Objective To explore the prevalence of multilevel lumbar spondylolysis in operation patients,and to evaluate the diagnostic value of CT reconstruction on multilevel lumbar spondylolysis.Methods A total of 312 patients,who had undergone surgical treatment in our hospital from January 2004 to March 2012 for lumbar spondylolysis,were enrolled in this study.There were 147 males (47％) and 165 females (53％),aged from 12 to 76 years (average,44 years).Every patient underwent lumbar spine X-ray examination including anteroposterior,lateral,over-flexion,over-extension and double oblique X-rays,as well as CT examination.The prevalence of multilevel lumbar spondylolysis in all operation patients and the involved segments were recorded and analyzed.Moreover,the clinical manifestation and radiological features were summarized.Results In all enrolled patients,there were 9 patients (2.9％) with multilevel lumbar spondylolysis,including 5 males and 4 females,aged from 21 to 51 years (average,39 years).As for lesion distribution,there were 8 cases of bilateral spondylolysis located at both L4 and L5,and 1 case of bilateral spondylolysis at L5 combined with right spondylolysis of L4 and discontinuity in the base of left pedicle of L4.Among 9 patients,only 3 patients obtained correct diagnosis by anteroposterior and double oblique X-rays of the lumbar spine,while all patients got final diagnosis by sagittal and oblique coronal reconstruction of lumbar spine CT scan.The oblique coronal CT reconstruction could show the details of bone defect in lumbar vertebral isthmus,bony callus,peripheral osteophytes,as well as fibroplasia.For unilateral lumbar spondylolysis,the oblique coronal CT reconstruction could also show the reactive sclerosis in contralateral lamina of vertebra.Conclusion Multilevel lumbar spondylolysis is not rare in operation patients,and L4 and L5 are most common involved levels.Sagittal and oblique coronal reconstruction of lumbar spine CT scan is more accurate in showing the details of lumbar spondylolysis,which is helpful in decreasing the missed diagnosis and improving therapy.

Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Trichloroacetic Acid ; urine

Objective To study the effect and mechanism of Xinkai Kujiang method(TCM treatment with the pungent and bitter herbs to regulate the gastrofunctions)on the functional dyspepsia(FD)rats.Methods Twenty-four rats were randomized into control group,model group,and Weikangning(herbal medicine for dyspepsia)group,with 8 in each.After a 7-day adaptive feed,the FD models were made with the clipping tail stimulation.Seven days after modeling,the Weikangning group was given Weikangning Capsule 0.625g/kg by gavage,twice a day,and the other two groups were given normal saline in the same dosage.The medication was appliey in succession for 12 days,and on the thirteenth day,the serum and gastric tissues were collected for detecting the lab indications:plasma motilin(MTL),plasma nitric oxide(NO),gastric tissue MTL,nitric oxide synthase(NOS),and the expression of Cajal interstitial cells(ICC)and gastrointesinal smooth muscle cells(SMC).Results Compared with the control group,the level of plasma MTL in the model group was significantly decreased,the level of NO significantly increased,and the expression of MTL,ICC and SMC positive neurons in the stomach myenteric nerve plexus was significantly weakened,but the expression of NOS positive neurons was significantly strengthened(P

This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood

OBJECTIVETo determine the interaction between miR-21 and DNA methylation in different breast cancer cells.

METHODSFluorescence tagged miR-21 inhibitor and its negative control (NC) were transient transfected into MCF-7 and MDA-MB-231 cell, the transfection efficiency was observed using fluorescence microscopy, and the miR-21 expression level and genome DNA methylation status before and after transfection were assessed by real-time PCR and bisulfite-qMSP respectively. To investigate the regulation effect of DNA methylation on miR-21, cells were treated with 5-AZA (2.5 µmol/L) for 72 h, with dimethyl sulfoxide (DMSO) treatment as its negative control (NC), and the expression level of phosphatase and tensin homolog deleted on chromosome ten (PTEN) and AKT(also known as Protein Kinase B), two downstream genes of miR-21 were detected by Western blot.

