[Objective]To investigate the possible etiological factors,pathogenesis,diagnostic criteria,clinic characteristics and the choice of treatment of the adolescent instability of lower cervical spine.[Method]The diagnosis,therapies and follow-up materials of the two typical cases were analyzed and researched with the available literatures.[Result]The two cases showed dissappearance of syndroms.The Roentgen film showed that the operative segments have gotten bone-fuse.Results were excellent according to Henderson-evaluation classification without any complications at 3 and 4 years follow-up.[Conclusion]The degeneration is probable one of the etiological factors causing adolescent instability of lower cervical spine.It is resemble on the pathogenesis,diagnostic criteria and the choice of treatment between the adolescent and the adult.But the each characteristic on the pathogenesis,pathologic process,clinical situation should be remarked.The growth potentiality and other correlated factors should be paid attention to for the choice of treatment.

Objective To observe effect of muscle basal lamina containing neural stem cells (NSCs) in repair of spinal cord injury.Methods Thirty-six SD rats from the same nest were used in the study and spinal cord hemisection models were induced.The animals were classified to blank control group (clearance of the lesion edge only with isotonic saline),NSCs group (transplantation of NSCs to the edge),NSCs + muscle basal lamina group (transplantation of complex of NSCs and muscle basal lamina to the edge) according to random number table,with 12 rats per group.At weeks 4 and 8,survival and migration of the transplanted cells and compatibility of muscle basal lamina with the host were detected.At weeks 2,4,and 8,the hindlimb function was assayed using BBB scoring system.Results NSCs in NSCs + muscle basal lamina group grew at the lesion edge,migrated to both sides of the edge,and integrated with peripheral tissues.Whereas,few NSCs survived at the lesion edge in NSCs group and inflammatory cell infiltration was notable.At week 2,there was no statistical difference of BBB score among the three groups.At weeks 4 and 8,BBB score in NSCs + muscle basal lamina group (7.92 ± 1.00,11.38 ± 1.51) was significantly higher than that in blank control group (3.82 ± 0.75,3.71 ± 0.76) and NSCs group (6.25 ±1.06,8.25 ± 1.83) (P＜0.05).Conclusion Muscle basal lamina orients growth of NSCs along its lumen,facilitates migration of host cells to ground substance within its lumen,and reduces local inflammatory reaction.

Objective To evaluate the role of spinal c?Jun N?terminal kinase ( JNK ) signaling pathway in incisional pain in rats. Methods Sixty?three adult male Sprague?Dawley rats, weighing 200-250 g, were randomly divided into 3 groups ( n=21 each) using a random number table: incisional pain group ( IP group) , dimethyl sulfoxide ( DMSO) group, and JNK inhibitor SP600125 group ( SP group) . A 1?cm longitudinal incision was made through skin, fascia and muscle of the plantar aspect of the hindpaw in anesthetized rats. In group DMSO, 10% DMSO 10 μl was injected intrathecally at 30 min before surgery. In group SP, SP600125 25 μg (in 10 μl of 10% DMSO) was injected intrathecally at 30 min before sur?gery. Six rats in each group were sacrificed, and the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured at 24 h before establishment of the model and 2, 6, 24, 48 and 72 h after establishment of the model. After measurement of the pain threshold at 24 h before establishment of the model and 6, 24, 48 and 72 h after establishment of the model, the lumbar segment of the spinal cord was removed for determination of the expression of phosphorylated JNK ( p?JNK) by im?munofluorescence. Results The MWT was significantly lower, the TWL was shorter, and the expression of p?JNK was lower at each time point after establishment of the model than at 24 h before establishment of the model in group IP (P<0?05). Compared with group IP, the MWT was significantly increased, the TWL was prolonged, and the expression of p?JNK was down?regulated at each time point after establishment of the model in group SP ( P<0?05) , and no significant change was found in the parameters mentioned a?bove in group DMSO ( P>0?05) . Conclusion Spinal JNK signaling pathway is involved in the develop?ment and maintenance of incisional pain in rats.

