Many controversies and unanswered questions surround AIS(adolescent idiopathic scoliosis),the most difficult one is the absence of information about its aetiopathogenesis.Although bracing has been regarded as the standard of care for patients at a high risk of progression,it has never been subjected to rigorous assessment of either its efficacy or effectiveness.With respect to surgical management,although technology has greatly increased the safety with which we can correct spinal deformity and preserve spinal balance,long-term results of these changing methods of management are absent.Surgery can reduce deformity and prevent further progression;thereby decreasing the risk of future cardiopulmonary compromise,but its role in the prevention of other negative long-term effects of scoliosis is not clear.In this paper we discuss present notions about aetiopathogenesis,natural history,non-operative treatment,and surgery.

The compositions and contents of fatty acids in the meat and viscera in Chlamys ferreri near Yantai seacoast, Shandong Province were studied in detail. The result showed that the contents of the unsaturated fatty acids in the meat and wastes were 65. 0% and 66. 2%, respectively. Moreover, the contents of the polyunsaturated fatty acids and EPA+DHA were 55. 1% and 37. 5% in the meat, respectively. The contents in the viscera were 48. 8% and 22. 2%, respectively.

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function in rats with chronic cerebral hypoperfusion.Methods The animal model of chronic cerebral hypoperfusion was established in 30 Sprague-Dawley rats by surgically induced bilateral common caroid artery stenosis,who were then divided into a control group and a treatment group.The rats in the treatment group were administered with 20 Hz rTMS 4 weeks postoperation for 7days.Another 10 rat subject to sham operation served as blank controls.The cognitive function was assessed by Morris water maze (MWM) at the time points of 2nd,3rd,4th and 5th days after ending of the 4 weeks of tretment.The morphologic changes of hippocampus neurons were observed with HE staining.The apoptosis was examined by TUNEL,the expression of Bcl-2 or Bax protein was determined using immnunohistochemistry assay.Results At all the time points the MWM escape latency in the rTMS group was shorter than that in the control group (P ＜ 0.01).The percentage of crossing the corresponding platform during the same time period in platform quadrant in the rTMS group was significant higher than that in the control group (P ＜ 0.01).Compared with the control group,the treatment group demonstrated significantly decreased percentage of neuronal apoptosis (P ＜0.05),as well as increased expression of Bcl-2 protein (P ＜0.01) and reduced expression of Bax protein (P ＜ 0.01).Conclusion rTMS can improve the cognitive dysfunction in rats caused by chronic cerebral hypoperfusion,probably through inhibiting neuronal apoptosis in hippocampus region.

Sustained release drug delivery from microparticles is an excellent alternative for daily protein/peptide drug administration protocol. Poly(lactic acid) (PLA) and poly(lactic-co-glycolic acid) (PLGA) are the most commonly used polymer carriers in the development of protein/peptide microspheres. Basically there are three preparation methods for PLA/PLGA microspheres: the solvent extraction/evaporation based multiple emulsion (W/O/W emulsion) method, the phase separation method and the spray drying method. The stability of the protein/pipetide loaded, encapsulation efficiency, and the burst effect of the microspheres are key problems usually met in the preparation of microspheres. In this review the preparation techniques and progress in the development of protein/pipetide microspheres which aimed to stabilize protein/peptide structural integrity, keep the bioactivity of drugs, increase the encapsulation efficiency and improve the release profile were summarized and evaluated.

Objective To investigate the clinical value of the optical microscope on the quality control of the coagulation specimen microscopic examination before the coagulation test.Methods 92 patients with coagulation specimens agglutination occurs which taken were selected as the experimental group,92 patients re-blood microscopy to ensure that no agglutination phenomenon was set to control,observed differences in coagulation indexes of the two groups.Results The PT,APTT,TT and Fg were statistically significant(P ＜ 0.05) between experimental group and control group by the q test.Different agglutination specimens group in the experimental group by analysis of variance,PT,APTT.TT and Fg were statistically significant(P ＜ 0.05) between groups comparison of the q test analysis,PT,APTT,TT and Fg were significant differences (P ＜ 0.05).With the aggravation of blood specimens agglutination,PT,APTT and TT time extension and Fg concentration reduce more serious.Conclusion Optical microscope before the introduction of clotting function tests experimental quality control a large extent,to enhance the accuracy of laboratory coagulation test results,clinical diagnosis and preoperative preparation has important clinical value.

Serious and/or continuous cerebral hemodynamics disorder is the main cause of neonatal brain injury.Monitoring its changes by using simple,accurate and effective techniques has guiding significances in maintaining the stability of neonatal cerebral hemodynamics.This paper aims to introduce several cerebral hemodynamic monitoring techniques,including color Doppler ultrasound,near infrared spectroscopy,noninvasive magnetic resonance imaging,and provide references to the clinical application in neonatal field.

