Objective To report the results using endoscopic techniques in ce rvical discectomy and intervertebral fusion. Methods From October 2002 to August 2003, 26 patients underwent cervical discectomy and intervertebral fusion using endoscopic techniques. 16 patients had been followed-up more than 3 months, inc luding 4 females and 12 males. The average age was 53.2 years (range, 23 to 65 y ears). The disorders lasted from 3 to 14 months before surgery. There were 3 cas es of cervical injury associated cervical disc herniation (CDH), 8 of cervical s pondylotic myelopathy (CSM), 2 of solitary ossification of the posterior longitu dinal ligament (OPLL), and 3 of radiculopathy. The mean preoperative ADL of Japa nese Orthopedic Association (JOA) score was 7.2. The working channel was inserte d through a 2 cm long incision, the protruded discs or ossified posterior longit udinal ligaments were excised for complete decompression, then an appropriate in tervertebral PEEK fusion cage was implanted. Results All patients obtained endos copic cervical discectomy and interbody fusion successfully. None of cases was c onverted to open procedures. The surgery lasted an average of 120 min (range, 50 to 150 min), mean blood loss was 110 ml (range, from 40 to 140 ml). There was n o complication during operation and no any stimulating symptoms on laryngopharyn x after surgery. However, postoperative hemorrhage of the incision occurred in 1 case, then an injury of a thyroid vessel was found during immediate exploration . The follow-up period extended from 3 to 8 months (mean, 6.5 months), the aver age preoperative ADL of JOA score was 13.1 while the improvement rate was 60.2%. Conclusion The cervical discectomy and intervertebral fusion through endoscopi c approach is able to reduce the soft tissue injury and the incidence of stimula ting symptoms on laryngopharynx, which makes the surgery more safe. The indicati ons for this procedure include cervical disc herniation, cervical myelopathy, ra diculopathy, and traumatic cervical disc injury on C3,4 to C5,6 segments.

BACKGROUND: Stem cells, cells with special function in animals and humans, exist in various tissues. Most of stem cells differentiate into special tissue organs and some of them remain in the status of stem cells for tissue repair. Mesenchymal stem cells were transplanted to burn wounds in some researches for inducing the proliferation and activation of skin stem cells so as to cure burn.OBJECTIVE: To observe the effect of stem cell culture medium cultured in vitro instilled locally into the severely traumatic skin in guinea pigs on healing time and healing degree of the wound.DESIGN: Random grouping and blank control trial.SETTING: Department of Toxicology, School of Public Health, Jilin University.MATERIALS: Totally 14 adult healthy guinea pigs of either gender weighing 300 to 350 g were recruited.METHODS: The experiment was conducted in the Laboratory of Toxicology Department, School of Public Health, Jilin University, from March to September 2003. Ten guinea pigs were put to death by bloodletting on the neck. The bone marrow was extracted and cultured in unicellular supematant fluid for use. The 14 guinea pigs were made into models of bilateral severe skin trauma.Ten of the guinea pigs were chosen randomly, stem cell culture was instilled into one side of the animals (stem cell group), while the culture medium was instilled into the other side of the animals (culture medium group). The remaining 4 guinea pigs that received no treatment were blank control group.Three days later, transparent lucite was put on the wound every other day for drawing the shape and observing the wound. After the shape was copied onto the transparent lucite, the wound area was worked out on the rectangular coordinate paper and the speed of wound healing was calculated.MAIN OUTCOME MEASURES: Gross observation was performed on the healing status of the wound and average healing time and speed of the guinea pigs in each group.wound healing status of the guinea pigs in each group: At day 3, the wound in stem cell group was dry without obvious exudation. There was a layer of membrane at the bottom of the wound and it stuck to the pledget closely so that the dressing could not easily be removed. The wound status in the culture medium was practically the same as that of the stem cells, but no membrane-ike material was formed and the dressing was easily removed. Inflammation appeared obviously in blank control group.nificantly less in stem cell group than in culture medium group and blank control group [(12.45±2.18) days vs (26.29±1.38) days and ＞ 30It was obviously faster in stem cell group than in culture medium group and blank control group [(40.42±2.14) mm2 per day vs (15.53±5.22) mm2 per day and(10.27±4.57) mm2 per day,P ＜ 0.05].CONCLUSION: The stem cells of homologous animals were instilled on the skin surface to repair injury wound. Stem cells can grow on the wound and transform into skin cells, which promotes the recovery of wounded skin. Therefore, it is feasible to treat severe skin defect with stem cells.

