Objective To evaluate the surgical outcomes in patients with lumbar disorder treated with enlargement of the spinal canal through spinous process osteotomy. Methods Posterior central incision was used for unilateral exposure of lamina. Osteotomy was done at the base of the spinous process; complete exposure of the lamina was done by retracting the interspinous and supraspinous ligaments. Ligament flaven was resected at the superior and inferior margin of the lamina. Undermining enlargment of the central spinal canal and the neural canal were then carried out; in some cases the intervertebral disc was resected. Thirty seven patients suffered from lumbar spinal stenosis were treated with the above mentioned procedure; among them decompression of a single segment was done in 24 cases, in two segments in 13 cases. Postoperatively, Oswestry evaluation score and imaging observation were carried out. Results Thirty four cases had follow up for one year and the excellent and good results was seen in 82.4%; 27 cases had follow up of 3 years, the rate of excellent and good results was 81.5%. Both sagittal and transverse diameter of lumbar vertebrae canal were increased notably in postoperative CT scanning. 87% of osteotomized spinous processes had bony fusion. Conclusion Spinal canal plasty by spinous process osteotomy for patients with lumbar disorders affords easy performing procedure with less complications and satisfactory surgical results.

[Objective]To measure the feasibility and efficiency of treating vertical sacral fractures with iliac hollow screws.[Method]Sixteen patients with vertical sacral fractures were treated.10 cases of Denis type Ⅰ and 6 cases of Denis type Ⅱ.[Result]The average following-up period was 16 months. All fractures united within 3 months.Two cases showed symptoms of root L5 injuries.1 case totally recovered and 1case partly recovered by the 3nd month after operation.[Conclusion]It showed simple and easy to master for clinical applying of treating vertical sacral fractures with iliac hollow screws.

Objective To investigate the effect of warm needling on learning and memory abilities and the calmodulin kinaseⅡ (CaMKⅡ) content of prefrontal cortex area in morphine withdrawal rats andexplore the mechanism of its action. Methods Forty clean-grade male SD rats were randomly allocated to control, model, manual needling and warm needling groups, 10rats each. A SD rat model of morphine addiction and withdrawal was made by dorsal subcutaneous injection of day-by-day incremental morphine and rapid withdrawal with Naloxone after addiction. Learning and memory abilities were tested using a Morris water maze and the CaMKⅡ content of prefrontal cortex area was measured by an immunohistochemical method in every group of rats.Results There were statistically significant differences in mean platform escape latency, the number of platform crossing and the CaMKⅡ content of PFC area between the control, manual needling or warm needling group of rats and the model group (P<0.01). There were statistically significant differences in mean platform escape latency, the number of platform crossing and the CaMKⅡ content of PFC area between the warm needling and manual needling groups (P<0.05).Conclusions Warm needling treatment can restore learning and memory abilities in morphine withdrawal rats. The mechanism of its action may be related to an increase in the CaMKⅡ content of prefrontal cortex area.

Objective To observe the effect of puerarin on the expression of NF-?B65 and TNF-? in kidney of diabetic rats. Methods SD rats were randomly assigned to 5 groups (10 each):normal control group (group A),diabetic group (group B),low-dose,middle-dose and high-dose treatment groups (group C,D and E). After diabetes model was reproduced,animals in group C,D and E were i.p. injected with puerarin in a dose of 40,80 and 160mg/(kg?d),respectively; animals in group A and B were treated with corresponding normal saline. Fasting blood glucose (FBG),urinary albumin excretory rate (UAER),serum creatinine (Scr) and blood urea nitrogen (BUN) were determined at the 8th weekend after treatment. The histological changes in renal cortex were observed with light microscope and electron microscope. The qualitative and semi-quantitative expressions of NF-?B65 and TNF-? in nephridial tissue were determined by immunohistochemical method. Results FBG,UAER,Scr and BUN were higher in group C,D and E than that in group A (P

