[Objective]To explore the technique and effect of anterior cervical decompression for the treatment of the mixed type of ossification of posterior longitudinal ligament. [Methods]Data on 37 patients(24 males and 13 females,with mean age of 54.3 years) who underwent resection or floating of posterior longitudinal ligament were reviewed.The occupying rate of OPLL ranged 32%~85% with an average of 51.4%.The Japanese Orthopaedic Association(JOA) scores ranged 4 ~14 points with an average of 7.9 points before operation.[Results]The Mean follow-up duration was 16 months(range,6~36 months).The JOA scores were 10.3 and 11.1 at 3 and 12 months after surgery.The results were excellent in 72.7% and good in 78.8%.[Conclusion]The resection of the longitude ligament and floating in anterior cervical decompression is a safe and effective treatment for the mixed type of ossification of posterior longitudinal ligament.

Objective To determine whether morphine postconditioning (MP) could protect the heart against ischemia reperfusion (I/R) injury and which specific type(s) of the opioid receptor is involved in the cardioprotective effect produced by hiP. Methods Male SD rots weighing 180-200 g were killed after intraperitoneal heparin 500 U/kg. The hearts were immediately removed and passively perfused in a Langendorff apparatus with K-H solution gassed with 95% O2-5% CO2. HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. The experiment was performed in 3 parts. In Part Ⅰ 32 isolated rat hearts were randomly divided into 4 groups (n = 8 each): group Ⅰ control received no treatment; group Ⅱ ,Ⅲ,Ⅳ were first perfused with K-H solution containing morphine 0.3, 3.0 and 30 μmol/L respectively for 10 min immediately after the end of ischemia followed by 50 min normal K-H solution perfusion. In part Ⅱ,the concentration of morphine in K-H solution which provided the best cardio-protective effects was chosen according to the result of Part Ⅰ , 32 isolated rat hearts were randomly divided into 4 groups ( n = 8 each) : group Ⅰ received no treatment; gvoup Ⅱ,ⅢⅣ were first perfused with K-H solution containing morphine for 5, 10, 20 min respectively immediately after ischemia followed by 50 min peffusion with normal K-H solution. In part Ⅲ,the MP method which provided the best cardio-protective effects was chosen according to the result of Part Ⅱ , 37 isolated rat hearts were randomly divided into 5 groups: group Ⅰ control (n=8);group Ⅱ-Ⅴ were first perfused for 10 min with K-H solution containing morphine (Ⅱ,n = 8)/morphine + naloxone 10 μmol/L(Ⅲ, n = 7)/morphine + nor-binaltorphimine 5 μmol/L (specific κ receptor antagonist, n = 7)/morphine + nalu'indole 5 μmol/L (specific δ receptor antagonist, n = 7) followed by 50 min reperfusion with normal K-H solution. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) determined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion.Results The postconditioning with morphine 3.0 μmol/L perfusion for 10 min provided the best cardio-protective effects in terms of IS/AAR and myocardial release of CK-MB. Nuloxone completely abolished the cardio-protective effects of MP. Nor-binaltorphimine partly reversed the protective effect of MP, while naltrindole had no effects on MP. Conclusion MP protects the heart against I/R injury via activating κ receptor.

Objective To evaluate the effects of morphine preconditioning-postconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 180-200 g were killed after intraperitoneal injection of heparin 500 U/kg. The hearts were immediately removed and perfused in a Langendorff apparatus with K-H solution gassed with 95%O2-5%CO2 .HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. Forty isolated rat hearts were randomly divided into 5 groups (n = 8 each): group 1 (I/R); group II morphine preconditioning (M1 ); group Ⅲ morphine postconditioning (M2); group IV M1 + M2; group V 5-hydroxydecanoate (5-HD) + M2. Group M1 was perfused with K-H solution containing morphine 3.0 μmol/L for 20 min 30 min before ischemia followed by 10 min normal K-H solution perfusion. Group M2 was perfused with K-H solution containing morphine 3.0 μmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Group 5-HD + M2 was perfused with K-H solution containing morphine 3.0 μmol/L+ 5-HD 10-4 mmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) detennined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion. Results The preconditioning, postconditioning and combination of preconditioning and postconditioning with morphine 3.0 μmol/L perfusion for 10 min all provided cardio-protective effects in terms of IS/AAR and myocardial activation of CK-MB. Conclusion Although the combination of morphine preconditioning and postconditioning can protect the heart against I/R injury, the effects are similar to those of either of them alone, and the reason may be that either of them alone protects the heart against I/R injury via activating mitoKATP .

