Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.

Objective To design fast cluster indicators (FCIs) and compare it with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring to judge the value and prognosis of sepsis patients.Methods Based on 33 cases of severe infected patients as samples for this study from September 2013 to July 2014 in Intensive Care Unit (ICU) in the Second People's Hospital of YiYang,and with the Procalcitonin (PCT),lactic acid (LAC),D-Dimer (DD) and base excess (BE) as the indicators,as well as drawing on the APACHE Ⅱ scoring system ideological,as is to design the FCIs to evaluate the prognosis of patients with severe infection.Results After treatment,the survivals were 17 cases,16 patients were died out of 33,and the mortality rate was 48.5％.The sensitivity and specificity of fast cluster indicator that predict patient mortality rates were 75％ and 71％,respectively.The area under the receiver operating characteristic curve (ROC) of FCIs assessing the prognosis of patients with severe infections was 0.895,which was higher than the value 0.721 of APACHE Ⅱ scoring.Conclusions FCIs scoring has a certain significance and guiding role in clinical practice.

To assess the roles of glutamate and its ionotropic receptor in processing noxious sensory input from dental pulp,glutamate NMDA receptor subtype antagonist,MK-801 and non-NMDA receptor subtype antagonist,CNQX were administrated separately into left lateral cerebral ventricle prior to exposing pulp cavity of left maxillary first molar tooth.The number of Fos-positive neurons in medulla oblongata was measured and compared with that of the group with simple exposure of dental after same survival time pulp.Fos protein expression was reduced dose-dependently by an administration of MK-801,but CNQX had little effect.The results showed that glutamate may be an excitatory transmitter of noxious dental pulp sensory input to neurons in medulla oblongata.In pain nodel of mechanical exposing dental pulp,NMDA receptor subtype has an important role in this process.

three years survival group,and those who died within 3 yrs had P-gp positive expression(24 cases,53.3%).Comparing of the two groups showed statistical significance(P3 year survival stage group,and the patients who died within three years group,the P27 expression was positive in 26 cases(56.5%)(P

Objective To evaluate the clinical value of vertebral body venography in performance of percutaneous vertebroplasty(PVP). Methods 92 patients with 124 vertebraes underwent PVP. Before injecting the bone cement, venography was performed with injection of nonionic contrast material into vertebral body. 124 vertebraes were classified into four groups according to the results of vebgrophy. Group A: no draining veins displayed; group B: draining veins appeared late; group C: draining veins appeared ahead of time; group D: draining veins appeared ahead of time, then intervention such as adjusting the puncture needle's position or gelatin sponge embolization of vein was performed to delay the appearance of veins. Results 94 of 124 vertebraes displayed draining veins. According to the results of vebgrophy, there're 30 vertebraes in group A, 25 in group B, 30 in group C, 39 in group D. Thirty-seven vertebraes demonstrated cement extravasation, cement entering vein was observed in sixteen vertebraes and two patients among them had pulmonary embolism. Venograms showed all correlative venous extravasation. Bone cement extravasation rate of each groups was 20.0%, 24.0%, 56.7% and 20.5% respectively. Moreover, extravasation rate of group C was higher than any other group. Pain reduction was observed in 88 of 92 patients after 30 days of the operation, the rate of pain relief was 95.7%. Conclusion Vertebral body venography could describe the velocity of venous blood flow within vertebral body and predict the direction of bone cement leaking to veins effectively, which could provid valuable information in takeing some measures to prevent bone cement leaking into veins. Vertebral body venography has very impotant clinical value in improving the safety and preventing complication of PVP.

Objective To modify the posterior procedures for severe thoracolumar fractures. Methods Twenty-one patients of thoracolumbar fractures with over 40% of anterior compression were studied. After reduction and fixation with short-segment pedicle instrumentation was performed, the transpedicular vertebroplasty of the fractured vertebrae with injectable self-setting calcium phosphate cement was carried out under fluoroscopic guidance. All patients were checked with X-ray and CT scanning before and after operation. They were followed up for 4-23 months (average 13 months). Results All patients obtained successful surgery without neurological complications or foreign body response. On CT scanning, the fractured vertebrae were well augmented in 13 cases and insufficiently augmented in 4 cases. Slight extrusion of cement into paravertebral tissue occurred in 4 cases without clinical symptoms. All patients were perfectly recovered without notable correction loss or implant failure during the follow-up. Conclusions Reduction and fixation with short-segment pedicle instrumentation followed by vertebroplasty with injectable self-setting calcium phosphate cement is a promising procedure for severe thoracolumbar fractures.

Phytoestrogen is a kind of plant element which is similar to animal estrogen. Phytoestrogens can prevent progreator system cancer, cardiovascular disease and osteoporosis. Recently more and more researches are reported on the protection of phytoestrogens on central nerve system.

