Objective To understand the epidemiological characteristics of human brucellosis in Baotou City of Inner Mongolia from 2008 to 2011.Methods Datas were collected from surveillance and investigation of human brucellosis in Baotou City during 2008-2011,and analyzed by descriptive study and statistics methods,including the main outcome measures:incidence,time distribution,endemic distribution,occupation distribution,age and sex distribution.Results About 2 338 cases were reported during the 4 years,the average annual incidence rate was 25.52/one hundred thousand,the annual incidence rate was in the range of 5.37/one hundred thousand to 38.65/one hundred thousand,and the incidence rate was rising year by year.The incidence mainly concentrated from April to August,and total reported cases were 1 423,accounting for 60.86％(1 423/2 338).Damaoqi and Guyangxian were regions with high prevalence rate of human brucellosis,and total reported cases were 1 652,accounting for 70.66％(1 652/2 338).The incidence of farmers was higher,accounting for 75.53％ (1 766/2 338).The 31-60 years old group had the highest incidence,accounting for 75.02％(1 754/2 338).The incidence of male was higher than that of female,male accounted for 75.19％ (1 758/2 338).Conclusions The infection of human brucellosis in Baotou City shows an increasing trend and widening scope.The incidence of human brucellosis has significant seasonal,regional,gender and age differences.

BACKGROUND: Recently, α-hydroxy-acid and aliphatic series polyester synthetized with its derivates such as polylactide and polyglycolide have been studied extensively for scaffold of peripheral nerve tissue engineering.These materials might improve the effect of nerve guidance through overcoming several shortcomings of autografts, including permanent denervation of donor site, tissue deficiency, and potential differences in tissue structure and size.OBJECTIVE: To investigate the biocompatibility of poly (DL-lactide-coglycolide) (PLGA). Copolymer ratio of lactide: glycolide was 85:15 or 50:50)and evaluate its effect on nerve guidance.DESIGN: A comparative study and observation.SETTING: Department of Orthopaedics, Xinqiao Hospital of Third Military Medical University of Chinese PLA.MATERIALS: A total of 66 Wistar rats of either sex and clean grade,weighting 180-200 g, were involved; the 85:15 or 50:50 copolymer of poly (lactide-co-glycolde) (PLGA).METHODS: The experiment was carried out in Field Surgery Institute No. 6; State Key Laboratory of Trauma, Burns and Compound Injury, Daping Hospital of Third Military Medical University, from November 2001 to December 2002. ① Co-culture of Schwann cells with PLGA film: Growth of Schwann cells co-cultured with PLGA film was observed under scanning electron microscope. ② Histological observation of PLGA film: Fifteen Wistar rats were randomly divided into five groups (according to 1, 2, 4, 8and 12 weeks time point postoperatively) with 3 rats in each group. PLGA was trimmed to pieces of film with the size of 10.0 mm × 5.0 mm × 0.3 mmand implanted into the rat dorsal muscles under aseptic condition. Hematoxylin/eosin staining was used to evaluate inflammatory reaction. ③Bridging of sciatic nerve defect in rats with PLGA conduits: Fifty-one Wistar rats were divided into PLGA (85:15) conduit group, PLGA (50:50) conduit group and silicone conduit group, each of which was further divided into 5 subgroups according to different time points (2, 4, 6, 8, and 12weeks postoperatively) with 3 rats in each subgroup, except for 12-week time point subgroup which used 5 rats. Gross observation and electrophysiological studies (only 12 weeks time point postoperatively) were performed.The midconduit regenerated nerves were removed and then stained with toluidine blue. Histological observation of regenerated nerves was performed under the optical microscope.MAIN OUTCOME MEASURES: Primary outcome: ① Histological observation of PLGA film implanted in rat muscles. ② Electrophysiological and morphological evaluation of nerve guidance effect of PLGA conduits.Secondary outcome: Growth behavior of Schwann cells when co-cultured with PLGA films.RESULTS: All the 66 rats entered the result analysis. ① Histological observation of PLGA film implanted in rat muscles: The PLGA implants caused only minimal non-specific inflammatory reaction at an early time,as characterized by a low concentration of lymphocytes and fibroblasts,which was not present 10-12 weeks postoperatively. ② Cell attachment and morphological observation by scanning election microscopy: Schwann cells grew and proliferated well when co-cultured with PLGA film. ③Bridging of sciatic nerve defect in rats with PLGA conduits: Gross observation: Silicone induced significant proliferation of fibre tissues, characterized by encapsulation, when bridging sciatic nerve defects in rats, but the similar response could not be seen in PLGA in the same situation. At week 12 after bridging sciatic nerve defects in rats, motor nerve conduction velocity in PLGA (85:15) group was 17.03±0.66 m/s; it was 17.15±0.76 m/sin silicone group, with no significant difference between the two groups (P ＞ 0.05). Quantitative evaluation of regenerated nerves in PLGA group showed that the thickness of myelin sheath was (0.45±0.16) μm, fiber width was (3.96±1.73) μm, axon/mm2 10 135±1 053, and area percentage of neural tissues (%) was 23.4±2.7; in silicone group the corresponding data were (0.45±0.19) μm, (4.07±1.86) μm, (9879±1491) mm2 and (23.6±3.1)%, respectively, and there was no significant difference between the two groups (P ＞ 0.05). Since PLGA (50:50) conduit collapsed at an early time in the same animal model, corresponding indexes couldnot be detected in PLGA (50:50) group.CONCLUSION: In contrast to PLGA (50:50) and silicone, PLGA (85:15)is a good material for peripheral nerve tissue engineering because of its good biocompatibility and proper biodegradation rate.

