Objective To discuss the feasibility of using three-dimensional simulation positioning of puncture route that is sketched according to the transversal and sagittal CT images to design percutaneous vertebroplasty (PVP) plan. Methods A total of 58 patients with 63 diseased vertebral bodies were enrolled in this study. Before PVP, the simulation puncture route was delineated according to the transversal and sagittal CT images, and the simulation puncture parameters were determined by using the software of PACS, in this way the three-dimensional simulation puncturing route was established , and the skin needle entry point as well as the puncture angle were calculated. Unilateral transpedicular approach was used when the simulation puncture route could meet the requirements of unilateral approach. Otherwise , bilateral transpedicular approach would be employed. Three months after PVP visual analogue score (VAS) was used to evaluate the degree of pain relief, and the result was compared with that determined before PVP. SPSS 13.0 software was used for statistical analysis. The estimating data were statistically analyzed with paired t-test and the results were expressed in the form of (x ± s). Results The measurement results showed that significant differences in the puncture angles and skin needle entry points existed between different vertebral bodies. Guided by the preoperatively determined simulation puncture route , PVP was successfully accomplished in all patients. The success rate of single puncturing was 100% (63 vertebral bodies in total). Among 63 vertebral bodies, unilateral transpedicular approach was adopted in 55 and the operation time was (28.5 ± 5.5) minutes, while bilateral transpedicular approach was carried out in 8 and the operation time was (37.5 ± 5.5) minutes. After PVP, complete pain relief was achieved in all patients. No serious complications occurred during the follow-up period. Conclusion Three-dimensional simulation positioning of puncture route that is sketched according to preoperative transversal and sagittal CT images is very useful in precisely determining the puncturing route before PVP, which is very helpful to increase the success rate of single puncture and to improve the procedural safety.

OBJECTIVE: To determine the concentration of sodium L-lactate in sodium lactate injection. METHODS: Lactic oxidase was immobilized at a hydrogen peroxide electrode and the enzyme electrode was used for the amperometric determination of sodium L-lactate in sodium lactate injection. Sodium D, L-lactate in injection was analyzed by that technique according to Chinese Pharmacopoeia. RESULTS: The quantity of sodium L-lactate was about 10% in total amount of sodium D, L-lactate in sodium lactate injection. CONCLUSION: Sodium L-lactate in sodium lactate injection could be determined specially, rapidly and inexpensively.

Objective To study the influence of carboxymethyl-chitosan (CM-chitosan) on phenotype and proliferation of chondrocytes stimulated by recombinant human interleukin-1? (rhIL-1?), and explore its mechanism. Methods Chondrocytes were isolated and cultured. 10 ng/ml IL-1? with or without CM-chitosan of varied concentrations were added into the culture medium. After 24 h, changes of proliferative ability of chondrocytes were tested by MTT and flow cytometry. Proteoglycan synthesis was measured by incorporation of Na235SO4 into chondrocytes, nitric oxide (NO) production was detected by Greiss reaction, mRNA expression of typeⅠ、Ⅱcollagens, Aggrecan and inducible NO synthase (iNOS) were examined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results CM-chitosan could significantly antagonize IL-1?-induced inhibitory effect on proliferation of chondrocytes, restore proteoglycan synthesis of chondrocytes, decrease NO production of IL-1?-induced chondrocytes, increase the mRNA expression of typeⅡcollagen and Aggrecan, but decrease the expression of typeⅠcollagen and iNOS. The effects of CM-chitosan were in a dose-dependent manner. Conclusion CM-chitosan can maintain the proliferation and phenotype of IL-1?-induced chondrocytes.

Objective: To establish a RP-HPLC for determination of bergenin in Rodgeris aesculifolia batal from different sources. Methods : Chromatographic conditions were as follows: C 18 column(5?m, 4.6mm?150mm,i.d), was adopted, mobile phase consisted of 25% ethanol and 75% water. The column temperature was set at (30?1)?C. The flow rate was 1.0mL?min -1 and the detection wavelength was at 275nm. Results : The method was proved to be linear in the range of 0.8～4.0?g with a regression coefficient of 0.9993. The average recovery was 99.95% with RSD 3.0%( n =5). The minimum detection limit was 0.1ng. Conclusion : The method is proved to be quick, simple and highly sensitive. There is some relationship between the bergenin contant and different sources of raw materials.

