Objective To explore the clinical features of thoracolumbar disc herniations and to improve the quality of the diagnostic procedure.Methods Clinical data of 65 patients with thoracolumbar disc herniations confirmed by X-ray examinations,CT,MRI,and operations from September 1995 to January 2004 were retrospectively reviewed.The 65 patients were divided into three groups: lower thoracic disc herniations(T_(10-11)~T_(12)L_1) in 43 patients,upper lumbar disc herniations(L_(1-2)~L_(2-3)) in 16 patients,and multiple levels of herniations in 6 patients.Results Paresthesia and lower extremity weakness were the most frequent symptoms,with their occurrence proportions being 89.2%(58/65) and 83.1%(54/65),respectively.Among the 65 patients,9.2%(6/65) showed the presentation of upper motoneuron involvement,47.7%(31/65) manifested symptoms of lower motoneuron impairment,and 43.1%(28/65) presented as mixed motoneuron disorders.Neurological deficits were usually extensive and the cauda equino syndrome was commonly seen,while isolated radicular impairment was noticed only in 3 patients.Back pain(44.6%,29/65) and lower extremity weakness(40.0%,26/65) were the most common initial complaints.Lower thoracic disc herniations were characterized by mixed motoneuron disorders at the occurrence proportion of 58.1%(25/43),with a tendency leading to ambulatory dysfunction,drop foot,increased lower extremity muscle tension,and positive pathologic reflexes.By contrast,most upper lumbar disc herniations were manifested as lower motoneuron disorders at the occurrence proportion of 93.8%(15/16),with back pain,lower extremity pain,and the cauda equino syndrome frequently encountered.Conclusions The clinical presentation of thoracolumbar disc herniations is complicated with the large-scale distribution and diversity of the symptoms and the complexity of clinical signs.We put forward four circumstances under which a high suspicion of thoracolumbar disc herniation was recommended: ①if there is a sensory disturbance at the anterior and lateral aspect of the thigh or at the groin area;②if there is a lower extremity weakness,especially in the quadriceps and the tibialis anterior muscle(drop foot);③if an extensive and irregular range of sensory and motion disturbances exists,with a lack of typical radicular distribution;or ④if there are mixed motoneuron disorders,or lower motoneuron disorders unexplained by lumbar disc herniations.

Objective:To study the chemical constituents in the seed of Cassia leschenaultiana.Methods: The compounds were separated and purified by column chromatography , thin-layer chromatography and recrystallization .The structures were identified by the physicoche mical identification and spectral analysis .Results:Seven compounds were isolated from the seeds of Cassia leschenaultiana and identified as 1-desmethylchryso-obtusin (Ⅰ) , aurantio-obtusin (Ⅱ) , ale-emodin (Ⅲ) , obtusin (Ⅳ) , chryso-obtusin (Ⅴ) , ob-tusifoline(Ⅵ)and aurantio-obtusin(Ⅶ).Conclusion:All of the compounds are isolated from the seeds of Cassia leschenaultiana for the first time.

Objective:To establish the HPLC fingerprint of Cassia leschenaultiana from different regions. Methods: The column was SinoChrom ODS-BP (250 mm × 4. 6 mm, 5 μm). The mobile phase consisted of acetonitrile-0. 1% phosphoric acid with gradient elution. The flow rate was 1. 0 ml·min-1 , the detection wavelength was 285 nm, the column temperature was 25℃, and the injection volume was 10 μl. Results: The fingerprint consisted of 13 common peaks. The range of similarity for ten batches of Cassia le-schenaultiana was 0. 839-0. 998. And the reference fingerprint of Cassia leschenaultiana was established by HPLC. Conclusion: The fingerprint method is simple and reproducible, which can provide basis for the quality control and the medicinal resources exploration.

Objective:To explore the relationship between spino-pelvic sagittal and coronal parameters in Lenke 1 group of adolescent idiopathic scoliosis (AIS).Methods:The subjects were retrospectively col-lected from 2005 to 2013.On the posteroanterior and lateral radiographs, apical vertebra ( AV) , Cobb an-gle of main thoracic curve (MT), pelvic incidence (PI), C7 translation ratio (C7TR) and other sagittal parameters were measured and recorded.Comparison and correlation studies were conducted between these parameters using specific softwares.Results: In the study, 51 subjects, including 18 males and 33 fe-males, were recruited, aged (14.9 ±2.0) years averagely.The apical vertebra ranged from T7 to T11,with mean MT being 49.6闭±16.7闭, and mean PI 44.7°±6.7°.Significant correlation existed between PI and PT, SS, LL, as well as between LL and SS, TK ( P <0.05) .Significant differences were found in TK, LL and SS among the different LM groups, but no difference in the other sagittal parameters.AV had no significant correlation with any sagittal parameter.MT was significantly correlated with TK, LL and SS, but its correlation with PI was not significant.Conclusion:Most of sagittal parameters were significantly corre-lated in Lenke 1 adolescent idiopathic scoliosis, forming a regulation chain of spine-pelvic sagittal balance on the basis of PI.Significant correlation exists between some sagittal and coronal parameters.

