Objective To evaluate the chnical effect of posterior decompression and shortsegment pedicle instrumentation treating for thoracolumbar fracture with neurologic deficits in different time intervals.Methods Seventy-nine cases of thoracolumbar fracture with neurologic deficits were treated with shortsegment pedicle instrumentation combined with decompression according to the injury and surgery patients with injury of different time interval were divided into ≤24 h group (41 cases) and ＞ 24 h group (38 cases),the curative effect was evaluated by imaging and nerve function recovery.Results Postoperative hospital stay were performed X-ray check,10-14 d after hospital discharge,were primary healing of incision.A total of 79 patients with thoracolumbar fracture combined with neurologic deficits were followed up for 23.5 (15-32) months averagely.Did not appear in the source sex procedure for postoperative infection,nerve injury and postoperative spinal cord injury aggravated phenomenon,not implants rupture,bending and screw loose phenomenon.There was significant difference at 3 d postoperative and the last follow-up in the rate of vertebral compression,cobb' s angle and spinal canal stenosis rate in two groups [≤ 24 h group:(7.9 ± 4.2)％,(8.5 ± 5.0)％ vs.(40.8 ± 8.4)％ and (3.9 ± 2.5)°,(4.2 ± 2.6)° vs.(28.1 ± 13.1)° ; ＞ 24 h group:(8.8 ± 4.8)％,(9.2 ± 4.8)％ vs.(41.7 ± 7.6)％ and (5.3 ± 2.6)°,(5.7 ± 2.7)° vs.(27.6 ± 12.1)°] (P ＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).The stenosis rate in two groups at 3 d postoperative was obviously better than preoperative[≤24 h group:(5.3 ± 1.5)％ vs.(41.4 ± 6.1)％; ＞ 24 h group:(6.8 ± 1.1)％ vs.(40.5 ± 5.4)％] (P ＜ 0.05),and ≤ 24 h group was superior to ＞ 24 h group,there was significant difference (P ＜ 0.05).At the last follow-up,the neurological function with ASIA grade 1-2 level recovery,≤24 h group mean improved 1.4 level,and ＞ 24 h group mean improved 1.2 level.Conclusion The opertion of pedicle instrumentation combined with decompression with nerve function damage can rebuild spinal stability,favorable neural functional recovery.

Objective To evaluate the efficacy of neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia.Methods One hundred and forty-seven patients with primary trigeminal neuralgia of both sexes,aged 32-99 yr,with VAS score ≥ 8,were randomly divided into 2 groups:C-arm group (group C,n =72) and neuronavigation group (group N,n =72).Hartel anterior puncture was used and the C-arm guided puncture was performed at the target point foramen ovale in group C.In group N,three-dimensional reconstruction was made after the skull MRI images were transmired to the navigational system of StealthStation,and then the puncture path and point were designed after the target in the trigeminal ganglion was determined.The successful puncture and puncture-and radiofrequency-related complications were also recorded.The VAS scores were recorded at 1 and 7 days and 1,6,12 and 24 months after operation and the analgesic efficacy was evaluated.The therapeutic effect was evaluated by using Barrow Neurological Institute scoring system at 1 and 24 months after operation.Results No puncture-related side effects,damage to the oculomotor nerve or tinnitus developed in group N.The success rate of puncture at first attempt and the effective analgesia rate at different time points after operation were significantly higher,and the treatment effect was better in group N than in group C (P ＜ 0.05).There was no significant difference in the time for location of the nerve and incidence of facial numbness between the two groups (P ＞ 0.05).Conclusion Neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia provides a better efficacy,and a lower recurrence rate and a higher probability of successful puncture,with fewer complications.

