Objective To evaluate the special roles of modified procedure of instrumented posterior lumbar interbody fusion (PLIF) for the treatment of the isthmic lumbar spondylolisthesis. Methods Surgical procedure was modified. The definitive reduction of the spondylolisthesis using pedicle screw instrumentation was followed by primary reduction using intervertebral disc space distraction and interbody fusion with insert cages and local morselized bone after decompressive laminectomy. A prospective, single-cohort, observational study of the clinical outcomes and radiological data, was assessed in a series of 46 patients with isthmic spondylolisthesis who underwent surgery from January 1999 to February 2004. The clinical outcomes were evaluated according to Oswestry disability questionnaire, and the radiographic data included slipping degree, slipping angle and posterior height of intervertebral disc. Thin-section helical computed tomography (CT) scanning was used in 5 cases post-operatively to assess the interbody fusion. Results Post-operatively, the slipping degree reduced, the posterior heights of intervertebral space increased and slipping angle decreased. The radiographic data had no obvious loss in mean follow-up time of 36 months (range, 12-73 months). Thin-section helical CT study clearly demonstrated the radiographic presence or absence of bridging bone, and solid bony fusion could be obtained at least one year after operation. The objective clinical outcomes of the Oswestry disability questionnaire were in average 33.6?6.4 before operation and 17.6?5.5 after operation. Conclusion The modified procedure as described offers advantages for isthmic spondylolisthesis, not only in substantial deformity correction, but also in suitable interbody cages choosen and normal sagital plane alignment restoration.

Objective To evaluate how well the risk factors associated with stroke recurrence been controlled by community-based medical centers in urban areas of Beijing.Methods A cross-sectional study was performed in 5 community-based medical centers in urban areas of Beijing.A total of 999 patients with the experience of ischemic stroke were evaluated from Dec.2004 to Nov.2005.Results Ninety-six percent of patients suffered from at least one of the most common diseases(risk factors) associated with stroke recurrence,i.e.hypertension(HT),heart disease,diabetes,hyperlipidemia and obesity,and 80% of patients were with more than 1 disease.The proportion of HT was 79.1%(790/999) and the awareness,treatment and control rates of HT patients were 93.3%(737/790),84.3%(666/790) and 40.3%(318/790),respectively.The proportion of heart diseases and obesity among 999 stroke patients were 34.4% and 19.1%%,respectively.31.9%(319/999) of patients had diabetes and 84.0%(268/319) of the patients knew their history of diabetes.Of 319 diabetes patients,68.3%(218/319) were under active treatment and 45.4%(99/218) of them had their fasting blood glucose well controlled.The proportion of hyperlipidemia was 72.9% and the treatment rate for hyperlipidemia was as low as 29.5%(215/728).There were 43.7% and 50.0% of patients quit smoking and alcohol drinking after their acute stroke.72.7%(726/999) of patients were receiving aspirin regularly.Conclusion The proportion of cardiovascular diseases were high among the patients with ischemic stroke who were under the management of community-based medical centers.The community-based medical centers have played an important role in the secondary prevention of stroke.However,the management for ischemic stroke patients with diabetes and hyperlipidemia needs to be improved.

Objective To explore the effect of early administration of alendronate (ALN) and pulsed electromagnetic fields (PEMFs) on bone mass of rats after spinal cord injury(SCI). Methods Sixty-two healthy female SD rats aged 3 months were randomly allocated into 5 groups: a Sham group, a SCI group, a SCI+ALN group, a SCI+PEMFs group and a SCI+PEMFs+ALN group. Rats in the Sham group underwent laminectomy, while the rats in the other 4 groups underwent complete spinal cord transection, and the remained 3 groups were treated with ALN and/or PEMFs 1 week after SCI. All rats were sacrificed 8 weeks after operation. The bone mineral density(BMD), biomechanical parameters of the femurs, and histomorphometric parameters of proximal tibias were mea-sured, respectively. The data were analyzed with one way-ANOVA and factorial design-ANOVA. Results After early treatment of ALN and/or PEMFs, the BMD of femur was significantly increased as compared with that of rats in the SCI group; the elastic load, maximal load of femur were significantly increased as compared with those of rats in the SCI group; the percent trabecular bone area and trabecular bone width of tibias were significantly increased when compared to those of rats in the SCI group. Conclusion Early treatments of ALN and PEMFs can reduce the loss of bone, improve biomechanical properties of the femur, and inhibit the decay of microstructure of upper part of tibia. The study suggests that ALN and PEMFs may help prevent osteoporosis after SCI.