Objective To investigate the correlation between auditory steady state responses(ASSR)and click audiotory brainstem respone(cABR)of infants as a function of different ages below 36 months.Methods 299 infants(497 ears from 1 to 36 months)were divided into 5 groups:208 ears in group 1(1~ month old),81 ears in group 2(4~ months old),47 ears in group 3(7~ months old),53 ears in group 4(13~ months old),and 108 ears in group 5(19~36 months old).The correlation analysis of the thresholds of 2 kHz and 4 kHz between ABR and ASSR were conducted,respectively with SPSS.Results In group 1,the correlation coefficient at 2 kHz between ABR and ASSR was 0.499,the correlation coefficient at 4 kHz between ABR and ASSR was 0.541,the correlation coefficient of the means of 2 kHz and 4 kHz between ABR and ASSR was 0.531.In group 2,these three correlation coefficients were 0.678,0.705 and 0.726,for group 3,0.792,0.717 and 0.777;for group 4,0.934,0.880 and 0.915,for group 5,0.817,0.810 and 0.867.Conclusion For infants of 1~18 months old,the correlation between ABR and ASSR increases as a function of ages.

Arbuscular mycorrhizal fungi(AMF) are ancient,asexual,and obligate symbiotic endophytes which have not been cultured in vitro.So there is some limitation in the study of mycorrhizology.While the molecular technology based on DNA analysis could increase the detection sensitivity and specificity of AMF.rDNA sequence homology and variability can reveal the relationship between species and their evolution.Thus rDNA sequence analysis are widely used in the classification,identification,genetic,ecology and bio-diversity of AMF.This article summarizes the rDNA sequence analysis techniques and their application in phylogeny,molecular detection and community structure of AMF in different plant vegetation.

Objective To evaluate the clinical value of self-designed big cup membranate stent on restenosis after stenting for carcinoma of esophago-cardia. Methods 12 cases of restenosis after stenting for carcinoma of esophago-cardia were involved in the study. Self-designed big cup membranate stent made by Nanjing Weichuang Company(the length of the cup was 3.5 cm)was placed into the constricted stent under guidance of fluoroscopy. Clinical effect, restenosis, and complications were observed during followed up. Results All the 12 cases of big cup membranat stent placement went along smoothly without indigitation of the cup of the stent. Follow-up of 1.5-8 months showed that 2 cases developed severe restenosis on the big cup of the stent, resulting in third grade difficult deglutition. Among them, one occurred 1 month after stenting, caused by hyperplasia of large amount of granulation tissue; another occurred 6 months after stenting, caused by growth of tumor tissue. 3 cases developed mild to moderate restenosis, 2.3-7 months(mean: 4.6 months)after stenting, with result of first grade difficult deglutition. The remaining 7 cases(mean5.6 months follow-up) did not have difficulty during deglutition. Conclusions Application of big cup membranate stent on restenosis after stenting for carcinoma of esophago-cardia can effectively prevent the stent from moving downwards and thus lower down the rate of restenosis, and postpone the occurrence of restenosis.

Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126～13.926,P=0.000),male sex (OR=5.531,95%CI 2.014～15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016～6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400～8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954～111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685～10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654～10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161～102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in systemic sclerosis (OR=55.809,95% CI 12.879～241.832.P=0.000).Conclusion Aggressive therapy should be given to those systemic sclerosis patients with onset later than 60 years old,male sex,diffuse skin involvement,anti-RNP antibody positivity,cardiac involvement,kidney lesions,scleroderma renal crisis and pulmonary artery hypertension,especially seevere pulmonary hypertension.

Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1) acted as controls.The incidence of SD and Scheuermann's signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann's signs was compared to that within segments without Scheuermann's signs.Results All except one patient in TLDH group(97.8%) had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann's signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann's signs was all higher than that within segments without Scheuermann's signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl's node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.