BACKGROUND:The lumbar interspinous device, as a kind of non-fusion technology has been extensively applied in the clinic and exerts superiority in biomechanics compared with the traditional fusion technology. With the development of prosthesis design and impanation technology, it reveals a better application prospect. OBJECTIVE:To review the biomechanics and finite element analysis of lumbar interspinous devices. METHODS:The first author retrieved the databases of CNKI, WanFang, PubMed and SpringerLink using the keywords of“lumbar spine, interspinous devices, biomechanics, finite element analysis”in Chinese and English, respectively. Researches related to the biomechanics and finite element analysis of lumbar interspinous devices were included and repeated researches were excluded. A total of 44 literatures were enrol ed for review, including 8 Chinese and 36 English literatures. RESULTS AND CONCLUSION:(1) Biomechanical y, several interpinous devices, which are commonly used in the clinic, can increase the stability of the implanted segment in sagittal alignment by limiting the range of flexion-extension, with no significant change in lateral bending and axial rotation. (2) Few studies analyze the influence of the implant size and placement on the implanted segment and on the adjacent segments. (3) Through the stress nephogram, three-dimension finite element analysis can intuitively analyze the changes of the stress distribution in the intervertebral disc, isthmus and facet joints before and after implantation. Both biomechanical studies and finite element analysis indicate that interspinous devices can share the load of the disc and facet joints, and at the same time, make no effect on the range of motion and stress of the adjacent segment. (4) In conclusion, the short-term biomechanical advantage of the interspinous devices is obvious, but further studies are needed. The finite element analysis can simulate different body physical environment, and can analyze mechanical distribution changes after implantation, which is an effective way to evaluate the mechanical mechanism of the interspinous devices.

Objective To observe the changes of visual acuity?multifocal electroretinogram (mfERG) and optical coherence tomogram(OCT) before and after successful idiopathic macular hole (IMH) surgery, and evaluate the efficiency of the IMH surgery. Methods A total of 28 eyes of 28 patients with IMH who underwent vitrectomy during February 2001 and May 2002 in our hospital were collected. visual acuity, mfERG, and OCT were examined preoperatively and 1, 3, 6, and 12 months postoperatively, respectively. The results were analyzed statistically compared with 33 eyes in control group. Results (1) OCT showed that 27 eyes (96.43%) had anatomic closure of the macular hole 1 month after the surgery without recurrence in 12 months. Just 1 eye (3.57%) failed in the closure within 1 year. (2) The visual acuity was much higher in the eyes 1 year after surgery, especially within 6 months postoperatively, than that before the vitrectomy(P

Objective To investigate the correlations between the level of blood lactic acid (Lac),lactate clearance rate (LCR) and emergency stratification Ⅰ or Ⅱ as well as the prognosis in patients.Methods A retrospective analysis was conducted.The clinical data of 370 critically ill patients with emergency stratification Ⅰ or Ⅱ accompanying with hyperlactacidemia admitted to emergency center of People's Hospital of Wuwei City during January 2013 to April 2015 were analyzed.The patients were allocated into two groups:Lac ≥ 10 mmol/L (n =181) and Lac 4-10 mmol/L (n =189).Base excess (BE),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and hospital mortality were compared between the two groups.The differences in initial Lac,6-hour LCR and APACHE Ⅱ score were compared between survival group and death group as well as emergency stratification Ⅰ and Ⅱ groups.The correlation between initial Lac,6-hour LCR and APACHE]Ⅱ score was analyzed by Pearson correlation method.Results ① With the increase in Lac level,the negative deviation extent of BE and APACHE Ⅱ score in critical patients were gradually increased [BE (mmol/L):-16.74 ± 8.21 vs.-5.98 ± 8.43,APACHE Ⅱ score:27.6 ± 5.6 vs.20.1 ± 4.8],and hospital mortality was increased [76.79％ (139/181) vs.43.39％ (82/189),all P ＜ 0.01].② The initial Lac and APACHE Ⅱ score of the death group were significantly higher than those of the survival group [initial Lac (mmol/L):8.81 ± 4.71 vs.4.43 ± 2.82,APACHE Ⅱ score:23.6 ± 5.6 vs.17.3 ± 3.7],and 6-hour LCR was significantly decreased [(12.26 ± 6.47)％ vs.(35.16± 10.63)％,all P ＜ 0.01].③ Patients in emergency stratification Ⅰ group had a higher initial Lac and a higher APACHE Ⅱ score but a lower 6-hour LCR level than those in emergency stratification Ⅱ group [initial Lac (mmol/L):8.7±2.6 vs.6.8±2.0,APACHE Ⅱ score:25.2±6.3 vs.16.3±4.7,6-hour LCR:(14.8±4.7)％ vs.(33.5±5.8)％,both P ＜ 0.01].④ It was shown by correlation analysis that initial Lac was significantly positively correlated with APACHE Ⅱ score (r =0.731,P =0.017) in 370 emergency critical ill patients,while 6-hour LCR was negatively correlated with APACHE Ⅱ score (r =-0.694,P =0.010).Conclusions The early arterial blood Lac of patients with emergency stratification Ⅰ was significantly higher than emergency stratification Ⅱ,and the 6-hour LCR in patients with emergency stratification Ⅱ was significantly higher than emergency stratification Ⅰ.Furthermore,the Lac level and LCR were simple and easy to implement as compared with APACHE Ⅱ score in emergency critical ill patients.

