Abstarct:Objective To evaluate mid-term efficacy and complications of Prestige LP cervical disc arthroplasty ( CDA) for treatment of single-level cervical spondylotic myelopathy .Methods Retrospectively analyzed the clinical data of 29 patients who underwent Prestige LP cervical disc arthroplasty from June 2009 to December 2013 and were followed up for 2 to 6 years.Among them, there were 19 males and 10 females, and the average age was (45.4 ±7.6)years old (ranged from 28 to 58 years old).Cardinal symptom of spinal compression occured in 20 cases of them,and nerve root compression occured in the other 9 cases.Clinical symptoms and functional outcomes were evaluated with Japanese Orthopaedic Association(JOA) scores,neck and arm visual analog scale(VAS) scores,and Neck Disability Index(NDI).Oerpation segmental range of motion(ROM) were evaluated with follow-up dynamic X-ray.Displacement,subsidence of the prosthesis,heterotopic ossifi-cation(HO) and other complications were also investigated .Results The 29 patients were followed up for 24 to 66 months,(35.5 ±10.4) months averagely .At the final follow-up,the JOA score,NDI,Neck-VAS and Arm-VAS were (15.62 ±1.12) points,(14.65 ±5.68)%,(1.93 ± 1.10) points,and (0.76 ±0.99) points respectively,which were significant improved compared with (12.03 ±2.23) points,(42.52 ± 16.31)%,(5.00 ±2.22) points,and (4.59 ±3.18) points preoperatively,and the differences were of statistical significance (P<0.05). The opreation segmental ROM was (7.37 ±3.11)°,which was better remained compared with (8.50 ±3.35)°before operation.After the surgery,there were 1 case of forward displacement ,3 cases of backward displacement ,1 case of subsidence of the prosthesis ,3 cases of adja-cent segment degenerations ,and 14 cases of heterotopic ossification .Conclusion The mid-term efficacy and safety of Prestige LP cervical disc arthroplasty is fine .But there is a high incidence of the prosthesis-related complications which may counteract the function of protecting the adjacent segment .Therefore,the indication,operation skills and perioperative period management of cervical disc arthroplasty are impor -tant aspects to avoid the adverse effect .

Objective To study the treatment of abdominal compartment syndrome(ACS) secondary to fulminant acute pancreatitis (FAP).Method A retrospective study was conducted from Jan.2009 to Dec.2011 to analyze the therapeutic results of 18 patients with ACS secondary to FAP.Results Three out of 7 patients who received non-operative therapy died (mortality rate 42.9％).Three out of 11 patients treated with early surgery died (mortality rate 27.3％),which was significantly better than those patients treated conservatively.Conclusion A reduction in intra-abdominal pressure improved the function of the viscera in the treatment of ACS secondary to FAP.The decompressive effects of early surgery was efficacious,and it reduced the mortality rate.

Objective To evaluate the procedure and the therapeutic efficacy of duodenumpreserving pancreatic head resection (DPPHR) in treating benign lesions in the head of the pancreas.Methods From February 2003 to August 2011,DPPHR was performed in 21 patients with benign lesions in the head of the pancreas.Thirteen patients were male and eight were female.Age ranged from 30 to 48 years,and the lesions ranged from 2.0 cm to 5.6 cm in diameter.Posterior superior pancreaticoduodenal artery was conserved in all patients.Results There was no hospital death.Pancreatic fistula was the main and the most often morbidity,occurring in 33.3％.After operation all patients with preoperative abdominal pain were completely pain free.Preoperative hypoglycemia in 2 patients turned to eugycemia.There was no recurrences report during following up.Concl~ions DPPHR was safe and effective in treating benign lesion in the head of pancreas.It was important in preserving blood supply to the duodenum by posterior superior pancreaticoduodenal artery.

Succinic acid is regarded as C4 platform chemical, which has a huge potential market with wide applications in biopolymer, food, medicine, and so on. Production of succinic acid by microorganism fer-mentation has attracted much attention in recent times. By fermentation, succinic acid could be produced from renewable resources in place of petroleum with low cost and low pollution; especially CO2 could be fixed by microorganism to form the product, which is a promising way to deal with the green gas. Some E. coli have been chosen as good succinic acid producing strains because of their clear genetic backgrounds, convenience to be modified and controlled, and good growth properties with low nutrients requirements. The progress of genetic engineering strategy and metabolic engineering technology for construction of succinic aicd producing recombinant E. coli has been introduced in this paper with the discussion of the future re-search in this area.