RESULTSThe expression of miR-21 in MCF-7 cell was significantly knocked down (P < 0.01) by miR-21 inhibitor, with the genome DNA methylation level (P < 0.05) and all the three Dnmts: Dnmt1, Dnmt3a, and Dnmt3b unregulated. In contrast, the miR-21 expression in MDA-MB-231 cell was elevated ( P < 0.01) by miR-21 inhibitor, meanwhile, down- regulated of genome DNA methylation (P < 0.05) and Dnmt3b expression, upregulation of Dnmt3a were also observed. In addition, treated with 5-AZA resulted in significant increases of miR-21 expression in both MCF-7 and MDA-MB-231 cells (P < 0.01), with the protein level of PTEN increased in MCF-7 cell, which was further involved in the downregulation of AKT.

CONCLUSIONThe regulation effects of DNA methylation by transient transfection of miR-21 in MCF-7 and MDA-MB-231 cells are almost opposite, whilst the expression of miR-21 in two cell lines were all upregulated by decreased DNA methylation level and our results may provide some experimental evidences for the future development of rational therapy for different breast cancer.

Azacitidine ; Breast Neoplasms ; genetics ; Cell Line, Tumor ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; metabolism ; DNA Methylation ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Humans ; MCF-7 Cells ; MicroRNAs ; genetics ; PTEN Phosphohydrolase ; metabolism ; Promoter Regions, Genetic ; Proto-Oncogene Proteins c-akt ; metabolism ; Real-Time Polymerase Chain Reaction ; Up-Regulation

Objective To observe the abnormality of gray matter volume and density in patients undergoing postoperative delirium (POD).Methods Forty-seven cases of aged patients, 26 males and 21 females, aged 60-75 years, ASA physical status Ⅱ or Ⅲ, were selected.On the third day after operation, cognitive function estimation was performed.The patients were assigned into group POD and group C according to whether POD occurred and brain magnetic resonance imaging (MRI) scanning was implemented.The discrepancy in gray matter volume and density between the two groups were compared using voxel-based morphometry method (VBM).Correlation analysis was performed between the corresponding parameters in the regions where notable differences between the two groups existed and minimum mental state examination (MMSE) score were found.Results Global gray matter volume of group POD was notably lower than that of group C (P<0.01).Cerebrospinal fluid volume of group POD was significantly higher than that of group C (P<0.01).Gray matter volume of bilateral frontal gyrus and right parahippocampus was remarkably reduced in group POD (P<0.001).Gray matter density of bilateral hippocampus and right parahippocampus decreased significantly (P<0.001).Right parahippocampal gray matter volume was positively correlated with MMSE score in POD patients (P<0.05).Conclusion Structural abnormality in frontal regions, hippocampus and parahippocampus may play an important role in pathogenetic and developing process of POD.Gray matter volume in the right parahippocampus may be one of reference index for POD severity.

This paper focuses mainly on the study of optimal fermentation conditions of S-adenosyl-L-methionine.Effects of carbon sources,nitrogen sources,inorganic constituents,growth factors and adding time of L-methionine on the yield,the content and biomass of S-adenosyl-L-methionine are studied.And ingredients of the culture medium are also optimized by the method of uniform design.The final optimum culture medium contains: glucose 30 g,Yeast powder 11 g,(NH_4)_2SO_4 12 g,K_2HPO_4?3H_2O 5 g,KH_2PO_4 10 g,MnSO_4?H_2O 0.09 g,ZnSO_4?7H_2O 0.14 g,MgCl_20.5 g,CaCl_2 0.3 g,CuSO_4 0.005 g per liter. Using that optimum culture medium,the yield of S-adenosyl-L-methionine can reach 0.9 g/L in Erlenmeyer flask which is 30 % higher than before.Experiment on 5 L fermenter reveals that the accumulation of S-adenosyl-L-methionine can reach 2.66 g/L.Biomass is 23.4 g/L.

