Objective To investigate the correlation between the formation of pigmented biliary calculus and biliary H.pylori infection.Methods Bile from 35 patients with pigmented biliary calculus and 10 healthy controls was cultured for aerobic,anaerobic and H.pylori.The expression of H.pylori- DNA in bile,bile duct mucosa and pigmented calculus were determined by PCR.The expression of H. pylori associated protein in bile duct mucosa was determined by Western-blot and Warthin-Starry staining.Results H.pylori culture was negative in all bile samples.In 35 patients with biliary pigmen- ted calculus,H.pylori was detected by PCR in the center of calculus,bile and bile duct mucosa of 14.29%,31.43% and 56.67% patients,respectively.Among H.pylori-DNA positive bile samples,7 contained anti-CagA antibodies,and 6 contained Vac A.in addition to Vacuolating cytotoxin(35000), glycoprotein(30000),Urase Band Urase A.Bacteria resembling H.pylori by Warthin-Starry stainning were found in 7 of 30(23.33%)bile duct mueosal samples from patients with biliary pigmented calculus. H.pylori-DNA and its associated protein were not detected in all bile and bile duct mucosae samples from the healthy controls.Conclusions The evidence of H.pylori-DNA and its associated protein in biliary system might indicate the role of H.pylori in the formation of biliary pigmented calculus.

Objective To evaluate the clinical and radiological outcomes of skip-level anterior cervical discectomy and fusion(ACDF) for the treatment of two-level noncontiguous cervical spondylotic myelopathy(CSM).Methods There were 34 patients with two-level noncontiguous CSM underwent skip-level ACDF in our department from January 2014 to December 2016.The clinical outcome including surgery time, intraoperative blood loss,Japanese Orthopaedic Association(JOA) scores,Neck dysfunction index(NDI),the improvement rate of JOA,segment lordosis,fusion rate and Odom's criteria were evaluted.Results The surgery time was from 92 minutes to 125 minutes,mean operative time 103.28 minutes;the intraoperative blood loss was 50 to 150 mL,with average blood loss of 90 mL.The cervical spine lateral radiographs showed that the cervical physiological curvature had restored.The patients were followed up for average 6 months.The fusion rate of was 94.1％ at the lastest follow-up.No cages subside,implant failure or migration and infection occured.The JOA and NDI scores at the latest follow-up were(14.21±0.732) and (3.26±1.14),respectively,the JOA scores improvement rates was 58.62％.The segmental lordosis before surgery was(10.75±1.132)°,the one after surgery was(15.61±1.312)°,the difference was significant(P<0.05).The Odom's criteria at the lastest follow-up showed that excellent in 21 patients,good in 9 patients and fair in 4 patients,with excellent and good rate of 88.2％.Conclusion Skip-level ACDF can achieve good clinical and radiological outcomes including a high fusion rate and well maintainence of spinal curvature and intervertebral height for patients with two-level noncontiguous CSM.

Objective To investigate the effects of intervertebral bridging ossifications in patients of osteoporotic vertebral compression fracture (OVCF) on bone fracture healing.Methods A total of 170 patients of thoracolumbar vertebral endplate fracture who were admitted into our hospital were selected.Divided these patients into the observation group,namely 60 patients with nonunion of vertebral endplate after 3 months of conservative treatment,and the control group, including 110 patients with well healed vertebra after 3 months of conservative treatment.Compared the distribution of intervertebral bridging ossifications of the two groups 3 weeks after injury.Results The incidence of bridging ossification at levels of T9 to T10,T10to T11,T11to T12 in the observation group were significantly higher than that in the control group.And it showed a significantly higher incidence of bridging ossification at the second proximal intervertebral segment in the observation group than that of the control group.There was a significantly greater sagittal wedge angle in the observation group compared with the control group.Conclusion Conservative treatment may increase the risk of nonunion of osteoporotic vertebral compression fractures when there is a bridging ossification at the second proximal intervertebral level or the sagittal wedge angle was greater than 14.2°in a fresh osteoporotic vertebral compression fracture.It should be a careful choose whether to take conservative treatment or surgical intervention.

