Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

Background Uveal effusion syndrome is uncommon in clinic.To understand the clinical characteristics of uveal effusion syndrome is helpful for rescuing visual acuity of patient.Objective This study was to discuss the diagnosis,classification and surgical outcome of uveal effusion syndrome.Methods This was a descriptive study.The clinical data of 14 eys from 10 patients with uveal effusion syndrome,ineluding ophthalmologic examination,B-scan sonography,ultrasound biomicroscopy (UBM),fundus fluorescence angiography (FFA),indocyanine green angiography (ICGA),surgical treatment and prognosis,were retrospectively analyzed.The follow-up period was 6 months.Results The fundus findings of all impacted eyes showed bullous-shape retinal detachment (RD).B-scan sonography revealed retinal and choroidal detachment.A annular peripheral ciliochoroidal detachment was observed in the cases under the UBM.FFA exhibited leopard spots without any leakage from choroid into the subretinal space.ICGA demonstrated diffusely choroidal granular hyperfluorescence in the very early phase,which presented with an increasing intensity as time lapse until the late phase.Full-thickness sclerectomy was performed on 4 eyes of 2 patients and subscleral sclerectomy was performed in 1 eye of 1 patient,achieving a retinal anatomic reattachment after surgery.All of the patients finished the fellow-up.No recurrence of RD was seen during the followup duration.Conclusions Comprehensive preoperative evaluation,including ophthalmologic ultrasonography,MRI and CT,is crucial for accurate classification of uveal effusion syndrome and determine of proper management strategy.

Background A multitude of studies reported statins prevent the myocardial hypertrophy induced by pressure overload,but the mechanism is unclear.Objective To study the protective effect of atorvastatin on the myocardial hypertrophy caused by pressure overload and it's anti-inflammation effect.Methods Forty Wistar rats were randomized to untreated group(n=10),atorvastatin group(2 mg/kg?d,by gavage,n=10),sham op- eration group(n=10)and control group(n=10).Ventricular hypertrophy model was achieved by surgical con- stricting the abdominal aorta.All rats were sacrificed 8 weeks after the operation and the heart weight to body ratio,left ventricular weight to body ratio,and the size of cardiomyocyte were determined.The expressions of interleukin 18(IL-18)and cardiotrophin 1(CT-1)in the cadiocyte were assessed by reverse transcription polymer- ase chain reaction(RT-PCR).Results Compared with control group,SBP in myocardial hypertrophy group was significantly increased(174?9 vs control 112?15 mmHg,P

OBJECTIVETo summarize clinical results of the microdecompression for the treatment of intraforaminal lumbar disc herniations.

METHODSFrom September 2005 to May 2013,16 patients( 12 males, 4 females)with intraforaminal lumbar disc herniations underwent microdecompression, ranging in age from 32 to 56 years old with a mean of 38.6 years old. The lumbar disc herniations were located at L(3,4). in one patient, L(4,5) in 10 cases and L5S1 in 5 cases.

RESULTSAll the patients were followed up, and the duration ranged from 20 to 48 months, with a mean period of 36 months. According to Macnab evaluation, 12 cases got an excellent result, 4 good. No apparent complications related to the technique occurred. Satisfactory clinical results were obtained in this series.

CONCLUSIONMicrodecompression may be particularly useful in the treatment of intraforaminal lumbar disc herniations. The microdecompression procedures are more likely to be well tolerated by older patients.

Adult ; Decompression ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome

The process performance of simultaneous anaerobic sulfide and nitrate removal was studied. The results showed that the process held a high sulfide and nitrate removal loading rate of 3.73kg/(m3 x d) and 0.80kg/(m3 x d), respectively, under steady state. It was capable of tolerating high influent substrate concentration (580mg/L and 110mg/L) with the optimum substrate concentration of 280mg/L and 67.5mg/L. It was capable of tolerating short hydraulic retention time (HRT) with the optimum HRT of 0.13d. Careful operation was needed when HRT was shortened because the process performance was deteriorated abruptly.
Anaerobiosis ; Bioreactors ; Nitrates ; isolation & purification ; Sulfides ; isolation & purification ; Time Factors ; Waste Disposal, Fluid ; methods ; Water Pollutants, Chemical ; isolation & purification ; Water Purification ; methods

OBJECTIVETo compare the efficacy difference in the treatment of supraspinous ligament injury between floating acupuncture at Tianying point and the conventional warm needling therapy.

