Objective To evaluate the safety and effectiveness of one stage surgery of release and bone reduction by posterior approach to treat basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD),and to explore the indications and crucial techniques of posterior approach.Methods All of 17 Consecutive patients (8 males and 9 females) with BI and IAAD who underwent release and reduction by posterior approach from July 2000 to June 2015 were enrolled in the present study,the mean age was 35.2±13.8 years with a range of 12-56 years.The clinical symptoms and signs was recorded,and preoperative imaging examination,including anteroposterior,lateral,dynamic films,MRI and CT of cervical spine,were performed to identify the series.There were 14 cases with atlanto-occipital fusion,7 cases with C2,3 fusion,6 cases with Chiari malformation,6 cases with Syringomyelia,and 8 cases with myelomalacia.The clinic symptoms include occiput/neck pain in 15 cases,cervical movement limitation in 13 cases,short neck in 9 cases,torticollis in 12 cases,Paresthesia in 14 cases,weakness in 13 cases,tendon reflexes hyperfunction in 16 cases and ataxia in 13 cases.The postoperative X-rays,MRI or CT were used to observed the results of decompression,fixation and fusion.Neurological function was assessed by JOA scale and Ranawat's score before,after surgery and at final follow-up.Pre-and post-operative Chamberlain (CL),Wackenheim (WL),McGae (ML),atlantodental interval (ADI) and cervico-medullary angle (CMA) were analyzed by student t-test.Results The average operation time was 145 mins (90-210 mins) and blood loss was 175 ml (150-350 ml).The average follow-up was 44.47 months (9-94 months).JOA score was increased from 8.06 preoperatively to 15.20 postoperatively,the improvement rate was 77.2％.Preoperative Ranawat's score was Ⅱ in 1 case,Ⅲla in 12 cases,ⅢB in4 cases.Postoperative score was Ⅰ in 13 cases,Ⅱ in 4 cases.The preoperative CL,WL,ML,ADI and CMA were (12.52±5.17) mm,(6.59±3.04) mm,(6.96±4.32) mm,(9.88± 1.93) mm,115.35°± 12.40°,respectively.and the postoperative CL,WL,ML,ADI and CMA were (2.0±3.67) mm,(-3.06±1.85) mm,(-1.76±2.88) mm,(1.17± 1.18) mm,136.76°±11.44°,respectively.The perioperative complications were discovered in 2 cases,including 1 case of infection and1 case of cerebrospinal fluid(CSF) leakage.Conclusion Primary surgery of nerve release and bone reduction by posterior approach may be safe and efficient for the treatment of BI and IAAD.Preoperative evaluation,proper surgical indications and advanced surgical techniques are important for treatment results.

To discover novel fluoroquinolone lead compounds as possible anti-infective or/and antitumor chemotherapies, combination principle of pharmacophore-based drug design, a series of novel tricyclic fluoroquinolone title compounds, [1,2,4]triazino[3,4-h][1,8]naphthyridine-8-one-7-carboxylic acid derivatives ( 5a-5p), were designed and synthesized with a fused [1,2,4]-triazine ring unit. Their structures were characterized by spectral data and elemental analysis and the in vitro antibacterial and anti-cell proliferation activities were also evaluated. The results showed that the titled compounds exhibited more significant inhibitory activities against drug-resistant bacteria (Methicillin-resistant Staphylococcus aureus and multi drug-resistant Escherichia coli strains) and three tested cancer cell lines (human hepatoma SMMC-7721, murine leukemia L1210 and human murine leukemia HL60 cells). Interestingly, SAR showed that compounds with electron-donating groups attached to benzene ring had stronger antibacterial activity than antitumor activity, but electron-withdrawing compounds displayed more potential antitumor activity than antibacterial activity, especially antitumor activity of nitro compounds was comparable to comparison doxorubicin. Thus, novel triazine-fused tricyclic fluoroquinolones as potent anti-infective or/and antitumor lead compounds are valuable to pay attention and for further development.
Animals ; Anti-Bacterial Agents ; chemical synthesis ; chemistry ; Antineoplastic Agents ; chemical synthesis ; chemistry ; Carboxylic Acids ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation ; Drug Design ; Escherichia coli ; drug effects ; Fluoroquinolones ; chemical synthesis ; chemistry ; HL-60 Cells ; Humans ; Leukemia L1210 ; Liver Neoplasms ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Mice ; Naphthyridines ; Triazines

To explore an efficient strategy for the conversion of antibacterial fluoroquinolones into antitumor fluoroquinolones, an azole heterocyclic ring of oxadiazole instead of the C-3 carboxylic acid group with a functionalized hydrazone group as a modified side-chain, fifteen novel 2-(fluoroquinolon-3-yl)-oxadiazole-5- sulfanylacetylhydrazone derivatives 7a-7o were designed and synthesized on the basis of the pharmacophore hybridization principle from pefloxacin, separately. The structures for fifteen title compounds were characterized by elemental analysis, 1H NMR and MS, and their in vitro antitumor activity against Hep-3B cell line was evaluated by a MTT assay. The results showed that the title compounds exhibited more significantly inhibitory activity than that of the parent pefloxacin, in which compounds with electron-withdrawing group attached on aryl ring had more potency than that of compounds with electron donating group, especially compounds with a carboxylic substituent were comparable to comparison doxorubicin. It suggests that it is favorable for an improvement of antitumor activity to remain a carboxylic acid unit at the aromatic ring.
Antineoplastic Agents ; chemical synthesis ; chemistry ; Cell Line, Tumor ; Fluoroquinolones ; chemistry ; Humans ; Oxadiazoles ; chemistry ; Structure-Activity Relationship

BACKGROUND:Discectomy and pedicle fixation fusion are golden standard to repair lumbar degenerative disease, but the treatment would induce other complications such as degeneration of adjacent segments or severer pre-existing spinal degeneration. For the problem of lumbar fusion and fixation, lumbar elastic fixation has recently been a hot focus. ＜br> OBJECTIVE:To evaluate the short-term effectiveness of dynamic lumbar pedicle fixation in repair of lumbar spinal stenosis and lumbar disc herniation. ＜br> METHODS:From December 2010 to December 2012, 62 cases of lumbar spinal stenosis and lumbar disc herniation treated with lumbar dynamic system were included. The involved segments included:5 cases at L 3/4 , 20 cases at L 4/5 , 20 cases at L 5 S 1 , 6 cases at double segment L 3/4 and L 4/5, 8 cases at double segment L 4/5 , L 5 S 1 , 3 cases at L 3/4 and L 5 S 1 . There were 34 males and 28 females with an average age of 50.8 years (range 32 to 72 years). According to different fixation systems, they were assigned to three groups:general dynamic lumbar fixation system in 17 cases, K-Rod posterior dynamic stabilization system in 28 cases, and Dynesys system in 17 cases. The fol ow-up time was from 24 to 48 months. Evaluation indexes included visual analogue scale, Oswestry disability index, imaging analysis and excellent and good rate of curative effects. ＜br> RESULTS AND CONCLUSION:Compared with before treatment, visual analogue scale score and Oswestry disability index were significantly improved at 6 months after treatment and final fol ow-up (P＜0.01). No apparent changes were detected in the length of inserted segments and adjacent segments before treatment and during final fol ow-up. There were no significant differences in the excellent and good rate in each group after treatment (P>0.05). These data indicated that the lumbar dynamic system was an effective option for lumbar disc herniation and spinal stenosis. Although there are some differences in the structure of three kinds of flexible fixation, no obvious difference in early therapeutic effects was detected. Long-term effects deserve further investigations.

Objective To investigate the effect of acute normovolemic hemodilution (ANH) combined with controlled hypotension (CH) on the extravascular lung water (EVLW) and oxygenation in elderly orthopaedic surgery patients.Methods Forty-five elderly orthopaedics surgery patients,23 males,22 females,aged 65-75 years old,ASA grade Ⅰ or Ⅱ,were randomly divided into 3 groups (n=15 each).Group A,served as control,received regular routine transfusion and intraoperative crystalloid fluids and colloidal liquid to add volume.Group B,namely ANH group,received normovolemic hemodilution till Hct reaching 30% after induction of anesthesia.Group C,ANH combined with CH group,received ANH with Hct reaching 30% after induction of anesthesia,and the patients were continuously pumped nitroglycerin combined with esmolol for controlled hypotension.The target mean arterial pressure controlled and cut by 30% below the basic value.We collected arterial blood for blood gas analysis at 5 points: before before induction of anesthesia (T1),immediately after ANH (T2),30 min after ANH (T3),30 min after CH (T4),immediately after surgery (T5).Meanwhile the MAP,HR,PaO2,SpO2,Hct,HCO3-,pH,cardiac index (CI),stroke volume variation (SVV),stroke volume index (SVI),extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI) were recorded.Blood loss,urine output after surgery and the operation time were also recorded.Results The volumes of autoblood removed had no significant difference between group B and group C,and no autoblood was removed in group A.The volume of blood loss in group C was significantly less than that in group A and group B (P<0.05).Six cases in group A,one case in group B and none in group C needed homologous allogeneic blood transfusion.Compared with T1,MAP,HR,CI,SVI and Hct were significantly decreased at T2-T5 (P<0.05),but all those are stable in the normal range.Compared with T1,SVV was significantly decreased at T2-T4 (P<0.05).Compared with T1,ITBVI,PaO2 and SpO2 were increased at T2-T5 (P<0.05),but all those are stable in the normal range.CI and SVI at T2 in group A was significantly lower than that in group B and C.Compared with group A and B,MAP at T4 in group C were significantly decreased and SVV at T4 in group C were significantly increased(P<0.05).Urine output,the operation time,EVLWI,HCO3-and pH in three groups had no significant difference.Conclusion Acute normovolemic hemodilution combined with controlled hypotension has an effect of saving blood in elderly patients,without any influence on the extravascular lung water and oxygenation,which can be used safely in elderly patients which they are monitored.