Objective To observe whether immature Brain Derived Neurotrophic Factor (proBDNF)can affect the activities of OPCs in the fields of cell proliferation and migration after SCI,and to investigate the relationship between proBDNF and p75NTR signal pathway on OPCs.Methods OLN-93 cell line was cultured and maintained for in vitro experiments.Immunofluorescence were used to check the expression of endogenous proBDNF,p75NTR and sortilin on OPCs.MTT assay was used to illustrate the inhibitory effect of proBDNF.The effects of anti-proBDNF was also observed by BrdU staining to find a probably signal pathway for proBDNF on OPCs.The Sprague-Dawley rats were administered for T9 spinal cord injury animal model.BBB score was applied to observe the situation of functional recovery after treated by anti-proBDNF.BrdU staining was managed to observe the situation of OPCs proliferation and migration after SCI.Results Endogenous proBDNF inhibited proliferation and migration of OPCs after SCI.BrdU staining showed that population of proliferative OPCs in lesion site of spinal cord was less in proBDNF in treated group than that in control group and anti-proBDNF group.While anti-proBDNF could inhibit proBDNF specifically and might induced a better functional recovery which was illustrated by BBB scores.The in vitro experiments found the inhibitory effect of proBDNF is dose-dependent and can be neutralized by anti-proBDNF properly.Moreover,the expression levels of p75NTR and sortilin are down regulated by proBDNF antibody treated group.This indicated that proBDNF may inhibit OPCs via p75NTR pathway.Conclusion Endogenous proBDNF can inhibit cell proliferation of OPCs after SCI and can be neutralized by specific antibodies of proBDNF.This kind of detrimental effect may be induced by p75NTR-sortilin pathway.Furthermore,proBDNF antibody treatment is effective to block proBDNF and promote the functional recovery.

Objective To explore the surgical strategies of thoracic spinal stenosis with dural ossification. Methods One-hundred and eight patients with thoracic spinal stenosis were treated. Dural ossification was found in 29 cases during operation from January 2004 to June 2008. There were 19 males and 10females, with an average age of 56.4 years (42-74 years). The course of disease was 13 months (2-48months). The lesion was located in T1-T4 in 4 cases, T5-T8 in 5 cases, and T9-T12 in 20 cases. All the patients were treated by posterior lamina resection. Both ossificated dural and ossificated yellow ligament were resected in 16 patients. Decompression was performed with partial ossification remaining on dural surface in 13 cases. JOA score was used to evaluate the outcomes 1, 3 and 12 months after operation. Results The average operation time was 140 min, and average bleeding was 300 ml. Dural incisions were repaired with a wound drainage in 11 cases. Seven cases appeared cerebrospinal fluid leakage which healed in 3-5 days.Dural incisions were not repaired without wound drainage in 5 cases. Cerebrospinal fluid leakage occurred in these cases healed in 5-7 days. Thirteen cases treated with floating method did not appear cerebrospinal fluid leakage. All patients did not undergo subarachnoid infection and the aggravation of original nervous system symptoms. According to JOA score, all patients were evaluated as excellent in 22 cases, good in 5 and fair in 2 cases, and excellent and good rate was 93%. Conclusion For thoracic spinal stenosis with dural ossification, resection of both ossificated dural and ossificated yellow ligament and complete decompression with partial ossification remaining on dural surface is safe and reliable. Dural ossification does not influence the prognosis, but increase operative difficulty and risk.

Objective To study the clinical features and surgical strategies of thoracic spinal stenosis caused by ossification of posterior longitudinal ligament(OPLL).Methods From January 2004 to March 2009,21 cases of thoracic spinal stenosis casued by OPLL,including 13 males and 8 females,received surgical treatments.Those cases aged from 34 to 71 years,with an average of 51.2 years old.The courses of disease were from 2 to 50 months,averaged 11 months.The lesions located in upper thoracic(T1-T4)for 4 cases,in middle thoracic(T5-T8)for 7 cases,in lower thoracic(T9-T12)for 10 cases.Nine cases were associated with ossification of ligamentum flavum(OLF),and 8 cases combined with cervical OPLL.Eleven cases received laminectomy and 10 cases received anterolateral decompression.Results The operation time was 90 to 240 min for posterior laminectomy with an average of 140 min,and 110 to 360 min for anterolateral decompression with an average of 240 min.All cases had no worse postoperative symptoms,neurological complications,subarachnoid cavity or wound infection.Japanese Orthopaedic Association(JOA)score was 8 to 15 with an average of 9.17±1.63 in 6 months after surgery.Nerve function improvement was excellent for 8 cases,good for 6 cases,fair for 5 cases and poor for 2 cases.The excellent and good rate was 66.7%.JOA score was 8-15,averaged 10.23±1.64,in 12 months after surgery.Nerve function improvement was excellent for 8 cases,good for 7 cases,fair for 4 cases,and poor for 2 cases.The excellent and good rate was 71.4%.Conclusion Thoracic spinal stenosis result from OPLL,which often combine with cervical OPLL and OLF,often show multiple manifestations.Posterior laminectomy and anterolateral decompression are suitable for those conditions.

