0.05).The expression of survivin mRNA and BCRP mRNA was correlated with therapeutic effect of chemotherapy(P

Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46％,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious improvement of symptoms and a satisfactory short-term efficacy can be obtained.Therefore,this method is an alternative procedure for cervical spondylosis myelopathy.

Objective To explore the relationship between airway responsiveness and bronchial asthma inhalation therapy .Meth-ods Select 50 asthmatic patients as research subjects ,Fluorine given inhaled salmeterol 50 mcg/fluticasone propionate 250 micro-grams ,1-2 times a day ,Respectively before treatment ,after treatment ,3 months ,6 months ,12 months ,conventional pulmonary function tests and bronchial provocation test ,Determination of peak expiratory flow (PEF) ,and a second forced expiratory volume (FEV1 ) ,maximum mid-expiratory flow (MMEF) and specific airway conductance decreased 35% or above to inhaled methacholine the concentration(PC35sGaw) .Results Three months after the majority of patients with clinical symptoms before treatment ,after treatment ,significant improvement ,PEF ,FEV1 increased significantly in all cases of bronchial provocation test is still positive ,six months after treatment ,more than 80% of patients with asthma ,complete control ,lung function returned to normal follow-up prov-ocation test positive cases of 38 cases ,up to 76% after 12 months of treatment ,more than 90% of patients with lung function re-turned to normal .29 cases(58% ) stimulation test positive .Conclusion Asthma clinical indicators have reached complete control to achieve the desired level of time earlier than the airway responsiveness ,airway responsiveness index value in the long-term follow-up of the combination therapy ,and adjust the treatment plan is superior to clinical symptoms and lung function ,is a serious assessment of asthmadegree of judgment and withdrawal of drug treatment of one of the indicators .

BACKGROUND:A large number of studies have shown that adult stem cels derived from multiple tissues are available to differentiate towards nucleus pulposus-like celsin vitro. It is unclear whether mesenchymal stem cels derived from nucleus pulposus tissues have the ability to differentiate towards nucleus pulposus-like phenotypes induced by transforming growth factor-beta 1. Up to now, there are few reports on the difference between the differentiation ability of mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels. OBJECTIVE:To compare the ability of mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels differentiating into nucleus pulposus-like cels under induction of transforming growth factor-beta 1. METHODS:The groin fat tissue and the coccygeal spine of rats were taken respectively to isolate and culture mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels by mechanical enzyme digestion method. Flow cytometry was employed to detect the expression of CD105, CD90, CD29, CD45, CD44, CD34, and CD24 of both two kinds of stem cels. Mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels were divided into complete induction group (complete induction medium with transforming growth factor-beta 1), incomplete induction group (complete induction medium without transforming growth factor-beta 1) and control group(DMEM/F12 containing 10% fetal bovine serum and 100 mg/L penicilin/streptomycin), respectively. After 14 days of culture, real-time PCR was used to detect the expression of colagen type II, Aggrecan and SOX-9 in each group. RESULTS AND CONCLUSION:CD105, CD90, CD29 expressed positively and CD45, CD44, CD34, CD24 negatively in both two kinds of stem cels. After 14 days of induced differentiation, the expressions of colagen type II, Aggrecan and SOX-9 in the two kinds of cels were significantly higher in the complete induction groups than in the control groups (P < 0.05). Under the induction of transforming growth factor-beta 1, the expression of colagen type II, Aggrecan and SOX-9 in mesenchymal stem cels derived from nucleus pulposus tissues was significantly higher than that in adipose-derived mesenchymal stem cels (P < 0.05). These findings suggest that both two kinds of mesenchymal stem cels have the ability to differentiate towards nucleus pulposus-like cels induced by transforming growth factor-beta, and mesenchymal stem cels derived from nucleus pulposus tissues may be more suitable as seed cels for nucleus pulposus tissue engineering research.

Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization (TACE) using two dimensional color-coded digital subtraction angiography (2D-ccDSA).Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma (HCC),treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve (TDC) was derived from the 2D-ccDSA imaging.Time-to-peak (TTP) was measured for the ostia of the catheter,the origin of the tumor feeding artery (TFA) and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time (TBST) for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery (TFA) before TACE were (3.47 ± 0.96) and (4.09 ± 1.09) s,after the TACE were (3.49 ± 1.02) and (3.78 ± 1.05) s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks (t values were 0.10 and 1.15,P values were 0.92 and 0.26).TTP at the embolized site of the main TFA were [(4.62± 1.16) and (5.59± 1.57)s]for pre and post-TACE,the tumor blood supply time (TBST) was greatly delayed compared with that after the TACE procedure [(1.82± 1.10)s and (0.52±0.41)s].The mean maximal TDC enhancements of the tumor parenchyma areas were (3.03±0.88)units before TACE and (1.10±0.67)units after TACE.The differences were all statistically significant (t values were 3.32,6.04 and 8.93,respectively,P＜0.01) Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.

Objective To differential the biologic characteristics and multiple differentiation potential of mesenchymal stem cells in nucleus pulposus in (NP-MSC) scoliosis patient and patient with degenerative interverthral disc.Methods The human nucleus pulposus-mesenchymal stem cells were isolated and cultured with enzyme digestion from 2 patients of scoliosis and 2 patient with degenerative intervertbral disc separately.Cellular proliferation was detected with MTT assay and trypan blue.The immunophenotype expression of NP-MSC was detected by flow cytometry in scoliosis and degenerative group.The multiple differentiation ability of cells was assessed respectively using alizarin red dye,Oil red O dye and immunohistochemical staining.Results The primary cell morphology of scoliosis NP-MSC was the shape of spindle,while the degenerative NP-MSC was inhomogeneous.However,both of them became spindle shape after passages.The scoliosis NP-MSC was stronger than degenerative one in metabolic activity and proliferation.The percentage of positive antigen expression of CD44,CD105 and CD29 was 97％-100％ in scoliosis NP-MSC group,but 88.7％-97％ in the degenerative group.The expression of mature cell marker CD24 was negative in both groups.Furthermore,the MSC i.isolated from both groups differentiated along the osteogenic,chondrogenic but not adipogenic lineages.Conclusion The scoliosis and degenerative NP contains mesenchymal stem cells.Moreover the scoliosis NP-MSC had stronger ability of cell metabolic activity and proliferation.These cells have multiple differentiation potential with the exception of their adipogenic differentiation ability.

Objective To investigate the selection of surgery and clinical outcomes of upper cervical injuries.Methods 25 upper cervical injury patients were involved in this retrospective study from November 2011 to June 2014.Including 20 males and 5 females with mean age of 37.1 years old (range,14-55 years old).Individual operation methods were based on the comprehensive evaluation of specific situations including the clinical manifestation,the type of the injuries and the imaging data.HaloVest distraction was applicated before operation.The surgery by anterior approach were performed for 7 patients and posterior approach were performed for 18 patients.Preoperative and postoperative American Spinal Injury Association (ASIA) grade and Functional Independence Measurement (FIM) score were studied to evaluate the nerve functional restoration.Imaging data before and after the operation were contrasted to evaluate the reduction of the fracture,the bone union,the fusion of the bone graft and the condition of the internal fixation.Wilcoxon Singed Rank Test was applied to compare the FIM score between pre-operation and last follow-up.Results 15 patients presented neurological function deficit because of cervical spinal cord compromise.All cases were followed up for 6-35 months (mean 18.2 months),showing good clinical and radiological effects.Solid fusion was obtained in all patients among 3-12 months.The ASIA grade improved by an average of 1.1 (6 months after operation) and 1.2 (12 months after operation).There was significant difference in FIM score between pre-operation and last follow-up.One patient got cerebrospinal fluid leakage.Conservative treatment was implemented with the Trendelenburg position,rehydration fluids and so on.Removal of drainage tube 8 days later when the drainage was less than 30 ml/24 h.No incision infection,cerebrospinal fluid leakage,migration or breakage of internal fixation was observed at the last follow-up.Conclusion The type of upper cervical injuries are complicated,the characteristics of fracture,dislocation and nerve injury in different patients are different.The specific situation should be evaluated comprehensively to make individual operation methods.The success of the operation requires the proficiency of the anatomic basis,the biomechanical characteristics,precise entrance point and direction in operation,appropriate diameter of the screw and suitable depth of the screw road.

