Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.

Objective To study the changes of pressure in cervical disc after percutaneous radiofrequency nucleoplasty,and provide theoretical basis for percutaneous radiofrequency nucleoplasty in the treatment of cervical disc herniation. Methods Forty-two patients with cervical disc herniation (33 cases of nerve root-type cervical spondylopathy and 9 cases of vertebral artery-type cervical spondylopathy) were treated with pereutaneous radiofrequeney nucleoplasty. The pressures of operated cervical disc were measured in the operation, and their clinical effects were evaluated using the JOA values 1 week after operation. The relationship between pressure changes in cervical disc and clinical effect was studied. Results The pressure in the cervical disc in 33 cases of nerve root-type cervical spondylopathy was decreased (1.84 ± 0.96) kPa (P=0.000), and the JOA values increased (3.27 ± 1.35) scares (P=0.000) 1 week after operation. The pressure in the cervical disc in 9 cases of vertebral artery-type cervical spondylopathy was decreased (1.72 ± 0.92) kPa (P= 0.000), and the JOA values increased (2.78 ± 0.67) scores (P= 0.000) 1 week after operation. Correlative analysis showed that there was a positive correlation between the pressure decrease of cervical disc and the JOA values increase (P < 0.05). Conclusion Percutaneous radiofrequency nucleoplasty can help to reduce pressure in the cervical disc and relieve the clinical symptoms.

ObjectiveTo observe the effect of parathyroid hormone on expression of matrix GLA protein (MGP) in ovariectomized SD rats and primary osteoblast,and to study the role of MGP on the possible mechanism of postmenopausal osteoporosis.MethodsThirty-six Sprague-Dawley female rats were allocated into 3 groups,12 in each:sham operation group,ovariectomized group( OVX group),ovariectomized and parathyroid hormone treatment group.Animals in the parathyroid hormone group were injected parathyroid hormone (20 μg/kg,three times a week for 12 weeks) three weeks after ovariectomy.All rats were sacrificed after 18 weeks.Urine and serum were collected every three weeks.Lumbar vertebral bones were observed by immunohistochemistry.Bone mineral density (BMD) of lumbar vertebra of rats was determined.The content of MGP in serum and urine was determined by enzyme-linked immunosorbent assay (ELISA).Expression of undercarboxylated Matrix GLA Protein (ucMGP) was detected by immunochistochemistry.Relative quantification of MGP mRNA expression in lumbar vertebra bone was detected by Fluorescent real-time quantitative polymerause chain reaction.Results ( 1 ) 18 weeks after ovariectomy,BMD of lumbar vertebra in OVX group was lower than those in sham group and parathyroid hormone group significantly ( P＜0.05 ).(2) The content of MGP in serum and urine was dynamic variation after treatment hy parathyroid hormone,and it was significant compared with OVX group ( P＜0.05 ).( 3 ) Immunohistochemical localization of ucMGP was seen in lumbar vertebra in OVX group.(4) Relative quantification of MGP mRNA expression in lumbar vertebra in OVX group was increased significantly compared with other groups ( P＜0.01 ).( 5 ) parathyroid hormone ( 1-34 ) in 10-7mol/L,10-8mol/L,10-9 mol/L up-regulated MGP mRNA expression in primary osteoblasts about 6.78,5.31,and 2.23 times than control respectively.It was in a dose-dependent manner.ConclusionThe effect of parathyroid hormone on the expression of matrix gla protein may play an important role in mechanism of postmenopausal osteoporosis

