Objective To prepare rat models of liver stagnation syndrome constipation-type irritable bowel syndrome(IBS-C)using single and multi-factor modeling method with different indicators,to provide ideal experimental animal models of IBS-C.Methods Forty-two SD rats were divided randomly into blank(Normal),cold-water gavage(Cold),restraint(Restrain),tail-clamping(Tail),cold-water gavage + restraint(C + R),and cold-water gavage + tail-clamping groups(C + T).Body weight,food intake,water intake,and survival status,as well as open-field behavior,fecal Bristol score,visceral sensitivity,and small intestine propulsion were observed in each group during the modeling period.Pathological changes in the rat colon were observed by hematoxylin and eosin staining,and the serum and colon contents of 5-hydroxytryptamine(5-HT)and vasoactive intestinal peptide(VIP)were determined by enzyme-linked immunosorbent assay.Results The body weight in each group decreased after modeling(P<0.05,P<0.01),the food and water intakes decreased,and serum 5-HT levels increased.The number of fecal particles and Bristol score decreased while the colon 5-HT content increased in the Cold group(P<0.05,P<0.01);the total distance and average speed of the restraint group in the open field decreased(P<0.01);the preference for sugar water in the Tail group decreased(P<0.01);the preference for sugar water,total open-field distance,small intestine propulsion rate,defecation particles,and Bristol score all decreased,while the colon 5-HT content increased and the VIP content decreased in the C + T group(P<0.05,P<0.01);and the total distance,average speed,and VIP content in the colon decreased in the C + R group(P<0.05).Except for the Tail group,all the model groups showed visceral hypersensitivity(P<0.05,P<0.01)compared to the blank group at various pressure values on days 7 and 14 of modeling.Pathological observations showed no significant inflammatory cell infiltration or pathological changes in any of the model groups.Conclusions The combination of ice-water gastric lavage and tail clamping can be used to establish a rat model of liver depression syndrome in IBS-C.This may be the best of the five tested method,and the resulting model may lay the foundation for further systematic and in-depth research into the mechanism of traditional Chinese medicine in preventing and treating IBS-C.

Objective:To investigate the clinical and genetic characteristics of cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) with replication factor C subunit 1 (RFC1) gene mutation to improve the understanding of this disease.Methods:A case of CANVAS diagnosed in the Peking University Third Hospital in January 2021 was reported. Detailed genetic analyses of ataxia were performed with DNA extracted from the peripheral blood of the patient. Studies including pathogenic variants of RFC1 gene causing CANVAS were reviewed and the clinical and genetic characteristics of the disease were summarized.Results:The patient was a 51-year-old female with the prominent manifestation of progressive walking instability. And the clinical data met the diagnostic criteria of CANVAS. The genetic tests excluded other hereditary ataxia mutations and identified the biallelic expansion of the pathogenic variant structure (AAGGG)exp repeat amplification in RFC1 gene. A total of 14 studies on CANVAS with RFC1 gene mutation were reviewed. The overall mutation rate of RFC1 gene in CANVAS was 68%-100%, and it varied in sporadic and familial CANVAS. And the mutation had ethnic differences.Conclusions:Among adult patients with late-onset ataxia, the combination of brain magnetic resonance imaging, electrophysiology tests and vestibular function examination is beneficial to the identification of CANVAS. And the genetic test of RFC1 gene has significant value in the diagnosis of this disease. This patient with CANVAS expands the disease spectrum of ataxia in China, and confirms that RFC1 gene mutation is of great significance in the screening of ataxia disorders in the Chinese population.

