The discogenic back pain has been paid more and more attention to.It is lumbar intervertebral disc degenerative disease without performance of pressure to nerve tissue(that is,except for lumbar disc herniation,lumbar spinal stenosis,etc.).The pathogenesis and diagnostic method was investigated in a large number of studies.A number of attempts have also been carried out in the treatment.Minimally invasive treatment,integration and non-fusion surgery have achieved good efficacy.This article summarizes the diagnosis and new progress in treatment of this disease,at the same time looks to the future development.

This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.

Objective To compare the efficacy of zillah risperidone and risperidone in the treatment of schizophrenia. Methods In our hospital from January 2010 to January 2014,selected 60 cases schizophrenic patients hospitalized as observed object,60 cases hospitalized patients with schizophrenia during as the observed object, all patients were ran-domly divided into group A (ziprasidone) and group B (risperidone), each group of 30 patients, before and after treatment efficacy PANSS score changes and two groups of patients after treatment, adverse reactions were compared between two groups. Results After 4,8 weeks, the PANSS total score,PANSS positive symptoms, PANSS negative symptoms of A group and B group were significantly lower than before treatment,the difference was statistically signifi-cant(P<0.05),PANSS scores of A group after treatment 4,8 weeks were significantly lower than in group B,the differ-ence was statistically significant (P<0.05),but after treatment 4,8 weeks,PANSS positive symptoms, PANSS negative symptoms of group A and group B had no significant significance. The total effective rate of A group was 86.7%,was higher than that in group B (83.3%),but the difference was not statistically significant between the two groups (P>0.05). After treatment for 6 weeks,the incidence of adverse reactions of A group was 20%,group B was 40%,the inci-dence of adverse reactions in group A was significantly lower than group B,the difference was statistically significant(P<0.05). Conclusion Ziprasidone and risperidone in the treatment of schizophrenia have better efficacy, but com-pared to risperidone, ziprasidone has advantages,with fewer adverse reactions.

Objective To study the effect of venlafaxine and fluoxetine in depression and improvement on cognitive function. Methods Retrospectively analyzed from January 2012 to January 2014 in our hospital for treatment of 32 cas-es of depression with venlafaxine in patients with clinical data, set up for the observation group, selected the same pe-riod of fluoxetine in 32 patients with depression in patients with clinical data, set up as the control group, HAMD score, cognitive function before and after treatment were compared between two groups. Results The total effective rate of ob-servation group after treatment was 93.75%,was significantly higher than the control group (P<0.05). The observation group and the control group of patients with HAMD scores were significantly lower than before treatment, and the HAMD score of observation group was significantly lower than that of the control group (P<0.05). The observation group group after treatment 8 weeks, number of errors, random errors were significantly lower than before treatment, and sig-nificantly less than the control group (P<0.05). Patients in the control group after 8 weeks of treatment, number of perse-verative errors connected rates had no significant difference before treatment (P>0.05). Conclusion Venlafaxine in the treatment of depression and improve the effect on cognitive function, has more advantages than fluoxetine.

Objective To study the Homer1a protein expression and its relationship with neurological deficit and neuronal apoptosis in craniocerebral trauma patients. Methods Forty-two craniocerebral trauma patients, admitted to our hospital from May 2012 to March 2016, were selected as craniocerebral trauma group; 50 healthy subjects accepted physical examination at the same period in our hospital were selected as normal control group (n=50). Immediately after admission, serum contents of Homer1a protein and nerve function damage indices (neurospecific estrogenase [NSE]), fatty acid binding protein [FABP], insulin-like growth factor [IGF-1], and S100B protein) were measured by enzyme linked immunosorbent assay (ELISA). Serum apoptotic indices (soluble apoptotic factor [(sFas)], sFas ligand [sFasL], and cell lymphoma-2 [Bcl-2]) were detected by radioimmunoassay. Results Immediately after admission, serum content of Homer1a protein content in craniocerebral trauma group ([113.27±12.19] pg/mL) was significantly higher than that in normal control group ([53.93±4.06] pg/mL, P<0.05); the median serum Homer1a protein level was 115.302 pg/mL, and according to this level, the patients from the craniocerebral trauma group were further divided into high Homer1a group and low Homer1a group. Serum NSE, FABP, S100B, sFas and sFasL levels in the high Homer1a group, low Homer1a group and normal control group were decreased in sequence, and IGF-1 and Bcl-2 levels increased in sequence, with significant differences (P<0.05). Conclusion Expression of Homer1a protein is increased in patients with traumatic brain injury, and its content is directly related to nerve injury and neuron apoptosis.

