Objective To explore the clinical outcomes of the removal of nucleus pulposus with vertebral lamia fenestration in the treatment of lumbar disc herniation.Methods A total of 5482 patients with lumbar disc herniation were performed to remove nucleus pulposus with vertebral lamia fenestration.The follow-up study was conducted in 4329 cases for the duration varying from 6 months to 20 years,averaging 6.7 years,and the therapeutic effect of the operation was evaluated.Results After operation,the patients could walk in(3?2) days,resumed their daily activities in (15?6) days and went back to work in(28?9) days.According to the Nakai scale,excellent results were achieved in 3374 cases(77.9%),good in 652 cases(15.2%),improved in 249 cases(5.8%) and poor in 54 cases(1.1%).The rate of excellent and good results was 93.1%.Conclusion The advantages of the removal of nucleus pulposus with vertebral lamia fenestration are the removal of the annulus fibrosus,the calcified ligamentum flavum and osteophyte under direct vision.The operation may preserve the utmost integrity of the posterior lumbar structures,and the operative treatment has shown its good results.

Objective To investigate the changes of gene expression in the cardiac outflow tract (OFT) in Cx43 knockout (Cx43-/-) mouse embryos, and to elucidate the genes involved in the myocardialization of proximal cardiae outflow tract septum. Methods The cDNA was retrotranscripted from RNA, which extracted from OFT tissues of both Cx43-/- and Cx43 wild type (Cx43+/+) mouse embryos on embryonic day (ED) 14.5. The biotin-labeled cRNA derived from the transcription of cDNA was fragmented as probes. The probes were hybridized with Affymetrix Mouse Genome 430 2.0 Array. Gene Array Scanner was used to screen the signals of hybridization, and the expression of genes was detected. Results Among the differentially expressed genes, there were 143 upregulated and 235 downregulated in Cx43 knockout OFT tissue compared with those in Cx43+/+ heart. Functions of proteins encoded by the altered genes encompassed all functional categories, with the largest percentage in genes involved in signaling pathways such as regulation of transcription, cell cycle, etc. Among the differentially expressed genes in the Cx43-/- heart, some were related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were related with conotruncal defects. These genes were verified by Real-time PCR, and the result was consistent with that of microarray (P<0.05).Conclusions Scaned by Gene Array and verified by Real-time PCR, genes related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were differentially expressed in ED 14.5 Cx43-/- OFT tissue, which may be involved in the myocardialization of proximal cardiac outflow tract septum.

Objective To explore the possible risk factors that influence bone mineral density (BMD) in elderly men with type 2 diabetes. Methods A total of 80 elderly men with type 2 diabetes were included in this study. The BMD of lumbar vertebrae and femur were measured by dual-energy X-ray absorptiometry (DXA). And fasting blood and urine samples were taken to check the biochemical levels of bone metabolism and blood glucose. The correlations between BMD and other related factors were analyzed. Results In this group, the prevalence rates of osteoporosis and osteopenia were 18. 6% and 53.8%, respectively. Body mass and body mass index (BMI) were positively correlated with BMD at all sites (r=0. 202～0. 298, P<0. 05 or P<0. 01). However, age and glycosylated hemoglobin (HbAlc) were negatively correlated with BMD of lumbar and femoral neck (r=-0. 172～-0. 211 ,all P<0. 05). Leptin was not only positively correlated with the BMD of femoral neck and Ward's triangle, but also with body mass, BMI, fasting blood glucose (FBG), total cholesterol and HbAlc (r=0. 219 ～ 0. 509, P<0.05 or P<0.01). Using stepwise regression analysis, body mass was the predictor of BMD at all sites assessed, while the HbAlc and leptin levels could respectively influence BMD at femoral neck and Ward's triangle (r~2= 0. 196 ～ 0. 276, all P< 0. 01). Conclusions It may suggest that differential factors predict the variance of BMD at different sites in elderly men with type 2 diabetes.

Objective To evaluate the effect of curcumin on spinal inflammatory factor in rats with diabetic neuropathy. Methods Diabetic neuropathy was induced by intraperitoneal injection with 1% STZ (60 mg/kg) in sprague-dawley rats. These diabetic rats were randomly allocated to diabetic group (D group, n=10) and curcumin group ( C group , n = 10 ) . Another 10 age-matched normal rats served as controlled group ( N group , n = 10 ) . 28 days after STZ injection, the rats in C group received daily intragastric administration of curcumin (200 mg/kg) whereas those in D group received the same volume of normal saline for 2 weeks. Caudal vein blood glucose levels at T1( before STZ injection)and at T2-T8(2、7、14、21、28、35、42 days after STZ injection)from all rats were detected. Responses to the mechanical stimulus were measured with von Frey filament, and paw withdraw threshold (PWT) was recorded at T1 and at T3 to T8. At T8,the rats were killed and lumbar segments of spinal cord were removed to detect TNF-αand IL-6 content. Results Compared to N group, rats in both C and D group showed hyperglycemia at T2 to T8 (P<0.05) and lower PWT at T4~ 8 (P < 0.01). Compared to D group, C group showed higher PWT at T7,8(P<0.05). Both D and C group showed higher levels of blood sugar at T2 ~ 8 than that at T1 (P < 0.05). C group showed higher PWT at T7,8 than that at T6(P<0.05). Compared to N group,spinal TNF-αand IL-6 content increased in both D and C groups (P<0.05). Compared to D group, C group had reduction of TNF-αand IL-6 concentration (P < 0.05). Conclusion Curcumin can attenuate diabetic neuropathic pain on rats probably by reducing inflammatory factor in spinal cord.

