Objective To discuss the necessity of cervical spinal plating after single-level anterior decompression and fusion on mono-segmental cervical disc herniation and cervical spondylosis without obvious kyphotic deformity and segmental lability. Methods The ranges of motion of the two groups with and without plating were tested under the load of 2.0 Nm on cervical spine specimens taken from 16 fresh cadavers. Finite element method was used to calculate the strength of bony callus and the average stress of the parts adjacent to the fused segments at various time intervals. 45 cases after single-level anterior decompression and fusion with and without cervical plating were followed-up at least 3 years, and 33 ones without cervical plating, more than 10 years. Results The test of specimens showed a higher stability of the group with plating just after operation (P

Objective To evaluate the clinical results of self-designed anterior cervical low-profile plate system (ACLPS). Methods The anterior cervical plate system, composed of one plate, two locking caps and two types of screws. The system was made of medical titanium alloy possessing the following characteristics: low profile, instant locking, versatile use and unicortical screw fixation. 37 patients with cervical disorders were fixed with ACLPS after anterior spinal decompression and interbody fusion. The diagnosis included spondylosis in 8 cases, cervical intervertebral disk protrusion in 12, fracture and /or dislocation with paralysis in 14 and metastatic tumor in 3. The fusion were performed with autologous iliac crest bone graft for 29 patients while the others with cages. The fixed levels ranged from C3 to T1. Results 37 cases were followed-up for an average of 9.6 months, ranging from 6 to 12 months. Postoperatively all patients felt comfortable in neck without any foreign body sensation. No obvious complications such as wound infection, hematoma, asphyxia, nerve injury, laceration of spinal cord dura, leakage of cerebrospinal fluid, bleeding and nonhealing of the wound were observed. Solid interbody fusion were achieved in all cases. According to JOA scores, the total effective rate was 94.6% while the good rate was 83.8%. The radiograph confirmed that there was no dislocation or subsidence of graft, no obvious loss of intervertebral height, no loosening or failure of implant. Conclusion In regard to the high rigidity, good bony purchasing and easy handling, ACLPS is able to provide sufficient biomechanical stability and is an optional choice for clinical use.

Objective To investigate therapeutical methods on lumbar disc herniation with posterior edge separation of the vertebral body. Methods Different methods were applied to 31 patients, including 24 males and 7 females whose ages ranged from 18 to 61 years. Except that 2 patients with mild lumbar pain were treated with conservative therapy, the other 29 patients were treated with operation. The operations were made according to the relationship between compressive hernia and vertebral canal. For instance, for cases that the herniated mixtures were lateral, decompression with fenestration or amplified fenestration was applied to the trouble side; for cases that mixtures were central or paracentral, the same treatment was applied to both sides; and posterior lumbar interbody fusion(PLIF) or transforaminal lumbar interbody fusion (TLIF) was applied to those that the mixtures occupied most part of the front canal. Results The follow-up studies were made for all the patients for 1 to 4 years with an average period of 2.6 years. For the two patients treated with conservative therapy, one was fully recovered and the other, who took no effect from former therapy, was finally recruited after decompression with fenestration on the trouble side. Among the patients who were treated with operation, those with lateral herniated mixtures received significant effect, while only 60% of those with central or paracentral mixtures recovered (the unrecovered or even worsened patients after operation finally recruited by PLIF), and for those with mixtures occupying most part of the front canal, satisfactory effect were achieved. Conclusion Operation treatment should be applied to patients as early as possible when conservative therapy has no obvious effect. Different operation methods should be taken according to the relationship between compressive hernia and vertebral canal: 1) Decompression with fenestration or amplified fenestration on the trouble side be applied to those with lateral herniated mixtures; 2) Decompression with fenestration on both sides be applied to those with paracentral mixtures but no lateral crypt narrowness, and PLIF or TLIF to those with central mixtures or lateral crypt narrowness; 3) PLIF or TLIF be applied to those with mixtures occupying most part of the front canal.

Objective To analyze and compare clinical application of two types of clavicular hook plates. Methods From September 2000 to October 2003, 33 cases with acromioclavicular joint dislocation (Tossy Ⅲ) or distal clavicle fractures (Neer Ⅱ) were treated with insertion type (AO/ASIF) or knuckle-protruded type (WALDEMAR LINK) clavicular hook plates. The former one was used in 18 cases and the latter one in 15. Results In insertion type group, the average operation time was 28 minutes, with average incision length for 7.6 cm. All the cases got good reduction and fixation without any subluxation, except for one case suffering from impingement of the shoulder joint. In knuckle-protruded type group, the average operation time was 40 minutes, with an average incision length for 9.8 cm. After operation, one case lost hooking-up, one had born shoulder joint impingement, while another two suffered from skin pain at acromion caused by hook tip for a long time. Except for one case losing hooking-up, all cases of both groups achieved good recovery of function of shoulder joint and won satisfactory reduction without any redislocation after the implants being taken out. Conclusion Because of the advantages like convenient manipulation, short operation time, minor incisions and less potential complications, the insertion type clavicular hook plate is more suitable for cases with Tossy Ⅲ or Neer Ⅱ fractures.

AIM:To study the purified factors of Guanxinning for Injection(Radix et Rhizoma salviae miltiorrhizae,Rhizoma Chuanxiong,etc). METHODS: The total of salvianolic acid B、protocatchuci aldehyde and ferulic acid were used to evaluate for the study of type of macroporous adsorption resin,sample volume,the ratio of diameter to height,pH value and sample consistency etc. RESULTS: pH value Guanxinning extract was adjusted to 3.0,through D101 resin finally reached the ratio of diameter to height 1∶2,4 times of water was applied to elution and then 3 times of 70% ethanol for re-elution and collected. CONCLUSION: These factors are approprite for purifying Guanxinning for Injection.