Objective To investigate the expression of aquaporin (AQP) 1, AQP4, inward rectifying potassium channel 4.1 (Kir4.1) and cytoskeleton features of rat spinal cord astrocytes after cytochalasin D (CytD) intervention. Methods Spinal cord astrocytes isolated from 2~3-day-old rats were cultured till confluency. MTT was used to assess survival rate of astrocytes 2 h, 12 h and 24 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml, 0.80 μg/ml and 1.00 μg/ml of CytD, respectively. Confocal microscopy was used to observe cytoskeleton features of astrocytes 2 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml of CytD. The expression of AQP1, AQP4, Kir4.1 mRNA were determined with real-time PCR 2 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml, 0.80 μg/ml and 1.00 μg/ml of CytD. Results The survival rate of rat spinal cord astrocytes reduced with the time of co-culture and concentration of CytD (P<0.05). The cytoskeleton of astrocytes was reconstructed. The expression of AQP1, AQP4 and Kir4.1 mRNA increased after co- cultured with 0.05~0.40 μg/ml of CytD. Conclusion The appropriate dosage of CytD may remodel the cytoskeleton and increase the mRNA expression of AQP1, AQP4 and Kir4.1 in spinal cord astrocytes of rats.

Parkinson's disease is one of the most common neurodegenerative diseases,characterized by progressive degeneration of dopaminergic neurons.Diabetes is one of its common comorbidities,because both are affected by genetic factors and various environmental factors,as well as remarkably similar dysregulated pathways.The relationship between the two is receiving more and more attention.In particular,application of hypoglycemic drugs in Parkinson's disease has become a research hotspot in recent years.This article reviews the clinical features of Parkinson's disease and diabetes,the clinical features of Parkinson's disease with diabetes,and the application of hypoglycemic agents in Parkinson's disease.

Objective:This research was designed to investigate the safety and efficiency of laparoscopic simultaneous resection in the treatment of synchronous colorectal cancer liver metastases (sCRLM).Methods:From January 2009 to December 2019, 121 patients diagnosed as sCRLM received radical resection in Peking University Third Hospital were included in the research. According to the surgery approaches, the patients were divided into laparoscopic surgery group and open surgery group. Statistical analysis of general patient data, surgical data, postoperative complications and follow-up of the two groups of patients.Results:There were 79 cases in the laparoscopic surgery group including 30 females and 49 males, and the average age was 61.5 years. There were 42 cases in the open surgery group including 15 females and 27 males, and the average age was 63.2 years. There were no significant differences in the preoperative demographic characteristics, the location of primary tumor, gene status, the size of liver metastases, the proportion of multiple liver metastases, the level of tumor markers and the proportion of neoadjuvant chemotherapy between laparoscopic surgery group and the open surgery group ( P>0.05). The complication rate was 15.2% (12/79) in the laparoscopic surgery group and 23.8% (10/42) in the open surgery group. There were no significant differences between the two groups ( P>0.05). The 3-year and 5-year survival rates in laparoscopic surgery group were 52.9% and 44.4%, which were 42.5% and 23.0% respectively in open surgery group. There were no significant differences between the two groups ( P>0.05). The 1-year and 3-year disease-free survival rate in laparoscopic surgery group were 50.6% and 41.2%, which were 44.7% and 19.4% respectively in open surgery group. There were no significant differences between the two groups ( P>0.05). Conclusions:Laparoscopic simultaneous resection was safe and feasible for patients with sCRLM. Comparing with the open surgery, the laparoscopic surgeries had similar incidence of perioperative complications and long-term oncological efficiency.

ECG Recorder's automatic diagnosis function is uneven, it brings a lot of inconvenience to clinicians in the diagnosis and treatment. We developed the automatic diagnosis and evaluation system for ECG recorder based on data platform in General Hospital of PLA , in order to evaluate the automatic diagnosis function of ECG recorder and improve the level of automatic diagnosis, and through a large number of data evaluation results, to provides the standard basis of ECG recorder's automatic diagnosis.

