60?) in the Huaxi Hospital of Sichuan University. Three cases aged less than 15 years, but the patients or their relatives were informed of and consented the operation scheme. Without rectification, fusion segments were propped open about 5 mm via the upper and lower fixed vertebra, and anterior one was transplanted with fresh-frozen fibular allograft (offered by the donor corpse and excised extremities due to surgical trauma from the Department of Orthopaedics in Huaxi Hospital. The immunogenicity was greatly reduced by routine defat, acellular procedure, soaking sterilization and deep freezing), while rear one was transplanted with costal bone for supporting graft and filling the graft bone intervals with autogenous bone strips. Gypsum (brace) was used to assist external fixation for 8-10 month postoperation. The complications, graft incorporation, neurological function (Frankel grading scale A-E: complete paralysis-normal or no paralysis), back pain (0-3: none-severe), and mobility score (1-4: lying in bed-needing no assistance) before operation and at final follow-up of each patient were collected for analysis. RESULTS: All the patients were available for follow-ups and the mean period was 3.4 years (1.5-5 years).①Apparent fusion was observed in all cases with no graft fracture, only one patient reported mild graft shift and the kyphosis was unchanged.②There was no worsening of the neurological status in any patient. Frankel grades of 3 adult patients were unchanged after operation. All adolescent patients (n =3) had definite neurological improvement and could walk without assistance, while another was adult patient. Complete relief of back pain was observed in all patients. CONCLUSION: Fresh-frozen allograft fibular is a liable graft material for the treatment of severe kyphosis induced by inactive upper thoracic tuberculosis. Anterior decompression and fusion can promote the recovery of motive function and the alleviation of pain, especially is effective for neurological recovery of adolescent.

Objective To evaluate the effects of etomidate preconditioning on etomidate-induced toxicity to rat adrenal cortical cells in vitro.Methods After being primarily cultured for 7-9 days,the rat adrenal cortical cells at the exponential growth phase were seeded into 96-well culture plates (1 × 106 cells/ml) and cultured for 24 h.The cells were then randomly divided into 3 groups with 6 wells in each group:control group (group C),etomidate group (group E),and etomidate preconditioning group (group EP).In group E,the cells were incubated with 700 μmol/L etomidate for 24 h.In group EP,the cells were incubated with 1.25 μmol/L etomidate for 1 h,then washed out and incubated with 700 μmol/L eomidate for 24 h.The cell viability was determined by CCK-8 assay and the concentration of cortisol was determined by ELISA.Results Compared with group C,the cell viability and cortisol concentration were significantly decreased in E and EP groups.Compared with group E,the cell viability and cortisol concentration were significantly increased in group EP.Conclusion Etomidate preconditioning can reduce etomidate-induced toxicity to rat adrenal cortical cells in vitro.

Objective To observe the metabolic changes in the whole brain of chronic unpredictable mild stimulations ( CUMS)-induced depressive rats using PET imaging technology.Methods After 4 weeks’ of CUMS, rats of experimental group were divided into two groups:Group D( depression) and Group ND( no depression) , according to the degree of sugar addiction, distance of spontaneous activity and relative body mass.Then metabolic changes in the whole brain of these rats and those in control group ( CON) were observed using PET technology, and the differences were companred between the threegroups.Results (1)ComparedwithGroupCON,metabolismofGroupDwaselevatedinbilateralS1,thalamus, globus pallidus, insula, M2 and left claustrum, but descended in right inferior colliculus, splenium of corpus callosum and cerebellum.(2) Metabolism of Group D increased in the bilateral CA3 region of hippocampus, M1, M2, striatum, S1 and olfactory bulb, but decreased in the left cuneate nucleus and hippocampus compared to Group ND.( 3 ) Compared with Group CON, there was no region of the brain in Group ND where metabolism was enhanced, but metabolism in the lateral septal nucleus, bilateral striatum, hypothalamic paraventricular nucleus, bilateral S1 and right globus pallidus of Group ND was reduced.Conclusion The metabolic characteristic in the brain of depressive rats is that heightened regions are all in front of the coronal plane 4 mm post bregma, while lowered regions are behind.Moreover, both cerebral hemispheres are roughly symmetrical.It can be concluded that abnormal interactions between different regions of the brain contributes to the occurrence of depression.

