[Objective]To discuss the basic principles and methods of surgical protocols in treating multilevel cervical disc herniation.[Method]The surgical protocols patients underwent operation based on patient's changes in radiology.Protocols varied from anterior approach discectomy,partial corpectomy with bone grafting and plate fixing;titanium mesh+plate;titanium mesh+plate in major segment and decompression with trepan+cage in secondary segment;combined anterior and posterior surgical procedure.[Result]Totally 96 cases of cervical spondylosis in different types were observed.After average 32 months of follow-up,an overall excellent and good rate in 90% of the cases was obtained.[Conclusion]To choose the appropriate surgical protocol for different multilevel cervical disc herniaion or degenerative myelopathy patients,every treatment should rely on patient's symptoms and changes in radiology.We must check out which vertebra is major segment or secondary segment,generalized or localized,with or without developmental stenosis of cervical spinal canal.Most patients can achieve satisfied prognosis by anterior approach decompression with bone grafting and plate fixing.Intervertebral bone grafting and plate fixing is preferred to single level degenerative.Anterior decompression with approach discectomy,partial corpectomy with bone grafting and plate fixing is preferred to 2 or 3 level degenerative.Combined anterior and posterior surgical procedure is the best method to treat generalized degenerative or obvious stenosis of cervical spinal canal,and continuous type OPLL.In conclusion,the key to excellent prognosis of cervical spondylosis is choosing the right operation for the right patient.

Objective To evaluate the indications and clinical efficacy of the different surgical methods for lumbosacral tuberculosis.Methods 112 patients suffering from lumbosacral tuberculosis from January 1998 to October 2011 were reviewed retrospectively.Based on American Spinal Injury Association (ASIA) grading system,31 case was classified as grade C,32 as grade D and 49 as grade E.The affected locations were L5,S1 in 66 cases,L4-S1 in 32,and L5-S2in 14 cases.41 cases (posterior group) underwent posterior pedicle screw instrumentation,debridement and allograft; and 38 cases (anterior group) underwent one-stage anterolateral debridement plus allograft and internal fixation.33 (posterior-anterior group) cases experienced posterior pedicle screw instrumentation and anterior debridement and allograft.All cases underwent routine support and anti-tuberculosis treatment before and after operation.The change of erythrocyte sedimentation rate (ESR),signs of tuberculosis activity,graft fusion,neurological recovery and correction of deformity were evaluated in follow-up and compared among three groups.Results The average operating time in posterior,anterior and posterior-anterior group was (150±22) m in,(140± 18) min,(180± 1 8) min respectively.ESR and C-reactive protein (CRP) were recovered to normal 3 months post surgery.The quality of life total score of lumbosacral tuberculosis patients was very low (55.54 ± 9.23).After surgery and drug treatment,the total score and each dimension scores of the SF-36 were significantly improved.Postoperative ASIA classification and 1umbosacral angle were significantly improved.Tuberculosis recurrence occurred in three cases,fixation loosening in two cases,fixation fracture in one case,and all above cases were cured after revision surgery.The others all were cured and bone graft fusion was determined.Conclusion The quality of life of lumbosacral tuberculosis patients were impacted seriously,and which could be significantly improved with surgical intervention.According to the patient MRI,CT characteristics,surgical approach selection was based on lesion location.Effective internal fixation was based on the extent of damage in bone structure and anatomical characteristics.Following above principles,satisfactory clinical results could be achieved.

Objective: To investigate the role of expression of Caspase-9 in megalosplenia of cirrhotic portal hypertension. Methods: Using SP immunohistochemistry method to examine theexpression of Caspase-9 in the specimens of 50 cases of megalosplenia with cirrhotic portal hypertension and 15 cases of traumatic spleen of normal man. Results: The Caspase-9 positive rates in the traumatic spleen and megaloplenia were 26.7% and 76.0%, respectively. There was a significant difference between the groups(P

