BACKGROUND:In recent years, with the development of China Marrow Donor Program and the improvement of human leukocyte antigen (HLA) typing technique, novel aleles of human leukocyte antigen have been discovered constantly in China. OBJECTIVE:To identify and confirm a novel HLA alele in a Chinese individual. METHODS: A new HLA alele was found during routine human leukocyte antigen genotyping by PCR-sequence specific oligonucleotide probes and sequencing-based typing. RESULTS AND CONCLUSION:The HLA-B locus hybridization probe reaction patterns of this sample did not match with any known HLA-B aleles or alelic combinations. Exons 2, 3 were sequenced in both directions using HLA-B sequence primer and group-specific sequencing primer. The obtained sequence had 2nts change from B*07:02:01 at nt 226 and nt 228 where A->G (codon 76 ATA->GTG) and resulting in a coding change, 76 isoleucine (I) was changed to valine (V). This nucleotide sequence has been submitted to the GenBank nucleotide sequence database and it is available under the accession number HM989017. A novel HLA alele, HLA-B*07:110, was identified, and was named officialy by the WHO Nomenclature Committee.

Objective To explore the immunogenicity of a novel bionic scaffold of nucleus pulposus tissue engineering. Methods The biocompatibility of a subcutaneously implanted scaffold of nucleus pulposus tissue engineering was studied in SD rats by analyzing tissue reactions up to 3 months using histological and ultrastructural methods. The expression of IFN-?, IL-2, IL-4 and IL-10 mRNA was measured by RT-PCR, and the levels of serum antibodies to porcine type Ⅱ collagen were measured by ELISA. Results There was less inflammatory reaction in rats induced by subcutaneously implanted scaffold. By degrees, a granulation tissue had developed within the implant, which had disappeared by 3 months. The expression of IFN-?, IL-2 mRNA by RT-PCR was of no changes. But the expression of IL-4 and IL-10 mRNA increased, which meant the implant induced Th cell into Th2 cell and the induction inhibited the inflammatory reaction. No antibodies to porcine type Ⅱ collagen were found in the sera of implanted rats. Conclusion There was less immunogenicity in rats induced by implanted scaffold of nucleus pulposus tissue engineering.

[Objective]To investigate the diagnostic methods and clinical effects of the management of spondylolithesis with adjacent segment degeneration.[Method]Between October 2000 and October 2005,16 consecutive patients(3 males and 13 females) aging 42 to 76 years(mean 59.1 years) received instrumented lumbar interbody fusion procedure using traditional posterior approaches for spondylolithesis with adjacent segment degeneration.Lumbar functions were assessed using Prolo system.Preoperative and follow-up lateral lumbar radiographs were studied for reduction of spondylolithesis,disc heights,lumbar lordosis,fusion rates and complications.[Result]Fourteen patients were followed up,with an average duration of 28(16–53) months.Clinical outcomes in terms of Prolo system was 7 points in 3 patients,8 in 7 patients,9 in 2 patients,and 4 in 2 patients at 3 months after operation with 85.7% being graded as good or excellent.Seven points in 4 patients,8 in 6 patients,and 9 in 4 patients at last follow-up(graded as 100% good or excellent).Fusion rate was 66.7%(8/14)at 6 months and 92.9%(13/14)at 12 months after operation.Ten patients(71.4%) fully recovered from spondylolithesis,4 had partial reduction,and their reduction status was unchanged according to plain radiographs at 12 months and last follow-up.The operative wound healed without complications in all patients.The mean Lordosis was 26.64??6.67?,33.29??3.39?and 32.71??2.80?before and at 3-month,or last follow-up after operation.The mean of fused Lordosis was 15.64??6.21?,28.29??3.28?and 32.36??3.91?before at 6 months or at last time follow-up after operation.The disc heights were 6.54?1.13mm and 9.62?0.81mm before and after operation.Statistics showed significant difference(P

Recent original articles about investigation and application minimally invasive posterior pedicle screw fixation in thoracolumbar fracture were extensively reviewed.It can be divided into three parts,such as the improvement of navigated pedicle screw placement accuracy,the melioration of the internal fixation instruments and the advance of endoscopic decompression technique.With the development of minimally invasive spinal syrgery,the combination of percutenous pedicle screw fixation and the computer assist surgery have been widely applied in the treatment of spinal fractures.The combination of minimally invasive posterior pedicle screw fixation and the computer assist surgery accelerates the treatment of the thoracolumbar fractures,there will be more and more thoracolumbar fracture patients willing to be treated by the minimally invasive surgery.

Objective To investigate the expressions and role of bone morphogenetic protein(BMP) 2,basic fibroblast growth factor(bFGF),Core-binding factor al(Cbfa1)in the process of pathological bone formation in ankylosing spondylitis.Methods The expressions of BMP-2,bFGF and Cbfa1 in the synovial tissues of AS patients'sacroiliac ioint were detected using in situ hybridization.They were compared with those of patients with hip replacement and the gray scale of cells was analyzed with image analysis.Results The positive expressions of BMP-2,bFGF and Cbfal in the synovial tissues of patients'sacroiliac joint with AS were stronger than those of the control group(P＜0.01).Conclusion BMP-2,bFGF and Cbfal are important factors in the process of pathological bone formation in patients with AS.They areclosely correlated with the process of bone formation in patients'sacroiliac ioint with AS.Reduction of the expressions of BMP-2,bFGF and Cbfa1 with AS can block the process of pathological bone formation.