BACKGROUND: Traditional methods of repairing bone defect such as autograft and allograft have some disadvantages that are hard to deal with, gene treatment may be a new approach. OBJECTIVE: To investigate the biological properties of cultured human osteoblasts transfected with vascular endothelial growth factor (VEGF) gene. DESIGN, TIME AND SETTING: A controlled experiment based on cytology was carried out in the Scientific Experiment Centre of Liaoning Medical College from May 2005 to May 2006. MATERIALS: Human lilac born block was harvested from a cervical spondylosis patient who required lilac bone graft with his informed consent of this patient. Plasmid pCDI/VEGF_(121) was given as gift from Professor Ma, Peking Unviersity Human Disease Genomics Research Center. Competent Escherichia coU was given as gift from Professor Liu, Liaoning Medical College. METHODS: Human osteoblasts were isolated and cultured in vitro. There were a VEGF transfection group and a control group in the experiement. Using cation liposome, the pCDINEGF_(121) eukaryotic expression plasmis was induced into human osteoblasts.MAIN OUTCOME MEASURES: At 1, 3, 5, 7 days following passage culture, the expression of VEGF in human osteoblasts was detected. Its effects on the call proliferation, the secretion of osteocalcin and alkaline phosphatase were investigated.RESULTS: After the plasmid pCDI-VEGF_(121) was transferred into human osteoblasts 3 and 7 days, VEGF mRNA expression was detectable by RT-CPR method. The call number of transfection group was larger than that of control group (P < 0.05 or P < 0.01).When the cells were cultured for 3 days, the positive rate of alkaline phosphatase in the transfection group was increased compared with control group (P < 0.01 ); the secretion of osteocalcin in the transfection group was higher than that of control group (P < 0.05 or P < 0.01 ).CONCLUSION: VEGF gene transfection can improve the proliferation and biological function of human osteoblasts cultured in vitro.

AIM: To explore the mechanism of myocardium protection after ischemia/reperfusion (I/R) injury by preconditioning with ischemia in human. METHODS: Thirty - six patients underwent valve replacement were divided into ischemic preconditioning group (IP group, 20 cases) and non -ischemic preconditioning group (control group, 16 cases) according to whether they were given single cycle reperfusion before cardioplegia or not. Serum levels of interleukin -8 and 10 were measured with ELISA. Expressions of myocardial Bel -2 and caspase -3 were analyzed. RESULTS: The inflammatory factors IL - 8 and IL - 10 increased to the highest level in serum at 6 h after declamping and recovered to normal level on 5 d after declamping. On 6 h, 1 d and 2 d after declamping, serum level of IL -8 was significantly lower in IP group than that in control group ( P < 0.05 ) , but serum level of IL -10 was higher in IP group (P < 0.05 ). Expression of myocardial Bel - 2 and caspase - 3 increased in both groups after reperfusion, and Bel - 2 was lower in the control group than that in IP group while the level of caspase - 3 was higher (P < 0.05). Expression of myocardial Bel - 2 had positive correlation with IL - 10 and negative correlation with IL - 8.CONCLUSION: Ischemic preconditioning has the effect of protection of human myocardial cells after ischemia/reperfusion injury through decreasing systemic inflammatory response following ischemia reperfusion injury.