BACKGROUND:After acute myocardial infarction(AMI),there is still surviving myocardium in and around the infarcted area,which plays an important role in the occurrence of arrhythmia. OBJECTIVE:To study the alterations of the activities of Na+ channel current(INa),L-calcium current(ICa-L),transient outward K+ current(Ito) and inward rectifying K+ current(IK1) in the cardiomyocytes in the infarcted area after AMI. DESIGN: A randomized controlled study. SETTING:Department of Cardiology,Bethune International Peace Hospital. PARTICIPANTS:The experiment was finished in the Central Laboratory of the Department of Cardiology,Bethune International Peace Hospital from January to June 2003.Twenty New Zealand pure big-ear rabbits were randomly divided into AMI group(n=10) and control group(n=10). INTERVENTIONS:Rabbit AMI models were established by ligation of the left anterior descending coronary artery.The ventricular myocytes were separated with the method of enzymatic dissociation technique,and the changes of the ion currents were recorded with the whole cell patch-clamp techniques. MAIN OUTCOME MEASURES:The changes of INa,ICa-L,Ito and IK1 in the cardiomyocytes taken from the infarcted area of epicardium 24 hours after AMI in both the AMI and control groups. RESULTS:Twenty-four hours after AMI,the peak current densities of INa,ICa-L and IK1 in the AMI group [(28.48± 3.53) pA/pF,n=16;(3.91± 0.95) pA/pF,n=12;(26.93 ± 3.48) pA/pF,n=16]were all significantly reduced as compared with those in the control group [(45.50± 5.33) pA/pF,n=12;(5.58± 1.53) pA/pF,n=10;(34.12± 4.21) pA/pF,n=10] (t=3.026,P< 0.01;t=2.985,P< 0.01;t=2.706,P< 0.05).There was no significant difference in the Ito density between the AMI group and control group (P >0.05). CONCLUSION:The reduce of INa,ICa-L and IK1 caused by AMI can result in the decrease of myocardial conduction velocity,the shortening of action potential-time,abnormal repolarization,which is possibly the ionic mechanism for the reentrant ventricular arrhythmia after AMI.

Traditional Chinese medicine is the crystallization of civilization and wisdom of Chinese nation , in which the complex components exhibit unique advantages in anti-tumor therapy through multi-channel and multi-target.Through the summary of the litera-tures recently, the research on anti-tumor mechanism of traditional Chinese medicine was reviewed to provide reference for the deep re -search and clinical application of traditional Chinese medicine .

AIM:To study the pharmacokinetics of penciclovir injection in Chinese healthy volunteers.METHODS:10 healthy volunteers were infused a single dose of 10 mg/kg of penciclovir.The concentrations of penciclovir in plasma and urine were determined by HPLC-FLD.Pharmacokinetic parameters were conformed to a non-compartment model analyzed by WinNonLin program.RESULTS:The main pharmacokinetic parameters were as follows:the ke was(0.37?0.05)/h;the t1/2 was(1.91?0.26)h;the Cmax was(9.8?1.6)mg/L;the AUC0-t was(19.1?2.8)mg?L-1?h;the AUC0-∞ was(19.6?2.9)mg?L-1?h;the Vd was(1.4?0.4)L/kg;the CL was(0.52?0.08)L?h?kg-1.About 70% of penciclovir was excreted into urine within 12 h.CONCLUSION:Penciclovir is widely distributed and rapidly excreted,predominantly by the kidney.

Objective To study mRNA expression of neuroglobin (NGB) in thalamus of DAI rats and explore the relation between NGB and heed injury. Method 46 male SD rats were randomly divided into four groups. The DAI model was established according to modi-fied Mamamu method. The mRNA expression of NGB in thalamus at different time point after injury was detected by RT-PCR method. All data were analyzed with statistical software. Result The mRNA expression of NGB in thalamus increased obviously from 30 minutes after in-jury while decreased at the 24th hour after injury. But the expression increased again and reached peak at the 48th hour after injury. Conclu-sion The mRNA expression of NGB in thalamus increased after DM. Those changes suggested NGB might participate in the response mech-anism of stress, secondary ischemia and hypoxic brain injury after neuron injury.

