Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.

Objective To investigate the technique and effectiveness of CT-guided collagenase injection into prominence of herniated lumbar disc and the surface of prominence in the treatment of lumbar disc herniation. Methods One hundred and fifty-five patients with lumbar disc herniation diagnosed by clinic and CT received CT-guided collagenase injection, with the approaches via intervertebral foramen in L3-4 and L4-5, and the approaches via margo medialis of joint processus articularis in L5-S1. Results Injection was done successfully in all patients (100%), the clinical rate of excellent and good results were 94.2%. The herniation disappeared or significantly reduced as demonstrated by CT scan in 32 of 34 patients (94.1%), the rate of excellent and good results were 100%. No changes existed in 2 cases. There were 2 cases of disc inflammation in our group. Conclusions CT-guided collagenase injection into the prominence of herniated lumbar disc and its surface is a safe and efficient method in the treatment of herniated lumbar disc.

Objective To improve the diagnosis and treatment of von H ippel-Lindau (VHL) disease.Methods The clinic data of one kindred with VHL disease type Ⅱ B was reviewed including clinical manifestation,imaging,pathology and therapy.A 40-year-old male complained of the left upper extremity numbness for 6 months,and a variety of visceral tumors were found 3 months ago.Contrast-enhanced MR imaging showed multiple brain tumors.CT showed left kidney tumor,pancreatic tumor,pars-aortic tumor and left adrenal tumor.Fundoscopy showed multiple retinal hemangioblastoma.PET-CT discovered abdominal multiple tumors.And pedigree analysis was to determine the family medical history,and 6 members got genetic screening.Results In the kindred with VHL disease type Ⅱ B,9 members (30％) out of 40members in 4 generations got the disease.Six members got genetic screening,and the result showed 5 (5/6) members had mutation.Three (3/5) members with 3 sites genetic mutation showed clinical manifestation,1 (1/5) members with 3 sites genetic mutation without clinical manifestation found brain tumors by MRI,and 1 ( 1/5 ) member with 1 site genetic mutation did not find disease by comprehensive checkup.The main mutation located at exon 1 in chromosome 3p25 of VHL gene.All mutation was hetcrozygous mutation.The 295,337 and 337 nucleotide thymine of the VHL gene were substituted by cytosine,cytosine and adenine,which made the 98th,112th and 112th tyrosine substituted by histidine and asparagines.One member with 1 site mutation had 98th tyrosine substituted by cytosine.The first operation was to remove brain tumor,and the second operation was to remove adrenal tumor,para-aortic tumor and renal tumor.Pathology of the brain tumors showed hemangioblastoma,and the retroperitoneal tumors were clear cell carcinoma,paraganglioma and pheochromocytoma.Followed up for 6 months after operation,no relapse occurred.Conclusions VHL disease is a relatively rare autosomal dominant disorder.Comprehensive management of patients should also include genetic counseling and screening for other manifestations of the disease process.Genetic testing might be helpful in early detection of asymptomatic VHL patients.Members having gene mutation should be followed up strictly.Surgical management of VHL disease should be decided on the base of comprehensive assess.Multiple lesions could be cut off in one operation.For patients with pheochromocytoma,pheochromocytoma shuld be handled first.

Objective To analyze the results of inhaled allergens detection in children with allergic rhinitis(AR)in Changzhou ar-ea and the distribution situation of allergens in different age groups.Methods The levels of serum allergen specific IgE antibodies in 473 children cases(aged 1-12 years)of allergic rhinitis(AR)were detected by the Allergy Screen allergen screen system.The children cases were divided into the infants group(0-3 years old),preschool children(4-6 years old)and school age children(7 -12 years old)according to age.The allergen positive rates and the change tendency were compared among different age groups.Re-sults Among 473 children cases of allergic rhinitis,340 cases(71.9%)were positive.The top three allergens were house dust mite (55.6%),mixed fungi(25.8%)and house dust(18.8%).The positive rate of allergen showed the upward trend with the age in-crease.The distribution of house dust mite(χ2 =21.061,P =0.000),house dust (χ2 =15.111,P =0.000)and the cat and dog dan-der(χ2 = 7.597,P = 0.022 )was statistically significant among the three groups.Single allergen positive rate was the highest (38.5%)and the secand was double allergens(23.7%).The top three positive in single allergens was consistent with sort of total allergen positive rate.The most common double allergen was the combination of house dust mites and house dust.The multiple al-lergen positive rate had statistical significance in the distribution among groups(χ2 =13.399,P =0.001).Conclusion The inhaled allergens of AR children in Changzhou area are dominated by house dust mite,mixed fungi and house dust.The positive rate shows the increasing trend with age increase.The allergen constituents are different in different age groups.The positive single allergen is most common,followed by positive double allergens.

Objective To observe how the ACC transmits nociceptive information and how it regulates spinal noceciption.Methods A total of 32 male SD rats were randomly divided into four groups:Sham group,CCI group,ACC group,and AP-5 group.After light-dark transition test, forced swimming test (FST),paw withdrawal mechanical threshold (PWMT),paw withdrawal ther-mal latency (PWTL)had been measured,the rats were finally anesthetized,then ACC and the spinal cord was rapidly removed,the expression of cAMP-response element binding protein (pCREB)and extracellular regulated protein kinases (pERK)were measured by Western blot.Results Compared with the sham group,the PWMT of the CCI rats were significantly decreased,rats spent less time in the light compartment and number of transition were decreased (P <0.01 ).The immobility time in FST were also significantly prolonged (P <0.01).After AP-5 injected in bilateral ACC 13 days after CCI operation,the PWMT of the CCI rats were significantly increased,rats spent more time in the light compartment and number of transition were increased (P <0.01).The immobility time in FST were also significantly shortened (P <0.01).Compared with sham group,the expression of pCREB, pERK increased significantly in ACC in CCI group (P <0.01).The expression of pCREB,pERK in spinal cord was increased in CCI group and decreased in AP-5 group (P <0.01 ).Conclusion ACC facilitate the spinal nociception in a descending mode.

