Objective To explore the effect of docosahexaenoic acid(DHA)on the neuro-logical outcome as well as the expression of interleukin-1β,interleukin-6 and interleukin-10 after acute spinal cord injury(SCI).Methods One hundred and eight Sprague-Dawley rats were randomly divided into a spinal cord injury group(group A),a DHA treatment group(group B)and a sham operation group(group C),each with 36 rats.SCI models were established in the rats of groups A and B using a version of Allen's weight drop method(T10 level).Group C had removal of the lamina only.Ten minutes later,group A was injected with 5% ethanol in saline(the MT solvent)and group B with 500 mg/kg of DHA preparation.Basso beattie bresnahan locomotor rating scale(BBB)was used to detect locomotors function at 10,24,48 and 72 hours after operation.Rats were sacrificed at 72 h after operation,IL-1β,IL-6 and IL-10 levels in serum were detected in 6 rats of each group.Results BBB locomotor rating scale indicated that hindlimb motor function in Groups B was higher than that in Group A at 10,24,48 and 72 hours after operation.There was a significant difference in locomotor rating score between DHA injection group and control group(P<0.05).The specimens of group A showed inflammatory reaction and ulceration at 72 h:Group C showed the highest levels of IL-10 in serum ,while Group A showed the lowest level.The differences were statistically significant.Group A had the highest levels of IL-1β and IL-6 while group C had the lowest.The difference between group B and groups A and C was significant.Conclusion DHA could play protective role by balancing the reconstruction of the anti-inflammatory response and inflammation in rats with acute spinal cord injury.

BACKGROUND:The surgical management to reconstruct the stability in lumbosacral region is very chal enging. There are many techniques to reconstruct the stability of the lumbosacral region, but the internal fixation loosening, fracture and pseudoarthosis are not uncommon. OBJECTIVE:Finite element analysis was used to analyze the stability of two types of reconstruction procedures and the stress of the internal fixation system. METHODS:A 64-slice spiral CT scan was used in a subject from L1 to pelvis. The scan data were imported into the Mimics 15.0 software to generate a three-dimensional surface model. The three-dimensional solid model was established using in the SolidWorks software. The solid geometry model of the L3, 4 pedicle screws combined with single iliac screw fixation and L3,4 pedicle screws combined with dual iliac screws and anterior titanium mesh cage support fixation were constructed by the Solidworks software. Two kinds of reconstruction procedures were simulated. The models were given material properties and analyzed by using the ABAQUS software. RESULTS AND CONCLUSION:(1) The maximum stress was 195.3 MPa in the complete model, 189.5 MPa in single iliac screw model, and 149.2 MPa in dual iliac screw+titanium cage model when constrained the roof of double acetabulum and applied a vertical load of 1 000 N. (2) The axial compression rigidity was 551.572 N/mm in the complete model, 613.87 N/mm in the single iliac screw model and 1 683.50 N/mm in the dual iliac screw+titanium cage model. (3) The bending rigidity of the dual iliac screw+titanium cage model was bigger than other models at 6 directions when applied 7 N?m bending loads. The maximum stress of single iliac screw model was bigger than other models. (4) The results suggest that the dual iliac screw+titanium mesh cage reconstruction can effectively restore the stability of the lumbosacral area. The stress of internal fixation system is smal er and more dispersed. There is obvious stress concentration in the connecting rod and the tail of the single iliac screw. The single iliac screw internal fixation system is easy to fatigue fracture and loosening.

Objective To compare suture bridge and single row techniques in repair of rotator cuff tears in a rabbit model.Methods Seventy-six mature male New Zealand white rabbits were used in this study.The 12-month old rabbits,weighing from 2.5 to 3.0 kg (average,2.8 kg),were made models of full-thickness rotator cuff tear by cutting off at the foot print the supraspinatus tendon.The models were randomly divided into 2 even groups (n =38 each).Their right shoulders were repaired by suture bridge and single row techniques respectively in the 2 groups,with their left shoulders untreated as controls.The rabbits were then sacrificed at the 2nd,4th and 8th weeks after surgery for histological comparisons of healing under microscopy.Biomechanical comparisons were made at the 8th week to analyze advantages and disadvantages of the two methods.Results At 2,4 and 8 weeks postoperatively,there were no significant differences between the anterior and middle 1/3 zones of bone-tendon junction regarding cartilage growth or collagen fiber morphology in the suture bridge group,while the cartilage growth and collagen fiber morphology in the middle 1/3 zone of bone-tendon junction were significantly more mature than in the anterior 1/3 zone in the single row group.At the 8th postoperative week,the load to failure in the suture bridge group (134.59 ± 17.69 N) was significantly higher than that in the single row group (72.23 ± 12.08 N) (P ＜ 0.05),but remained significantly lower than that in the control group (192.61 ± 9.42 N) (P ＜ 0.05).Conclusion The suture bridge technique is a feasible and reliable method for repair of rotator cuff tear and has a better healing effect than the single row technique.

