BACKGROUND: Although the clinical effect of cervical disk replacement in short term has been ascertained, but the middle and long term result is not known, especially for the adjacent level. OBJECTIVE: To observe clinical result and effect of cervical disk replacement on adjacent level in middle and long term. DESIGN, TIME AND SETTING: Retrospective case analysis was performed at Beijing Jishuitan Hospital from December 2003 to March 2005. PARTICIPANTS: Thirty-three patients (aged 35-73 years) undergoing cervical disc replacement were followed up for 3 years. Of them, 25 patients received one-level disk replacement, and 8 received two-level disk replacement. METHODS: The clinical results and imaging before and after operation were compared. MAIN OUTCOME MEASURES: Clinical indexes including JOA grade, Odom’s grade, NDI, SF-36; X-ray: Kellgren X-ray grade, disk cervical height, disk motion, Pfirrmann disk grade, sigittal diameter of spinal cord, and compression of the spinal cord. RESULTS: The point of JOA is 13.62?2.31 before operation, 15.75?1.55 after operation; the differences were significant (P=0.000). For Kellgren X-ray, 10 levels occurred degeneration above the disk replacement level, accounted for 33% (P=0.004), and 9 levels developed degeneration below the disk replacement level, accounted for 32% (P=0.011). No obvious changes in imaging indexes were observed before and after surgery. CONCLUSION: The clinical outcome of cervical disk replacement is good in middle-term follow up. Some adjacent level degeneration may occur after cervical disk replacement, and the degeneration type is osteophyte formation in the adjacent level. This kind of adjacent level degeneration does not affect the clinical outcome in middle term follow-up.

Objective To study the change of the expression of cellular growth factor receptor and its effect on the proliferation and migration of vascular smooth muscle cells (VSMCs) under electrical field. Methods 1) A electrophoresis apparatus was designed for applying the direct current electric fields to the cultured VSMCs, which were separated from the aorta of rats. Interval photographs were used to analyse the direction and distance of VSMCs migration. Cellular growth factors such as platelet derived growth factor receptor (PDGFR), angiotensin II type 1 receptor (AT1R) and its type 2 receptor(AT2R) were studied by immunohistochemistry or immunofluorescence to show the mechanism relation to the migration of VSMCs. Results Under the direct current electric field, the expression of PDGFR was increased obviously and distributed asymmetricly on the membrane of VSMCs. The receptor mainly focused on the cathode side of cellular membrane in electric field. The AT1R were also enhanced in the cells after exposure to the electric field, but the expression of AT2R was uncharged. The longer exposure time to the 150 mV/mm electric field, the more electrotaxis the cells showed. The distance of cellular migration increased obviously with the time to exposure the electric field comparing with the control group. There was no significant difference in the expression of proliferating cell nuclear antigen (PCNA) between two groups. Conclusion External electric fields applying to the rat VSMCs can change the growth characteristic and enhance directional migration of VSMCs. These effects maybe related to the up-regulated expression and re-distribution of some cellular growth factors such as PDGFR, AT1R and AT2R.

Homoacetogens are a group of microorganisms with application potential to produce chemicals and biofuels by the bioconversion of synthesis gas. In this study, we collected waste activated sludge samples to screen homoacetogens by Hungate anaerobic technique, and studied the effect of pH on acetate and alcohol production from H2/CO2 gas. The mixed culture contained Clostridium ljungdahlii, Lysinibacillus fusiformis and Bacillus cereus. Acetate concentration achieved 31.69 mmol/L when the initial pH was 7. The mixed culture containing homoacetogen could converting H2/CO2 to acetate, which provides an efficient microbial resource for the bioconversion of synthesis gas.
Acetates ; chemistry ; Bacteria ; classification ; Biofuels ; Carbon Dioxide ; Hydrogen ; Sewage ; microbiology

