[Objective]To explore the therapeutic effect of three surgical procedures(anterior approach,posterior approach and posterior-anterior approach) for cervical spondylotic myelopathy(CSM). [Methods]A total of 111 patients with cervical spondylotic myelopathy treated with three surgical procedures from June 2002 to December 2007 were retrospectively analyzed.Group A(anterior approach) comprised 54 patients with a mean age of 57.1 years(ranged,44~75 years).Group B(posterior approach,Laminoplasty) comprised 33 patients with a mean age of 61 years(ranged,41~73 years).Group C(posterior-anterior approach) comprised 24 patients with a mean age of 62 years(ranged,48-78 years).All patients were followed-up,neural function and cervical sagittal alignment were recorded.According to JOA score,preoperative and postoperative follow-up scores were compared,improvement rates were calculated,respectively.[Results]Patients were followed up for 3 months to 5 years with an average of 2 years.JOA scores of the three groups at 3,6,12 months and at the last follow-up after operation were compared with those of preoperation(P0.05).Cervical sagittal alignment(D numerical value) had no statistical difference at the postoperative and the final follow-up between group A and group C(P=0.434,P=0.492,P=0.569).There was significant difference between group B and group A/C(P

Objective Visceral hypersensitivity is an important feature of irritable bowel syndrome (IBS). This investigation was to establish an animal model of visceral hypersensitivity associated with IBS, and to test its effectiveness by two different ways. Methods The model was established by intrarectal administration of acetic acid daily in the neonatal rats between postnatal 8 and 21 days. The threshold of abdominal withdrawal reflex(AWR) was evaluated during rectal distension at postnatal 6,8 and 10 weeks respectively, and the changes of rectal sensitivity were identified by the abdominal electrical activity measured at postnatal 12 weeks. Results In contrast to neonatal rats subjected to saline intrarectally (NS group) and adult rats subjected to acetic acid intrarectally (AA group), neonatal rats subjected to acetic acid intrarectally(NA group) showed a significant decrease(P

Objective To study the gene expression of Wnt signal transduction pathway in experimental liver fibrosis and to investigate its role in liver fibrosis. Methods Liver fibrosis model was induced with carbon tetrachloride in 8 SD rats. Another 8 healthy rats were served as control. The gene expression in liver tissues of models and controls were examined using real time PCR array. The differential gene expression was identified as either up- or down-regulated 2-fold. The expressions of smooth muscle actin (SMA), Wnt4, Frizzled2 and β-catenin in the tissues were examined by immunohistochemistry and Western blot. Results The examination confirmed that 36 genes were differentially expressed, including 25 genes up-regulated and 11 genes down-regulated. Compared with the controls, the expressions of Wnt4, Wnt5 a and W nt11 were up-regulated more than 13.9-, 16.5-and 2.17-fold respectively, while the expressions of Wntl and Wnt3 were down-regulated more than 2.32- and 2.15-fold respectively in fibrotic liver. Immunohistochemistry and Western blot showed that the expressions of SMA, Wnt4 and Frizzled2 in fibrotic liver were remarkably higher than those in normal controls. While the level of phosphorylated β-catenin was decreased. Conclusion Both canonical and noncanonical Wnt signal transduction pathway may involve in the mechanism of liver fibrogenesis.

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional 2D ultrasound and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks The position of bladder the existence of bladder neck funneling were observed and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver The rates of bladder neck funneling cystocele and stress urinary incontinence were higher in vaginal delivery group Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery.

Objective To observe the effect of early enteral feeding on clinical outcomes and immune function in patients after colorectal cancer surgery.Methods 90 cases of colorectal cancer patients were randomly divided into early enteral feeding group (43 cases) and control group (45 cases).Patients in early feeding group were given small amount of water several times and enteral nutrition early after surgery,while patients in the control group were administrated according to conventional postoperative care protocol.Data were collected on serum IgA,IgG,IgM,CD4 +,CD4 +/CD8 + and CRP on the postoperative first,third and seventh days,postoperative length of stay,complications and quality of life.Results The postoperative fever time [(54 ±6) h vs.(65 ±6) h,t =8.688,P ＜0.01],time to flatus [(58 ±8) h vs.(72±7) h,t=8.573,P＜0.01],postoperative length of stay [(6.9±1.4) dvs.(8.5 ±1.9) d,t=4.277,P ＜ 0.01] and health care cost [(41 868 ± 3 168) RMB vs.(45 950 ± 3 714) RMB,t =5.536,P ＜ 0.01] were significantly in favour of early enteral feeding group than those in control group.Further,the score of quality of life at discharge were significantly higher in early enteral feeding group [(18.4 ± 1.7) vs.(16.4 ± 1.9),t =5.235,P ＜ 0.01],while the complication incidence showed no difference between the two groups [18.6％ (8/43) vs.22.2％ (10/45),t=0.177,P＞0.05].The CD4+,CD4+/CD8+ and IgM on the seventh postoperative day and the IgA and IgG on the third and seventh postoperative day were significantly better in early enteral feeding group while the CRP was significantly lower as compared to the control group (t =3.639,t =2.255,t =2.119,t =2.035,t =2.961,t =2.060,t =2.108,t =7.308,t =3.435,P ＜ 0.05).Conclusions Early oral enteral feeding after elective colorectal cancer surgery can improve patient's immune function,reduce the stress and accelerate rehabilitation.

