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.

Objective To understand the influence of operation to quality of life by evaluating the QoL of the patients with rectal cancer, before and after the Miles' operation. Methods To select 57 patients received Miles operation. To evaluate the quality of life of the 57 sample patients that before Miles' operation and the first, the sixth, the twelfth month after the operation by using the QoL evaluation sheet. Results The QoL score of the rectal cancer patients after operation is obviously lower than that before operation [(89.24±10.62) vs (106.32±11.2.9, P<0.01]; the QoL scores the 12th month after operation is obviously higher than before operation [(114.05±8.20) vs (106.32±11.29), P<0.05]. Conclusion The recent QoL of the patients with rectal caucer after Miles' operation was descents obviously, but the long-term QoL of the patients after operation promotes obviously.

Objective To determine the three dimensional motion data of each segment of cervical vertebrae and analyze the characteristics of the intervertebral coupled motion during cervical axial rotation under physiological weight bearing. Methods A total of 16 healthy volunteers (ranging from 22 to 29, median age, 23 years) were recruited to our study. Any cervical spine disorder history, pain or other discomfort and malformations were excluded so as to avoid abnormal neck motion. These subjects underwent CT scans of their cervical segments in a supine position, and 3D models of C1-C7 were constructed. Next, each subject was asked to sit up straight and was positioned in the following sequence:maximal left and right twisting, while double oblique images by DFIS were taken simultaneously at each of the positions. Then, the CT models were matched to the osseous outlines of the images from the two oblique views to quantify the position of cervical vertebraes in 3D at each position. Through local coordinate systems at the center of vertebral bodies, changes of position and angle of each cephalad vertebrae relative to the cauddal one were calculated before and after the axial rotation. Results (1) In the axial rotation of the cervical spine, the contribution of C1/2 accounted for the most of the total cervical rotation range. For the lower levels, axial rotation was found to be maximal at C3/4 and C5/6, minimal at C2/3. (2) In cervical axial motion, C1/2 demonstrated a coupled lateral bending opposite to the axial rotation direction, while each segment of C2-7 demonstrated coupled lateral bending towards the same side of the axial rotation. Among these segments the lateral bending angle of C2/3 was smaller than angles of C3/4, C4/5 and C5/6. Conclusion This study investigated the cervical coupling behavior using the noninvasive 2D-3D matching technique and obtained the motion data at each cervical spinal segment. These findings will help to improve the understanding on physiological cervical spine movement and potential biomechanical mechanism and treatment of cervical spondylosis. Also our data may provide useful reference for the prosthesis design.

OBJECTIVETo observe the clinical efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension (PAH) in children.

METHODSFifty children (aged 2 months to 2 years) with high altitude heart disease associated with severe PAH, who were continuously transferred to the Intensive Care Unit between January 2011 and October 2013, were randomly assigned to observation and control groups. The control group was given conventional treatment, while the observation group received oral sildenafil [1 mg/(kg . d)] three times daily for 7-10 days in addition to the conventional treatment. Before and after treatment, hemodynamics, blood gas, routine blood parameters, and blood biochemical parameters were recorded.

RESULTSAfter treatment, the observation group had a significantly higher decrease in mean pulmonary artery pressure and significantly higher increases in arterial partial pressure of oxygen, cardiac output, cardiac index, and oxygenation index compared with the control group (P<0.05). In the observation group, there were no significant changes in mean arterial pressure, routine blood parameters and blood biochemical parameters (P>0.05), and no obvious adverse reactions were found.

CONCLUSIONSFor children with high altitude heart disease associated with severe PAH, sildenafil can effectively reduce pulmonary artery pressure and improve cardiac function and does not cause adverse reactions. This therapy has good safety according to the preliminary evaluation.

Altitude ; Familial Primary Pulmonary Hypertension ; Female ; Heart Diseases ; drug therapy ; Humans ; Hypertension, Pulmonary ; complications ; physiopathology ; Infant ; Male ; Piperazines ; adverse effects ; therapeutic use ; Purines ; adverse effects ; therapeutic use ; Sildenafil Citrate ; Sulfones ; adverse effects ; therapeutic use ; Vasodilator Agents ; adverse effects ; therapeutic use

Considering the core concept of the system theory,the author describes the conception,components and main functions of the subjects,the objects and behavioral factors for the popularization and application of appropriate health technologies.This theoretically built up the system model for transfer and application of the appropriate health technologies in Chinese rural areas.

