1.The nutrient arteries of the lumbar vertebrae were studied on 55 fresh cadaversof different ages by dissection,clearing,casting,radiography and histologicalexamination.2.The nutrient arteries of the lumbar vertebral body enter both the ventrolateraland dorsal surfaces of the body.They can be divided into two types:central andperipheral.The central branches reach the center of the body.While the peripheralbranches supply the outer collar of the body.In number,the former is 1 to 3(averagenumber 2.24?0.09)and that of the latter is 1 to 2(average number 1.47?0.04).The peripheral branches are numerous and inconstant.On the ventrolateral surface theperipheral branches have the average number of 7.83?0.21 and 5.67?0.11 on thedorsal surface.The peripheral branches of the ventrolateral nutrient arteries increaseobviously as age advances.On the contrary,the central branches of the ventrolateralnutrient arteries decrease as the ordinal number of the lumbar vertebrae increases.3.The central branches lie in the middle third zone of the body.They havestraight and less branched stem,preterminal coils and centrifugal terminal brancheswhich spread radially to the upper and lower vertebral end-plates of the body.In theadult,the terminals of both central and peripheral branches anastomose each other toform a dense arterial network.4.In the hyaline cartilage,there are cartilaginous canals which contain 1～2 smallveins and arteries,a number of capillaries and a little of amount of the connectivetissue.The small artery is usually only one in number.5.The nutrient arteries of the arch are mainly:to the pedicle of arch(84.53?1.57%),to the mammillary process(49.45?2.34%),and to the lamina(47.17?2.17%).6.At no age have we been to detect any blood supply for the deep part of theannulus fibrous and nucleus pulposus.

Objective To observe the clinical efficacy of enhanced external counterpulsation (ECP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods It was a case-control study.83 patients (166 eyes) of NPDR were randomly divided into ECP treatment group (ECP group) and conventional therapy group (drug group) by date of visit odd and even number,each with 42 patients of 84 eyes and 41 patients of 82 eyes respectively.The blood glucose,glycated hemoglobin (HbAlc),low-density lipoprotein (LDL-C),corrected visual acuity,stages of diabetic retinopathy (DR) and hemodynamic index such as peak systolic velocity (PSV),diastolic velocity (EDV),resistance index (RI) of ophthalmic artery (OA) and central retinal artery (CRA) were not statistically different between these two groups (P＞ 0.05).All patients were regularly educated for lifestyle management and diabetes mellitus.The following parameters were controlled by drugs including blood glucose＜8.0 mmol/L,HbA1c＜7.5 ％,blood pressure ＜140/90 mmHg (1 mmHg=0.133 kPa) and LDL-C＜3.1 mmol/L.The ECP group received both ECP and medical treatments.The ECP parameters were gasbag pressure 0.35-0.45 kg/cm2,40 min/each time,1 time/d.35 days of ECP was one course,one course each year for 3 years.The treatment effectiveness was determined at the end of follow-up after 3 years of treatment.The blood glucose,HbA1c,blood pressure,LDL-C,visual acuity,fundus changes and hemodynamic index of OA and CRA before and after treatment were comparatively analyzed.Improved or stable visual acuity and fundus condition was judged as effective treatment.Results At latest follow up,the differences of blood glucose,HbA1c,blood pressure and LDL-C were not statistically significant (P＞0.05).Compared to drug group,the PSV and EDV of OA and CRA were increased,but RI of OA and CRA was decreased in ECP group (P＜0.05).The vision effective ratio was 91.67％ and 30.49％ in ECP group and drug group respectively with a significant different (x2 =65.56,P＜0.05).The fundus effective ratio was 92.86％ and 48.78％ in ECP group and drug group respectively with a significant different (x2 =43.38,P＜ 0.05).During follow-up,1 eye (1.19％) progressed to proliferative DR (PDR) in ECP group,while 6 eyes (7.32％) progressed to PDR in drug group.The difference of PDR incidence rate between two groups was significant (x2 =3.87,P＜ 0.05).During the ECP treatment,there were 2 patients with small blisters in the skin of lower limb and cured finally.There were no other treatment-related complications.Conclusion ECP in the treatment for NPDR can improve PSV and EDV,reduce RI of OA and CRA;improve vision and fundus state,reduce the incidence of PDR.