ObjectiveTo observe the effect of early administration of alendronate on bone mineral density and biomechanical properties of the femur of spinal cord injuried rats.Methods36 3-month-old female SD rats were randomly divided into the Sham group, SCI group and SCI+ALN group. Rats in the Sham group underwent a sham procedure. Rats in the SCI group and in SCI+ALN group underwent spinal cord transection at the level of the tenth thoracic vertebra. Rats in the SCI+ALN group were injected with alendronate intraperitoneally 1 week after SCI, three times a week. All rats were sacrificed 8 week after operation. Bone mineral density and biomechanical properties of the femur were measured, respectively.ResultsBone mineral density and biomechanical properties of the femur changed significantly after spinal cord transection. After the treatment of alendronate injection, bone mineral density of the femur in the SCI+ALN group was significantly increased compared with that of the SCI group(P<0.01). Elastic loading and maximal loading of the femur in the SCI+ALN group was significantly increased compared with that of the SCI group(P<0.01). Maximal stress was significantly increased compared with that of the SCI group(P<0.05). ConclusionThe rats 8 week after spinal cord transection can be used in osteoporotic research following SCI. Early administration of ALN after SCI can inhibit bone resorption, improve biomechanical properties of the femur of spinal cord injured rats so as to prevent the development of osteoporosis and osteoporotic fracture.

Objective To observe the degree of arterial oxygenation and the incidence of hypoxaemia by different antalgic modes in elderly patients postoperatively, and to investigate the way of prophylaxis and treatment. Methods Sixty elderly patients by different postoperative antalgic modes were randomly divided into three groups with 20 in each: patient-controlled epidural analgesia group, continuously intravenous infusion analgesia group and intramuscular injection analgesia group. The oxygen saturation was monitored during 24 hours and the arterial blood gases were measured immediately before and 4, 24 and 48 hour after operation. Results The rates of hypoxaemia occurring once or more in patient-controlled epidural analgesia group, continuously intravenous infusion analgesia group and intramuscular injection analgesia group were 21%, 36% and 32% respectively . There were no significant differences in PaO 2 (arterial PO 2) and PaCO 2 (arterial PCO 2) between postoperative 48 hour and immediately before operation in patient-controlled epidural analgesia group. PaO 2 and PaCO 2 at 4 and 24 hour after operation were significantly lower than those immediately before operation, and all were over 70 mmHg. Conclusions Patient-controlled epidural analgesia may improve the degree of arterial oxygenation and lower the incidence of hypoxaemia after operation in elderly patients.

Objective: To investigate the free radical scavenging properties of six aloe species and study its protective effect on red blood cells. Methods: Free radical scavenging properties were investigated in modified chemical system. The antioxidant was purified by silica column and thin layer chromatography and analyzed by HPLC. Its protection on red blood cells was studied with red blood cells culture system in vitro. Results: The extract from A. berebihoria showed the most effective scavenging activities on O - 2? and ?OH (32.19% and 26.05% respectively) in six aloe species. The fraction A with a Rf value of 0 497 was proved to be a pure antioxidant (Rt=15.956 min). It is an anthraquinone with phenol hydroxyls. Fraction A showed strong inhibitory activity on H 2O 2 induced hemolysis of red blood cells and its IC 50 was 0.856 g/L. Conclusion: Fraction A of the extract from A. berebihoria had strong scavenging activities of O - 2? and ?OH, thereby inhibiting the peroxidation of red blood cells and maintaining their functions.

