Many reasons cause low back pain, such as muscles and ligaments injury, vertebral joints retrogression, spinal canal stenosis, lumbar disc herniation, lumbar spondylolisthesis, spondyloarthritis, infection, tumor and metabolic bone disease. It is in recent years that discogenic low back pain be recognised, especially after the MRI widely applied in clinics. This article makes a summary on discogenic low back pain of recent years from etiology, pathogenesis, diagnosis and therapy.

There is a lot of drug to cure the osteoporosis.The drug effect feature is different,and clinicle choice and application is complicated,too.This paper will review the advancement of drugs and their mechanism for treating osteoporosis,including calcium and vitamin-D,estrogen,selective estrogen receptor modulators,caicitonin,bisphosphonates,parathormone and fluoride etc.

Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

AIM: Anterior cervical discectomy and Cage bone graft fusion followed by steel plate internal fixation can decompress the vertebral canal and then spinal cord in patients with multilevel cervical spondylotic myelopathy. Complete decompression is very important for such patients. This study is to investigate the effect of this technique on reconstruction of spinal function.METHODS:①Thirty-eight inpatients with multilevel cervical spondylotic myelopathy admitted to Department of Spine Surgery, Tianjin Hospital between April 2003 and February 2006 were involved in this study. The involved patients, 35 male and 3 female, were aged 43-72 years, with disease course of 0.5 to 5 years. Informed consents of therapeutic regimen were obtained from all the patients.②All the patients underwent anterior cervical discectomy and cage placement operation. The patients with destabilized combination underwent titanium-plate fixation, and those with stabilized combination underwent cage implantation alone. The cage used in the experiment was made of tetragonal polyether ether ketone (Intromed Company), and titatium-plate was Zephir plate (sofarmor Danek Company). The elastic modulus of tetragonal polyether ether ketone Cage was similar to bone tissue and could allow X-ray pass through, which was easy for postoperative fusion of implanted bone. The outer design of Cage bone graft with certain angle could allow cervical physiological antecurvature well recover; Surface radian was the same as end plate, and good fitness contributed to the good fusion rate of bone graft; The sawtooth antiskid design on the surface provided good stability immediately after implantation; Elastic modulus was between os integumentale and cancellous bone that made stress-shielding and subsidence of fusion cage reduced, and had good anticausticity and biocompatibility. ③ The clinical results were evaluated with Japanese Orthopaedic. Association (JOA) scoring system before, 2,8 and 24 weeks after operation: upper limb motor function (4 points), lower limb motor function (4 points), sensation (6 points) and bladder function (3 points). Higher scores indicated better function. Postoperatively, body examination and X-ray and MRI scanning of anteroposterior cervical vertebra were performed.RESULTS: Thirty-eight patients with multilevel cervical spondylotic myelopathy participated in the final analysis. Within postoperative several days, nervous symptoms improved obviously, muscle strength of lower limb was increased, limbs were more flexible after operation than before operation, and paresthesia of two upper limbs recovered in 38 patients. JOA was a score of (9.25±1.85) before operation, and it was (12.4±2.08) at postoperative 2 weeks, (13.2±2.07) at postoperative 8 weeks and (13.8±1.67) at postoperative 24 weeks.CONCLUSION: Multilevel discectomy and Cage implantation obviously improve sensorimotor function and lessen symptoms of patients with multilevel cervical spondylotic myelopathy.

Objective To measure the vertebral rotational centers in sagittal and transverse plane. These data may be quite valuable for the design of artificial disc. Methods Ten healthy volunteers of 40-60 years old were recruited under IRB approval and informed consent. Three-dimension lumbar spine models of L_2, L_3 and L_4 were reconstructed from MR scans. Spine motions were then reproduced using combined dual fluoroscopic imaging system (DFIS) and MR scan technique during flexion-extension and left-right twisting of the body. Based on the geometrical features of the vertebrae, ranges of motion (ROM) of 3 representative lo-cations were measured from anterior to posterior, the vertebral body center, the spinal cord canal center and the spinous process tip. Rotational centers of the vertebral segments were then located by calculating the point of zero ROM. Results Motion patterns: The ROMs of L_2 with respect to L_3 (L_(2,3)) and L_(3,4) increased pro-portionally from anterior to posterior locations. During flexion-extension motion, the vertebral body center moved within a range of 0.6 mm, while the spinous process tip moved within 7.5 mm in the sagittal plane. During left-right twisting, the vertebral body center moved within 1.0 mm, while the tip moved within 1.6 mm in the transverse plane. No statistical differences were found in the ROMs between L_(2,3) and L_(3,4). Rotational centers: the rotational centers of flexion-extension in sagittal plane for both L_(2,3) and L_(3,4) segments were located at posterior one-third of the vertebral body. The rotational centers of both L_(2,3) and L_(3,4) segments were located approximately 30 mm anterior to the front edge of the vertebral body. Conclusion The anterior portion of the vertebrae was found to have smaller ROM than the posterior portion. The vertebra rotates with the center of rotation located at approximately the posterior one-third of the vertebral body in sagittal plane. However, the vertebra rotates in transverse plane with respect to a point about 30 mm in front of the vertebra. The data indicated that the different portions of the vertebra have distinct motion characters during different motions.