Since the 1960s,endovascular coil embolization has gradually become another treatment for intracranial aneurysms in addition to craniotomy clipping surgery,and in recent years,it has become the preferred method for many neurologists.However,the complexity of intracranial vascular anatomy and the diversity of intracranial aneurysm make the coil embolization alone unable to meet the needs of all intracranial aneurysms.And then some novel materials and techniques emerged,such as coated coils,balloon-assisted embolization,stent-assisted embolization,and covered stents.The principle of covered stents for the treatment of intracranial aneurysms is to place a kind of stents with bio-physical barriers into the parent arteries,while maintaining the patency of the parent artery,thus isolating aneurysms,leading to thrombogenesis inside and finally curing the lesions while maintaining the patency of parent arteries.It has huge advantage in the treatment of wide-necked,huge,dissecting and pseudo aneurysms without important adjacent branch vessels.This article reviews the application situation and the prospects of development of covered stents in the treatment of intracranial aneurysms.

The electroencephalogram (EEG) has proved to be a valuable tool in the study of comprehensive conditions whose effects are manifest in the electrical brain activity, and epilepsy is one of such conditions. In the study, multiscale permutation entropy (MPE) was proposed to describe dynamical characteristics of EEG recordings from epilepsy and healthy subjects, then all the characteristic parameters were forwarded into a support vector machine (SVM) for classification. The classification accuracies of the MPE with SVM were evaluated by a series of experiments. It is indicated that the dynamical characteristics of EEG data with MPE could identify the differences among healthy, interictal and ictal states, and there was a reduction of MPE of EEG from the healthy and interictal state to the ictal state. Experimental results demonstrated that average classification accuracy was 100% by using the MPE as a feature to characterize the healthy and seizure, while 99. 58% accuracy was obtained to distinguish the seizure-free and seizure EEG. In addition, the single-scale permutation entropy (PE) at scales 1-5 was put into the SVM for classification at the same time for comparative analysis. The simulation results demonstrated that the proposed method could be a very powerful algorithm for seizure prediction and could have much better performance than the methods hased on single sale PF
Algorithms ; Electroencephalography ; Entropy ; Epilepsy ; Healthy Volunteers ; Humans ; Seizures ; diagnosis ; Support Vector Machine

Ovarian cancer is one of the highest mortality rate of gynecologic malignant tumors. Chemotherapy can improve the survival rate of the traditional ovary. In recent years, PARP [poly(ADP-ribose)polymerase]inhibitors in breast cancer susceptibility gene (breast cancer susceptibility gene, BRCA) mutations in patients with ovarian cancer can significantly improve the disease-free survival, may change the prognosis of patients with ovarian cancer. This part of PARP [poly(ADP-ribose)polymerase] inhibitors, inhibiting the repairment of DNA damage in tumor cell, causing DNA damage accumulation, eventually killing tumor cells.In breast cancer susceptibility gene 1 (breast cancer susceptibility gene1, BRCA1)/BRCA2 mutation patients with ovarian cancer, PARP inhibitors and BRCA mutation of the synthetic lethal effect provides a new direction for the development of anti-cancer drugs. Now, many highly selective and sensitive PARP inhibitors have been developed and applied in clinical trials.Although PARP inhibitor monotherapy can produce a therapeutic effect in BRCA mutation in patients with ovarian cancer, but the clinical application is still used in combination with other chemotherapy or radiotherapy. This review is focused on the recent progress in clinical trials of PARP inhibitors in combination with common chemotherapeutic agents.

Artery aneurysm occurred in the aortic arch involving branches of vital organs is the difficulty of the endovascular repair.In recent years,experts have made a few researches,and have obtained some effects. We reviewed the present situation this technique in this paper.

