Objective To explore the prevalence of multilevel lumbar spondylolysis in operation patients,and to evaluate the diagnostic value of CT reconstruction on multilevel lumbar spondylolysis.Methods A total of 312 patients,who had undergone surgical treatment in our hospital from January 2004 to March 2012 for lumbar spondylolysis,were enrolled in this study.There were 147 males (47％) and 165 females (53％),aged from 12 to 76 years (average,44 years).Every patient underwent lumbar spine X-ray examination including anteroposterior,lateral,over-flexion,over-extension and double oblique X-rays,as well as CT examination.The prevalence of multilevel lumbar spondylolysis in all operation patients and the involved segments were recorded and analyzed.Moreover,the clinical manifestation and radiological features were summarized.Results In all enrolled patients,there were 9 patients (2.9％) with multilevel lumbar spondylolysis,including 5 males and 4 females,aged from 21 to 51 years (average,39 years).As for lesion distribution,there were 8 cases of bilateral spondylolysis located at both L4 and L5,and 1 case of bilateral spondylolysis at L5 combined with right spondylolysis of L4 and discontinuity in the base of left pedicle of L4.Among 9 patients,only 3 patients obtained correct diagnosis by anteroposterior and double oblique X-rays of the lumbar spine,while all patients got final diagnosis by sagittal and oblique coronal reconstruction of lumbar spine CT scan.The oblique coronal CT reconstruction could show the details of bone defect in lumbar vertebral isthmus,bony callus,peripheral osteophytes,as well as fibroplasia.For unilateral lumbar spondylolysis,the oblique coronal CT reconstruction could also show the reactive sclerosis in contralateral lamina of vertebra.Conclusion Multilevel lumbar spondylolysis is not rare in operation patients,and L4 and L5 are most common involved levels.Sagittal and oblique coronal reconstruction of lumbar spine CT scan is more accurate in showing the details of lumbar spondylolysis,which is helpful in decreasing the missed diagnosis and improving therapy.

Objective:To analyze the outcomes of patients with osteoporotic vertebral compression fractures treated with polymethylmethacrylate (PMMA) and GeneX(R) bone cement in percutaneous kyphoplasty and to provide guidance in selecting the vertebral filling material for this procedure.Methods: In this study,86 patients with osteoporotic vertebral compression fractures treated at Peking University Third Hospital between June 2012 and June 2013 were retrospectively analyzed.The patients were followed-up with questionnaires and X-ray and CT examinations after 1 month,3 months,6 months,and 1 year.Postoperative conditions,including recovery rate of vertebral height,recovery rate of vertebral Cobb angle,CT data,reductions in visual analogue scale (VAS) and Oswestry scores,and postoperative complications,were evaluated.The results were analyzed using SPSS 18.0.Results: According to the rank sum test,there were significant differences in the recovery rate of vertebral height,vertebral Cobb angle and vertebral volume between the two groups after 3 months,6 months,and 1 year (P<0.05).The GeneX(R) group had greater losses in vertebral height,Cobb angle and volume than did the PMMA group.The PMMA group had 3 cases of cement leakage and 1 case of an adjacent vertebral fracture after percutaneous kyphoplasty.The GeneX(R) group had 2 cases of cement leakage.Conclusion: GeneX(R) bone cement is similar to PMMA in terms of postoperative pain relief.As the filling material in percuta-neous kyphoplasty,it is effective at maintaining vertebral height,quickly improves strength and stiffness of the vertebral body and has fewer complications.However,it is not satisfactory in maintaining long-term postoperative vertebral height.GeneX(R) bone cement can be used as the filling material for patients with osteoporotic vertebral compression fractures in percutaneous kyphoplasty.Patients with severe osteoporosis and vertebral compression should be treated with standardized osteoporosis treatment and should try to avoid early postoperative walking exercises.Sustained vertebral filling materials,such as PMMA,are more suitable for such patients.Research into better biodegradable materials is still needed.

Objecive To evaluate and compare the efficacy of injecting tissue glue and lauromacrogol in modified sandwich method combined with synchronous ligation for patients with esophageal and gastric variceal.Methods 42 cases of patients with esophageal and gastric variceal were randomly divided into synchronous treatment group (22 cases) and sequential treatment group (20 cases). Both group received modiifed sandwich method for gastric varices (lauromacrogol-tissue adhesive-lauromacrogol). Synchronous treatment group meanwhile received synchronization ligation for esophageal varices, but sequential treatment group received sequential ligation after one week. The hemostasis rate, effective rate of varices, rebleeding and complications rate were analyzed.Results There were no signiifcant difference in hemostasis rate, effective rate and rebleeding rate between two groups. The incidence of complications, such as chest and abdominal pain, fever, transient bacteremia were equal between these two groups. No patients had ectopic embolism. The number of ligation device in synchronous treatment group was more than sequential treatment group (8.19 ± 2.01 vs 7.81 ± 1.78,P > 0.05), and the rate of esophageal varices disappearance was inferior to sequential treatment group (59.09% vs 70.00%), however, there were no statistical difference (P > 0.05).Conclusion Endoscopic injection of tissue glue and lauromacrogol synchronization ligation is safe and effective for esophageal and gastric variceal with low complication rates. This method could reduce gastroscopy times and medical expenses, and is worthy of further investigating.

