Posterior pedicle fixation-based dynamic stabilization is now densely studied in the non-fusion spine surgery. The method is characterized by the motion preservation of segmental lumbar, avoidance of the stress change after fusion surgery, and adjacent disc degeneration. Posterior pedicle fixation-based dynamic stabilization systems have undergone fast development and are now used for the treatment of degenerative lumbar spine disease. As an innovation of traditional fusion surgery, the clinical evaluation of its efficacy has become a focus of study among spine surgeons. In this paper, we review the recent progress in the clinical efficacy of posterior pedicle fixation-based dynamic stabilization.

Adult ; Arterial Occlusive Diseases ; etiology ; Arteritis ; complications ; Coronary Artery Disease ; etiology ; Female ; Humans

Objective To explore the expressions of adiponectin and adiponectin receptor 2 (AdipoR2) in the liver of patients with hepatitis B virus (HBV)-related liver failure and their clinical implications in the pathogenesis of liver failure.Methods The healthy controls (HC),patients with chronic hepatitis B (CHB) and patients with HBV-related liver failure (HBV-LF) were enrolled in the study.Each group had 20 participants.The liver tissues from 11 CHB patients who were diagnosed by liver biopsy,6 patients with HBV-LF and 6 liver donors during liver transplantation were collected.Histological specimens were observed by hematoxylin-eosin staining and Masson trichrome staining under microscope.The mRNA and protein expressions of adiponectin and AdipoR2 in the liver were measured by semi-quantitative reverse transcription and polymerase chain reaction (SqRT-PCR) and immunohistochemical staining,respectively.The level of serum adiponectin was detected by enzymelinked immunsorbent assay.Serum biochemical parameters and HBV DNA levels were also measured.The pairwise comparison between groups was done by Student-Newman-Keuls and mann whitney U test.The relationship between two variables was analyzed using Spearman correlation.Results The level of serum adiponectin in HBV-LF group [(0.86 ± 0.15) ng/mL] was higher than those in HC [(0.59±0.15) ng/mL] and CHB groups [(0.62±0.13) ng/mL,Z=3.963,Z=3.774,both P＜0.01)],but showing no difference between CHB and HC groups (P＞0.05).The expressions of adiponectin and AdipoR2 mRNA in the liver were significantly higher in HBV-LF group (0.251 ±0.028 and 0.223 ± 0.021,respectively) than those in HC (0.091 ± 0.018 and 0.072 ± 0.020,respectively) and CHB (0.121±0.019 and 0.097±0.017,respectively) groups (q=18.428,17.069,19.807,18.673,respectively; all P＜0.01).Also,the expressions of adiponectin and AdipoR2 mRNA in CHB group were significantly higher than those in HC group (q=3.895,3.860,both P＜0.05).The expressions of adiponectin and AdipoR2 proteins in the liver were significantly higher in HBV-LF group (8.482±0.772 and 7.654±0.272,respectively) than those in HC (4.045± 0.815 and 2.804±0.623,respectively) and CHB (5.545±0.613 and 4.775±0.458,respectively) groups (q=15.327,11.542; Z=2.802,3.266; respectively; all P＜0.01).Also,the expressions of adiponectin,AdipoR2 proteins in CHB group were significantly higher than those in HC group (q=5.894,Z=3.266,both P＜0.01).In HBV-LF group,serum adiponectin levels as well as the expressions of adiponectin mRNA and protein in the liver were negatively correlated with serum albumin (r=-0.815,-0.886,-0.943; P＜0.01 or P＜0.05),but positively correlated with serum alanine aminotransferase (r=0.701,0.886,0.943; P＜0.01 or P＜0.05).The expression of AdipoR2 mRNA in the liver was negatively correlated with serum albumin (r=-0.943,P＜0.01),but positively correlated with serum aspartate aminotransferase (r=0.829,P＜0.05).Conclusions The expressions of adiponectin and AdipoR2 are up-regulated during HBV infection,especially in patients with HBV-LF,which might reflect the degree of necroinflammation in the liver.

