Objective To develop a reliable and reproducible modei of hyperalgesia arising from chronic compression of dorsal root ganglion (DRG) and investigate the contribution of spinal cord dorsal horn calcitonin gene-related peptide (CGRP) to the clinical manifestation of sciatica.Methods Sixty healthy Wistar rats of either sex weighing 200-300 g were randomly divided into three groups: group A control ( n = 12) ; group B sham operation (n = 24) and group C chronic compression of DRG ( n = 24) . In group B and C the animals were anesthetized with intraperitoneal 1.25% thiopental sodium (50mg?kg-1) . The animals were then placed in prone position and the left L4 and L5 intervertebral foramina were exposed. In group C a 4 mm long 1-0 chromic catgut was inserted into the intervertebral foramen. Motor function of the hind limbs was assessed by gait disturbance scores (GDS) , and paw-withdrawal threshold (PWT) was measured with modified Randall algometer 3, 5, 7, 10, 14, 17, 21 and 28 days after operation. In group B and C 12 animals were decapitated on the 5th and 28th days after operation respectively and lumbar section of spinal cord was removed for determination of dorsal horn CGRP content (by radio-immunoassay) and microscopic examination of DRG. Results In chronic compression group (C) significant hyperalgesia occurred after operation and reached a peak one week after operation then gradually decreased but didn't return to normai on the 28th day, while in sham operation group (B) postoperative hyperalgesia quickly decreased and returned to normai on the 7th day. In group C dorsal horn CGRP content on the compressed side significantly increased on the 5th and 28th day after operation as compared with that on the contralateral side in the sham operation and control group. Microscopic examination of DRG showed significant edema of endoneurium and neurons which persisted on the 28th day but significantly attenuated. Conclusion This animal model reliably produces a disorder resembling low back pain. It is easy to perform less traumatic and produces significant hyperalgesia. The dorsal horn CGRP content on the compressed side significantly increases, which is consistent with chronic pain.

Objective To investigate the effect of different end-tidal PCO2 (PETCO2) on the quantitative electro-encephalogram (qEEG) and auditory evoked potential index (AAI) in patient undergoing elective general surgery under inhalation anesthesia. Methods Thirty-eight ASA Ⅰ-Ⅱ patients aged 22-48 yrs weighing 49-79 kg undergoing elective general surgery under inhalation anesthesia were studied. The intra-operative blood-loss was expected to be

Objective To evaluate the effect of the interlocking nail for extremity fractures. Methods This study reviews 1224 cases of extremity fractures treated with locking intramedullary nail fixation from October 1996 to June 2004, including 92 cases humeral shaft fracture; 210 cases intertrochanteric fractures; 488 cases femoral shaft fractures; 92 cases supracondylar femoral fractures; 342 cases tibia and fibular fractures. According to the AO classification there were 642 type A, 364 type B and 218 type C. There were 986 cases (72.4%) high-energy injury; 405 cases were multiple injury. There is 778 male and 446 female with mean age 39 years (range 16-92 years). Duration from injury to operation was 8 days(3 hour-30 days). Close reduction was 1203 cases and open reduction were 21 cases. Results Mean follow-up period is 24 months(6-70 month), mean operation time was 90 minutes(40-480 minutes). Union was in 1204 cases, union rate was 98.2%, mean union time was 5 months (3-12 months) on average, there were nonunion in 22 patients: 4 in humeral shaft, 8 in femoral shaft, 4 in supracondylar femur, 6 in tibia shaft, the nonunion rate is 1.8%. Late deep infection occurred in 3 patients: 1 in femoral shaft, 1 in supracondylar femur, 1 in intertrochanteric femur, the infection rate is 0.2%. There were 16 split in intraoperation: 4 in humeral nail, 4 in Gamma nail, 9 in supracondylar nail. Iatrogenic nerve palsy occurred in 6 patients: 2 in radial nerve, 2 in sciatic nerve, 2 in common peroneal nerve, the occurrence is 0.4%. One femoral nail was broken, locking screw were broken in 9 patients (0.6%), femoral shaft fracture of distal nail end occurred in 3 cases: 1 in Gamma nail, two in supracondylar nail. 53 patient complained uncomfortable in entry point (8 shoulders; 9 hips; 36 knees). Conclusion The result is satisfactory in bone healing low infection reduced blood loss and rapid recovery of the joint and body with the close interlocking nailing to be treatment of fresh extremity shaft fracture. It is a perfect method, however the complication should be pay more attention.

