Pedicle screw fixation is widely used in spine surgery, which allows 3?dimensional fixation with a more rigid construct and permits a shorter fusion length. However, conventional pedicle screw fixation has some drawbacks, including signifi?cant muscle dissection for the exposure of bone marks. Although percutaneous pedicle screw technique can compensate for above defects, it requires an additional approach for decompression and bone graft insertion. Besides, the percutaneous pedicle screw technique depends on intraoperative multiplanar fluoroscopy, which results in high risk of radiation exposure of the surgeons and patients. Screw loosening is a well?known complication, especially in osteoporosis patients. Several methods can enhance screw stability, for example, modifying screw design and augmenting vertebral bodies with reinforcing materials that can improve the structural capacity of the deteriorated tissue, however, they also have some disadvantages. Although we can enhance bone?screw by modifying screw design, it is not useful in severe osteoporosis patients. At the same time, bone cement can increase pedicle screw axial pullout strength and fatigue resistance, however, it is associated with a number of inherent disadvantages such as its high exothermic polymerizing temperature, toxicity of the monomer, and risk of leakage to the spinal canal. Santoni et al. intro?duced cortical bone trajectory (CBT) for lumbar pedicle screw with a new screw design that is shorter and smaller in diameter which has been proposed to maximize the thread contact with this higher density bone surface. In addition, the CBT technique fol?lows a caudocephalad path sagittally and a laterally directed path in the transverse plane, engaging only cortical bone in the pedi?cle without the involvement of the vertebral body trabecular space. Finally, the screw insertion point of this technique locates around lateral pars, enabling less tissue dissection. Therefore, it can be an alternative approach to enhance screw fixation strength, and it may rescue failed pedicle screw and be used in minimally invasive spine surgery.

Objective To investigate the effect and safety of Tongqiaoxingnao soup applied in elder severe craniocerebral injury stasis resistance qing qiao patients.Methods 40 cases with severe craniocerebral injury stasis resistance qing qiao were enrolled in the study,and they were divided into two groups randomly,each group had 20 cases.Patients in the monotherapy group received routine western medicine treatment,while the combination group was added the treatment of Tongqiaoxingnao soup,200mL per day for 4 weeks.GCS scores and the persistent time of coma were analyzed.After treatment for 4,8,14 days of intracranial pressure and cerebral edema were recorded and analyzed,the total effective rate and the incidence of adverse reactions were compared between two groups.Results GCS score of the combination group was (13.7 ±4.2)points,and it was obviously higher than the monotherapy (9.2 ±3.5)points (t =2.86,P <0.05).The coma duration of the combination group was (6.5 ±1.4)d,and it was obviously shorter than the monotherapy group (10.2 ±2.5 )d (t =2.86,P <0.05 ).The amount of intracranial pressure increased of combination group were 10 cases and 8 cases,which were significantly less than the monotherapy after 8 and 14 days with 16 cases and 15 cases (χ2 =3.96,5.01,all P <0.05).Total effective rate of combination treatment group was 75.0%,which was significantly higher than 40.0% of monotherapy group (χ2 =5.01,P <0.05).The occurrence of adverse reactions such as bleeding,electrolyte imbalance,hypoxemia,and the acid -base imbalance had no significant differences between the two groups (P >0.05 ).Conclusion Tongqiaoxingnao soup applied in elder severe craniocerebral injury stasis resistance qing qiao patients has clinical curative effect,can shorten the coma time,reduce intracranial pressure and relieve cerebral edema,and has high security,it is worthy of populari-zation and application.

Animals ; Antihypertensive Agents ; pharmacology ; Blood Pressure ; drug effects ; Cold Temperature ; Hypertension ; etiology ; physiopathology ; Hypolipidemic Agents ; pharmacology ; Isoflavones ; pharmacology ; Kidney ; pathology ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Male ; Mice ; Mice, Inbred ICR

Objective To analyze the incidence and risk factors of contralateral radiculopathy in patients after unilateral transforaminal lumbar interbody fusion (TLIF) surgery.Methods A retrospective study was conducted within 587 patients (average age 57.1 years,range 19-71 years) who underwent unilateral TILF from January 2010 to January 2014 in our hospital,including 334 males and 253 females.Patients were divided into a symptomatic group and an asymptomatic group.The causes of contralateral neurological symptom were evaluated according to the radiological data.The difference of pre-and post-operative contralateral foramen area (CFA),segmental angle (SA) and the clinical treatment outcomes (VAS,JOA score) were compared between two groups.Results Patients were followed up for 9-21 months,average 15.1 months.Post-operative contralateral radiculopathy occurred in 28 (4.8％) of the patients who underwent unilateral TLIF,including contralateral foraminal stenosis in 16 (57.1％,16/28),screw malposition in 5 (17.9％,5/28),contralateral lateral recess stenosis and/or newly developed disc herniation in 3 (10.7％,3/28),hematoma in 1 (3.6％,1/28),cement compression in 1 (3.6％,1/28),and unknown origin in 2 patients (7.1％,2/28).Nineteen (3.2％,19/587) of the 28 patients received revision surgery because of ineffective conservative treatment.Compared with the asymptomatic group,the difference of pre-and post-operative CFA was significantly smaller (-13.8±13.2 mm2) in symptomatic group,while the SA was significantly greater (7.0°±9.8°) in symptomatic group.The JOA score at 3 months after the surgery was significantly improved in asymptomatic group (63.0％±18.1％,P＜0.05).Conclusion The incidence rate of contralateral neurological symptom was 4.8％ in the present study.The potential risk factors associated with contralateral radiculopathy were predominantly contralateral foraminal stenosis and screw malposition.The excessive restoration of SA might have an effect on contralateral nerve compression,which should arouse the attention of the surgeon.

