Objective To investigate the method and the effect of posterior approach low lumbar spinal nerve root sheath decompression under microendoscope (MED-Ⅱ). Methods Thirty-nine patients with low lumbar disc herniation, accompanying severe preoperative limb numbness and radiculalgia, who were found obvious edema of nerve root with adhesion during surgery, entered the study. In the course of lumbar discectomy, a self-made mini-scalpel was used for the incision and decompression of the nerve root sheath, in which a 3～5 mm longitudinal incision was made along the dorsal side of the nerve root. Results Decompression was achieved under microendoscope (MED-Ⅱ) in all the 39 patients. Limb numbness and radiculalgia subsided completely in 17 patients within 24 postoperative hours, while the symptoms trailed off within 2 weeks following the surgery in the remaining patients. The time to complete disappearance of the symptoms was 1～14 d (mean, 6 5 d). Conclusions Minimally invasive spinal nerve root sheath incision and decompression can give a prompt relief from limb numbness and radiculalgia, improving the recovery of nervous system. Lumbar spinal nerve root sheath incision and decompression under microendoscope (MED-Ⅱ) is a safe and effective procedure.

Objective To explore the technical feasibility and effects of ant erior cervical discectomy and interbody fusion using endoscopic technique. Metho ds A retrospective study was undertaken in 23 patients with single segmental cer vical fracture and dislocation or cervical spondylotic myelopathy. There were 14 males and 9 females with an average age of 41.5 years (range, 23 to 64). The fr acture and dislocation patients consisted of 2 cases with complete tetraplegia e ither of C3,4 or C4,5, 3 with incomplete tetraplegia of C5,6 and 2 of C4,5 free from nervous symptoms. The operative procedures included anterior cervical disce ctomy and interbody fusion with insertion of cage or/and plate fixation through an endoscopic working canal. Results All 23 cases were followed-up from 6 to 18 months. The operative incisions healed smoothly. All patients achieved interbody fusion, and no loosening or displacement of the cage and plate occurred. For th e cervical fracture and dislocation patients, by Frankel's classification, 2 cas es with complete tetraplegia showed no any improvement, 2 cases with incomplete tetraplegia improved from grade C preoperatively to grade D postoperatively, 1 c ase with incomplete tetraplegia upgrade from C to E, 2 cases without nervous sym ptoms maintained preoperative status. For cervical spondylotic myelopathy patien ts, according to Odom's scoring system, 10 cases were assessed as excellent (dis appearance of all symptoms), 5 good (alleviation of main symptoms), 1 fair (alle viation of partial symptoms). 94% patients gained excellent and good results. No complications occurred in this series. Conclusion With the improvement of the t echnique and instrument, the endoscopic procedures can be used for anterior cerv ical discectomy, interbody fusion and internal fixation. It presents microsurgic al advantages such as minimal incision, less traumatic reaction, clear intraoper ative visualization, and less postoperative discomfort comparing to traditional approach.

Objective To study the effect of ecdysterone (EDS) on rabbits chondrocytes that is injuried by lipopolysac?charide (LPS). Methods Aricular chondrocytes were isolated from rabbits and randomly divided into three groups:control group;chondrocytes with LPS induced injury (LPS group);injury chondrocytes treated with EDS (LPS+EDS group). The cell proliferation and cell apoptosis of chondrocytes were determined by MTT method and flow cytometry assay respectively. The mRNA and protein expression levels of inducible nitric oxide synthase (iNOS) were detected by RT-PCR and western blot. In addition, the content of NO and IL-1βwere measured by nitric acid reductase assay and enzyme-linked immunosorbent assay (ELISA) respectively. Results Attenuated proliferation, increased cell apoptosis, iNOS, NO and IL-1βwere seen in LPS group , but all these changes were significantly reversed by EDS treatment (P<0.05). Conclusion Ecdysterone exhib?ited a protective effect on LPS induced rabbits chondrocytes injury through inhibiting the expression of iNOS.

Objective To explore the changes and the clinical relevance of plasma p-selectin (PS) and vascular endothelial cell function in patients with carotid stenosis (CS) before and after carotid artery stenting (CAS). Methods The plasma levels of PS, yon willebrand (vWF) and endothelin-1 (ET-1) before CAS and 1hour,6 hours,24 hours,2 months after CAS in 67 patients with carotid stenosis and 54 cases of TIA with negative result from cerebral angiography were measured. The patients of the therapy group were further divided into group A and group B according to complexity of CAS. The plasma levels of PS and vWF were determined by enzyme linked immunosorbent assay,and the level of ET-1 was measured by radioimmunoassay. Results The plasma levels of PS,vWF and ET-1 all increased in the patients group after CAS. In the therapy group,the level of PS reached peak value (29.23 ± 6.98) ng/ml 1 hour after CAS, and the levels of vWF and ET-1 reached peak value (119.63 ±16.75) %, (79.71 ± 9.78) ng/L 6 hour after CAS. In therapy group, there was significant difference in the levels of PS and ET-1 between each time points after CAS and before CAS (P＜0.05,P ＜0.01 respectively). There was significant difference in the level of vWF between 1 hour, 6 hours, 24 hours after CAS and before CAS (P ＜ 0.05 orP ＜ 0.01). There was significant difference in tihe levels of PS 1 hour after CAS and ET-1 at 6 hours after CAS (P ＜0.05) ,and in the level of vWF at 1 hour,6 hours after CAS between control group and therapy group (P ＜0.01).There was significant difference in the level of vWF at every time point after CAS (P ＜ 0.05 or P ＜ 0.01), and in the level of ET-1 at 1 hour,6 hours,24 hours between A group and B group(P ＜0.05 or P ＜0.01). Conclusions PS, vWF and ET-1 were activated to some extent and related to pathological changes degree and complexity of CAS. Monitoring these biological indexes after CAS maybe of great value in predicting risk, evaluating clinical therapy and judging prognosis.

Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the total scores of BEHAVE-AD and the factor scores of affective disorder, anxiety and terror (P<0.001). The interactive effect of time×group was significant in the total scores of BEHAVE-AD and the factor scores of delusion and affective disorder (P<0.05). ② Intergroup comparison of the BEHAVE-AD scores indicated that by the end of 6 months, factor scores of hallucination, circadian rhythm disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, total scores of BEHAVE-AD, and factor scores of delusion, conduct disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③ There was no significant difference in the scores of MMSE, ADL, QOL-AD and GQOLI-74 between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.

Objective To analyze the CT findings and mechanisms of intracranial hemorrhage complicating infective endocarditis(IE).Methods The clinical materials of 5 cases with intracranial hemorrhage complicating IE were collected. Unenhanced CT was performed in all cases. Results Intracranial hemorrhage complicating IE included parenchymal hematomas, subarachnoid hemorrhages and hemorrhagic infarcts. Parenchymal hematomas could be sporadic or multiple and were all located in cortical or subcortical regions. Conclusion Perfectly understanding the mechanisms of the intracranial hemorrhage complicating IE is helpful to understand its CT findings and helpful for etiological diagnosis .

With the development of stem cells and regenerative medicine (treatment of various diseases using stem cells) research, the induction of differentiation of human stem cell technology has also made significant progress. The development of chemical biology offers a variety of small biological molecules for stem cell biology. This review focuses on how small molecule compounds (natural and synthetic) induce differentiation of stem cells.

Objective To identify the pathogen of an influenza epidemic situation and analyze the genetic characteristic of hemagglutinin( HA ) gene and neuraminidase(NA) gene of this pathogen. Methods Real-time RT-PCR was used to dectect nucleic acid of the pandemic( H1N1 ) 2009 virus from oropharyngeal swabs of initial influenza-like illness in epidemic. The viruses were was inoculated and isolated with embryonated eggs. And the HA gene and NA gene were sequenced to analyze their characteristic. Results The influenza epidemic situation was caused by the pandemic( H1N1 ) 2009 virus. The HA and NA sequences data showed that the virus had the high homology with reference virus, and the NA sequences had not the H274Y mutation. Conclusion In this study, the pandemic( H1N1 ) 2009 virus were similar with the vaccine-like virus and the isolated virus of China, and sensitive to oseltamivir.

Objective To analyze factors associated with long-term survival of acute leukemia(AL). Methods Clinical data is analyzed in 27 leukemia cases who had at least 5 years free survival (EFS). Combined intensive chemotherapy was administered under the principle of individualization to induce remission.Regular consolidation treatment after remission was strictly continued.Long-term follow up Was kept on,with the therapeutic regimen modified accordingly.Results Complete remission(CR) was achieved in 112 of 143(78.3%)AL patients and 27(18.9%)of them had survived more than 5 years.Conclusion The long-term survival of AL patients is related to the type of AL,leukemia cell burden,extramedullary leukemia, individual treatment,time required to achieve CR,continuous intensive chemotherapy and the regular postremission treatment.

Objective To prepare a new type of micropore porcine acellular dermis matrix with the aid of laser (LPADM),and to validate the healing effect of the LPADM through the phrase Ⅰ composite transplanting on the back of the full- thickness skin defects in SD rats.Methods In vitro,the allogeneic fibroblasts were separately cultured with the LPADM (LPADM group) or the non-pore PADM (non-pore LPADM group),while fibroblasts cultured by pure medium were used as control.After culture of 1 day,3 days and 5 days,the contents of IL-10,IL-6,TGF-β1,LN,VEGF expressed by fibroblasts were determined by double-antibody sandwich ELISA method.In vivo,the phrase Ⅰ transplantations of LPADM graft with split-thickness autologous skin were carried on the backs of the full-thickness cutaneous defects of SD rats.The healing condition was observed and analyzed by histological tests.Results The differences of the absorbance value between the LPADMgroup,PADM group and control group in each day were not statistically significant (F=0.050-1.763,P＞0.05).The transplantation of LPADM graft with split-thickness autologous skin graft resulted in high rate of surviving without signs of rejection 3 weeks later.After 1-month of transplantation,the regenerated skin was well enough to be lifted without any serious scars.Conclusions The phrase Ⅰ transplantation of LPADM graft with split-thickness autologous skin graft can accelerate the healing process of full-thickness skin wounds with high biological safety.