OBJECTIVE: To understand the research on the development and application of non-fusion inter-spinous stabilization devices.DATA SOURCES: Using the key terms of "inter-spinous and low back pain", relevant articles on non-fusion inter-spinous stabilization devices and low back pain in English were retrieved from Medline between January 1966 and October 2004 and the Ovid database between January 2003 and June 2007.STUDY SELECTION: Titles and most abstracts of all articles on the types of non-fusion inter-spinous stabilization devices and action mechanisms of non-fusion inter-spinous stabilization devices were selected. Duplicated researches and meta analytic papers were excluded.DATA EXTRACTION: A total of 351 articles met the inclusion criteria and 322 were excluded. Among them, 29 papers were analyzed. The major exclusion factor was duplicate studies.DATA SYNTHESIS: Non-fusion inter-spinous stabilization devices can improve mechanism of low back pain and cause certain effects on the biodynamic environment of degenerative lumbar vertebrae, such as relieving loading of the posterior border of the anulus fibrosus of the intervertebral disc and opening the intervertebral foramen. At present,non-fusion inter-spinous stabilization devices, such as X-STOP, Wallis and DLAM, have been tested for a long time;therefore, the effects of their effectiveness, utility and risk of complications will be proved by clinical experiments as soon as possible.CONCLUSION: Non-fusion inter-spinous stabilization devices have good effects on the treatment of degenerative low back pain originating in the anulus fibrosus of the intervertebral disc and can reduce complications caused by the fusion technique.

Objective To Screen the carbapenem-resistant acinetobacter baumannii so as to understand the drug resistance,and to analyze the outer membrane protein expression between the carbapenem-resistant Acinetobacter baumannii and the sensitive strains.Methods The twofold agar dilution method was used to screen the carbapenem-resistant acinetobacter baumannii.PCR technique was used to detect the outer membrane protein-encoding gene carO.SDS-PAGE was used to analyze the expression of outer membrane protein.Results 32 strains were carbapenem-resistant acinetobacter baumannii separated from 1 10 strains,which were 100% sensitive to polymyxin B and were resistant to other drugs with different degrees O.They all carried carO gene.There were different protein bands between the carbapenem-resistant strains and the sensitive strains,in which two protein bands of 50× 10 3 and 22×10 3 were recognized as outer membrane proteins through the analysis of SDS-PAGE.Conclusion Drug resistance of acinetobacter baumannii is serious,and the outer membrane protein expression between the carbapenem-resistant strains and the sensitive strains presents discrepancy.

Objective To investigate the diagnostic value of computed tomography,X ray enterography and digestive endoscopy for intestinal Crohn's disease in active and chronic phase.Methods The clinical data of 39 patients with Crohn's disease who were admitted to the Subei People's Hospital from June 2008 to August 2011 were retrospectively analyzed.All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients).The results of computed tomography,X ray enterography and digestive endoscopy of the 2 groups were compared.The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings.The enumeration data were analyzed using the chi-square test.Results The incidences of intestinal wall stratification,intesitnal edema strap,severe enhancement,ulcers,intestinal stenosis,intestinal fistula,phlegmon,swollen lymph nodes and comb sign in patients with active phase of Crohn's disease were significantly higher than those with chronic phase of Crohn's disease (x2 =10.700,3.954,22.025,7.661,10.700,7.661,6.810,7.661,4.592,P＜0.05).The incidences of intestinal wall thickening,intramural fat,mild enhancement,unenhancement,inflammatory polyps,abscesses and inflammatory masses in patients with chronic phase of Crohn's disease were significantly higher than those with active phase of Chrohn's disease (x2=17.475,11.345,18.050,5.366,22.856,12.662,5.846,P ＜ 0.05).Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease,but it was difficult in demonstrating ulcers and inflammatory polyps.X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps,but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease.Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn's disease in active and chronic phase.

Objective To investigate clinical,endoscopic and CT characteristics in Crohn's disease (CD),intestinal tuberculosis(ITB) and primary small intestinal lymphoma (PSIL).Methods In this study,39 cases of CD,24 cases of ITB and 23 cases of PSIL were retrospectively analyzed.Clinical and CT data were collected in all patients,23 CD cases,20 ITB cases and 20 PSIL cases underwent endoscopic exam.Chi-square tests or analysis of variance were used to evaluate and differentiate characteristics.Results Diarrhea,perianal disease,intestinal obstruction occurred significantly more in CD than in ITB and PSIL (x2 =10.134,6.769,8.000,P ＜ 0.05).Febrility,night sweating,pulmonary tuberculosis and ascites occurred more in ITB than in CD and PSIL (x2 =25.696,19.194,35.133,P ＜0.05).Abdominal mass,hematochezia and enterobrosis occurred more in PSIL than in CD and ITB (x2 =19.562,17.708,12.647,P＜0.05).Longitudinal ulcer,cobblestone sign were found more in CD than in ITB and PSIL(x2 =6.283,11.592,P ＜ 0.05).Transverse ulcer and rodent ulcer were found more in ITB than in CD and PSIL(x2 =15.633,19.686,P ＜ 0.05),but lump eminentia were found more in PSIL than in CD and ITB(x2 =26.120,P ＜0.05).Layering thickening,mural gas,fat,edema,enteric cavity stenosis,abscess were discovered more in CD than in ITB and PSIL (x2 =17.472,10.346,7.773,6.867,16.325,10.994,P＜0.05),single layer thickening and hollow lymph nodes were discovered more in ITB than in CD and PSIL(x2 =17.997,12.475,P ＜ 0.05).Multi segmental lesions was discovered more in CD and ITB than in PSIL (x2 =28.460,P ＜ 0.05),while single segmental lesions,mural single eccentric layer thickening and intussusceptions were discovered more in PSIL than in CD and PSIL (x2 =28.460,P ＜0.05).The intestinal wall thickening and lymph nodes enlargement in ITB and PSIL were higher than the CD (F =8.661,7.166,P ＜ 0.05),while the intestinal wall enhancement at CT imaging in PSIL was lower than CD and ITB (F =10.179,P ＜ 0.05).Conclusions Comprehensive analysis made on clinical,endoscopic and CT features of CD,ITB and PSIL may facilitate correct diagnosis.

