Objective To study the causes of hematoma-induced spinal cord injury after surgical treatment of fluorosis cervical canal stenosis (FCCS) so as to conclude the methods for early diagnosis and treatment.Methods A retrospective review was conducted on 329 cases of FCCS undergone expansive laminoplasty (ELOP) between 2006 and 2009.Eighteen out of the 329 cases presented with neural deterioration in postoperative 2 weeks,including l 1 males and 7 females at age of 45-73 years (mean 56.9 years).MRI scan at postoperative 1-5 days confirmed that the injury cause was hematoma formation (incidence of 5.47％).Once the definite diagnosis was made,immediate local puncture decompression,immobilization in the prone position as well as a timely second surgical probe and spinal decompression were performed.Results Nerve symptom of the 18 cases obtained different degree of recovery.Japanese Orthopedic Association (JOA) score promoted from preoperative (7.44 ± 1.25) points to (12.6 ± 2.1)points at 12 months after second operation.Scatter plot between time of definite diagnosis and improvement value in JOA score before and after the second operation was drawn so as to establish linear equation (Y =6.240 7-0.777 8X(F =9.89,P ＜0.01).As a result,the two variables presented a negative linear relationship,which suggested a better outcome after early treatment than delayed treatment.Conclusions Hematoma compression is the main cause of spinal cord injury following operation for FCCS patients.Strict hematosis and alternate lateral clinostatism after operation were effective prevention methods.Besides,early diagnosis and timely treatment are critically important.

Objective To study the spinal neurocyte apoptosis and the changes of p53 in chronic fluorosis rats,and the improvement after drinking no fluoride water.Methods One hundred twenty Wistar rats were divided into 4 groups by random number table method according to body mass,30 rats in one group fed with high concentration NaF water (200 mg/L) to make fluorosis model and classified as high fluoride group;other 30 rats were fed with distilled water as control group;another 30 rats were fed with high concentration NaF water (200 mg/L) for 12 weeks,then fed with distilled water for 12 weeks and classified as defluorination group;the rest 30 rats were classified as defluorination control group.The content of fluoride in urine was tested after the 4th,8th,and 12th weeks.Then the content of fluoride in urine of defluorination group and defluorination control group was tested.The high fluoride group rats and control group rats were killed after 12th week.Defluorination group rats and defluorination control group rats were killed after 24th week.Their spinal cord was collected.The expression of p53 protein in spinal cord was detected by immunohistochemistry and Westem blotting.Apoptosis of the neurocyte was quantitatively analyzed by flow cytometry (FCM).Results By FCM,apoptosis of neurocyte was increased in both high fluorosis group rats and defluorination group rats compared with those in control group rats [(3.36 ± 0.71)％ vs.(0.78 ± 0.65)％;(3.47 ± 0.56)％ vs.(0.83 ± 0.64)％,t =14.680,17.003,all P ＜ 0.01)],but no difference was found between these two groups [(3.47 ± 0.56)％ vs.(3.36 ± 0.71)％,P ＞ 0.05)].Immunohistochemistry and Western blotting revealed that p53 expression in spinal cord of high fluorosis group rats was increased compared with those in control group rats (422.69 ± 12.35 vs.177.82 ± 14.16;253.37 ± 10.42 vs.87.14 ± 7.39,t =77.212,72.988,all P ＜ 0.01).And p53 expression in spinal cord of defluorination group rats was increased compared with those in control group rats (418.75 ± 11.84 vs.163.47 ± 8.57;248.29 ± 10.23 vs.98.74 ± 11.52,t =95.663,53.167,all P＜ 0.01).But the differences were not statistically significant (418.75 ± 11.84 vs.422.69 ± 12.35;248.29 ± 10.23 vs.253.37 ± 10.42,t =1.261,1.906,all P ＞ 0.05).Conclusions There is apoptosis of neurocytes in the spinal cord of chronic fluorosis rats;overexpression of p53 probably plays an important role in the mechanism of damage induced by excessive fluorine.Apoptosis can not be recovered after defluorination for a short time,and persistent overexpression of p53 may be one of the reasons that apoptosis of neurocytes in the spinal cord can not decrease.