BACKGROUND:It may be an important approach to avoiding organ transplant rejection by utilizing immature dendritic cells to induce donor-specific immunologic tolerance. OBJECTIVE:To study the effect of sinomenine on the differentiation and maturation of rat bone marrow-derived dendritic celsin vitro. METHODS:Bone marrow-derived dendritic cells were isolated from the rat femur and tibia, and immature dendritic cells were induced by granulocyte-macrophage colony stimulating factor and interleukin-4. On day 7, lipopolysaccharide was added and the cells were cultured to generate mature dendritic cells. Cells were divided into control group and low-, middle- and high-dose sinomenine treatment groups (SNL, SNM, SNH groups). Forty hours later, dendritic cels were harvested, and cell morphology was observed by inverted phase contrast microscope. The expression of CD80 and RT1B was detected by flow cytometry. ELISA was used to detect the expression of interleukin-12. The mixed lymphocyte reaction was used to detect the ability of dendritic cells to stimulate the activation of allogeneic T lymphocytes. RESULTS AND CONCLUSION: (1) Under the inverted microscope, the morphology of mature dendritic cells was observed in the control group; in the SNL group most dendritic cells were visible; in the SNM group, there were partially suspended cells with poor maturation; and in the SNH group, most of the cells were not mature. (2) The expression of CD80 in the control group was significantly lower than that in the SNL, SNM and SNH groups (P < 0.05), and the expression of RT1B was significantly reduced in the SNM and SNH groups than the control group. (3) Compared with the control group, the level of IL-12p70 in the cell supernatant was significantly decreased in the SNM and SNH groups (P < 0.01). (4) The ability of dendritic cells to stimulate T lymphocyte proliferation in the SNM and SNH groups was significantly decreased compared with the control group (P < 0.05). To conclude, sinomenine can inhibit the maturation of dendritic cells.

BACKGROUND:Liver regeneration is the key factor influencing the prognosis of living donor liver transplantation. There has not been the research on special miRNA of liver regeneration after living donor liver transplantation. OBJECTIVE:To analyze the variation of miRNAs expression profile after rat reduced-size liver transplantation at certain time point, select and verify target miRNA which can provide targeting intervention strategies in liver regeneration after rat reduced-size liver transplantation and provide theoretical evidence for liver regeneration after living donor liver transplantation.METHODS:The reduced-size liver transplantation models were established. miRNAs microarray was used to detect miRNA expression. In differentialy expressed microRNAs, real-time quantitative PCR was utilized to detect target miRNAs. The credibility of miRNAs microarray results was verified. RESULTS AND CONCLUSION:Compared with rat liver tissue in the sham operation group, 11 miRNAs up-regulated in reduced-size liver transplantation, including let-7b-5p, let-7c-5p, miR-101a-3p, miR-103-3p, miR-130a-3p, miR-142-5p, miR-186-5p, miR-199a-3p, miR-21-5p, 221-3p and miR-34a-5p. Four miRNAs were down-regulated, including miR-26b-5p, miR-150-5p, miR-19a-3p and rno-miR-146-5p. PCR test further verified that miR-221-3p and miR-199a-3p expression changes approximated the chip results at 24, 48 hours and 1 week, indicating that results of miRNA microarray were believable. These results verified that it exists variation of miRNAs expression profile after rat reduced-size liver transplantation, which picked out and verified the target miRNAs.

Objective To investigate effects of interleukin-35 (IL-35) on proliferation,invasion and migration of a HepG2 cell line in vitro.Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine peripheral blood expression levels of IL-35 in hepatocellular carcinoma patients and in normal healthy subjects.The effects of exogenous IL-35 on cell proliferation activity of HepG2 in vitro were measured using CCK-8 assay.The transwell invasion and scratch test were used to study the invasive and migration abilities.Results The content of IL-35 protein in hepatocellular carcinoma patients (HCC) was significantly higher than in healthy individuals [(118.45 ±28.66) ng/L vs (39.56 ± 11.15) ng/L,P ＜0.05].Exogenous IL-35 significantly promoted proliferation,invasion and migration abilities of HepG2 cells in vitro (P ＜ 0.05).Conclusions The level of IL-35 was elevated significantly in hepatocellular carcinoma patients.IL-35 had biological characteristics of promoting HCC cell proliferation,invasion and migration.

In this study ,we aimed to understand the sequence characteristics ,transmembrane structures ,line B cell epitopes present in the OMP18 from Campylobacter jejuni ,and provide candidate antigens for the antibody detection and vac-cine development .NCBI/Blast ,TMHMM Server V2 and DNA Star softwares were used for the OMP18 sequence analysis . Based on the ELISA ,the whole bacterial antibody IgG of Campylobacter jejuni was used for the identification of the predicted line B cell epitopes .The OMP18 gene was found conserved in different Campylobacter jejuni strains .The OMP18 was predic-ted to be located on the outer surface of the bacteria .And three line B cell epitopes were determined to be present in the OMP18 protein .As a conclusion ,the OMP18 protein was confirmed to be an important outer membrane protein ;three line B cell epitopes were identified in the OMP18 ,which could be further used for Campylobacter jejuni antibody detection and vaccine development .