Objective To observe the expression of zinc finger protein A20(A20), NF-κB and related inflammatory factors before and after lipopolysaccharide (LPS) stimulates degeneration of rabbit intervertebral disc nucleus pulposus cells.Methods The normal and degenerative nucleus pulposus cells were isolated and cultured, then divided into normal group,degenerative group,LPS stimulation group and NF-κB inhibition group.HE staining observe the morphological changes of nucleus pulposus and annulus fibrosus,immunohistochemistry was used to detect the expression of A20,NF-κB/p65 and COL-Ⅱ.Real-time PCR was employed to analyze the expression of A20,IL-1β,TNF-α,NF-κB and COL-Ⅱ,Western blot was used to observe the A20 protein,p65 and COL-Ⅱexpression in the four groups, and TNF-α, IL-1β in cell supernatant was determined by ELISA.Results The number of nucleuspulposus cells significantly decreased, aggregation occured in the degenerative group.COL-Ⅱ was obvious lower and A20, p65 significantly higher than that in normal group by immunohistochemical staining.Compared with the normal group,A20,TNF-α,IL-1β,p65 expression was significantly increased and COL-Ⅱ decreased in the mRNA and protein levels in degenerative group.Above indexes changed more significant in LPS stimulation group than in degenerative group.The expression of A20, TNF-α, IL-1β, p65 in the NF-κB inhibitor group was lower than that in the LPS group, and the expression of type Ⅱ collagen increased(P<0.05).Conclusions Intervertebral disc inflammatory response is closely related to the development of intervertebral disc degeneration, A20 may play an important role.

Objective:To report the diagnosis and surgical treatment of a special type of Maisonneuve injury.Methods:A total of 4 patients were treated at Department of Orthopaedics, Beijing Chao Yang Hospital from January 2015 to July 2019 for Maisonneuve injury. They were 3 males and one female, aged from 34 to 61 years (average, 45.3 years). All injuries were closed, initially manifested as posterior dislocation of the ankle on X-ray films and X-ray and CT re-exams after manual reduction showed fine reduction with no obvious fracture of the ankle joint. Consequently the diagnosis of their Maisonneuve injury was missed in emergency visits, but re-exams in outpatient visits showed separation of distal tibiofibular syndesmosis. All the patients were treated by restoration of the fibular length, fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to evaluate functional recovery of the ankle joint at 12 months after operation.Results:All the 4 patients were followed up for 12 to 14 months (average, 12.7 months). The fractures united after 110 to 185 days (average, 149.3 days). No post-operative complications like infection, delayed union or nonunion were observed. The AOFAS score at 12 months ranged from 82 to 96 points (average, 90.5 points), giving 3 excellent and one good cases.Conclusions:The Maisonneuve injury which is clinically manifested as posterior dislocation of the ankle with no obvious fracture of the ankle joint is likely to be missed in clinical diagnosis. Therefore, X-ray exam of the full length tibia and fibula should be taken in physical examination after reduction for the patients with simple posterior dislocation of the ankle. Once the special type of Maisonneuve injury is diagnosed, surgical treatment is indicated. Satisfactory treatment efficacy can be achieved by fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament.

Objectve To explore the application of exercise test use in diagnosis of periodic paraly sis.Methods Forty five cases of hypokalemic periodic paralysis were collected,and 40 health persons as control group.Both groups were measured serum potassium,serum creatase and thyroid function tests.All of them were taken exercise test (ET) and observe 50 minutes,measured before and after the test to seek the changes of compound muscle action potentials (CMAP),and its decreased more than 33％ were considered abnormal.The application of exercise test use was analyzed in diagnosis of periodic paralysis.Results In patients with periodic paralysis,the incidence of ET positive was higher than the control subjects (80％ vs 3.3％,P ＜ 0.001).This trend was significant after 20 minutes,such as 30 min[(37.8 ± 13.2)％ vs (6.2±3.2)％,P＜0.01],40min [(40.3 ±17.6)％ vs (3.2±1.9)％,P＜0.01],50min [(45.26 ± 19.9) ％ vs (-5.1 ± 2.6) ％,P ＜ 0.01].Moreover,linear correlation analysis showed that the serum potassium had negative correlation with serum creatase (r =-0.483,P =0.024).ALL of symptoms improved after a week treatment,the ET positive rate was still higher in patients with periodic paralysis than the control subjects (80.0％ vs 71.1％,P =0.824).Conclusions Exercise test was one of the important objective basis in the diagnosis of low potassium type periodic paralysis,and was not affected by treatment and testing time.

