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.

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 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 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.

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.

[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 study the effects of Yiqi Huayu Recipe on neural cell adhesion molecule (N-CAM) in neuromuscular junctions during nerve regeneration in rats with lumbar nerve root compression. METHODS: The rats with lumbar nerve root compression were given Yiqi Huayu Recipe for 10, 20 and 30 days respectively. The distribution of N-CAM in neuromuscular junctions of soleus muscle in rats was examined with immunohistochemical method and confocal laser scanning microscopy technique. The acetylcholine receptor (AChR) was visualized with fluorescein-conjugated alpha-bungarotoxin (alpha-BTX). The overlap areas of N-CAM and AChR sites were measured with NIH image technique. RESULTS: The aggregates, sprouts and extensions of N-CAM in the neuromuscular junctions and the overlap areas of N-CAM and AChR sites in the Yiqi Huayu Recipe-treated group were all better improved than those in the untreated group. CONCLUSION: The expression of N-CAM is regulated according to the state of innervation for muscles. Yiqi Huayu Recipe may accelerate this nerve regeneration process.

OBJECTIVE: To study the effect of Yiqi Huayu Recipe on neurons in neuromuscular junction after L5 nerve root compression in rats. METHODS: By using immunohistochemistry, confocal laser scanning techniques and protein gene product 9.5 as a neuronal marker, the motor endplates were visualized with fluorescein-conjugated alpha-BTX. The effect of Yiqi Huayu Recipe on nerve terminals of neuromuscular junction at 10, 20, 30, 60 days after L5 nerve root compression was observed in rat soleus muscles during regeneration. The overlap areas of terminals and endplates were measured with NIH image technique. RESULTS: As for the aggregates, sprouts, extension of nerve terminal during regeneration, the connecting speed and range of nerve terminal with endplates, as well as the reformation of neuromuscular junctions during regeneration, Yiqi Huayu Recipe group was better than that of the control group. CONCLUSION: Yiqi Huayu Recipe can promote the hyperplasia of neurons and enhance the regeneration function. It also can accelerate the neuromuscular junction reformation and shorten the process of regeneration.

Objective To evaluate the clinical effects of free fibula and flap grafts on the repair of all the first metatarsal bone at one stage.Methods There were 9 cases with the first metatarsal bone defect from Janurary 2003 to December 2009 that treated with free vascularized fibular bone and free vascularized flap at one stage.In which 6 cases reconstructed at the primary stage and 3 cases reconstructed at the second stage.Seven cases reconstructed by free vascularized fibular combined with ALTPF,two cases reconstructed by free vascularized fibular combined with TAPF.The free vascularized fibular and flap restored the first metatarsal bone and the soft tissue defects respectively.Vascular anastomosis was the artery of flap anastomosis with anterior tibial artery and the vein of the flap anastomosis with great saphenous vein,the peroneal artery and accompany vein anastomosis with artery and vein of the flap.Results The grafted tissues survived smoothly in 8 cases,vein crisis happened in I case and the ALTPF necrosis after blood vessels expedition.So the TAPF was changed to cover the soft defect and survived smoothly.Followiy-up were done from 6 to 36 months in 9 cases.There were no ulcer on flaps and no fracture again,the fibulas had been bone healing.Evaluated by Maryland standards,six cases were excellent,two cases were fine,one case was good.Conclusion The fibula combined flap grafts provide a relatively better alternative to repair the first metatarsal bone compound tissue defects at one stage.In addition,the procedure decreased frequency of operations and short the course of treatment.Sensory function reconstruction of fibula flaps should be given full attention.As fine function of the reconstructed foot,it is a effective method for reconstruction the burdened area of the foot.