ObjectiveTo evaluate the long-term therapeutic efficacy of muscle-region alignment needling plus dermalneedle therapy in treating post-stroke upper-limb spasticity.MethodTotally 488 patients with post-stroke upper-limb spasticity were randomized into a treatment group and a control group, 244 in each group. Besides theessentialrehabilitation treatment, the treatment group was intervened by muscle-region alignment needling plus dermal needle therapy, while the control group was given regular Western medication.Thetwo groups were intervened for 3 weeks and were followed up for 6 months. The neurologic function, Functional Comprehensive Assessment (FCA), and Stroke Speciality-Quality of Life (SS-QOL) were observed for the follow-up study.ResultThe total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant (P<0.05); the neurologic function, FCA score, and SS-QOL score in the treatment group were significantly superior to that in the control group at the end of the follow-up study (P<0.05).ConclusionMuscle-region alignment needling plus dermal needle therapycan produce a content long-term therapeutic efficacy in treating post-stroke upper-limb spasticity.

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism. Murine models of abdominal heterotopic heart transplantation were established. Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografts until the occurrence of rejection or the observation terminals. The animals without FTY720 treatment and those with syngeneic cardiac grafts transplanted served as controls. The mean survival time (MST) of grafts, and T lymphocyte subsets in grafts, peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry, and compared among groups. The results showed that the MST of allografts in FTY720-treated mice was more than 40 days, significantly longer than that in the untreated group (MST=8 days, P<0.01). After the long-term administration of FTY720, the proportion of CD4(+) and CD8(+) lymphocytes in peripheral blood was diminished significantly, but the proportion of CD4(+) lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen. Immunofluorescence staining revealed that the infiltration of CD4(+) and CD8(+) lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720. It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts, resulting in the inhibition of rejection and the long-term survival of allografts.

Objective To investigate the different operation methods for kyphosis deformity of ankylosing spondylitis(AS)complicated with cervical vertebral fracture and their effects.Methods A retrospective case series study was conducted to analyze the clinical data of 19 patients with AS kyphosis complicated with cervical vertebral fracture admitted to Henan People's Hospital from April 2007 lo October 2017.There were 18 males and one female,aged 28-73 years,with an average age of 38.6 years.Among the patients,17 were complicated with spinal cord dysfunction.According to the American spinal injury association(ASIA)classification,there were four patients with grade A,five with grade B,five with grade C and three with grade D.According to the degree of nerve injury and the displacement of fracture,reduction and fixation or orthopedic fixation were selected;14 patients with severe nerve injury(ASIA grades A-C)were treated with reduction and fixation,of which six were treated by simple anterior approach,two by simple posterior approach,five by combined anterior-posterior approach,and one by combined anterior-posterior approach 2 months after Halo fixation.Five patients with ASIA grade D or E were treated with orthopedic fixation.Firstly,kyphosis was corrected with manual technique and the Halo external fixator was installed,and then surgical fixation fusion was performed via simple posterior approach(one patient)or combined anterior-posterior approach(four patients).Visual analogue scale(VAS)was used to evaluate the relief of neck pain.The improvement of nerve function,the effect of orthopedic fixation,the fracture healing time and the postoperative complications were recorded.Results One patient died 11 days after operation due to pulmonary infection and respiratory failure.The remaining patients were followed up for 1-10 years,with an average of 27.3 months.The neck pain in all patients was relieved significantly,and the VAS score[(2.9±0.9)points]decreased significantly 3 days after operation compared with that before operation[(8.2±1.0)points](P＜ 0.05).The nerve function of 12 patients improved significantly(P＜ 0.05).The chin-brow vertical angle of the patients after orthopedic fixation was 60-180(mean,11.8°),suggesting that the level vision function was restored.Fracture healing time ranged from 3 to 8 months,with an average of 3.9 months.There were 4 patients with cerebrospinal fluid leakage and three patients with pulmonary infection.No complications such as wound infection and aggravation of nerve injury occurred.Conclusions For AS kyphosis combined with cervical spine fracture,if without severe nerve injury,manual correction of kyphosis and installation of Halo frame followed by fixation and fusion can effectively correct spinal deformity and improve the quality of life.Patients with severe spinal cord injury should avoid stage I correction and receive reduction of fracture and long segment fusion fixation as far as possible to facilitate the recovery of nerve function.