Objective:To study assessment value of brachial‐ankle pulse wave velocity (baPWV) for severity of coro‐nary disease in patients with coronary heart disease (CHD) .Methods :According to SYNTAX score of coronary an‐giography ,a total of 206 CHD patients from our hospital were divided into mild group (n=74 ,SYNTAX score <23 scores) ,medium group (n= 72 ,SYNTAX score 23~32 scores) and severe group (n= 60 ,SYNTAX score > 32 scores) .Another 80 healthy subjects undergoing physical examinations were selected as healthy control group during the same period .BaPWV ,ankle brachial index (ABI) and carotid -femoral pulse wave velocity (cfPWV) were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation among baPWV ,cfPWV ,ABI and SYNTAX score in CHD patients ;multi -factor Logistic regression model was used to analyze whether baPWV ,cfPWV and ABI were risk factors for SYNTAX scores .Results:Compared with healthy control group ,there were significant rise in baPWV [ (1.2 ± 0.3) m/s vs .(1.5 ± 0.4) m/s vs .(1.8 ± 0.6) m/s vs . (2.0±0.7)m/s]andcfPWV [ (1.3±0.5)m/svs.(2.5±0.7)m/svs.(2.9±0.8)m/svs.(3.4±0.7)m/s]in mild group ,medium group and severe group (P<0.05 or <0.01) ,and that of severe group was more than that of medium group ,and>mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all);significant reduction in ABI [ (1.02 ± 0.32) vs .(0.82 ± 0.24) vs .(0.73 ± 0.16) vs .(0.56 ± 0.09)] in mild group , medium group and severe group ,and that of severe group was < medium group ,and < mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all) .Pearson correlation analysis indicated that baPWV and cfPWV were positively correlated with SYNTAX score ( r= 0.613 , P= 0.007;r=0.528 , P=0.023) ,while ABI had no correlation with SYNTAX score .Multi-factor Logistic regression analysis indicated that diabetes melli‐tus ,hypertension ,baPWV and cfPWV were risk factors for SYNTAX score (OR=4.016~5.809 , P<0.05 or <0.01) .Conclusion:The baPWV can effectively assess severity of coronary disease in CHD patients .

Objective To evaluate the clinical value of tomography ultrasonic imaging (TUI) in staging carcinomas of the cervix.Methods Eighty-seven patients with biopsy proven cervical cancer who underwent transvaginal TUI examination were enrolled.Clinical and ultrasonic staging were based on the FIGO staging system.Surgical-pathological or MR results was taken as golden standard.Ultrasonic staging were compared with clinical staging.Tumor sizes of 38 cases of cervical cancers measured by TUI were recorded and compared with the pathological results.Results The overall accuracy of preoperative TUI staging was higher than that of preoperative clinical staging (91.95 ％ vs 81.60 ％,P ＜0.01).Mean size of the 38 malignant tumors was 2.5 cm×2.1 cm×2.2 cm by TUI and 2.6 cm×2.1 cm×2.3 cm by pathological samples (P ＞ 0.05).Conclusions TUI technology may be useful in the noninvasive examination of preoperative staging of carcinoma cervix.