Objective To investigate the expression of Netrin-1 protein in human renal clear cell carcinoma (RCCC) and the relationships between Netrin-1,pathology and prognosis.Methods Fortyeight cases of RCCC and their adjacent tissues were selected for study,including 26 males and 22 females.The median age was 62 years (range,26 to 83 years).All 48 patients were onset for the first time,confirmed by pathology.All cases had no radiotherapy,chemotherapy or biological treatment before operation.Fuhrman grade:6 cases in grade Ⅰ,6 cases,in grade Ⅱ,27 cases in grade Ⅲ and 9 cases in grade Ⅳ.The AJCC staging in 2010:20 cases in stage Ⅰ-Ⅱ],28 cases in stage Ⅲ-Ⅳ.The expression of Netrin-1 protein was detected by immunohistochemical staining and its clinical significance was analyzed.All cases were followed up for more than 5 years.Survival analysis lines were made by Kaplan-Meier method and the difference between groups was tested by the Log-rank test.Results The expression of Netrin-1 protein was higher in renal cancers [71％ (34/48)] than that in the adjacent normal tissues [17％ (8/48)] (P＜0.05).Netrin-1 protein expression rates were 42％(5/12) in Fuhrman Ⅰ-Ⅱ tumors and 81％ (29/36) in Fuhrman Ⅲ-Ⅳ tumors,while 55％ (11/20) in stage Ⅰ-Ⅱ and 82％ (23/28) in stage Ⅲ-Ⅳ,respectively (P＜0.05).The 5-year survival rate in high protein expression group and in low protein expression group was 62％ (21/ 34) and 79％ (11/14).The survival curve had different trend,with no significant difference between groups (P＞0.05).Conclusions Netrin-1 protein plays an important role in the development of RCCC.It might be a new specific tumor marker of RCCC,and might become a new target in treatment of RCCC.

Objective To observe the effects of acetyl-l-carnitine (ALC) on autophagy, apoptosis and motor function after acute spinal cord injury (ASCI) in rats. Methods Thirty-six adult female Sprague-Dawley rats were randomly divided into sham operation group (Sham group, n=12), simple spinal cord injury group (SCI group, n=12), ALC treatment group (ALC group, n=12). Spinal cord injury model at the level of T10 segment was established using Allen's method. They were assessed with Basso-Beattle-Bresnahan (BBB) scale three days after injury. Then the rats were sacrificed, and the expression of microtubule associated protein 1 light chain 3 (LC3)-II in spinal cord was detect-ed with Western blotting and immunofluorescent labeling, and the number of apoptotic cells were assessed with TUNEL staining. Results The expression of LC3-II and the number of apoptotic cells increased in SCI group compared with those in Sham group (P<0.01), while the BBB score decreased (P<0.001). The expression of LC3-II increased and the number of apoptotic cells decreased in ALC group compared with those in SCI group (P<0.001), while the BBB score increased (P<0.01). Conclusion ALC may promote autophagy, and inhibit apopto-sis to improve the locomotor function after ASCI.

BACKGROUND: Foreign studies have demonstrated that the blue light at 470 nm inhibits melatonin secretion and displays the most obvious biorhythm regulation. To date, light-emitting diode (LED) applied in regulating biorhythm remains poorly explored. OBJECTIVE: To explore whether a certain intensity of LED (blue) light could induce retinal injury in rats. DESIGN, TIME AND SETTING: Randomized, controlled animal experiment was performed at the Animal Laboratory of Peking University Third Hospital between May 2007 and April 2008. MATERIALS: A total of 32 SD rats and 16 BN rats were provided by Animal Department of Peking University Third Hospital. METHODS: A total of 16 SD and 16 BN rats were respectively randomly divided into test and control groups. Test group rats were placed in light boxes which were controlled by blue LED (wavelength 470 nm) at a intensity of 300-350μW/cm2, 4 hours everyday for 3 days. The remaining SD rats were placed in light box which was controlled by blue LED (wavelength 470 nm) at a intensity of 120-150μW/cm2, 4 hours everyday for 3 days. The control rats were not treated. MAIN OUTCOME MEASURES: At the second day after light irradiation, the rats of all groups were sacrificed and both eyeballs were harvested. The frozen sections were subjected to hematoxylin-eosin staining to observe changes of rat retina. RESULTS: A total of 48 rats were included in final analysis. The retina of SD rats became thinning and disorderly arranged following blue LED irradiation at density of 300-350μW/cm2, but the retina of BN rat remained unchanged similar to control group. After blue LED irradiation at density of 120-150μW/cm2, the retina of SD rat remained unchanged similar to control group. CONCLUSION: Blue LED light source irradiation at a intensity of 300-350μW/cm2 is safe to pigment-protected retina, and at a intensity of 120-150μW/cm2 does not injury retina of different races of rats.