Objective To compare the early and delayed tracheostomy in patients treated with prolonged mechanical ventilation in respects of mortality.incidence of nosocomial pneunonia and length of ICU stay.Methods Randomized controlled trials(RCTs)and quasi-randomized controlled trials(quasi-RCTs)were performed by searching throush the Ovide MEDLINE(1996-2006.7),EMBASE(1980-2006.7),Cochrane Database(Issue 2,2006),Chinese Cochrane Centre Database and CBMdisc(1978-2006.7).The published and unpublished data and their references were searched.All RCTs and quasi-RCT of tracheostomy for critically ill patients treated withprolonged mechanical ventilation were included.Data were collected and evaluated by two reviewers independently and separately.RevMan version 4.2 software was used for data analysis.Results Two hundred and eighty-six patients from 4 RCTs and 106 cases from one quasi-RCT were taken for meta analysis.The meta-analysis showed that the early tracheostomy could reduce mortality(OR 0.69,95%CI 0.51,0.95),significantly shorten the duration of mechanical ventilation(WMD-8.49,95%CI-15.32,-1.66)and shorten the length of ICU stay as well(WMD-15.33,95%CI-24.58,-6.08)in patients treated with prolonged mechanical ventilation.but the incidence of nosocemial pneumonia was not different between two sorts of patients(OR 0.91,95%CI 0.70,1.18).Conclusions In case of prolonged mechanical ventilation,the tracheostomy performed at earlier stage may decrease the mortality,and shorten the duration of mechanical ventilation and the length of ICU stay.but cannot reduce the incidence of nosocomial pneumonia.

Objective To study the heart rate variability(HRV) and blood pressure variability(BPV) in patients with different grades of hypertension.Methods 120 cases of patients with hypertension,according to 1999 WHO/ISH hypertension diagnostic criteria are:1 hypertension in 40 cases,2 of hypertension in 40 cases,3 of hypertension in 40 cases and 40 cases of normal control group were detected heart rate variability and blood pressure variability.Results HRV was significantly different between the two groups(P <0.05 or p <0.01).The blood pressure increased and HRV tended to decrease.The BPV was significantly different(P < 0.01) between the two groups;the blood pressure increased and the BPV tended to increase.Conclusion The grade of hypertension is related to HRV and BPV.

Objective To investigate the relevant factors of early stage hyponatremia in patients with complete cervical spinal cord injury (CSCI). Methods A retrospective study was conducted in consecutive 49 individuals with complete CSCI from January 2010 to December 2015.The diagnostic criteria for hyponatremia was two consecutive tests (interval <24 h) of serum sodium <135 mmol/L.Twenty-six patients with hyponatremia were classified as hyponatremia group , and the other 23 patients without hyponatremia were classified as control group .Ten factors were included in the univariate analysis: age, gender, the highest level of CSCI , the degree of CSCI , the blood albumin when transferred to ICU , the serum sodium when transferred to ICU , the use of glucocorticoid , the incidence of neurogenic shock , the average daily urine output , and the average daily liquid balance .The variables with significance (P<0.05) in the univariate analysis then entered stepwise logistic regression analysis .The optimal critical point of the continuous variables with statistical significance in the univariate analysis was determined by drawing the receiver operator characteristic curve . Results There were differences in two variables between the two groups ( P<0.05 ) .The incidence of neurogenic shock before the occurrence of hyponatremia was 57.7% ( 15/26 ) in the patients with hyponatremia and 26.1% ( 6/23 ) in the patients without hyponatremia(χ2 =6.516,P=0.011).The average daily urine output was (2225 ±389) ml in the patients with hyponatremia and (1936 ±289) ml in the patients without hyponatremia (t=2.924,P=0.005).The stepwise logistic regression analysis indicated that these two factors may be the independent relevant factors (OR =13.708 and 0.996, P =0.004 and 0.002, respectively).The receiver operator characteristic curve demonstrated the average daily urine output more than 2331 ml was the optimal critical point . Conclusion The neurogenic shock and the average daily urine volume more than 2331 ml are the independent relevant factors of early stage hyponatremia in patients with complete CSCI .

Objective To investigate the postoperative changes of serum proteins and immune responses in critical patients and the effect of recombinant human growth hormone(rhGH).Method 45 critical patients were divided randomly into rhGH group (15 cases) and control group (30 cases) after operation. Patients in rhGH group were given rhGH 8*!U/d,im for 7 days starting 48 hours post operation. Result The postoperative level of serum transferin,albumin and prealbumin decreased in all patients, and so did the activity of CD 3,CD 4 ,CD 8,NK and the ratio of CD 4/CD 8 .Serum prealbumin level increased significantly in rhGH group at day 4 and after ( P