[Objective]To detect the predictors of residual low back pain (LBP) after laminectomy.[Method]From 1996 to 2000,69 cases (31 males and 38 females) of degenerative lumbar stenosis who had underwent laminectomy treatment and with at least 5 years' follow-up documents were involved in this study.LBP were evaluated by the Japan Orthopedic Association (JOA) Scoring System (3 points) pre- and post operation.The relationship between the patients' outcomes and all these clinical and radiographic parameters were analyzed by software package SPSS 13.0.[Result]Twenty-two cases were classified as residual LBP group(group 1) and 47 cases as no-residual LBP group(group 2),binary logistic regression analysis indicated that the predictors of residual LBP were preoperative lumbar lordosis angle、ROM and the number of decompressed laminae.The forward comparison revealed that the lumbar lordosis (22.27??3.12?) and ROM (22.91??2.31?) in group 2 were lower than the lordosis angle (37.23??2.19?) and ROM (31.66??1.52?) in group 1,but the number of decompressed laminae of group 2 (2.77?0.19 ) were higher than that in group 1(1.70?0.10 ) significantly,the P values were 0.000、0.002 and 0.000 respectively.[Conclusion]Residual LBP may attribute to the decrease of compensation ability to the postoperative instable tendency on a more flat and inflexible lumbar spine especially for multi-laminectomy,so that more attention should be paid to these kind of patients to avoid the development of refractory residual LBP.

Objective To understand the structures and functions of enterovirus 71 (EV71)VP1 gene and its encoded protein using bioinformatics method, so as to direct studies of its biological function. Methods VP1 gene and its encoded protein of EV71 2008-GZCH07 strain and other representative EV71 strains were analyzed by online analysis at bioinformatics websites and software packages. Multi-sequence homological alignment and phylogenetic analysis were performed.Physicochemical characteristics, secondary structure, homology modeling of tertiary structure,enzymological characteristics, antigenic epitope of VP1 gene encoded protein were predicted. Results The homology of EV71 2008-GZCH07 strain was highest (97% and 98%) with ZJ001 strain, and lowest with human coxsackievirus A16. The homology of EV71 2008-GZCH07 strain and EV71 types A,B,C was 86%-98%. Phylogenetic analysis demonstrated that 2008-GZCH07 stain was close to ZJ001 and BJ08-Z025-5 stains, which belonged to C4 subtype. In VP1 encoded proteins of EV71 types A,B,C, the relationship between 2008-GZCH07 and EV71-B, EV71-C was closer than EV71-A.The whole length of VP1 gene was 510 bp, with open reading frame (ORF) located at 116-510 bp region,and it encoded 132 amino acids with isoelectric point of 4.39.The protein was rich of a-helix and random coilon without transmembrane regions, and contained 5 high hydrophobic regions and belonged to extracellular protein. The homology modeling of tertiary structure showed that the region was on the surface of protein and formed a binding loop. There was 5 antigen epitopes. And 7 key catalytic sites were located at or close to the loop. Conclusions EV71-VP1 encoded protein contains many phosphorylation sites, with many biological function sites and antigenic epitope regions, which might be a potential target antigen for immunodiagnosis, anti-schistosome drug and vaccine development, and would be basis of further study of diagnosis, treatment and prevention of EV71 infection.

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.

A new caffeate compound, (E)-erythro-syringylglyceryl caffeate (1), was isolated from the roots and rhizomes of Nardostachys chinensis Batal., together with nine known phenolic compounds, including (+)-licarin A (2), naringenin 4', 7-dimethyl ether (3), pinoresinol-4-O-β-D-glucoside (4), caraphenol A (5), Z-miyabenol C (6), protocatechuic acid (7), caffeic acid (8), gallic acid (9) and vanillic acid (10). Their chemical structures were elucidated on the basis of spectroscopic data and physicochemical properties. Furthermore, this is the first report of compounds 2, 5 and 6 from Nardostachys genus.

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 explore the clinical efficacy of internal fixation with dynamic anterior plate-screw system for quadrilateral area(DAPSQ) in the treatment of complex acetabular fractures involving the quadrilateral surface.Methods Between January 2005 and January 2017,a series of 143 patients with complex quadrilateral surface fracture of the acetabulum were treated at Department of Orthopaedics,General Hospital of Central Theater Command.They were 86 males 57 females,with a mean age 46.6 years (range,from 19 to 77 years).By the Letournel-Judet classification,there were 38 anterior column plus posterior hemitransverse fractures,26 T-shaped fractures and 79 double column fractures.They were all closed.The delay from injury to surgery averaged 9.6 days(range,from 3 to 21 days).All the cases were treated with DAPSQ internal fixation via the ilioinguinal approach.Their operation time,intraoperative bleeding volume,quality of fracture reduction,hip function and complications were recorded.Results The operation time for this series ranged from 2.5 to 5.0 hours,averaging 3.8 hours.The intraoperative blood bleeding ranged from 400 to 2,500 mL,with an average of 680 mL.By the Matta criteria for fracture reduction,76 cases were rated as excellent,51 as good and 16 as poor,giving an excellent and good rate of 88.8％.The 143 patients were followed up from 4 months to 10 years (mean,4.1 years).The clinical fracture union was achieved after 2 to 4 months (mean,3 months).By the modified Merle d'Aubigné & Postel criteria,the affected hips scored 9 to 18 points (mean,16.3 points) at the final follow-ups,with 64 excellent,52 good,19 fair and 8 poor cases,giving an excellent and good rate of 81.1％.The postoperative complications included lesion of lateral femoral cutaneous nerve in 7 cases,urinary tract infection in 15 ones,traumatic osteoarthritis in 20 ones 5 of whom had to receive total hip arthroplasty,and heterotopic ossification (Brooker Grade Ⅰ) in 5 ones.Conclusion Internal fixation with DAPSQ is safe and effective for the treatment of complex acetabular fractures involving the quadrilateral surface.

OBJECTIVE： To prepare Syringopicroside solid lipid nanoparticles （SYR-SLN）， and optimize the formula and characterize SYR-SLN. METHODS： SYR-SLN were prepared by emulsion evaporation method. Using entrapment efficiency as index， based on single factor， orthogonal design was adopted to optimize the mass ratio of lecithin-monoglyceride， volume ratio of organ phase to water phase， poloxamer 188 （F68） concentration and drug dosage. The optimal formula technology was established to investigate entrapment efficiency， drug-loading amount， morphology， particle size， Zeta potential， stability， etc. RESULTS： The mass ratio of lecithin-monoglyceride was 3 ∶ 1； the volume ratio of organic phase to water phase was 1 ∶ 2； the concentration of F68 was 0.4％； drug dosage was 10 mg. The optimal formula included that monoglyceride 80 mg， lecithin 240 mg， 0.4％ F68， syringopicroside 10 mg， absolute ethyl alcohol 5 mL， distilled water 10 mL， emulsification temperature at 65℃ and stirring at 600 r/min. Encapsulation efficiency of SYR-SLN was （42.35±0.60）％ （n＝3）； drug-loading amount was （5.33±0.03）％ （n＝3）； SYR-SLN had a spherical morphology and was evenly distributed. The average particle size was （180.30±5.31） nm with Zeta potential of （－41.9±0.8） mV， and the SYR-SLN could maintain stable for 15 days at 4℃. CONCLUSIONS： SYR-SLN is prepared successfully， and the technology is simple with high encapsulation efficiency.