BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration.
These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P<0.05). In the final fol ow-up, the visual analog scale scores of neck and upper limbs and cervical dysfunction index were al lower than those after one week of treatment, and the Japanese Orthopaedic Association scores were higher than those after one week of treatment (P<0.05). There were no significant differences in the above indicators at each time point between these two groups (P>0.05). The cervical activity and surgical segmental motion after cervical disc replacement were significantly higher than those in the fusion group;the difference was statistical y significant (P<0.05). There were no serious complications in these two groups. There was no significant difference in the incidence of complications between these two groups (P>0.05). These results suggest that the artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single cervical disc herniation have the same effect in terms of patients’ symptoms mitigation. With respect to fusion technique, artificial disc replacement surgery has the advantage of maintaining cervical stability and activities of replacement segments.

Objective To observe the protective effects of Diemailing Injection (DMLI) on myocardial ischemia-reperfusion injury in rats. Methods The myocardial ischemia-reperfusion model was induced by 30 min left anterior descending coronary occulusion and 24 h reperfusion in open-chest anesthetized rats. The changes of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA) contents in serum, and prostacycline (PGI2) and thromboxane A2 (TXA2) levels in plasma were determined. Results In rats treated by DMLI (with dose of 2. 5, 5 and 10 mL ? kg-1 i. v. at 30 min after coronary occulusion), the myocardial ischemia size (MIS) was significantly reduced, the AST, LDH and CK-MB activities in serum and the TXA2 level in plasma were declined, while PGI2 level in plasma and PGI2/TXA2 ratio were increased significantly. In addition, the LPO content in serum declined, SOD and GSH-Px activities in serum were increased markedly. Conclusion DMLI has protective effects on myocardial ischemia-reperfusion injury through improving free radicals metabolism, decreasing TXA2 level in plasma, increasing PGI2 level in plasma and PGI2/TXA2 ratio.

OBJECTIVE:To study the pharmacokinetic characteristics of Puerarin solid self-microemulsion capsules in rats in vi-vo. METHODS:The rats were randomly divided into two groups with 18 rats in each group. They were given Puerarin solid self-mi-croemulsion capsules(S-SMEDDS capsules)and commercially available Yufeng ningxin tablet,with the dose of 158.15 mg/kg puer-arin. The 0.2 ml blood samples were collected from tail vein 0,5,10,20,40,60,90,120,180,240,360,480,600 min after medication,respectively. The blood concentration of puerarin was determined by HPLC,and pharmacokinetic parameters and rela-tive bioavailability were calculated by using 3p87 software. RESULTS:The metabolism of puerarin was one-compartment model in rats. Pharmacokinetic parameters of S-SMEDDS capsules and Yufeng ningxin tablet were as follows as cmax of (1.032 0 ± 0.020 6) and(0.587 3±0.011 7)μg/ml,t1/2ke of(116.431 4±2.166 0)and(88.222 6±1.752 4)min,AUC0-t of(261.532 2±1.464 0)and (102.835 5±1.957 4)μg·min/ml. Relative bioavailability was 238.77%. CONCLUSIONS:Compared with Yufeng ningxin tablet, S-SMEDDS capsules are absorbed more completely and removed faster.

The heel vessel belongs to the eight extra meridians in human meridian system, which is closely related to the human motion function. Balance function plays an essential role in successful completion of activities in daily life, so the physiological function and pathology of heel vessel as well as human balance function are analyzed, and from the aspect of running course of heel vessel and syndrome, the correlation between heel vessel and human balance function is explored, and the application status of acupoints related to heel vessel for balance dysfunction is introduced. It is believed that heel vessel is closely related to human balance function, especially the motion regulation mechanisms of balance function, and it is hoped that new ideas and methods can be provided for acupuncture treatment for the balance function disorders.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Meridians ; Postural Balance

OBJECTIVETo compare the differences in the clinical efficacy on post-stroke upper limb spasmodio hemiplegia among the combined therapy of relaxing needling (Huici) technique combined with wheat-grain moxibustion, simple relaxing needling and conventional acupuncture.