Objective To establish a more sensitive method to detect free cancer cells in peritoneal washings of gastric cancer cases during surgery. Methods The CEAmRNA levels in peritoneal washings in 65 cases of gastric cancer were detected by Real-time RT-PCR. PLC was applied simultaneously to detect free cancer cells. Negative controls included the peritoneal washings from 5 cases of benign gastric diseases and the blood samples from 5 cases of healthy adult volunteers. Results (1)CEAmRNA was not found in peritoneal washings in benign gastric diseases and in blood of healthy adult volunteers. (2)The positive percentage of free cancer cells detected by Real-time RT-PCR was 47.7%, while PLC′s was only 12.3%.(3)The positive rate of CEAmRNA showed a significant difference between gastric cancer with serosal invasion and without serosa invasion groups, between peritoneal metastasis group and no peritoneal metastasis groups, and also between stages I+II and III+IV diseases(all P

BACKGROUND: After neural precursor cells (NPCs) induced from embryonic stem cells (ESCs) have been grafted into the brain, it would still keep some potency of proliferation and differentiation, strong plasticity and integration into the host neural tissues, which would help to observe the therapeutic effect of PD.OBJECTIVE: To observe the differentiation of mouse ESCs into NPCs and the therapeutic effect of NPCs after being transplanted on the behavior of Parkinson disease (PD) rats.DESIGN: Randomly and controlled animal experiment.SETTING: Staff Room of physiology and Staff Room of Neurobiology, Depayment of Basic Medical Sciences, the Third Military Medical University of Chinese PLA.MATERIALS: Totally 50 healthy adult Wistar rats were chosen and randomly divided into experimental group (n=45) and control group (n=5).METHODS: ① 5 μ L (2 g/L)6-hydroxydopamine (6-OHDA) was injected into substantia nigra pars compacta and ventral tegmental area two points in the experimental group to prepare PD rats, and normal saline with the dosage of 5 μL per point was injected into the rats in the control group.Behavioral test began at 1 week after operation to measure successful rate of model establishing, once a week for 7 consecutive weeks. ② Totally 20 successful PD rat models were chosen to perform corpus striatum NPCs with the dosage of 2 μL [the count of cell suspension was (5-8)×106/μL].The other 5 rats were given 2 μL normal saline at corpus striatum as normal saline control group.MAIN OUTCOME MEASURES: ① Successful rate of PD model. ②Effect of NPCs transplantation on the rotation times of PD models. ③ Distribution of transplanted NPCs in vivo, and survival and differentiation.RESULTS: ①6 weeks later, totally 33 of 45 rats in the experimental group achieve the standard of PD model . ② About 85% of mouse ESCs were differentiated into Nestin-positive NPCs 5 days after the embryoid bodies formed in the bacterial dishes and cultured in the N2 serum-free medium. ③The rotation times of the PD rats was significantly decreased after the intracerebral transplantation of NPCs as compared with normal control group. Most of the NPCs grafted into striatum of PD rats were survived, and some were differentiated into TH-positive neurons.CONCLUSION: The mouse ESCs-derived NPCs could be transplanted into striatum of PD rats, and then differentiated into TH-positive neurons,which leads to the obvious decrease of rotation times.

Objective To compare the serum levels of transforming growth factor (TGF)-beta 1,bone morphogenetic protein (BMP)-4 in patients with rheumatoid arthritis (RA) and RA with interstitial lung disease (RA-ILD).Methods Twenty-eight RA-ILD patients,32 patients with RA but without ILD and 20 normal controls were enrolled.The RA-ILD group was further divided into early group and late group.All the observed subjects were analyzed using enzyme linked immunosorbent assay (ELISA) for the determination of serum TGF-β1 and BMP-4 levels.The relationship between the serum levels of TGF-β1,BMP-4 and laboratory examinations were investigated.Comparisions between groups were tested by one-way ANOVA analysis and ttest.Correlation of indexs were observed by Spearman method.Results Patients in the RA-ILD group were older than RA group in disease onset age,in addition,patients with ILD had better joint function and higher serum rheumatoid factor titers.The occurrence time of interstitial lung disease was 2-6 years after the onset of arthritis,with an average time of (3.0±1.2) years.The TGF-β1 levels in the RA-ILD group were slightly higher,but not statistically significant than other groups (P＞0.05).The TGF-β1 serum levels in the early RA-ILD patients were significantly increased than those of the late RA-ILD group and the RA group.BMP-4 levels in patients with RA-ILD group were less than RA without ILD group and healthy control group,and the difference was statistically significant (P＜0.05).BMP-4 level in early RA-ILD group was significantly decreased than those of the late RA-ILD group and RA group.No correlation between the serum BMP-4,TGF-β1 level (P＞0.05) no assay result correlated with laboratory parameters including ESR,CRP,RF and anti-CCP antibodies (P＞0.05).Conclusion TGF-β1 serum levels are increased and BMP-4 levels are decreased in early RA-ILD patients.The serum levels of TGF-β1 and BMP-4 may be indicatior for asymptomatic ILD and reflect disease progression.

