[Objective] To observe the clinical effect of Bryan cervical prosthetic disc in treating ossification of posterior longitudinal ligament(OPLL)of cervical spine.[Method]From October 2005 to June 2007,15 localized OPLL patients were treated surgically by cervical arthroplasty using Bryan disc prosthesis.JOA score and radiological study were performed before and after operation.The range of movement(ROM)of replaced level were investigated postoperatively.[Result]Neurological deficit was alleviated in all patients.All patients were followed up at least 6 months,JOA score increased from an average of 8.5 to 15.8.Replaced segment restored the normal ROM in flexion and extension.[Conclusion]Cervical arthroplasty using Bryan disc prosthesis can achieve good clinical outcome in treating localized OPLL of cervical spine;and the normal ROM can be retained in the replaced level.

[Objective]To evaluate the validity and feasibility of somatosensory evoked potentials(SEP) and transcranial magnetic stimulation motor evoked potential(TMS-MEP) in early decompression of spinal cord injury(SCI). [Method]Thirty-two rabbits fell into four groups randomly. The static load model were used to simulate human SCI. According to the compression time, the animals were divided into 4 groups (control,5min, 15min,30min). In this study, somatosensory evoked potentials (SEP) and transcranial magnetic stimulation motor evoked potential (TMS-MEP) were used to assess neurologic function. The EPs were recorded at 5min, 15min, 30min, 60min, 6 hours, 24 hours, 3 days, 7 days post-decompression and before spinal cord injury in injury groups. Latency and amplitude were measured for each wave. Tarlov behaviour score was performed before surgery and after surgery at 1,3,7 days. Histologic studies were performed on part of animals. [Result]Spinal cord compression resulted in a gradual increment in the peak latency and significant decrement in the peak amplitude. After decompression, the recovery of the latency was more obvious than the amplitude in all injury groups, EPs recovered earlier than Tarlov score. [Conclusion]EPs may evaluate the neurologic function of SCI models sensitively and impartially. Dcompression early may promote SCI recovery.

Objective To investigate the distribution of alpha2-HS glycoprotein (AHSG) gene polymorphisms and the relationships of AHSG gene polymorphisms with atherosclerosis as well as serum bone related biochemical mark-era. Methods Blood samples of 344 hospitalized female patients, aged 20 ～ 80 years, were sampled for serum bone alkaline phosphatase, cross-linked N-telopeptide of collagen type Ⅰ, cross-linked C-telopeptide of collagen type Ⅰ , osteoprotegrin and leptin were determined by ELISA. Serum TC,TG and calcium content were detected. Poly-morphism of AHSG gene was detected by polymerase chain reaction fragment length polymorphisms (PCR-RFLP) of restriction enzyme Sac Ⅰ. BMD (Norland XR-36) of the anteroposterior spine (AP), supine lateral spine (Lat) and femoral neck (FN) were measured. Morphological changes in the aorta and bone of type GG patient were detected by pathological microscopy. IMT were measured by color doppler ultrasound equipment(SEQUOIAS12). Results (1) The genotype frequency of CC, CG, and GG were 59.7%, 25.1% and 15.2% respectively in all elderly female patients. There were significant difference in blood lipids, Ca~(2+) and serum bone relative biochemical markers to different AHSG genotypes. (2)There were significant differences in the BMD of the AP, Lat, FN and IMT and the serum biochemical markers among the CC, CG and GG genotypes. (3)GG-female patients bone tissue pathology section verify the AHSG polymorphism genetic mutation and atherosclerosis, osteoporosis development of the relationship. Conclusion There was close relationship among AHSG polymorphism variation and the incidence of arteriosclerosis and osteoporosis in elderly female.