Objective To explore the prevalence of health literacy in China in 2011-2013.Methods The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI),Chinese BioMedical Literature Database (CBM),VIP Database for Chinese Technical Periodicals (VIP),Wanfang database,PubMed and Embase.The Meta-analysis was applied with Stata 12.0 software.Subgroup analysis and sensitivity analysis were performed to test the robust of the results.Results A total of 28 studies,including 53 308 residents,were finally included in the review.Meta-analysis revealed the prevalence of health literacy in China to be 16％ (95％CI 15％-16％),and the prevalence of health concepts and knowledge was 25％ (95％CI 25％-26％),and healthy lifestyles and behaviors was 13％ (95％CI 12％-14％),and health skills was 32％ (95％CI 31％-32％).Conclusions The health literacy levels of residents showed a rising trend.There were differences between rural and urban health literacy levels and different regions.Rural residents' health literacy level increased more significantly than that of the city.Due to limited kinds of methods,more scientific and effective methods were needed to evaluate the health literacy.

Objective To detect the inhibitory effect of siliver nanoparticles loaded titanium nanotubes on staphylococcus aureus, and provide a theoretical basis for implant local application. Methods Orderly arrangement of titania nanotubes produced by anodic oxidation, loaded silver nanoparticals by situ replacement. Scanning electron microscopy (SEM) and transmission electron microscopy(TEM) were used to detect the morphology topology of silver nanoparticals, titanium nanotubes and siliver particals loaded titanium nanotubes. The minimum inhibitory concentration of silver nanoparticles was calculated. The antibacterial of planktonic bacteria was detected 1 day, 3 days and 5 days after culturing staphylococcus aureus on siliver particals loaded titanium nanotubes. The inhibitory bacterial adhesion properties were detected by scanning electron microscopy. Results The uniform and orderly diameter of 80～120 nm TiO2 nanotubes were prepared under 18 V voltage, loaded diameter of 20 nm silver nanoparticals, which effectively inhibited adhesion and proliferation of staphylococcus aureus. Conclusion Titanium nanotubes produced by 18 V have a stronger drug loading capacity. The 100 mmol/L silver nanopartical solution loaded nanotubes can effectively inhibit staphylococcus aureus adhesion and proliferation within three days.

[Objective] To evaluate the effect of hydromorphone for postoperative analgesia on residual carbon dioxide during recovery after laparoscopic colorectal surgery.[Methods] A total of 100 patients performed with elective laparoscopic colorectal surgery were randomly allocated into two groups according to different patient controlled intravenous analgesia (PCIA) formula:Group H contained hydromorphone 8 mg and Group M contained morphine 40 mg.Total PCIA volume was 100 mL saline with loading volume 2 mL,background volume 2 mL/h,and lockout time was set on 15 min.Analgesia infusion pump was used in the two groups half an hour before the end of surgery.Surgery time,pneumoperitoneum time,anesthesia time,extubation time,recovery time and retention time in postanesthesia care unit (PACU) were rccordcd,rcspcctively.PaCO2,the pain Visual Analogue Scale (VAS) score,Ramsay sedation score,at 30 min (T0) after pneumoperitoneum,extubation time (T1),30 min (T2),1 h (T3),2 h (T4),and 24 h (T5) after extubation,the times of PCA compressions were recorded.Anesthesia complications during waking-up period such as postoperative nausea and vomiting (PONV),shoulder pain,hypersomnia,pruritus and satisfaction degree after surgery were also recorded.[Results] Compared with group H,PaCO2 was higher at T2 ～ T4 (P ＜ 0.05);Recovery time,extubation time and the retention time in PACU were longer after surgery (P ＜ 0.05);The incidence of postoperative nausea and vomiting,shoulder pain were higher in group M (P ＜ 0.05).Compared with group M,VAS score at T1 ～ T3,and Ramsay sedation score T1 ～ T4 were decreased in group H (P ＜ 0.05).[Conclusion] Compared with morphine,hydromorphone can increase fewer residual carbon dioxide during recovery and fewer side effects for the patients caused by that after laparoscopic colorectal surgery.Hydromorphone was a safer and more effective analgesic for postoperative analgesia than morphine.