Objective To study the changes of six sex hormones corresponding to the follicle growth during the normal menstrual cycle of Chinese women.Methods Thirty Chinese women with regular menstrual period and average age of (28.8±3.2) years were selected for the study by Peking Union Medical College Hospital in September,2010.Growth of follicles was monitored by using transvaginal sonography.Six sex hormones,including follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P),testosterone (T),and prolactin (PRL) were measured by chemoluminescence immunoassay every day during a menstrual cycle.Nonparametric statistical analysis was used.ResultsMenstrual cycle of all the patients was in the range of 25 to 39 d,with mean of (29.5 ± 3.1) d.Length of follicular phase and luteal phase was 15.3 and 14.4 d,respectively.Number of days from antral follicle to emergence of dominant follicle,and from the latter to ovulation,was 6.2 and 8.9 d,respectively.Average diameter of preovulatory follicle was 19.33 mm.Both FSH and LH reached peak on the day before ovulation.P started to increase before ovulation and remained at a high plateau from 6th to 9th day after ovulation.Both PRL and T reached peak after ovulation,near the end of a menstrual cycle.Conclusions A small rise of LH and P emerges just 1 to 2 d before ovulation,indicating the maturing of follicle.PRL and T shows cyclic changes as follicle grows.Therefore,PRL and T levels should be measured in the early follicle phases in the clinical practice so that leading the impact of menstrual cycle minimal.

This study was aimed to investigate the effects of Chai-Hu Shu-Gan Tang (CHSGT) on levels of TNF-α and 5-HT in lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model, in order to discuss the intervention effect of CHSGT on TNF-α and 5-HT in epilepsy–depression comorbidity. The lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model was established. After 6 weeks of animal establishment, rats were randomly divided into 5 groups, which were citalopram group (A), physiological saline group (B), CHSGT high dose group (C), medium dose group (D), and low dose group (E). Intragastric administration was given for 4 weeks, twice a day. Before and after the treatment, RT-PCR was performed to detect hippocampal TNF-αlevels. Liquid chromatography-mass spectrometry was performed to detect hippocampal 5-HT levels. Both forced swimming test (FST) and saccharin preference test were carried out to monitor the depressive behaviors of rats. In the meantime, 24 hours a day video camera surveillance were performed to record the number of seizures of rats. The results showed that after treatment, the number of seizures of rats were significantly reduced, the accumulative immobility time in FST was shortened, and the consumption of sucrose increased significantly (P < 0.01) in group A, C and D. Compared with group B, after the treatment, the expressions of hippocampal TNF-α mRNA of rats in group A, C, D were distinctly downregulated, with the level of 5-HT significantly increased (P < 0.05,P < 0.01). Compared with group A, group C and D showed no significant changes. It was concluded that TNF-α played a role in the pathogenesis of epilepsy–depression comorbidity through mediating the level of 5-HT. High and medium doses of CHSGT can downregulate the expression of TNF-α mRNA in depression comorbidity of chronic temporal lobe epilepsy, increase 5-HT level, reduce the number of seizures of rats, and improve depressive behaviors.

Objective To investigate the clinical,imaging,pathological and molecular biological features of mitochondrial encephalomyopathy with lactic acidosis and stroke -like episodes(MELAS)in children.Methods The clinical,imaging,pathological and molecular biological features of 1 2 children with MELAS diagnosed through muscle biopsy or gene sequencing in the Fifth Affiliated Hospital of Zhengzhou University from January 201 1 to December 201 5 were retrospectively analyzed.Results (1 )Clinical features:the main manifestations included headache and vomiting in 1 1 cases,epileptic seizures in 9 cases,short stature in 8 cases,hairy in 7 cases,intolerance fatigue in 7 cases,cogni-tive decline in 7 cases,visual disturbance in 6 cases,hearing disturbance in 6 cases,and 5 cases had positive family history.In addition,7 cases had the serum lactic acid level increase in a rest for 1 0 min after exercise.(2)Imaging fea-tures:4 cases showed bilateral basal ganglia calcification symmetry in 8 patients who underwent head CT scan.The most frequently involved parts of the lesion were occipital in 1 0 cases,temporal in 9 cases and parietal lobe in 7 cases in stroke -like episodes.The lesions were lamellar necrosis.The abnormal areas by MRI showed low signal intensity on T1 weighted imaging,high signal intensity on T2 weighted imaging and fluid attenuated inversion recovery,high or equal signal intensity on diffusion weighted imaging,high or low signal intensity on apparent diffusion coefficient;the lactate peak significantly increased on magnetic resonance spectroscopy.The distribution was not in accordance with the control region of the cerebral vessels.Dynamic observation revealed that the lesions were reversible and migratory.(3)Myo-pathological features:muscle biopsy was performed in all children,and ragged -red fibers were found in 1 0 cases by im-proved Gomori staining,strongly succinate dehydrogenase -reactive were found in 9 cases,and the lipid droplets slight-ly increased in 8 cases by oil red O staining.Besides,the crystalline inclusion bodies in mitochondria were arranged in a parking lotpattern in 9 cases by electromicroscope.(4)Molecular biological characteristics:the mitochondrial gene mutations were analyzed in peripheral blood of 9 children and their parents,including 8 cases with A3243G muta-tion and 1 case with G13513A mutation.Five mothers had the same A3243G mutation site in 8 cases.Conclusions Children with MELAS have complex and varied clinical manifestations and certain characteristic of neuroimaging.More-over,muscle pathology and gene sequencing have important diagnostic value.Fully understanding the clinical,muscle pathology,imaging and molecular biological characteristics of children with MELAS can be helpful to the early diagnosis and treatment,also reduce misdiagnosis.

