BACKGROUND: Resent studies demonstrate that sciatica is caused by inflammatory reaction of nucleus pulposus, and dorsal root ganglion (DRG) is in involved in this process; however, its pathophysiological changes remain poorly understood. OBJECTIVE: To explore pathogenesis of sciatica related to nucleus pulposus protrusion without mechanical compression. METHODS: Totally 24 male SD rats were randomly divided into the experimental group and control group, with 12 rats in each group, The coccygeal intarvartebral discs of rats were opened to obtain 5 coccygeal nucleus pulposus, mixed with 50 μL physiological saline to prepare suspension. Rats in the experimental group were prepared non-compressive models by injecting suspension to the epidural cavum of rats. Meantime, the same volumes of physiological saline were injected into rats in the control group. The rat hind paw mechanical withdrawal thresholds were measured, pain-related behavior and dorsal root ganglion morphology were observed. RESULTS AND CONCLUSION: In the absence of mechanical pressure, disappearance of the nucleolus, degeneration of the nuclear membrane and significant hyperalgesia derived by auto-transplantation of nucleus pulposus to the epidural cavum of rats were observed. Dorsal root ganglion cells often had hyperemia, edema and intracytoplasmic vacuoles, with large and irregular nuclei. Prominent Nissl bodies were not seen. The Inflammatory reaction derived by autograft nucleus pulpcsus is an important factor in DRG injury and sciatica.

Intracranial atherosclerotic stenosis is one of the important causes of ischemic stroke. It is of vital importance to guide clinical treatment using imaging methods to diagnose intracranial artery stenosis and accurately assess the degree of stenosis. This article reviews the advantages and shortcomings,advances and clinical application values of diagnosing intracranial artery stenosis using transcranial Doppler ultrasound,transcranial color-coded duplex sonography,intravascular ultrasound,magnetic resonance angiography,computed tomography angiography,and digital subtract angiography,which will provide references for clinicians to select ideal checking tools.

Objective To explore the factors affecting the duration of secondary prophylaxis for penicilliosis marneffei in patients with acquired immunodeflciency syndrome (AIDS).Methods A retrospective analysis was conducted.The study included 92 adult patients with AIDS and penicilliosis mameffei which were confirmed at the Guangxi Centers for Disease Control and Prevention/Medecins Sans Frontieres clinic.The patients were divided into two groups based on the counts of CD4+ T cells at the time of discontinuation of secondary prophylaxis with itraconazole.The patients with a CD4+ lymphocyte count ＞ or =200 × 106 cells/L at the discontinuation of secondary prophylaxis were assigned to Group Ⅰ,and those with a CD4+ lymphocyte count ranging from 100 × 106 to 200 × 106 cells/L to Group Ⅱ.The treatment duration and clinical outcome were compared between the two groups,and factors which might affect the duration of secondary prophylaxis,including organ involvement,complications,antifungal regimen,antiviral treatment timing,and so on,were assessed.The SPSS 13.0 ~ftware package was used for statistical analysis.Results All the 92 patients received highly active antiretroviral therapy (HAART).No significant difference was observed in the sex ratio,age,follow up duration,number of organs involved,occurrence of complications,composition and duration of antifungal treatment regimens between the two groups (all P ＞ 0.05).The duration of secondary prophylaxis was significantly shorter in Group Ⅱ than in Group Ⅰ (8.13 ± 5.13 vs.12.44 ± 9.51 months,P＜0.05).The commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis were associated with a longer duration of secondary prophylaxis,and the influence degree of these factors decreased in order,whereas the commencement of HAART before the treatment of penicilliosis was associated with a shorter secondary prophylaxis (P ＜ 0.05).Conclusions For AIDS/PSM patients receiving HAART,secondary prophylaxis could be discontinued 3 to 6 months after the CD4 +lymphocyte count restores to 100 × 106 cells/L or more.The duration of secondary prophylaxis may be extended by the commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis,but shortened by the commencement of HAART before the treatment of penicilliosis.