Objective To establish the method of contact heat evoked potential(CHEP)and to explore the value of this evoked potential in pain testing of patients with cerebral infarction.Methods A total of 100 healthy volunteers and 30 patients were examined.The healthy volunteers were divided into 3 groups according to the length of their arms:(Group A:56.0～65.0 cm ;Group B :65.5～74.0 cm ;Group C :74.5～83.0 cm).A recently de- veloped heat-foil technique with a rapid temperature rising rate at 70℃/s was used to elicit pain and contact heat e- voked potentials.Contact heat was delivered via one circular thermode(diameter 27 mm,area 573 mm~2)and set at two intensity levels(49.5℃and 54.5℃)to three body sites:the thenar eminence,the dorsum of hand and proximal volar forearm.The subjects were asked to rate the pain with numerical rating scale after each stimulus and CHEP was recorded from Cz and Pz.The association between stimulus intensities and pain rating was explored,the main compo- nents of the evuked potential were watched.CHEP,sensory conduction velocity(SCV)and somatosensory evoked potentials(SEP)were performed in patients with hemi-anesthesia caused by cerebral infarction.Results The pain intensity ratings were 3.2?0.3 and 4.4?0.5 at thenar eminence,5.0?0.7 and 6.3?0.8 at the dorsum of hand and 5.3?0.6 and 7.2?0.5 at the proximal volar forearm when the temperature of 49.5℃and 54.5℃was applied, respectively;Three components,Cz/N550,Cz/P750 and Pz/P1000,were identified in the evoked potentials.Cz/ N550 and Cz/P750 appeared when the dorsum of hand and proximal volar forearm were stimulated.In contrast,Pz/ P1000 could be identified when nociceptors of thenar eminence and proximal volar fbrearm were excited.In the pa- tients with cerebral infarction,CHEP disappeared or became abnormal on one side,while SCV and SEP were normal on that side.Conclusion It was suggested that CHEP could be elicited reliably in the controls.CHEP is helpful in the assessment of analgesia in patients with cerebral infarction.

Objective To study the effects of acute coronary comprehensive syndrome with PCI therapy after secondary HIT-Ⅱ give sulphur of liver fondaparinux therapy clinical comprehensive effect.MethodsDecimation in 66 patients with acute coronary syndrome after PCI patients was applied on the basis of drug therapy and postoperative anticoagulation.Study group (33 cases) in the postoperative secondary HIT Ⅱ after being diagnosed with stop heparin and give sulphur of fondaparinux, bleeding in the coagulation indexes, within 30 days event and 6months heart vascular pieces efficacy evaluation.ResultsThe use of heparin before.The index of blood coagulation in study group were normal, confirmed HIT Ⅱ when the index change significantly (P<0.05) and the discontinuation of heparin 24h, 3d, 7d indexes compared at diagnosis were restored (P<0.05) and 14 days of heparin to stop with the use of heparin levels.The patients in the study group, the incidence of bleeding events was 9.1%, compared to 15.2% in the control group no significant difference.The patients in the study group of adverse cardiovascular events occurred rate was 12.1%, compared to 18.2% in the control group no significant difference.ConclusionAcute coronary syndrome after PCI HIT-Ⅱ to grant the sulphur of fondaparinux treatment had no significant effect on blood coagulation function and safety.

AIM: To observe the survive, differentiation and therapeutic effect of neural precursor cells (NPCs) differentiated from mouse embryonic stem cells (ESc) when transplanted in the frontal cortex of Alzheimer's disease (AD) rats. METHODS: NPCs were induced from mouse ESc with serum-free methods. The differentiation of transplanted NPCs was observed with immunohistochemistry methods and memory of rats was evaluated with Morris water maze test. RESULTS: About 85% of mouse ESc were differentiated into NPCs 5 days after the embryoid bodies cultured in the N2 medium. 4 and 6 weeks after transplantation, the memory impairment of AD rats was relieved, most of the grafted NPCs were kept undifferentiated and proliferated in clone shape, neuron-like long processes was observed. CONCLUSIONS: The NPCs derived from ESc survive and differentiate into neurons after grafted into the frontal cortex of AD rats, which produces therapeutic effects on AD.