BACKGROUND: Cervical spinal cord injury without radiographic abnormality (SCIWORA) is a special type of spinal cord injury. Because of the particularity of children in the period of growth and development on the aspects of anatomy and biomechanics, their injured mechanism and therapeutic method differ from those of adults.OBJECTIVE: To explore clinical feature and therapy of first-episode cervical SCIWORA in children.DESIGN: Retrospective analysis and self pre-and post-control observation.SETTING: Department of Spine Surgery, Second Affiliated Hospital,Harbin Medical University.PARTICIPANTS: Totally 14 patients with cervical SCIWORA, who were treated at the Departmentof Spine Surgery, Second Affiliated Hospital,Harbin Medical University between June 1997 and June 2003. Inclusive criteria: ①patients who had dysfunction of sensation, exercise and sphincter to different degree in clinic, ②patients who had no fracture dislocation after cervical vertebra X-ray plain film and MRI examination. The MRI examination showed the sign of spinal cord injury. T1WI spinal cord became thick. T2WI distributed at strip-shape high-signal region along spinal prosenchyma and spread upward and downward. There were 3 patients with complete spinal cord injury and 11 patients with incomplete spinal cord injury, among the patients with incomplete injury, there were 6 patients with central cord syndrome (CCS), 3 with Brown-Sequard syndrome and 2withfrontal spinal cord injury syndrome.METHODS: Retrospective analysis was performed in 14 children patients with cervical SCIWORA. Thirteen patients were not treated with operation and one patient was treated with cervical posterior atlantoaxial fusion. MAIN OUTCOME MEASURES: ASIA grading before and after treatment in patients.RESULTS: There were 1 dead patient and 13 cases with 3-year follow up averagely. Three patients were with insignificant amelioration, and others had recovery of limb function to different degree. According to ASIA grading standard, before treatment there were 3 cases in A grade, 5 cases in B grade, 5 cases in C grade and 1 case in D grade, and after treatment there were 1 case recovering to B grade, 2 cases to C grade, 5 cases to D grade and 2 cases to E grade.CONCLUSION: Restoration of neurofunction of children with cervical SCIWORA has closely correlation with degree of primary injury of spinal cord. Most of the patients were not treated with operation, and those with obviously instable cervical vertebra can be treated with operation.

ObjectiveTo investigate the effect of cerebroprotein hydrolysate on diabetic peripheral neuropathy.Methods105 diabetic patients were randomly divided into the treatment group (34 cases, treated with intravenous injection of cerebroprotein hydrolysate), standard control group (38 cases, treated with intramuscular injection of Metrycobal combined with intravenous injection of Actovegin) and blank control group (33 cases, treated with oral vitamin B1, B6, B12). Curative effects of three groups were evaluated.ResultsIt was shown that intravenous injection of cerebropotein hydrolysate could improve patients' symptoms, raised speed of nerve conduction and its curative effect was as same as intramuscular injection of Metrycobal combined with intravenous injection of Actovegin.ConclusionIntravenous injection of cerebropotein hydrolysate has a curation effect on diabetic peripheral neuropathy.

A HPLC method was established to determine the contents of the five anthraquinones and rhaponticin in the different varieties of Rhei Radix et Rhizoma. The difference existed in different varieties. The results showed that rhein and rhaponticin were marker substances which could be used to distinguish palm leaf groups rhubarb and wave leaf groups rhubarb. Authentic rhubarb didn't contain rhaponticin. Falsify rhubarb contains trace amounts of rhein. Rheum tanguticum contains abundant rhein. The ratio value of the content of rhein to chrysophanol could be used to distinguish R. tanguticum from the other two authentic varieties (R. palmatum and R. officinale). The content of rhaponticin varied largely in different varieties of wave leaf groups rhubarb.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Quality Control ; Rheum ; chemistry ; classification ; Rhizome ; chemistry ; classification