Objective To observe the expression of matrix gla protein(MGP) mRNA in primary osteoblasts of Sprague-Dawley (SD) rat in vitro after treatment with anti-osteoporosis agents [vitamin K2,PTH,1,25 (OH)2D3,and alendronate],and to investigate the potential role of MGP in the pathogenesis of osteoporosis.Methods Primary osteoblasts(OBs) were derived from sequential trypsin/collagenase-digested calvaria isolated from newborn SD rat (postnastal day 1-3).OBs of the second generation were identified by Van Gieson collagen staining,alkaline phosphatase(ALP) staining and calcified nodules staining.OBs of the fourth generation were selected to interfere with vitamin K2,PTH,1,25 (OH)2D3,and alendronate,then cultured for 24 h in mediums which contained various concentrations of vitamin K2 (10-7,10-6,and 10-5 mol/L),PTH (10-9,10-8,and 10-7 mol/L),1,25 (OH) 2D3(10-10,10-9,and 10-8mol/L),alendronate(10-6,10-5,and 10-4mol/L).After being cultured for 24 h,total RNA was extracted and examined by real-time quantitative RT-PCR.Results The primary cultured cells had typical morphological characters of osteoblast.van Gieson collagen staining,ALP staining,and calcified nodules staining were all positive.Vitamin K2,PTH,1,25 (OH)2D3,and alendronate could modulate the expression of MGP mRNA in osteoblasts in a dose-dependent fashion.MGP mRNA expressions were 2.56-fold,2.12-fold,and 1.57-fold with 10-5,10-6,and 10-7 mol/L of vitamin K2 treatment,respectively.The expressions were 6.78-fold,5.31-fold,and 2.23-fold with 10-7,10-8,and 10-9mol/L of PTH(1-34) treatment,8.93-fold,6.95-fold,and 3.47-fold with 10-8 10-9,and 10-10mol/L of 1,25 (OH)2D3 treatment,and 3.47-fold,2.49-fold,and 1.98-fold with 10-4,10-5,and 10-6mol/L of alendronate treatment.Conclusion Vitamin K2,PTH,1,25 (OH)2D3,and alendronate all canregulate MGP mRNA expression in calvarial osteoblasts in a dose-dependent manner.MGP seems to be a potent target of anti-osteoporosis agents,and involved in the pathogenesis of osteoporosis.

Objective To explore the clinical outcomes of the percutaneous radiofrequency nucleoplasty in the treatment of cervical disc herniation.Methods 183 patients with cervical disc herniation were treated with percutaneous radiofrequency nucleoplasty.A retrospective analysis of 183 patients was made,and their effects were evaluated using the VAS and the subjective satisfactory degree of the patients.Results All cases were followed up for 3 to 36 months( average 12 months).There were no complications observed such as hemorrhages,infections and nerve root injurys due to the procedure.One week after operation,symptom remission rate was 58.4％ and perfect rate of subjective satisfaction was 95.1％.At final follow up,symptom remission' rate was 66.1％ and perfect rate of subjective satisfaction was 85.8％.Conclusion Percutaneous radiofrequency nucleoplasty was an effective,minimally invasive and safe procedure to treat cervical disc herniation,and the operative treatment had shown better results.

Objective:To describe the epidemiological characteristics of mental disorders in Ximeng Wa Au-tonomous County and explore psychosocial risk factors of mental disorders. Methods:Two thousand three hundred and eighty one residents aged 1 8 years and over were sampled using multistage sampling in Ximeng Wa Autono-mous County in 2013. All respondents were investigated by face-to-face interview. Mental disorders were screened out by using the General Health Questionnaire (GHQ)and diagnosed according to the International Classification of Diseases Checklist (ICD-10-Checklist)criteria. Results:Life time prevalence of any mental disorder was 19. 86%(419/2110). The lifetime prevalence rates of substance use disorder,anxiety disorder,insomnia,mood disorder, schizophrenia were 12. 99%(274/2110),6. 30%(133/2110),2. 94%(62/2110),2. 32%(49/2110)and 1. 00%(21/2110)respectively. Male (OR=0. 43),older age (35 -49 years,OR=1. 78;50 -64 years,OR=2. 59;≥65 years,OR=3. 5 1 ),unmarried and other marital status (OR=0. 3 1 ),non-Wa and non-Lahu ethnic groups (OR=0. 29)were associated with neurotic,stress-related and somatoform disorders. Male (OR=2. 41),older age (35 -49 years,OR=2. 29;50-64 years,OR=3. 20;≥65 years,OR=4. 58),non-farmer and non-self-employed occupation (OR=0. 41),and non-Wa and non-Lahu ethnic groups (OR=0. 32)were associated with psychoactive substance use disorder. Male (OR =0. 35 ) and order age (≥65 years,OR =3. 05 ) were associated with mood disorders. Conclusion:Lifetime prevalence of any mental disorder,substance use disorders and anxiety disorders are high in Ximeng Wa Autonomous County. Measures should be strengthened against prevalence of mental disorders in ethnic minority areas.