Objective To explore the correlation between acute infarctions in different parts of the brain and the risk of vascular cognitive impairment (VCI). Methods 212 patients with acute cerebral infarction were tested using Mini Mental State Examination(MMSE)and Montreal cognitive assessment(MoCA),and were divid-ed into normal cognition group,VCI group,vascular dementia group,and mixed dementia group. We analyzed the gender,age,past medical history,personal history,MMSE and MoCA scores,and imaging data. Results Of the 212 patients,61(28.77%)had normal cognition level,74(34.91%)had VCI,56(26.42%)had vascular demen-tia,and 21(9.91%)had mixed dementia. Multiple regression analysis showed that frontal lobe infarct increased the risk of VCI(OR,41.72)and vascular dementia(OR,48.49);cerebellar infarction also increased the risk of vascular dementia(OR,4.70)and mixed dementia(OR,12.38);and temporal lobe infarction increased the risk of mixed dementia significantly(OR,56.98). Conclusions Approximately 71.3%of the patients with acute cere-bral infarction develop vascular cognitive impairment. The infarcts occurring in the frontal lobe ,temporal lobe and cerebellum increase the risk of VCI significantly ,which should be given interventional therapies.

Objective To evaluate the diagnostic value of three nuclide imaging methods in patients with hyperparathyroidism. Methods Thirty five patients with hyperparathyroidism underwent 201 Tl/ 99m TcO-4 (8 cases), double phase 99m Tc MIBI imaging methods (27 cases) and 99m Tc MIBI/ 99m TcO-4 substraction imaging (20 cases). Abnormal increase of radioactivity in substraction imaging or delay imaging denoted positive result. All data of nuclide imaging were evaluated according to final clinical results and were compared with ultrasound or CT. Results 35 cases of hyperparathyroidism were proved, including 31 adenomas (ectopic 1), 3 hyperplasia and 1 carcinoma. The sensitivity of 201 Tl/ 99m TcO-4 , double phase 99m Tc MIBI imaging and 99m Tc MIBI/ 99m TcO-4 substraction imaging was 62.5%, 88.9%,90.0%, respectively. The specificity of 3 nuclide imaging methods was 100%. The sensitivity and specificity of ultrasound were 74.3%, 85.7%, respectively. The sensitivity of CT was 78.6%. The results showed that 99m Tc MIBI/ 99m TcO-4 was superior to other imaging. Conclusion An accurate diagnosis of hyperparathyroidism and preoperative anatomic localization can be determined by means of nuclide imaging.

BACKGROUND:At present, liver transplantation is the best method to treat end-stage liver disease. UW solution is recognized as the best liver preservation solution, but it is expensive. Moreover, the extracel ular fluid of high K+condition is inconsistent with human physiology. Because transient hyperkalemia of UW solution often causes cardiac arrest, research and development of the new liver preservation solution already brook no delay. OBJECTIVE:To study the protective effect of self-designed KYL solution on ischemia reperfusion injury in macaque donor liver. METHODS:A total of eight recipient macaques and eight donor macaques were selected in this study. Each group contained KYL solution group (n=4) and UW solution group (n=4). Donor liver was perfused and cryopreserved for 4 hours and subjected to al ogenic orthotopic liver transplantation. At 30 minutes and 6 hours after transplantation, bile production was recorded. Blood was obtained and used to detect concentrations of aspartate aminotransferase, alanine aminotransferase, nitric oxide, endothelin-1 and tumor necrosis factor-α. Liver tissue was col ected and detected under the light microscope. RESULTS AND CONCLUSION:Bile secretion was found in both groups. Bile secretion production increased as time went on (P<0.05). At 30 minutes and 6 hours after donor liver reperfusion, serum aspartate aminotransferase and alanine aminotransferase concentrations were lower in the KYL solution group than in the UW solution group (P<0.05). No significant difference was found in levels of serum nitric oxide, endothelin 1 and tumor necrosis factor alpha between the two groups (P>0.05). Under light microscope, morphological observation of liver tissue revealed that cel ular edema was evident in the UW solution group than in the KYL solution group. Results suggest that the effect of KYL solution on preventing ischemia/reperfusion injury was identical to the UW solution, and partial effect was better than UW solution.