Acupuncture Therapy ; methods ; Botulinum Toxins, Type A ; therapeutic use ; Cerebral Palsy ; therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Male ; Massage

Actinobacillus succinogenes A3 was mutagenized by ultra high hydrostatic pressure for improving the production ability of succinic acid.The effects of pressure,rate of pressure changes and growth periods on the lethality rate of the strain were investigated.The strain in stationary phase was mutagenized at 200 MPa with the pressure changes at the rate of 50 MPa/min.As a result,a mutation strain Actinobacillus succinogenes B19 was obtained,and the concentration of succinic acid could reach 32.2 g/L,which was 17.9%higher than that of the original strain,and in the meanwhile the concentration of acetic acid was decreased by 11.5%.After six generation,the mutant also has good stability of descendiblity for succinic acid production.

OBJECTIVETo observe effect of electroacupuncture on hemodynamics at peri-intratracheal intubation period under general anesthesia.

METHODSSixty cases at peri-intratracheal intubation period under general anesthesia were randomly divided into electroacupuncture group [Before anesthesia induction, electroacupuncture stimulation was given at Neiguan (PC 6), Hegu (LI 4), Quchi (LI 11), Shenmen (HT 7)], and control group, 30 cases in each group. All the patients in the two groups received intratracheal intubation with light-guide laryngoscopy under general anesthesia with midazolam, fentanyl, isopropyl, succinylcholine, etc.; changes of various indexes of hemodynamics were detected at anesthesia induction and different time points of the intubation.

RESULTSAt the anesthesia induction, various indexes of hemodynamics in the electroacupuncture group were relatively stable, and decreased significantly in the control group (P < 0.01); during intratracheal intubation, the various indexes in the electroacupuncture group (P < 0.05) and in the control group (P < 0.01) increased significantly as compared with those before anesthesia induction; 5 min after intubation, the various indexes in both the two groups restored normal.

CONCLUSIONElectroacupuncture at Neiguan (PC 6) and other points can stabilize changes of hemodynamics at the intratracheal intubation and increase safety of operation under anesthesia.

Acupuncture Analgesia ; Anesthesia, General ; Electroacupuncture ; Hemodynamics ; Humans ; Intubation, Intratracheal

OBJECTIVETo explore the possible mechanism of electroacupuncture preconditioning (EAPC) and combined with ATP-sensitive potassium channel (KATP) blocker preconditioning for hypoxia/ischemic brain injury protection by observing the changes of the immediate genes (c-fos and c-jun protein content) in brain at the early stage after cerebral hypoxia/ischemic injury, and the effect of EAPC on these changes.

METHODSIntegrated density (ID) of c-fos and c-jun expression was measured by Western blot and computerized image processing.

RESULTSHypoxia/ischemia could induce c-fos and c-jun protein in both cerebral cortex and hippocampus simultaneously, with the peak appearing 2-4 hrs later, and the expression in hyppocampus was higher than that in cortex. EAPC could lower KATP blocker induced permanent high expression in hyppocampus.

CONCLUSIONThe effect of EAPC preconditioning in antagonizing cerebral hypoxia/ischemic injury may be related with its action in activating KATP, inhibiting the neuron apoptosis induced by the immediate genes at early stage of injury.

Animals ; Animals, Newborn ; Apoptosis ; Brain ; metabolism ; pathology ; Electroacupuncture ; Female ; Hypoxia-Ischemia, Brain ; metabolism ; prevention & control ; Ischemic Preconditioning ; methods ; Male ; Proto-Oncogene Proteins c-fos ; metabolism ; Proto-Oncogene Proteins c-jun ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the outcome of reoperation(after I stage anterior/posterior operation)for thoracolumbar fractures combined with kyphosis and spinal cord injury. Methods A retrospective study was done on the medical records of 12 patients who underwent two-stage decompression with kyphosis and neurologic deficit due to single-stage approach(anterior or posterior) operation of thoracolumbar fractures combined with spinal cord injury between January 2005 and April 2009.There were 9 males and 3 females,at mean age of 34.6 years(range,19-57 years).According to the Denis classification,there were five patients with burst fractures,five with compression fractures and two with fracture dislocation.All the patients had couns medullaris injury.Of all the patients,five underwent one stage anterior approach surgery and the others underwent posterior approach operation.All the patients had vailous degrees of neurological symptoms.The patients treated with one stage anterior surgery were treated with two stage posterior surgery and the patients treated with one stage posterior surgery were treated with the two stage anterior operation.The mean interval from one stage operation to two stage decompression was 13.4 months(range,12-18 months).The radiologic,neurologic and functional outcomes were assessed through observation of the Cobb angle,Frankel spinal cord injury grading and Japanese Orthopaedic Association Scores(JOA). Results AIl the patients were followed up for mean 25 months (12-48months),which showed primary healing of the incisions in all the patients.The average anterior and posterior heisht of the vertebrae wers corrected from preoperative 42.6%and 70.5%to postoperative 92.5%and 95.7%and to 87.3%and 92.2%at the final follow-up respectively.Neurologic status was improved at least one Frankel grade in the patients who had preoperative incomplete paraplegia.The Cobb angle was corrected from preoperative 36.3°to postoperative 5.8°and to 5.9°at the final follow-up(P<0.05).No patient had any notable loss of correction between discharge and final follow-up.According to JOA coring,the results were excellent in nine patients,good in two and fair in one,with excellence rate of 92%. Conclusions Two stage decompression for epiconus and cauda equina syndrome resulted from one stage approach(anterior or posterior)operation of thoracolumbar fractures combined with spinal cord injury call attain satisfactory correction of the kyphosis and nerve decompression as well as various degrees of nerve function recovery.