METHODSNinety patients were-randomized into a group with the combined therapy of relaxing needling technique combined with wheat-grain moxibustion (a combined therapy group), a simple relaxing needling group and a conventional acupuncture group, 30 cases in each group. In the combined therapy group, the relaxing needling technique was used in combination with wheat-grain moxibustion. The relaxing needling technique was applied to Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), etc. The wheat-grain moxibustion was applied to Qihai (CV 6), Guanyuan (CV 4), Mingmen (GV 4), etc. In thel simple relaxing needling group, the relaxing needling technique was used simply. In the conventional acupuncture group, the conventional lifting, thrusting and rotating technique with filiform needle was adopted at the same acupoints as the simple relaxing needling group. The treatment was given once every day; 6 treatments made one session. Totally 4 sessions were required, with 1 day at intervals. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA) and Barthel index (BD were adopted to assess the upper limb muscle tension, motor functioni and daily life activity.

RESULTSAfter treatment, MAS score was all reduced as compared with that before treatment in each group, and FMA score and BI score were increased as compared with those before treatment (all P<0.01). MAS score in the combined therapy group was lower than that in either the simple relaxing needling group or the conventional acupuncture group (both P<0.01), and the score in the simple relaxing needling group was lower than that in the conventional acupuncture group (P<0.05). FMA score and BI score in the combined therapy group were higher than those in the simple relaxing needling group and the conventional acupuncture group (both P<0.01). FMA score in the simple relaxing needleing group was higher than that the Enventional acupuncture group (P<0.05). The total effective rate in the combined therapy group was 93.3% (28/30), higher; than 86.7% (26/30) in the simple relaxing needling group (P<0.01), and 83.8% (25/30) in the conventionaP acupuncture group (P<0.01).

CONCLUSIONThe combined therapy of relaxing needling technique and wheat-grain moxibustion achieves more satisfactory efficacy on post-stroke upper limb spasmodic hemiplegia compared with the simple relaxing needling and conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Aged ; Combined Modality Therapy ; Female ; Hemiplegia ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Stroke ; complications ; Treatment Outcome ; Triticum ; chemistry

OBJECTIVE:To establish the quality standard for Solanum tuberdsm. METHODS:The microscopic characteristics were detected;TLC was used for qualitative identification;moisture,ash,heavy metals and the amount of extract were deter-mined;HPLC was conducted for content determination of oxidized cyanidin:the column was Alltima C18 with mobile phase of ace-tonitrile-0.1% trifluoroacetic acid(80∶20,V/V)at a flow rate of 1.0 ml/min,detection wavelength was 538 nm,column tempera-ture was 30℃. RESULTS:It showed clear microscopic identification map. S. tuberdsm TLC had clear spots and well separated. The water content was 8.5%-11.0%;total ash was 2.0%-2.9%;Pb was lower than 5 ppm and alcohol-soluble extracts was 15.6%-22.3%. The linear range of oxidized cyanidin was 0.043-0.215 μg(r=0.999 8);RSDs of precision,stability and reproduc-ibility tests were lower than 2.0%;recovery was 95.50%-99.65%(RSD=1.35%,n=9). CONCLUSIONS:The established method can be used for the quality control of S. tuberdsm.

Objective To investigate the safety of cleaning and disinfection of duodenoscope used in endoscopic retrograde cholangiopancreatography (ERCP).Methods The duodenoscopes,which were used in Endoscopy Center of Digestive Disease Hospital,Heilongjiang Provincial Hospital from May 4 to May 31 2016,were cleaned manually and disinfected with sterilization powder.The samples from elevator and elevator channel were collected for bacterial culture to evaluate the safety of clinical application of duodenoscope.Results Among 60 high level disinfections,one was excluded because disinfectant concentration wasn't effective.Among 59 elevator samples no positive cultures were detected,while among 59 channel samples,4(6.8％) cultures were positive and all from the same duodenoscope,including 3 cases of Klebsiella pneumonia and 1 case of Pseudomonas aeruginosa.Conclusion Sterilization powder is effective for disinfection of duodenoscope used for ERCP.Residual organic material can't be excluded from elevator sample even if it is negative for culture.Duodenoscope with high level disinfection still has the risk of transmitted infection,and should be monitored regularly by culture and reprocessed in time.