Objective To study the therapeutic effects and mechanisms of Astragaloside-Ⅳ (ASG-Ⅳ) on diabetic cardiomyopathy (DCM) in the rat diabetic model. Methods Forty SD(Sprague-Dawley)healthy rats were used. The diabetic retinopathy rats model were induced by STZ, 45 mg/kg, 3d. Another 10 were injected the same amount of citrate buffer as a control group. Fasting blood glucose was measured with SureStep Plus detector 72 h later. The blood glucose of the diabetes model was ≥16.7 mmol/L. And 12 weeks later, DCM rats were divided into 4 groups randomly in the experiment, includes: DCM, ASG-Ⅳ-L (10 mg/kg), ASG-Ⅳ-M (30 mg/kg), ASG-Ⅳ-H (60 mg/kg)groups. After give dugs 4 weeks, the phosphokinase isoenzyme (CK-MB) and LDH level were tested, the cardiac hypertrophy was evaluated by HW/BW and LVW/BW. Activity of Na+-K+-ATPase and Ca2+-ATPase were determined in left ventricular tissues by ATPase ELISA Assay Kit. The content of FFA was measured and myocardial pathological examination was performed. Results Compared with the control group, blood and urine glucose were higher than experimental animal in diabetic model group, were significantly increased (P<0.05). LDH and Phosphokinase isoenzyme (CK-MB) level were significantly increased, the HWI and LVWI ratio were enhanced in DCM group (P<0.05). ASG-Ⅳ could reduce the ratio of HWI and LVWI, decrease the level of CK-MB and LDH, improve the pathomorphological changing of DCM rat model (P<0.05). Moreover, compared with DCM group, ASG-Ⅳ could restore the Na+-K+-ATPase and Ca2+-ATPase activity, reduced the content of FFA (P<0.05). Conclusion ASG-Ⅳ plays therapeutic effect on diabetic cardiomyopathy might via restore the Na+-K+-ATPase and Ca2+-ATPase activity, reduce the content of FFA, protect the myocardial energy metabolism in DCM.

Objective To explore the effects of corticosteroids on the recurrence of atrial fibrillation (AF) after radio fre-quency catheter ablation (RFCA ) .Methods A total of 50 patients with paroxysmal AF who underwent RFCA and then treated with corticosteroids from January 2011 to April 2014 were enrolled in this study .At the same period ,37 patients with paroxysmal AF who also underwent RFAC but without corticosteroids treatment were selected as control group .The follow-up was carried out by the fixed physician at 1st week ,1st month ,3rd months ,6th months ,12th months after RFCA through a telephone visit or a hos-pital visit ,including the 12-lead electrocardiogram (ECG) and the HOLTER examination ,symptom of heart-throb inquiry and the interpretation of ECG ,AF recurrence were analyzed and compared between hormone treatment group and control group .Results After 1 week treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 54 .1% ,re-spectively ,there was statistic difference(P < 0 .05) ,the recurrence of AF in treatment group was significantly decreased ;after 1 month treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 67 .6% ,respective-ly ,there was no statistic difference(P = 0 .187) ;after 12 months treatment ,the recurrence of AF in treatment group and control group ,was not found statistic significance(P= 0 .711) .Kaplan-Meier survival rate was drew to conduct Log-rank test ,the difference of AF recurrence between the two groups was no statistic significance(P= 0 .711) .Conclusion Transient use of small amounts of corticosteroids after AF ablation may be effective for preventing AF recurrences within 1 week after ablation but it is not effective for preventing AF recurrences at 1st month and 12th months after ablation .

Objective To investigate the role and mechanism of simvastatin on colonic fibrosis in rats with 2,4,6-trinitrobenzene sulphonic acid (TNBS) induced colitis.Methods Forty-eight healthy male Sprague-Dawley rats were evenly divided into six groups:control group,TNBS group,simvastatin treated group Ⅰ,group Ⅱ (from zero to 21 days after modeling,simvastatin 5 mg/kg or simvastatin 20 mg/kg treated),group Ⅲ and group Ⅳ (from seven to 21 days after modeling,simvastatin 5 mg/kg or 20 mg/kg treated).Body weight and disease activity index (DAI) of the rats were inspected,and general colon,histological injury and fibrosis were scored.The expressions of collagen types Ⅰ and connective tissue growth factor (CTGF) at mRNA level were detected by reverse transcription-polymerase chain reaction (RT-PCR).The expressions of collagen types Ⅰ,CTGF and phosphorylation of myosin phosphatase target subunit-1 (p-MYPT-1) at protein level were determined by Western blotting.The data were analyzed by one-way ANOVA.Results Compared with control group,the colon length shortened,while colon weight,DAI score,general colon score,histological injury and fibrosis score significantly increased in TNBS group.And the expressions of collagen types Ⅰ also obviously increased.After intervention of simvastatin,both the colon length and weight of rats were improved.The DAI score,general score,histological injury and fibrosis score were lower than those of TNBS group.The expressions of collagen types Ⅰ,CTGF and p-MYPT-1 (group Ⅰ:0.68±0.22 ; group Ⅱ:0.59 ± 0.27 ; group Ⅲ:0.71 ± 0.20 ; group Ⅳ:0.59± 0.25) in colonic tissue were all lower than those of TNBS group (F=5.169,P＜0.05).There were no statistical significance among four groups (al1 P＞0.05).Conclusion Simvastatin can effectively prevent TNBS-induced rat colitis from colonic fibrosis,the mechanism may be related with Rho-kinase inhibition and down-regulation of CTGF over-expression.