Objective: To analyze the basic thyroid hormone level on long term prognosis and peri-operative recovery in patients after heart transplantation (HT) at the terminal stage of heart failure (HF).
Methods: A total of 270 consecutive patients who received HT at the terminal stage of HF in our hospital from 2009-09 to 2014-07 were retrospectively studied. According to serum levels of thyroid stimulating hormone (TSH), the patients were divided into 3 groups: TSH < 0.55 mIU/L group, TSH (0.55-2.5) mIU/L group and TSH > 2.5 mIU/L group. The peri-operative recovery condition and long term prognosis were observed and compared among 3 groups.
Result: The average age of patients was at (44.58 ± 13.30) years including 228 (84.4%) male and 42 (15.6%) female. The average post-operative follow-up period was (31.88 ± 17.48) months with 100% follow-up rate. There were 41.8% of patients with hypothyroidism, and 46 (17.0%) patients with low T3 syndrome, 56 (20.7%) with subclinical hypothyroidism and 11 (4.1%) with clinical hypothyroidism. The ratio of low level thyroid hormone in HT patients was much higher than general population. For peri-operative recovery, the ICU stay time and mechanical ventilation time were similar among 3 groups,P>0.05, while TSH (0.55-2.50) mIU/L group had the shortest times and TSH > 2.50 mIU/L group had longest times. For long term prognosis, no matter uni-/multi- aviate regression analysis or Kaplan-Meier surviving curve all suggested that TSH > 2.50 mIU/L was the independent risk factor inlfuencing the prognosis of HT patients at the terminal stage of HF. Upon TSH increasing, the patients would have worse prognosis accordingly.
Conclusion: Serum level of TSH > 2.50 mIU/L was the independent risk factor in HT patients at the terminal stage of HF.

Objective To determine the incidence and independent risk factors of new onset posttransplantation diabetes mellitus (PTDM) and its prognostic value in medium term survival rate in heart transplant recipients.Method We performed a retrospective study on all heart transplant recipients in a single center from June 2004 to May 2012,and selected 226 patients without DM in pretransplant period with median 41-month follow-up.According to the diagnostic criteria of the American Diabetes Association (ADA) 2006 revised edition of PTDM,the selected patients were divided into PTDM (group 1) and NPTDM (group 2).Univariate analysis and logistic regression analysis were used to determine preoperative and postoperative risk factors responsible for PTDM.Kaplan-Meier method and Log rank test were used for survival analysis.Result Of the 226 patients,53 case developed DM (23.5 ％).The multivariate analysis identified the following as predictive factors for the development of PTDM:age ([OR]:1.05,95％ CI:1.01 ～2.30,P =0.012),and first-degree relatives of family history of DM ([OR]:1.90,95％ CI:1.04～4.10,P =0.032).The 1-,3-and 5-year survival rate in PTDM patients post-transplantation was 100.0％,98.0％ and 89.8％,and that in NPTDM patients was 98.2％,94.2％ and 92.4％,respectively.Log Rank test displayed no significant difference between two survival curves (P＞0.05).Conclusion PTDM is a frequent comorbidity after HT.Age and first-degree relatives of family history of DM were significant and independent risk factors for the development of PTDM during the follow-up period.By appropriate treatment,the medium-term survival rate of patients with PTDM was unaffected.