On the basis of principal-agent theory,this paper analyzed the reasons of doctor-patient problems from the perspective of patients and hospitals,hospitals and physicians,and patients and physicians.It included asymmetric medical information,ethical risks of physicians,incomplete contracts between physicians and patients,and uncertainty of medical results.Aimed at these problems,this paper put forward relevant suggestions.In the view of recognition,patients are supposed to get a rational idea in the process of selecting hospitals and try making a contract with general practitioners.In the view of improvement,the pattern of performance assessment to physicians should be developed.In the view of system,the corresponding management measures of health service should be improved so as to better serve patients.

The trypsin inhibitor of soybean can not be removed when, the dry bean in heated by steaming. The presence of a definite amount of water is necessary for such a process. The quantitative relationship between the water content of the bean during steaming and the degree of the removal of the trypsin inhibitor has been studied. It was found that the trypsin inhibitor can be completely removed by steaming at atmospheric pressure for 30 minutes when the water content of the bean reached 45-55% after soaking in water at 20-30℃ for 4 hours or in the water at 10℃ for 8 hours or longer. The role played by water in the removal of the trypsin inhibitor is postulated.

Tetrandrine (Tet) is a bibenzylisoquinoline alkaloid isolated from Stephania tetrandra S Morr. Lots of studies demonstrated that Tet could: ① act as a calcium antagonist via blocking plasma membrane voltage- or receptor-operating calcium channels, inhibiting extracellular calcium entry and intracellular calcium mobilization, so it could prevent hepatocytes, cardiomyocytes, pancreas cells and neurocytes from toxic or ischemia-reperfusion injuries. However, in HL-60 and leukamia T cells, Tet promoted calcium releasing from mitochondria or/and microsomes and induced these cells death. ② down-regulate T cell protein kinase C signal transduction pathway, inhibit T cell proliferation, interleukin-2 secretion and expression of the T cell activation antigen. It could also interrupted integrity of macrophages, reduced neutrophiles and macrophages respiratory-bursting and proinflammatory cytokines secretion through minimizing nuclear transcription factor kappa B DNA binding activity. ③ induce tumor cells apoptosis. ④ down-regulate P glucoprotein activity and reverse tumor cells multidrug resistance. ⑤ also inhibit platelet-derived growth factor induced hepaticstellate cells and human lung fibroblast proliferation, down-regulete type Ⅰ and type Ⅲ collagen secretion. In this article, we also reviewed the therapeutic effects of Tet on hepatic fibrosis, pulmonary fibrosis, portal hypertension, pulmonary hypertension, anti-inflammation and anti-tumors.

Objective To investigate the clinical effect of surgical treatment of acetabular fractures. Methods From June 1995 to December 2000, 62 cases of acetabular fracture with dislocation were treated with open reduction and internal fixation. There were 13 cases with fractures of the posterior wall, two with posterior column fractures, three with anterior column fractures, five with transverse fractures, 15 with transverse and posterior wall fractures, three with posterior column and wall fractures, five with T-shaped fractures, four with anterior and hemi-transverse fractures and 12 with fractures of both column. Kocher-Langenbeck (K-L) approach was applied in 37 cases, ilioinguinal approach in 12, extended iliofemoral approach in four, iliofemoral approach in two, and combined approaches (K-L+ilio-inguinal) in seven. Results Anatomic reduction was done in 37 cases, with satisfactory results in 17 and unsatisfactory results in eight. Reduction for joint vallatae was performed in four cases. The follow-up was 1-5 years (average 2.7 years). The total excellence rate of clinical results was 71% (44/62), with excellence rate in anatomic and non-anatomic reduction groups for 89% (33/37) and 44% (11/25), respectively, with a very significant difference (?2=22.89, P

