Spinal disease is the injury caused by congenital malformation, degeneration, inflammation and trauma. These injuries lead to structural lesion of spinal itself, intervertebral discs, spinal cord, nerve root and the attachment, and can cause spinal and associated diseases. Spinal diseases include some frequently encountered diseases, as well as some stubborn and serious diseases. These diseases may cause pain of head and neck, shoulder and arm, waist and leg when they are mild, and partial or thorough paralysis when they are serious. In this article, the history, development, foundations and research progress of non-surgical operation of spinal diseases and the developing tendency of modern spinology are introduced.

[Objective]To observe the histomorphology and ultrastructure of the intervertebral disc(I D) in the rat model with cervical vertebral unbalance of dynamic and static force.[Method]Sixty SD rates were randomly divided into 4 groups: 3 months,5 months,7 months and the control group.The cervical I D degeneration model was made by destroying the neck muscle of rats and the tissues wer collected every month.The number,area and thickness of the cartilage end-plate were measured by the means of Miyamoto's Classes.The ultrastructure of the apoptosis cells of the intervertebral disc was observed under the electron microscope.[Result]Compared with the control group,the 3 months group showed degeneratin changes,with disordered structure of the annular fibrosis and thickness increase of calcification layer and decrease of blood vessel unmber in the cartilage layer.Complete fibrosis was found in nucleus pulposus in 5 months model group,with the fibro lamellar structure disappeared and few blood vessel buds.The features of 7 months model group was similar to 5 months and osteophyma had been formed near the bordr of part intervertebal.Under the electron microscope,the number of surface projection and organelles was decreased.Fatty drop and apoptotic body could be seen in disc cells of 3 month model group.Few cells,broken collagen fibers in ECM and more cavitation cells for necrosis in 5 months and 7months model groups could be seen.[Conclusion]The cervical I D of model groups has shown typical morphological changes of degeneration and this trend was more serious with the time passing.In the early and middle stage of degeneration,the apoptosis cells can be seen,but in the terminal stage the cellular necrosis was more common.

[Objective]To inrestigate the clinical outcomes of using bilateral tibial flap of the second toe nail flap combined with the fibulal flap of the big toe to repair the multi-finger degloving injury.[Method]A variety of different methods were used to repair the multi-finger degloving injury,six fingers in 3 cases were repaired by partial bilateral wrap-around flaps combined with the tibial flap of the second toe.Sixteen fingers in 8 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe.Six fingers in 2 cases were repaired by bilateral second toenail flap,the fibulal flap of the big toe and the digital arterial island flap.Three fingers in l case were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe and the the lateral flap of dorsum of foot.Six fingers in 3 cases were repaired by bilateral second toe nail flap and the fibulal flap of the big toe and bilateral dorsum flap of foot.Four fingers in 1 case were repaired by partial bilateral wrap-around flaps and the tibial flap of the second toe and the anterolateral thigh flap.Six fingers in 3 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe,and bilateral dorsum flap of foot and bilateral anterolateral thigh flap.[Result]Ninety-seven flaps of 98 flaps of 47 fingers in 21 cases were suvived well,with 1 flap developed necrosis.The follow-up duration ranged from 6 months to 9 years in 17 cases (37 fingers).In addition to the activities of DIP limited,the other interphalangeal joint activities were nearly normal.All of the fingernail grew well.Two point discrimination of the fingers was between 5mm and 11 mm.The donor site was hardly affected.[Conclusion]It is a better method using the big toe flap combined with the second toe flap to repair the the multi-finger degloving injury at one stage.

Objective To map the approximate transcription initiation site of STK11/LKB1 and identify its potential promoter region. Methods All reported transcripts of STK11/LKB1 were colllected through searching online database. The “first exon”, “first intron” and 5' UTR upstream gDNA sequence of STK11/LKB1 were analysed by MethPrimer and FiretEF to predict the CpG island and possible transcription initiation site, respectively. The STK11/LKB1 gDNA sequence was also analysed by softwares such as PromoterInspector to predict the probable promoter region. Results Among all the reported transcripts of STK11/LKB1, 5'UTR of BC007981 was the longest. STK11/LKB1 gene was a typical CpG island associated gene. There was no exon in the upstream region of the “first exon”, and 5'UTR in BC007981 was close to transcription initiation site. Promoters were predicted in the BC007981 5' upstream 200～400bp region. Conclusion The 5'UTR of STK11/LKB1 approaches the transcription initiation site. The transcription initiation site of STK11/LKB1 gene in several hundreds bp region of 5'UTR upstream may be indentified. The data will benefit further research on the trascriptional regulation of STK11/LKB1 through experimental methods.