Objective To investigate the effect of cyclosporine A(CsA)on viral protein syn- thesis and hepatitis B virus(HBV)DNA replication in vitro.Methods The HBV DNA transfected cell line HepG2.2.15 was treated with different concentration of CsA(0.6-20.0?g/ml)for 4 days. Hepatitis B surface antigen(HBsAg)and hepatitis B e antigen(HBeAg)in supernatant were detected by enzyme-linked immunosorbentassay(ELISA);intracellular hepatitis B core antigen(HBcAg)mR- NA and HBV DNA were analyzed by RT-PCR and slot blot hybridization,respectively;the phospho- rylation at tyrosine acid position 402 of PyK2 kinase(PyK2 Y402)was detected by Western blot.Re- sults CsA could suppress the expression of HBsAg and HBeAg,and inhibit the HBV DNA replica- tion in a dose-dependent manner.The suppression rate of HBsAg and HBeAg under the action of CsA at the concentration of 10.0?g/ml for 4 days was 49.7% and 34.3%,respective;similar effect was observed on HBV DNA replication,HBV DNA was only 34.9% of the control at the concentration of 10.0?g/ml of CsA.The phosphorylation level of PyK2 Y402 was declined under the action of CsA at the concentration of 2.0?g/ml.Conclusions CsA can inhibit the expression of HBsAg,HBeAg and HBV DNA replication in the HepG2.2.15 cell line in a dose-dependent manner.Suppression of the phosphorylation level of PyK2 Y402 maybe involved in the mechanism of the inhibitory activity of CsA on HBV replication.

This paper discussed in detail the external macro factors and internal key function mechanisms of the transformation and application system for appropriate health technologies in rural areas.The macro components include political factors,social factors,population factors,environmental factors and health policy factors.The internal key function mechanisms include policy mechanism,benefit mechanism and guarantee mechanism.

OBJECTIVE:To provide reference for further improving negotiation mechanism of drug medical insurance in Chi-na. METHODS:Questionnaire investigation was conducted among the medical insurance agency and pharmaceutical company staff who participated in drug medical insurance negotiation in Jiangsu province,Jiangxi province,Qingdao,Chengdu. Their business fa-miliarity and recognition of the negotiating mechanism were also investigated. The descriptive analysis,independent sample t test and other methods were adopted to analyze the data statistically. RESULTS:A total of 70 questionnaires were distributed and 68 val-id questionnaires were collected with effective recovery rate of 97.14%. Respondents included 21 staff members of medical insur-ance agencies and 47 of pharmaceutical companies. In terms of business familiarity,the average score of respondents in all aspects was greater than 3(4 points system),the lowest score wasmanagement of the implementation of drug negotiation projects. There were statistical significances in scores of 3 items between 2 parties in the negotiation(P<0.05):basic principles of the drug negotiation process should be followednegotiation objectives in the substantive negotiation process total score of busi-ness familiarity. The scores of respondents in pharmaceutical companies were higher than those of health insurance agencies. In the recognition of the negotiating mechanism,average score of each survey item was ≥4(5 points system)in the recognition of the overall effect of the negotiation mechanism except forwhich is conducive to maintaining the price system of pharmaceutical com-panies. The average score of all aspects of preparation of the negotiations,substantive negotiation,implementation of the negotia-tion agreement and negotiation project's supervision and evaluation was >4 except forpatients taking drugs is quick and easy. There was no statistical significance between 2 types of respondents in all aspects of overall effect of the negotiation mechanism, preparation of the negotiations and negotiation project's supervision and evaluation(P>0.05). But in the recognition of the substan-tive negotiation,there was statistically significance between 2 types of respondents innegotiations between the two sides in an equal,cooperative,harmonious atmosphere(P<0.05). Healthcare agencies'respondents had higher scores than pharmaceutical companies'ones. And in the recognition of the implementation of the negotiation agreement,there was statistical significance be-tween 2 types of respondents in theafter the agreement entered into force,the medical insurance agency will be strictly in accor-dance with the agreementandfund pay to pharmaceutical companies timely and reasonable(P≤0.05). Healthcare agencies're-spondents have higher scores for than pharmaceutical companies'ones. CONCLUSIONS:The current drug medical insurance nego-tiation mechanism shows good overall effect and runs smoothly. But there are still some shortages,such as collected information the preparation stage is not sufficient;the procedures of patients taking the drug is complicated;negotiating parties do not have equal status;the fund is not paid to the pharmaceutical enterprise timely;evaluation is not perfect.

Objective To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results (1)LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion(14%vs 58%), larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5± 4.6), lower vasual analogue scalescore(VAS) pain score (2.1 ± 1.6 vs 3.0 ± 1.1), shorter gastrointestinal recovery time [(2.6 ± 0.8) vs (3.5 ± 0.9) days] and shorter hospital stay [(9.9 ± 2.9) vs (11.3 ± 5.0) days] when compared with LPT group (all P<0.01). No significant difference were found in operation time, number of para-aortic lymph nodes, rate of postoperative upstaging and adjuvant chemotherapy between the two groups (all P>0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19%(6/31),χ2=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ2=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874). Conclusion Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.

A complete explanation of the new idea,grounds,spirit,inner-contradiction of the 3 major documents in the new framework of epileptic knowledge re-defined by International League Against Epilepsy was made in accordance with the International League Against Epilepsy original articles.And the different recognition about them nowadays existed among our nerologists was also deeply explored.