BACKGROUND:At present, liver transplantation is the only way to cure end-stage liver disease, but the complications after transplantation is stil an important factor of affecting the long-term survival of patients who received orthotopic liver transplantation, therefore it is necessary to establish a stable animal transplantation model. OBJECTIVE:To establish rat models of orthotopic liver transplantation. METHODS:After inhalation anesthesia with ether, 204 SD rats were perfused with 2-4℃ Ringer’s solution through the abdominal aorta. In order to reduce warm ischemia of the liver, the liver was not turned over before perfusion. The suprahepatic inferior vena cava was cut off along the phrenic ring after perfusion. No further trimming was needed when dressing, so as not to damage the vena cava. The donor liver was removed and preserved in 4℃Ringer’s liquid. The receptor liver was cut off and alogeneic orthotopic liver transplantation was performed using modified two-cuff method. After transplantation, rats could automaticaly turn over and drink water. Surviving more than 3 days is regarded as a successful transplantation. RESULTS AND CONCLUSION:102 liver transplantations were performed in 204 rats, with 86 rats surviving more than 3 days. The success rate of transplantation was 84%. The results demonstrate that rat models of orthotropic liver transplantation can be constructed successfuly through improving techniques.

BACKGROUND:Acelular dermal matrix is a cel-free natural tissue scaffold similar to human soft tissue, which is easy to shape and has non-toxic side effects. It has been used to repair the urethra and ureter. OBJECTIVE:To investigate the effect of acelular dermal matrix on the repair of bile duct injury. METHODS:Thirty Diannan miniature pigs were randomly divided into three groups: in blank group, the bile duct was resected folowed by end to end anastomosis; in experimental group, bile duct defect model was made folowed by repair with acelular dermal matrix; in control group, bile duct defect model was made folowed by repair with expanded polytetrafluoroethylene. At 6 and 24 weeks after repair, bile duct patches and surrounding tissues were taken for immunohistochemical observation and RT-PCR detection. RESULTS AND CONCLUSION: Compared with the control and blank group, the expression of cytokeratin was higher, but the expression of transforming growth factor β1 was lower in the experimental group. Within 24 weeks after repair, the total mRNA level of transforming growth factor β1 was lower in the experimental group than the other two groups (P < 0.05), but the total mRNA levels of insulin-like growth factor 2 and vascular endothelial growth factor were higher in the experimental group (P < 0.05). These findings indicate that the acelular dermal matrix for repair of bile duct injury can promote angiogenesis and bile duct epithelial regeneration, but not increase the formation of scars.

Trimethoprim molecularly imprinted polymer (MIP) was prepared as the coating of stir bar sorptive extraction (SBSE) and applied to the trace analysis of trimethoprim and three sulfonamides in complex samples.The MIP-coating was about 21.5 μm thickness with the relative standard deviations (RSD) of 5.9％ (n=10).It was homogeneous and dense with good thermal and chemical stability.The extraction capability of the MIP-coating was 1.7 times over that of the non imprinted polymer (NIP) coating.The MIP coating exhibited selective adsorption ability to sulfonamides,triazines and methotrexate besides antibacterial synergists.The methods for the determination of trimethoprim and three sulfonamides by MIP-coated stir bar sorptive extraction coupled with HPLC were developed.It was successfully applied to the trace trimethoprim analysis in spiked urine and plasma samples.The linear range was 5 to 200 μg/L and the detection limit was 1.6 μg/L.The recoveries in urine and plasma samples were 84.5％ to 91.7％ with RSDs of 2.9％ -4.4％,71.9％ to 85.1％ with RSDs of 3.0％ -7.3％,respectively.The trimethoprim MIP-coated stir bar was also applied to the trace sulfonamides analysis in spiked milk sample.The linear range was 10-200 μg/L,the detection limit was within the range of 4.5-6.1 μg/L,and the recovery was 83.2％ - 110.2％ with RSDs of 4.1％ -8.0％.

Objective To evaluate and compare C5 palsy and closure of the opened lamina after expansive open-door Laminoplasty (EOLP) with miniplate or suture/anchor fixation.Methods Between January 2011 and January 2013,a total of 142 patients with cervical myelopathy who were treated by EOLP were divided into hinge-side fixation group (fixed with suture/anchor,78 cases)and open-side fixation group (fixed with miniplate,64 cases).The Japanese Orthopaedic Association (JOA) score was used for neurological assessment and recovery rate (RR) counting.Opening angles,cervical curvature index (CCI),posterior shifting of spinal cord (PSSC) and severity of cord compression were recorded and compared.Results All patients in both group were followed up for more than 12 months.All incisions healed by first intention.C5 palsy occurred in 9 patients (9/78,11.5％) of hingeside fixation group,and 1 patients (1/64,1.6％) of open-side fixation group,showing significant difference (P=0.047).Opening angles and PSSC in hinge-side fixation group were greater than that in open-side fixation group.PSSC of 10 patients with C5 palsy were 3.97±1.19 mm,and greater than that of other patients without C5 palsy 2.57± 1.01 mm.There was no significant difference in CCI before (12.23％±3.70％,11.38％±4.29％) and 1 week (12.12％±3.77％,11.31％±4.35％) after operation.No significant difference was found in JOA scores (12.35±1.09,13.55±0.91),JOA improvement rate (64.24％±9.49％,61.78％±11.48％) and cord compression (0.74±0.71,0.75±0.67) at 12 months after operation.In 6 months postoperatively,27％ of patients in hinge-side fixation group,none in open-side fixation group were identified with 10％ decrease or more in opening angles of lamina.Conclusion EOLP with miniplate fixation has the same clinical outcome as fixed with suture/anchor,but will reduce the incidence of C5 palsy and prevent further closure of the opened lamina.

Objective To evaluate the role of miR-143, miR-145 in the development of gastric gastrointestinal stromal tumor. Methods The expression levels of miR-143 and miR-145 in 21 cases of gastric gastrointestinal stromal tumor and the matched non-tumor adjacent tissue specimens were examined by stem-loop real-time RT-PCR, and its correlation with clinicopathologic features of gastric gastrointestinal stromal tumor were analyzed. Results Expression level of miR-145 were significantly higher in tumor than adjacent normal tissues (P＜0.01 ) and that with mitotic count ≥ 5/50HPF cases was significantly lower than that with mitotic count ＜5/50HPF cases (P=0.02). miR-145 expression in huge tumor (＞10 cm)was significantly lower than that in the large tumor (5～10 cm) and small tumor (2～5 cm) (P=0.048).By Fletcher risk stratification system, miR-145 expression in high-risk cases was significantly lower than that in the intermediate-risk and low-risk cases (P=0.048). While the expression of miR-145 in low-risk group was significantly different compared to that in intermediate-risk group and high-risk group (P=0.01).There was no difference between the expressions of miR-143 in tumor and that in normal tissue(P=0.06).Conclusion In gastric gastrointestinal stromal tumor, MiR-145 expression is significantly higher in tumor than adjacent normal tissues. miR-145 is closely associated with tumor size. mitotic counts and Fletcher risk stratification system.