Iatrogenic nerve injury is one of the most severe complications of surgical correction for spinal deformity with different etiologies.The intraoperative neurophysiological monitoring (IONM) has been widely used to detect the nerve injury in spinal correction surgery.The commonly used IONM techniques involve somatosensory evoked potential (SEP),motor evoked potentials (MEP) and electromyography (EMG).All the IONM techniques have both advantages and disadvantages,while combing SEP,MEP and EMG in the spinal correction surgery could maximumly improve the accuracy and reliability of the IONM.The different pathophysiology of patients with spinal deformity due to different etiologies might significantly decrease the success rate,sensitivity,and specificity of IONM,which might further decrease the reliability of IONM.However,the IONM still serves as the most important monitoring method for the iatrogenic nerve injury in patients with different spinal deformity due to different etiologies.For those monitoring changes that cannot be distinguished,the wake-up test is still the gold standard.

BACKGROUND:Parathyroid hormone related peptides are accompanied by the syndrome of humoral hypercalcemia of malignancy. As a potential therapeutic drug of promoting the healing of bone fracture, parathyroid hormone related peptides have significant clinical application value.
OBJECTIVE:To explore the regulating effects of parathyroid hormone related peptides in diabetic osteoporotic fracture
METHODS:A computer-based online research of CNKI and PubMed databases was performed to col ect articles published between 1990 and 2013, with the key words“parathyroid hormone related peptides, diabetes, osteoporotic fracture”in Chinese and English. There were 1 279 articles after the initial survey. A total of 43 articles were included according inclusion and exclusion criteria.
RESULTS AND CONCLUSION:Animal and clinical experiments demonstrated that parathyroid hormone related peptides notably accelerate bone fracture healing, and improve the repair process of islet cellfunction defects that are related with diabetes. Meanwhile, as an analogue, parathyroid hormone has been identified as clinical medication in the treatment of fracture. But the appropriate dose, and method of application at the different stages of bone fracture healing and the problem of drug combination need further investigation.

Objective To investigete the changes of neurons in cortex and hippocampus of spontaneously hypertensive rat.Methods Systolic pressure,diastolic pressure and mean arterial pressure,heart rate were measured by caudal artery manometry in six-month old SHR and age-matched Wistar rats(control group).Neurons in frontal lobe,parietal lobe,temporal lobe,and hippocampal CA1,CA3 sub-field and the dentate gyrus were observed through Nissl staining.Results Systolic pressure,diastolic pressure and mean arterial pressure in SHR were significantly higher than that in control group(P

Objective To exploer the function and underlying mechanism of Lunasin on sports articular cartilage injury.Methods Wistar rats were randomly divided into control group and model group;after injection molding for 3 times, the model rats were feed for 28 days.Then the model rats were divided into sham model group, 0.01, 0.05 and 0.1 mmol/L Lunasin treatment group respectively.After treatment, ELISA was used to analyze the production of IL-1β,IL-6,TNF-α,MMP-6 and MMP-8.SOD activity and iNOS were evaluated by their ELISA kit.Western blot was used to detect the expression of NRF2, Keap1, LC-3Ⅱ, Bax, Beclin1, p-AMPK, AMPK.Results Compared with control, the dose of IL-1β,IL-6,TNF-α,MMP-6 and MMP-8 in serum of model rats were significantly increased (P<0.05), however, after treatment with Lunasin for 1 month, these inflammatory factors were obviously reduced then that of model rats (P<0.05);Furthermore Lunasin treatment obvi-ously increased SOD activity,up-regulated NRF2 expression and down-regulated the generation of nitric oxide synthase (iNOS) (P<0.05);Additionally, Lunasin can raise the expression of autophagy-related protein(beclin1 and LC-3Ⅱ), reduce the expression of apoptosis protein (Bax) in damaged articular cartilage.ConclusionsLunasin benefits the repair of damaged joints by reducing the production of inflammatory mediators, activating of oxidative stress system and autophagy pathway.

