Objective To compare the clinical outcomes of modified and traditional posterior lumbar interbody fusion (PLIF) in treatment of lumbar spinal stenosis.Methods A retrospective review was made on 47 patients who sustained monosegmental L4.5 stenosis due to lumbar degenerative revise and characterized by typical intermittent claudication and single or both limb numbness and pain.The patients were randomly allocated to Group A and Group B using the lottery method.Group A (n =24) consisted of 10 males and 14 females at mean age of 52 years (range,47-66 years) and the course of disease averaged 13 months (range,9-23 months).Group B (n =23) contained 8 males and 15 females at mean age of 53 years (range,49-67 years) and the course of disease averaged 11.5 months (range,6-22months).Modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction and interbody fusion was performed in Group A.Traditional PLIF,namely posterior spinal decompression and interbody fusion,was performed in Group B.Waist function rehabilitation after surgery of the patients in the two groups was assessed using the Oswestry disability index (ODI) and postoperative results were analyzed.Results There were no significant differences between Groups A and B regarding the operation time [(1 90 ± 15.66) min vs (170 ± 11.32) min] and intraoperative blood loss [(980 ± 35.58) ml vs (879 ± 21.25) ml] (P ＞ 0.05).Mean period of follow-up was 20 months (range,12-28 months).Postoperative results in Group A were graded as excellent in 19cases,good in three,fair in two and poor in zero,with excellence rate of 88％.While in Group B,the results were excellent in 13 cases,good in four,fair in four and poor in two,with excellence rate of 74％(P ＜ 0.05).ODI score and symptom improvement rate after operation were better in Group A than in Group B (P ＜ 0.05).Conclusion The modified PLIF including spinous process replantation combined with canal H-shaped bone grafting for posterior column reconstruction is relatively an ideal surgical technique for treatment of lumbar spinal stenosis and deserves wide promotion.

Objective: To observe the influence of acupoint application therapy on serum eosinophilic granulocyte cationic protein (ECP), 6 keto prostaglandin F 1 (6-keto-PGF 1) and thromboxane B2 (TXB2). Methods: 300 cases of asthma out-patients in a remission period were divided into a treatment group (150 cases) and a control group (150 cases). The control group was given the basic treatment, and the treatment group was given external application on the acupoints in July and December every year, as well as the basic treatment of the control group, with continuous treatment for 2 years as one course. ECP, 6-keto-PGF 1, and TXB2 were checked every year in the patients of the two groups, and an Asthma Control Test Table was filled in for comparative analysis. Results: After the external application on the acupoints, the frequency of seizures, dyspnea and frequency of medication administration of the patients had been more reduced than those in the control group, indicating that the levels of ECP in inflammation of air passage and of 6-eto-GF 1 and TXB2 were obviously improved (P＜0.05). Conclusion: The herbal application on the acupoints is effective and positively influential to the improvement of the symptoms in the asthma patients and to ECP, 6-keto-PGF 1, and TXB2 remarkably.

BACKGROUND:As a new self-synthetized medical orthopedic fixation material, micron traditional Chinese medicine functional lining material can promote the secretion of alkaline phosphatase and cal us formation, decrease serum calcium level, as wel as increase serum phosphorus level and calcium-phosphorus product. OBJECTIVE:To further verify the therapeutic effect of micron traditional Chinese medicine functional lining material on fracture healing. METHODS:Twenty-four New Zealand rabbits were selected to prepare models of right radial fracture, and then were randomly al ocated into four groups:rabbits in micron group were treated with micron traditional Chinese medicine functional lining material (micron Panax notoginseng powder mixed with active ingredients of Daval ia divaricata and Carthamus tinctoriousplus) plus plaster external fixation;those in traditional Chinese medicine control group treated with ordinary Chinese medicine functional material plus plaster external fixation;those in lining material control group treated with ordinary lining material (sterile degreasing cotton) plus plaster external fixation;those in model control group received no treatment. The whole blood viscosity at high/middle/low shear rates and plasma viscosity were detected at 2, 4 and 6 weeks before and after modeling. Additional y, rabbits in each group were kil ed at 6 weeks after modeling, and radial samples were removed for histological observation. RESULTS AND CONCLUSION:The whole blood viscosity at high/middle/low shear rates and plasma viscosity in the micron group were al lower than those in the other three groups in the same period, and had significant differences from those in the model control group at 4 and 6 weeks after modeling (P<0.05 or 0.01). A large number of osteoblasts could be found, woven bone began to form and the bone marrow cavity was recanalized in the micron group;in the traditional Chinese medicine group, woven bone, chondrocytes and endochondral ossification coexisted and there was a connection between cal uses inside and outside of the broken end, but the bone marrow cavity was not recanalized. In contrast, neither connection between cal uses inside and outside of the broken end, nor recanalized bone marrow cavity appeared in the lining material and model control groups. In conclusion, micron traditional Chinese medicine functional lining material can promote fracture healing by improving microcirculation and accelerating osteoblast proliferation.

OBJECTIVE To investigate the production of metallo-beta-lactamase in clinical isolates of multi-resistant Pseudomonas aeruginosa and evaluate the validity of the detection methods.METHODS The multi-resistant strains were selected by K-B method according to the standard Aloush et al recommended.The metallo-beta-lactamase phenotypes were detected by multi-disk-multi-inhibitors synergy test(MDMIST),and the genotypes of IMP and VIM gene were analyzed by PCR amplification.RESULTS A total of 192 strains of multi-resistant P.aeruginosa were selected from 1081 clinical strains.The antimicrobial agents test in these multi-resistance strains demonstrated that ciprofloxacin and piperacillin had the highest resistant rate(92.5%),and the next were aztreonam and trimethoprim-sulfamethoxazole(91.5%),the polymyxin showed sensitive in all of these strains.Sixty-seven strains of metallo-beta-lactamase phenotypes were positive and the amplification PCRs showed that 65 strains were IMP or VIM in these 192 multi-resistant strains.CONCLUSIONS The resistance mechanisms in multi-resistant P.aerugionsa present multiple and changeable.The clinical laboratory should enhance the detection of metallo-beta-lactamase in these multi-resistant strains.

Objective To investigate the psychological well-being and the correlation between psychological status and social support among the settled immigrations from Three Gorges Reservoir areas. Methods A cluster randomized sampling was selected and 646 objects were interviewed with Basic Situation Scale,Symptom Check-list 90(SCL-90) and Social Support Rating Scale (SSRS). Results Our findings from the results of SCL-90 revealed that the positive rate of psychological problem was higher in settled immigration than that of local permanent residents (χ2= 4.10, P=0.04). The differences of scores on 6 factors including compulsion ( t=2.644, P=0.009 ), interpersonal-sensitivity ( t= 3.220, P =0.001), depression ( t=2.684, P=0.008 ), anxiety ( t=3.003, P= 0.003 ), paranoid-ideation ( t =3.246, P=0.001 ), psychoticism ( t=2.088, P=0.038) and the total score ( t=2.506, P=0.013) were significantly different in female between the two groups. There were also significant differences of 10factors score and total score (t=4.114, P=0.000) noticed between the two groups in age≤50 (P<0.05) and the differences of 4 factors score including somatization ( t=2.777, P=0.006), interpersonal-sensitivity (t=2.384, P=0.018), hostility ( t = 3.174, P = 0.002), paranoid ideation ( t = 2.611, P =0.010). The total scores (t = 2.125, P = 0.034) were significantly different between the two groups in illiteracy and having received primary school education. Other than compulsion factor (t = 1.884, P =0.061) and phobic anxiety factor (t = 0.979, P = 0.328), there were significant differences on other factors and the total score between the two groups in non-farmers (P< 0.05). Except compulsion (r =- 0.103,P >0.05), hostility ( r = -0.084, P>0.05) and paranoid ideation factor ( r =-0.071, P>0.05), the negative correlations were obvious between the total score, other factors score and social support(P<0.05 ). The negative correlation was obvious between somatization (r=-0.128, P<0.05 ),depression ( r=-0.140, P<0.05 ), anxiety. ( r=-0.137, P<0.05 ), phobic anxiety ( r =-0.120, P <0.05),additional factor ( r=-0.143, P<0.05) total score ( r =-0.137, P< 0.05) and subjective support. The correlation coefficient was not significant between SCL-90 total score, 10 factors score and that of objective support (P>0.05). Conclusion The psychological status of settled immigration was not satisfactory and closely correlated to psychological mental level and social support.

