Objective To evaluate the efficacy of fusion with and without instrumentation in the treatment of chronic low back pain.Methods To search Medline(from 1966 to Deeember.2006).Embase (1984 to December,2006),Cochrane Central Register of Controlled Trial f4th Quarter 2006),Current Controlled Trials.The China Biological Medicine Database(1984 to December,2006).and hand searched several related journals.The quality of included trials was evaluated.Data were extracted by two reviewers independently with a designed extraction form RevMan 4.2.8 software was used for data analysis.Results Eight studies involving 656 patients were included.The results of meta-analysis indicated that statistically significant difierences were observed between the two operative procedures in the fusion rate(OR=2.26,95% CI 1.51-3.38,P=0.0001),clinical outcome(OR=1.54,95%CI 1.09-2.19,P=0.01),incidence of re-operation (OR=2.16.95% CI 1.08-4.33,P=0.002).There were no statistically significant difierences in back pain scores (WMD=-0.22,95% CI-0.81-0.36),leg pain scores(WMD=0.22,95%CI-0.50-0.93),complications(OR=1.68,95%CI 0.78-3.63),satisfaction of surgery by patients(OR=1.54,95%CI 0.93-2.55).Three studies described the mean surgical time,perioperative blood loss,days in hospital after surgery,which revealed that single fusion was superior to fusion with instrumentation.Three studies described the work status of patients post-operatively.Two studies indicated smoking could decrease the fusion rate.Conclusion To compare with single fusion,fusion with instrumentation can increase the fusion rate and improve clinical outcome slightly,but it also increases the incidence of re-operation.More high quality large-scale randomized controlled trims are required.

Objective To evaluate the therapeutic effect of intravenously use of ambroxol in treatment of mechanical ventilator patients.Methods Meta-analysis was used.The Cochrane Library,PubMed,Elsevier (ScienceDirect),OVID series medical databases and domestic main databases were searched,the quality of included studies was evaluated by certain standards.The Review Manager 5.0 software was used for analysis.Results 14 studies were included,1 184 mechanical ventilation patients were involved.The Meta-analysis showed that there were significant differences between two groups in blood gas analysis,airway resistance and pressure and lung compliance.However,there were no differences between two groups in expectorant effect and VAP incidence.Conclusions Intravenously use of ambroxol in treatment of mechanical ventilator patients was effective.A large multi-center sample of high-quality clinical studies is needed to confirm the results.

Objective To investigate the causes, prevention and treatment of recurrent laryngeal nerve (RLN) injury during operation in patients with thyroid cancer. Methods Clinical data of 192 patients undergone thyroidectomy operation were reviewed. Results RLN was exposed during operation in 192 patients. There were 3 cases of RLN injury, then RLN anastomosis was happened immediately during operation. It was significantiy improved in pronunciation after operation. 2 ～ 3 d after surgery, transitory hoarseness was observed in 3 patients. Unilateral RLN resection performed in 1 case with cancer involving RLN. Conclusions There were some causes of RLN injury. Exposure of RLN selectively,delicate operation and thyroid gland surgery specialist were the key point for prevention of the injury of RLN. Once RLN injury occured ,repairing should be performed as soon as possible.

Objective To evaluate the effects of TAT-heme oxygenase-1 (TAT-HO-1) fusion protein on liver injury in rats undergoing orthotopic liver transplantation (OLT).Methods Adult male Lewis (inbred) rats (aged 8-10 weeks,weighing 180-230 g) were used as donors and Brown Norway rats (aged 8-10 weeks,weighing 180-230 g) as recipients.The recipient rats were randomly divided into 2 groups (n=6 each) using a random number table:OLT group and TAT-HO-1 group.The livers were harvested according to the method described by Kamada.In OLT group,the donor livers were flushed and preserved with 4 ℃ HTK solution,while the livers were flushed and preserved for 6 h with 4 ℃ HTK solution containing TAT-HO-1 50 μg/ml in group P.Blood samples were obtained at 7 days after transplantation for measurement of activities of alanine aminotransferase and aspartate aminotransferase in serum.Hepatic specimens were obtained at 7 days after transplantation and stained with haematoxylin and eosin for examination under light microscope.Rejection activity index was calculated according to Banff criteria.The contents of transforming growth factor-beta 1 and interleukin-6 in liver tissues were determined using ELISA.Kupffer cells were isolated and cultured for 48 h to determine the levels of transforming growth factor-beta 1 and interleukin-6 in culture medium.Results Activities of alanine aminotransferase and aspartate aminotransferase in serum,rejection activity index and levels of transforming growth factor-beta 1 and interleukin-6 in liver tissues and culture medium of Kupffer cells were significantly decreased,and the pathological changes of livers were mitigated in group TAT-HO-1 as compared to group OLT.Conclusion TAT-HO-1 fusion protein applied during cold storage of donor livers can attenuate liver injury in rats undergoing OLT.

