There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.
Cervical Vertebrae ; surgery ; Decompression, Surgical ; Humans ; Spondylosis ; diagnosis ; surgery ; Treatment Outcome

BACKGROUND:Both local infiltration analgesia and femoral nerve block are used for the pain management after total knee arthroplasty. Controversy stil remains regarding the optimal technique for pain relief. OBJECTIVE:To systematical y evaluate analgesic effects of local infiltration analgesia and femoral nerve block after total knee arthroplasty. METHODS:Databases including PubMed, EMBASE, the Cochrane Library, Web of Science and CBM, were comprehensively searched to identify randomized control ed studies comparing local infiltration analgesia with femoral nerve block. Two reviewers independently selected trials, included literatures, extracted data, and assessed the methodological qualities of included studies according to Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. When there were different opinions, it was decided by the third author. Data were analyzed by RevMan 5.3 software. RESULTS AND CONCLUSION:(1) Eleven randomized control ed trials involving 566 patients were included. (2) At 24 and 48 hours (h) after surgery, there were no significant differences between the local infiltration analgesia and femoral nerve block groups, in Visual Analog Scale scores [MD24 h=0.15, 95%CI (-0.26, 1.28), P>0.05;MD48 h=0.19, 95%CI (-0.06, 0.44), P>0.05] in the resting state, and [MD24 h=-0.01, 95%CI (-0.51, 0.48), P>0.05;MD48h=0.18, 95%CI (-0.45, 0.82), P>0.05] in the active state, amount of analgesic drug use [MD24 h=-2.23, 95%CI (-5.63, 1.16), P>0.05;MD48 h=2.44, 95%CI (-1.08, 5.95), P>0.05], hospital stay [MD=0.05, 95%CI (-0.40, 0.50), P>0.05], postoperative nausea and vomiting [OR=1.09, 95%CI (0.39, 3.04), P>0.05] and postoperative infection [OR=0.99, 95%CI (0.44, 2.59), P>0.05]. (3) These results indicated that the analgesic effect of local infiltration analgesia was identical to that of femoral nerve block after total knee arthroplasty. Due to its simple operation, local infiltration analgesia can be used as a standard analgesia method after total knee arthroplasty.

Objective To investigate the clinical efficacy of acupuncture plus ashi point pricking bloodletting in treating acute gouty arthritis.Methods Seventy patients with acute gouty arthritis were randomly allocated to a treatment group of 38 cases and a control group of 32 cases. The treatment group received acupuncture plus ashi point pricking bloodletting and the control group, routine medication. Blood uric acid and C reaction protein contents were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant differences in blood uric acid and C reaction protein contents after one and two courses of treatment compared with before treatment in the two groups (P<0.01). After two courses of treatment, there was a statistically significant difference in comparing C reaction protein contents between the two groups (P<0.05). The total efficacy rate was 84.2% in the treatment group and 81.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus ashi point pricking bloodletting is an effective way to treat acute gouty arthritis.

Endoscopy ; Humans ; Male ; Middle Aged ; Myoepithelioma ; surgery ; Nasal Septum ; pathology ; Nose Neoplasms ; surgery

As one branch of epigenetics, the sirtuins family ( ClassⅢ histone deacetylase) receive much attention in recent years. SIRT1 as the most famous of the sirtuins family members has been verified involved in a variety of age-related diseases. While the SIRT1 formation is paid more and more attention in age-related cataract. Now, we briefly overviewed the research progress on the role of SIRT1 in age-related cataract.

The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature ; Disinfection ; instrumentation ; Hydrogen Peroxide ; chemistry ; Plasma Gases ; chemistry

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

A cluster sampling method was used to select 5 Huaihai communities of Shanghai.All individuals were aged ≥60 years.Visual acuity without correction and presenting acuity with their habitual distance correction were measured separately for each eye.The prevalence of blindness and low vision was 0.49％ and 1.65％ respectively.The leading causes of blindness in a descending sequence included macular degeneration,cataract and retinal vascular disease.

Objective:To study the antihyperglycemic effect of water soluble polysaccharides (MCW) and alkaline soluble polysaccharides (MCB) from Momordica charantia L. on streptozotocin-induced diabetic mice. Method:Twelve mice were selected randomly as control, while the other l08 mice were injected with STZ 200 mg/kg?bw to induce diabetes.The diabetic mice were divided into 4 groups,the model, MCW (300 mg/kg bw), MCB (300 mg/kg bw), Gilbenclamide (15 mg/kg bw). The above components were administered intragastrically for 10 d and then blood samples were taken to determine concentrations of serum glucose and insulin. Results: The blood glucose levels could be obviously decreased by MCW and MCB in the diabetic mice. MCB has the best antihyperglycemic effect, in terms of improving the serum insulin level and decreasing the blood glucose level of diabetic mice. Conclusion:The polysaccharides from Momordica charantia can repair the injured pancreatic islet tissues and enhance insulin secretion so as to reduce blood glucose level of the diabetic mice.

Objective: To express mSDF-1?/GM-CS fusion protein in the Pichia pastoris expression system and investigate its in vivo promoting effects on hematopoiesis function and immune function.Methods: The mSDF-1?/GM-CS fusion gene was chemically synthesized and was cloned into pichia expression vector;the vector was then transfected into Pichia pastoris expression system.Then the expressed products were detected by SDS-PAGE,Western blotting and purified by ion exchange columns.Rat irradiation model was established by 60Co ? ray and were subcutaneously injected with the fusion protein.The hematopoietic and chemotactic activities of the fusion protein were investigated in vivo.Results: The expression vector pPIC9K-SDF1-L-GM-CSF was successfully constructed,and mSDF-1?/GM-CS fusion protein was successfully expressed by Pichia pastoris strain GSl15.The molecular weight of the protein was about 32000 D,with a concentration of 78 ng/ml.The numbers of bone marrow mononuclear cells and GM-CFU were significantly increased in rats after subcutaneous injection of the fusion protein(P