Objective　To determine the diversity of ureB gene of H. pylori for development of vaccines and evaluation of diagnostic kits by sequence analysis of ureB genes of 8 H. pylori. Methods　Primers were designed according to the sequence of strain 26695 and used to amplify the ureB gene of H. pylori (CAPM N62, CAMP N93, CAMP N98, CAMP F3). The PCR products were cloned into pGEM-T vector respectively and sequenced. The sequences of tested strains were compared with the corresponding regions of the GenBank strains (26695, J99, MD506, CPM630) and analyzed by DNA and Winstar software. Results　There are three kinds of length of ureB gene in all 8 strains. The lengths of ureB gene of CAMP F3 and CPM630 are 1269bp and 1680bp respectively. The others are 1710bp. The result of the sequence analysis of ureB gene of 6 strains of H. pylori with length of 1710bp indicated that the three foreign strains showed high homology in nucleotide acid and their homology were 100% in putative amino acid. The three domestic strains were closely related. Conclusions　As a potential protective antigen, ureB has the problem of variable coverage rate in different populations. In order to gain extensive coverage rate, it is important to find the antigen peptide of conservative ureB gene of H. pylori which is predominant in population.

Objective To evaluate the safety and effectiveness of one stage surgery of release and bone reduction by posterior approach to treat basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD),and to explore the indications and crucial techniques of posterior approach.Methods All of 17 Consecutive patients (8 males and 9 females) with BI and IAAD who underwent release and reduction by posterior approach from July 2000 to June 2015 were enrolled in the present study,the mean age was 35.2±13.8 years with a range of 12-56 years.The clinical symptoms and signs was recorded,and preoperative imaging examination,including anteroposterior,lateral,dynamic films,MRI and CT of cervical spine,were performed to identify the series.There were 14 cases with atlanto-occipital fusion,7 cases with C2,3 fusion,6 cases with Chiari malformation,6 cases with Syringomyelia,and 8 cases with myelomalacia.The clinic symptoms include occiput/neck pain in 15 cases,cervical movement limitation in 13 cases,short neck in 9 cases,torticollis in 12 cases,Paresthesia in 14 cases,weakness in 13 cases,tendon reflexes hyperfunction in 16 cases and ataxia in 13 cases.The postoperative X-rays,MRI or CT were used to observed the results of decompression,fixation and fusion.Neurological function was assessed by JOA scale and Ranawat's score before,after surgery and at final follow-up.Pre-and post-operative Chamberlain (CL),Wackenheim (WL),McGae (ML),atlantodental interval (ADI) and cervico-medullary angle (CMA) were analyzed by student t-test.Results The average operation time was 145 mins (90-210 mins) and blood loss was 175 ml (150-350 ml).The average follow-up was 44.47 months (9-94 months).JOA score was increased from 8.06 preoperatively to 15.20 postoperatively,the improvement rate was 77.2％.Preoperative Ranawat's score was Ⅱ in 1 case,Ⅲla in 12 cases,ⅢB in4 cases.Postoperative score was Ⅰ in 13 cases,Ⅱ in 4 cases.The preoperative CL,WL,ML,ADI and CMA were (12.52±5.17) mm,(6.59±3.04) mm,(6.96±4.32) mm,(9.88± 1.93) mm,115.35°± 12.40°,respectively.and the postoperative CL,WL,ML,ADI and CMA were (2.0±3.67) mm,(-3.06±1.85) mm,(-1.76±2.88) mm,(1.17± 1.18) mm,136.76°±11.44°,respectively.The perioperative complications were discovered in 2 cases,including 1 case of infection and1 case of cerebrospinal fluid(CSF) leakage.Conclusion Primary surgery of nerve release and bone reduction by posterior approach may be safe and efficient for the treatment of BI and IAAD.Preoperative evaluation,proper surgical indications and advanced surgical techniques are important for treatment results.

OBJECTIVE:To evaluate the economic effects of different doses of methylprednisolone treatment regimes on traumatic reaction in patients with cervical spondylotic myelopathy after anterior decompressive operation.METHODS:56cervical spondylotic myelopathy cases who have been subjected to anterior decompressive operation were chosen to be the sub-jects.The56cases were divided into3groups and treated with different dosage of methylprednisolone,the initial dose for group A(18cases,low dose group)was80mg;the initial dose for group B(21cases,medium dose group)was600mg and that for group C(17cases,large dose group)was1000mg,the improvement of clinical symptom of each group was observed re-spectively and the cost-effectivenesses of the three groups were compared.RESULTS:The costs of the A,B,C groups were990.00,1339.10and1886.70yuan respectively;the effectiveness rates(E)of the A,B,C groups were5.56%,14.29%and35.29%respectively;The costs for each unit of obvious effectiveness(C/E)of the A,B,C groups were178.06,93.71and53.46yuan respectively;On the basis of group A,the needed costs of group B and C were39.99and30.16yuan respectively for each obvious effectiveness unit increase(?C/?E).CONCLUSION:Compared with group A and B,the effectiveness rates of group C had a bigger increase while the needed cost for each unit of obvious effectiveness was the lowest,therefore,the dose regimen of group C is more rational.