Objective To explore the effects of high-dose ambroxol hydrochloride (Mucosolvan) on pulmonary protection and anti-inflammatory in traumatic brain injury patients treated by mild hypothermia.Methods From June 2008 to June 2012,40 elderly traumatic brain injury patients aged 60-70 years treated by mild hypothermia in our hospital were selected.Patients were randomly divided into two groups:low-dose ambroxol hydrochloride group and high dose ambroxol hydrochloride (n=20,each).Patients in low-dose ambroxol hydrochloride group were treated with ambroxol 30 mg plus saline infusion,3 times/day; while patients in high-dose ambroxol hydrochloride group were treated with ambroxol 300mg plus saline infusion,3 times/day; both groups were treated for 7 days.The changes of characteristic and quantity of sputum,PaO2and PaO2/FiO2,and serum TNF α level were analyzed at day 1,3,7.Duration of mechanical ventilation,tracheotomy proportion,and mortality were compared between the two groups 3 months after treatment.Results At day 3-7 after the intervention,the sputum got thinner and less,and more easy to suck in highdose group than in low-dose group (thin sputum proportion:75％ vs.40％,P =0.025; clean proportion by once suction:65％ vs.25％,P=0.011).The improvement of PaO2,PaO2/FiO2 were more significant in high dose group than in low dose group (PaO2 ∶ 3d,(92.3±12.3) mm Hg vs.(83.3±15.2) mm Hg,P=0.046;7d,(95.9±12.5) mm Hgvs.(87.1±11.7) mm Hg,P=0.028;PaO2/FiO2∶3d,(290.8± 15.8) mmHgvs.(221.8± 16.4) mm Hg,P=0.000;7d,(296.3±16.9)mm Hg vs.(238.4±15.0) mm Hg,P=0.000).Serum concentrations of TNF α was lower in highdose group than in low dose group [3d,(54.1± 4.9) ng/L vs.(71.4± 5.6) ng/L,P=0.000;7d,(35.1± 2.7) ng/L vs.(63.3±4.3) ng/L,P 0.000].Duration of mechanical ventilation was shorter and tracheotomy proportion was lower in high dose group than in low dose group [(116.8±18.7) hrsvs.(178.4±35.5) hrs,P=0.000; 25％ vs.60％,P=0.025].There was no significant difference in mortality between groups 3 months after treatment.Conclusions The application of high dose ambroxol can improve respiratory function,decrease duration of mechanical ventilation and tracheostomy proportion,and reduce the systemic inflammatory response in elderly traumatic brain injury patients treated by mild hypothermia,but without long-term survival benefit.

Objective To investigate the prognostic value of fever burden in traumatic brain injury (TBI) patients.Methods A retrospective analysis of 355 TBI patients admitted to the emergency department and intensive care unit from November 2010 to October 2012 was performed,and the Glasgow outcome scale (GOS) was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group (4 to 5) and poor outcome group (1 to 3).Relevant clinical findings were studied by statistical description,logistic regression analysis,Spearman correlation analysis and ROC curve analysis.Results Fever burden level was continuously increased with the decrease of GOS from score 5 to 2,except for score 1 of GOS,which was corresponding to a significant lower fever burden.There were significant differences in age,pupil reactivity,Glasgow coma scale (GCS) and fever burden between two groups (P ＜ 0.05).Compared to the good outcome group,the poor outcome group was featured with more advanced average age (P =0.000),poorer pupil reactivity (P =0.000),lower GCS score (P =0.000) and higher fever burden level (P =0.000).Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and fever burden level (OR 1.166,95％ CI:1.117-1.217) were associatedwith poor outcome.The fever burden level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of fever burden level was 1.098 (95％ CI:1.031-1.169,P =0.003).ROC curve analysis showed the respective AUC for fever burden was 0.713 (95％ CI:0.663-0.760).The relevant analysis revealed a significant negative correlation between the fever burden and the GOS score (r =-0.376,95％ CI:-0.462--0.283,P =0.000).Conclusions Fever burden can be considered as an independent predictor of poor outcome of patients with TBI.The TBI patients with early onset of high levels of fever burden will have increased poor outcome risk.

In this study, we prepared various matrices of hydrogel patches and studied their cross-linking mechanism by observing their rheological properties, which could provide theoretical basis and deep technical support for further industrial development of hydrogel patch. Rheology method was used to do the amplitude scanning and single-frequency scanning for various hydrogel matrix, under the condition of oscillation mode of the rheometer. Then the linear viscoelastic region, composite modulus value, as well as changes in slope with time of the composite modulus and phase angle of various hydrogel matrix were analyzed in detail. The results showed that the stability of matrix was mainly determined by hydrogel frame; only in acidic environment, the cross-linking reaction between cross-linker and hydrogel frame can occur; elasticity of matrix can be decreased by organic acid and the effect level was related to the ratio of the number of carboxyl and hydroxyl (-COO(-)/-OH) in adjusters: if the ratio was not equal, the higher -COO(-)/-OH in adjusters would be the less elasticity of matrix decreased; the cross-linking speed of matrix was determined by adjuster, the cross-linking speed of matrix contain different adjusters was ranged in following order: matrix containing tartaric acid > matrix containing lactic acid > matrix containing malic acid > matrix containing citric acid; the cross-linking speed of matrix was not uniform in the whole cross-linking process.