Objective:To explore therapeutic effect of atorvastatin on aged patients with mild to moderate hyperten-sion.Methods:A total of 427 aged patients with mild to moderate hypertension treated in our hospital from Jul 2011 to Jul 2013 were randomly divided into routine treatment group (n=210)and atorvastatin group (n=217,received atorvastatin additionally based on routine treatment)according to number table.All patients were treated with a continuous 24 months.Therapeutic effect of controlling blood pressure,changes of blood pressure level and high sensitive C reactive protein (hsCRP)level and occurrence of adverse reactions during treatment were compared be-tween two groups.Results:Compared with routine treatment group,there was significant rise in total effective rate of long-term (24 months)controlling blood pressure (76.8% vs.85.9%),and significant reductions in blood pres-sure [(145.3±10.1/88.6±6.7)mmHg vs.(136.9±6.8/83.0±5.2)mmHg]and hsCRP [(2.02±0.29)mg/L vs. (1.60±0.18)mg/L]level in atorvastatin group,P<0.05 or <0.01. There was no significant difference in inci-dence rate of adverse reactions during treatment between two groups (P>0.05).Conclusion:Atorvastatin combined antihypertensive drugs can well control blood pressure and reduce inflammatory reactions,which is suitable for long term use in aged patients with hypertension.

Objective To evaluate the clinical application of a novel hepatitis B virus YMDD mutation DNA diagnostic kit (magnetic beads method kit).Methods A total of 324 HBV clinical serum samples was tested with the magnetic beads method kit and another kind of fluorescence diagnostic kit (boiling method).Accuracy, specificity, and sensitivity were compared.Results The consistency of positive detection rate of two kits was 100％ (95％ CI : 98.0％ ～ 100％), negative consistency was 97.12％ (95％ CI : 92.8％ ～99.2％) and the total consistency was 98.76％ (95％ CI : 96.9％ ～99.7％).Four cases of discrepant samples were confirmed by sequencing, and statistical analysis performed by Kappa test (Kappa =0.975) shows good consistency between the two methods.Conclusions The magnetic beads method kit has good consistency compared to the regular boiling method kit, and the polymerase chain reaction (PCR) detection system contains an internal positive control (internal control) to avoid a false negative resuit, which is more suitable for clinical diagnosis.

OBJECTIVE:To establish a rapid,accurate and standardized DNA barcode identification method for the ferulic me-dicinal plants. METHODS:Genomic DNA was extracted from Ferula sinkiangensis K. M. Shen and Ferula fukanensis K. M. Shen,ITS2 sequences were amplified and sequenced,analytical similarity search method was conducted,13 species 26 samples gene ITS2 sequences of ferulic medicinal plants in GenBank database were downloaded and comparatively analyzed;interspecies and intraspecies genetic distances were calculated,and phylogenetic tree was developed for cluster analysis. RESULTS:According to calculation,species genetic distances of the 15 species ranged 0.009-0.230,average genetic distance was 0.018;results of clus-ter analysis showed DNA barcode ITS2 sequences can cluster the 32 kinds of ferulic medicinal plants into different classes. CON-CLUSIONS:The established DNA barcode ITS2 sequences identification method can accurately and rapidly identify the genuine and false samples of ferulic species.

To explore the influence of glucose level of 75 g oral glucose tolerance test ( OGTT ) druing pregnancy on delivery of large for gestational age infants. This research selected 790 cases of patients diagnosed as gestational diabetes mellitus( GDM) , 478 cases of pregnant women diagnosed as normal glucose tolerance( NGT) from Affiliated Hospital of Jining Medical University in 2014 and followed up until they delivered. Single live births were selected, risk factors which had influence on offsprings, birth weight were analysed. GDM group had significantly higher rate of delivering large for gestational age(LGA)infants than that of NGT group(47. 30% vs 31. 30%, P<0. 05). Adjusting for confounding factors, it suggested that 2 h plasma glucose level of 75 g OGTT was an independent risk factor for the delivery of LGA infants, and 1 mmol/L glucose increment in 75 g OGTT 2 h plasma glucose level, mayincreasetheriskofLGAby29%(OR=1.29,95%CI1.05-1.58,P=0.02). The2hplasmaglucoselevelof75 g OGTT is an independent risk factor for delivery of LGA infants.