The literature was analyzed on the improvement of motor sensory function, urination and defecation in myelitis treated with acupuncture and moxibustion and focused on the characteristics of the diagnosis and treatment. The literature on acupuncture and moxibustion treatment for myelitis was collected from CNKI, Wanfang, VIP and PubMed. The analysis included the characteristics of acupoint selection, methods of acupuncture and moxibustion, time of treatment, total treatment period, efficacy, follow-up, safety, etc. Totally, 26 articles were collected. The combined therapy of acupuncture and moxibustion was predominated (12/26, 46. 15%). For the motor and sensory impairment, the acupoints were mainly selected from the four limbs, the yangming meridians of hand and foot and those adjacent to the affected spinal segments and on the governor vessel as well as Jiaji (EX-B 2) points. For urinary impairment, the acupoints were selected mainly from the lower abdominal region on the conception vessel and the lumbosacral region on the bladder meridian. For the intestinal impairment, the acupoints were from the lower limb on the stomach meridian, the lower abdominal region on the conception vessel and the back points on the bladder meridian. The intervention started commonly in the first 3 months after onset. The total treatment period was in the range from 1 to 3 months. The efficacy of acupuncture and moxibustion was 69.19% to 82.56% for the improvement of motor sensory and urination, defecation function. The efficacy in follow-up was stable and the adverse reactions were not reported. It is viewed that on the basis of early diagnosis and active medication, acupuncture and moxibution achieve a certain of efficacy on the impairment of motor sensory function, urination and defecation. A clinical research is expected to further verify the efficacy.
Acupuncture Therapy ; Databases, Bibliographic ; Defecation ; Humans ; Motor Activity ; Moxibustion ; Myelitis ; diagnosis ; physiopathology ; therapy ; Sensation ; Urinary Bladder ; physiopathology ; Urination

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Objective To know prevalence of metabolic syndrome (MS) and metabolic abnormalities (MA) in overweight and obese children and adolescents in Guangzhou, China. Methods Totally, 439 children and adolescents aged six to 18 years were enrolled, including 129 obese, 115 overweight and 195 normal control ones. Their body height, body weight, waist circumference, hip circumference and blood pressure were measured, as well as their fasting blood glucose (FBG), lipid profiles and oral glucose tolerance test (OGTF). Results ①Prevalence of MS in overweight and obese children and adolescents was 20.9 % (27/129) and 10.4 % (12/115), respectively, 17.9 % (35/195) and 1.6% (4/244) in those with insulin resistance and non-insulin resistance, respectively. Prevalence of MS, each component of MA and cluster of each components of MA all increased in linear trend with their body mass index (BMI) or insulin resistance increasing. ② BMI correlated with all metabolic indicators and could independently predict risk of MS. Conclusions Prevalence of MS among overweight and obese children and adolescents in Guangzhou was considerably high, and BMI can be used as a suitable index for their obesity assessment in MS diagnosis.

The human brain-derived neurotrophic factor (hBDNF) gene was cloned by polymerase chain reaction and the recombinant adeno-associated viral vector inserted with hBDNF gene (AAV-hBDNF) was constructed. Cultured rat hippocampal neurons were treated with Abeta(25-35) and serued as the experimental Abeta-induced neuronal damage model (AD model), and the AD model was infected with AAV-hBDNF to explore neuroprotective effects of expression of BDNF. Cell viability was assayed by MTT. The expression of bcl-2 anti-apoptosis protein was detected by immunocytochemical staining. The change of intracellular free Ca ion ([Ca2+]i) was measured by laser scanning confocal microscopy. The results showed that BDNF had protective effects against A-induced neuronal damage. The expression of the bcl-2 anti-apoptosis protein was raised significantly and the balance of [Ca2+]i was maintained in the AAv-hBDNF treatment group as compared with AD model group. These data suggested that recombinant AAV mediated a stable expression of hBDNF in cultured hippocampal neurons and resulted in significant neuron protective effects in AD model. The BDNF may reduce neuron apoptosis through increasing the expression of the bcl-2 anti-apoptosis protein and inhibiting intracellular calcium overload. The viral vector-mediated gene expression of BDNF may pave the way of a novel therapeutic strategy for the treatment of neurodegenerative diseases such as Alzheimer's disease.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.