Objective To explore the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) for elderly patients with periampullary diverticula accompanied with choledocholithiasis.Methods The retrospective cross-sectional study was conducted.The clinical data of 297 elderly patients with age ＞70 years and periampullary diverticula accompanied with choledocholithiasis who were admitted to the Zhongshan Hospital affiliated to Fudan University between January 2013 and January 2016 were collected.All the patients received lithotomy by ERCP after completion of preoperative preparation,and then underwent symptomatic treatment.Observation indicators included:(1) treatment results:cannulation time,success rate of cannulation and success rate of stones removed;(2) surgical complications:hemorrhage,perforation and pancreatitis;(3) follow-up results.All patients were followed up by outpatient examination and telephone interview up to December 2016.Follow-up included postoperative delayed perforation,patients' survival,further attack of acute cholangitis and reoperation for removing stones.Measurement data with normal distribution were represented as x ± s,and measurement data with skewed distribution were described as M (range).Results (1) Treatment results:all the 297 patients underwent successful lithotomy by ERCP,with a cannulation time of (5±4)minutes and a success rate of cannulation of 100.00％ (297/297).Of 297 patients,292 had one-off success of stones removed,with a one-off success rate of 98.32％ (292/297),and 5 received partial stones removed due to choledocholithiasis combined with acute cholangitis.(2) Surgical complications:4 patients were complicated with immediate hemorrhage during intraoperative endoscopic sphincterotomy (EST).Bleeding of 1 patient was cauterized by biopsy forceps,and 3 patients had simplex JHY-BAL compression hemostasis.Two patients with postoperative delayed hemorrhage had successful hemostasis by biopsy forceps with metal hemostatic clip under endoscope after emergency duodenoscopy.One patient with intraoperative perforation was cured by conservative treatment.Two patients with severe acute pancreatitis underwent continuous gastrointestinal decompression combined with maintenance therapy of somatostatin,and then received endoscopic ultrasound-guided puncture and drainage for pseudocyst around the pancreas,with a stable symptoms of pancreatitis after 4 weeks.(3) Follow-up results:all the 297 patients were followed up for 6-12 months,with a median time of 8 months.During follow-up,292 patients had healthy survival,without recurrences of cholangitis and bile duct stone,and no delayed perforation and death were detected.Five patients underwent the second time lithotomy by ERCP after 2-3 months postoperatively.Conclusion Lithotomy by ERCP is safe and effective in the treatment of elderly patients with periampullary diverticula accompanied with choledocholithiasis.

BACKGROUND:The majority of rheumatoid arthritis treatment is chronic anti-arthritis drugs, biological agents and plant drugs. Among them, plant drugs have been widely concerned due to low cost and few adverse effects. OBJECTIVE:To observe the expression of tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) in the
synovium of col agen-induced arthritis rats, and explore the effect of Aconitum leucostomum Worosch. on the expression.
METHODS:Forty-five rats were randomly divided into normal control group (8 rats) and model group (37 rats). The col agen-induced arthritis model was established with the injection of type II bovine col agen into the end of the tail and paws. After the success of modeling, the 24 successful model rats were randomly selected and divided into model group (8 rats), Tripterygium wolfprdi polyglycoside group (8 rats) and Aconitum leucostomum Worosch. group (8 rats). The arthritis index of the rats in the three intervention groups and one control group were evaluated weekly. After treated by intragastric administration for 4 weeks (Tripterygium wolfprdi polyglycoside group and Aconitum leucostomum Worosch. group were taken by the corresponding drug solution, model group and normal control group were taken by the same volume of physiological saline), the expressions of TNF-αand IL-1βin the synovium were tested by immunohistochemistry.
RESULTS AND CONCLUSION:Compared with the model group, the arthritis index of mice in Tripterygium wolfprdi polyglycoside group and Aconitum leucostomum Worosch. group was decreased significantly after treatment (P<0.05). The expression levels of TNF-αand IL-1βin the synovium of model group were significantly higher than those of the normal control group (P<0.05). After treatment with Aconitum leucostomum Worosch. and Tripterygium wolfprdi polyglycoside, the expression levels of TNF-αand IL-1βin the synovium was decreased compared with the model group (P<0.05). Experimental findings indicated that, the mechanism that Aconitum leucostomum Worosch. treats rheumatoid arthritis is related to the inhibition of TNF-αand IL-1β.

Objective:To investigate the effects of BMP9 combined with NGF on the osteogenic differentiation of mesenchymal stem cells(MSCs).Methods:Recombinant BMP9 adenovirus was transfected into C3H10T1/2 cells.The cells were treated by GFP,NGF,BMP9 and BMP9 + NGF respectively.The expression level of COL1,RUNX2 was detected by RT-PCR and Western blot,ALP activity was examined by ALP kit 3,12,24,48 hours,3 and 7 days after treatment,respectively.Results:The ALP activity of BMP9 + NGF group was the highest among the 4 groups.The difference in the groups firstly appeared at 3 h after treatment.The highest expression level of RUNX2 and COL1 was detected in BMP9 + NGF group.Conclusion:NGF and BMP9 may synergisticly promote osteogenic differentiation at the early stage of osteogenic induction of C3H10T1/2 cells.