AMPARs are excitatory glutamate receptors that mediate the fast synaptic transmission. AMPARs are homo- or hetero-tetramers composed of selective combinations of four subunits: GluR1, GluR2, GluR3 and GluR4. AMPARs containing GluR2 are mainly in the central nervous system and are Ca2+ impermeable. MPARs-lacking GluR2 are Ca2+ permeable, and GluR2-lacking AMPARs are confined to certain neurons or certain physiological or pathological conditions. Recent research showed that GluR2-lacking AMPARs play special roles in the synaptic function and plasticity and transduction of local signal transduction. This paper reviews the GluR2-lacking AMPARs and their roles in the synaptic function and plasticity.

Acidosis ; etiology ; Humans ; Kidney Diseases ; etiology ; Toluene ; toxicity

Background Vitretomy and lenstomy with silicone oil tamponade is an effective method for complicated vitreous retinopathy.The severe anisometropia after silicone retention is usually treated by two-point transscleral suture fixation for posterior chamber intraocular lens(IOL)implantation.In order to reduce the number and difficulty and complication of the operation,the surgical method should be improved.Objective The goal of this study was to observe the resuh of silicone oil removal combined with four-point trans-scleral suture fixation of posterior chamber IOL after vitrectomy.Methods A retrospective case-observational study design was adopted.Twenty eyes with silicone oil tamponade from 20 patients without lens and posterior capsule after vitrectomy were included in this study.Silicone oil removal with four-point trans-scleral suture fixation of posterior chamber IOL was performed.The anterior ocular inflammatory response,intraocular pressure,uncorrected and corrected acuities before and after operation,corneal endothelial cell counting and postoperative complications were observed and analyzed.Written informed consent was obtained from all patients prior to the operation.Results All of the operative eyes in this study showed improvement of visual acuity after operation.Of the 20 eyes,a visual acuity of ≥0.8 was seen in 2 eyes,0.6-0.7 in 6 eyes,0.3-0.5 in 8 eyes and 0.05-0.2 in 4 eyes 3 months after the removal of silicone oil.The uncorrected acuity postoperation was significantly improved in comparison with preoperation(H=10.147,P＜0.01),but no significant difference was found in the corrected acuity between preoperation and postoperation(X =2.089,P＜ 0.01).The number of the corneal endothelial cells was(2064±329)cells/mm2 before operation,and that after operation was(1987±269)cells/mm2,showing an insignificant change between them(t =1.660,P ＞ 0.05).No abnormality of IOL position was found in all 20 operated eyes.There was not serious postoperative complication in all 20 patients.Conclusions The combination of silicon oil extraction with four-point transscleral suture fixation IOL is effective in eyes without posterior capsule or lens after vitrectomy.It can reduce the operation time and improve the postoperative acuity and the quality of life of patients.