Objective To explore the guiding role of double volume reconstruction (DVRT) in interventional embolization of intracranial aneurysms. Methods Ninety?six cases of subarachnoid hemorrhage with 115 aneurysms underwent total cerebrovascular angiography and interventional endovascular embolization of intracranial aneurysms in our hospital from January 2017 to December 2017 were retrospectively analyzed. They were randomly divided into observation group (n=48) and control group (n=48) according to random number method. In the control group, guided by the results of 2D?DSA and 3D?DSA 3D reconstruction, the aneurysm neck and tumor were fully exposed with the optimal position. the responsible aneurysms were performed with the interventional endovascular embolization. The operators finished the embolization According to the size and shape of aneurysms and the operative experience. In the observation group, the operators could speculate the embolization density of aneurysms by using the data of 3D reconstruction and digital subtraction reconstruction and adjusted the surgical plan to make the aneurysms had been completely embolized. The baseline data, treatment status, adverse cerebrovascular reaction and recurrence rate of aneurysms were compared between the two groups. All patients in the two groups were operated by Deputy chief surgeons or above of the neurosurgery department. The comparison of the counting data were tested by χ2. The measured data conformed to normal distribution were tested by independent sample t. Results Statistically, There was no significant differences in baseline data including sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05). Comparing the responsible aneurysms in different positions and sizes, the differences was not statistically significant (P>0.05).There was no statistically significant differences in the dosage of contrast media and the cost of operation between the two groups (P>0.05). The radiation dose and operation time in the observation group were smaller and shorter than those in the control group, but there was no statistical differences between the two groups (P<0.05). Statistically, The incidence of rerupture of aneurysm and thrombosis in the observation group was significantly lower than that in the control group (P<0.05). and The incidence of cerebral infarction and the recurrence rate of aneurysm in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05).There was no significant difference in the location and size of responsible arterial tumors (χ2=0.148, P=0.929).There was no significant difference in the dosage of contrast agent and the cost of operation between the two groups (t=-0.769, 0.225; P>0.05). The radiation dose and operation time were (479.81 ± 51.21)mGy, (103.52 ± 10.18) minin the observation group and (511.95 ± 53.26)mGy, (114.60 ± 9.51)min in the control group. The difference was statistically significant (t=-1.376,-2.516; P<0.05).There were 1 case of rerupture of aneurysm in the observation group, 4 cases in the control group;There were 0 cases of thrombus, respectively, 3 cases in the control group. The difference was statistically significant (χ2=11.748, 4.256; P<0.05).There were 0 cases postoperative cerebral infarction occurred in the observation group, and aneurysm recurrence in 1 case. Four cases postoperative cerebral infarction occurred in the control group, and aneurysm recurrence in 3 cases, respectively. The difference was statistically significant (χ2=5.719, 10.811; P<0.05). Conclusions The clinical effect of interventional embolization of intracranial aneurysms under the guidance of double volume reconstruction is remarkable, and the effect of interventional embolization and the relationship with the peripheral vessels can be clearly demonstrated. It can reduce the incidence of adverse cerebral vascular reactions and the recurrence rate of aneurysms and reduce the intraoperative risk. It is worthy to be popularized in interventional embolization of intracranial aneurysms and follow?up after operation.

Signal transducer and activator of transcription 3 (STAT3) and Chemokine CX3C ligand 1 (Fractalkine/CX3CL1) play important roles in vascular inflammation and injury. To study if STAT3 promotes vascular endothelial cell proliferation and migration through fractalkine, we overexpressed or knocked down STAT3 in vascular endothelial cells, and used quantitative real-time PCR and Western blotting to determine the effect of STAT3 on fractalkine expression. The wild type and STAT3 binding site mutant fractalkine promoter luciferase reporter plasmids were constructed, and luciferase activity assays were used to explore the effect of STAT3 on the transcriptional activity of the fractalkine promoter. MTT assays were used to detect the effect of overexpression or knockdown of STAT3 or fractalkine on the proliferation rate of vascular endothelial cells. Scratch assays were used to detect the effect of overexpression or knockdown of STAT3 or fractalkine on vascular endothelial cell migration. There results showed that overexpression of STAT3 could promote fractalkine expression, and knockdown of STAT3 could down-regulate fractalkine expression. STAT3 could directly bind to the promoter of fractalkine to promote its transcriptional activity via binding the GAS site of the fractalkine promoter. Knockdown of STAT3 could inhibit the migration of vascular endothelial cell, and overexpression of fractalkine antagonized this inhibition. Our data concluded that STAT3 promotes the proliferation and migration of vascular endothelial cell by binding the GAS site of the fractalkine promoter to promote fractalkine transcriptional activity and expression.
Cell Proliferation ; Chemokine CX3CL1 ; Endothelial Cells ; Promoter Regions, Genetic ; STAT3 Transcription Factor