Objective To identify the helper plasmids from HEP-Flury strain rabies virus that could encapsidate the full-length genome of CTN strain. Methods Four overlapped fragments covering the full-length genome of rabies virus CTN strain were cloned into expression vector. A recombinant full-length genome plasmid (pCTN-GFP) contained the full-length genome of the CTN strain expect for ψ gene which was replaced by GFP gene was then constructed using restriction enzyme cleavage and ligation in vitro. In order to obtain the recombinant rabies virus CTN-GFP, the pCTN-GFP was transfected with helper plasmids carrying N, P, L gene of HEP-Flury strain. Results The four gene fragments of the genome were amplified and cloned into the expression vector. The recombinant genome cDNA plasmid pCTN-GFP was constructed and subjected to restriction endonuclease digestions. After sequenced to assure no absence and mutations compared with their parental viruses, it was ready for virus rescue. After the transfection of both pCTN-GFP and the helper plasmids from HEP-Flury strain into BHK-21 cells, the recombinant rabies virus CTN-GFP was rescued and confirmed by fluorescence analysis and RT-PCR, which demonstrated that the CTN-GFP was recovered from cloned cDNA. Conclusion The proteins of HEP-Flury strain rabies virus could encapsidate and transcribe the CTN strain rabies virus RNA genome.

Objective To detect the clinical effect of posterior reduction combined with H-shaped bone grafting and spinous process replantation for reconstruction of spinal structures in treatment of thoracolumbar fracture.Methods Forty-three patients with thoracolumbar burst fracture treated surgically from February 2008 to June 2012 were reviewed retrospectively.There were 30 male and 13 female patients aged 23 to 55 years (mean,38 years).Fracture resulted from high falls in 21 patients,traffic accidents in 16 patients,and a crush by heavy objects in 6 patients.Denis system was used for classification of fracture and Frankel rating for assessing the degree of nerve damage and recovery.After posterior reduction combined with H-shaped bone grafting and spinous process replantation for all patients,visual analogue scale (VAS) was utilized to assess symptom improvement and Cobb' s angle and sagittal spinal canal diameter were measured to help assess the treatment outcome.Results Pain was apparently eased at a 24-month follow-up (range,12-46 months).Cobb' s angle improved from preoperative 43.56° to postoperative 8.23° (t =1.33,P ＜ 0.01).CT findings showed mean spinal canal stenosis rate was 56.3％ before surgery and that mean sagittal canal diameter of the injured spine was larger than that of adjacent segments at follow-up,with the mean ratio of 116.3％ (range,111.3％-120.3％).Rate of spinal canal stenosis was negative for all patients and posterior canal with bone grafts healed.Spinal cord injury improved at least one Frankel grade.Conclusion Posterior reduction combined with H-shaped bone grafting and spinous process replantation is worthy of clinical application,for the procedure can restore the fractured thoracolumbar spine and posterior canal structure,but also effectively avoid the iatrogenic spinal stenosis.