Objective To investigate the effects of GDNF-modified Schwann cells on the repair of sciatic nerve defects in rats. Methods Forty adult Wistar rats were randomly divided into four groups: group A (nerve grafts, fabricated by extracellular gel and PLGA conduits, n=10), group B (Schwann cells and extracellular gel and PLGA conduits, n=10), group C (GDNF-modified Schwann cells and extracellular gel and PLGA conduits, n=10), and group D (autograft, n=10). Motoneuron conduction and morphology (including anatomical measures and ultrastructure) of the regenerated axons were investigated at 12 weeks postoperatively. Regeneration rate of the motoneuron in spinal cord was also evaluated by using HRP label technique. Results Higher rate of nerve regeneration or number of labeled motoneurons in spinal cord was observed using PLGA conduits seeded with GDNF enhanced expressing Schwann cells (group C) than that with PLGA conduits (group A) alone or PLGA conduits seeded with control Schwann cells (group B), but there was no significant difference as compared with that in the autograft group (group D). Conclusion These results suggest that using gene transfer techniques to increase neurotrophic factor expression in Schwann cells added to nerve grafts may be a promising method for improving nerve regeneration.

Objective To evaluate the effect of TLR2McAb and TLR4McAb on intestinal flora of DSS-induced colitis in mice. Methods Fifty healthy male BALB/c mice (SPF level), were randomly assigned into five groups: the control group( group A), the UC model group( group B), TLR2McAb intervention group( group C), TLR4McAb intervention group( group D) and TLR2McAb + TLR4McAb intervention group(group E). Clinical symptoms were evaluated by the disease activity index(DAI), while tissue sam ples were evaluated by histological scoring(HS). The quantities of mRNA for IFN-γ, IL-4 and IL-17 were determined by real-time PCR. Meanwhile, fecal samples were obtained directly from the cecum for microbiological studies. Results After the treatment with TLR2McAb and TLR4McAb, DAI and HS were decreased significantly. Compared with group A, inflammatory cytokines such as IFN-γ, IL-4 and IL-17 in group B were higher. Compared with group B, expression of these three cytokines in group C to E was all markedly decreased. Group A showed a considerable predominance of Lactobacillus spp and Bifidobacterium spp,while the UC model group showed a conspicuous increase of Escherichia coli and decreases of Lactobacillus spp and Bifidobacterium spp. After treatment with TLR2McAb or/and TLR4McAb, Lactobacillus spp and Bifidobacterium spp increased to the normal level. But counts of E. Coli in the three intervention groups were not changed. Conclusion TLR2McAb and TLR4McAb suppressed the development of DSS-induced colitis and increase cecum counts of Lactobacilli and Bifidobacteria.

Objective To study the effects of Cad-Ⅱgene on osteogenic differentiation of human mesenchymal stem cells in vitro. Methods The human marrow mesenchymal stem cells (hBMSCs) were isolated and cultured in vitro before they were divided into 2 groups. In the transfeetion group, the hBMSCs were transfeeted with Cad- Ⅱgene;in the simple osteogenic inducement group, they were cultured in the condition medium. Then the expressions of Cad- Ⅱ protein were determined and the alkaline phosphatase (ALP) activities and the expressions of ostcocalein were measured at 3, 7, 14 and 21 days for comparison between the 2 groups. Results The ALP activity and positive expression of osteoealcin were regulated significantly higher in the transfeetion group than in the simple osteogenic inducement group at different times (P <0.05). The mineralized nodes began to appear at 14 days in the 2 groups and increased with time. Conclusion Cad-Ⅱgene transfeetion can promote differentiation of hBMSCs into the osteoblasts.

Based on the analysis of the current status and limited factors of MISS at home and aboard,this paper discussed on the importance of MISS training base construction and explored the construction from the aspects of infrastructure constructing,teaching staff training,teaching materials compiling and teaching practice(teaching forms,contents and evaluation)researching.

Objective To determine the safety and efficacy of minimally invasive surgical treatment for post-traumatic thoracolumbar kyphosis. Methods A retrospective review was performed on seven patients with post-traumatic thoracolumbar kyphosis admitted from April 2009 to February 2010.There were four males and three females, at average age of 45.3 years. After general anesthesia, minimally invasive transarticular osteotomy and multi-level SextantTM percutaneous reduction and internal fixation were performed under QuadrantTM working tube system. The status of pain and ability was evaluated by using visual analogue scale (VAS) and Oswestry disability index (ODI). The kyphotic deformity was evaluated by using the Cobb's angle. Results The operation lasted for mean 135 minutes, with mean perioperative blood loss of 106 ml but with no any complications occurred. The mean follow -up period was 5.5 months ( range 4 -16 months ). The mean VAS score was improved from preoperative ( 7.6 ±3.5) points to postoperative (2.5 ± 1.3) points, with statistical difference (P ＜0.01 ). The mean ODI was improved from preoperative 53.6 ± 24.2 to postoperative 20.6 ± 6.3, with statistical difference ( P ＜0.01 ). The Cobb angle was also improved from preoperative ( 32. 1 ± 4.5 ) ° to postoperative ( 7.3 ±2.9 ) °, with statistical difference ( P ＜ 0. 01 ). Conclusion Minimally invasive transarticular osteotomy under QuadrantTM working tube system is a safe and effective alternative for dealing with post-traumatic thoracolumbar kyphosis.

Object To discuss the surgical techniques and the clinical outcomes of the bilateral microendoscopic decompression surgery for lumbar spinal canal and lateral recess stenosis through unilateral approach. Methods 18-ram-diameter microendoscopic tubular retractor was placed with fluoroscopic gnidance, bilateral microendoscopic decompression surgery for lumbar spinal stenosis through unilateral approach were managed by adjusting the angle of tubular retractor. During the procedure, supra-interspinal ligament and contralateral bony lamina were well preserved. Results In the group of single-level microendoscopicdecompression, the mean operation time was 94 min and the mean blood loss was 65 ml. In the group of twolevel microendoscopic decompression, the mean operation time was 135 rain and the mean blood loss was 90 ml. The mean bed rest time was 6.5 days. After operation, the average back pain VAS score decreased from 6.5 to 3.1, the average leg pain VAS score decreased from 7.2 to 2.2, the average Oswestry Disability Index (ODI) decreased from 46.8 to 24.6, which had shown significant statistical difference before and after surgery (P ＜ 0.05). According to Nakai criteria, the excellent and good rate was 84%. Conclusion Bilateral microendoscopic decompression of lumbar canal through unilateral approach under METRx system offers a save, effective and minimal invasive option for lumbar spinal stenosis.

