[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 It has been know that visceral hypersensitivity is one of the important features of irritable bowel syndrome(IBS) and psychological factors may be implicated in the etiology of IBS. The aim of our study was to investigate the influence of an acute psychological stress on the rectal sensitivity in rats and the role of mast cell in this response. Methods A stress model was established by mild restraint lasting 2 hours and the effect of acute stress on visceral sensitivity to rectal distension(RD) was measured by abdominal electromyography. The number of mast cells was counted and mast cell activation was determined by histamine release after in vitro stimulation with substance P(SP) in colonic pieces from stressed and control rats. We also studied the effect of acute stress on somatic nociception and colonic transit. Results Abdominal response to RD for all volumes of distension(0.5, 0.8, 1.2, 1.6 ml)was significantly enhanced by acute restraint stress compared with sham stress( P 0.05 ). Acute stress also stimulated colonic transit and produced significant somatic analgesia. Conclusion Acute stress enhanced rectal sensitivity in response to rectal distension and colonic mast cell activation may be involved in this response.

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.

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.

Objective To illustrate and discuss the technique and clinical value of scapula Y-position radiography.Methods Scapula Y-position radiographies were performed on 110 patients with shoulder joint injury or omalgia.The patient standed in front of the panel face to face, with the affected joint closed to the panel, and the arms fell naturally and palms pronated to stick close to the body.The angle between the coronal plane and the panel was about 55 to 65 degree, put the affected caput humeri at the center of the panel,tilted the tube to foot-side by 15 degree,and aimed the axis at caput humeri.Results Among the 110 patients, 82 radiographies were successfully taken by the first time,28 failed because of the inappropriate body-tilt angle.We had exposed 5 acromion fractures cases, 20 flexural and hook-form acromion cases, 35 cases with the acomion-caput humeri distance less than 1 cm, and 2 coracoid fracture cases.Conclusion Scapula Y-position radiography has high clinical value that could expose the osseous anatomic exit of the rotator cuff and guide the clinical treatments.

Objective To explore the establishment method of brain ischemia model with blood stasis. Methods The rat models of blood stasis were established by intramuscular injection of dexamethasone 0.2 mg?kg-1?d-1 inside the thigh for successive 10 d. When the blood stasis models were successfully established, the rats were anaesthetized and common carotid arteries in both sides were separated and ligated to make brain ischemia model. Meanwhile the blank control group and Sham-operation to one of the model groups were conducted. Results Compared with the blank control group, the level of whole blood viscosity were obviously increased and TT、PT、APTT markedly decreased in the operation group and pseudo-operation group. Compared with the blank control group and the operation group, the changes of ATP activity,the LD ,LDH ,NO,NOS, SOD,MDA, Glu, T-AA, ET and CGRP levels were significant in the pseudo operation group(P

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.