Objective To investigate the expressions of interferon γ(IFNγ), interferon inducible protein-10(IP-10). chemokine receptor CXCR3 and their significance in infection-associated hemophagocytic syndrome(IAHPS). Methods Forty-three patients with IAHPS, 35 infection patients without HPS and 25 healthy controls were included in the study. The serum IFNγ and IP-10 levels were measured by enzyme linked immunosorbent assay(ELISA). The expression of CXCR3 on cell surface of CD_4~+ and CD_8~+ T cells in peripheral blood was determined by flow cytometry. SPSS 13.0 was used for data processing, and independent-sample t test was performed to compare the differences among the groups. Results The serum IFNγ and IP-10 levels in patients with IAHPS were( 608±135) pmol/L and(939±141) pmol/L respectively, which were significantly higher than those in without HPS group[(154±45) pmol/L and (385±119) pmol/L, t=4.97 and 4.02, P<0.05] and healthy controls[(56±18) pmol/L and (248±98) pmol/L, t=5.27 and 4.77, P<0.05]. The expressions of CXCR3 on CD_4~+ and CD_8~+ T cells in IAHPS group were (35±11)% and (23±8)% respectively, which were significantly higher than those in without HPS group[(24±7)% and (16±7)%, t=3.12 and 3.62, P<0.05] and healthy controls[(20±6)% and (12±5)%, t=4.46 and 4.93, P<0.05]. Conclusion The expressions of IFNγ, IP-10 and CXCR3 are increased significantly in patients with IAHPS, which may be related to the disease pathogenesis.

Hepatitis B virus surface antigen(HBsAg),a specific antigen on the membrane of Hepatitis B virus (HBV)-infected cells,provides a perfect target for therapeutic drugs.The development of reagents with high affinity and specificity to the HBsAg is of great significance to the early-stage diagnosis and treatment of HBV infection.Herein,we report the selection of RNA aptamers that can specifically bind to HBsAg protein and HBsAg-positive hepatocytes.One high affinity aptamer,HBs-A22,was isolated from an initial 115 mer library of ～1.1×1015 random-sequence RNA molecules using the SELEX procedure.The selected aptamer HBs-A22 bound specifically to hepatoma cell line HepG2.2.15 that expresses HBsAg but did not bind to HBsAg-devoid HepG2 cells.This is the first reported RNA aptamer which could bind to a HBV specific antigen.This newly isolated aptamer could be modified to deliver imaging,diagnostic,and therapeutic agents targeted at HBV-infected cells.

Objective To investigate the associations of IFNL3/IFNL4 single-nucleotide polymorphisms(SNPs)with the efficacy of highly active antiretroviral therapy(HAART)in patients with HIV-1 infection.Methods Sixty-three adult patients with HIV-1 infection receiving HAART for at least 1 year in the First Affiliated Hospital, Zhejiang University School of Medicine were enrolled.HIV-1 RNA loads in plasma and HIV-1 DNA loads in peripheral blood mononuclear cells(PBMCs),and blood SNPs were detected by quantitative polymerase chain reaction(qPCR).Plasma inflammatory cytokines were examined by magnetic beads method,and the CD4 +T and CD8 +T lymphocyte counts in peripheral blood were measured by flow cytometry.According to response to HAART,the patients were classified as low HIV-1 RNA group(viral load <100 copies/mL)and high HIV-1 RNA group(viral load≥100 copies/mL);according to CD4+T lymphocyte counts,the patients were defined as low CD4+T cell group(<250 cells/μL), and high CD4+T cell group(≥250 cells/μL);according to HIV-1 DNA levels,the patients were divided into low(<100 copies/106cells)and high(≥100 copies/106cells)HIV-1 DNA groups.Results Three candidate SNPs rs368234815,rs8099917 and rs4803223 had significantly different distribution between low and high HIV-1 RNA groups(χ2=0.043,0.047 and 0.032,all P<0.05).The levels of interleukin(IL)-10 were declined in the low HIV-1 RNA group(U=4.00,P<0.05);the levels of IL-13 were decreased in the high HIV-1 RNA group and the high HIV-1 DNA group(U=0.00 and 2.00,both P<0.05);the levels of IL-21 were reduced in the high HIV-1 RNA group and in the low CD4 +T cell group(U=3.00 and 2.00, both P<0.05),the levels of IL-28A were decreased in the high HIV-1 RNA group,the high HIV-1 DNA group,and the low CD4 +T cell group(U=3.00, 0.50 and 3.00,P<0.05 or <0.01).In addition, rs368234815 was associated with IL-21 level(H=6.690,P<0.05),the IL-21 level in rs368234815 ΔG/ΔG [131.88(2.66,174.00)]was higher than that in TT/TT[6.79(2.81,26.48)](P<0.05);rs4803223 was correlated with IFN-γlevel(H=6.690, P<0.05),the IFN-γlevel in GG subtype[62.26(19.45, 96.49)]was higher than that in GA subtype[6.98(2.19, 99.14)](P<0.05).Conclusion The polymorphisms of IFNL3/IFNL4 rs368234815, rs8099917 and rs4803223 are associated with efficacy of HAART and immune-associated cytokines levels in patients with HIV-1 infection.