Objective To conclude partial traumatic hemipelvectomy score and assess its value in partial traumatic hemipelvectomy treatment.Methods Data of the managements of 14 partial traumatic hemipelvectomy patients between January 2003 and December 2015 were retrospectively analyzed.10 of these patients were males and 4 females,with an average age of 31 (range,21-55).11 patients were brought directly to the hospital emergency department,and 3 patients were transferred from other hospitals.According to Tile classification system,all pelvic fractures were type C fracture:nine with type C 1,three with type C2 and two with type C3.Partial traumatic hemipelvectomy score was concluded according to soft tissue injury severity,the distance between hemi-pelvic and body axis,injury degree of iliac vessel and nerve.All these factors were further classified into four grades (range,1-4) on the basis of injury severity.Based on clinic outcomes and our experiences,hemipelvectomy should be performed at the early stage when patients had scores more than 12;if the score was between 8 and 12,reassessment should be done according to practical situation and hemipelvectomy was recommended;if the score was between 4 and 8,limb salvage was strongly recommended;if the score was below 4,limb salvage should be done.Results All 14 patients were assessed by partial traumatic hemipelvectomy.The average score was 11 (range,9-14).12 of them were scored at the range of 9-12.2 of them had scores more than 12.3 patients died during the initial resuscitation stage.7 patients underwent completion of the hindquarter amputation after control of hemorrhage and all the patients were successfully survived.Limb preservation was attempted in 4 patients:3 of them died eventually because of infection.1 patient underwent hip disarticulation in emergency operation,but this patient eventually required hindquarter amputation for severe infection.Conclusion Partial traumatic hemipelvectomy score could be a rapid and accurate tool in initial assessment of partial traumatic hemipelvectomy.After the control of hemorrhage,early hemipelvectomy could lower the death rate of this kind of patients.

Objective To evaluate the effect of intrathecal rapamycin on diabetic neuropathic pain in rats.Methods Thirty adult male Sprague-Dawley rats,weighing 180-220 g,in which IT catheters were successfully implanted,were randomly divided into 5 groups (n =6 each) using a random number table:control group (group C),diabetic neuropathic pain group (group DN),rapamycin 1 μg group (group R1),rapamycin 3 μg group (group R3) and rapamycin 10 μg (group R10).Diabetes mellitus was induced by intraperitoneal streptozotocin (STZ) 60 mg/kg on 5 days after IT catheters were implanted in DN,R1,R3 and R10 groups.Citric acid-sodium citrate buffer 6 ml/kg was injected intraperitoneally in group C.In R1,R3 and R10 groups,rapamycin (dissolved in 10 μl 4％ dimethyl sulfoxide) 1,3 and 10 μg were intrathecally injected,respectively,once a day for 7 consecutive days starting from day 21 after STZ injection,while the equal volume of 4％ dimethyl sulfoxide was given instead in C and DN groups.Paw withdrawal threshold (PWT) to yon Frey filament stimulation was measured before IT catheters were implanted,before STZ injection,on 7,14 and 21 days after STZ injection,and on 1,3,5 and 7 days after rapamycin administration.After measurement of PWT,the rats were sacrificed and L2-5 segments of the spinal cord were removed for determination of the expression of mTOR and phosphorylated mTOR (p-mTOR),S6K and phosphorylated S6K (p-S6K) (by Western blot) and expression of mTOR mRNA and S6K mRNA (by RT-PCR).Results Compared with group C,MWT was significantly decreased at 14 and 21 days after STZ injection in DN,R1,R3 and R10 groups,and the expression of mTOR,p-mTOR,S6K,p-S6K,mTOR mRNA and S6K mRNA was up-regulated in group DN (P ＜ 0.01).Compared with group DN,MWT was significantly increased at 5 and 7 days after rapamycin administration in group R1,at 3,5 and 7 days after rapamycin administration in group R3,and at 1,3,5 and 7 days after rapamycin administration in group R10,and the expression of mTOR,p-mTOR,S6K,p-S6K,mTOR mRNA and S6K mRNA was down-regulated in R1,R3 and R10 groups (P ＜ 0.01).Conclusion Intrathecal rapamycin can alleviate diabetic neuropathic pain in rats.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.