AIM　To study the metabolic pathway of chiral clausenamide in the rat and understand its stereoselectivity. METHODS　The urine, feces and blood of rat were gathered after the drug was administered, the known metabolites were analyzed by HPLC-DAD and one unknown metabolite was elucidated by using LC-MS analysis. Metabolic stereoselectivity was determined by comparing the metabolic results of (+)- and (-)-clausenamide. RESULTS　Six known metabolites were determined and one unknown metabolite was elucidated as N-demethylclausenamide. The metabolic stereoselectivity was shown distinctly. CONCLUSION　Chiral clausenamide was mainly metabolized by hydroxylation in liver and the biotransformation exhibited pronounced substrate stereoselectivity.

Pancreatic sarcomatoid carcinoma is an extremely rare malignant tumor.The clinical data and computed tomography images of 8 patients with pancreatic sarcomatoid carcinoma who were admitted to the Subei People's Hospital from March 2001 to January 2013 were retrospectively analyzed.The results of computed tomography showed that 8 tumors were cystic and solid,showing exophytic growth.Two tumors were located in the pancreatic head,1 in the pancratic neck,3 in the body of pancreas,and 2 in the tail of the pancreas.The shape of the tumors were round or ellipse,and the mean tumor diameter was (7.2 ± 1.8)cm (range,6.3-9.6 cm).The plain scan of computed tomography showed that the attenuation of the tumors was mild hyperdense (7 cases) or equal to pancreatic tissue (1 case).Tumors were solid with cystic components,and no hemorrhage within the tumor was detected.Small calcification nodule wasdetected in 1 case.The enhanced scan of computed tomography showed that the enhancement of the tumor was moderate; the enhancement of the tumor was higher than that of normal pancreatic parenchyma during venous phase and delayed phase,while lower than that of normal pancreatic parenchyma on arterial phase; the enhancement of tumors was significantly lower than that of aorta during all the enhanced phases.All the tumors had complete capsule,and abnormal enhancement of the capsule was not detected.Three tumors had peripancreatic lymphadenectasis,2 had infiltration of splenic artery,2 had infiltration of splenic flexure of colon and 1 had infiltration of duodenal serosa or muscle.Familiarity with the imaging features of the pancreatic sarcomatoid carcinoma can help surgeons to make a suggestive diagnosis.

Objective To investigate the MSCT features of the renal cell carcinoma associated with XP11.2 translocation-TFE gene fusion ( XP11.2-TFE Ca).Methods The MSCT features of XP11.2-TFE Ca in six patients were retrospectively analyzed,which were confirmed by postoperative histopathology.All the tumor features were recorded and compared to the histopathological findings.Variance test analysis was performed to compare the CT values among tumor,normal renal cortex and normal renal medulla.Results XP11.2-TFE Ca appeared as a solitary lesion in all the 6 patients,which limited in the medulla in 3 patients and infiltrated both medulla and renal pelvis in other 3 patients.The tumor diameter ranged from 3.8 to 5.2 cm [mean diameter,(4.2 ± 1.3) cm],And the adjacent renal cortex was compressed or involved.Four lesions were oval,2 lesions were irregular shape.Tumor capsule showed in all lesions in the six patients.Cystic component and retroperitoneal lymph node metastasis respectively occurred in one patient.In all lesions,calcification was not detected.On unenhanced CT scan phase,the CT values of the normal cortex,normal medulla and XP11.2-TFE Ca were (42 ±5),(38 ±4) and (48 ±4) HU respectively,with no significant statistical difference ( F =1.267,P ＞ 0.05 ) ; on cortical nephrographic phase after contrast injection,they were ( 174 ± 10 ),( 72 ± 8 ) and ( 100 ± 9) HU respectively,with significant statistical difference among the three groups (F =6.588,P ＜ 0.01) ; on parenchymal nephrographic phase,they were (207 + 12),(109 +8) and ( 121± 11) HU respectively,with significant statistical difference (F =7.172,P＜0.01) ; and on the excretory phase,they were (148 ± 12),(67 ±8) and (83 ±7) HU respectively,with significant statistical difference ( F =2.678,P ＜ 0.05 ).On each phase of contrast-enhanced MSCT scan,the enhancement of XP11.2-TFE Ca was higher than that of the medulla and lower than that of the cortex.Conclusions XP11.2-TFE Ca had some characteristic MSCT features.Comprehensive analysis of its MSCT features may help for improving the diagnosis.