Objective To study biologic effect of high radon exposure in non-uranium miners by measurements of serum levels of 1L-2, IL-6 and TNF-u and study on their gene polymorphism. Methods Serum levels of IL-2, IL-6 and TNF-αin the miners selected from a Yunnan-based copper mine were measured by ABC-ELISA. TNF-α (-308,G→A) genotypes were identified by RFLP-PCR, IL-2 (-330, T→G) genotypes by sequence analysis. Results Compared the miners with its control group, there were no statistical significance of the concentrations of serum IL-2 (F=0.71, P>0.05), IL-6 (F=1.09, P>0.05) and TNF-α(F=0.95,P>0.05). Frequencies of IL-2 (-330, T→G) genotypes (X2=0.02, P>0.05) and TNF-α(-308, G→A) genotype (x2= 2.21, P>0.05) were shown no statistical significance too. Conclusions Compared with the control group, concentrations of serum IL-2, IL-6 and TNF-n in miners working in the copper mine was lower, frequencies of genotypes of TNF-o (-308,A/A) was higher in the miners. But all the differences were not statistical significant.

Objective To compare the efficacy of different sedation depths of monitored anesthesia care (MAC) in vitrectomy.Methods Ninety-six patients of both sexes,aged 40-64 yr,with body mass index ≤ 35 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective vitrectomy,were randomly divided into 2 groups (n =48 each) using a random number table:mild sedation group (group Ⅰ) and profound sedation group (group Ⅱ).Anesthesia was induced with iv midazolam 0.02 mg/kg and sufentanil 0.15 μg/kg.Anesthesia was maintained with iv infusion of propofol 0.5-2.0 mg · kg-1 · h-1 maintaining bispectral index (BIS) value＞80 in group Ⅰ,or with iv infusion of propofol 2-6 mg · kg-1 · h-1 maintaining BIS value at 65-80 in group Ⅱ.The occurrence of unexpected head movement,SPO2＜90％,snoring,and oculocardiac reflex during the procedure,postoperative nausea and vomiting,and the time when the patients in supine position were turned to prone position were recorded after surgery.Results Compared with group Ⅰ,the incidence of unexpected head movement,SpO2 ＜90％,and snoring was significantly increased,and the time when the patients in supine position were turned to prone position was prolonged (P＜0.05),and no significant difference was found in the incidence of postoperative nausea and vomiting and oculocardiac reflex during the procedure in group Ⅱ (P＞0.05).Conclusion Mild sedation of MAC (BIS value ≥ 80) provides better efficacy than profound sedation (BIS value 65-80) when used for vitrectomy.

BACKGROUND:It is notable to treat cervical spondylosis using the anterior cervical discectomy and fusion, but there are such complications as cervical instability and low fusion rate. Titanium plate with cage can solve those defects, while anterior unfamiliar matter and dysphagia appear. A new anterior cervical interbody fusionZero-Pwith support and fixation function has been widely used in clinic.
OBJECTIVE:To analyze early stability in repairing cervical spondylosis using a newZero-Pinterbody fixation and fusion system, and compare with a titanium plate with cage interbody fixation andfusion system.
METHODS:We retrospectively analyzed the clinical date of 31 patients with cervical spondylosis who underwent the anterior cervical discectomy and fusion in the Department of Orthopedics, Affiliated Hospital of Jiangsu University between August 2010 and August 2014. Fifteen patients were treated with aZero-P implant (Zero-Pgroup) and sixteen patients with a titanium plate with cage (cage group). We recorded operation time, intraoperative blood loss, preoperative and postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores, postoperative incidence of dysphagia and degeneration rate of adjacent joint.
RESULTS AND CONCLUSION:(1) Postoperative symptoms were apparently improved, without severe complications in both groups. (2) Operation time and intraoperative blood loss were better in theZero-P group than in the cage group (P< 0.05). (3) Postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores were significantly improved in both groups (P< 0.05). The recovery rate of Japanese Orthopedic Association scores was similar between the two groups (81%, 81%;P> 0.05). (4) Mild dysphagia was experienced by one case (7%) in theZero-Pgroup, but nine cases (44%) in the cage group. Significant difference in the incidence of dysphagia was detected between the two groups after treatment (P=0.037). However, no significant difference in degeneration rate was detectable between the two groups (P=0.48). (5) These findings verify that in the anteriorcervical discectomy and fusion, the new Zero-Pand titanium plate with cage interbody fixation and fusion system are effective choices for cervical spondylosis. However, theZero-Pinterbody fixation and fusion system showed a low incidence of postoperative dysphagia and better stability.

Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .