OBJECTIVETo study the correlation between lumber disc degeneration and sacroiliac joint disorder, in order to provides a new understanding concepts and therapeutic approach for the prevention and treatment of chronic intractable low back pain.

METHODSFrom August 2009 to October 2010,129 cases with lumbar disc herniation were studied with epidemiological methods. Among them, 61 patients with L4, disc herniation included 37 males and 24 females, ranging in aged from 20 to 75 years old, duration of the disease ranged from 1 to 144 months; The other 68 patients with L5S1 disc herniation included 32 males and 36 females,ranging in aged froml8 to 76 years old,duration of the disease ranged from 0.5 to 240 months. The clinical data, symptoms and signs,X-ray characteristics of lumbar spine and pelvis of the patients were investigated by epidemiological. The risk of lumbar disc herniation was calculated with case-control study; independent variables were screened with single factor analysis; the risk factors for lumbar disc herniation were determined with logistic regression analysis, and biomechanics analyses were taken.

RESULTSAmong 129 patients with lumbar disc herniation, 88 cases associated with sacroiliac joint disorders, sacroiliac joint disorder was a risk factor of lumbar disc herniation (OR = 4.61, P = 0.00); 47 cases associated with sacroiliac joint disorders in 61 patients with L4,5 disc herniation, iliac crest uneven caused by iliac rotational displacement was a high risk factor of L4,5 disc herniation (OR = 11.27, P = 0.00); 41 cases associated with sacroiliac joint disorders in 68 patients with L5S1 disc herniation, lumbar sacral angle abnormalities caused by sacral tilt shift was a high risk factor L5S1 disc herniation (OR = 2.31, P = 0.03).

CONCLUSIONLumbar disc herniation and sacroiliac joint disorder are two of fallot, the two factors affect each other and there is a causal relationship. They are common exists in low back pain.

Adult ; Aged ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; Joint Diseases ; physiopathology ; Lumbar Vertebrae ; physiopathology ; Male ; Middle Aged ; Sacroiliac Joint ; physiopathology

OBJECTIVETo study the biomechanical relationship between iliac rotation displacement and L(4,5) disc degeneration, and to provide clinical evidences for the prevention and treatment of L(4,5) disc degeneration and herniation.

METHODSFrom March 2012 to February 2014,68 patients with lumbar disc herniation combined with sacroiliac joint disorders were selected. Among them, 42 patients with L(4,5) disc herniation combined with sacroiliac joint disorders included 22 males and 20 females, ranging in age from 19 to 63 years old, with an average of (51.78 +/- 20.18) years old, and the duration of the disease ranged from 1 to 126 months with an average of (11.18 +/- 9.23) months. Twenty-six patients with L5S1 disc herniation combined with sacroiliac joint disorders included 11 males and 15 females, ranging in age from18 to 65 years old with an average of (45.53 +/- 27.23) years old, and the duration of the disease ranged from 0.5 to 103 months with an average of (11.99 +/- 12.56) months. Sixty-eight anteroposterior lumbar radiographs, 68 lateral lumbar radiographs,and 68 pelvic plain films were taken. The degree of lumbar scoliosis, pelvic tilt,and disc thickness were measured. The correlation between pelvic tilt and lumbar scoliosis ,lumbar scoliosis and disc thickness were studied by using linear and regression methods. The hiomechanical analysis was performed.

RESULTSThere was a positive correlation between pelvic tilt and lumbar scoliosis in patients with L(4,5) disk herniation (R=0.49, P=0.00). There was a causal relationship and good linear proportional relationship (Y=3.05+1.07X, P=0.00) in the two variables. There was a negative correlation between lumbar scoliosis and intervertebral space in male patients with L (4,5) disk herniation (R = -0.50, P=0.01). There was a causal relationship and good linear proportional relationship in the two variables (Y=13.09-0.27X, P=0.02). But there was a positive correlation between lumbar scoliosis and intervertebral space in male patients with L5S1 disk herniation (R=0.46, P=0.04).

CONCLUSIONIliac rotational displacement are closely related with L(4,5) disc degeneration and herniation in biomechanics. A new concepts and therapeutic approach is provided for clinical treatment of chronic and refractory herniation of L(4,5) disc in patients

Adult ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; Intervertebral Disc Displacement ; physiopathology ; Lumbar Vertebrae ; physiopathology ; Male ; Rotation ; Sacroiliac Joint ; chemistry ; physiopathology ; Young Adult

Objective To evaluate the relationship between von Hippel-Lindau (VHL) gene mutations and the prognosis of Chinese sporadic clear cell renal cell carcinoma (CCRCC). Methods VHL gene mutations were detected by polymerase chain reaction (PCR), direct DNA sequencing in 74 paired specimens of sporadic CCRCC and normal kidney. The mutation findings, pathologic fea-tures and prognostic characteristics were analyzed. Results Fifty-one patients (68.9%) were in clinical stage T1, 9 patients (12.2%) were in T2 and 14 patients (18.9%) were in T3. In the aspect of pathological grade, 15 patients (20.3%) were in G1, 50 patients (67.6%) were in G2 and 9 pa-tients (12.2%) were in G3. VHL gene mutations were detected in 40 of 74 cases (54.1%). There were no significant differences of VHL gene mutations in different pathological grade and clinical stage of CCRCC, P=0.915, P=0.237, respectively. All patients were followed up for 34 to 107 months (mean 71 months). Seven patients died of CCRCC. Another 11 patients developed CCRCC related me-tastasis. Five-year tumor-free survival was 78%. The incidence of death or metastasis of CCRCC in VHL gene mutation group (15.0%, 6/40) was significant lower than non-mutation group (35.3%,12/34), P=0.043. Logistic regression results showed that lower tumor pathological grade and stage, better patients' prognosis would be (P=0.016, P=0.024, respectively). However, VHL gene muta-tion was related with better prognosis (P=0.033). This association was stronger among patients with high grade tumors (G3, P=0.048). Conclusions There are frequent VHL gene mutations in spo-radic Chinese CCRCC. Tumors' pathological grade and clinical stage are the important parameters for prognosis. However, VHL mutations are strongly associated with better cancer specific survival for CCRCC patients. These associations are relatively stronger in patients with high grade tumors.

Objective To investigate the clinical value of 18 F-FDG PET CT scan in the diagnosis of thin lung nodules. Methods 56 solitary cases of nodules in the lungs,nodule size ranged from 1～3 cm,conducted 18 F-FDG PET/CT imaging and thin layer CT scan at the same time, 18 F-FDG PET imaging using visual measurement combined with semi-quantitative method to determine the degree of malignant of the lesions; conducted MPR recon-struction after thin layer CT scan, based on the lesions morphology to determine the degree of malignant. Then com-pared the results of above,and the results of the combination of 18 F-FDG PET imaging and thin layer CT scan,with the pathological results after surgery. Results The sensitivities of PET imaging alone,thln layer CT alone,joint ima-ging diagnosis of SPN are 92.6% ,88.2% ,96.4% ,specificity are 73.3% ,57.1% ,85.7% ,accuracy percentage rate are 89.3% ,80.4% ,94.6% ,the positive predictive values are 92.6% ,91.8% ,96.4% ,and negative predictive val-ues are 84.6% ,61.5% ,92.3% ,respectively. Conclusion 18 F-FDG PET combined with thin layer CT scanning is a very effective method to clinical diagnosis the malignant degree of SPN.

Objective To detect the mutation of STK11 in a family with Peutz-Jeghers syndrome.Methods Genomic DNA was extracted from peripheral blood and harmatoma polypus of all the patients,and 9 exons and noncoding regions of STK11 were amplified by PCR.Cycle sequencing was used to analysis the DNA sequence,and western blot was used to detected the mutational STK11 protein in the harmatoma polypus.Results The 21th codon CAG in exon 5 of STK11 gene transformed to TAG in all the patients,which translated into a truncated STK11 protein.Conclusion This novel mutation is the pathogeny of PJS in this family,which could be an indicator for the diagnosis of PJS in this family.And it may lead to a higher risk of cancer in patients.

Probability of causation (PC) was used to facilitate the adjudication of compensation claims for cancers diagnosed following exposure to ionizing radiation. In this article, the excess cancer risk assessment models used for PC calculation are reviewed. Cancer risk transfer models between different populations, dependence of cancer risk on dose and dose rate, modification by epidemiological risk factors and application of PC are also discussed in brief.

Objective To study the function and mechanism of GIT1(G protein coupled receptor kinase interacting protein 1)in osteoblast migration.Methods GIT1 and ERK1/2(Extracellular Signal-regulated ki- nase 1/2)were detected in mice primary osteoblasts.The localizations of GIT1 and ERK1/2 were determined by immunofluorescence stain with or without PDGF(platelet-derived grnwth factor)stimulation.The association of GIT1 anti ERK1/2 was analyzed by co-immunoprecipitation and western blot.After stimulation,the co-localization of GIT1 and pERK1/2 in osteoblasts was detected by double-immunnfluorescence stain.The pERK1/2 localization was detected by immunofluorescence stain after GIT1RNAh adenovirus infection of osteoblasts.The role of this associa- tion was determined by wound healing assay.Results The co-immunoprecipitation results showed that GIT1 in- teracted with ERK1/2 in osteoblasts induced by PDGF and this association occurred in focal adhesions.GIT1 RNAh adenovirus significantly inhibited the pERK1/2 translocation to focal adhesions and osteoblast migration induced by PDGF.Conclusion GIT1 associates with ERK1/2 in osteoblasts,which is required for pERK1/2 translocation to focal adhesions and osteoblast migration.

Objective To explore the association between glycated hemoglobin (HbA1c) level at admission and coronary plaque characteristics under intravenous ultrasound (IVUS) study in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods 118 patients with NSTE-ACS were divided into the low(HbA1c ≤ 5.6％), medium(HbA1c 5.7％-6.4％)and high(HbA1c ≥ 6.5％)level groups based on admission HbA1c. IVUS was performed in all target lesions. Results As compared with the other two groups, patients with high level HbA1c had higher mean body weight index, higher co-morbidities of diabetes mellitus, dyslipidemia and non-ST-elevation acute myocardial infarction.The high HbA1c level group had more diffuse coronary atherosclerosis ,increased plaque burden and higher rates of positive remodeling, soft plaque and plaque rupture. Conculsions The HbAlc level of admission is associated with plaque vulnerability in NSTE-ACS patients.

Objective To explore the prevalence of health literacy in China in 2011-2013.Methods The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI),Chinese BioMedical Literature Database (CBM),VIP Database for Chinese Technical Periodicals (VIP),Wanfang database,PubMed and Embase.The Meta-analysis was applied with Stata 12.0 software.Subgroup analysis and sensitivity analysis were performed to test the robust of the results.Results A total of 28 studies,including 53 308 residents,were finally included in the review.Meta-analysis revealed the prevalence of health literacy in China to be 16％ (95％CI 15％-16％),and the prevalence of health concepts and knowledge was 25％ (95％CI 25％-26％),and healthy lifestyles and behaviors was 13％ (95％CI 12％-14％),and health skills was 32％ (95％CI 31％-32％).Conclusions The health literacy levels of residents showed a rising trend.There were differences between rural and urban health literacy levels and different regions.Rural residents' health literacy level increased more significantly than that of the city.Due to limited kinds of methods,more scientific and effective methods were needed to evaluate the health literacy.

Objective: To observe the clinical efficacy of tuina manipulations in treating different types of tic disorders (TD). Methods: Eligible TD patients were classified into three types, transient tic disorders (TTD), chronic multiple tic disorders (CMTD) and Tourette syndrome (TS), according to their disease duration and severity. The three types of children were treated with the same tuina manipulations. Changes in the Yale global tic severity scale (YGTSS) score, effective rate for tic, and cervical spine imaging examination results (including asymmetry of the lateral atlanto-dental interval, broadened anterior atlanto-dental interval, C2 spinous process deviation, occipito-atlanto-axial flexion/ extension instability) were observed after 1-month and 3-month treatments respectively. Results: The YGTSS score changed significantly after 1-month and 3-month treatments compared with that before treatment (both P<0.01); the effective rate for TD was 46.6％ and 86.7％ respectively after 1-month and 3-month treatments; there were significant differences comparing the effective rate for tic between different types of TD after 1-month and 3-month treatments (all P<0.05); comparing the effective rate for tic after 1-month treatment with that after 3-month treatment for the same type, the intra-group differences were statistically significant [TTD group (P<0.01), CMTD group (P<0.01), TS group (P<0.05)]; the abnormal parameter rates in neck imaging examination after 3-month treatment were significantly different from those before treatment (all P<0.01). Conclusion: Tuina manipulation is effective for TTD, CMTD and TS. It can correct the abnormal alterations of patients' cervical vertebrae, and its efficacy for TTD is most significant.