Objective To explore the biological activities and the MR imaging signal intensities (SIs) characteristics of differentiations of neural-like cells induced by superparamagnetic iron oxide (SPIO)
and green fluorescent protein (GFP) double-labeled bone marrow-derived mesenchymal stem cells (BMSCs) in vitro. Methods GFP-BMSCs were labeled with different concentrations of SPIO in vitro (the concentration of the A, B, C and D group was 25, 50, 75 and 100 ug/ml, respectively;the E group without labels of SPIO served as the control group). The Prussian blue stainings were used to detect the labeling rates of SPIO. The iron contents of cells were measured by atomic absorption spectrometer. The CCK8 experiments were used to detect the cell proliferation rates. The cell cycles were detect by PCR. Each of the A-E groups had a test tube with 1 × 108 cells. All test tubes underwent T2* weighted imaging (T2*WI) and susceptibility weighted imaging (SWI) in a MR imaging scanner. The optimal group was defined by comparing the measurements of SIs between T2*WI and SWI. The optimal group and the E group together induced the differentiations of osteogenesis and neural-like cells. The stainings of alizarin red, osteocalcin and Nissl, NeuN, and NF-200 were performed at 72 hours. Real-time quantitative PCR was used to detect the expression levels of RNA in tub3, nestin, NSE, MAP-2 and Syt1. The positive staining rates and the expression levels of RNA were compared between the two groups. Finally, SWI was used to analyse the changes of SIs. One-way analysis of variance (ANOVA) was used to the multi-group comparison. Using least significant difference (LSD) test to analyse the comparisons between the multi-groups. Results The labeling rates of the A-D groups were 100%. The iron contents of cells in the A-E groups were (14.36 ± 7.61), (21.73±3.42), (30.54±8.73), (33.65±9.62), and (2.31±0.32) pg/cell, respectively. The iron contents of cells in the A-D groups were significantly higher than those in the E group ( F=3.852, P=0.003). There was no significant difference between the C and D groups (P=0.267). In all groups, the D group had the lowest OD value in the CCK-8 experiments (3.18 ± 0.46). In the A-E groups, the changes of SIs in SWI were significantly lower than those in T*2 WI. There was no significant difference in SIs of SWI between the C group (145.89±14.31) and the D group (127.37±12.21). Except the comparison between the group C and D, the comparisons between all the groups had significant differences (P<0.001). The percentages of SI attenuations in SWI and T*2 WI were 48.15% and 69.34%, respectively. The proportions of non-neurons cells and the positive rates of Nissl's stainings in group C and E had no significant differences (P>0.05). The expression levels of tub3, nestin and NSE were significantly higher before than after induced differentiations (P<0.01). SIs of SWI had no significant difference between before and after induced differentiations in the C group (t=1.26, P=0.236). Conclusions SPIO and GFP double-labeled BMSCs can induce neural-like cells without influencing biologic activities. MR SIs are decreased by the increase of SPIO concentrations in cells. SWI was the most sensitive sequence. The SIs of SWI has no differnce between before and after induced differentiations.

ObjectiveTo investigate the effects and molecular mechanism of simvastatin in liver fibrosis model of non-alcoholic fatty liver disease (NAFLD) in vivo and hepatic stellate cell in vitro.MethodsFirstly,the rat liver fibrosis model of NAFLD was established by high-fat diet administration and intervened with simvastatin.The expression of endothelial nitric oxide synthase (eNOS),inducible nitric oxide synthase (iNOS) and Collagen Ⅰ at mRNA and protein level were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.Secondly,quiescent phenotype of LX-2 cell line was induced by promoting adipocyte differentiation medium in vitro,and then the quiescent phenotype of LX-2 cell were treated with transforming growth factor β1(TGF-β1),Nitroso-L-arginine methyl ester (L-NAME) which was NOS inhibitor,simvastatin,TGFβ1 with simvastatin,and L-NAME with simvastatin separately.The changes of eNOS,iNOS,αsmooth muscle actin (α-SMA) and Collagen Ⅰexpressions at mRNA and protein level were determined by RT-PCR and Western blot.ResultsAs modeling time extended,the expressions of eNOS in rat's liver tissue of model group at mRNA and protein level decreased gradually,however the expression of iNOS and Collagen Ⅰ at mRNA and protein level increased gradually,compared with normal control group and the differences were statistically significant (P ＜0.05 and 0.01).By 24weeks,the expressions of eNOS in rat's liver tissue of simvastatin group at mRNA and protein level were increased,the expression of iNOS at mRNA and protein level were decreased and the expression of Collagen Ⅰ at mRNA and protein level were decreased (all P ＜0.05).The expression of eNOS in rat's liver tissue of model group negatively correlated with the expression of Collagen Ⅰ at mRNA and protein level (all P ＜0.01).The expression of iNOS positively correlated with that of Collagen Ⅰ at mRNA and protein level (all P ＜0.01).In LX-2 cell culture,L-NAME inhibited the activation of LX-2,reduced eNOS and iNOS expression and increased α-SMA and CollagenⅠexpression,consistent with the role of TGF-β1.Simvastatin could directly increase the eNOS expression both in quiescent and activated LX-2 cells,decrease iNOS expression,maintain quiescent phenotype and inhibit its activation.ConclusionsSimvastatin ameliorated the genesis and progression of liver fibrosis by increasing eNOS expression in LX-2 cells and reducing iNOS,α-SMA and Collagen Ⅰ expression.

