[Objective]To explore the feasibility and outcome of posterior single open-door and pedicle screw in treating canal stenosis and instability of cervical vertebrae at one time.[Method]The preoperative radiographs of 15 patients were measured and were diagnosed to be developmental spinal canal stenosis and instability of cervical vertebrae.MRI showed the spinal cords were compressed obviously.Posterior C_(3~7) single open-door decompression and canal-plasty was adopted.Self-designed pedicle screws and intertransverse fusion were used in the unstable segments.[Result]Complications were not found after the operation.The postoperative radiographs showed that the screws were in the right places.The average follow-up time was 13 months,ranging from 7 to 18 months.The short-term radiographs showed firmly fixed screws.[Conclusion]It is a simple and reliable method to treat canal stenosis and instability of cervical vertebrae at one time with posterior single open-door and pedicle screw.Anterior and posterior operations have been avoided and the short-term outcome is satisfied.

Objective To investigate the diagnostic value of HLA-B27 in ankylosing spondylitis(AS).Methods A diagnostic test was employed in the study.The patients with ankylosing spondylitis and the controls in Shandong Provicial Hospital from 2001—2005 were enrolled in the study.HLA-B27 was detected by flow cytometer assay when recruited.SPSS 13.0 was used for statistical analysis.Results Totally 133 patients with AS and 88 controls were available in the study.HLA-B27 was significantly different between AS group and the controls(P=0.000).The areas below ROC curve was 90.5%.Three cut-off points of HLA-B27,11.55%,46.6% and 85.25%,were selected based on clinical practice and ROCcurve,and the sensitivity was 94.7%,90.2% and 63.6%,the specificity was 56.8%,92.0% and 95.45%.Conclusion HLA-B27 which is more than 46.6% is a valuable marker for the diagnosis of AS.

Objective To systematically review the relationship between mycoplasma infection and rheumatoid arthritis (RA).Methods Articles on case-control studies about the relation between mycoplasma infection and RA were collected by literature searching according to the selection criteria.Meta-analyses were performed for the included studies using RevMan 4.3.2 software.The odds ratio (OR) and its corresponding 95％ confidence interval (95％CI) were calculated by Meta-analysis.Results Seventeen casecontrol studies involving 729 RA patients and 1191non-RA controls,such as osteoarthritis (OA),reactive arthritis (ReA),gouty arthritis (GA),healthy controls were included.The results of Meta-analyses showed that there was a significant difference in the infection ratio of mycoplasma between patients with RA and non-RA (OR=4.40,95％CI 2.26 to 8.56,P＜0.01),and sensitivity analysis according to different published date and detection methods showed no difference.There were also significant differences between RA patients and OA patients (OR=11.29,95％CI 5.55 to 22.97,P＜0.01) and healthy controls (OR=6.80,95％CI 3.96 to 11.67,P＜0.01).Conclusion Mycoplasma infection is associated with RA.More evidence are needed to prove whether mycoplasma has played an equal role in RA and ReA,as well as the significant difference of mycoplasma infection between RA and GA groups.

Objective To observe the role of the P-glycoprotein (P-GP)in the pathogenesis of colitis in FVB and multiple drug resistance (mdr) gene, mdr1a, knockout (mdr1a~(-/-)) mice. Methods The clinical, pathological and immunohistochemical characteristics were observed in FVB control mice and mdr1a~(-/-) mice with or without inflammation of intestinal tract. The functions of T cell and B cell in these mice were analyzed. Results Approximately 26 of the 124 mdr1a~(-/-) mice were found to have symptoms of colitis such as diarrhea and weight loss in this study, and pathologic changes in these mice were similar to that in the human active ulcerative colitis. CD4~+ T cell and B cell infiltrated into the (proper) lamina were observed by immunohistochemical staining in mdr1a~(-/-) mice with colitis. There were (significant) increases in serum antibody titers of all types in mdr1a~(-/-) mice with active colitis. The levels of IgG1, IgG2a, IgG2b, IgG3, IgA and IgM were 7568, 1876, 823, 234, 897 and 189 ?g/ml, (res-)(pectively), significantly higher than those in FVB mice, which were 623, 102, 54, 42, 32 and 58 ?g/ml, (respectively) ( P

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for patient with multiple pulmonary in-fection after renal transplantation. METHODS:Clinical pharmacists participated in drug therapy for a patient with multiple pulmo-nary infection after renal transplantation,and assisted physicians to formulate primary therapy plan:ganciclovir 250 mg,ivgtt,q12 h+ Cefoperazone sodium and sulbactam sodium 3 g,ivgtt,bid+ methylprednisolone 80 mg,ivgtt,qd+ Compound sulfamethoxazole tablet,2 piece,po,qd+Ciclosporin soft capsule 75 mg,po,q12 h+Sodium bicarbonate tablet 1 g,po,qd+Nifedipine controlled release tablet 30 mg,po,qd+Famotidine tablet 20 mg,po,bid. The dose of ganciclovir was adjusted twice because of complica-tion cytomegaloviral pneumonia;the dose of ganciclovir was adjusted twice because of complication pneumocystis pneumonia. Pre-vention and disposal of ADR,patient education were also conducted. RESULTS:Physicians adopted the suggestion of clinical phar-macists;the pulmonary infection had been controlled,and the patient was discharged from hospital. CONCLUSIONS:Clinical pharmacists identify the breakthrough point to promote rational drug use,indicating the value of pharmaceutical care in the clinical treatment.

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .

Objective To investigate the quantity of perforin (PF) expressed on peripheral lymphocytes of active systemic lupus erythematosus (SLE) patients and its distribution in lymphocytes subsets. The effect of glucocorticosteroid on PF expression is also explored. Methods Phenotype analysis of peripheral lymphocytes was carried out by flow cytometry. SLE patients with SLEDAI≥10 (n=16) and normal controls (n=12) were enrolled into this study. The PF expressed on the iymphocytes of SLE patients with disease flares (n=10) Was studied before and after glucocorticosteroid treatment. Results SLE patients with active disease were characterized by higher proportions of PF-positive lymphocytes and higher perforin density. PF and CD8 double positive T cell proportions was evidently increased. The proportions of PF-positive lymphocytes was correlated to SLEDAI (r=0.673). After a short period of glucocorticosteroid therapy, a reduced expression of PF was observed. Conclusion There is an increased expression of perforin in peripheral lymphocytes from SLE patients with active disease. CD8 positive T cell subsets expand significantly in those patients. In addition, the frequency of PF-positive lymphocytes is correlated with SLEDAI. Finally, glucocorticosteroid inhibits the expression of perforin.

Objective To investigate the influence of Wnt-3a signaling on aggregative growth of dermal papilla cells.Methods Recombinant adenovirus pAdEasy-1/Wnt-3a was constructed at first,and used to transfect cultured dermal papilla cells(DPCs).Then,the growth pattem of DPCs was observed by inverse microscopy;laser confocal microscopy and Western blot were utilized to detect the expressions of Wnt-3a,β-catenin and versican in low-passage DPCs,high-passage DPCs and transfected high-passage DPCs.Results The over-expression of Wnt-3a protein could effectively induce the aggregative growth of DPCs.Laser confocal microscopy showed that the fluorescence intensity of β-catenin and versican increased from 34.16±9.62 and 18.81±9.59 in high-passage DPCs to 87.35±17.28 and 92.18±18.39 in transfected high-passage DPCs(t=11.98,17.88,both P＜0.0 1),respectively.Also,Western blot proved a significant increase of expression intensity of β-catenin(15.27±2.17 vs 60.09±7.24,t=10.10,P＜0.01)and versican(19.32±2.46 vs 58.46±2.78,t=20.63,P＜0.01)in transfected high-passage DPCs compared with untransfected high-passage DPCS.ConclusionsWnt-3a signaling plays an important role in modulating aggregative growth of DPCs,which is mainly through the classical pathway with β-catenin as the key protein.As an important downstream gene of Wnt signaling,vesican is an indispensable part for the modulation of aggregative growth of DPCs.

Objective To investigate whether there is any consistent evidence of linkage across multiple studies,and to identify novel AS susceptibility loci by using GSMA method.Methods Genome-search Meta-analysis(GSMA)method was applied to genome scans of AS and spondyloarthropathy(SpA)to assess evidence for linkage across studies.Results Four AS genome scans including 479 families with 1151 affected individuals were used.Suggesting these BINS most likely contain AS-linked loci;BINS 6p22.3-p21.1,6pter-p22.3,17pter-p12,2p12-q22.1 and 5q34-qter.Four AS genome scans and one SpA scan including 544 families with 1,331 affected individuals were used.The GSMA produced genome-wide evidence for linkage on bin 6p22.3-p21 and 16q23.1-qter.Conclusion This GSMA added the evidence of the HLA loci as the greatest susceptibility factor to AS and shows evidences of chromosome 6,17p,2,5q and 16q as non-HLA susceptibility loci.

Objective To cxplore the variation of the range of motion (ROM) of operative level after different heights of artificial cervical disc replacement,and to provide guidance for clinical work in selecting appropriate height of artificial cervical disc prosthesis.Methods The preoperative cervical anteroposterior and lateral Ⅹ-rays of 9 fresh male cadaveric cervical spine specimens were obtained to measure the intervertebral height of C5-6,and 3 screened specimens with the height of about 5 mm were included in the experiment.The experiment was designed to test self-control,and other four groups of cervical specimens including intact group,appropriate height (5 mm) of C5.6 artificial cervical disc replacement group,1mm increased (6 mm) group and 2 mm increased (7 mm) group were made biomechanical test sequentially.The specimens were fixed to the cervical three-dimensional movement machine,with a 75 N follower load and pure moments of 2 Nm for flexion/extension 、left/right bending and left/right axial rotation,to measure the ROM of operative level under the condition of changes in 0.2 Nm/s.Results There were no significant differences in the ROM of flexion/extension,lateral bending and axial rotation between 5 mm group and intact group;the ROM of flexion/extension、lateral bending and axial rotation in 6 mm group increased compared with 5 mm group,but the difference was not statistically significant;the ROM of flexion/extension in 7 mm group was significantly less than that of intact,5mm and 6 mm group (9.5°± 1.0° vs 12.5°±0.9°、11.3°±0.8°、11.6°±0.9°),but significantly greater in axial rotation than 6 mm group (10.4°±1.4°vs 8.6°±0.3°),and there was no significant difference in lateral bending compared with other 3 groups.Conclusion 2 adjacent heights of cervical disc prostheses are implantedsuitably when testing the mold of disc prosthesis,the choice of cervical disc prosthesis with 1 mm increased can improve the ROM of operative level to some extent;while the height with 2 mm increased can lead to the ROM of flexion/extension at the operative level reduced,but the ROM of rotation shows an increasing trend.