AIM To investigate the possibility of microvolume rodent ventilator in improving the quality of global ischemia-reperfusion injury model in mice. METHDOS Global cerebral ischemia-reperfusion injury was preduced in mice by obstructing and decompressing bilateral common carolid arteries and pressuring and decompressing cervical soft tissue, artificial respiration was performed using rodent ventilator before those procedures. EKG, ECG was detected and pathological examination. RESULTS Rodent ventilator was used to keep essential physiologic ventilative volume befer pressure, EKG change was not been found in observed duration in all animals. The suppressed cephalograph was displayed continuously in various time in ischemic and reperfusion injury. Pathological examination indicated that the damage was worse progressly in cerebral cortex and hippocampus, as times of ischemic and reperfusion prolonged. CONCLUSION Using microvolume rodent ventilator success rate and stability is increased obviously in model of global cerebral ischemia-reperfusion injury in mice and mortality was decreased greatly.

Objective To observe the imaging features of intraosseous ganglion of the wrist. Methods The radiographs (6 cases), CT (4 cases), and MR (1 case) in 6 cases (7 lesions) of surgically confirmed intraosseous ganglion were retrospectively reviewed. Results Typical intraosseous ganglion was seen as sharp margined and cystic lesion with the size of approximately 0.5 cm in diameter. All but one lesion showed no communication with joint. No degenerative changes were seen in the joints nearby. CT was able to depict the lesions better than radiographs in 4 cases. Intraosseous ganglion was seen as slight low signal on T 1WI and slight high signal on T 2WI MR images. Conclusion Intraosseous ganglion was typically seen as sharp-margined and cystic lesion on radiographs, and it could be better demonstrated with CT and MR. With typical imaging appearance, a suggestion to the diagnosis of intraosseous ganglion could be made.

This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia. Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve. After allodynia developed, the rats were randomly divided into 2 groups (n=20 in each): diprospan group, in which the rats received diprospan (7 mg/mL, 0.1 mL) injected to the left infraorbital foramen area; control group, in which saline (0.1 mL) was administered as the same manner as the diprospan group. The pain threshold (PT) in the left infraorbital area was measured before and 2, 6, and 8 weeks after the administration. The expression of neuropeptides [substance P, preprotachykinin A (PPTA), calcitonin gene-related peptide (CGRP)] in the trigeminal nerve was detected at the same time points as the PT measurement by immunohistochemistry or in situ hybridization method. The results showed that in the diprospan group, the PT was 10.65±1.26, 10.77±1.19 and 14.13±1.34 g 2, 6, and 8 weeks after the administration respectively, significantly higher than that before the administration (PT value: 0.36±0.11) (P<0.05 for each). In the saline group, the PT was 0.37±0.13, 0.66±0.09, 4.45±1.29 and 13.72±1.72 g before and 2, 6, and 8 weeks after the administration respectively with differences being significant between before and 6, 8 weeks after the administration (P<0.01). No significant difference existed in the PT between the diprospan group and the saline group at pre-administration (P>0.05). The PT in the diprospan group was significantly greater than that in the saline group 2 and 6 weeks post-administration (P<0.05). In the diprospan group, the expression levels of neuropeptides were significantly reduced as compared with those in the saline group 2 and 6 weeks post-administration (P<0.05). It was concluded that diprospan has an obvious analgesic effect on the trigeminal neuropathic pain partly by reducing the expression of neuropeptides in the trigeminal ganglia.

Objective To introduce the method and experience of the setting of psychological care nurses,to discuss its effect on high-quality nursing and on amelioration of the patients' negative moods.Methods Psychological care nurses were set up in all the clinical departments,after systemic training of psychological knowledge and became qualified psychological consultant via national certification examination.We took psychological care nurses as the leading role,assisted with other nursing modes.By the means of mental status scale in non-psychiatric settings (MSSNS) and the satisfaction questionnaire of psychological care to evaluate the patients' mental status and satisfaction degrees before and after the intervention in 297 cases.Results Patients'scores of anxiety scale,depression,anger,loneliness factor and the total score of the MSSNS after the psychological nursing intervention were significant differences than those before the psychological nursing intervention,[(39.66±4.70)vs (45.59±6.45),(23.31±2.28)vs (26.59±3.35),(13.91 ±3.01) vs (15.12±2.58),(17.58±3.74)vs (20.29 ±4.67),(92.09±6.85)vs (106.66±8.58),t values was 14.376,15.213,23.992,13.974,13.641 respectively,P＜0.05].The satisfaction rate of patients for psychological nursing intervention after the intervention was 96.97％(288/297),which was significant higher than that before the intervention,69.70％(207/297),x2=79.53,P＜0.05.Conclusions Psychological care demands professional qualities.Only through systemic training,can grasp the nurses master professional psychological knowledge and skill,so as to apply scientific psychological care to the patients and help them to solve their psychological perplexities and maintain physical and psychological well-beings.

