Objective To assess the accuracies and feasibility of spine surgery assisted by different types of navigation system.Methods In experiment study,40 human cadaveric cervical spines were employed and 3.5 mm screws were placed into the C 3 to C 7 pedicles following five kinds of insertion techniques:blind screw placement(Group 1),assisted by X-ray fluoroscopy(Group 2),assisted by virtual fluoroscopy navigation system(Group 3),assisted by CT-based navigation system(Group 4),assisted by Iso-C 3D navigation system(Group 5).Thereafter,cortical integrity of every sample was examined by anatomic dissection.In clinical study,163 cases of spine operations assisted by different types of navigation were reviewed.The accuracies of screw placement were evaluated by postoperative CT or Iso-C 3D scan.Results In experiment study,there were 398 pedicles inserted.Group 1,the average operation time per sample was 27 minutes;36.3% of the screws were excellent,26.3% good,and 37.5% bad.Group 2,the average operation time was 112 minutes;44.9% excellent,37.2% good,and 17.9% bad.Group 3,the average operation time was 69 minutes;42.5% excellent,45.0% good,and 12.5% bad.Group 4,the average operation time was 98 minutes;87.5% excellent,12.5% good.Group 5,the average operation time was 91 minutes;90% excellent,10% good.In clinical study,272 screws inserted with virtual fluoroscopy navigation system,89.3% excellent,10.7% good.571 screws inserted with CT-based navigation system,84.9% excellent,14.4% good,0.7% bad.142 screws inserted with Iso-C 3D navigation system,95.8% excellent,4.2% good.Conclusion Computer-assisted navigation system enhances accuracies and further improves the safety of spine surgery,especially utilizing CT-based navigation system and Iso-C 3D navigation system.Iso-C 3D navigation method is better than the other two navigation methods.

Objective To study the relationship between slow coronary flow and endothelium disorder.Methods One hundred and twelve patients with normal coronary angiography were divided into the slow flow group(n=38)and the normal flow group(n=84)in terms of their TIMI frame counts.Risk factors including sex,age,cholesterol,hypertension,diabetes,history of smoking and blood levels of endothelium-1,nitric oxide and interleukin-6 were compared between the 2 groups.Results Slow coronary flow was more common in male than in female(45 vs 39).Patients who smoked showed a higher incidence of slow coroany flow than non-smoker patients(P=0.010).The blood levels of ET-1(108.42?0.81 pg/mL vs 84.74?39.16 pg/mL,P=0.001)and IL-6(158.28?178.86 pg/mL vs 108.07?84.43 pg/mL,P=0.019)was higher in the slow flow group but with a lower levels of NO(35.66?12.28 ?mol/L vs 42.74?17.51 ?mol/L,P=0.032)when compare with the nomal coronary folw group.Conclusion Slow coronary flow is related to endothelium disorder but other risk factors should also be taken into consideration.

Objective To investigate the prevalence of cervical spondylosis among adults in Beijing.Methods The prevalence of cervical spondyiosis among people older than 18 years who had lived in Beijing for more than six months was investigated in December 2010.The multi-stage sampling was used in this cross-sectional study.The related information was obtained by a self-designed questionnaire.Single and muhivariable Logistic regression models were applied to analyze high risk districts and populations.Results A total of 3859 people were enrolled in this study.Among them there were 531 people with cervical spondylosis,and the prevalence was 13.76％.The prevalence of cervical spondylosis in suburb (15.97％) was the highest compared with city center and countrysides (x2=8.257,P=0.016).The prevalence in females (10.49％) was higher than that (16.51％) in males (x2=29.432,P＜0.001).The distribution of prevalence among different age populations was inverted U shape,and the prevalence was higher in 45 years group (20.43％) and 60 years group (18.91％) compared with other two groups.The prevalence in employed group was 1.303 times higher than that in unemployed group (95％CI:1.008,1.684).According to the muhivariable logistic regression result,suburb (OR=1.306,P=0.026),females (OR=1.81 1,P＜0.001),people who were 45years or 60 years (OR=2.171,P＜0.001; OR=2.430,P＜0.001,respectively) and employed and retired people (OR=1.664,P=0.001; OR=1.303,P=0.043,respectively) were high risk population of cervical spondylosis.Conclusion The prevalence of cervical spondylosis among adults in Beijing was much higher and vastly distributed.It's necessary to reinforce the prevention,diagnosis and treatment study.Young females,people aged 45 years or 60 years,and employed people were high risk populations.

Objective To investigate the prevalence of low back pain among adults in Beijing.Methods The study design was a cross-sectional study,and the multi-stage sampling was used.A questionnaire survey was conducted in December 2010 to investigate prevalence of low back pain in adults who had lived in Beijing for over 6 months.Total prevalence and prevalence by region,gender and age were calculated.The chi-square test was used to compare results.Results A total of 3860 people were enrolled in this study.The one-year prevalence of low back pain was 26.09％ (1007/3860),and the point prevalence was 6.11％ (236/3860).The prevalence of different duration of low back pain (3 months,3-6 months,≥6 months) was 16.76％ (647/3860),4.12％ (159/3860) and 5.21％ (201/3860),respectively.The prevalence of females (28.83％) was higher than that of males (23.03％).The prevalence among different regions was significantly different.Prevalence in suburb and rural area (29.88％ and 27.54％,respectively) was higher than that in urban area (20.88％).No matter males or females,the prevalence in urban area was the lowest (17.48％ and 24.00％,respectively).With the increasing of age,the prevalence of low back pain became higher.In males,the prevalence of 55 to 59 years group was highest,while 60 to 64 years group was highest in females.In urban area and rural area,the prevalence of 60 to 64 years group was highest (34.43％ and 48.68％,respectively),while 55 to 59 years group was highest in suburb (47.26％).Conclusion The oneyear and point prevalence of low back pain among adults in Beijing are higher,with wide distribution.The chronic low back pain is more common.The prevalence of low back pain is higher in suburb and rural area.Females have a higher prevalence than males.Moreover,the prevalence of low back pain increases with age.