Aim To observe histopathological changes of hippocampus after acute epilepsy induced by penty-lenetetrazole (PTZ)in rats.Methods Five groups as control group,PTZ-induced 24 hours(h)group,PTZ-induced 72 hours group,PTZ-induced 1 20 hours group and PTZ-induced 1 44 hours group were designed.PTZ (64 mg·kg -1 )was administered with a single intrap-eritoneal injection for generalized tonic-clonic sei-zures in the current experiment.Control and PTZ trea-ted animals were sacrificed after specific time points. Brain was dissected out and then evaluated for neuro-pathological changes using Nissl staining and immuno-histochemical technique.Results In this study PTZ-induced hippocampal neuron status apoptosis occurred at 24 hours and was sustained for 1 44 hours after status epilepticus.Whereas,activated caspase-3 and AIF ap-peared at 24 hours and were sustained for 1 44 hours af-ter status epilepticus.Conclusion The results of this study show that the significant histopathological chan-ges of hippocampus appear in the vicinity of 1 20 hours after intraperitoneal injection of pentylenetetrazole.

BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients.
OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization.
METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation.
RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P<0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months fol ow-up (P>0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.

OBJECTIVE Liver cancer is one of the most common causes of cancer related deaths worldwide, specially, in China. Hinesol, extracted from Atractylodeslance a(Thunb.) DC. has been proved that has anti-cancer effect in leukemia in vitro and in vivo.However,it has been not well under-stood in liver cancer cells.METHODS Cell proliferation,apoptosis,cell cycle and invasion were performed to investigate the anti-liver cancer effect of hinesol in SMMC-7721 and LM3 by MTT assay,flow cytometry and scratch assay.Western blot was used to research the potential mechanism.RESULTS We revealed that hinesol suppresses cell proliferation and invasion,prompts population of G1 phase,induces apop-tosis in dose-dependent manner in SMMC-7721 and LM3 cells.Western blot data showed that hinesol could inhibits the expression of cyclin-D1, Bcl-2 and Bax, and inhibited phosphorylation of MEK and ERK, down-regulated the expressions of NF-κB p65 and phosphor-p65 in nucleus. The results indicated that hinesol reduces cell proliferation via arresting cell cycle at G1 phase and induces apoptosis.Further-more,western blot showed that hinesol inhibited phosphorylation of MEK and ERK,down-regulated the expressions of NF-κB p65 and phosphor-p65 in nucleus.CONCLUSION Our results demonstrate that hinesolreduces cell proliferation via arresting cell cycle at G1 phase and induces apoptosis, it has potent anti-cancer effect against liver cancer cells via down-regulation of MEK/ERK and NF-κB pathway,and indicate that hinesol is a potential liver cancer drug for further research.

OBJECTIVETo study the effects of antisense Bmi-1 (B cell-specific moloney murine leukemia virus insertion site 1) RNA on the growth, cell cycle and apoptosis of lung cancer cell line A549.

METHODSRecombinant plasmids carrying antisense Bmi-1 RNA were transfected into A549 cells, which expressed a high level of endogenous Bmi-1. The mRNA level of A549 cell was analyzed by real time quantitative RT-PCR and the protein level was determined using Western blot. MTT growth curve and plate colony forming assay were used to measure the effect of antisense Bmi-1 RNA expression on the growth of A549. Flow cytometry was used to analyze cell cycle and apoptosis.

RESULTSAntisense Bmi-1 RNA reduced the Bmi-1 expression at the protein level, but did not alter the mRNA level in A549 cells. Compared with the control cells, A549 cells transfected with antisense Bmi-1 RNA showed a strong inhibition of the cell growth. The number of plate colony formation of the antisense Bmi-1 transfected cells (0.67 +/- 0.50) was less than those of the control (73.0 +/- 4.1) and cells transfected with empty vector (67.0 +/- 4.0, P < 0.01). Transfection of antisense Bmi-1 RNA arrested the A549 cells at G₀/G₁ phase of the cell cycle and did not increase the apoptosis.

CONCLUSIONAntisense Bmi-1 RNA expression inhibits A549 cells proliferation, likely through the interference of Bmi-1 leading to an arrest of the proliferating cells at the G₀/G₁ phase.

Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Nuclear Proteins ; biosynthesis ; genetics ; Polycomb Repressive Complex 1 ; Proto-Oncogene Proteins ; biosynthesis ; genetics ; RNA, Antisense ; pharmacology ; RNA, Messenger ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Repressor Proteins ; biosynthesis ; genetics ; Transfection

Adenocarcinoma ; metabolism ; pathology ; surgery ; Cardia ; Esophageal Neoplasms ; metabolism ; pathology ; surgery ; Esophagogastric Junction ; metabolism ; pathology ; surgery ; Humans ; Neoplasm Staging ; Receptor, ErbB-2 ; metabolism ; Sirtuin 1 ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Survival Rate

OBJECTIVETo evaluate the subgingival prevalence of human cytomegalovirus (HCMV), Epstein-Barr virus-1 (EBV-1) in chronic periodontitis (CP) patients before and after treatment and to analyze the relationship between the prevalent variance and periodontal clinical parameters.