Objective To investigate the distribution of alpha2-HS glycoprotein(AHSG) gene polymorphisms and the relationships of AHSG gene polymorphisms with atherosclerosis as well as serum bone related biochemical markers.Methods Blood samples of 344 hospitalized female patients,aged 20～80 years,were sampled for serum bone alkaline phosphatase,cross-linked N-telopeptide of collagen typeⅠ,cross-linked C-telopeptide of collagen type Ⅰ,osteoprotegrin and leptin were determined by ELISA.Serum TC,TG and calcium content were detected.Polymorphism of AHSG gene was detected by polymerase chain reaction fragment length polymorphisms(PCR-RFLP) of restriction enzyme Sac Ⅰ.BMD(Norland XR-36) of the anteroposterior spine(AP),supine lateral spine(Lat) and femoral neck(FN) were measured.Morphological changes in the aorta and bone of type GG patient were detected by pathological microscopy.IMT were measured by color doppler ultrasound equipment(SEQUOIA512).Results(1) The genotype frequency of CC,CG,and GG were 59.7%,25.1% and 15.2% respectively in all elderly female patients.There were significant difference in blood lipids,Ca2+ and serum bone relative biochemical markers to different AHSG genotypes.(2)There were significant differences in the BMD of the AP,Lat,FN and IMT and the serum biochemical markers among the CC,CG and GG genotypes.(3)GG-female patients bone tissue pathology section verify the AHSG polymorphism genetic mutation and atherosclerosis,osteoporosis development of the relationship.Conclusion There was close relationship among AHSG polymorphism variation and the incidence of arteriosclerosis and osteoporosis in elderly female.

Objective To study the interaction of BDNF gene C270T polymorphism and estrogen receptor alpha (ERα)gene Xba Ⅰ loci and Pvu Ⅱ loci polymorphism in late-onset Alzheimer's disease(LOAD)pathogenesis in southern Chinese Han population.Methods BNDF gene C270T locus,ERα gene Xba Ⅰ site and Pvu Ⅱ site polymorphisms were examined in 203 LOAD patients and normal controls using PCR-RFLP technique.Results There was an interaction be-tween BDNF gene and ERα gene,and BDNF gene C270T locus CC genotype and the ERa gene Xba Ⅰ locus xx genotype increased the LOAD incidance risk(OR=2.38,95%CI:1.02～5.53).Conclusions BDNF gene and ERα gene are in-teracted each other in the pathogenesis of LOAD.Patients carrying both BDNF gene C270T locus CC genotype and the ERα gene Xba Ⅰ locus xx genotypes might have an increased risk for LOAD.

BACKGROUND:Surgical treatment is commonly used for decompressing the spinal cord in multilevel cervical spondylotic myelopathy, but the optimum anterior cervical reconstructive method has not been determined. OBJECTIVE:To compare and analyze the biomechanical characteristics of four anterior cervical reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy utilizing the three-dimensional finite element model. METHODS:A three-dimensional finite element model of an intact C2–7 segment was developed and validated based on healthy adult male CT images. Four additional models were developed from the fusion model, including anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical hybrid decompression and fusion and anterior cervical discectomy and fusion with Cage alone. Von Mises stresses on the plate and the disc of adjacent levels (C2/3, C6/7) were comparatively analyzed. RESULTS AND CONCLUSION:(1) The C2/3 disc stress in flexion, extension, lateral bending and rotation condition was significantly higher than the C6/7 disc in 4 anterior cervical reconstructive techniques, and the adjacent disc stress (C2/3, C6/7) was lowest in the anterior cervical discectomy and fusion with Cage alone, and highest in the anterior cervical corpectomy and fusion. (2) The stress at the plate-screw interface was highest in the anterior cervical corpectomy and fusion, and lowest in the anterior cervical discectomy and fusion. (3) In conclusion, among the four anterior cervical reconstructive techniques for multilevel cervical spondylotic myelopathy, the anterior cervical discectomy and fusion with Cage alone makes little effect on the adjacent disc stress, which might reduce the incidence of adjacent segment disease after fusion. However, the accompanying risk of the increased incidence of cage subsidence should never be neglected.

Objective To investigate the expression of Musashi-2 and CD133 in colonic adenocarcinoma,and their correlation with the occurrence and development of colonic adenocarcinoma thereof. Methods The expressions of Musashi-2 and CD133 protein were detected by immunohistochemical method in 40 colonic adenocarcinoma samples and 15 normal colonic structure samples. The different histological types, TNM staging, lymph node metastasis, serous infiltration, distant metastasis and expressions of Musashi-2 and CD133 proteins in colonic adenocarcinoma tissues were analyzed. Results The positive expression rates of Musashi-2 and CD133 protein were 60%and 27.5%in 40 colonic adenocarcinoma samples and 26.7%and 0 in 15 normal colonic samples, which showed the significantly higher expression rates in colonic adenocarci-noma group than those of control group (χ2=4.850 and 5.156,P<0.05). There were significant differences in expressions of Musashi-2 proteins between different histological stages and TNM staging (P<0.05). The positive expression rate of Musa-hi-2 protein increased as the degree of differentiation decreased and TNM stage increased. There were significant differenc-es in expressions of CD133 proteins between different histological stages and lymph node metastasis (P<0.05). The positive expression rate of CD133 protein increased as the degree of differentiation decreased and lymph node metastasis occurred. Conclusion The expression of Musashi-2 and CD133 may be related with the initiation and development of colonic can-cer, which can be used as the stem cell markers of colonic adenocarcinoma for the further study.

Objective To investigate the minimum local analgesic concentration(MLAC)of epidural hydromorphone combined with bupivacaine for analgesia during the first stage of labor by establishing clinical model.Methods Sixty four labouring parturi-ents at 3-7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups.After a lumbar epidural cath-eter was placed,study participants received 15 mL bupivacaine(n=30),bupivacaine with hydromorphone 200 μg(n=30).The con-centration of bupivacaine was determined by the response of the previous patient using 0 - 100 mm visual analog pain scores, with≤30 mm within 30 min defined as effective.Results Four women were excluded,leaving 30 patients in each of the two groups for analysis.The MLAC of bupivacaine alone was 0.103%(95% CI :0.094%-0.113%).The addition of hydromorphone at doses of 200 μg resulted in significant reduction(P <0.05)in the MLAC of bupivacaine to 0.044%(95% CI :0.034%-0.053%),the difference was significant (P <0.05).There was no significant difference in Bromage scores,HR,BP,FHR,UC and adverse reac-tion (P >0.05).Conclusion The study showed a significant reduction in the MLAC of bupivacaine by hydromorphone.Hydromor-phone could be safely used in epidural analgesia for labor.

Objective To explore the clinical features,diagnosi s and prognosis of incontinentia pigmenti.Methods Analyzing and summarizing the clinical characteristic, diagnosis and prognosis of neonatal incontinentia pigmenti in 6 neonatal infants that were hospita- lized in our department during the period from January 1 998 to December 2003 were studied,and some relevant literature were reviewed. Results 1.Three of 6 infants were male which was unusual;2.Four infants had typical skin lesions at birth and 1 case at 6 days old.Four cases had typical 3 stages o f skin lesions including the erythematous and vesicular inflammatory stage,verr ucous lesions and hyperkeratosis stage,macular hyperpigmentation stage,but the re was overlap;3.Four infants were complicated by central nervous system involv ement (two cases presented mental retardation,2 infants were temporary damage). Two cases were complicated by ocular manifestations ( one case had optical nerve atrophy and blind in left eye,the other had severe bilateral retinal lesions); 4.On specific examination 5 infants were diagnosed by skin biopsy.Gene analysis was made in 1 case,but we didn′t find the mutations of NEMO. Conclusions Incontinentia pigmenti is a rare X-linked dominant multisystem disease.It may be misdiagnosed in the initial stages.Except typical clinical features,skin biops y and gene analysis are main evidence for diagnosis.Early detection and interven tion are important for prognosis. J Appl Clin Pediatr,2005,20(2):123-125

Objective To improve the recognition of intramedullary spinal abscess by a case of congenital dermal sinus with intramedullary spinal abscess and reduco the incidence of congenital dermal sinus with intramedullary spinal abscess.Methods Clinical,laboratory data and image of a confirmed case about one infant of congenital dermal sinus with multiple intramedullary spinal abscess were investigated,the related literature was reviewed.Results In this case,when the infant with congential dermal sinus had infection,he failed to gain antibiotic therapy, timely surgical treatment,his infection had diffused, and multiple intramedullary spinal abscess flared up.Conclusions Intramedullary spinal abscess is a rare disease.If treatment is delayed, the prognosis is poor and the mortality rate is high.MRI is the ideal investigation for diagnosis.Intramedullary spinal abscess can happen subsequent to congenital dermal sinus with infection, and cause neurological sequela. So an infant with congenital dermal sinus should be offered to avoid complication caused by infection.