Objective To introduce laminar shelling decompression technique and to discuss its benefit for decompression of thoracic ossification of ligamentum flavum. Methods 102 patients were diagnosed as thoracic ossification of ligamentum flavum, 63 males and 39 females with an average age of 49.7 years (range, 33 to 71 years). 99 cases suffered with sensation disturbance, 73 cases with constriction on trunk or lower limbs, 77 cases with sphincter dysfunction. The IMSOP Standard Neurological Classification of Spinal Cord Injury was applied for localized the level of thoracic spondylopathy. The JOA lower limb motor function standard and sphincter function standard were used to evaluate the ability of lower limb motion and sphincter function respectively. In the decompression the dorsal cortex of lamina was the first layer to resect, the facet joint surface indicate the depth for removing the second layer, then thinning the ossified tissue by shaving with the motor bur until it was somewhat lucent. Finally decompress the spinal canal by moth eaten manner. Results The mean decompression length was 2.8 lamina(2 to 4 lamina). The mean follow-up duration was 18.9 months (3 to 41 months). Among 99 sensation disturbance 69 totally recovered, 30 relived. 73 cases with the feel of constriction of trunk or lower limbs were completely recovered. Postoperative JOA sphincter function score was 2.632?0.407, comparing with the preoperation score, and the difference was significant (t=15.93, P

3 cm)ultrasonography image was the absent of rotator cuff image(nonvisualization)or discontinuity(local nonvisualization);moderate full thickness cuff tears(size 1-3 cm)ultrasonography image was the hypoechoic zone extending through the entire substance of the cuff;bursa surface partial thickness was small hypoechoic discontinuities of the external surfaces of the cuff;articular surface partial thickness was small hypoechoic discontinuities of the internal surfaces of the cuff.All the ultrasonography examination results were compared with findings at shoulder operation or arthroscopy as a golden standard.12 shoulders were open repaired;16 shoulders were limited open and arthroscope repaired;6 shoulders were contracted under the radio frequency ablation;22 shoulder were taken acrominal plasty under the arthroscope.Results The ultrasonography correctly depicted 30 of 33 rotator cuff tears with sensitivity 90.91%,specificity 91.30%,positive predictive value 93.75%,negative predictive value 87.50%.6 large to extensive tears,11 small and moderate full-thickness tears,5 acrominal partial-thickness tears,11 articular partial-thickness tears.Conclusion The ultrasonography is a highly accurate diagnostic method for detecting full-thickness rotator cuff tears,but is less sensitive in detecting partial-thickness rotator cuff tears.

Objective To investigate the pathological and physiopathological difference between the ruptured” and the “degenerated” typed lumbar disc herniation (RDH and DDH) by measurement of the pressure of the herniated lumbar disc both in the herniated site and in the nucleus pulposus during the surgery, combined with the clinical,light microscopical and immunohistochemical properties. Methods Fifty seven cases of lumbar disc herniation undergone operation in the Tianjin Medical University Hospital were included in this study. The patients were divided into 2 groups. 1) Rupture typed lumbar disc herniation in which the herniated chip of the lumbar disc separated from the parent disc and was squeesed or drew out easily when the superficial posterior longitudenal ligament and anulus fibrosis were opened in the herniated site. 2) Degenerated typed lumber disc herniation in which no herniated chip of the lumber disc escaped; the herniated material can not be taken out unless the disc was resected by the instrument. Before the herniated disc was incised, the intervertebral disc pressure was measured using GENERAA710 multifunctional monitor. Both the light microscopical and the immunohistochemical difference between the RDH and the DDH was studied. Results 1) In the herniated site, the pressure in the RDH is higher than that in the DDH(P0.05). 3) In the RDH, the pressure in the herniated site is higher than that in the nucleus pulposus (P0.05). 5) The“lumbar pain score”and the pressure have obviously relationship in all of 35 patients(r=0.539,P

Objective To explore the effect of icariin on stimulating Smad4 mRNA level in MC3T3-E1 cells. Methods MC3T3-E1 cells were treated by 0 ng/ml, 10 ng/ml, 20 ng/ml, 40 ng/ml icariin respectively. MTT method and population diploid time were applied to observe the cell proliferation. The cell ALP level was measured by atomic absorptiometry and the type Ⅰ collagen was observed by immunohisto-chemistry. RT-PCR was used to find the Smad4 mRNA level in the MC3T3-E1 cells. Results Under the inversion phase contrast microscopy, MC3T3-E1 cells were oligodendrocytes-shaped rich with cell organs. The cells density in 10 ng/ml, 20 ng/ml were higher than those in 0 ng/ml,40 ng/ml. Cell growth curve in 10 ng/ml was higher than other 3 groups and the 20ng/ml was higher than 0 ng/ml, 40 ng/ml groups( P