Objective To observe clinical efficacy of warm-promotion needling for the treatment of cold coagulation and blood stasis of primary dysmenorrhea.Methods Totally 120 patients with cold coagulation and blood stasis of primary dysmenorrhea were randomly divided into warm-promotion needling group (60 cases) and control group (60 cases). Warm-promotion needling group was treated with warm-promotion needling at Guanyuan (RN4), Sanyinjiao (SP6), Shiqizhui (EX-B8), and Diji (SP8), and cooperated with Ciliao (BL32), Hegu (LI4), and Taichong (LR3). Control group took same acupoints and applied uniform reforcing-reducing method. The two groups began treatment 5-7 d before menstruation, 1 times a day, for 7 times. The treatment was given 3 menstrual cycles. The visual analogue scale (VAS) and COX menstrual symptom scale (CMSS) were used to observe the pain degree at the end of 1, 2, 3 menstrual cycles. The clinical efficacy was evaluated 3 months after treatment.Results The scores of VAS and CMSS was obviously reduced in the two groups after the treatment compared with those before treatment (P<0.01). The synperiodic scores of VAS and CMSS in warm-promotion needling group was obviously lower than those in the control group (P<0.05). The total effective rate of warm-promotion needling group was 96.67% (58/60), and the control group was 73.33% (44/60), the difference was significant (P<0.05).Conclusion Warm- promotion needling can obviously relieve dysmenorrhea symptoms and shorten the time of pain of patients with cold coagulation and blood stasis of primary dysmenorrhea, which has affirmative clinical efficacy.

Objective:To investigate the regulation of proliferation and differentiation of bone marrow mesenchymal stem cells(BM-SCs)by CKIP-1 in vitro.Methods:BMSCs from CKIP-1 nock out(KO)and wild type(WT)C57 mice were isolated and cultured u-sing adherence method in vitro.BMSCs of the 3rd passage were induced to osteogenic and adipgenic differentiation.Cell proliferation was examined by MTT assay.Cell surface markers were tested by FCM.The osteogenic and adipogenic differentiation was studied by alkaline phosphatase (ALP)staining,alizarin red staining and oil red O staining.Results:The proliferation and cell marke expression of the 2 groups were similar.ALP staining of KO group was strong than that of WT group after osteogenic induction.Alizarin red stai-ning showed that there were more mineralized nodules in BMSCs of KO group than in those of WT group.Oil red O staining of KO mice BMSCs was stronger than that of WT.Conclusion:CKIP-1 deficiency can enhance the osteogenic and adipogenic differentiation without influence on the proliferation of BMSCs.

Objective To evaluate the mid-term tollow-up results of cervical artificial disc replacement (CADR) for cervical degenerative disc disease,and to explore whether it can reduce the occurrence of adjacent segment degeneration (ASD).Methods A prospective comparative study of 93 patients who underwent CADR or anterior cervical decompression and fusion (ACDF) for cervical degenerative disc disease were conducted.All patients were followed up for more than 6 years.The Japanese Orthopaedic Association (JOA) score,neck disability index (NDI),Odom's scale,X-rays and magnetic resonance imaging (MRI) were used to evaluate the clinical and radiologic results.Results Twenty eight patients who underwent CADR and 35 patients who underwent ACDF had complete follow-up data.At final follow-up,the JOA score and NDI improved significantly in both groups.Between the two groups,there was no significant difference in terms of JOA score,NDI and Odom's scale.The sagittal alignment was well maintained in both groups.The total cervical spine range of motion (ROM) had no significant change for the CADR group,whereas,it significantly decreased for the ACDF group.The ROM at the replacement level of CADR patients decreased from 9.5° ± 3.7° before operation to 7.0° ± 3.0° 3 months after operation,and it was maintained to 6.6° ± 4.1° at final follow-up without significant decrease.Lateral radiographs and T2-weighted MRI showed the incidence of ASD in CADR group was significantly lower than that in ACDF group.Conclusion The six-year follow-up results of CADR are basically satisfactory.Compared with ACDF,it could better preserve physiological motion and biomechanics of cervical spine,and reduce the incidence of ASD.