Objective To investigate the differential diagnostic features of subtpes of renal cell carcinoma (RCC) using CT scan.Methods The CT appearances of 53 RCCs,including 28 clear cell RCCs (CCRCC),6 Xp11.2 /TFE RCCs (Xp11.2 /TFE RCC),7 collecting ducts RCCs (CDC),12 chromophobe RCCs (CRCC),were retrospectively analyzed and compared with finding of pathology.Dynamic contrast-enhanced CT (DCE-CT) was conducted in each case after intravenous administration of contrast agent,and the data was analyzed by AVONA and LSD text.Results On unenhanced and enhanced CT,most CCRCCs and CDCs showed heterogeneous density (23/28,6/7),with necrosis (21/28,6/7),and most Xp11.2/TFE RCCs,CRCCs showed homogeneous density(5/6,8/12).Most CCRCCs,Xp11.2/TFE RCCs and CRCCs had clearly boundaries with well demonstrated at enhanced CT delayed phase (25/28,6/6,10/12),CDCs had unclearly boundaries (6/7),and most CCRCCs had lymph node or other metastasis (19/28).A phenomenon of quick staining and quick fainting was observed in CCRCCs.Xp11.2/TFE RCCs,CDCs,CRCCs showed delayed enhancement.On unenhanced CT,the Xp11.2/TFE RCC attenuation was greater than CCRCC,CDC,CRCC and normal renal cortex (53.7±4.1 vs 45.8±3.6 vs 41.4±2.4 vs 47.7±3.6 vs 41.5±5.1,F=5.458,P＜0.01,respectively).The enhancement degree was highest for CCRCCs,lowest for CDCs,and intermediate for Xp1 1.2/TFE RCCs and CRCCs.The enhancement degree of Xp1 1.2/TFE RCC was higher than that of the CDC and CRCC (P＜ 0.01).The enhancement degree of Xp11.2/TFE RCC and CRCC were higher than that of the normal renal medulla at cortical and medullary phases (P＜0.01),but lower than that of the renal medulla on delayed phase (P＜0.01).The enhancement degree of CDC were lower than that of the normal renal cortex and medulla on cortical,medullary and delayed phases (P＜0.05).Conclusions CT could distinctly show imaging features of CCRCC,Xp1 1.2/TFE RCC,CDC and CRCC,which were related to their pathological characteristics,and these features were helpful in predicting a specific subtype of RCC.

Objective: To analyze the effects of technetium99 conjugated with methylene diphosphonate(99Tc-MDP) on adjuvant arthritis in rats.Methods: Thirty SD rats were randomly and equally divided into a normal control group an adjuvant arthritis control group and a 99Tc-MDP treatment group.Intraperitoneal injection of 99Tc-MDP(2.5?10-3?g/kg) was given to the rats in the treatment group on the tenth day and repeated every other day after arthritis induction.The left-right diameter of the left hind ankle,arthritic index,serum TNF and IL-1? levels,articular radionuclide imaging and histopathological changes were observed.Results: Compared with the adjuvant arthritis group,the diameter of the left hind ankle,arthritic index,the serum TNF and IL-1? levels and the T/NT value were decreased in the treatment group,and histopathology showed less synovium hyperplasia and fewer infiltration of inflammatory cells in the group treated with 99Tc-MDP intraperitoneal injection than in the adjuvant arthritis control group.Conclusion: 99Tc-MDP intraperitoneal injection is effective for adjuvant arthritis in rats.

Objective To characterize the inheritance of erythropoietic protoporphyria (EPP) by detecting the mutations of ferroehelatase (FECH) gene in a Chinese family with EPP. Methods Peripheral blood samples were obtained from 4 patients and 3 unaffected individuals in a family with EPP, as well as from 50 unrelated healthy human controls. PCR was performed to amplify all the 11 exons and flanking sequence of FECH gene followed by direct sequencing. Results A splicing mutation,I.e., IVS3+1G→A, was identified in the proband as well as his symptomatic sister, cousin, grandfather and asymptomatic mother, but not in his asymptomatic father, grandmother, or unrelated healthy controls. The genotypes IVS1-23 T/C and IVS3-48 C/T were noted in the proband, his father, sister, cousin and grandfather, but absent in his mother or grandmother who carried IVS1-23 C/C and IVS3-48 T/T genotypes. Conclusions A novel splicing mutation is found in the FECH gene in a Chinese EPP family, which, together with two lowly expressed alleles IVS1-23T and IVS3-48C, is likely to be responsible for the clinical phenotype of EPP in this family.