OBJECTIVEThe cascade of physiological events underlying hypoxic-ischemic brain damage (HIBD) remains to be fully established. The perinatal brain shows both an increased tolerance to hypoxic-ischemic (HI) injury and a faster and more complete recovery than the adult. It is, therefore, important to understand the sequence of events following hypoxia and ischemia in young animals. The present study aimed to clarify the time-course of the activation of the mu-calpain, and the expression of c-Fos, c-Jun, HSP70 and HSP27 proteins following severe HI (2 h hypoxia) and their relationship with each other.

METHODSA modified newborn rat model of HIBD that included a combination of hypoxia and ischemia as described by Rice was used. Forty-two postnatal 7-day-old Sprague-Dawley rats were randomly divided into seven groups (6 rats in each): 6 time-window groups and a normal control group. Samples were collected at 0, 1, 2, 4, 12 and 24 h after HI insults. The protein concentration was determined using a modified Bradford assay. mu-calpain activation, c-Fos, c-Jun, HSP70 and HSP27 expressions were observed respectively by Western blot from cortical and hippocampal samples.

RESULTSThe cleavage of cytosolic mu-calpain was observed from both cortical and hippocampal samples in neonatal rats after HI. The ratio 76:80 of mu-calpain was increased significantly post-HI and reached a maximum at 24 h in cortex and at 12 h in hippocampus after HI. The expressions of c-Fos and c-Jun from both cortical and hippocampal samples in neonatal rats were up-regulated and peaked at 2 or 4 h after HI, demonstrating significant differences at 1, 2, 4, and 12 h compared with that observed in the control (P < 0.05). When compared with that observed in cortex, the nuclear c-Fos expression from hippocampal samples was highly elevated at 2, 4 and 12 h but significantly decreased at 24 h after HI (P < 0.05), while the nuclear c-Jun expression from hippocampal samples was highly elevated at 0 and 1 h but significantly decreased at 4 and 24 h after HI (P < 0.05). Similarly, the expressions of HSP70 and HSP27 from both cortical and hippocampal samples were up-regulated and reached a maximum at 12 or 24 h after HI, demonstrating significant differences at 12 or 24 h both in cortex and hippocampus for HSP70, and at 24 h in cerebral cortex as well as at 12 and 24 h in hippocampus for HSP27 compared with the control (P < 0.05). Furthermore, in comparison with that observed in cortex, the HSP70 expression from hippocampal samples was highly elevated at 1 h, but significantly decreased at 4, 12 and 24 h after HI (P < 0.05), while the HSP27 expression was permanently elevated in hippocampus after HI.

CONCLUSIONThe neuronal injury induced by HI insults appears to involve many ongoing and simultaneous mechanisms. HI activates the calpains immediately, which may contribute to neuron apoptosis, and induces a significant brain neuroprotection, since there is an increased HSP70 expression and a relatively late remarkable HSP27 expression in hypoxic-ischemic neonatal rat brain. Nuclear c-Fos and c-Jun may participate in the pathogenesis of HIBD.

Animals ; Animals, Newborn ; Blotting, Western ; Brain ; metabolism ; pathology ; Calpain ; metabolism ; Enzyme Activation ; Female ; HSP27 Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; metabolism ; Heat-Shock Proteins ; metabolism ; Hypoxia, Brain ; metabolism ; Male ; Neoplasm Proteins ; metabolism ; Proteins ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Proto-Oncogene Proteins c-jun ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors