Objective To survey the relationship between myocardial damage of chronic and latent Keshan disease with A360P missense mutation in desmin gene exon6. Methods By clinical epidemiology method,30 cases had been collected randomly among chronic Keshan disease patients and 30 cases equally among healthy adults (inner control groups) in Diantou town,Huangling county,Shaanxi province,a Keshan disease area,and 30 cases among health adults(outer control group) in Chang'an district,Xian city,a normal area. Genome DNA had been extracted from 90 blood samples. Different restriction sites had been analyzed by the methods of PCR,digested by restriction endonuclease and electrophoresis. By virtue of Bsp1286 Ⅰ enzyme,122 bp and 60 bp strap could be found in control group from exnn4,showing that Bsp1286 Ⅰ enzyme was active. By virtue of Bsp1286 Ⅰ enzyme,desmin gene exon6 was digested to 184 bp and 66 bp strip when A360P missense mutation site exited in exon6. Results One hundred and twenty two bp and 60 bp strap could be found in control group from exon4 digested by Bsp1286 Ⅰ ,which showed Bsp1286 Ⅰ enzyme was active. Two hundred and fifty bp strips can only be found in digest products of exon6. One hundred and eighty-four and 66 bp strips which were the products of DNA digested by Bsp1286 Ⅰ could not be found. A360P missense mutation site of desmin gene exon6 had not been found among chronic and latent Keshan disease patients and tow control groups in Keshan disease area and in normal area. Conclusions A360P missense mutation site of desmin gene exon6 has not been found among chronic and latent Keshan disease patients. A360P missense mutation of desmin gene exon6 probably is not predisposing genes of chronic Keshan disease.

Objective To explore the effective of minimally invasive techniques for diagnosis and treatment of the spinal fungal infec-tions. Methods The clinical data of 6 patients with spinal fungal infection in our hospital from January 2012 to June 2014 was reviewd. All patients were taken biopsy diagnosis for spinal fungal infection by percutaneous endoscopic lumbar discectomy. Along with the oral antifungal drugs treatment,all the patients received the interbody fusion surgery by percutaneous pedicle screw fixation and debridement. The clinical and image data were collected during the 6 months following period. Results The symptoms of all the patients was relieved after surgery and no complications occurred. All the patients were followed up for 6 months. The value of ESR and CRP decreased to normal level at the first month after operation. The VAS scores decreased from (7. 0 ± 0. 8) to (0. 8 ± 0. 7) and the ODI scores decreased from (56. 1 ± 7. 7) to (5. 7 ± 2. 1). The X-ray image confirmed solid fusion at the 6 months after surgery. Conclusion The minimally invasive technique of spine is a good way to treat spinal fungal infection.

Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.

Objective To investigate the effect of high mobility group box chromosomal protein 1 (HMGB-1) on the proliferation and inflammatory phenotype of human fibroblast like synoviocytes (FLS).Methods FLSs were isolated from the synovial tissues of rheumatoid arthritis (RA) patients undergoing joint replacement surgery.All the experiments described here utilize the FLSs between the third and sixth passages.FLS were incubated with HMGB1 at (100,500,2 000 ng/ml) or interleukin (IL)-1β (0.5 ng/ml) or lipopolysaccharide (LPS) (100 ng/ml) alone or HMGB1/IL-1β complexes or HMGB1/LPS complexes.Cell proliferation assay were used by CCK-8,IL-6,IL-8 and matrix metalloproteinase-3 (MMP-3) in culture supernatants were measured using enzyme-linked immunosorbent assays.The measurement data were compared with single factor analysis of variance.Results Stimulation with all concentrations of HMGB1,IL-1β and LPS alone did not affect the cell proliferation of FLS.HMGB1/IL-1β complexes and HMGB1/LPS complexes did not affect the cell proliferation of FLS,neither (F=0.415.P=0.915).Except high concentration of HMGB1 (2 000 ng/ml) could significantly stimulate the secretion of IL-6 from FLS [(23.0±1.1) ng/ml],HMGB1,IL-1β and LPS alone did not affect the production of IL-6,IL-8 and MMP-3.However,HMGB1/IL-1β complexes and HMGB1/LPS complexes increased IL-6,IL-8 and MMP-3 production from FLS (F=97.804,117.383,70.179,P=0.000).Conclusion Neither HMGB1,IL-1β,LPS alone nor HMGB1/IL-1β complexes or HMGB1/LPS complexes affect the cell proliferation of FLS.HMGB1 in complex with LPS or IL-1β boost IL-6,IL-8 and MMP-3 production in synovial fibroblasts from RA patients.

Objective Summarize the experiences of treating after-operation ventricular electrical storm (VES) with extra-corporeal membrane oxygenation (ECMO) .Methods Examine the clinical data of seven cases of treating after-operation VES with ECMO from January 2013 to April 2014 and analyze the basic pre-operation conditions of the patients ,diagnoses ,causes of VES ,ai-ding processes with ECMO ,and prognoses .Results Seven patients all were successfully separated from the machine after the treat -ment ,one patient infected seriously after being separated from the machine ,having multiple organ failure one week later and dis-charged voluntarily ;one patient having cerebral hemorrhage two days later after being separated from the machine and discharged voluntarily ;the remaining five patients cured and discharged with no complications .Conclusion ECMO can provide effective circu-lar support to patients suffering VES after heart operation ,maintaining coronary blood supply ,avoiding further myocardial damage , stabilizing electrolytes and the internal environment ,and gain time for restoration of heart rhythm and treatment according to the causes and triggers .

Objective To investigate the effect of ultrasound-guided paravertebral nerve block on stress reaction in patients undergoing esophageal resection. Methods Eighty patients scheduled to do the operation of esophageal resection were randomly divided into two groups with 40 cases in each group. The patients in group A were given the general anesthesia combined with ultrasound-guided paravertebral block, and the patients in group B were given the general anesthesia only. Both of two groups received postoperative patient controlled intravenous analgesia (PCIA). The amount of propofol and remifen-tanil used were recorded. The data of blood pressure, heart rate (HR) and pulseoxygen saturation (SpO2) before anesthesia (T1), before induction (T2), after intubation (T3), in 2 h of surgery (T4), after surgery (T5), 1 h after surgery (T6), 8 h after surgery (T7), 24 h after surgery (T8), 48 h after surgery (T9)were recorded. The analgesic effect was measured by VAS scores and Ramsay sedation scores were also recorded at T6-T10. The levels of blood glucose, epinephrine (E), norcpincphrinc (NE) and dopamine (DA) were also detected at T1, T4, T5, T9. Results The amount of propofol and remifentanil used in group A were lower than those in group B: (960.0 ± 216.9) mg vs. (1 242.5 ± 200.2) mg, (1.5 ± 0.4) mg vs. (2.3 ± 0.4) mg, P<0.05. The patients in two groups successfully completed surgery, and intraoperative vital signs was stable. The quiet and active VAS scores at T6-T9 in group A were significantly lower than those in group B (P<0.05). The Ramsay sedation scores at each time point in two groups had no significant differences (P>0.05). The levels of blood glucose and NE at T9 were significantly higher than those at T1, T4 or T5 of same group, P<0.05.The level of E at T4 and T5 was significantly lower than that at T1 and T9 of same group, P<0.05. The level of DA at T9 was significantly higher than that at T1, T4 and T5 in group B (P<0.05). The levels of blood glucose, NE, E and DA at T9 in group B were significantly higher than those in group A (P<0.05). Conclusions General anesthesia combined with ultrasound-guided paravertebral nerve block could offer favorable anaesthesia effect. It could decrease stress reaction and anesthetics requirements in patients undergoing esophageal resection.

Objective To investigate the clinical effect of human neural stem cells transplantation on severe visual disability infants after cerebral palsy. Methods Cells obtained from the forebrain of an 11-week-old abortive fetus were cultured and expanded for 15 days, then injected into cerebral ventricle of 7 patients. Results Their vision of 4 patients improved, as well as changes of flash visual evoked potential and functional magnetic resonance imaging in a few days after transplantation. Conclusion Neural stem cells transplantation may benefit in some CP children with severe visual disability.

Objective To investigate the effects of Rehmannia and Storesin (RS) on early hepatic encephalopathy (HE) in rat model.Methods HE rat model was induced by CCl4 intragastric administration. The effects of RS on serum nitric oxide (NO) and nitric oxide synthase(NOS) as well as hippocampal tumor necrosis factor α (TNF-α) level of animals were evaluated in 3 dose groups. Lactulose was usedas the positive group. Results The serum NO and NOS as well as hippocampal TNF-α level of the model rats were significantly increasedcompared with that in control animals (P<0.01). The RS high dosage treatment could significantly decrease the levels of those indexes (P<0.01). Conclusion Rehmannia and Storesin is effective on early HE by decreasing the level of serum NO and NOS as well as hippocampalTNF-α.

Objective To assess the effects of Rehmannia and Storesin (RS) on peripheral-type benzodiazepine receptors (PBRs) in early hepatic encephalopathy (HE) rats. Methods CCl4 was used to induce the HE model. The benzodiazepine binding sites of PBRs in rats cortex were studied using the specific ligands [3] PK11195. Lactulose was used in the positive medicine group, and the treatment groups received different dosages of RS. Results The specific binding and the Bmax value of [3] PK11195 both significantly increased in the model group than in the control group (P<0.01). The specific binding decreased in the medium dosage group and the high dosage group than in the model group (P<0.05), and the Bmax value of [3] PK11195RS-H decreased in the high dosage group than in the model group (P<0.01). Conclusion Rehmannia and Storesin is effective on early HE rats by decreasing the specific binding of PBRs, which could reduce the neural injury.

ObjectiveTo assess the effects of rehmannia and storesin on minimal hepatic encephalopathy(MHE) in rat model.MethodsMHE rat model was induced by carbon tetrachloride (CCl4) intragastric administration. The effects of rehmannia and storesin on spontaneous movement and learning and memory function of model animals were evaluated with open field test and Morris water maze in 3 dose groups. Lactulose was used in the positive group.ResultsThe spontaneous movement and the spatial learning and memory ability of the model rats both improved significantly in the high dose group. Meanwhile, the serum level of alanine transarninase(ALT) and ammonia(Amm) also decreased in the high dose group.ConclusionRehmannia and storesin has therapeutical effect on MHE rat model.