Objective To explore effects of atorvastatin on the expressions of cyclooxygenase-2(COX-2) and membrane-associated prostaglandin E2 synthase-1 (mPGES-1) in the carotid atherosclerotic plaques of rabbits.Methods Totally 33 male New Zealand white rabbits(≥ 36months of age ) were assigned into normal control group (n=8) and animal model group with carotid atherosclerotic stenosis (n =25).The rabbit models were randomly divided into non-intervention group,celecoxib treatment group (15 mg · kg-1 · d-1,twice daily) and atorvastatin treatment group (5 mg · kg-1 · d-1,once daily) (n=8 each).Four weeks after treatment,the mRNA and protein expressions of COX-2 and mPGES-1 in carotid plaques were determined by RT-PCR and Western blot,respectively.Results The mRNA expressions of COX-2 (0.97±0.09,0.44±0.05,0.60±0.04vs.0.23±0.04,F=66.77,P＜0.01) and mPGES-1 (0.92±0.07,0.41±0.04,0.61±0.03 vs.0.17±0.03,F=54.87,P＜0.01)in carotid atherosclerotic plaques were significantly higher in non intervention group,celecoxib treatment group and atorvastatin treatment group than in normal control group.The mRNA expressions of COX-2 and mPGES-1 were decreased in celecoxib treatment group and atorvastatin treatment group as compared with non-intervention group ( both P ＜ 0.01 ).The protein expressions of COX-2 (0.89±0.06,0.42±0.07,0.62±0.04 vs.0.18±0.05,F=61.75,P ＜0.01) and mPGES-1(0.91±0.05,0.44±0.05,0.63±0.05 vs.0.21±0.04,F=86.44,P＜0.01)in carotid atherosclerotic plaques in non-intervention group,celecoxib treatment group and atorvastatin treatment group were increased as compared with those in normal control group.The mRNA and protein expressions of COX-2 and mPGES-1 were decreased in celecoxib treatment group and atorvastatin treatment group as compared with non-intervention group(all P＜0.01 ).The expressions of COX-2 and mPGES-1 in carotid atherosclerotic plaques were reduced in celecoxib treatment group as compared with atorvastatin treatment group (P ＜ 0.01).Conclusions As COX-2 inhibitor celecoxib,atorvastatin may inhibit the expressions of COX-2 and mPGES-1,and interfere with the inflammatory response which plays key role in the pathological progress of carotid atherosclerotic plaques,and thus slow the progress of carotid atherosclerosis.