Objective To explore the expression and significance of vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGF-β1) in hepatic fibrosis.Methods Fifty-six cases of patients with hepatic fibrosis were selected as observation group and 50 healthy persons as control group.Immunohistochemistry were performed to detect VEGF and TGF-β1 in two groups.Results Serum VEGF and TGF-β1 in observation group were significantly higher than those in control group(VEGF:(110.87 ±32.64) μg/L vs (15.98 ±6.75) μg/L,t =20.166,P ＜0.001;TGF-β1:(15.08 ±4.27) ng/L vs (7.17 ±2.86) ng/L,t =11.066,P ＜ 0.001) ;There were significant differences on VEGF and TGF-β1 level among S1,S2,S3 and S4 subgroups(VEGF:(84.25 ±16.86) μg/L vs (101.87 ±36.70) μg/L vs (118.04 ±40.75)μg/L vs (134.65 ± 45.73) μg/L,F =15.689,P =0.015 ; TGF-β1:(10.87 ± 2.64) ng/L vs (13.06 ± 2.74)ng/L vs (17.87 ± 3.28) ng/L vs (22.76 ± 4.75) ng/L,F =12.438,P =0.026).VEGF had positive correlation with TGF-β1 (r =0.532,P =0.013).Conclusion VEGF and TGF-β1 level have close relationship with the occurrence and development of hepatic fibrosis.Combined detection of VEGF and TGF-β1 can be serum index for diagnosis and evaluation disease condition.

We expound the origin and development of preventive treatment's concept in the Huangdi's Internal Classic and the Treatise on Cold-induced and Miscellaneous Diseases.We also discussed how Zhang Zhonjing transmitted his knowledge about preventive treatment from the Huangdi's Internal Classic.We explained in detail the importance and the clinical applications of treating before occurrence of disease,treating early after occurrence,preventing the propagation,avoiding critical evolution of disease and preventing the relapse when the patient is recovered.

ObjectiveTo explore the role of BTBD10 overexpression in the proliferation of insulinoma cell line INS-1and its mechanism. MethodsThe recombined expression plasmid of pcDNA4.0-BTBD10 was constructed by gene cloning technique and was transfected into INS-1 cell by lipofectamine 2000. The stable overexpression BTBD10 of INS-1cell was selected at 48th hour after transfection.INS-1 cell proliferation activity was measured by MTT method.The expression of BTBD10,protein kinase B(Akt),phospho-Akt(p-Akt),mammal target of rapamycin (mTOR) and phospho-mTOR (p-mTOR) were determined by Western blot.ResultsThe stable overexpression BTBD10 of INS-1 cell wassuccessfullyconstructed.OverproductionofBTBD10promotedbetacellproliferation.The phosphorylation of Akt and mTOR was increased and the ratio of p-Akt/Akt and p-mTOR/mTOR was enhanced in the INS-1 overexpressed by BTBD10.But the expression of total Akt and mTOR presented no obvious changes. Conclusion The overexpression BTBD10 of INS-1 cell could activate of Akt/mTOR signalling pathway via stimulating phospho-mTOR and Akt,and enhance overall cell protein translation,so as to promote proliferation of INS-1 cell.