Objective To find the effect of Rhodiola herb on the phenotypic transfer of epithelial cell in renal tubule of adriamycin-induced nephropathy rats.Methods The rat nephropathy model is established by adriamycin.For Rhodiola herb treated group,feed with Rhodiola herb 0.672 g/kg?d from the 4th week,for the control group and neohropathy group,feed with water [3 mL/(kg?d)].Kill the rats per batch at the week of 4th,8th,12th,16thand 20th week,observe the pathological change of nephridial tissue,test the expression of ?-SMA-protein of myofibroblast in the tuhulointerstitial.Results A semi-quantitative analysis of ?-SMA of rats at the 16th week in the nephropathy group is 6.24?0.57,which is obviously higher than that of Rhodiola herb treated group,3.84?0.28(P

Objective To investigate the role of c-Jun N-terminal kinase (JNK1/2) signaling pathway in enterovims 71 (EV71) infection.Methods The effects of different concentrations of SP600125 on the activity of human rhabdosarcoma (RD) cells were detected by trypanbalu staining.The levels of VP1 mRNA and protein in EV71-infected RD cells were detected by real time Q-PCR and western blot,respectively.The levels of total and phosphorylated JNK1/2,c-Fos and c-Jun protein were determined by western blot.Last,the effects of.JNK1/2 inhibitor SP600125 on EV71 replication and JNK1/2 signaling pathway were analyzed.Results The results of trypanbalu staining showed that 5 and 10 μmol/L of SP600125 didn't influence on the activity of RD cells (P ＞ 0.05),while 20 μmol/L of SP600125 decreased the survival of RD cells significantly (P ＜ 0.05).Compared with the control,the expression levels of VP1 mRNA and protein in EV71-infected RD cells decreased obviously at 8 hours post-infection (P ＜0.01).In addition,after RD cells were infected EV71,the levels of phosphorylated JNK1/2,c-Fos and c-Jun increased significantly (P ＜ 0.05).However,the pretreatment of SP600125 decreased the phosphorylation levels of JNK1/2,c-Fos and c-Jun protein obviously (P ＜ 0.05).Conclusion EV71 infection may effectively activate the JNK1/2 signaling pathway in RD cells,which may be related to EV71 replication.

The application of standardized patient SP is the tendency of medical education in China.The applied characteristics of using SP in diagnostics teaching were summarized in this article.We described the recruitment,training and application of SP in the teaching process of diagnostic.The great advantages of SP and its shortage were analysed,and our expectation of deepening SP was brought forward.

Objective To compare the effects of early and long term treatment with captopril on clinical outcome between elder patients (65 75 years old) and younger patients (0 05), 25 patients in elder treatment group and 52 patients in elder control group (9 29% vs 24 41%, relative risk = 0 37, 95% CI 0 29 0 48, P 0 05), and both the elder and younger patients had better survival (all P

Objective To examine the analgesic effect of intrathecal (i.t.) adenovirus containing human beta-endorphin (?-EP) gene in a rat model of neuropathic pain produced by chronic constrictive injury (CCI) . Methods Thirty-six male SD rats weighing 210-260 g were randomly divided into 3 groups: (1) blank control group (n = 5); (2) sham-operated group (n = 5) ; (3) neuropathic pain group (n = 26) . The neuropathic pain group was further divided into 3 subgroups: Ad-NEP subgrouop (n = 9); Ad-GFP (the recombinant adenovirus containing green fluorescent protein) subgroup (n = 9) and normal saline (NS) subgroup (n = 8). The animals were anesthetized with intraperitoneal ketamine 100 mg?kg-1 and atropine 50 mg?kg-1. Neuropathic pain was produced by ligation of right sciatic nerve according to the technique described by Bennet and Xie. In sham-operated group the sciatic nerve was exposed but not ligated. In blank control group no operation was performed. Seven days after the surgery a PE-10 catheter was placed in the subarachnoid space at L5,6 according to the method of Milligan et al. Seven days after catheter placement 1?108 pfu Ad-NEP, Ad-GFP and 0.9% saline were injected i.t. via the catheter respectively. The paw-withdrawal latency to radiant heat was measured before surgery (T0,baseline) , the day of i.t. injection (T1) and 1 day (T2) , 1 w (T3), 2 w (T4), 3 w (T5), 4 w (T6) 5 w (T7) after i.t. injection. At one week after i.t. administration one animal in Ad-NEP subgroup and Ad-GFP subgroup was killed and the lumbar segment (L3-6) of the spinal cord was removed for immuno-histochemical examination. Naloxone 1 mg?kg-1 was given intraperitoneally in Ad-NEP subgroup (n = 8) and Ad-GFP subgroup (n = 8) at 10 days after i.t. injection. Pain threshold to thermal stimulation of the right paw was measured before (t0) and from 10-90 min after intraperitoneal naloxone injection at an interval of 10 min (t1-9). CSF samples were obtained at T1-7 for determination of CSF concentration of ?-EP using radio-immunological assay. Results The right paw-withdrawal latencies (PWLs) were significantly lower in Ad-GFP subgroup and NS subgroup than in blank control and sham-operated groups (P