OBJECTIVETo compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints.

METHODSSixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups.

RESULTSThe excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05).

CONCLUSIONMild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.

Acupuncture Points ; Adolescent ; Adult ; Collateral Ligaments ; injuries ; Electromagnetic Radiation ; Female ; Humans ; Joint Diseases ; therapy ; Magnetic Field Therapy ; Male ; Moxibustion ; Pain Measurement ; Young Adult

Objective To explore the relationship between the polymorphism of methionine synthase reductase(MTRR) A66G and the susceptibility to unexplained repeated spontaneous abortion (URSA).Methods Total of 200 Henan Han couples with URSA (URSA group) and 76 Henan Han healthy couples without URSA (control group)were enrolled in this study.Their MTRR A66G genotypes were determined by PCR restriction fragment length polymorphism (PCR-RFLP).Results (1) The allele frequencies of MTRR A66G:the frequencies of allele A and allele G in URSA group were 76.5％ (153/200)in husband and 72.8％ (146/200) in wife,23.5％ (47/200) in husband and 27.2％ (54/200) in wife,respectively.The frequencies of allele A and allele G in control group were 78.9％ (60/76) in husband and 78.3％ (59/76) in wife,21.1％ (16/76) in husband and 21.7％ (16/76) in wife,respectively.The frequencies of allele A and allele G were not significantly different between female and male subjects within the same experimental group (P ＞ 0.05),and also there were not significantly different between the same gender subjects at URAS and control groups(P ＞ 0.05).(2) The genotype frequencies of MTRR A66G:the frequencies of genotype AA,AG and GG in URSA group were 57.0％ (114/200) in husband and 52.0％ (104/200) in wife,39.0％ (78/200) in husband and 41.5％ (83/200) in wife,4.0％ (8/200) in husband and 6.5％ (13/200) in wife,prepectively.The frequencies of genotype AA,AG and GG in control group were 59.2％ (45/76) in husband and 59.2％ (50/76) in wife,39.5％ (30/76) in husband and 38.2％ (29/76) in wife;1.3 ％ (1/76) in husband and 2.6％ (2/76) in wife,prepectively.The frequencies of genotype AA,AG and GG were not significantly different between female and male subjects within the same group (P ＞ 0.05),and also there were not significantly different between the same gender subjects at URSA and control groups (P ＞0.05).(3) Combined genotype of couples:the combined genotype frequencies of GG + GG,GG + AG,GG +AA,AG + AG,AG + AA and AA + AA in URSA group were 1.0％ (2/200),2.5％ (5/200),6.0％ (12/200),20.0％ (40/200),38.0％ (76/200),and 32.5 ％ (65/200),prepectively ; the combined genotype frequencies in control group were 0,1.3％ (1/76),2.6％ (2/76),17.1％ (13/76),42.1％ (32/76),36.8％ (28/76),prepectively.The combined genotype analysis between the two groups were also not significantly different (P ＞ 0.05).Conclusion The polymorphism of MTRR A66G gene was not associated with the susceptibility to URSA (P ＞ 0.05),and so it was not the inherited genetic risk factor of URSA.

