Objective To compare the effects of transcranial and trans-spinal low frequency magnetic stimulation (MS) on the expression of growth-associated protein-43 (GAP-43) in the spinal neurons of rats after spinal cord injury (SCI). Methods Forty-five Sprague-Dawley female rats were divided randomly into a transcranial magnetic stimulation (TMS) group,a trans-spinal cord magnetic stimulation group and a model control group with 15 in each group.Another 6 rats served as a normal control group.Spinal cord injury at the T9-10 level was modeled according to the modified Allen's method.The rats in the two MS groups received magnetic stimulation at 0.5 Hz and 75％ of the maximum output intensity ( 1.9 T) of the magnetic stimulator beginning 24 h post injury.They received 30 pulses daily for 28 days while the rats in the model control group were not exposed to MS.Basso-Beattie-Bresnahan (BBB) scale scores and motion evoked potentials (MEPs) were measured at the 1st,7th,14th,21 st and 28th day post injury.The expression of GAP-43 protein was studied using immunohistochemical methods and semi-quantified by Western blotting. Results At the 4th week post injury the average BBB scores in the model control group,the TMS group and the trans-spinal cord magnetic stimulation group were all significantly different. MEP amplitudes decreased significantly in all groups after the injury,and the latency was prolonged,but there were no significant differences among groups at any time point.GAP-43 expression also increased after SCI,and it was significantly higher in the MS groups than in the model control group at 4 weeks. Moreover,the expression of GAP-43 in the trans-spinal cord MS group was significantly greater than in the TMS group.Conclusion Magnetic stimulation can promote nerve regeneration and improve locomotor recovery after spinal cord injury,at least in rats.The effect of trans-spinal cord magnetic stimulation is superior to that of TMS.The mechanism may be related to the activation of central pattern generators.

Bone marrow-derived mesenchymal stem cells (MSCs) are capable of migrating and homing to brain tumors in vivo and therefore is a promising targeted-delivery vehicle in cancer gene therapy. MSCs are transfected or transducted with the therapeutic genes and achieve stable expression in vitro, then are delivered to the host to exert their therapeutic effects. The Ex Vivo gene transfer of MSCs has been studied in several types of tumors including gliomas, and results were postive. The safety of MSC-based gene delivery remains to be controversial. The interactions between MSCs and host tumor cells need to be investigated.

Objective To observe the expression of the transforming growth factor beta 1, the basic fibroblast growth factor and the core protein of proteoglycan on the convex and concave sides of apex and end vertebral cartilagnous endplate in adolescent idiopathic scoliosis. Methods There were 12 cases in the study group. There were 4 males and 8 females. The age of patients at the surgery ranged from 12 to 20 years(with an average of 14.9 years). The Cobb angle ranged 43? to 102? (mean, 65.1?) preoperatively. The diagnosis of idiopathic scolisis was made based on radiography, CTM and/or MRI to rule out congenital, neuromyeputhic and other scolisis. All patients underwent anterior correction procedures. The sections of the convex and concave side of the resected apex and end vertebral cartilage endplate were examined with S-P immunohistochemistry and the results were analyzed with image analysis system. Results The transforming growth factor beta 1, the basic fibroblast growth factor and the core protein of proteoglycan were all expressed in the cytoplasm of chondrocytes in the cartilaginous endplate. With non-parameter Wilcoxon rank test, the area density and quantity density of the transforming growth factor beta 1, the basic fibroblast growth factor on the concave curve of the apex and end vertebrae are expressed in a significantly higher level than those of the convex curve at the apex and end vertebrae(P0.05). Conclusion There was a significantly higher expression of TGF?1 and bFGF, while a lower expression of the core protein on the concave side, which suggest a possible aetiological factor or a secondary change in the development of AIS.

Objective To investigate the surgical management of scoliosis in neurofibromatosis Ⅰ type. Methods Since 1983, the results of surgical intervention of 31 consecutive patients for scoliosis in neurofibromatosis were reviewed. There were 19 males and 12 females. The mean age of the patients was 15.4 years (range, 5 to 25 years). The type of curve in scoliosis included thoracic curve in 23 patients, lumbar curve in 3 and thoracolumbar curve in 5. There were 6 cases of thoracic curves associated with kyphosis. The mean Cobb angle of scoliosis was 85.9? ranging from 45? to 145?, and the mean Cobb angle of kyphosis was 81.3? ranging from 43? to 120? before operation. The surgical methods included posterior operation in 17 patients, anterior operation in 2, and combination of anterior and posterior in 12. The instrumentation used for internal fixation included Harrington rod in 7 patients,Luque rod in 3, combination of Harrington and Luque rod in 5 patients, CD in 4 patients, CDH in 3 patients,TSRH in 7, and PRSS in 2, 10 cases of whom only single rod fixation were used. Results The patients were followed up for an average of 9.4 years (range, 1-18 years). The correction rate of Cobb angle in scoliosis was 33.4% in scoliosis, and 39.6% in kyphosis postoperatively. The complications of the group consisted of Luque rod breakage in 1 patient, Harrington rod breakage in 1, Harrington rod and Luque wire breakage in 1,nonunion of bone graft and pseudarthrosis in 4, curve aggravation in 1. One patient underwent revision for three times because of recurrent hook dislodgement. Conclusion Scoliosis in neurofibromatosis should be operated early, sufficient bone graft and the solid instrumentation for internal fixation are required.