ObjectiveTo investigate the cause,diagnosis and treatment measures of neonatal pneumothorax.MethodsThe clinical data of 98 cases with neonatal pneumothorax in our hospital from Mar 2005 to Mar 2010 were reviewed retrospectively.ResultsThere were 27 premature neonates and 71 full-term neonates in the 98 cases.Ten cases were spontaneous pneumothorax and 88 cases were non spontaneous pneumothorax.After the treatnent of primary disease,pleural aspiration,chest drainage and mechanical ventilation,88 cases were cured,8 cases were improved and 2 cases died.ConclusionNeonatal pneumothorax is related with cesarean section,improper use of endotracheal intubation,meconium aspiration,premature hyaline membrane disease using pulmonary surfactant and ventilator therapy.Most pneumothorax is due to lung disease.The prevention of preterm birth and asphyxia can reduce the incidence of neonatal pneumothorax.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) of ATP-binding cassette B1 (ABCB1),ATP-binding cassette C2 (ABCC2) and solute carrier organic anion transporter 1B1 (SLCO1 B1) genes with high dose methotrexate (HDMTX)-induced toxicity in children with acute lymphoblastic leukemia (ALL).Methods This study was designed as a casecontrol.From September of 2005 to December of 2011,the blood samples were randomly collected from 142ALL patients from Nanjing Children's Hospital,Enzyme-multiplied immunoassay technique (EMIT) was used to measure the plasma concentration of MTX,Seven SNPs in ABCB1 (rs1045642,rs2032582,rs1128503),ABCC2 (rs717620,rs2273697) and SLCO1 B1 (rs4149081,rs11045879) genes were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR).Results A significantly increased risk of MTX-induced toxicity was observed in patients with MTX elimination delay (OR ＝ 2.828,95％ CI:1.217-6.571,P ＜ 0.05).Two SNPs in SLCO1B1,rs4149081 and rs11045879 were linkage disequilibrium (LD) with each other (R2 =0.979,P ＜ 0.05).Multivariate analysis revealed that individuals with SLCO1B1 rs4149081 AA genotype or SLCO1B1 rs11045879 CC genotype showed increased incidence of MTX elimination delay (OR =4.41,95％ CI:1.537-12.654,P =0.042),and the two genotypes were also associated with significantly increased risk of MTX-induced toxicity (OR =4.118,95％ CI:1.135-14.944,P =0.022).No association of MTX elimination delay or MTX-induced toxicity with the other SNPs analyzed was found.Conclusions SLCO1B1 rs4149081 AA or SLCO1B1 rs11045879 CC genotypes might be a risk factor for the susceptibility to MTX-induced toxicity in children with ALL.

Objective To study the function of Fkbp51 in the heart and liver by analyzing the differential RNA expression profiles in the wild-type mice (WT) and Fkbp51 knockout (KO) mice, and to elucidate the role of Fkbp51 gene in metabolic pathways in the heart and liver.Methods Using the second generation of high-throughput gene sequencing technology, the mRNA expression profiles of heart and liver were sequenced in WT and Fkbp51 KO mice.The data of sequencing of heart tissues were analyzed by DEGseq, and the results of sequencing of liver tissues were analyzed by BRB-Array Tools.The differential genes of the heart and liver in the mice were screened respectively.Gene ontology (GO) analysis and KEGG pathway analysis were performed to analyze the differentially expressed genes using the online tool DAVID.In addition, the differential genes of the two organ tissues were analyzed by Venn diagram.The interaction network of proteins was analyzed using the STRING database.Results (1) The absence of Fkbp51 led to changes in mRNA expressions of heart-related signal pathways such as vascular smooth muscle contraction, chemokine, retinol, and MAPK signaling pathways.(2) The lack of Fkbp51 mostly induced changes in cholesterol synthesis and metabolism, lipid metabolism, redox and other related genes and pathways in the liver.(3) In the heart and liver, Fkbp51 deletionresult ed in four co-differential genes, among them, down-regulation of Rnaset2b, Hmga1 and Fkbp51, while Cyp2b10 was down-regulated in the heart but up-regulated in the liver.All these proteins may interact with HSP90 protein and participat in the metabolism of heart and liver tissues.Conclusions Fkbp51 is involved in different metabolic and gene expression regulation pathways of heart and liver, and the roles are both independent and interrelated.

Objective To study the influence of CRT brightness on image reading. Methods Both physical testing and compared viewing were used in the study. (1) Setting the CRT brightness at high and low grade (the blank brightness of CRT was 112 cd/m 2 and 82 cd/m 2, respectively). (2) 21 films with the density ranging from 0.27 to 2.71 were digitized by a scanner and displayed on the CRT. The brightness of CRT that varied with film density was measured by a bright meter, then the relation chart between CRT brightness and the film density was drawn. (3) Thirteen films on which there were many small and low contrast signals were viewed on CRT by three doctors. The tested data were calculated by statistics (? 2 test, the difference was significantly marked when P 0.05), but the signals viewed in the lung were 87 and 29, and the difference was significantly marked (? 2=53.73, P

BACKGROUND:Previous studies have mainly focused on costal cartilage, articular cartilage, nasal septal cartilage, and auricular cartilage, but in vitro culture of human vertebral endplate cartilage is stil rarely reported. OBJECTIVE: To discuss the feasibility of culture of vertebral endplate chondrocytes from type I neurofibromatosis associated with scoliosis patientsin vitro and to study the biological characters of the chondrocytes. METHODS: Through two-step enzymatic digestion and tissue culture, the chondrocytes from the vertebral endplate of seven type I neurofibromatosis patients isolated and cultured in monolayer and passaged to observe the changes of cel morphology under inverted phase contrast microscope. Colagen type II expression was detected by immunocytochemistry to identify whether the cels had chondrocyte characters. The growth kinetics was detected by using MTT colorimetric assay to draw the growth curve of passage 2 chondrocytes. RESULTS AND CONCLUSION:A few chondrocytes crawled from the cartilage after 2 weeks culture and cels were passaged at 3 weeks. Along with passage going on, the phenotype of chondrocytes was changed from polygonal, round, triangle, and irregular shapes to fusiform. The colagen type II expression in passage 2 cels was positive by immunohistochemical staining. MTT test showed the growth curve of the passage 2 chondrocytes presented a transverse “S”. Cels were found logarithmic growth at days 4-7, reached platform stage at days 8-13, and decreased at day 14. It is an effective and simple procedure by two-step enzymatic digestion and tissue explant method to culture vertebral endplate chondrocytes with high purity and good viability from type I neurofibromatosis patients associated with scoliosisin vitro. Passage 2 chondrocytes from the vertebral endplate exhibit the best viability at days 4-7, which can be used as targets for research of pathogenesis of type I neurofibromatosis with atrophic scoliosis.

Objective To investigate the methods and results of reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins for repairing soft tissue defects of the fingers.Methods From March 2009 to June 2011,twenty cases with soft tissue defect distal to the proximal interphalangeal join of fingers were treated by reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins.There were 12 cases of the index finger,eight of middle finger,the largest area of the flaps was 4.5 cm × 3.5 cm,and the smallest area was 3.5 cm × 2.5 cm,an average of the pedical length was 4.0 cm.All cases anastomosis one superficial vein,fourteen cases suture dorsal digital nerve,and the donor area covered with full-thickness skin graft.Results All flaps survived.Postoperative follow-up time ranged from 8 to 16 months,the appearance and texture of the flaps were excellent,the flaps with suture nerves,the two-point discrimination was 7 mm to 9 mm,the other flaps that the nerves were disconnected.The sensation of the flaps recovered to S2-S3,no morbidity of the donor fingers occurred.Conclusion Reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins can form a longer vascular pedicle,to repair the soft tissue defect distal to the proximal interphalangeal joint,through anastomoses superficial venous can reduce the flap venous pressure obviously,improve the survival quality of the flap,the effect is satisfacted.