Objective To explore effective methods of nursing quality evaluation. Methods Guided by human-centered thinking,the new DRG quality indicators were formulated based on clinical investigation,literature review and expert consulta-tion. Then,the standards of the new indicators for radical masteetomy were identified by Delphi method and the reliability and validity were tested in 30 patients with radical mastectomy. Results The two new quality indicators were illness observation and health education. The Cronbach'α was 0.82 and 0.88 respectively. The results of expert consultation showed high content validity. Moreover,the new quality indicators got high commend by involved nurses. Conclusion The new quality indicators will lead nursing work to illness observation and health education,which will more benefit to reflect the true work of nurses and improve the internal quality of nursing.

Objective To explore the difference between before and afteintervertebral fusion in transforaminal lumbainter-body fusion (TLIF) by unilateral obilateral pedicle screw (PS) fixation .MethodThe L3 -5 Cdatbased on the normal people were used to rebuild the L3 -5 three-dimensional finite elemenmodel(INT) and TLIF operative model .On thibasi,the unilateral Pfixation (M1) and bilateral Pfixation (M2) modelbefore the intervertebral fusion and the unilateral Pfixation (M3) and bi-lateral Pfixation (M4) modelafteintervertebral fusion were buil.Aftesetting the boundary and loading the burden ,the ante-flexion ,retroversion ,lateral bending and rotation of lumbavertebrwere simulated and the L 4 -5 segmenanguladisplacemenand the stresdistribution of implanwere recorded .ResultThe unilateral and bilateral Pfixation model before fusion reduced the range of motion(ROM ) of segmencompared with the Inmodel ,the bilateral fixation wareduced greatethan the unilateral fixa-tion ,buthe difference aftefusion wasignificantly decreased .The peak Von Misestressebefore fusion in the unilateral Pfixa-tion wasignificantly highethan thain the bilateral fixation ,while theipeak Von Misestresseaftefusion trended to be con-sisten.Conclusion The unilateral Pfixation aftefusion can provide the consistensegmenstability same to the bilateral Pfixa-tion .The long-term effecof TLIF with unilateral Pfixation isimilato thawith the bilateral Pfixation .

Objective To design and construct a new bionic scaffold of nucleus pulposus tissue engineering. Methods The collagen-hyaluronic acid (HyA) matrices were prepared, and mixed with Collagen type Ⅱ (pH 1-2) and lyophilized. 6-chondroitin sulfate (CS) was covalently attached to collagen using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS). Afterwards the initial structure of bionic scaffolds was evaluated. Results The bionic scaffolds were porous structure, of which the pore size was 89-132 ?m, the porosity was 94.8%. Water-binding capacity of resulting matrices was 79.2%, and the denaturation temperature was 74.6 ℃. Glycosaminoglycan (GAG) content was 224 mg/g, and the elastic modulus was 0.673 MPa. Conclusion Composition and tissue structure between the scaffolds are similar to the extracellular matrices of nucleus pulposus. The bionic scaffold is an ideal scaffold material of nucleus pulposus tissue engineering in structure. Further experiment is required on the biocompatibility of the novel scaffolds.

Objective To review the preliminary experience on managing the patients suffering from lumbar disc herniation with lateral recess stenosis by microedoscopic discectomy.Methods A total of 79 patients affected with lumbar disc herniation with lateral recess stenosis were treated by MEDⅡ in our hospital from Jan 2002 to Sep 2004.Results All patients were discharged within 7 d postoperatively and no complications occurred.The average duration of follow-up was 12.3 months and the successful clinical outcome was 99%.Conclusion Microendoscopic discectomy is a minimum invasive procedure.The successful clinical outcome could be achieved in properly selected patients.The microendoscopic discectomy is an effective procedure in managing lumbar intervertebral disc herniation with lateral recess stenosis.

Objective To construct a vector containing protein transduction domain (PTD) and cardiotrophin-1 and a vector containing PTD and EGFP, express them in E. coli. and purify them. To detect the distribution of the two fusion proteins in mice. Methods CT-1 and EGFP were cloned to GST-fusion expression vector pGEX-4T3 by PCR and cloning techniques respectively, and then TAT was cloned into the vectors respectively to give pGEX-TAT/CT-1, pGEX-TAT/EGFP. After induced by IPTG the soluble protein GST-TAT/CT-1 and GST-TAT/EGFP was purified by Glutathione Sepharose 4B. The purified fusion proteins were injected into mice through caudal vein and examined in tissue section by immunohistochemical staining. Results CT-1 and EGFP were effectively amplified and the TAT/CT-1 and TAT/EGFP gene sequencing showed the same sequence as scheduled. The fusion proteins was successfully expressed in E. coli. and purified. Conclusion TAT/CT-1 and TAT/EGFP fusion proteins were expressed and purified successfully. The two fusion proteins were all detected positively in mouse brain, spinal cord, heart and liver.