Objective To prospectively compare the clinical efficacy between high versus low viscosity bone cement in percutaneous vertebroplasty (PVP) for severe osteoporotic vertebral compression fractures (OVCF).Methods A prospective study was conducted in 61 old patients with single severe OVCF who had sought medical attention in our hospital from August 2014 to October 2015.They were randomly assigned to group H (n =30) to receive PVP using high viscosity bone cement and group L (n =31) to receive PVP using low viscosity bone cement.The 2 groups were compared preoperatively and postoperatively in terms of visual analogue scale (VAS),Oswestry disability index(ODI),short Form-36 General Health Survey(SF-36),Kyphosis cobb's angle,height of the injured vertebra,and volume and leakage of bone cement.Results Significant improvements in VAS,ODI and SF-36 score were noted after operation in both groups,but there were no significant differences between the 2 groups (P ＞ 0.05).The 2 groups made significant improvements after operation in cobb's angle and height recovery rate of the injured vertebra;improvements in group H (14.7° ± 3.4° and 28％ ± 8％) were significantly greater than in group L (16.5° ± 2.5° and 22％ ± 7％) (P ＜ 0.05).The bone cement volumes in groups H and L were 4.94 ± 0.72 mL and 4.89 ±0.75 mL respectively,showing no statistically significant difference between the 2 groups (P ＞ 0.05).The leakage rate in group H was significantly lower than that in group L (13.33％ versus 35.48％) (P ＜ 0.05).All the patients were followed up for a mean time of 12 months (range,from 3 to 17 months).Cauda equina symptoms were observed in one patient and compression fracture of the adjacent vertebra happened in 2 patients,but no infection or pulmonary embolism occurred in any patient.Conclusions Both high viscosity cement PVP and low viscosity cement PVP can relieve back pain and improve quality of life in patients with severe OVCF,but the former may increase the efficacy and safety of PVP obviously in correction of cobb's angle,height restoration of the injured vertebra and reduction of cement leakage.

Objective To explore the neuroprotection and mechanisms of bone marrow mononuclear cells (BMMNCs),and evaluate whether ERK1/2 signaling pathway was involved in it.Methods384 healthy male SD rats,which were 6-8 week old,weighting 250-280 g,were selected.The middle cerebral artery occlusion (MCAO) model was established in SD rats using the suture method.The rats were randomly divided into sham operation group,model group,BMMNCs group and ERK1/2 inhibitor group,with 96 rats in each group.At the time of 24 h after the successful modeling,200 μl PBS solution was injected into the caudal vein of the rats in the model group,200 μl PBS solution containing 5×106 BMMNCs was injected into the rats in the BMMNCs group and the ERK1/2 inhibitor group.meanwhile,5 μl PD98059 was injected into the lateral ventricle of the brain of rats in the ERK1/2 inhibitor group.At the time points of 3 d,7 d and 14 d,the modified neurological severity scores (mNSS) was used to evaluate the neurological function,the volume of cerebral infarction was assessed by TTC staining,the pERK1/2,Bax,Bcl-2 and caspase-3 levels were detected by Western blot,and the effect of BMMNCs on activation of microglia was detected by immunofluorescence assay.Results(1)At each time point,the mNSS and the volume of cerebral infarction of the model group were significantly higher than those of the sham operation group (P<0.05),while the mNSS and the volume of cerebral infarction of the BMMNCs group were lower than those of the model group,higher than those of the sham operation group,and it was gradually decreased with the treatment time extension (P<0.05).There was no difference in comparison between the ERK1/2 inhibitor group and the model group (P>0.05).(2)At each time point,the pERK1/2,Bcl-2,Bax and caspase-3 protein levels of the model group were significantly higher than those of the sham operation group (P<0.05).The pERK1/2 and Bcl-2 protein levels of the BMMNCs group(pERK1/2:(0.38±0.16),(0.39±0.15),(0.40±0.20),Bcl-2:(0.38±0.14),(0.39±0.15),(0.37±0.13)) were higher than those of the model group(pERK1/2:(0.17±0.05),(0.14±0.04),(0.13±0.03),Bcl-2:(0.23±0.11),(0.24±0.12),(0.27±0.14),Bax:(0.39±0.13),(0.40±0.14),(0.45±0.23),caspase-3:(0.52±0.26),(0.56±0.27),(0.58±0.28)),while Bax and caspase-3 protein levels(Bax:(0.25±0.13),(0.19±0.06),(0.21±0.08),caspase-3:(0.35±0.13),(0.34±0.16),(0.29±0.09)) were decreased (P<0.05).The pERK1/2 protein level of ERK1/2 inhibitor group was lower than other groups,There was no difference in the level of Bcl-2,Bax and caspase-3 between the ERK1/2 group and the model group.(P>0.05).(3) At each time point,microglia (Iba1 positive) in ischemic penumbra of the BMMNCs group was significantly more than those of the model group,and it was increased with the time extension (P<0.05).There was no difference in comparison between the ERK1/2 inhibitor group and the model group (P>0.05).ConclusionBMMNCs can reduce the apoptosis through ERK1/2 signaling pathway,thus improving the neurological function and reducing the infarct scope.