Objective To assess the curative effect of microscopic anterior cervical approach in cervical spondylotic diseases. Methods A total of 75 patients were selected, who underwent microscopic subtotal anterior cervical decompres-sion and titanium mesh to fusion fixation or microscopic decompression of resection of the cervical intervertebral disc and cage implant fixation in Tianjin People's Hospital since October 2011 to October 2012. The Cervical vertebra gap involved 1 level in 41 cases, 2 levels in 30 cases and 3 levels in 4 cases. Pateints followed up regularly after operation. The nerve func-tion was assessed using Japanese orthopaedic association scoring system (JOA) function was calculated to examine the im-provement rate and to assess the curative effect of microscopic anterior cervical approach. Results All patients were fol-lowed up. The nerve function recovery was excellent in 44 cases, was well in 25 cases, was general in 6 cases, and the ex-cellent and well recovery rate was 92%. There was no significant difference between excellent recovery rate and well recov-ery rate. There were significant differences in values of each cervical levels between before and after surgery in the last fol-low-up of patients (P<0.05). Conclusion Microscopic operative treatment for cervical spondylotic is safe and effective, with less trauma and bleeding. After surgical decompression, the recovery is rapid in patients with early ambulation.

Objective In order to evaluate the therapeutic effect, to screen effective drugs for AIDS, and to find out the changes of patient's condition, it is necessary to develop an objective method to quantitate the levels of viral load of the patients before and after treatment.Method Differential PCR(D PCR) was used to co amplify the target HIV 1 gag gene and reference template ? globin gene, so as to determine the level of HIV replication quantitatively. The levels of HIV DNA in the peripheral blood mononuclear cells of 8 patients with AIDS were determined quantitatively.Results The levels of the provirus of the 8 patients ranged from 0 508 2 210 copies/?g DNA, there were differences in the levels of replication and integration. Conclusion It is the authors′ opinion that this method is easy to control with an advantage of reliability, quickness and reproducibility, It is suitable to measure clinical specimens, and provides an objective evidence for the evaluation of responses to therapeutic intervention.

Objective:To explore the role of DKK-1 andβ-catenin expressions in progression of proximal gastric cancer (PGC). Methods:The expression of DKK-1 andβ-catenin in 61 cases with PGC and para-neoplastic tissues and 20 cases with normal gastric mucosa was detected by immunohistochemistry. The related clinical significance in the cases was studied. Results:The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in the tissue sections of PGC were 34.4%(21/61) and 68.9%(42/61), respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in para-carcinoma tissues were 8.2%(5/61) and 6.6%(4/61) , respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in normal gastric mucosa were 15.0%(3/20) and 10.0%(2/20), respectively. The expression rate was significantly higher in PGC than that in the other tissues (P<0.05). The expression of DKK-1 was positively related to that ofβ-catenin in PGC (r=0.454, P<0.05), but not in the others. Conclusion:Higher expressions of DKK-1 and the abnormal expression ofβ-catenin are closely related to the occurrence of PGC.

BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect.
OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis.
METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group.
RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.

This study was aimed to observe effects of herbal pair of semen Ziziphi Spinosae (SZS) and A lbizia Julib-rissin flower (AJF) on cognitive function and serum BDNF among depression patients. A total of 60 depression pa-tients were enrolled and randomly divided into two groups. In the SZS-AJF group, 30 patients were administered with SZS-AJF decoction. In the control group, 30 patients were administered with venlafaxine hydrochloride sus-tained-release tablets. Hamilton Depression Rating Scale (HAMD), Wisconsin Card Sorting Test (WCST), and the serum-brain derived neurotrophic factor (BDNF) were detected before treatment and after six weeks of treatment. The results showed that there were no significant differences on the HAMD score, WCST (Response Administered (Ra), Categories Completed (Cc), Correct Responses (Cr), Perseverative Errors (Pe), Non-perseverative Errors (Npe)), serum BDNF before and after treatment between two groups. Compared with pretreatment, HAMD score, Ra, Cc, Cr, serum BDNF were increased after treatment in both groups. The Pe and Npe were decreased after treatment. There was sta-tistical significance between pretreatment and posttreatment (P< 0.05, or P< 0.01). It was concluded that the herbal pair of SZS-AJF has anti-depressant effect. It can improve cognitive function of depression patients. The anti-de-pressant mechanism of herbal pair of SZS-AJF may be related to the increasing of serum BDNF level.

Objective To explore the causes and risk factors affecting early death in patients with traumatic cervical spinal cord injury (SCI). Methods Clinical data of 553 patients with traumatic cervical SCI were analyzed retrospectively to discuss the related factors affecting early death of patients with traumatic cervical SCI by using univariate analysis and multivariate logistic regression analysis. Results The early mortality of the patients with traumatic cervical SCI was 4.0% ( 22/553 ). The main causes of the early death were respiratory failure in nine patients (40.9%) and electrolyte disorders in five (22.7%). Univariate analysis showed that age, cervical spinal cord injury severity, complications in respiratory, cardiovascular, digestive systems and electrolyte disturbance as well as tracheotomy were considered statistically significant for early death in patients with traumatic cervical SCI ( P < 0, 05 ). Multivariate logistic regression analysis showed that age, cervical SCI severity, complications in respiratory,cardiovascular system and electrolyte disturbance as well as tracheotomy. Conclusion Severe cervical SCI, combined respiratory, cardiovascular system and electrolyte disorder complications as well as tracheotomy are high risk factors for the early death in patients with traumatic cervical SCI.

ObjectiveTo summarize the prevention and treatment of complications of carotid angioplasty and stenting (CAS) in the elderly. Methods88 cases (≥60 years) who underwent carotid angioplasty and stenting were collected from our hospital. The prevention and treatment of complications were analyzed retrospectively. ResultsNinety-two self-expanding stents were placed in the 88 cases and the technical success rate was 100%. The degree of stenosis was significantly improved from 82.6% to 13.2%. All patients were followed up for 3-12 months. Carotid sinus reaction was observed in 23 cases (26.1%) and it was more often in ≥70 years group than in 60～69 years group (P＜0.05). Meanwhile, compared with the distance ＞10 mm, Carotid sinus reaition was more often in the distance ≤ 10 mm between carotid bifurcation and maximum stenotic lesion (P＜ 0.05). Hypertension occurred in 6 cases, cerebral hyperperfusion syndrome in 4 cases including 1 case of cerebral hemorrhage. There were cases with cerebral ischemia in 1 case, cerebralvaseular spasm in 4 cases, acute renal insufficiency in 3 cases and ecchymosis and hematoma at the puncture site in 7 cases. There were 3 cases of transient ischemic attack, 1 case of myocardial infarction, 1 case of cerebral hemorrhage, 2 cases of mild neurological deficits and no death occurred during the period of follow-up. ConclusionsThere is higher risk for elderly patients undergoing CAS, but careful preoperative preparation and properly treatment may avoid the occurrence of complications.

Objective To explore whether there were abnormalities of behavioral tests and CNV-like potential in stressed rats following repeatedly forced swim stress.Methods Forty male rats were randomly divided into 4 groups: the control groups (Control-1 and Control-2) and the stress groups ( Stress-1 and Stress-2).Rats in stress groups were administered to repeatedly forced swim 7 or 14 days respectively.Body weight gain, saccharin preference test and open field test were performed.After being anesthetized with urethane, CNV-like potentials were elicited by condition-test stimulus.Results Results of behavioral tests displayed less body weights (F =253.60, P＜0.001 ) and less saccharine solution intake (F= 13.67, P=0.001 ) in stressed group rats and significant effects of stress on the number of crossing squares, the duration of rearing and the number of grooming in open field test.CNV amplitudes were lower in the stressed rats than those in control (F=21.312, P＜0.01 ).Conclusion This study provides an important evidence of changes of CNV-like potential in depressed rats following repeatedly forced swim stress.Based on this study, ER Ps should be taken into consideration and applied as the useful tools in the research work of depressed animal models.

Objective To observe the therapeutic effect of spinal cord injury(SCI)by transplantation cryopreserved neural stem ceils(NSCs).Methods 45 Wistar rats were randomly divided into three groups.with 15 rats in each group.Transplantations were carried out two days after SCI,group A:0.9% saline water,group B:NSCs,group C:cryopreserved NSCs.After the transplantation,immunohistochemical and tissue incision were appeared to detect the survival and differentiation of the transplanted ceils in nivo,and the methods of BBB and oblique plate were used to estimate the recovery of function.Results Group B and C all had active NSCs except group A.The injuried spinal cord A[(3.9±0.1)mm2],B[(1.2±0.3)mm2]and C[(1.1±0.3)mm2],there was an variance in the three groups (F=423.949,P＜0.01),BBB test:group A[(2.0±0.5)mark],B[(16.4±0.8)mark]and C [(16.0±1.4)mark],there was an variance in the three groups(F=970.157,P＜0.01),the oblique plate test:group A[(31.3±2.9)degree],B[(46.8±2.1)degree]and C[(46.5.4-2.4)degree],there was an variance in the three groups(F=151.099,P＜0.01),the tests demonstrate there were no variance in group B and C(all P＞0.05),there was no variance in living rate between the cryopreserved NSCs group [(55.9±5.2)%]and no eryopreserved[(65.1±3.4)%,t=3.334,P＞0.05].Conclusions Cryopreserved NSCs keep the ability of reproducdon and differentiation.NSCs is a kind of valuable cell resource for the therapy of SCI.

BACKGROUND: The treatment of multilevel cervical spondylotic myelopathy (MCSM) aims at sustaining the spinal cord compression and restoring the stability of the cervical vertebrae at most.OBJECTIVE: To analyze the clinical characters of anterior cervical discectomy with fusion and expansive open-door laminoplasty for MCSM.METHODS: Sixty-seven patients with MCSM were divided into two groups, and treated with anterior cervical discectomy with fusion (group A) or posterior cervical expansive open-door laminoplasty (group B). All the patients were followed up for 12 months, and the range of motion of cervical vertebrae, cervical curvature index were observed,as well as the Visual Analogue Scale and Japanese Orthopaedic Association scores were condueted. Moreover, the operation time, blood loss and adverse reactions were recorded.RESULTS AND CONCLUSION: (1) The loss of range of motion of the cervical vertebrae in the group B was significantly less than that in the group A (P < 0.05). (2) The cervical curvature index in the group A was significantly improved (P < 0.05), but the index had no significant change in the group B. (3) The axial systems were significantly improved in both groups, especially in the group A (P < 0.05). (4) The neurological function was significantly improved in both groups (P < 0.05), which showed no significant difference between two groups (P > 0.05). (5) The intraoperative blood loss in the group B was significantly more than that in the group A (P < 0.05). (6) The incidence of hoarseness and dysphagia in the group A was 19％. The incidence of wound infection, cerebrospinal fluid leakage and C5 nerve root palsy in the group B was 9％. (7) These results suggest that during choosing an appropriate method for MCSM,surgeons' skills and patients' situation should be considered.