Objective To discuss the clinical efficacy and surgical indications of one?stage transforaminal debridement, interbody fusion combined with posterior instrumentation for thoracolumbar spinal tuberculosis. Methods All of 34 patients with thoracolumbar spinal tuberculosis were retrospectively analyzed,treated by one?stage transforaminal debridement, interbody fusion and posterior instrumentation from June 2010 to April 2013, including 21 males and 13 females, aged 21 to 64 years old, av?erage 38.2 years. All patients were treated by preoperative quadruple antituberculosis drugs therapy for 2-4 weeks, postoperative regular chemotherapy for 12-18 months. Preoperative and postoperative changes in clinical symptoms, nervous function, the situa?tion of the erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) with strict follow?up, as well as other related compli?cations were observed. The spinal fusion rate and fusion situation, changing of the physiological curvature, as well as loosening or breaking of the internal fixation device were detected through regular imaging examination. Results The surgery duration time was 60-150 min, average 110 min, and the blood loss was 80-550 ml, average 320 ml. Cerebrospinal fluid leakage occurred in one case. All of the operations were completed successfully without nerve or spinal cord injuries. Postoperative follow?up time was 1 to 4 years, average 2.5 years. Clinical symptoms improved significantly in three months after operation. The visual analogue scale (VAS) improvement rate was about 93%. All patients' ESR and CRP returned to normal levels at the last follow?up. The Kirkaldy?Willis function score showed that the total fine rate was 94%. 12 cases of patients had various degrees of neurological dysfunction before operation, which were back to normal at the final follow?up, except one case of ASIA class B turned to C. Inci?sion fistula formation happened in one case at the third months after surgery, and the wound was healed after debridement. All pa?tients got solid fusion between vertebral body, and there was no graft absorption or collapse, pseudarthrosis, tuberculosis recur?rence, and loosening or breaking of internal fixation devices. Cunclusion One?stage transforaminal debridement, interbody fu?sion and posterior instrumentation is a simple, effective and safety surgical approach, which has great application value for surgi?cal treatment of patients with thoracolumbar spinal tuberculosis.

OBJECTIVE TTo evaluate the clinical manifestations of the laryngeal amyloidosis and its laryngoscopic characteristics.METHODS The clinical data of 11 cases with laryngeal amyloidosis confirmed pathologically was studied retrospectively. RESULTS There were 4 males and 7 females in this study.The age of the patients ranged from 16 to 64 years old (average 43.36?4.16).The duration of symptoms was 4 months to 10 years (average 2.85?0.87 years).Hoarseness presented in 10 patients (90.90%) and dyspnea in 4 patients.The false vocal cord was involved in 8 patients,laryngeal ventricle in 6 patients,true vocal cord in 5 patients and subglottic area in 3 patients observed with fibrolaryngoscope. The appearance of the lesions was mainly described as waxy yellow or yellow-gray submucosal plaques and nodules without ulceration of the overlying mucosa.The laryngostroboscopy demonstrated that the wave of the mucosa and vibration of the involved vocal cords were adynamic or disappeared.CONCLUSION The chief complaint of the laryngeal amyloidosis was hoarseness. Laryngeal amyloidosis is a slowly progressive disease. The lesions commonly involve the false vocal cord, laryngeal ventricle,true vocal cord and subglottic area.

Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

Objective To establish the separation and expansion method of human umbilical cord derived mesenchymal stem cells (hUCMSCs) and explore the influence of 1,25 (OH)2VD3 on hUCMSCs in vitro.Methods UCMSCs were cultured from adherent tissue pieces and detected by immunohistochemistry.Taking the third generation with good growth state UCMSCs make intervene experiment.Set 10-7 mol/L,10-9mol/L and 10-11 mol/L 3 kind of concentration of 1,25(OH)2VD3 as the experimental group,and a control group (DMEM medium).The morphologic change of UCMSCs was observed by inverted microscope.Observe the cell proliferation by the method of MTT.Detect alkaline phosphatase assay and type Ⅰ collagen assay from immunohistochemistry.And the calcium tubercle formation would be examined after 21 days.Results UCMSCs were cultured from adherent tissue pieces and strongly positive for CD44,CD105 and negative for CD34,CD45.consistent with the hUCMSCs characteristics.Under different concentration of 1,25 (OH)2VD3hUCMSCs proliferation were promoted within 7 days but were suppressed beyond 7 days.The high doses group ( 10-7 mol/L group ) obvious inhibitted the stem cell proliferation.Different concentrations of 1,25 (OH)2VD3 and days have interactive effect (P ＜ 0.05).The differences between different groups with ALP and type Ⅰ collagen assay has statistical difference (P ＜ 0.05).The secretion of ALP and type Ⅰ collagen assay of 10-7 mol/Lconcentration group was higher than others.Typical mineralization nedus was found in intervene groups.Conclusion HUCMSCs can be successfully cultured from the adherent tissue pieces.1,25(OH)2VD3 can effectively induce hUCMSCs to differentiate into osteoblasts in vitro.

Periosteal autograft from different sources have been used to repair 1.5cm bone defects of radius in 10 rabbits.On the left side,sharp-dissected grafts were implanted and the animals were sacrificed 4,8,14,30 and 60 days after operation.Bone formation was studied with X-ray and histologic technique.The results showed that the way of sharp-dissecting can preserve the periosteum completely,and good bone formation was found in this group.It suggested that the sharp-dissecting of the periosteum is the important key for periosteal graft.

Cochlear Implantation ; Cochlear Implants ; Humans ; Vestibulocochlear Nerve Diseases

Periosteal autograft from different sources have been used to repair 1 5cm bone defects of radius in 10 rabbits.On the left side,sharp dissected grafts were implanted and the animals were sacrificed 4,8,14,30 and 60 days after operation.Bone formation was studied with X ray and histologic technique.The results showed that the way of sharp dissecting can preserve the periosteum completely,and good bone formation was found in this group.It suggested that the sharp dissecting of the periosteum is the important key for periosteal graft.