Objective To understand the genotypes of hepatitis C virus(HCV) and the genetic evolution and molecular characteristics of the predominant genotypes (6n and 3a) currently circulating in the Dali,Yunnan province.Methods From January to May 2014,sera were collected from patients with HCV infection in the First People' s Hospital of Dali.RNA was extracted from the serum samples,which were analyzed using RT-PCR with 5'UTR and E1/E2 primers.The RNA was sequenced,and sequence analysis was performed using bioinformatics software.Results Of 24 serum specimens from patients suspected of infection with HCV,21 were confirmed positive for HCV by RT-PCR with HCV 5UTRspecific primer,of which 15 were HCV genotype 3 (4 cases of 3a and 11 cases of 3b) and 6 were HCV genotype 6 (4 cases of 6k and 2 cases of6n).The homology of the nucleotide sequence and amino acid sequence of E1/E2 gene between isolate 4 and genotype 3a were up to 87.98％ ± 3.07and 87.97％ ± 2.82.The homology of the nucleotide sequence and aminoacid sequence between isolate 10 and genotype 6n were up to 90.30 ± 1.87 and 90.54 ± 1.53.There were 10 potential glycosylation sites on both of E1/E2 gene of two isolates HCV isolates.Only the predicted value of 5 T cell epitopes of 4 and 10 increasedor decreased because of amino acid mutations.The rest of predicted value of epitope slightly changed.Conclusion HCV genotype 3 (3a and 3b) and genotype 6 (6k and 6n) were the predoniuant geuotypes or subtypes currently circulating in the Dali,Yunnan province.The virulence and immunological characteristics of HCV 3a and 6n did not change significantly.

[Objective]To explore the clinical experience and characteristics of ZHU Danxi's Siwu Decoction,a famous doctor in Jin Yuan Dynasties.[Methods]This study comprehensively collected the medical cases and theories of Siwu Decoction in ZHU Danxi's medical works.Statistics and association rules analysis methods were used for prescriptions and drugs.The qualitative theme analysis method was used in the medical theory sections,and pathogenesis and treatment were respectively coded at three levels by Nvivo 11,open coding,axial coding and selective coding.Finally,the pathogenesis and treatment system of ZHU Danxi using Siwu Decoction was constructed.[Results]A total of 97 medical case reports of ZHU Danxi using Siwu Decoction were collected,having 125 discussions about Siwu Decoction,and involving 40 internal diseases,6 gynecological diseases,8 surgical diseases,6 andrological diseases and 1 pediatric disease.The top 12 drugs frequencies were Danggui,Baishao,Shu Dihuang,Baizhu,Renshen,Chenpi,Gancao,Huangqin and Huangbai.Based on Siwu Decoction,six methods were applied to treat corresponding syndromes based on the different pathogenesis,which were nourishing Yin(39),clearing heat(37),dispelling wind(23),supplementing Qi(28),generating blood(28)and promoting blood(27).[Conclusion]ZHU Danxi widely used Siwu Decoction for nourishing blood method and generating blood method to treat a variety of diseases on the internal disease,gynecological disease,surgical disease,andrological disease and pediatric disease caused by deficiency of blood or domination of pathogen in blood.The former was nourishing blood and assisting Yin,nourishing blood and clearing heat,nourishing blood and dispelling wind.The latter was tonifying blood and Qi,replenishing and generating blood,replenishing blood and promoting blood circulation.

Objective To analyze the loss coefficient of bivalent live attenuated oral polio vaccine（bOPV) in Hongshan District, and understand the causes and influencing factors, and to provide a basis for scientifically formulating vaccine use plans and regulating vaccine management. Methods Using the data of Hubei Province Immunization Planning Information System and Hongshan District Vaccination Storage and Management System, a special questionnaire was designed to understand the vaccination and use of bOPV in various immunization units in Hongshan District. A descriptive statistical analysis method was used to calculate the loss coefficient. Results The bOPV loss coefficient of 25 vaccination units in Hongshan District was 1.69. The difference of the loss coefficient between the out-patient clinics of the District Health and Family Planning Committee（1.35）and the community clinics undertaken by large hospitals (2.01）was statistically significant. The difference of the loss coefficient between the inoculation once a week（1.57）and 2-6 times per week（1.94）was statistically significant. In terms of vaccine-disabled time, the two groups of <4 hours and >4 hours had different calculated loss coefficients 1.86 and 1.61, respectively, and the difference was statistically significant. Multivariate regression analysis of the factors related to the loss coefficients found that different outpatient attributes had a greater impact on the loss coefficient than the inoculation cycle and the number of inoculation stations. The loss coefficient for 2016 and 2017 was 2.09 and 1.75, respectively. The difference was statistically significant. Conclusion The management and use of live attenuated bivalent polio vaccine in Hongshan District was relatively standardized. The vaccine loss can by further reduced by strengthening supervision and assessment, setting up centralized vaccination and standardizing publicity and training.