Objective To review and analyze the clinical effect of combined posterior mini-invasive fixation with anterior debridement via small incision for the treatment of single segment lumbar vertebral tuberculosis. Methods Totally 31 cases with single segment lumbar tuberculosis (both borderline tuberculosis) without attachment involvement underwent one-stage anterior debridement, interbody fusion and posterior mini-invasive fixation from July 2010 to July 2015. Among these patients, 19 were male and 12 were female. The average age was (36.1±17.8) years old (ranged 21-61 years old). The average course of disease was 11(9, 12) months (ranged from 2 to 16 months). All were single segment involvement, and the involved segment was L2-3 in 7 cases, L3-4 in 10 cases, L4-5 in 6 cases, and L5-S1 in 8 cases. The clinical manifestations included lumbar back pain in 31 cases with an average pain visual analog score (VAS) of 7(6, 8) points. ASIA grade of spinal cord injury was E in 25 cases and D in 6 cases. Paravertebral abscess occurred in 22 cases and iliac fossa gravity abscess appeared in 9 cases. Kyphosis was observed in 12 cases and the average Cobb angle was 21° ± 6° . Quadruple anti-tuberculosis chemotherapy was used for at least 2 weeks preoperatively. Posterior mini-invasive fixation was fulfilled on prone position, including mini-invasive percutaneous screws in 18 cases and pedicle screw fixation via Wiltse approach in 13 cases. Posterior distraction and deformity correction were performed simultaneously for patients with kyphosis. Then the patients were changed to lateral position for anterior debridement, bone grafting and/or titanium mesh fusion. Results The average operation time was (204±54) min (ranged 160-240 min) in 31 patients, and the mean blood loss was (168±73) mL (ranged 100-300 mL). Delayed healing of anterior incision occurred in 1 case and the incision healed after two-week dressing of wound. The incision healed well in the rest 30 cases. No complications such as nerve function, blood vessel injury were found in patients. The VAS scores of the 3 days after operation were 1.3 ± 0.3 and 2.1 ± 1.4 in percutaneous group and Wiltse approach group, respectively, and the difference between them was statistically significant ( P<0.05). The VAS score of low back pain was 2(1, 3) points in all the 31 patients three months after operation, which was significantly lower than that before surgery (P<0.05). The six patients with neurological symptoms recovered to E grade after operation. The average Cobb angle correction was 15°±5° in 12 patients with kyphosis (P<0.05), which was significantly decreased compared with that before surgery (P<0.05). All patients were followed up for an average of (36.8 ± 9.3) months (ranged from 12 to 72 months). The clinical healing of tuberculosis was achieved at the final follow-up in all the 31 patients. No complications were observed, such as lumbar kyphosis, internal fixation loosening and breakage, dislocation and titanium mesh subsidence. Conclusion Mini-invasive posterior internal fixation and anterior debridement via small incision is effective for the treatment of single segment lumbar vertebral tuberculosis in lesion debridement and spine stability reconstruction by short segment fixation. This technique can reduce fused segments, surgical trauma of anterior approach and related complications.

Objective:To discuss clinical effect of Zhuyu Zhixuetang to chronic endometritis （CE） with syndrome of Qi deficiency and blood stasis and to study improvement effect to pregnancy outcome. Method:One hundred and forty-four patients were randomly divided into two groups， patients in control group were 72 cases and in observation group were 72 cases. In control group， 66 patients completed the therapy because of 4 falling off or missing visit and 2 eliminated， and in observation group， 65 patients completed the therapy because of 3 falling off or missing visit and 5 eliminated. In two groups. anti-infection treatment was gicen to patients. Patients in control group got Fuke Qianjin Pian， 6 tablets/time， 3 times/day. Patients in observation group got Zhuyu Zhixuetang， 1 dose/day. The treatment was continued for 3 months and the follow up was recorded for 6 months. Before and after treatment， changes of menstrual volume， period and cycle were recorded. And hysteroscopy and color Doppler ultrasound of vagina were made， and endometrial morphology and endometrial receptivity were evaluated ［endometrial thickness， resistance index （RI）， pulsation index （PI） and blood flow index （FI）］ were evaluated， and pathology of endometrial were tested. And scores of syndrome of Qi deficiency and blood stasis were graded， levels of interleukin-1 β （IL-1 β）， IL-6 and tumor necrosis factor-α （TNF-α） and T-lymphoid subsets （CD3⁺， CD4⁺， CD8⁺） in peripheral blood were measured. Pregnancy and miscarriage were recorded and the safety was evaluated. Result:After treatment， menstrual volume， menstrual period， cycle and complete normal rate of menstruation in observation group were all higher than those in control group （P<0.05）. Endometrial thickness and FI were more than those in control group （P<0.01）， RI and PI were lower than RI and PI in control group （P<0.01）. And compared with control group， levels of IL-1β， IL-6， TNF-α and CD8⁺ were less （P<0.01）. And levels of CD3⁺， CD4⁺ and CD4⁺/ CD8⁺ were higher than the data in control group （P<0.01）. During 6 months follow-up， pregnancy rate in observation group was 46.97% （31/66） was higher than 27.69% （18/65） in control group （χ²=5.197， P<0.05）. Total effective rate of endometrial morphology was 96.97% （64/66） higher than 86.15% （56/65） in control group （χ²=4.981， P<0.05）. Total effective rate endometrial pathology was 95.45% （63/66） higher than 84.62% （55/65） in control group （χ²=4.304， P<0.05）. Total effective rate of comprehensive clinical effect was 93.94% （62/66） higher than 81.54% （55/65） in control group （χ²=4.696， P<0.05）. There was no adverse reactions related to traditional Chinese medicine. Conclusion:Zhuyu Zhixuetang can regulate menstruation， relieve clinical symptoms， improve endometrial morphology under hysteroscopy， regulate systemic and local immune inflammatory response， improve CP， thus improve pregnancy outcome， with better comprehensive effect and safety.