OBJECTIVE: To evaluate the efficacy of lumbar transforaminal epidural block (LTEB) for treatment of low back pain with radicular pain. METHODS: We retrospectively analyzed the clinical data of 78 patients with low back pain and radicular pain admitted to the Department of Orthopedics of Beijing Chuiyangliu Hospital from March, 2017 to April, 2019. Thirty-three of the patients received treatment with LTEB (LTEB group), and 45 received comprehensive conservative treatment including traction, massage, acupuncture and physiotherapy (control group). The demographic and clinical data of the two groups were compared. The patients were followed up for 3 to 24 months, and numerical rating scale (NRS) and Oswestry disability index (ODI) scores of the patients were evaluated before the treatment and at 2 weeks, 1 month and 3 months after discharge to assess the efficacy of the treatment. RESULTS: The mean operation time of LTEB was 25.7 7.5 min (15-45 min). After the operation, 5 patients developed weakness of the lower limbs but all recovered within 24-72 h. The patients receiving LTEB all showed significantly decreased NRS scores for low back and radicular pain and ODI scores after the operation ( CONCLUSIONS As a minimally invasive approach, LTEB is effective for treatment of low back pain with radicular pain and can produce good short-term effects of pain relief and functional improvement.
Humans ; Injections, Epidural ; Low Back Pain/drug therapy* ; Lumbar Vertebrae ; Radiculopathy/drug therapy* ; Retrospective Studies ; Treatment Outcome

Objective:To evaluate the clinical effect of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of complex lumbar disc herniation (LDH).Methods:A retrospective analysis of clinical data of 122 patients with LDH who underwent PELD from October 2015 to June 2019 in department of orthopedics, Beijing Chui Yang Liu Hospital was performed. There were 71 males and 51 females. According to whether lumbar disc herniation was a simple non migrated type, the patients were divided into control group ( n=85) and complex group ( n=37). The age, length of stay, operative approach, operation time, the bleeding volume, operative segments, perioperative complications, and excellent and good rate of 3 months after operation were recorded. Follow-up visit was performed by regular outpatient visit for 3 to 36 months. Before and after surgery, 3 days, 1 month, and 3 months after surgery, the Oswestry disability index (ODI) and modified MacNab criteria were used to evaluate the effect of surgery. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison between groups was performed by ANOVA analysis, the count data were expressed as percentage (%), and the comparison between groups was performed by χ2 test or Fisher test, the rank grouping data were performed by Mann-Whitney U non-parametric test. Results:The age of patients in complex group [(63.0±15.9) years] was older than that in control group [(48.7±16.3 years] ( t=2.289, P=0.030), and the length of stay in complex group [(13.0±6.9) d] was longer than that in control group [(8.2±4.3) d] ( t=2.384, P=0.024). There were no significant differences of the operative approach between the two groups ( χ2=0.420, P=0.517). Compared with the control group [(59.0±25.0) min, (16.3±10.9) mL], the operation time of the complex group [(87.0±29.2) min] was longer ( t=2.737, P=0.011), and the bleeding volume [(63.5±52.5) mL] was more ( t=3.925, P=0.001). There were no significant differences of the operative segments between the two groups ( χ2=0.356, P=0.837). The incidence of operation related complications in the complex group (13.5%, 5/37) was significantly higher than that in the control group (2.4%, 2/85) ( χ2=5.937, P=0.026). There were no significant differences in the excellent and good rate between the two groups at 3 months after operation ( U = 1 398.000, P=0.106). The preoperative ODI score of the complex group [(86.6±8.8) scores] was significantly higher than that in the control group [(76.1±7.7) scores]( t=3.359, P=0.002). The ODI score of the two groups decreased significantly. There were significant differences ( t=18.683, P=0.001) between the preoperative [(76.1±7.7) scores] and 3 d postoperative [(36.6±7.5) scores] in the control group. There were significant differences ( t=7.365, P=0.001) between the 3 d postoperative [(36.6±7.5) scores] and 1 month postoperative [(15.0±10.8) scores] in the control group. There were significant differences ( t=4.524, P=0.001) between the 1 month postoperative [(15.0±10.8) scores] and 3 month postoperative [(10.4±12.7) scores] in the control group. There were significant differences ( t=9.923, P=0.001) between the preoperative [(86.6±8.8) scores] and 3d postoperative [(40.1±11.0) scores] in the complex group. There were significant differences ( t=3.619, P=0.006) between the 3d postoperative [(40.1±11.0) scores] and 1 month postoperative [(18.2±15.1) scores] in the complex group. There were significant differences ( t=5.966, P=0.001) between the 1 month postoperative [(18.2±15.1) scores] and 3 month postoperative [(12.7±14.5) scores] in the complex group. Conclusions:PELD technology can treat complex LDH. Compared with simple non migrated LDH, although the operation time is longer, the amount of intraoperative bleeding is more and the incidence of postoperative complications is higher, there is no difference in ODI scores, excellent and good rate. The clinical effect is similar to that of simple non migrated LDH.

Objective:To evaluate the clinical effect of percutaneous coablation nucleoplasty (PCNP) in the treatment of discogenic low back pain (DLBP).Methods:From March 2015 to March 2019, the clinical data of 97 single segment DLBP patients with PCNP admitted to orthopaedic department of Beijing Chui Yang Liu hospital were analyzed retrospectively. They were divided into PCNP group ( n=43) and control group ( n=54). The sex proportion, age, medical history, length of hospital stay, follow-up time, operation time, responsibility segment, Pfirrmann classification and complications were recorded. 1 month, 3 months and 6 months after the operation, the routine outpatient reexamination and follow-up were conducted for 6-36 months. The therapeutic effect was evaluated by numeric rating scale (NRS) and Roland-Morris Disability Questionnaire (RMDQ) before, 1 month, 3 months and 6 months after the operation. Measurement data were presented by Mean± SD, t test was used for comparison between groups, and analysis of variance of repeated measurement data was used for comparison of NRS score and RMDQ score before and after treatment. The counting data were expressed by percentage, χ2 test or Fisher precision test was used for comparison between groups, and Mann-Whitney rank sum test was used for comparison between groups of follow-up time and hierarchical grouping data. Statistical software SPSS 20.0 was used to process the data, P< 0.05 was statistically significant. Results:The average operation time of PCNP patients was (36.3±13.2) min (15 to 65 min), and no complications occurred. After treatment, the NRS score and RMDQ score of the two groups decreased significantly( F组内=26.000, P=0.001; F组内=26.000, P=0.001), and the NRS score and RMDQ score of the PCNP group decreased more significantly( F组间=5.666, P=0.024; F组间=4.261, P=0.048), and the NRS score and RMDQ score of the PCNP group decreased more significantly with time ( F交互=26.000, P=0.028; F交互=26.000, P=0.010). Conclusion:PCNP with DLBP patients showed satisfied clinical results in pain relief and improve dysfunction. PCNP is a safe, minimally invasive and effective treatment method, which has a long therapeutic effect and is superior to conservative treatment.

To analyze the incidence and distribution of oral mucosal diseases in Hunan Province and provide reference for prevention and treatment.
 Methods: The clinical data for all patients, who were treated in Xiangya Hospital of Central South University from April 2013 to March 2017, were collected. After screening, weighing and classifying, sex and age distribution for the disease was analyzed.
 Results: The female with the age between 40 to 49 were in the majority among 21 972 patients. The ratio between men to women was 1:1.05. According to the classification of diseases, the most common diseases were as follows: recurrent aphthous ulcer (27.17%), burning mouth syndrome (15.72%), oral submucous fibrosis (14.75%), oral lichen planus (10.38%), oral leukoplakia (4.21%), traumatic ulceration (4.14%), chronic cheilitis (3.47%), oral fungal infection (3.26%), and atrophic glossitis (2.74%). Recurrent oral ulcer (28.65%), burning mouth syndrome (23.70%) and oral lichen planus (13.31%) were the most common 3 kinds of oral mucosal diseases during females in Hunan. Oral submucous fibrosis was the most common oral mucosal disease among males in Hunan (28.56%).