An automated on-line solid phase extraction-liquid chromatography-tandem mass spectrometry ( on-line SPE-LC-MS/MS ) method for the simultaneous quantification of six endogenous phytohormones including abscisic acid ( ABA ) , indole-3-acetic acid ( IAA ) , salicylic acid ( SA ) , jasmonic acid ( JA ) , indole-3-propionic acid ( IPA) and indole-3-butyric acid ( IBA) in rice tissues was described. Plant samples were extracted with methanol and on-line SPE procedure was performed with C18 SPE cartridges. Analytes were eluted to C18 analytical column with mobile phase and further analyzed by LC-MS/MS. The performance of the method was fully validated. Linearity showed good correlation (R2≥0. 99). Limits of detections (S/N=3) were in the range of 0. 1-0. 8 μg/kg. Recoveries varied between 71. 2% and 126%. The method was rapid and sensitive to determine multiple phytohormones in rice young panicles and the results were cross-validated with the off-line SPE-LC-MS/MS phytohormone analytical method. Finally, the method was applied to monitor the changes of ABA, IAA, SA and JA in wounded rice leaves. The trends were in accord with plant physiological processes.

2% hydroxypropyl methyl cellulose (HPMC, medical grade, Taian Ruitai Cellulose Co., Ltd.) was added into calcium phosphate cement (Orthopedics Institute of General Hospital of Chinese PLA) and the mixture was put into distilled water to observe whether the surface was corrupt. Some calcium phosphate cement was immersed in water at different time and the residual cement was weighed 24 hours later. The results showed that there was no surface corruption in calcium phosphate cement with 2% HPMC after shake; the residual weight measured 24 hours later showed that 2% HPMC could shorten calcium phosphate cement cohesion time from 4 minutes to 1 minutes. The experiment indicates that 2% HPMC can significantly increase the waterproof performance of calcium phosphate cement, increase the work time and is adaptable in clinical application.

Objective To explore the influence of stereoscopic vision on the development of posterior capsule opacification (PCO) after intraocular lens implantation. The efficacy of Nd: YAG laser was studied. Design Case-controlled study. Participants 57 consecutive patients with POC(59 eyes with phacoemulsification and IOL implantation). Methods A prospective observational study was conducted comprising 57 patients (59 eyes) who had postoperative PCO. Neodymium: YAG (Nd: YAG) laser posterior capsulatomy was performed on all patients following a standardizes procedure. Preoperative and postoperative evaluation included LogMAR visual acuity, best-corrected visual acuity (BCVA), contrast sensitivity and stereoscopic vision. Main Outcome Measures LogMAR visual acuity, BCVA, contrast sensitivity and stereoscopic vision. Results The average LogMAR eyesight median of sick eye before laser treatment was (0.22?0.31) and the contrast sensitive degree of each frequency area was relatively lower than the opposite eye; After the treatment, there was evident improvement of the sick eye, and the LogMAR eyesight median of that was 0.00; The ratio of reaching the central spatial eyesight and the average sharpness degree both improve much than ahead of treatment. Those whose spatial eyesight sharpness don't get normal after the low best remedy eyesight. Irregular dipodic and previous eye disease. Conclusions LogMAR visual acuity, BCVA, contrast sensitivity and stereoscopic vision were damaged markedly with PCO. Our results indicate that Nd: YAG capsulotomy may affect the reconstruction of stereoscopic vision. Nd:YAG laser posterior capsulotomy is a valuable and clinically relevant method for clinical treatment of PCO.

BACKGROUND:For the elderly osteoporotic thoracolumbar burst fractures without nerve root symptoms,it is difficult to choose between traditional surgical and conservative treatment,because they have their advantages and disadvantages.How to select their advantages and to discard their disadvantages? Concept of minimal invasion builds a new platform and provides a new way of thinking and therapeutic tool.OBJECTIVE:To design and develop a new thoracolumbar distraction reduction devicein vitro in the repair of elderly osteoporotic burst fractures.METHODS:We designed and developed a new type of thoracic and lumbar spinein vitrodistraction reduction device,including bracket,guide pin and two holow screws.Its characteristic is that it also contained distractor,pressurizer and wrench.In accordance with the theory of muscles as important as bones and actual anatomical condition,bone fragment in the spine canal was restored using percutaneous ligament reconstructive technique.RESULTS AND CONCLUSION:This thoracic and lumbar spinein vitro distraction reduction device combined with ligament reconstructive technique can be used in elderly osteoporotic burst fractures and elderly osteoporotic compression fractures.It is percutaneous minimaly invasive operation,can restore the height of anterior and central cylinders and correct Cobb's angle through multi angle distraction.Simultaneously,percutaneousvertebroplasty can be utilized.Bone cement was infused in the injured vertebra.According to patients' economic situation,percutaneous baloon kyphoplasty can be employed.These can provide an inexpensive,less-pain,less-invasive way to repair.

Objective To investigate the clinicopathologic features and the expression of p53,PCNA and Bcl-2in tricholemmal carcinoma.Methods Skin lesions were studied with HE staining and immunohis-tochemical markers for p53,PCNA and Bcl-2(S-P method)in22cases of skin tricholemmal carcinoma.Both morphological manifestations and immunohistochemical expression were observed.Results There were15fe-male and7male cases of tricholemmal carcinoma with the ages of40-79y,including16cases whose scalp were involved.Positive staining of p53,PCNA and Bcl-2was found in72%,100%and63%of patients,re-spectively.The positive cells of p53were diffusely distributed.PCNA-positive cells were increased along with the degree of differentiation.Significant differences of Bcl-2expression were found among the various degrees of differentiation(P