Objective To discuss the application of color-coded digital subtraction angiography (ccDSA) in quantitatively analyzing the instant perfusion changes of hepatic tumors during transcatheter arterial chemoembolization (TACE).Methods The clinical data of 35 patients with hepatocellular carcinoma (HCC) who underwent TACE were reviewed.Before and after TACE,two-dimensional DSA (2D-DSA) was performed by using the same parameters in all patients.The image sequences were post-processed with 2D-ccDSA.On ccDSA images the regions of interest (ROIs) were measured to obtain the time-contrast-intensity (CI[t]) curves as well as the perfusion parameters,including tumor blood supply time (TBST),area under the curve (AUC),contrast-intensity peak (C I-Peak) and maximum upslope (MS),which were used to evaluate the degree of the reduction in direct blood flow and in tumor staining.The relationship between the above parameters and subjective angiographic chemoembolization endpoint (SACE) was analyzed.Results After TACE,the perfusion parameters were significantly different from pre-TACE ones.AUC and CI-Peak values were dramatically decreased.After TACE,TBST slowed a significant delay.The reduction of perfusion about 30％-40％ was equal to SACE grade Ⅲ;the reduction of perfusion about 60％-70％ was equal to SACE grade Ⅳ.Conclusion 2D-ccDSA can be used to objectively and quantitatively evaluate the effect of TACE on the perfusion of hepatic tumors,providing useful indexes for making quantitative assessment of the degree of blood flow stagnation and the reduction of tumor staining.

BACKGROUND:Endogenous stem cells have no repair effects on the process of disc degeneration. Authors assumed that this maybe associate with abnormal effects of related etiological factor, resulting in an inhibitory effect on the function of nucleus pulposus-derived mesenchymal stem cells. OBJECTIVE:To investigate the effects of inflammatory cytokine interleukin-1βon biological characteristics of nucleus pulposus-derived mesenchymal stem cells of rats. METHODS:Lumbar spinal nucleus pulposus was obtained from 3-month-old male Sprague-Dawley rats. Nucleus pulposus-derived mesenchymal stem cells were isolated and cultured with col agenase and sequential trypsin digestion. The expression of CD24, CD34, CD45, CD90 and CD105 was detected using flow cytometry. Stem cellgene SOX2 and Nanog expression was measured using RT-PCR. Adipogenic, osteogenic and chondrogenic abilities of nucleus pulposus-derived mesenchymal stem cells were observed. The apoptotic rate of interleukin-1β-treated nucleus pulposus-derived mesenchymal stem cells was detected using flow cytometry. Fluorescent quantitative PCR was used to measure the expression of SOX9, proteoglycan, type II col agenase and caspase-3 gene after nucleus pulposus-derived mesenchymal stem cells were treated with interleukin-1β.

Objective To study related factors of the duration of untreated psychosis (DUP) in Tibetan patients with schizophrenia in Qinghai Province. Methods The related factors on DUP were investigated in totally 188 Tibetan pa?tients with schizophrenia using questionnaires of mental health services and symptom onset for schizophrenia. All the Ti?betan patients were provided with the National Continuing Management and Intervention Program for Psychoses (686 Pro?gram). Results The median (low quartile, upper quartile) of DUP in Tibetan patients with schizophrenia was 375 days (4 days, 1661 days). The patients were divided into short DUP group (DUP≤375days, 90 patients) and long DUP group (DUP>375 days, 98 patients). There were significant differences in mode of onset,marital status, educational level, family type, place of residence between short DUP group and long DUP group (P<0.05). Logistic regression analysis found that lack of family structure (OR=2.340, 95%CI:1.130~4.847, P=0.022), chronic onset (OR=2.136, 95%CI:1.172~3.891, P=0.013) and living in pastoral areas (OR=2.239, 95%CI:1.097~4.571, P=0.027) were risk factors of DUP. Conclusion Ti?betan patients with schizophrenia have a longer DUP and related risk factories of DUP are lack of family structure, chron?ic onset and living in pastoral areas.