Interventional pulmonary procedures performed by flexible bronchoscopy has been widely used in the adult clinics.However,pediatric interventional pulmonary procedures are different from adult in anesthesia methods,equipment,technology and so on.At present.it is more limited.This review showed the experiences of pediatric bronchoscopy in Taipei Veterans General Hospital of Taiwan,China.

Objective To investigate the clinical and pathological characteristics as well as immunophenotypes of subcutaneous panniculitis-like T-cell lymphoma for its differential diagnosis with other similar diseases.MethodsThe clinical、histological and immunophenotypic features of 6 cases were described in detail and related literatures were reviewed.Results All of 6 patients presented with subcutaneous nodules or /and erythematous plaques without lymph nodes swelling and with 5 cases had fever,one case developed to ulcer from its nodules.All of 6 patient presented typical histological changes and 2 of them associated with prominent hemophagocytic syndrome.The neoplastic cells were of T-cell phenotype.Two patients under went an aggressive clinical course with short survival period of 9～16 months and four patients who treated with chemotherapy have an improved survival state,but two of them had recurrence.Conclusion SPTCL is a uncommon type of T-cell lymphoma with clinical and pathological characteristics,and it needs to be differentiated from benign panniculitis or other lymphomas of the skin.

Neuroblastoma(NB),the common extracranial solid tumor of childhood,is thought to derive from neural crest cells.In disialoganglioside (GD)2 is highly expressed on NB,whereas GD2 expression is weak and restricted to the central nervous system,peripheral pain fibers and skin melanocytes.Therefore,GD2 is an ideal antigen target for immunotherapy of NB.The research progress on GD2 as target for immunotherapy of NB was reviewed.

Objective To investigate the effects of overexpression of Mash-1 gene on functional recovery and neural differentiation of embryonic stem cells in spinal cord injury mice. Methods CE3 cell line with overexpression of Mash-1 gene was generated with murine stem cell virus. Spinal cord injury model was established with forceps compression in 4-week-old KM mice. Normal saline (model group, n=12), CE3 cells with or without overexpression Mash-1 gene (CE3-Mash-1 and CE3 groups, n=12 respectively) were transplanted into the ar-eas of injury 3 days after injury. They were assessed with the Basso Mouse Scale (BMS) 1, 7, 14, 21, and 28 days after injury. 6 mice from each group were sacrificed 14 and 28 days after injury respectively. The spinal cord area remained were observed with HE stained, and the expression of Oct3/4, nestin,β-tubulin III and glial fibrillary acidic protein (GFAP) were detected with immunofluorescence in the injured spinal cord in the CE3 and CE3-Mash-1 groups. Results The score of BMS significantly improved in CE3 and CE3-Mash-1 groups com-pared with that of the model group (F>84.471, P<0.05), with the more area of spinal cord remained (F>49.990, P<0.05). There were less Oct3/4 positive cells in the CE3-Mash-1 group than CE3 group (t=5.439, P<0.001), with more nestin (t=-7.536, P<0.001) andβ-tubulin III (t=-9.941, P<0.001) positive cells. However, there was no significant difference in GFAP positive cells between CE3-Mash-1 and CE3 groups (t=1.701, P>0.05). Conclusion Overexpression of Mash-1 gene promotes CE3 cells to differentiate into neurons in spinal cord injury mice, and improve the motor function recovery.

Objective To explore the method for repair of total avulsion of 2~4 fingers and to find the best procedure. Methods The wrap-round flap with part toenail combind with the dorsal pedical flap to repair soft tissue defect of the dorsal of finger and part of the palmar of finger, the second simepulp flap to repair soft tissue defect of the palmar of finger,transfer of two tissues with one pedicle to repair total avulsion of 2~4 fingers. Results All of 9 composite transplants in 6 cases were survived,the received areas were primary healing in 8 finger,1 case repaired by the bilateral wrap-round flaps and second simepulp flaps for index and middle finger,the distal phalanx of middle finger necrosis because of dislocation of DIP,3 months later,injury healed after the necrosis of phalanx excised,but the nail and the nail bed were dead.Except 1 case which the grafted skin necrotized in the donor area of the big toe,the rest had primary healing.All cases were followed up 6~14 months,the activity of joints were: MP 0-70,PIP 0-40.The repaired pulps had excellent appearance,the nail was fine,1 finger's mail was atrophy and 1 finger's nail was defect.The donor area had good fountion without pain and edema,the grafted skin had normal color and the activity of joints were nomal. Conclusion The wrap-round flap with part toenail combined with the second simepulp flap is a good approach in treatment of the skin avulsion injury in the finger.