Objective To discover the mutation of ADAR gene in a pedigree with dyschromatosis symmetrical hereditaria(DSH). Methods We investigated this family and collected blood samples of the individuals in this family. Mutation screening was carried out by PCR and direct sequencing. The allele specific primer was designed for the mutation point, and allele-specific PCR was carried out on the patients, normal family members and 40 normal individuals. Results A single nucleotide deletion (c.1642 delC) was identified in exon3 of ADAR gene in the patients of this family. This mutation was not detected in the normal family members and in any of the control individuals. Conclusion This single nucleotide deletion was responsible for the disease in the family.

BACKGROUND: External preparations treatment of fractures in traditional Chinese medidne are mostly ordinary hard-paste, cream, ointment, which lack of modernized traditional Chinese medicine transdermal delivery systems, and the treatment has poor drug absorption and simple process. The treating procedure needs to be used repeatedly, which would affect fracture external fixation and lead to unsatisfactory therapeutic effect. In this Paler, the extemal treatment of traditional Chinese medidna was combined with advanced micro-nano-technology to develop a new medical complex functional materials-micron traditional Chinese medicine functional lining material, which is an organic combination of diaplasis, fixation and local drug remedy, which provides a better treatment for fractures. OBJECTIVE: To explore the effect of micron tradifional Chinese medicine functional lining material on the healing of fracture in rabbits, METHODS: After model preparation, rabbits were randomly divided into 4 groups: rabbits in the micron group were treated with micron traditional Chinese medicine functional lining material plus plaster external fixation; those in the traditional Chinese medidna control group were treated with ordinary Chinese medicine functional material plus plaster extemal fixation; those in the lining material control group were treated with ordinary lining material added plaster extemal fixation; those in the natural healing control group had no special treatments. The effect of fracture healing was evaluated by X-ray at 2, 4 and 6 weeks after modeling. The serum concentration of alkaline phosphatase, calcium and phosphorus was detected respectivaly before modeling and at 2, 4 and 6 weeks after modeling. RESULTS AND CONCLISION: ①X-rap examination:After 6 weeks the external was almost copletly absorbed and medullary cavity was completely recanalizad in the micron group, while fracture line disappeared and the external callus began to be absorbed and medullary cavity was not recanalized in the traditional Chinese medidne control group. Additionally, there were case of non-union stump hardening in natural healing group. ②Serum biochemistry:The activity of alkaline phosphatase reached a peak after 2 weeks in micron group, which was 2 weeks ahead of time compared with that in traditional Chinese medicine control group. And the peak concentration of alkaline phosphatase in micron group was higher than other groups. After 4 weeks serum calcium concentration started to fall significantly and phosphorus concentration started to rise significantly in micron group, as was statistically significant compared with other groups. After 6 weeks serum calcium concentration in micron group had fallen to normal level, while that in other groups was higher than normal. And phosphorus concentration in micron group increased significantly, which was statistically significant compared with natural healing group. The results demonstrated that micron feature traditional Chinese medicine lining matedat can enhance the activity of alkaline phosphatase, decrease the serum concentration of calcium and increase the serum concentration of phosphorus and the product of calcium and phosphorus, therefore, promote the healing of fracture, It shows that micron traditional Chinese medicine functional lining matedal plays a stronger effect on promoting the healing of fracture than that of ordinary Chinese medicine functional lining material.

Social governance is a novel form of public administration made based on the analysis and judgment for the power pattern in the course of social administration, a model advocated in the premise of a clearly positioned relationship among the government, marketplace, society and citizens.Social evaluation is an effective carrier and means leveraging the social governance theory, which has found extensive and outstanding use in such issues as expression of public interests and responsibilities,and in tackling sharp social problems. The authors called into play the scenario analysis based on public hospital management reforms with the social governance theory. In addition, they explored social governance at home and abroad as well as the theories, meaning and progress of social evaluation, and analyzed the pathways and probes in social evaluation and governance in the fields in question. On such basis, the paper proposed to explore and develop the social evaluation strategies and study framework for public hospitals in terms of healthcare management, aiming at building the social governance system and policies for public hospitals.