Objective: To extract the polysaccharides of Curcuma zedoaria Rosc (PCZ) and study its bioactivities. Methods: The crude polysaccharides were extracted from herbal slice of Curcuma zedoaria Rosc with hot water ,and precipitated by ethanol and savage deproteinization and depigmentation with activated charcoal. The constituents were isolated by column chromatography and the total polysaccharides content was determined. Experiments of immune function,anti-oxidation and anti-tumor activity of KM mice and in viro were studied. Results: The content of total polysaccharides of Curcuma zedoaria Rosc was 33.12%. and the extraction rate was 1.938% . It could raise spleen cell proliferation and transformation rate of lymphocyte and SOD activity in blood of mice. A higher antitumor effect of the polysaccharides by injection was observed dose-dependently. Conclusion: PCZ could raise the immune and anti-oxidative activities and then had a higher antitumor effect.

Objective: The chemical composition, extraction and biological activity of antioxidant substance of sweet potatoes were studied. Method: The antioxidant substance was extracted with alcohol and purified with AB-8 big-hole resin and its elimination rate of _?O 2 and OH and SOD activity were determined.Results: The content of antioxidant substance stockpiled respectively in the root tubers, stems and leaves of sweet potatoes and was different in varieties. The highest content in the root tuber was 0.324%, which accounted 70% of total content in sweet potatoes. Its extraction ratio was 85%. The major composition of the antioxidant substance was phenol acid, including chlorogenic acid,isochlorogenic acid,neochlorogenic acid and 4-0-caffeonyl quinic butyl ester. They had intense antioxidant function and their elimination rate to _?O 2 and?OH at concentration 90 mg/ml was 88.02% and 82.21% respectively. The antioxidantsubstance restrained oxidation of lipid and hemolysis of red cell induced by H2O2,and increased SOD activity in serum and skin of mice. Conclusion: Several kinds of phenol acid as antioxidant substance stockpiled in sweet potatoes were proved to have strong antioxidant activity.

Objective To investigate the relationship between serum uric acid (SUA) and metabolism syndrome (MS) in community-based elderly population in Beijing.Methods A community-based and cross-sectional survey on 1821 elderly person was performed in Beijing in 2000.Questionnaire survey,physical examination and blood biochemical tests were conducted.Relationship of MS and its components with SUA was analyzed.Results Among 1821 subjects,there were 365 cases with MS (20.0％) and 1456 cases without MS (80.0％).SUA level was higher in MS group than in non-MS group [(5.20±2.27) μmol/L vs.(4.50±1.44) μmol/L,t=-7.34,P=0.000].All subjects were divided into 4 groups according SUA level:goup 1 (≤3.5μmol/L,n=443),group 2 (3.6 μmol/L-4.4 μmol/L,n=465),group 3 (4.5 μmol/L-5.4 μmol/L,n=446) and group 4 (≥5.5 μmol/L,n=467).SUA level was increased along with the increased BMI,TG,TC,LDL-C levels,and decreased along with the decreased HDL-C level,which had significant differences (F=43.07,9.32,22.36,8.19,9.39,all P＜0.001).There were significant distribution differences in MS components numbers in the 4 groups (x2=73.62,P=0.000).After adjusting for age,sex,residential,education level,marriage,smoking,drinking and exercise habits,logistic regression analysis showed that MS was related with SUA level,and the risk of MS was increased along with the increased SUA level.Conclusions MS is correlated with SUA level in elderly people.SUA level should be observed and controlled effectively in the elderly.

Underwater treadmill training (UWTT) is a new hydrotherapy technique, with features of immersion bath, under water walking and body-weight support treadmill training. UWTT can reduce the load on legs, release spasm, improve gait, muscle atrophy and remain muscle strengthen for SCI patients. It also reduces the risk for cardiovascular disease, and incidence of postural hypotension. The present studies on UWTT are insufficient. More researches should further explore the therapeutic effects on SCI.