BACKGROUND: The treatment of upper cervical spine disorders through a posterior pedicle fixation approach have been carried out in some domestic large hospitals, but this surgery is still considered as a difficulty of cervical spine surgery. In order to minimize the risk of surgery, the authors designed a program of individual operations, and combined with self-developed pedicle locating and directing speculum to determine precise intraoperative position of pedicle screws, and no report is found by searching related database in China.OBJECTIVE: To improve the one-time success rate of internal fixation screws, to investigate the biomechanical effect of the implant, to formulate a simple, practical, individual protocol for atiantoaxial pedicle screw-plate system based on related data. METHODS: A total of 31 patients were recruited from Department of Orthopaedics in the 251 Hospital of Chinese PLA, between January 2002 and September 2006. Under the guidance of self-made atlantoaxial locating and directing speculum, the entrance point and angle for screw insertion, as well as screw diameter and length were determined according to the results of X-ray and CT measurement. Atlas pedicle screw was inserted at left (19.93±1.32) mm, and right (19.16±1.3) mm; Atlas pedicle screw insertion angle to inside was left (23.72±2.09)°, and right (23.35±1.91)°; Atlas pedicle screw insertion angle to side of head was (9.00±1.20)°. Axis pedicle screw was inserted at left (13.14±0.82) mm, and right (13.85±0.79) mm; Axis pedicle screw insertion angle to inside was left (24.52±1.26)°, and right (20.42±1.42)°; Axis pedicle screw insertion angle to side of head was (25.00±3.00)°.RESULTS AND CONCLUSION: ①Totally 124 pedicle screws were implanted into 31 patients, and 122 screws were of one-time success. The precision rate was 98.39%. Two screws were secondly inserted because of cutting lateral cortical bone of pedicle for deviation of inward angle. ②Occipital neuralgia was found in 2 cases postoperatively and cured after one month of treatment;screws penetrated atlas left vertebral lateral wall in 2 cases, no spinal or vertebral artery injury was found. ③Radiographs showed that atlas was completely reduced in all patients, and apposition of dentoid process of axis fracture was good. CT films showed the screws a good location to the vertebrarterial spinal cord. ④The follow-up visit was averaged of 10.5 months. Bony fusion was found in all patients. No screw-plate breakage was found. No inflammatory or rejection reactions occurred.⑤By JOA scale, there were 16 cases of excellent, 12 cases of good, 2 cases of fine, and 1 case of poor. The excellent and good rate was 90%. It is suggested that the success rate of atlantoaxial pedicle screw-plate mplantation can be improved through a biomechanical angle.

0.05).Conclusion MRI is a highly accurate diagnostic tool for detecting tears of the medial and lateral menisci.At present,there is no evidence to ascertain that higher magnetic field strength improves discriminatory power for meniscal tears.

Background The cryptochrom 2 (Cry2)in mammalian retina is a main influential factor of circadian clock.Objective Purpose of this study was to investigate the effect of light exposure rhythm on expression of Cry2 in retina.Methods Thirty clean healthy Sprague Dawley(SD)rats were collected and divided into two groups randomly.The rats of the control group exposed to natural light with the normal rhythm for 30 days,but rats of the experimental group exposed to the artificial light (light: dark =18 hours:6 hours) for 3 months with the light intensity of(533± 16)lx.The histopathological change and ultrastructural alteration of rat retina in both groups were examined under the light microscope and transmission electron microscope at the end of the experiment.Expressions of Cry2 protein and its mRNA were assayed by immunohistochemistry and quantitative PCR(Q-PCR).Results The rat retinal morphology and ultrastructure were clear and order-arranged under the light microscope and transmission electron microscope in the control group.However,atrophy and disorganization of retina were found under the light microscope,and liquefaction and vacuole of outer segments of photoreceptors were observed.The vacuolar degeneration of mitochondria in the inner segments of photoreceptors,cellular nuclear shrinkage,chromatin margination,nuclear notch and destruction were seen in the outer nuclear layer under the transmission electron microscope.Immunohistochemistry showed that the expression of Cry2 protein located in cytoplasm and nuclei membrane of the retinal ganglion cell layer and inner nuclear layer in both normal rats and experimental rats.The scores of Cry2 protein expression were 0.833±0.197 in the experimental group,and 1.700±0.245 in the control group,with a significant difference between them (P=0.009).The quantities of Cry2 mRNA were 0.962 ± 0.125 in the control group and 0.615±0.100 in the experimental group,showing a significant difference between the two groups (P =0.006).Conclusions Long-term light exposure under the 533 lx leads to retinal structural and functional damage probably by down-regulating Cry2 expression in retina.Whether the regulation of Cry2 expression is helpful for stabilizing the biorhythm or not is a worthy question to explore.