Objective To study the effect of long-time carbon dioxide (CO2) pneumoperitoneum on QT dispersion (QTd) in elderly patients during Davinci robotassisted surgery.Methods Thirty elderly patients undergoing elective Davinci robot-assisted hepato-pancreato-biliary surgery with general anesthesia were enrolled in this study.Pneumoperitoneum was established at 12 mm Hg ( 1 mm Hg =0.13 3 k Pa).QTd was recorded before the induction of anesthesia; at 5,15,30,60,120,180 and 240 min after pneumoperitoneum.Results Compared with before anesthesia,mean arterial blood pressure (MAP) increased significantly at 15,30 min after pneumoperitoneum ( P＜0.05 ),and had no significant difference at 5,60,120,180,240min (P＞0.05 ).Heart rate (HR) increased significantly at 15,30 min after pneumoperitoneum (P＜0.05 ).End-tidal pressure of carbon dioxide (PETCO2) increased after pneumoperi-toneum,and had significant difference at 30,60,120,180,240 min after pneumoperitoneum (P＜0.05).In 30 patients,11 patients occurred arrhythmia including atrial extrasystole,premature ventricular beats,tachycardia.Compared with before anesthesia,QTd,corrected QTd (QTcd),QT interval,corrected QT interval (QTe) were significantly increased at 15,30,60 min after pneumoperitoneum (P＜0.05),but had on significant difference at 5,120,180,240 min after pneumoperitoneum (P＞0.05).Conclusion The effect of CO2 pneumoperitoneum on the autonomic nervous system for elderly patients might be important,as an imbalance in autonomic cardiac control might lead to serious consequences.

OBJECTIVETo explore the protective mechanism of electroacupuncture (EA) at "Neiguan" (PC 6) on ischemic myocardial injury, and to explain the response patterns and characteristics of the specific effect of acupoints along meridians in sodium channel in the level of cardiac organ.

METHODSA total of 60 SPF male rats were randomly divided into a blank group, a model group, a non-acupoint group, a Neiguan group and a Lieque group, 12 cases in each one. Except the blank group, rats in the remaining group were treated with subcutaneous injection of isoprenaline to establish the model of myocardial ischemia. Rats in the Neiguan group, Lieque group and non- acupoint group were treated with EA, dilatational wave, with a frequency of 2 Hz/20 Hz. The intensity was 2-3 mA. The needles were retained for 20 min per time, once a day for consecutive 7 days. In the blank group and control group, the rats were grasped and fixed at the treating time each day. The western-blot method was used to test the expression of voltage-gated sodium channel alpha subunit (Nav 1.5), protein tyrosine kinase (PTKs) and protein tyrosine phosphatase (PTPs).

RESULTSThe expression of Nav 1.5 and PTKs in the model group was lower than that in the blank group (both P<0. 01); the expression in the Neiguan group and Lieque group was higher than that in the model group (all P < 0.01); the expression of Nav 1.5 and PTKs in the Neiguan group was higher than that in the Lieque group (both P < 0.01). The expression of PTPs in the model group and non-acupoint group was higher than that in the blank group (both P < 0.01); the expression of PTPs in the Neiguan group and Lieque group was significantly down-regulated, which was lower than the model group (both P < 0.01); the down-regulation in the Neiguan group was significantly different from that in the Lieque group (P < 0.05).

CONCLUSIONEA at "Neiguan" (PC 6), by down-regulating the expression of PTPs, up-regulating the expression of Nav 1.5 and PTKs, is likely to achieve the aim of regulation on sodium channel activity and calcium overload, further to improve myocardial ischemia, which provides experimental basis for the theory of the specific effect of acupoints along meridians.

Acupuncture Points ; Animals ; Disease Models, Animal ; Electroacupuncture ; Humans ; Male ; Myocardial Ischemia ; genetics ; metabolism ; therapy ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sodium Channels ; genetics ; metabolism