Objective The study was to probe into the causes and strategies of decompensation after operation in adolescent idiopathic scoliosis in order to reduce the operative mistakes and be aware of pitfalls in scoliosis surgery.Methods From July1997to December2001,174patients underwent the operation of three-dimensional correction of adolescent idiopathic scoliosis,ten of them developed postoperative decom-pensation.Other four patients with postoperative decompensation were referred to our hospital,who received the primary operation for idiopathic scoliosis at the local hospital.In all,fourteen patients with decompensa-tion were retrospectively reviewed including3male and11female cases aging from12to23years(range,15.7years).The criteria of postoperative decompensation was defined as trunk shift more than2mm,shoul-der tilting,aggravated distal lumbar rotation in coronal plane,the plumb line of center of C 7 deviating the from the posterior edge of S 1 and kyphosis of thoracic-lumbar junction more than10degree in sagittal plane.Results The analysis was made depending on preoperative and postoperative X-ray films,the causes of de-compensation after surgery included classification error,inappropriate fusion level,over correction for tho-racic curve and insufficient knowledge of lumbosacral hemicurve in this group.According to the patientssubjective symptoms and decompensation conditions,ten of the patients were treated surgically,which in-cluded re-fusion and fixation for3patients,fusion level extension for6patients and fusion of the upper tho-racic curve after removing major thoracic curve instrumentation for one patient.The other four patients re-ceived conservative therapy with brace.The patients were followed up from1to3years(average,18.9months),except one case followed up to6months.Twelve patients regained spinal balance;two patients re-mained more than20mm trunk shift.Conclusion Although operative treatment is frequently used for idio-pathic scoliosis,it is important to recognize the necessity for operative intervention,indication for surgery.The adolescent idiopathic scoliosis should be operated according to the curve type and flexibility,the appro-priate fusion level and operative procedures can contribute to lessen the postoperative decompensation.If postoperative decompensation occurs,therapeutic decision should be made according to subjective symptoms and the decompensation type of the patients.

Objective To evaluate the curative effect of infection caused by peritoneal dialysis(PD) catheter. Methods Eighty patients with infections caused by peritoneal dialysis catheter were enrolled in this study and randomized into silver-containing hydrofiber dressing group and control group with 40 patients in each group. The control group was treated with iodophor and/or gentamicin and the treatment group with silver-containing hydrofiber dressings. The two groups were compared in terms of curative effect at the wounds and time for cure. Result The cure rate in the treatment group was significantly higher than that in the control group (P<0.05), and the cure time in the observation group was significantly shorter as compared to the control group. Conclusion Silver-containing hydrofiber dressing is effective in the treatment of PD catheter-induced infections , and it can shorten treatment duration and reduce the frequency of dressing change.

0.05). Postoperative cataract incidence was higher in the patients without IOL implantation than that in the patients with IOL implantation. Postoperative cataract appeared 6 months after operation in the patients without IOL implantation, while it appeared 14 months after operation in the patients with IOL implantation. There was no significant difference in the postoperative complications between group A and group B. Conclusions Combined surgery is effective and safe for the selected patients of primary retinal detachment accompanied with cataract.

Objective: To explore the advantage of RR-Lorenz plot (RR-LP) in analyzing the patients of sinus rhythm with long RR interval.
Methods: A total of 308 RR-LP patients with long RR interval were retrospectively studied. The patients were divided into 7 groups according to the type of long RR intervals. ① Sinus bradycardia with arrhythmia group, n=63,②Repeated transient sinus arrest group, n=16, ③Ⅱ° sino-atrial block group, n=14, ④Ⅱ° atrial ventricular block (Ⅱ° AVB) group, n=47, ⑤ Un-passed atrial premature beats (APB) group, n=28, ⑥ Atrial premature beats group, n=72 and ⑦ Premature ventricular beats group, n=68. We analyzed the patients of RR interval greater than 1500 ms with ambulatory electrocardiogram record.
Results: ①RR-LP of sinus bradycardia with arrhythmia group showed a single distributing area with 1500 ms for the origin of transverse and longitudinal axis with B line slope at 1, tilt angle of 45°.②RR-LP of repeated transient sinus arrest,Ⅱ° sino-atrial block,Ⅱ° AVB and APB groups showed special four distributing areas with B line slope at (0.51 ± 0.01), tilt angle of (23.04 ± 0.50) °, B line slope at 0.6, tilt angle of (27°), B line slope at (0.57 ± 0.21), tilt angle of (25.69 ± 9.59)° and B line slope at (0.50 ± 0.01), tilt angle of (22.59 ± 0.54) ° respectively.③RR-LP of premature beats groups showed special four regional distributing areas, B line slope for atrial premature beats was at (0.38 ± 0.12), tilt angle of (17.06 ± 5.22) ° and B line slope for ventricular premature beats was at (0.07 ± 0.05), tilt angle of (3.02 ± 2.39) °.
Conclusion: RR-LP in patients of sinus rhythm with long RR interval had speciifc morphology and distribution features, the local abnormality could be found in a plane via all RR intervals which provided a differential diagnosis for repeated occurrence of short RR interval.

Objective To study the life quality of 2 - 3 years old survivors in Neonatal Intensive Care Unit (NICU). Methods Severe neonates were randomly assigned to intervention group (group 1,30 cases) and non- intervention group (group 2,30 cases) depending on the early intervention applied or not,as well as 30 healthy newborns as normal controls. The physical,neurological conditions and intelligence test were taken regularly. To investigate the psychological state, actions, temperament and family conditions when they were2-3 years old.Results Mental development index(MDI) and physical development index(PDI) in early interventional group were significant higher than those in group 2(P