Objective To evaluate the effect of modified bowel preparation-Polyethylene Glycol Electrolytes Powder (SF-PEG, Shu Taiqing) in combination with magnesium sulfate in patients with constipation undergoing colonoscopy. Methods Sixty cases from mild to moderate constipation were randomly divided into two groups:Group A: SF-PEG (438.4 g, 4 L), 30 cases; Group B: received low-dose SF-PEG (219.2 g, 2 L) and 50.00%magnesium sulfate 50 ml, and then 250 ml water, 30 cases. Boston Bowel Preparation Scale scores (BBPS) and bubbles in bowel lumen score were assessed by the same endoscopist blindly to the preparation regimen, and the time of colonoscopy and the tolerability was recorded. Results All patients underwent completely the bowel preparation and colonoscopy. The time of colonoscopy of group B was shorter than that of group A (P < 0.05). The BBPS score of group B was higher than that of group A (P < 0.05). The bubbles in bowel lumen were less in Group B than in Group A (P < 0.05). The willingness to retake in Group B were superior to those in Group A (P < 0.05). No significant difference was found in score of total adverse effects and taste score between the two groups (P > 0.05). Conclusion SF-PEG in combination with magnesium sulfate in patients with constipation for colonoscopy can improve tolerance to bowel preparation, cleanliness and effects of examination. It's safe to be recommended in clinical practice.

Androgen insensitivity syndrome (AIS) is a very uncommon genetic disorder that results from the resistance of androgen receptor (AR) to androgen, which influences the formation of the male genitalia and in turn presents with female phenotype.Surgical resection of undesceaded testicle and different kinds of genitoplasty are crucial methods to correct the deformity of reproductive system, as well as hormone replacement therapy, which is an essential therapy for postoperational rehabilitation in AIS patients.A 43-year-old patient, who was socially female, was first admitted to gastroenterology department due to recurrent ascites and occasional abdominal pain with unknown origin.Taking physical examination, ultrasonography, karyotype analysis and sex hormone levels into consideration, the overall manifestations revealed the typical clinical features of complete androgen insensitivity syndrome.After that she was transferred to urology department for laparoscopic gonadectomy.During the surgery, doctors found that there was a vesical fistula on the upper wall near the conjunction between the bladder and ligamenta umbilicale medium, which explained the recurrent ascites for more than 4 years.After resecting the testicles and the tissues around the vesical fistula for histopathology, the result suggested Sertoli cell adenoma, hyperplastic Leydig cells and urothelium atypical hyperplasia.Hormone replacement therapy was given right after discharge.The hormone levels of follicle-stimulating hormone, luteinizing hormone, estradiol and progesterone were modulated by the dysfunction of androgen production after gonadectomy and hormone replacement therapy together with psychotherapy could stabilize her hormone levels and improve the quality of her life.The patient was suspicious of AIS family history and the pedigree was made to analyze her family which was possibly X-linked recessive pattern.We propose three possible hypotheses of the fistula, which are direct surgical injury, recurrence of bladder cancer and congenital urachal anomalies.But whether it is relevant between urachal anomalies and AIS is yet to be discovered.

0.05).Conclusion Both PTX plus DDP and NVB plus DDP are effective to advanced breast cancer.There are no significant difference between the two groups.The two regimens can be applied to the first line chemotherapy.

Objective To investigate the status of appendicular skeletal muscle mass,muscular strength and changes of muscle function in the elderly in Shanghai.Methods A total of 402 participants were recruited from physical examination centers in our hospital.Appendicular skeletal muscle mass (ASM) was measured by bioelectrical impedance analysis (BtA).The ASM index (ASM/height2) was calculated.Muscle function was measured by testing gait speed (m/s).Muscle strength was measured by handgrip strength (HGS) using an electronic hand dynamometer.Results The ASM index significantly declined with age in both men and women (F＝2.133 and 3.124,both P＝0.000).For women,there was a significant difference in HGS only between the youngest age group (aged 60～69 years) and the oldest age group (aged≥80 years)(P＝0.005).For men,HGS was significantly different among all age groups (all P＜0.05).There was no significant difference in gait speed between 60-69 years group and 70-79 years group in both genders (both P＞0.05),while the significant differences in gait speed were observed between the 70-79 years old groups and ≥80year old group in both genders (both P＜0.05).Conclusions Appendicular skeletal muscle mass,strength and function are decreased with ageing in the elderly.The muscle strength decreases faster in the elderly man than in the elderly woman,and muscle function decreases significantly in both genders after 80 years old.