To explore the effect of Kudiezi injection on renal function in the real world, in order to provide the basis for the clinical medication safety. Patient aged between 18-80 were selected from 18 large hospitals information system (HIS) databases established by clinical research institute for basic traditional Chinese medicine of China academy of Chinese medical sciences. The patients who were treated with Kudiezi injection (24 225 cases) were defined as the exposed group, whereas those who were not treated with Kudiezi injection (14,191 cases) were defined as the non-exposed group. The propensity score method was used to balance the confounding factors. Classic logistic regression, GBM weighted propensity score logistic regression, GBM propensity score weighted logistic regression with covariate and sensitivity analysis were adopted to study the effect of Kudiezi injection on renal function. The results showed no significant difference in the possibility in abnormality in serum creatinine (Scr) (P = 0.940, 0.679, 0.834) and urea nitrogen (BUN) (P = 0, 0.045, 0.164) between both groups. Therefore, the existing data indicated no damage of Kudiezi injection on renal function. Because this study is a retrospective study based on the real world, there may be unknown confounding factors and potential bias. Therefore, further studies shall be conducted to monitor whether Kudiezi injection causes damage on renal function, in order to ensure the clinical medication safety.
Blood Urea Nitrogen ; Drugs, Chinese Herbal ; adverse effects ; Hospital Information Systems ; Humans ; Injections ; Kidney ; drug effects ; physiology ; Kidney Function Tests ; Logistic Models ; Propensity Score ; Retrospective Studies

Objective To measure the peak skin dose (PSD) in two cardiovascular interventional procedures,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) using radiochromic film.Methods Gafchromic XR-RV3 film was selected to measure PSD in two hospitals.The films were placed on the table underneath the patient during interventional surgery.The kV,mA,fluoroscopy time,dose-area product (DAP),and cumulative dose at reference point and other relevant information were recorded for all cases.Using the Epson V750 flatbed scanner for scanning and analyzing film,FilmQA software was chosen to analyze the pixel value of red,green and blue color channels.The PSD was determined using red channel data.The correlation and linear regression analysis between PSD and device-displayed parameters was carried out.Results PSD were measured using XR-RV3 film for 26 CA and 19 CA + PTCA procedures.For CA procedures,maximum fluoroscopy time,cumulative dose and DAP were 17.62 min,1 498.50 mGy and 109.68 Gy · cm2,respectively.The maximum PSD was 361.20 mGy.However,for CA + PTCA procedures,maximum fluoroscopy time,cumulative dose and DAP were 64.48 min,6 976.20 mGy and 5 336.00 Gy· cm2,respectively.One patient with CA + PTCA procedures was found to have received the PSD value more than 2 Gy,up to 2 195.70 mGy.DAP was found to be a good indicator (R2 =0.815,P ＜0.05) of PSD for CA procedure,and correlated with cumulative dose (R2 =0.916,P ＜ 0.05) for CA + PTCA procedures.Conclusions The PSD value of some patients in cardiac interventional procedures would exceed 2 Gy,the threshold of deterministic effects recommended by ICRP.The dose-related parameters value showed on DSA device can only used to estimate PSD roughly.Using XR-RV3 film accurate measurement of the PSD in interventional projects is a very fast and effective method.