 d:(55.73 ± 15.18) pg/ml vs (68.28 ± 20.57) pg/ml,t =2.69,P ＜ 0.01].Plasma CGRPs were higher compared with the control group on the D7,D10,and D14 [7 d:(26.55 ±6.45)pg/ml vs (23.64 ±4.56)pg/ml,t =2.02,P ＜0.05;10 d:(24.15 ±7.35)pg/ml vs (20.52 ±6.18) pg/ml,t =2.07,P ＜0.05;14 d:(30.37 ±6.28)pg/ml vs (26.88 ± 4.39) pg/ml,t =2.49,P ＜ 0.05].Conclusions The mild hypothermia treatment could reduce the plasma ET-1s,improve plasma CGRPs,and improve the prognosis of the patients.

Objective To observe the changes of plasma lipid,C-reactive protein(CRP) and fibrinogen(FIB) in patients with acute coronary syndrome(ACS)treated with low dose simvastatin.Methods One hundred and twenty patients with ACS were randomly divided into treatment group and control group with 60 cases in each.The patients in the control group were treated with conventional therapy,and those in the treatment group were treated with 20 mg simvastatin per day at the base of control group.The course of treatment was 2 months.Results In the treatment group,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),CRP and FIB were decreased significantly and the level of high-density lipoprotein cholesterol(HDL-C) was increased after the treatment(all P0.05).Conclusion The levels of plasma lipid,CRP and FIB can be effectively regulated with the treatment of low dose simvastatin in patients with ACS.

objective To analyze the causes of defective nonunion of femoral shaft and to evaluate interlocking intramedullary nails in treatment of shortened limb deformity following nonunion of femoral shaft. Methods 12 patients with shortened limb deformity following nonunion of femoral shaft were treated with autograft of ilium to fill up the defects and fixation by interlocking intramedullary nails. The patients were followed up for an average of 20 months. Results All the 12 patients healed by first intention after an average of 22 months. The limbs were lengthened averagely by 3.2cm. No failure occurred due to bent or broken major nails or intramedullary nails. Conclusions The main cause of shortened limb deformity following femoral shaft nonunion is bone resorption due to unreliable fixation. Interlocking intramedullary nails are an ideal device for shortened limb deformity following femoral shaft nonunion, though the union process is slow. In bone graft, care should be taken to avoid the complication of bone defect and weight bearing should be carried out some time later.

Objective To investigate the expression of galectin-3 in pancreatic cancer cell and its effect on the proliferation and invasion of SW1990.Methods Immunocytochemistry and semi-quantitative RT-PCR was used to detect the expression of galectin-3 protein and mRNA in SW1990,PANC1 and ASPC-1 cell lines.Galectin-3 mono-antibody of different concentrations ( 1,2,3,5 μg/ml) was used to treat SW1990 cells for 24,48,72 h,CCK-8 kits were used to detect the proliferation in SW1990 cells; Transwell chamber was used to study the invasion in SW1990.Results Expression of galectin-3 protein and mRNA was present in SW1990,PANC1,and ASPC-1.Galectin 3 mono-antibody inhibited the proliferation and number of invasive cells in a dose and time dependant manner.The inhibitory rates at 72 h were 19.8％,29.9％ and 42.7％ in 2,3,5 μg/ml galectin 3 mono-antibody groups,the difference among them and control group was statistically significant ( P ＜ 0.05 ).The inhibite rate of permeating membrane cells in 3 μg/ml galectin-3 mono antibody was 37.1％,the difference between this group and control group was statistically significant (P ＜0.05 ).ConcLusions Galectin-3 is highly expressed in pancreatic cancer cells.Galectin-3 antibody can inhibit the proliferation and migration capability of SW1990 cells.

Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.