METHODSNinety patients were randomized into a floating acupuncture group and a warm needling group, 45 cases in each one. In the floating acupuncture group, the floating needling technique was adopted at Tianying point. In the warm needling group, the conventional warm needling therapy was applied at Tianying point as the chief point in the prescription. The treatment was given 3 times a week and 6 treatments made one session. The visual analogue scale (VAS) was adopted for pain comparison before and after treatment of the patients in two groups and the efficacy in two groups were assessed.

RESULTSThe curative and remarkably effective rate was 81.8% (36/44) in the floating acupuncture group and the total effective rate was 95.5% (42/44), which were superior to 44.2% (19/43) and 79.1% (34/43) in the warm needling group separately (P < 0.01, P < 0.05). VAS score was lower as compared with that before treatment of the patients in two groups (both P < 0.01) and the score in the floating acupuncture group was lower than that in the warm needling group after treatment (P < 0.01). Thirty-six cases were cured and remarkably effective in the floating acupuncture group after treatment, in which 28 cases were cured and remarkably effective in 3 treatments, accounting for 77.8 (28/36), which was apparently higher than 26.3 (5/19) in the warm-needling group (P < 0.01).

CONCLUSIONThe floating acupuncture at Tianying point achieves the quick and definite efficacy on supraspinous ligament injury and presents the apparent analgesic effect. The efficacy is superior to the conventional warm-needling therapy.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adolescent ; Adult ; Aged ; Female ; Humans ; Longitudinal Ligaments ; injuries ; Male ; Middle Aged ; Pain Management ; Treatment Outcome ; Young Adult

Death, Sudden ; epidemiology ; Emergency Service, Hospital ; statistics & numerical data ; Humans

Objective To investigate the current conditions of water iodine,childrens'iodine nutrition and residents'edible circumstance of iodized salt in the villages with high iodine in drinking water and the adjacent three villages in Xiamen city of Fujian province.Methods Four natural villages of Qianbian,Donglian,Dazhong and Dongshan of Xiangan county were chosen as survey spots in 2008.In each village,one running water sample and all well water samples were collected to obtain the benchmark for each location.All children aged 7-13 year in the four villages underwent thyroid palpation and were selected to measure the urine iodine and the salt iodine.The water iodine and urine iodine were determined by As3+-Ce4+ catalytic spectrophotometry digestion,salt iodine was determined by direct titration.Results In four investigated villages,iodine of four running water samples were all 1.5μg/L.The range of 237 well water iodine samples was from 0.1 μg/L to 506.0 μg/L.There were 18.6% (44/237)specimens in which the well water iodine less than 10 μg/L,73.4%(174/237)between 10 μg/L and 150 μg/L and 8%(19/237)more than 150μg/L.The median of urinary iodine was 153.3 μg/L in 79 urine samples,which was 114%(9/79)more than 200μg/L and less than 300μg/L,12.7%(10/79)equal or more than 300 μg/L and less than 500μg/L,7.6%(6/79)equal or more than 500μg/L and less than 800 μg/L in all samples.Seventy-nine students were examined by palpation and the total goiter rate of children measured was 11.4% (9/79).Seventy-one samples of iodine salt were detected and the coverage rate of iodized salt was 77.5%(55/71).Conclusions The well water iodine contents have a wide distribution in the investigated villages.We should enhance the community awareness by educating them on the damage of iodine excess and iodine deficiency.