Objective To observe the efficacy of Xiao-tan-jie-yu prescription (XTJYF) on sleep quality of the soldiers who acutely exposed to western area of high altitude. Methods In this prospective, completely randomized, parallel, placebocontrolled study, 550 soldiers acutely exposed to western area of high altitude were investigated by the Pittsburgh Sleep Quality Index (PSQI), 100 soldiers with sleep disorder were selected and divided into two groups (50 each): treatment group received TCM XTJYF therapy and control group was treated with placebo. After 2 weeks' treatment, PSQI total score and respective factor scores before and after treatment were assessed, and clinical therapeutic efficacy and adverse reactions were observed. Results The PSQI total score and respective factor scores of these soldiers were significantly higher than those of normal adults, but significantly lower than those of insomnia patients, while their sleep disorder factor score was significantly higher compared with insomnia patients. XTJYF reduced the total score and some factor scores (subjective sleep quality, time for initiating sleep, total sleep time, and sleep efficiency) for PSQI in the soldiers with sleep disorder, and the overall response rate was 91.49% which is higher than those in the placebo control group (P<0.05 or 0.01), without toxic side effects. Conclusions The sleep quality of soldiers who acutely exposed to western area of high altitude in China is not high, and XTJYF may safely and effectively improve the sleep quality.

Objective:To compare the efficacy of anhydrous ethanol and lauromacrogol in the treatment of ovarian endometriosis cyst (OEC), and to provide evidence for more effective use of these two sclerotic drugs.Methods:Thirty-three cysts in 30 patients with OEC, who were admitted to Taizhou Hospital of Zhejiang Province from February 2017 to June 2018, were treated by ultrasound interventional therapy, followed by catheter aspiration, saline cavity cleaning, anhydrous ethanol rinsing and sclerotherapy, and lauromacrogol alcohol 1∶1 mixed solution retained in the capsule (mixed group). The therapeutic effects were observed 6 and 12 months after operation. A total of 30 OEC in 28 cases admitted to the same hospital from 2013 to 2015 were retrospectively analyzed after similar treatment steps, but the intracapsular retention fluid was anhydrous ethanol (ethanol group). A total of 28 OEC in 26 patients admitted to the same hospital from 2015 to 2017 were washed with normal saline, then washed with lauromacrogol and retained in the capsule with lauromacrogol (lauromacrogol group). The therapeutic effects of 6 and 12 months after treatment between the three groups were compared.Results:According to the classification of cure, marked effect and inefficacy, there was a weak correlation among the three groups. The mixed group did not tend to be ineffective, while the lauromacrogol group tended to be ineffective 6 and 12 months after treatmen.the difference was statistically significant (adjusted standardized residual >2). According to the total effective (cure+ markedly effective) and ineffective classification, the effective rate of the mixed group was significantly higher than that of the lauromacrogol group ( P<0.016 7). There was no significant difference for the effective rate between the mixed group and the ethanol group, and between the ethanol group and the lauromacrogol group ( P>0.0167). Conclusions:The retention of ethanol-lauromacrogol mixture in the capsule of sclerotic OEC, after pre-rinsing with anhydrous ethanol is helpful to improve the curative effect of OEC and give full play to the therapeutic effect of common sclerosing agents used in ultrasound intervention.