OBJECTIVE:To promote the healthy development of TCM decoction piece. METHODS:Based on analyzing the literature,national policy and data,the advantages and urgent problems of bringing TCM decoction piece into the National Essen-tial Medicine List were summarized,and the suggestions for its health development were provided. RESULTS:Bringing TCM de-coction piece into the National Essential Medicine List relieved the economic burden of patients and provided opportunity for the de-velopment of TCM decoction piece industry. However,it existed problems,such as production,circulation,storage and monitor-ing;mutual conflict in the relevant supporting policies;inconsistent medicare reimbursement;and urgent improvement of quality standard. CONCLUSIONS:The relevant departments should establish and improve the quality standard system of TCM decoction piece,and clear the varieties of TCM decoction piece in the National Essential Medicine List,perfecting supporting policies such as medicare reimbursement and attaching importance to the training of professional talents can ensure scientific and rational services for the public health.

BACKGROUND:Laminar flow operating room used in artificial joint replacement can improve the aseptic conditions and can effectively prevent the infections after joint replacement.
OBJECTIVE:To compare the number of colonies during artificial joint replacement in laminar flow operation room and traditional operation room.
METHODS:300 patients with artificial joint replacement in hundred-level laminar flow operation room and 300 patients with artificial joint replacement in traditional operation room were selected, and al the patients had no infection. Then 100 patients with artificial joint replacement were randomly selected from the hundred-level laminar flow operation room and traditional operation room respectively. The number of colonies in operation room of two groups was compared before and after replacement.
RESULTS AND CONCLUSION:There was no significant difference in the number of colonies between two groups before replacement, and the settling bacteria number of the artificial hip replacement patients in the hundred-level laminar flow operation room was significantly smal er than that in the traditional operation room (P<0.05). The results indicate that compared with the traditional operation room, the hundred-level laminar flow operation room for artificial joint replacement has higher safety and can effectively prevent infections after replacement.

NSP4, as the diarrhea-related protein of rotavirus, is becoming an attractive candidate for vaccine development. To compare the immunogenicity of NSP4 from different genetic groups, we constructed eukaryotic expression plasmids comprising the NSP4 genes from four different genetic types using the pCI vector. The recombinant vectors were designated as pCI-97B6, pCI-97S36, pCI-97S34 and pCI-97SZ8, respectively. Following the conformation of the transient expression of the constructs in 293 cells, the plasmids were respectively subjected to the 5 round i. m. inoculation of BALB/c mice. The specific antibodies against NSP4 as well as the IgG1/IgG2a subclasses of immunoglobulin in mice sera were examined with indirect ELJSA after each immunization. The results showed that the immunization of plasmids expression NSP4s could elicit not only humoral but also cellular immunity, but the humoral immune response is dominant. There is a difference of immunogenecity among the NSP4 of different genetic type. Further studies were needed to focus on the relationship between the immunogenicity and protection effect.

KK-Ay mice with type 2 diabetes were divided into metformin plus high-fat diet,metformin plus low-fat diet,high fat diet alone and low fat diet alone groups.AMP-activated protein kinase(AMPK)activity was measured in skeletal muscle.The results showed that metformin and low-fat diet were able to increase AMPK activity.However,no additive effect on AMPK activity by metformin and low-fat diet was found.

Objective To explore the influence of urbanicity of birth place,upbringing place,gender,childhood neglect,physical abuse and lack of parental accompaniment on the psychological distress and somatic symptom of university students in China.Methods Four thousand six hundred and twenty second-year undergraduates of a comprehensive university in Sichuan Province were surveyed using the 6-item Kessler psychological distress (K6) scale,patient health questionnaire-15 (PHQ-15),a questionnaire adapted from the childhood section of the World Mental Health Composite International Diagnostic Interview(WMH-CIDI) for childhood neglect and physical abuse and a self-designed questionnaire for lack of parental accompany in childhood.Generalized linear model (GLM) with gamma family was used for the multivariate regression analyses.Results Female (β=0.894,P＜0.001),rural upbinging (β=0.378,P＜0.010),childhood neglect (β=0.279,P＜0.001) and childhood physical abuse (β=0.550,P＜0.001) were associated with psychological distress.Female (β=2.638,P＜0.001),rural upbinging (β=0.395,P=0.015),childhood neglect (β=0.487,P＜0.010) and childhood physical abuse (β=0.483,P＜0.001) were associated with somatic symptom.And psychological distress was positively correlated with somatic symptom (r=0.545,P＜0.001).Conclusions Rural living,female,childhood adversities are prone to increase the severity of both psychological distress and somatic symptom of university students in China.Psychological distress and somatic symptom are positively correlated in aspect of severity.