Objective To investigate the application value of CT perfusion (CTP) imaging for the revascularization treatment in adult patients with Moyamoya disease.Methods Adult patients with Moyamoya disease underwent revascularization in the Department of Neurosurgery,Wuhan No.1 Hospital from July 2009 to December 2016 were analyzed retrospectively.CTP and clinical evaluation were performed before and after 3-6 months of procedure.The modified Rankin Scale (mRS) was used to assess the functional outcomes.Results A total of 20 patients were enrolled in the study,including 9 females and 11 males,aged 29 to 73 years,with an average of 53.5 years.The initial symptom was ischemic stroke in 10 patients,transient isehemic attack in 7 patients,and hemorrhagic stroke in 3 patients.All patients underwent superficial temporal artery-middle cerebral artery bypass grafting plus encephalomyo-synangiosis under general anesthesia.All patients have different degrees of improvement in cerebral blood flow after procedure,and the CTP parameters were significantly improved compared with those before procedure (all P ＜0.05).The clinical symptoms were significantly improved in 3 cases (15％) and recovered in 13 cases (65％) at 6 months after procedure.The proportion of the mRS score 0-2 was significantly higher than that before procedure (90.0％ [18/20] 对 50.0％ [10/20];x2 =7.619,P =0.006).Conclusion CTP can evaluate the cerebral perfusion status in various vascular areas through hemodynamic parameters in early stage,which can effectively guide the operation mode of Moyamoya disease,and evaluate the changes of cerebral perfusion status after procedure as a means of follow-up of the disease.

OBJECTIVETo compare the long-term real-world outcomes of consecutive patients with unprotected left main coronary artery disease (ULMCA) underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and coronary artery bypass grafting (CABG).

METHODSConsecutive patients with ULMCA (defined as stenosis ≥ 50%) undergoing DES implantation or CABG between January 2003 to July 2009 in Beijing Anzhen Hospital were enrolled. The follow-up period extended through August 2013. The end points of the study were death, cardiac death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization).

RESULTSFrom January 2003 to July 2009, 922 ULMCA patients were enrolled in this study (465 PCI patients, and 457 CABG patients). The median follow-up was 7.1 years (interquartile range 5.3 to 8.2 years). The crude relative risk was as follows: overall death rate (13.0% (41/465) vs. 22.1% (72/457), P = 0.009), stroke rate (5.8% (11/465) vs. CABG 18.9% (46/457), P < 0.001) were significantly lower whereas the rate of repeat revascularization (32.3% (110/465) vs. CABG 19.2% (58/457), P < 0.001) was significantly higher in PCI group than in CABG group. MI rate was similar between PCI and CABG group (13.9% (33/465) vs. 6.7% (26/457), P = 0.196). MACCE rate was also similar between the 2 groups (42.9% (145/465) vs. 42.5% (142/457), P = 0.122). After multivariate adjusting, there was no significant difference in rates of death, MI and a composite of serious outcomes (cardiac death, MI, or stroke) between the 2 groups. Rates of MACCE were significantly higher in the PCI group (P = 0.009) due to increased rate of repeat revascularization (P < 0.001). However, stroke rate was still significantly higher in CABG group (P = 0.001) after multivariate adjusting.

CONCLUSIONDuring a follow-up up to 8.2 years, the survival rate is similar between the PCI and the CABG group in patients with ULMCA disease. The rate of repeat revascularization is significantly higher and stroke rate is significantly lower in the PCI group compared to CABG group.

Coronary Artery Bypass ; Coronary Artery Disease ; epidemiology ; therapy ; Drug-Eluting Stents ; Humans ; Myocardial Infarction ; epidemiology ; Percutaneous Coronary Intervention ; Stroke ; epidemiology ; Survival Rate ; Treatment Outcome