Objective To study the effects and its probable mechanism of ultrasound-irradiation docetaxel-loaded microbubbles on apoptosis in human liver cancer cells MHCC97-H.Methods The MHCC97-H cells were randomly divided into 4 groups:control group,docetaxel-loaded microbubb[es group(DM),Ultrasound group (US),ultrasound irradiating docetaxel-loaded microbubbles group (DM + US).The livability,the morphological change of cells,cell apoptosis rate and the expression of proliferating cell nuclear antigen and MAPK pathway members of each group were respectively detected.Results After 24h,MTT test showed that the livability of MHCC97-H cells of DM group,US group and DM + US group were (76.0±3.0)％,(73.0± 5.0)％ and (52.0 ± 6.0)％ respectively,which was significantly declined comparing with control group (P ＜ 0.05).The morphological of tumor cells in control group remain normal size and grow eugenic,while the cells of DM group,US group and DM + US group decreased,their shapes were irregular,the intercellular space increased,and cells apoptosis occured in the medium.The cells in DM + US group were changed significantly.FCM showed the apoptosis rate of DM + US group was (26.81 ± 2.82) ％,which was declined clearly compared with (2.90 ± 0.99) ％ of the control group (P ＜0.05).Western-blot showed that the expression of proliferating cell nuclear antigen and p-ERK1/2 protein in DM + US group were down-regulated,and meanwhile p-p38 protein in human liver cancer cells MHCC97-H was up-regulated.Conclusions The method of ultrasound irradiating docetaxel-loaded microbubbles can significantly induce human liver cancer cells MHCC97-H apoptosis by regulating the expression of related protein.

Objective:To study the effects of adhesive peptide arginlie-glycine-aspartic acid(RGD) on the attachment and spreading of osteoblast on the surface of dental implant materials. Methods: RGDC peptides were covalently immobilized on the surface of dental implant materials by SAMs. Rat osteoblasts were isolated and cultured on the materials. The attachment and spreading behavior of the cells were analyzed by cell counting and FITC-conjugated immunofluorsescent assay. Results: On the RGD coated surface, cell attachment was increased by 50% (P

Objective To reconstitute hair follicles in mice using graft chambers,and to study the effect of different cell types on hair follicle regeneration.Methods Full-thickness skin was obtained from the back of C57BL/6 neonatal mice.Then,epidermal cell suspensions were prepared by shredding epidermis after trypsinization,hair follicles and dermal cells were collected by filtration,low-speed centrifugation and density gradient centrifugation,and hair follicle epithelial cells were obtained via trypsinization of hair follicles followed by filtration.Nude mice were classified into four groups to be transplanted with epidermal cells + follicular buds,dermal cells alone,epidermal cells + follicular buds + dermal cells,follicular epithelial cells + dermal cells,respectively.The cells were implanted into the dorsal skin of nude mice using fold chambers.After the grafting,the growth of skin and hairs was observed at the grafted sites on week 1,2,4 and 8,and skin specimens were obtained on week 2,4,and 8 for histological study of hair follicles using hematoxylin-eosin staining.Results After grafting,the chambers on the back of nude mice began to shed with crust formation on week 1; stunted hairs came out and follicle-like structures were seen under the microscope on week 2 at the grafted sites,normal hairs were observed on week 4 and 8 in all the mice except for those transplanted with epidermal cells + follicular buds,and the growth of hairs in mice grafted with epidermal cells + follicular buds + dermal cells and mice grafted with follicular epithelial cells +dermal cells was superior to that in mice grafted with dermal cells alone.Conclusions Hair follicles can regenerate after hair follicle cell transplantation into dorsal chambers in nude mice.Both epidermal cells and dermal cells play indispensable roles in hair follicle reconstitution.

Objective To study and estimate the effective dose of interventional employees in the common cerebralvascular, cardiovascular and liver interventional diagnosis and treatment.Methods The absorbed doses of tissue or organ of anthropomorphic phantom in these three procedures were estimated by the anthropomorphic phantom experiment.The effective doses were calculated by the tissue weight factor which was given by International Commission on Radiological Protection publication 103.Results The effective doses to high, medium and low group were 24.0, 9.7,6.8 μSv for cerebralvascular interventional diagnosis and treatment, and 36.3, 29.3, 17.8 μSv for cardiovascular interventional diagnosis and treatment, and 23.9, 11.3, 5.5 μ Sv for liver interventional diagnosis and treatment, respectively.Conclusions The effective doses of high, medium and low group of interventional employees in cardiovascular interventional procedure are higher than those of cerebralvascular and liver interventional procedures.

脑出血, 去骨瓣减压血肿清除术, 脑梗死, 并发症

Objective To investigate the mechanism of hypedipidemia on pancreas of rats by comparative proteomic analysis.Methods Ten male SD rats were randomly divided into two groups,the experimental group Was fed with high lipid forage and the control group Was fed with normal food.Pancreatic samples from the two groups were harvested six weeks later.Differential protein analysis Was performed using differential in-gel electrophoresis(DIGE),and characterizing the protein biomarkers using tandem mass spectrometry.Western blot Was used to confirm the expression of significantly changed proteins.Results Compared to the normal pancreas tissue,a total of 3 protein spot-features were found to be significantly increased and 11 significantly decreased in pancreatic samples with hyperlipidemia.Significantly increased proteins in hyperlipidemia pancreatic samples were arginaseⅡ,ribonuclease inhibitor and glyeine amidinotransferase,which increased by 2.19,1.82 and 1.12 fold,respectively.Significantly decreased proteins in hyperlipidemia group were tyrosyl-tRNA synthetase,alpha-amylase,triacylglycerol lipase,DJ-1protein,Cu,Zn superoxide dismutase,which dicreased by 2.48,2.37,1.85,1.73 and 1.65 folds,respectively.Western blot analysis revealed increased arginase Ⅱ levels and decreased alpha-amylase in pancreatic samples with hyperlipidemia.Conclusions Pancreas wag possibly injured by hyperlipidemia via increase of arginase Ⅱ.Decreased amylase and lipase may be the protection mechanism of pancreas.