Objective To investigate the effect of perioperative pulmonary infection in elderly patients with mild to moderate chronic obstructive pulmonary disease (COPD) undergoing general anesthesia.Methods Forty elderly patients undergoing general anesthesia and abdominal surgery, 24 males, 16 females, aged 65-81 years, ASA physical status Ⅰ-Ⅲ, BMI 19-28 kg/m2, were randomly divided into two groups (n=20 each): protective ventilation group (group PV) and conventional ventilation group (group CV).Lung protective ventilation was received in group PV: intermittent positive pressure ventilation, tidal volume 6 ml/kg (ideal body weight), positive end expiratory pressure (PEEP) 5-10 cm H2O, alveolar recruitment maneuver every 30 minutes;conventional ventilation was received in group CV: intermittent positive pressure ventilation, tidal volume 10 ml/kg (ideal body weight), without using the PEEP and alveolar recruitment maneuver.Venous blood samples for interleukin 6 (IL-6) and interleukin-8 (IL-8) were taken at five different time points: before the anesthesia induction (T1), 2 h after mechanical ventilation (T2), at the end of operation (T3), 6 h (T4) and 24 h (T5) after operation.The clinical pulmonary infection score (CPIS) was recorded at before anesthesia, days 1, 3, 5 and 7 after surgery.The incidence of postoperative pulmonary inflammation was also recorded.Results There was no statistical difference in the two groups with respect to age, body mass index, ASA physical status, intraoperative volume of infusion, estimated blood loss, urine volume, mechanical ventilation time, operation method and IL-6, IL-8 levels at T1-T5.Compared with T1, the IL-6 and IL-8 levels in two groups at T2-T5 increased significantly (P＜0.05).Compared that before anesthesia, CPIS in group CV on postoperative days 1, 3 and 5 increased significantly (P＜0.05);compared with group CV, CPIS and the incidence of postoperative pulmonary inflammation in group PV reduced significantly on postoperative days 1, 3 and 5 (P＜0.05).Conclusion Lung protective ventilation can not reduce perioperative IL-6, IL-8 levels in laparotomy elderly patients with COPD, but it can reduce the incidence of pulmonary inflammation and pulmonary infection within 5 postoperative days.

To study the genetic stability of Panax quinquefolium after introduced into China for 30 years, the samples of P. quinquefolium from 14 regions of China were studied. RAPD molecular marker technology was applied in this research, and POPGEN32 data analysis and NTSYS2. 10 cluster diagram were used to analyze the data. The results showed that there are abundant genetic diversity in the ginseng samples. There were 81 polymorphic bands based on the 13 random primers. The polymorphism was 83.51%, the effective number of alleles (N(e)) was 1.456 7; Nei's gene diversity index (H) was 0.274 8; Shannon's diversity index (H(o)) was 0.419 4. The clustering analyses indicated that P. quinquefolium and P. ginseng were classified into two obvious groups, especially, it was also found that the P. quinquefolium could be divided into two obvious groups based on whether the P. ginseng was cultivated in the same region or not, but it was thought that there was not genetically a qualitative difference. Thus it suggests that a good breeding field should be established in Jilin Province of China for the germplasm purification.
China ; DNA, Plant ; genetics ; Genetic Variation ; Introduced Species ; Panax ; classification ; genetics ; Phylogeny ; Polymorphism, Genetic ; Random Amplified Polymorphic DNA Technique ; United States

Background and purpose:Radiotherapy is the main method to manage head and neck tumors.About half of the patients with malignant tumor in head and neck could obtain long term survival through radiotherapy or other therapy combined with radiotherapy.However,it is necessary to clinically detect whether carotid stenosis is a major sequela of head and neck irradiation,especially in long term survivors such as patients with nasopharyngeal carcinoma.We analyzed this injury and the degree of carotid stenosis,and its related factors to provide information to reduce and delay the incidence of this injury.Methods:We analyzed the degree of arterial stenosis of the nasopharyngeal carcinoma patients who received radiotherapy and had survived more than three years in Cancer Hospital Fudan University,compared with newly diagnosed as nasopharyngeal carcinoma before radiotherapy.The degree of carotid artery injury was observed and the clinical factors which affect its occurrence and development.All patients were low differentiated squamous cell carcinoma confirmed by pathology.All patients were examined with color doppler ultrasound to detect the carotid artery.The main end points were the diameter of carotid artery,the peak systolic and end diastolic velocities.Results:Arterial stenosis was more common in the reserch group than the control group(80% vs 20%,P＜0.001).The common and internal carotid arteries were most commonly involved(70% vs 20%,P＜0.001;6313% vs 10%,P＜0.001),followed by the external carotid artery(30% vs 3.3%,P=0.015).Significant stenosis was only found in the research group,common carotid arteries 36.7%,internal carotid arteries 23.3%,external carotid arteries10%.Conclusion:This study showed that radiation could cause significant carotid stenosis in nasopharyngeal carcinoma patients who had received radiotherapy more than 3 years previously.Carotid stenosis developed more frequently in the common carotid artery and intemal carotid artery on the side that had received radiotherapy.