Objective To assess the interobserver reliability and intraobserver reproducibility of Neer classification system and its influencing factors.Methods The present study reviewed the series preoperative radiographs (including those of scapular anteroposterior view,scapular lateral view and modified Velpeau axillary view and an axial CT scan) of 40 patients who had been treated in our department from January 2010 to December 2010 for proximal humeral fractures.The radiographs were assessed by 12 individual observers on 2 separate occasions with an interval of 3 months at least Half of the observers (the professional group; n =6) had received a shoulder fellowship training and the other half (the control group; n =6) had not All the observers were asked to categorize the radiographs according to the Neer classification system of 16 types of fractures in a same process.The reliability and reproducibility of the system were assessed with the Kappa statistics.Comparisons of classification agreement were made between the professional group and the control group.We also evaluated the simplified Neer system of only 6 types of fractures with recombinant data.Results The interobserver reliability coefficients were 0.534 and 0.473 for the first and second assessments,with an intraobserver reproducibility coefficient of 0.669.The agreement level in the professional group was significantly higher than in the control group ( P ＜ 0.05).The interobserver reliability coefficients of the simplified Neer system were 0.581 and 0.502,with an intraobserver reproducibility coefficient of 0.680.Use of the modified Neer system did not elevate the agreement level beyond the moderate range.The classification was agreed on by all the observers in 17.5％ of the fractures during the first assessment and in 15.0％ during the second assessment.Conclusions Neer classification may have fair interobserver reliability and moderate intraobserver reproducibility.Experience of shoulder fellowship training is an important factor influencing the reliability of the Neer system.Simplification of the system may not help increase its reliability.

Post-operative pancreatic fistula(POPF)is the most common and severe complication after pancreaticoduodenectomy,which may have significant impacts on curative effects and prognosis.It has been shown that POPF is not only closely associated with texture of pancreatic parenchyma,diameter of pancreatic duct and tumor site,but also affected by surgeon's experience and surgical techniques.Double layer pancreaticojejunostomy and external pancreatic duct stent may be beneficial to decrease POPF.

Objective To investigate the changes of thrombomodulin (TM) and von Willebrand factor (vWf) and their clinical significance in patients with severe brain injury. Methods The study involved 62 patients with severe brain injury who were divided into diffuse axonal injury group (28 patients) and focal brain injury group (34 patients). Then, the 62 patients were divided into young group (16-30 years old, 20 patients), middle-aged group (31-65 years old, 20 patients) and elderly group ( ＞65 years old, 22 patients). The serum levels of TM and vWf were determined at days 1 and 7 after injury respectively. ELISA method was employed to determine the serum levels of TM and vWf.Results The vWf in focal brain injury group was significantly higher than that of diffuse axonal injury group at days 1-7 after injury ( P ＜ 0.05 ). Compared with the young and middle-aged groups, the TM and vWf levels in the elderly group at day 1 after injury were significantly elevated ( P ＜ 0. 05 ). The TM levels in patients with delayed traumatic intracerebral hematoma (DTICH) were significantly higher than that in patients without DTICH (P ＜ 0. 05). Conclusions In the acute stage of severe brain injury,injury severity and activation of endothelial cells varies in patients with different types of injury and at different ages. TM is one of sensitive indicators to reflect the cerebal vascular endothelial cell injury. It is very meaningful to assess the prognosis of severe brain injury by measuring serum levels of TM and vWf and take TM as a predictive indicator for DTICH.

OBJECTIVE: To observe monocyte chemoattractant protein 1 (MCP-1) changes in ischemic tissue during the process of angiogenesis induction in ischemic limbs by autologous mesenchymal stem cell (MSC) transplantation.METHODS: Twenty male Sprague-Dawley rats were randomized to 2 groups (n = 10): model and MSC transplantation. Femoral and tibial bone marrow was taken to isolate and culture MSCs by percoll density gradient method. Cells of the 3~(rd) or 4~(th) passage were used for transplantation. Severe bilateral hind limb ischemia was surgically created in each group rats. Two hours after model establishment, MSCs (1×10~(11)/L) were infused into the ischemic region of rats from the MSC transplantation group, and the model group received the same amount of phosphate buffered saline. Collateral artery formation was determined by angiographic analysis and histological assessment. CD68~+ macrophage infiltration was examined by immunohistochemistry. MCP-1 protein expression in the plasma and ischemic tissue was detected by enzyme-linked immunosorbent assay. MCP-1 mRNA expression in ischemic tissue was detected by reverse transcription-polymerase chain reaction.RESULTS: At postoperative 28 days, treatment with MSC transplantation lead to collateral vessel formation, and immunohistochemistry demonstrated that CD68~+ macrophage infiltration was lower compared with the model group. MCP-1 protein and mRNA expression in the plasma and ischemia tissue was significantly lower in the MSC transplantation group than in the model group (P < 0.05).CONCLUSION: Following MSC transplantation, MCP-1 may play an important role in ischemia-induced angiogenesis. This indicates that MCP-1 would become one possible target molecule for modulating inflammatory angiogenesis by MSC Transplantation.