Background:Andersson lesions (ALs),also known as spondylodiscities,destructive vertebral lesions and spinal pseudarthrosis,usually occur in patients with ankylosing spondylitis (AS).Inflammatory and traumatic causes have been proposed to define this lesion.Different surgical approaches including anterior,posterior,and combined anterior and posterior procedure have been used to address the complications,consisting of mechanical pain,kyphotic deformity,and neurologic deficits.However,the preferred surgical procedure remains controversial.The aim of this study was to illustrate the safety,efficacy,and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in AS.Methods:From June 2008 to January 2013,23 patients (18 males,5 females) at an average age of 44.8 years (range 25-69 years) were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our department.All sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the follow-up period.Assessment of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading system.Ankylosing spondylitis quality of life (ASQoL) and visual analog scale (VAS) scores were performed to evaluate improvements in daily life function and back pain pre-operatively and post-operatively.Paired t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric comparisons.The radiographic data change was evaluated by repeated measure analysis of variance.Results:The mean operative duration was 205.4 min (range 115-375 min),with an average blood loss of 488.5 mL (range 215-880 mL).Radiographical and clinical outcomes were assessed after a mean of 61.4 months of follow-up.The VAS back pain and ASQoL scores improved significantly in all patients (7.52 ± 1.31 vs.1.70 ± 0.70,t=18.30,P ＜ 0.001;13.87 ± 1.89 vs.7.22 ± 1.24,t=18.53,P＜0.001,respectively).The thoracolumbar kyphosis (TLK) changed from 40.03±17.61° pre-operatively to 13.86 ± 6.65° post-operatively,and 28.45 ± 6.63° at final follow-up (F =57.54,P ＜ 0.001),the thoracic kyphosis (TK) changed from 52.30 ± 17.62° pre-operatively to 27.76 ± 6.50° post-operatively,and 28.45 ± 6.63° at final follow-up (F =57.29,P ＜ 0.001),and lumbar lordosis (LL) changed from-29.56 ± 9.73° pre-operatively to-20.58 ± 9.71° post-operatively,and-20.73 ± 10.27° at final follow-up (F=42.50,P ＜ 0.001).Mean sagirtal vertical axis (SVA) was improved from 11.82 ± 4.55 cm pre-operatively to 5.12 ± 2.42 cm post-operatively,and 5.03 ± 2.29 cm at final follow-up (F=79.36,P ＜ 0.001).No obvious loss of correction occurred,according to the lack of significant differences in the sagittal balance parameters between post-operatively and the final follow-up in all patients (TK:27.76 ± 6.50° vs.28.45 ± 6.63°,TLK:13.86 ± 6.65° vs.14.42 ± 6.7°,LL:-20.58 ± 9.71° vs.-20.73 ± 10.27°,and SVA:5.12 ± 2.42 cm vs.5.03 ± 2.29 cm,all P ＞ 0.05,respectively).Conclusions:The modified posterior wedge osteotomy is an accepted surgical procedure for treating thoracolumbar kyphosis with ALs in AS and results in satisfactory local kyphosis correction,solid fusion,and good clinical outcomes.

OBJECTIVETo establish a model of smooth muscle cells differentiated from bone mesenchymal stem cells (BMSC-SMCs) in vitro and explore the relationship between scavenger receptors A (SR-A) and caveolin-1.

METHODSBMSCs were isolated from the femoral bone of SD rats by adherent culture. After treatment of the BMSC-SMCs with 80 mg/L ox-LDL for 72 h, Western blotting was performed to detect the expression of scavenger receptor SR-A, cell cholesterol transport protein ATP-binding cassette transporter Al (ABCA1) and caveolin-1.

RESULTSBMCS-SMCs became foam cells after treatment with ox-LDL. BMSC-SMC gave rise to more foam cell formation than VSMCs did. Western blotting showed that treatment with 80 mg/L ox-LDL for 72 h resulted in significantly increased expression of SR-A and significantly decreased expressions of ABCA1 and caveolin-1.

CONCLUSIONSTreatment of BMCS-SMCs with ox-LDL results in cholesterol ester accumulation in the cells to result in foam cells, the mechanism of which involves up-regulation of scavenger receptor SR-A expression and down-regulation of the reverse cholesterol transport protein ABCA1 and caveolin-1 expression.

ATP Binding Cassette Transporter 1 ; ATP-Binding Cassette Transporters ; metabolism ; Animals ; Bone Marrow Cells ; cytology ; Caveolin 1 ; metabolism ; Cell Differentiation ; Cells, Cultured ; Female ; Foam Cells ; cytology ; Lipoproteins, LDL ; pharmacology ; Male ; Mesenchymal Stromal Cells ; cytology ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Scavenger Receptors, Class A ; metabolism