Objective To explore the clinical users′experience on using the intelligent laboratory test system so as to provide reference for its optimization.Methods Fifteen laboratory staff with different sub specialty was selected for in-depth interviews and data were analyzed using phenomenological approach.Results Intelligent laboratory system could improve the quality of test result verification and interpretation,shorten the turnaround time and improve the work efficiency.It took about 1-2 months for users to accept the automatic verification function.After that,the users could believe in the system and used it in their daily work.The sys-tem could reduce the work stress and verification duty,while balancing the technical gap between laboratory technicians.Users could only understand the general rule of the intelligent system and it was difficult for them to manage the rule repository.Conclu-sion The intelligent laboratory system is one of the artificial intelligent system used for the medical laboratory,it can provide com-prehensive clinical decision support for the laboratory staff.

Objective To explore the effect of lysophosphatidic acid(LPA)on blood-brain barrier(BBB) permeability and its possible mechanism.Methods LPA or LPA+suramin(L+S)were stereotaxically injected into the right eaudate nucleus in SD rats in vivo.Evans blue(EB)was used to quantitatively measure the permeability of BBB at different time points.The expression of matrix metalloproteinase-9 was detected by immunohistochemistry technique.The pathological ultrastruetural changes of BBB were assessed by transmission electron microscopy.Results The BBB permeability began to increase after LPA administered into ipsilateral eaudate nucleus,and reached the peak at 24h.Then the permeability of BBB gradually lowered after 48h.In comparison with the same time points of control group,there were quite significant differences(P＜0.01).After L+S was injected,the change of BBB permeability had differences in comparison with those of LPA group in the same time points,(P＜0.05).MMP-9 positive cells were mainly vascular endothelial cells.The numbers of MMP-9 positive blood vessels grew at 6h in LPA group,and the expression of it reached maximum at 24h,then the number of it decreased at 48h,showing significant statistical differences in comparison with the L+S group(P＜0.01),It was observed microscopically that ultrastrueture of BBB of the LPA group was changed sharply,such as basement membrane roughed and fragmented,astroeyte end-feet swolled markedly and perivaseular space enlarged obviously.But there were no remarkable changes in BBB in L+S group.Conclusion LPA can induce increase of BBB permeability and its possible mechanism is the strong expression of MMP-9 protein produeted by endothelial cells through the mediation of LPA receptor,leading to degradation of basement membrane.

Amifostine ; pharmacology ; Anemia, Aplastic ; chemically induced ; pathology ; prevention & control ; Animals ; Benzene ; toxicity ; Dose-Response Relationship, Drug ; Male ; Mice

Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.

Objective:To investigate the effects of electroacupuncture (EA) at Neiguan (PC 6) and Baihui (GV 20) by observing the changes of CCAAT/enhancer-binding protein(C/EBP) homologous protein (CHOP) and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury (IRI), and explore whether the apoptosis pathway of endoplasmic reticulum stress (ERS) is involved in the protective mechanisms of EA.
Methods:Sixty rats were randomly assigned to five groups (12 in each group): a normal control group (group A), a sham-operation group (group B), an operation group (group C), an Edaravone group (group D) and an EA group (group E). The cerebral IRI rat model was induced by middle cerebral artery occlusion (MCAO) using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction (RT-PCR) was used to determine the mRNA expressions of CHOP and caspase-12.
Results: Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances (P<0.05 orP<0.01); compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly (P<0.05 orP<0.01); there were no significant differences between group D and group E in comparing the above items (P>0.05).
Conclusion:EA at Neiguan (PC 6) and Baihui (GV 20) can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan (PC 6) and Baihui (GV 20) is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.