Objective To investigate the difference of CCAAT/enhancer-binding protein α (C/EBP-α) gene induced apoptosis between hepatocytes and hepatic stellate cells (HSC) in mice with liver fibrosis.Methods Sixty BALB/c mice were evenly divided into normal group,model group,treatment group,blank control group and negative control group,12 mice in each group.Except the mice of normal control group,the mice of other groups were treated with intraperitoneal injection of CCl4 to establish liver fibrosis mice model.Mice of treatment group,blank control group and negative control group were administrated with C/EBP-α carried adenovirus (Ad-C/EBP-α),phosphate buffered solution and empty vector of adenovirus (Ad-EGFP) respectively through tail vein for the first week.The expression of C/EBP-α and α-smooth muscle actin (α-SMA) was detected by immunohistochemistry method.Sinusoidal endothelial structure of peri-portal regions and far from portal regions was observed by transmission electron microscope (TEM).Terminal dexynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was applied to detect apoptosis of cells in liver tissue.The degree of liver fibrosis in mice was determined with sirius red staining and hydroxyproline content measurement.Single factor variance analysis was performed for comparison among multiple groups,and t test was used for comparison between two groups.Results C/EBP-α was expressed in nucleus of hepatocyte in normal control group mice.The expression decreased in model group,blank control group and negative control group.However,the expression of C/EBP-α of treatment group increased,and mainly expressed in cells located in perisinusoidal and perivascular.Hepatic sinusoids was distorted,blood vessel wall thickened.Hepatocyte degeneration and lots of lipid droplets was found in model group,blank control group and negative control group.The thicken degree of endothelial layer of blood vessel of treatment group was lower than that of model group.The percentage of sirius red positive cells of normal group,model group,treatment group,blank control group and negative control group was (0.10±0.03)％,(5.81±0.32)％,(2.32±0.45)％,(6.34± 0.81)％ and (6.10± 0.92)％,respectively; content of hydroxyproline was (0.07±0.00) μg/mg,(0.69 ± 0.10) μg/mg,(0.19±0.06) μg/mg,(0.56±0.03) μg/mg and (0.64±0.08) μg/mg,respectively; the percentage of α-SMA positive cells was (0.50 ±0.03)％,(5.30 ± 0.52)％,(2.15 ± 0.29)％,(5.53 ± 0.43) ％ and (5.42 ± 0.25) ％,respectively; the number of TUNEL positive cells was (0.25 ± 0.08),(0.15±0.02),(7.10±1.53),(0.13±0.03) and (0.18±0.07),respectively.The differences between the groups were statistically significant (F=113.74,148.29,292.43 and 140.25,all P＜0.05).The difference between normal group and model group,between model group and treatment group,between treatment group and blank control group,between treatment group and negative control group were statistically significant (tarirus positive cell =-52.54,-16.20,-10.60 and-7.99,thydroxyproline content =-168.00,11.53,11.07 and 12.54,ta SMA pusitive cells-24.77,-13.82,15.94 and 18.37,tTUNEL positive cells =3.26,-11.91,-11.95 and-11.88,all P＜ 0.05),there was no statistically significant difference between model group and blank control group,between model group and negative control group (both P＞0.05).TUNEL positive cells mainly located in perisinusoidal and perivascular of liver in mice,which was consistent with the distribution of α-SMA-positive cells.Conclusion C/EBP-α could effectively relieve CCl4 induced liver fibrosis in mice mainly through inducing HSC apoptosis,however no apoptosis effect on hepatocytes.

Objective To investigate the effect of acupuncture plus Chinese herbal medication on plasma endothelin (ET-1) and calcitonin gene-related peptide (CGRP) in child patients with mesenteric lymphadenitis.Methods One hundred and eighty child patients with mesenteric lymphadenitis were randomly allocated to groups A, B and C, 60 cases each. Group A received acupuncture at Zusanli and pricking Sifeng points plus oral administration of Wudang Babao Zijinding; group B, oral administration of amoxicillin and clavulanate potassium granules; group C, oral administration of Wudang Babao Zijinding alone. ET-1 and CGRP contents were measured in the three groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in ET-1 and CGRP contents in group A (P<0.01). There were statistically significant post-treatment differences in ET-1 and CGRP contents between group A and group B or C (P<0.01).Conclusions Acupuncture plus Chinese herbal medication is an effective way to treat mesenteric lymphadenitis in children. It can regulate ET-1 and CGRP in the patients.

Estrogen receptors (ERs) are members of nuclear receptors and related to several diseases such as cancer, inflammation and osteoporosis. ERs have two forms, ERα and ERβ, which have different functions and organism distributions. Compounds selectively targeting ERβ can regulate important physiological functions and avoid the side effects caused by targeting ERα. Therefore, selective ERβ ligands have received considerable research interest in recent years. In this article, different kinds of selective ERβ ligands were summarized and their structure-activity relationships were also analyzed.