Background:Small bowel Crohn's disease (CD) is a chronic nonspecific inflammatory disease with unknown etiology.There is no clear criteria for assessing the progression of CD, and the endoscopic index for assessing disease activity in CD patients is limited to a single parameter.Aims:To investigate the clinical value of endoscopic index in evaluating disease activity in patients with CD and the correlation between different parameters.Methods:Sixty cases of CD patients form Jan.2008 to Dec.2012 at Affiliated Hospital of Yanan Uuiversity were collected, 60 healthy adults were served as control group.CECDAI score, CDAI score and Lewis score were used to evaluate disease activity in patients with CD, and their relationship with CRP and ESR were analyzed.Results:Levels of CRP and ESR were significantly increased in CD patients than in controls (P<0.05).CDAI score and Lewis score were statistically different in different CECDAI score groups (F=5.53, P<0.05;F=22.64, P<0.05).CECDAI score was statistically different in different CDAI score groups (F=3.55, P<0.05), and was statistically different in different Lewis score groups (F=4.26, P<0.05).CECDAI score was correlated with CDAI score, Lewis score, CRP, ESR (P<0.05);CDAI score was correlated with CRP, ESR (P<0.05) and not correlated with Lewis score (P>0.05);Lewis score was not correlated with CRP, ESR (P>0.05) in CD patients.Conclusions:CECDAI score, CDAI score, Lewis score, CRP, ESR can reflect disease activity of CD, and can be used together to assess disease activity of CD patients.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Objective: To study the effect of enteral nutrition in the treatment of heart failure with hyponatremia.Methods: Forty patients sufferd from heart failure with hyponatremia were divided into two groups at random: control group(n=20) with regular therapy and treatment group(n=20) with enteral nutrtion on the base of regular therapy.Time intervals from hyponatremia to normal natremia of the two groups were compared.Results: Time interval from hyponatremia to normal in the treatment group was 5.30?1.82 days,and that in the control group was(8.85?2.44) days.Conclusion: The treatment with enteral nutrition can significantly shorten the clinical treatment time in heart failure with hyponatremia.

Objective To explore the clinical characteristics and risk factors of re-fracture in patients suffering from osteoporosis-related fractures as well as effective interventions.Methods From January 2006 to January 2008,a total of 273 patients with osteoporosis-related fracture were entered in the study,including out-patients and in-patients who were over 50 years old.The patients were divided into fracture group(n=225)and re-fracture group(n=48).The re-fracture rate was followed up for 2 years,during which 11 patients developed re-fracture.General data including age and sex,fracture types,femoral neck bone mineral density(BMD)T-scores tested by dual-energy X-rays absorptiometry(DEXA),Charlson index,timeinterval between two fractures as well as mobility skill assessment were collected and analyzed.Results The average age at the first fracture was 67.7±8.5 years vs.72.7±9.5 years for the re-fracture cases.Female accounted for 70.2% of the fracture group and 77.1% of the re-fracture group.The most common re-fracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup.Risk factors for a second fracture in osteoporotic fractures patients include age(＞75 years,HR=1.23; ＞85years,HR=1.68),female sex(HR=1.36),prior vertebral fractures(HR=1.62),prior hip fractures(HR=1.27),BMD T-score＜-3.5(HR=1.38)and weakened motor skills(HR=1.27).The refracture rate in osteoporosis-related fractures was 4.9% followed up for 2 years.The second fracture happened 3.7 years after the first one on average.Conclusion The risks of second fracture among patients with initial brittle fracture are substantial.Mobility skill assessment is an important risk factor for osteoporosis fractures recurrence.There is adequate time between fracture and re-fracture for effective interventions to prevent or reduce the risks of refracture,especially for the old women with a vertebral or hip fracture.Medication,motor function rehabilitation and fall-down prevention training would be helpful.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Objective To investigate the relationship between personal disposable income and female depression,and to examine the moderating roles of personality in this link.Methods The demographic questionnaire,self-rating depression scale (SDS) and eysenck's personality questionnaire short scale (EPQ-RSC) were used to survey 139 cases of married female patients with depression.Results Personal disposable income could be used to significantly and negatively predict female depression(β=-0.669,P＜0.01).The interaction between personal disposable income and introversion-extroversion,personal disposable income and neuroticism was significant (β=0.142,P＜0.05.β=-0.232,P＜0.01).In the groups of higher and lower scores on the introversion-extroversion dimension,personal disposable income could be used to significantly predict female depression(β=-0.397,P ＜0.05.β=-0.452,P＜0.05).In the group of higher scores on the neuroticism dimension,personal disposable income could be used to significantly predict female depression(β=-0.553,P＜0.01),but not in the group of lower scores(β=-0.349,P＞0.05).Conclusion Personal disposable income has significantly negative prediction effect on female depression,and introversion-extroversion and neuroticism have significant moderating effects on the relationship between personal disposable income and female depression.