METHODSGingival crevicular fluids of 13 CP patients were collected at baseline, 2 weeks, 2 months and 4 months after periodontal mechanical treatment. HCMV and EBV-1 were detected using nested polymerase chain reaction (n-PCR).

RESULTSThe plaque index (PLI), probing depth (PD) and bleeding index (BI) of CP patients at 2 months, 4 months after periodontal mechanical treatment were evidently lower than before treatment, P < 0.01. These parameters at 4 months after treatment were higher than at 2 months, the differences were significant, P < 0.05. The prevalence of HCMV and EBV in CP patients was 42% (33/78), 14% (11/78). EBV and HCMV were mostly coexistent in the same site [9 sites HCMV(+) in 11 EBV positive sites]. The sites of HCMV(+) and EBV(+) were almost deep pockets. Thirteen of 14 sites with deep pockets were HCMV(+), 9 sites were deep pockets in 11 sites EBV(+). The prevalence of HCMV and EBV (8% and 0 respectively) at 2 weeks was the lowest in all four time points. The prevalence of HCMV and EBV at 2 weeks, 2 months and 4 months following treatment was significantly lower than baseline (P < 0.01), but the prevalence of HCMV (15%) at 2 months after treatment was higher than at 2 weeks (8%), the difference was not significant (P = 0.133).

CONCLUSIONSHerpesviruses may play a role in the development of CP. The changes of the prevalence of herpesviruses before the changes of clinical parameters could be detected after periodontal mechanical treatment. The patients should be re-evaluated and re-treated within 2 months after treatment.

Chronic Periodontitis ; therapy ; Cytomegalovirus ; isolation & purification ; Gingival Crevicular Fluid ; virology ; Herpesvirus 4, Human ; isolation & purification ; Humans

Perioperative stroke is cerebral infarction occurring in the perioperative period.The incidence of perioperative stroke in non-cardiac,and non-neurologic surgery is about 0.7％,but the mortality can be as high as 26％ to 40％.The outcome of the patients with perioperative stroke can be disastrous.Here we report a case of perioperative ischemic stroke that occurred after surgery of lumbar decompression and pedical screw fixation.A 76-year-old female admitted to our hospital because of lumbar spinal stenosis.Her medical history included hypertension and diabetes for ten years.Her personal history included a smoking history of 60 years by 2 cigarettes per day,not quitting.Her carotid artery ultrasound showed multiple low echo plaques on the right side and multiple high echo plaques on the left side of the carotid artery,but without distinct stenosis.Other examinations and tests showed no distinct abnormality.She went on a lumbar decompression and pedical screw fixation uneventfully.The blood loss was 400 mL and autologous blood transfusion 150 mL.The arterial blood pressure (ABP) maintained during 100-130 mmHg/60-80 mmHg (1 mmHg =0.133 kPa).Sixty minutes after she recovered from general anesthesia,the patient developed symptoms of slurred speech and right limbs weakness.The anesthesiologist evaluated the patient immediately with National Institute of Health Stroke Scale (NIHSS).The NIHSS score was 11 and a stroke was highly suspected.The acute stroke team was therefore initiated and fast responded.Within 4 h,digital subtraction angiography (DSA) was proceeded,which showed the M1 segment of the left middle cerebral artery was occluded and the local stenosis of her right middle cerebral artery was up to 80％.After the successful embolectomy by Solitaire stent,the left middle cerebral artery reflowed and the forward blood flow was thrombolysis in myocardial infarction (TIMI) grade 3.The patient was discharged after 33 days after the surgery with a NIHSS of 9.Our case provides an example that an acute stroke team that included the department of anesthesiology can be beneficial to the patients' perioperative strokes.During the perioperative period,anesthesiologists should be included into the acute stroke team,because anesthesiologists and anesthesia nurses might be first observers of those early onset strokes.Our case also put forward this thought that a standard peri-operative stroke evaluation tool,like NIHSS,should be discussed and applied to facilitate and accelerate the initiation of perioperative acute stroke team.