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.

Objective To investigate the prevalence and distribution of lumbar degeneration disease among adults in Beijing.Methods The study design was cross-sectional study.The multi-stage sampling was used.The study objects were residents who were lived in Beijing over six months and older than 18 years.The related information was obtained by self-designed questionnaire.Single and multivariable Logistic regression models were applied to analyze the high risk populations.Results A total of 3186 people were studied.There were 292 people who suffered lumbar degenerational disease.The prevalence was 9.17％.The prevalence at downtown,suburb county and rural area was 7.88％,10.20％,and 9.59％,respectively,and there was not significant difference (x2=3.545,P=0.170).The prevalence of female (10.05％) was higher than male (8.13％) (x2=4.081,P=0.043; OR=1.337,95％CI:1.044,1.713).The prevalence of the population who was not less than 45 years older was significant higher than that of the population less than 45 years older (x2=102.982,P＜ 0.001).The physical labor group (12.16％) had higher risk for lumbar degeneration disease compared with mixed group (6.65％)(OR=1.510,95％CI:1.102,2.071).There were no significant differences in different education,social insurance,and income populations.Conclusion The prevalence of lumbar degeneration disease among adults is much higher and vastly distributed.It's necessary to reinforce the prevention,diagnosis and treatment study.People of female,more than 45 years older and physical labor group are high risk populations.

Pharmacology can be defined as the study of sub-stances that interact with living systems through chemical proces-ses. Pharmacology plays an important role to bridge the transla-tional gap between the basic medicine and clinical medicine. In this article, the projects in pharmacology funded by NSFC during 2004~2013 were reviewed. The new features and new problems in the projects of pharmacology were briefly analyzed.

Objective To summarize the value of early mechanical ventilation plus continuous vacuum suction in treatment of serious pulmonary contusion.Methods Forty-eight cases of severe pulmonary contusion were assigned to mechanical ventilation plus continuous vacuum suction (observation group,n =20) and mechanical ventilation plus discontinuous vacuum suction (control group,n =28)according to the random number table.Modes of mechanical ventilation were synchronized intermittent mandatory ventilation (SIMV),pressure support ventilation (PSV),and positive and expiratory pressure (PEEP).Changes in blood gas analysis,mechanical ventilation time,and associated complications were compared between groups.Results At ventilation time of 6 and 24 hours,PaO2 in observation group was (100.36 ± 5.90) mmHg and (105.34 ± 7.40) mmHg respectively,with significant differences from (75.36 ± 8.95) mmHg and (76.36 ± 8.35) mmHg in control group (P ＜ 0.01).At ventilation time of 24 hours,PaO2/FiO2 was (283.50 ± 15.20) mmHg in observation group and (201.50 ± 10.20) mmHg in control group (P ＜0.01).Mechanical ventilation time and PEEP at ventilation time of 48 hours in observation group was (3.2 ± 1.1) days and (4.5 ± 2.3) cmH2 O,with significant differences from (6.5 ± 2.8) days and (8.5 ± 2.5) cmH2O in control group (P ＜ 0.01).Associated complications of the two groups revealed no significant difference (P ＞ 0.05).Conclusion Early mechanical ventilation with sustained vacuum suction is effective to keep airway clear,improve oxygenation index,decrease PEEP level,and control the duration of mechanical ventilation,but may not lower the risks of ventilator-associated pneumonia and pulmonary atelectasis.

Objective: To investigate the expression difference of TRAIL and its receptors between resting and activated peripheral blood lymphocytes, and to study their role in cellular growth and proliferation. Methods: Expression of TRAIL and its receptors were detected by RT PCR and DNA sequencing. Results: Neither the expression of TRAIL nor its receptors were detected in resting peripheral blood lymphocyte. However, both expression were found in activated peripheral blood lymphocytes of various degree. Conclusion: TRAIL and its receptors may play a role in regulation and control of the activated lymphocytes in immune reaction.

Objective:To measure the clivo-axial angle (CAA)and cervicomedullary angle (CMA)in upper cervical deformity patients who underwent computer-assisted posterior upper cervical reduction and fixation surgery,and analyze their correlation.Methods:In the study,25 patients with symptomatic upper cervical deformity were chosen for measurement of preoperative and postoperative CMA and CAA using magnetic resonance imaging (MRI)and intraoperative C-arm.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA;moreover,the angle between the straight line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two ex-perienced spinal surgeons performed the measurements.The CAA and CMA were measured three times, and the mean value was considered as the result.Results:Analyses of the CAA and CMA were per-formed with Wilcoxon rank test,which showed that there was consistency between the CAAs measured with MRI and intraoperative C-arm.The result showed that the postoperative CAA and CMA increased significantly compared with preoperation (P<0.001).Through Spearman rank correlation analysis,the preoperative CAA was positively correlative with the CMA (r=0.902,P<0.001),and so was the post-operative CAA (r=0.921,P<0.001).Conclusion:Preoperative and postoperative CAA in upper cer-vical deformity patients is significantly correlative with preoperative and postoperative CMA.CAA can be measured during surgery using intraoperative CT or C-arm based three-dimension navigation,and may predict the patient’s CMA,which cannot be measured during operation,but is essential for evaluating the decompression and reduction of the spinal cord.