Objective To investigate the clinic manifestations of intestinal involvement of Beh(c)et's disease (BD).Methods Medical data of patients with intestinal involvement of BD admitted to Peking Union Medical College Hospital (PUMCH) from January 1994 to August 2013 were retrospectively reviewed.Clinic manifestations,laboratory tests and endoscopic characteristics were analyzed,and the influence of sex on the clinic manifestations was investigated.Numerical data and categorical data comparisons were analyzed using t-test,x2 test respectively.Results Sixty-four patients with intestinal involvement accounted for 10.5 percent (64/611) of total hospitalized BD patients during the same period.Among these 64 patients,31 were male and 33 were female.The median age at the onset of intestinal involvement was 34 years old.Gastrointestinal symptoms were presented after other systemic symptoms of BD in 91％ patients (58/64).Abdominal pain (88％,56/64) was the most common clinical manifestations of intestinal involvement,and severe complications such as gastrointestinal bleeding (31％,20/64),intestinal obstruction (22％,14/64),intestinal perforation (11％,7/64) and intestinal fistula (16％,10/64) could also occur in some patients.Lesions usually located at ileocecum portion of the gastrointestinal tract.The common endoscopic manifestation was deep ulcers.Female sex was associated with higher C reactive protein level and lower serum albumin level [(52±46) vs (27±36) mg/L,t=2.287,P=0.026; Serum albumin:(34±6) vs (37±5) mg/L,t=2.237,P=0.029].After treated with glucocorticoid,im-munosuppressant and TNF-α blockers,62 patients achieved clinical remission while 21 cases were operated.Conclusion Most of intestinal involvement of BD patients are young adults,and the gastrointestinal symp-toms usually present after the presence of other systemic symptoms.Abdominal pain is the most common manifestations,while severe complications such as gastrointestinal bleeding and intestinal obstruction can also occur.The most common endoscopic findings are deep ulcers,which often located in the ileocecal region.Female patients are more likely to have severe clinical course.Glucocorticoid,immunosup-pressant and TNF-α antagonist therapy are effective,but some patients still need surgical intervention.

Objective To evaluate surgical techniques and clinical results of percutaneous transforam-inal endoscopic discectomy in the treatment of far lateral lumbar disc herniation. Methods Thirty-sev-en patients (24 males and 13 females) with far-lateral lumbar disc herniation were treated by percutane-ous transforaminal endoscopic discectomy from September 2005 to October 2008. The mean age of the pa-tients was 40.6 years. There were 19 patients (51.4%) with foraminal lumbar disc herniation, 11 (29.7%) with extraforaminal lumbar disc herniation and 7 (18.9%) with mixed lumbar disc herniation. The mean operation time, stay-in-bed time, postoperative hospital stay were 70 minutes, 9 hours and 5.0 days respectively. The mean operation costed mean 9 800 ￥ RMB. Results All the patients were fol-lowed up for an average period of 11.5 months. The efficacy of percutaneous transforaminal endoscopic discectomy was determined by Visual Analog Score (VAS), Oswestry Disability Index (ODI) and Nakai criteria. The mean value of VAS was significantly decreased from preoperative 8.3±2.3 to 3.1±1.6 at postoperative month 3, and to 2.9±1.9 at postoperative month 6 (P < 0.01). The mean value of ODI was significantly decreased from preoperative 64.5±23 to 23.6±12.0 at postoperative month 3, and to 12.9±7.0 at postoperative month 6 (P < 0.01). According to the Nakai criteria, the outcome of the op-eration was excellent in 19 patients (51%), good in 13 (35%), fair in 2 (5%) and poor in 3 (8%), with overall excellence rate of 87%. Conclusions Transforaminal percutaneous endoscopic discecto-my is safe and efficacious in the treatment of far lateral lumbar disc herniations, and proper selection of patients is the key factor to ensure the outcome of the operation.