Objective To investigate the changes of vitamin D level and its relationship with bone alkaline phosphatase(BAP)and parathyroid hormone(PTH)in infants fed with breast milk and vitamin D supplementation for 0-8 months in People`s Hospital of Longhua New District in Shenzhen city.MethodsTotally 67 newborns in the Department of Obstetrics and Gynecology of People`s Hospital of Longhua New District were selected.These newborns were breastfed and began to supplement vitamin D 400 U/d in the 15th day after birth.The serum 25-(OH)D3 and BAP and PTH levels were measured in newborns and 4-/8-month-old infants,and the correlations of serum 25-(OH)D3 with BAP and PTH were analyzed by Pearson correlation analysis.ResultsCompared with the newborns,the serum 25-(OH)D3 [(78.47±36.41)nmol/L,(75.26±34.73)nmol/L],BAP[(231.43±78.81)μg/L,(205.97±71.64)μg/L],PTH[(31.76±11.54)pg/ml,and(32.94±13.82)pg/ml] levels of 4-and 8-month-old infants were significantly higher,and the difference were statistically significant(t4 months=7.823,12.568,11.852,t8 months=7.364,9.473,11.947;all P=0.000).There was a negative correlation between serum 25-(OH)D3 and BAP in newborns and 4-/8-monthold infants(r=-0.372,-0.463,-0.309;P=0.008,0.016,0.021),the serum BAP was positively correlated with PTH in infants aged 4 months and 8 months(r=0.487,0.338;P=0.005,0.032),and the serum 25-(OH)D3 was negatively correlated with PTH in infants aged 4 months(r=-0.297,P=0.041).Conclusions Infants at birth are prone to vitamin D deficiency in Shenzhen City.After 4 months of breastfeeding and vitamin D400U/d supplementation,the vitamin D levels in most infants become normal.25-(OH)D3 is correlated with BAP and PTH in different months.

Objective To investigate the expression and the effect of nuclear factor-?B(NF-?B) in neonatal sepsis.Methods We separated 77 newborn infants into 3 groups, which were septic group (26 cases),non-septic group (31 cases) and control group (20 cases). NF-?B existed in PBMC was detected in 3 different periods, including at admission, after the 24th hour and 48th hour of admission, of the septic group and the non-septic group by flow cytometry. At the same time, the sample of the septic group and the non-septic group were drawn for blood cultures at admission before using antibiotics.Results The expression of NF-?B in septic group was more significant than that in the other 2 groups (P

Objective To survey the knowledge of chronic stable coronary artery disease management among general practitioners (GPs) in Shanghai Pudong New Area.Methods The survey was conducted among 363 GPs with at least 2-year work experiences from community health service centers in Shanghai Pudong New Area from July to September in 2014.A self-designed questionnaire based on the guidelines/consensus of chronic stable coronary artery disease management were used in the survey.The questionnaire consisted of 4 parts:diagnosis,drug therapy,revascularization and treatment of special types.Results Among 363 participants 362 questionnaires were completed.History taking,physical examination and electrocardiogram were applied for diagnosis in all participants,49.2％ (178/362) also used coronary computed tomography angiography,26.5％ (96/362)used exercise testing for assistant examination.More than 95.0％ of participants recognized that smoking,obesity,hyperlipidemia,hypertension,diabetes were risk factors.75.7％ (274/362) of participants used aspirin,91.4％ (331/362) knew the dose of aspirin as 75-150 mg;for aspirin intolerance 14.6％ (53/362)would use clopidogrel alternatively.50.6％ (183/ 362) of participants sometimes used statins;and 39.2％ (142/362) did not use stain because of not knowing the contraindication.Facing increases of alanine aminotransferase or aspartate aminotransferase levels 95.3％ (345/362) of participants would immediately discontinue stain;80.4％ (291/362) discontinued statins as creatine kinase increased.32.0％ (116/362) of participants gave enough drug-free period avoiding nitrates resistance.79.6％ (288/362) seldom used β-blockers and 42.5％ (154/362) failed to use β-blockers because not knowing the contraindication.78.7％ (285/362) knew percutaneous coronary intervention but did not know its indications;83.1％ (301/362)knew coronary artery bypass but did not know its indications.27.6％ (100/362) knew calcium antagonists were first-line drugs for variant angina and 93.6％ (339/362) never heard of microvascular angina.Conclusion The survey shows that GPs from community health service centers in Shanghai Pudong are not well familiar with examination of coronary heart disease and lack of sufficient knowledge of drugs recommended by the guideline,not well understand the indications for revascularization and the diagnosis and treatment of special types of coronary heart disease.