Objective To investigate the efficacy of autologous peripheral hematopoietic stem cell transplantation in the treatment of adult dermatomyositis. Methods A 21-year-old patient with dermatomyositis received autologous peripheral hematopoietic stem cell transplantation and was followed up for 6 years. Autologous peripheral hematopoietic stem cells were mobilized by recombinant human granulocyte colony stimulating factor (rhG-CSF) before the transplantation, and the conditioning regimens consisted of cyclophosphamide,methylprednisolone and cyclosporin. Rabbit anti-human T lymphocyte immunoglobulin began to be applied on day 3 after retransfer of stem cells. The improvement in symptoms, physical signs and biochemical indicators was observed, and hematopoietic restructuration and immunity resurrection were evaluated after the transplantation. Results After the transplantation, skin eruption greatly improved and gradually subsided. The muscle force of extremities restored from level Ⅳ before transplantation to level Ⅴ. The level of creatine kinase declined sharply after transplantation, but gradually returned to previous level. Leucocyte count began to decrease on the day of retransfer, and returned to the normal level on day 8. Immune function remained normal before and after the transplantation. Conclusion Autologous peripheral hematopoietic stem cell transplantation is an alternative treatment for severe and refractory dermatomyositis.

Objective Effect of provenance on seed biological characteristics and seedling growth in Glycyrrhiza uralensis was studied to indicate the important role of provenance in standardization production of traditional Chinese medicinal materials.Methods Indexes such as 1 000-seed weight,water content,seed capsule penetration,germination percentage,and germination potency of the seeds from various resources were determined by general ways.Growth indexes of young seedling and one-year seedling were determined.Results Between Shanghaimiao provenance and Bayinwusu provenance,1 000-seed weight of G.uralensis in Shanghaimiao was bigger,which was 12.3 mg for the former and 11.7 mg for the latter;water penetration of seed capsule was stronger in Bayinwusu and conductance rate was twice as much as it in Shanghaimiao.Shanghaimiao seed bearing storage and seed vigor were stronger and hard seed rate was higher.Germination percentage and germination potency of untreated seed in Bayinwusu was higher than that of Shanghaimiao,but lower after treatment.Germination percentage and germination potency of smaller seeds was the highest between the two different provenances in both the untreated and treated seeds.In growth indexes of two provenances,young seedling got a significant and the most significant difference.Growth index in Shanghaimiao was higher a little,which didn't get to an obvious level.Conclusion The provenances have an effect on physical characteristics,seed capsule penetration,and germination properties;provenance and seed size have an obvious effect on young seedling growth but have not any effect on one-year seedling growth and biomass.

Objective To evaluate the application of cervical lateral mass plate fixation in the treatment of fracture and dislocation of lower cervical spine. Methods From February 2001 to June 2003, 21 cases of lower cervical spine injury were treated by cervical lateral mass plating fixation, received spinal decompression and reduction according to the types of fracture and dislocation. A cervical lateral mass plate was applied in each lateral mass. The screw prick point was defined at 1-2 mm inner and lower to the mass center. The sagital angle, horizontal angle of internal fixation screw were 45 degrees and 25-30 degree respectively. Results The follow up ranged from nine months to two years and nine months (mean 13 months). All cases were encouraged to sit up, wearing soft collar 4-7 days after the surgery. The mean off-bed time of those cases without spinal cord injuries less than Frankel C grade were seven days (4-14 days) after operation. All cases obtained solid bony fusion 4-6 months postoperatively. Sixteen cases with spinal cord injury improved for one grade according to American Spinal Injury Association. Three cases with nerve root injury obtained complete recovery after operation. There was no severe complication such as vertebral artery nerve root or spinal cord injuries or aggravation of spinal cord injury. One case had uneven reduction and two suffered screw loosening. Conclusion Cervical lateral mass plate fixation is an efficient and reliable technique for segmental posterior fixation, for it has the advantages of wide indication, relatively simple and safe operating as well as strong stability.