BACKGROUND: Currently, the widely used intervertebral disc degeneration models are induced by altering intervertebral disc biomechanics, damaging intervertebral disc structure or changing hereditary features with genetic technique. All these methods are vades from natural duration of intervertebral disc degeneration. OBJECTIVE: To evaluate the feasibility of the establishment of rabbit model of ischemic lumbar vertebrae adjacent to endplate by percutaneous puncture followed by pingyangmycin injection. METHODS: A total of 46 New Zealand white rabbits were selected and two vertebraes were divided as experimental group (L_5) and control group (L_4) in every rabbit. Vertebrae adjacent to endplate was punctured. Pingyangmycin (2 g/L) 1 mL was injected into rabbits in the experimental group. And 1 mL normal sodium was injected into the control group. Lumbar artery angiography was performed in 4 rabbits before operation. Six rabbits were randomly performed MRI and then were executed for vertebral histology at weeks 1,2, 3, 4, 5 and months 2, 3 after operation. Ischemic areas of L_5 were measured by the MRI and histological section at week 4 after operation. RESULTS AND CONCLUSION: MRI and histology of control group had not specific changes. MRI had not significant signal intensity changes in the first 2 weeks in the experimental group. At week 3 after operation, it demonstrated slightly hyperintense signal on T_2-weighted image (T_2WI) and fat-suppression T_2-weighted image (FS T_2WI), while fat-suppression T_1-weighted image (FS T_1WI) was hypointense signal. The signal changed more obviously at week 4. Histology of experimental group had not specific changes in the first 2 weeks. From weeks 3-4, bone trabecula arranged confusedly and disorderly, with gradually decreased osteocyte and marrow haemocytes, while adipocytes increased and coalesced. Cartilage corpuscle of endplate decreased and architecture became disorder. But the anulus fibrosus and nucleus pulposus had no obviously changes. The intervertebral disk of the experimental group degenerated at week 5, and the ischemia of lumbar vertebrae still existed and intervertebral disk degenerated more obviously at months 2-3 after operation. There was significant positive correlation of ischemic areas of experimental group between MRI and histology at week 4 (t-=0.965, P < 0.001). The rabbit model of ischemic lumbar vertebrae adjacent to endplate can be established successfully by peroutaneous puncture vertebrae adjacent to endplate followed by pingyangmycin injection. The operation is minimally invasive, simple and reproducible, with high success rate. This is a fairly ideal animal model to study the degeneration of the lumbar spine and intervertebral disc.

[Objective]This study was designed to evaluate the effects of percutaneously puncturing vertebrate adjacent to cartilage endplate and injecting pingyangmycin on lumbar intervertebral disc and cartilage endplate in New Zealand Rabbits.[Methods]Thirty-six New Zealand white rabbits were enrolled in this study.The fifth lumbar vertebmte(L_5)was injected with pingyangrnycin as experimental group,and the fourth lumbar vertebmte(L_4)injected normal sodium as control group.Six rabbits were selected randomly,then MRI and histological observation was performed in the first,second,third,fourth,Fifth week and third month after operation respectively.Moreover,the correlation analysis was performed between MRI and histological measurements for areas of the lesion in L_5.[Results]There was no obvious changes on MRI and histological examination in control group.For experimental group,there were also no obvious changes in the first two weeks after bperation.However,in the third week,it demonstrated slightly hyperintense signal on T_2WI and fat-suppression T_2WI(FS T_2WI),while FS T_1WI was hypointense signal.The signal changed more obviously in the fourth week.Histologically,the structure of vertibrates arranged disordedy,chondrocyte of endplate decreased and architecture became disorder.Anulus fibrosus and nucleus pulposus did not change.The cartilage endplate and intervertebral disc degenerated in the fifth week.Both of them degenerated more obviously in third month.There was a strong correlation between MRI and histological measurements for areas of the lesion in the fourth week(r=0.965,P＜ 0.001).[Conclusion]Degeneration of lumbar intervertebral disc and cartilage endplate in New Zealand Rabbits can be induced by percutaneously puncturing vertebrate adjacent to cartilage endplate and injecting pingyangmycin.

Objective To investigate the efficacy of step decompression combined with decompressive craniectomy in treating severe traumatic brain injury (sTBI).Methods A retrospective case series study was conducted to analyze the clinical data of 192 patients with sTBI admitted to Changsha Traditional Chinese Medicine Hospital from January 2016 to April 2018.There were 149 males and 43 females,aged 11-79 years,with an average of 50.1 years.The Glasgow coma score (GCS) was 7-8 points in 57 patients,5-6 points in 45 patients,and 3-4 points in 90 patients.There were 55 patients with unilateral pupil dilation and 88 patients with bilateral pupil dilation.All patients were treated with step decompression and decompressive craniectomy.GCS and pupil sizes before and after operation,intraoperative diffuse brain swelling and acute encephalocele,intraoperative and postoperative delayed bleeding,secondary surgery,mortality during hospitalization,and Glasgow outcome score (GOS) 6 months after injury were recorded.Results At 24 hours after operation,the GCS was 7-8 points in 87 patients,5-6 points in 51 patients,and 3-4 points in 54 patients.The consciousness was significantly improved (P ＜ 0.01),and the pupil was reduced in 56 patients (P ＜ 0.0l).There were four patients with diffuse brain swelling during operation (2.1％),11 patients with acute encephalocele (5.7％),seven patients with delayed bleeding (3.6％),27 patients with postoperative delayed bleeding (14.1％),17 patients receiving secondary surgery (9.7％).Thirty-eight patients died during hospitalization (19.8％).The results of GOS follow-up of 6 months were as follows:there were 50 patients with good recovery (30.0％),36 patients with moderate disability (24.5％),15 patients with severe disability (10.2％),46 patients with persist vegetative states (31.3％),and seven patients died (4.8％).Conclusion For sTBI patients,step decompression combined with decompressive craniectomy can significantly reduce intraoperative diffuse brain swelling and encephalocele,intraoperative,and postoperative delayed bleeding,thus improving the prognosis.

Objective To investigate the differences of severities of depression and anxiety,clinical manifestations in elderly Kazak and Han post-stroke depression (PSD) patients with acute cerebral infarction.Methods Four hundred and forty-seven elderly Kazak and Han Ethnic patients with acute cerebral infarction,admitted to our hospitals within 7 days of onset,were chosen; according to the clinical diagnostic criteria and Hamilton Depression Rating Scale (HAMD) scores for PSD,the patients were divided into Kazak PSD group (n=40) and Han PSD group (n=78).The scores of HAMD,Hamilton Anxiety Rating Scale (HAMA),and the clinical features were compared between the two groups.Results The HAMD scores in Han PSD group were significantly higher than those in Kazak PSD group:factor scores of block,sleep disorder,depression were statistically higher than those in Kazak PSD group (P＜0.05).The HAMA scores in Kazak PSD group were significantly higher than those in Han PSD group:the factor scores of mental anxiety were statistically higher than those in the Han PSD group (P＜0.05).The incidences of restlessness,nervous agitation,cardiovascular symptoms in Kazak PSD group were significantly higher than those in the Han PSD group (P＜0.05).The incidences of insomnia,waking up early,too much attention to the body,hypochondria,pessimism about future,gastrointestinal symptoms in Han PSD group were statistically higher than those in the Kazak PSD group (P＜0.05).Conclusion The severity of depression and anxiety,and clinical manifestations are various in elderly Kazak and Han PSD patients.