Objective To compare the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism (APTE),and to explore a optimum screening method for APTE in the emergency department of China.Methods The study was carried out by using random,crossed,prospective methods to compare the screening effects between Wells and revised Geneva scores for 167 suspected APTE patients in the emergency department of the First Affiliated Hospital of Xiamen University.Results The areas under the receiver operating characteristic curve of Wells and revised Geneva scores for screening APTE in the emergency department were (0.917 ± 0.022 ) and (0.927 ± 0.020),respectively ( P ＜ 0.05 ).The diagnostic concordance between the two score systems for predicting APTE was poor (Kappa value =0.276 ). In addition, the difference between their hierarchical discrimination for the possibility of APTE was statistically significant ( P ＜ 0.05 ).Compared with revised Geneva score,fewer patients were diagnosed with low clinical probability of APTE and more patients were diagnosed with intermediate or high clinical probability of APTE through Wells score.The patients with low chnical probability of APTE were excluded from pulmonary embolism in Wells or revised Geneva score.At intermediate clinical probability,the accuracy rate of Wells score for predicting APTE (9.64％) was lower than that (32.84％ ) of revised Geneva ( P ＜ 0.05 ).At high clinical probability,there was no significant difference between their accuracy rate [ (67.24％ vs.86.21％),P＞0.05]. Conclusions Revised Geneva score is more suitable than Wells score in screening suspected APTE patients in the emergency department in our country.

Objective To investigate the expression of apolipoprotein M in rats after renal transplantation and its role and action mechanism in acute rejection (AR).Methods The kidney transplantation model in rats were established.Male SD and Wistar rats were used as donors,and Wistar rats as recipients.Three groups were designated:control group (syngeneic transplantation,n =24,recipients were treated with normal saline i.p.); AR group (allogeneic transplantation,n =24,recipients were treated with normal saline i.p.); PDTC group [allogeneic transplantation,n =24,recipients were treated with NF-κB inhibitor-pyrrolidine dithiocarbamat (PDTC) i.p.].The renal grafts were drawn at day 1,3,5 and 7 post-transplantation,and the expression levels of NF-κB P65 and apoM protein were detected by using Western blotting,and those of apoM,perforin and granzyme B mRNA were by using real-time PCR.The correlation of apoM and NF-κB,apoM and perforin,and apoM and granzyme B was respectively analyzed.Results As compared with control group,the expression levels of apoM,perforin and granzyme B mRNA in AR and PDTC groups were dramatically up-regulated at each time point (P＜0.01),and those in PDTC group were significantly lower than those in AR group (P＜0.01).The expression levels of apoM and NF-κB protein in AR group were both distinctly higher than those in control group (P＜0.01),and those in PDTC group were markedly lower than those in AR group (P＜0.01).A significantly positive correlation was found between the expression of apoM and NF-κB protein (r =0.469,P＜0.05).And the expression of apoM mRNA was positively correlated to perforin and granzyme B mRNA (r =0.731,P＜0.01 ; r =0.514,P＜0.05).Conclusion The expression of apoM is obviously up-regulated in renal grafts of rats,which may take part in the pathogenesis of AR via NF-κB.

BACKGROUND:Bone marrow mesenchymal stem cel transplantation is considered as a promising therapy for spinal cord injury. How to more effectively promote the survival of bone marrow mesenchymal stem cel s in the area of spinal cord injury and to accelerate the recovery of motor function after spinal cord injury is a current study focus. Previous studies have found that low-frequency electromagnetic fields can promote bone marrow mesenchymal stem cel proliferation and differentiation, but whether the low-frequency electromagnetic fields can be applied to bone marrow mesenchymal stem cel transplantation for treatment of spinal cord injury requires further studies. OBJECTIVE:To discuss the effects of low-frequency electromagnetic fields on motor function of spinal cord injury rats after transplantation of bone mesenchymal stem cel s. METHODS:Sixty-four rat models of incomplete spinal cord injury at T 10 were established by compression method and then randomized into control group, transplantation group (bone mesenchymal stem cel transplantation), electromagnetic field group and combination group (electromagnetic field+bone mesenchymal stem cel transplantation). After successful modeling, bone mesenchymal stem cel s labeled with 5-bromo-2'-deoxyuridine were injected into the original injured site in the transplantation group and combination group, which were isolated and purified with the fast adherence method;while alpha-minimum essential medium was injected into the electromagnetic field group and control group for instead. At 24 hours post-operation, the electromagnetic field group and combination group were explored to low-frequency electromagnetic fields (frequency 50 Hz, magnetic indaction intensity 5 mT) for 60 minutes per day. RESULTS AND CONCLUSION:After cel transplantation for 21 days, the Basso, Beattie, and Bresnahan scores in the combination group was higher than the other groups (P<0.05). 5-Bromo-2'-deoxyuridine positive cel s grew wel , and integrated into the normal spine;syringomyelia was reduced, and the number of spinal neural cel s was increased in the combination group. In addition, glial fibril ary acidic protein expression was decreased in the combination group, while matrix metal oproteinase 2 expression was increased. It indicates that low-frequency electromagnetic fields could promote recovery of motor function in the spinal cord injury rats transplanted with bone mesenchymal stem cel s, which could be associated that low-frequency electromagnetic fields facilitate the survival of transplanted bone mesenchymal stem cel s, up-regulate the expression of matrix metal oproteinase 2, and reduce glial scar formation in the spinal cord injured site.