Objective To compare the effect of compression hollow screw fixation,artificial femoral head replacement and total hip replacement in the elderly.Methods From August 2007 to April 2009,152 cases of femoral neck fracture in the elderly were divided into three groups: compression hollow screw fixation group(54 patients,24 males,with an average age of 59.8±5.3 years);artificial femoral head replacement group(48 patients,16 males,with an average age of 65.3±6.7 years);and total hip replacement group(50 patients,18 males,with an average age of 77.3±6.5 years).The evaluation indicators,including the average sugical time,the average amount of bleeding,the average length of stay and the average postopererative bed time,were compared respectively among the three groups.The postoperative evaluation was made according to Harris Score.Results Harris score in the three groups were 21 excellent and 23 good in the compression hollow screw fixation group,with an average score of 80.52±2.70;26 excellent and 14 good in the artificial femoral head replacement group,with an average score of 86.57±1.90;and 42 excellent and 3 good in the total hip replacement group,with an average score of 96.04±2.10.The total hip replacement group was significantly better than the other two groups(H=0.589,F=12.151,Ps＜0.05).The rate of postoperative complications were 25.93%(14/54) in the compression hollow screw fixation group,18.75%(9/48) in the artificial femoral head replacement group and 4.00%(2/50) in the total hip replacement group(H=1.291,P＜0.05).Conclusion Compared among the three surgery,total hip replacement could resume function and improve the quality of life better,with lower rate of complications.However,the surgical injury and the amount of bleeding were largest.Therefore,we suggest selecting appropriate surgery with considering the patient′s age,physical condition,displacement degree of the fracture,et al.in old femoral neck fractures patients.

BACKGROUND: The clinical application of one-level osteotomy and multilevel osteotomy has been well documented, but currently few studies were reported to compare their biomechanical characteristics.OBJECTIVE: To investigate the biomechanical characteristics of one-level osteotomy with Dick screw fixation and multilevel osteotomy with Luque instrumentation in the treatment of kyphosis.DESIGN: Randomized comparative experiment.SETTING: Laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: Fresh specimens of thoracic and lumbar spinal segments obtained from 12 3 or 4-year-old calves.METHODS: The experiment was conducted in the laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University between September 2002 and September 2003. Fresh spinal segments T8-L5 from 12 calves were randomized into an intact group, Dick screw group with one-level osteotomy with Dick screw fixation and Luque group with multilevel osteotomy with Luque instrumentation, with 4 spesimens in each group. Lateral bending test of the specimens was performed to examine the physiological overload using an Instron 5 500 universal material testing machine at the constant speed of 10 mm/minute until fracture or dislocation was induced. Changes in the loading were recorded and the induced injuries observed to obtain the load-displacement curve of the injury test.MAIN OUTCOME MEASURES: The load-displacement curve of the destructive right bending test in each group.RESULTS:All the data of 12 canines were involved in the result analysis.The spinal segments of the intact group yielded to the force of 3 600 N with a flat and smooth load-displacement curve, and those of Dick screw group yielded to a load of 2 800 N with also a relatively flat curve, while in Luque group, the segments did not yield until a load of 7 160 N, followed by drastic decrease of the resistance to less than 4 000 N, generating a flat and smooth curve afterwards.CONCLUSION: Luque instrumentation is a little more preferable than Dick screw in terms of the maximum resistance, but this difference does not justify the clinical decision of their superiority. Both techniques benefit postoperative recovery of spinal function with strong stability.

Objective To compare the effects and complications of lumboperitoneal shunt ( LP ) and ventriculoperitoneal shunt ( VP ) in the treatment of post?traumatic hydrocephalus. Methods Eighty patients with post?traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% ( 37/40) and 87. 50%( 35/40) in the VP group. The difference between the two groups was not statistically significant (χ2=0. 556,P=0. 456);the neurological deficit scores before treatment in the LP group and VP group were (28. 35±8. 64) points and (29. 13±7. 98) points,there was no significant difference between the two groups (t=0. 419,P=0. 676) . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant ( (19. 32±5. 34) points vs. (21. 62±4. 86) points,t=1. 480,P=0. 143),the average scores of neurological deficits in the two groups were significantly better than those before treatment ( t=5. 623, 5. 084,P<0. 001 ) . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment ( t=0. 376,1. 265,P>0. 05) ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment ( t=4. 891,5. 370,P<0. 001) . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% ( 1/40 ) , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% (3/40), 10% ( 4/40 ) , 5% ( 2/40 ) 10%, ( 4/40 ) , the overall complication rate was 32. 50%, there was significant difference between the two groups (χ2=6. 050,P=0. 014) . Conclusion LP and VP have significant curative effect on the treatment of post?traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice

OBJECTIVE To develop technique of central vein catheterization by external jugular vein puncture under ultrasound guidance.METHODS A total of 224 patients with central vein catheterization by external jugular vein puncture were randomized into two groups: the control group was treated by routine manipulation and observed blood vessels by macroscopic observation;the patients from the observation group were placed catheters with the assist of ultrasound techniques.To record the one time achievement ratio of catheterization and incidence of phlebitis and thrombus.RESULTS Comparing the two groups,we found the observation group had higher one time achievement ratio of catheterization and lower incidence of phlebitis and thrombus than that of the control group.And there were statistical significances between the two groups(P

OBJECTIVE To analyze the clinical therapeutic effect of a disposable vaginal adsorber for Weiyinkang and lacidophilin vaginal capsules(Yanhua) on bacterial vaginosis.METHODS A total of 140 patients were divided randomly and averagely into the group A and the group B.The two groups were treated respectively by metronidazole or Weiyinkang combined with lacidophilin vaginal capsules.RESULTS The effective rate of the groups B and A was 92.8% and 80.0%,respectively,with significant difference(?2 =4.93,P

Objective To examine loss of heterozygosity (LOH) and microsatellite instability (MSI) of locus D8S532 on chromosome 8 and their influence on the expression of sFRP1 in the hepatocellular carcinoma (HCCs), which may provide an experimental evidence for clarifying the mechanism of sFRP1 gene and tumor development. Methods DNA was extracted from formalin-fixed paraffin-embedded tissues. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and ordinary silver stain were used to study LOH and MSI of locus D8S532. Envision immunohistochemistry, Leica-Qwin computerized imaging system and Image-Pro PluS (IPP) version 4.5 professional imaging analysis software were used to assess the expression of sFRP1. Results The detection rates of LOH and MSI of locus D8S532 in the 36 specimens of HCC were 11.11% and 8.33% respectively. The down-regulation of sFRP1 was observed in 31 of 36 HCCs (86.11%) compared with non-carcinoma liver tissues, and the positive rate of sFRP1 protein of the HCCs was 52.78%( 19/36 ). The frequency of LOH was lower in the cases with positive expression of sFRP1 protein than those negative (0 vs 23.53%, P <0.05). Conclusion It was a common phenomenon that expression of sFRP1 protein is negative or low in Chinese with HCCs. The genetic instability of sFRP1 gene was one of causes, which lead to HCCs. LOH may play a major role in negative expression of sFRP1.

Objective:Cancer stem cells (CSCs) are resistant to chemotherapy. Our study aimed to investigate the stem cell-like proper-ties of doxorubicin-resistant osteosarcoma cell line 143B and its correlation with Notch signaling. Methods:We generated doxorubicin-resistant osteosarcoma cells by treating them with 2μm doxorubicin. Stem cell-like properties such as morphology change, Stro-1/CD117 double positive ratio, stem cell-related gene expression, sphere formation efficiency, and EMT character were assessed on day 5 after doxorubicin withdrawal. Notch receptor and its target genes were examined using qPCR and Western blot analysis. The stem cell-like properties of doxorubicin-resistant osteosarcoma cells were assessed when pretreated with Notch inhibitor or vehicle. The an-ti-tumor effect of Notch inhibitor was tested using a xenograft model. Results:Doxorubicin-resistant osteosarcoma cells were enriched in Stro-1+/CD117+cells, which showed obvious increased expression of stem cell-related genes, and exhibited enhanced spheroid for-mation and evident mesenchymal characteristics unlike doxorubicin-sensitive cells. qPCR and Western blot assays showed that Notch intracellular domain 1 (NICD1) and target genes Hes1 and Hey1 were upregulated in doxorubicin-resistant osteosarcoma stem cells compared with those in vehicle cells. Furthermore, pretreatment with a γ-secretase inhibitor (GSI) to prevent Notch signaling en-hanced chemo-sensitivity and inhibited doxorubicin-enriched osteosarcoma stem cell activity in vitro. Finally, the Notch inhibitor pre-vented tumor growth in mice xenograft models. Conclusion: Doxorubicin induced the enrichment of osteosarcoma stem-like cells through Notch signaling, and inactivation of Notch could be useful for overcoming drug resistance and eliminating osteosarcoma.