 Conclusion: Recurrent oral ulcer, burning mouth syndrome and oral lichen planus are very popular in women in Hunan Province, and oral submucous fibrosis is the most common disease in male in this region. It shows a high trend of incidence in the surrounding provinces.
Adult ; Age Distribution ; Burning Mouth Syndrome ; epidemiology ; China ; epidemiology ; Female ; Fibrosis ; Humans ; Incidence ; Leukoplakia, Oral ; epidemiology ; Lichen Planus, Oral ; epidemiology ; Male ; Middle Aged ; Mouth Diseases ; epidemiology ; therapy ; Mouth Mucosa ; pathology ; Oral Submucous Fibrosis ; Oral Ulcer ; epidemiology ; Sex Distribution ; Stomatitis, Aphthous ; epidemiology

Objective To evaluate the efficacy and satefy of percutaneous kyphoplasty for treating Kummel disease with severe osteoporosis.Methods The clinical data of 23 Kummell's patients with severe osteoporosis attending orthopedics in ChuiYang Liu Hospital Affiliated to Tsinghua University from March 2013 to July 2016 were retrospectively analyzed.The patients underwent percutaneous kyphoplasty,the first day after surgery was evaluated during the hospitalization period,outpatient review for 3 months and 1 year.All measurement data were expressed as ((x) ± s),repeated measures analysis of variance was used for statistical analysis of preoperative and postoperative pain visual analogue scale,Oswesay dysfunction index,mean vertebral anterior,central and posterior height,kyphotic angle and operative complications.Results Outpatients were followed up for 12 to 24 months,with an average follow-up of (18.1 ± 5.6) months.The mean preoperative visual analogue scale of the patients with percutaneous kyphoplasty was (8.4 ± 1.5) scores after operation,(2.2 ± 1.1) and (3.1 ± 1.7) scores at 1st day after operation,3 months and (4.6 ± 2.0) scores at 1 year after operation respectively,all P ＜0.001.The preoperative average Oswesay disability index score was (70.1 ± 10.5) scores,(27.4 ± 7.9) and (36.6 ± 8.1) scores at 1st day after operation,3 months,and (46.5 ± 9.3) scores at one year after operation,all P ＜0.001.Postoperative one year pain visual analogue scale and Oswesay dysfunction index score compared with 1 st day and 3 months after operation,the difference was statistically significant (P ＜ 0.05).The mean preoperative vertebral body height percentage was (44.4 ± 6.9)％,(50.1 ± 6.3)％ and (88.2 ± 4.1)％,respectively,(65.5 ± 5.0)％,(66.2 ± 5.7)％ and (89.3 ± 3.7)％ respectively at 1st day after operation,(63.8 ± 7.4)％,(64.6 ± 5.0)％ and (88.1 ± 3.9)％ respectively at 3 months after operation,(57.8 ± 6.3)％,(63.0 ± 6.7)％ and (87.1 ± 4.2)％ respectively at 1 year after operation.Postoperative vertebral anterior and central height percentage compared with the preoperative significantly improved (P ＜ 0.05).There was no significant difference in the height of vertebral trailing edge.The height of vertebral body at 1 year after operation was significantly different from that at one day and three months after operation (P ＜ 0.05).The kyphotic angle improved significantly from 25.0° ± 7.5° to 16.5° ±4.1° at 1st day after surgery (P =0.001),18.2° ±5.8° at 3 months after surgery (P =0.032),but the kyphotic angle increased to 21.3° ± 8.1° at 1 year after the procedure (P =0.051).However,asymptomatie peripheral bone cement leakage occurred in 2 patients and 5 patients sustained adjacent fractures after percutaneous kyphoplasty,the rest of the patients did not have surgical complications and adjacent vertebral fractures.Conclusion Percutaneous kyphoplasty is a safe and effective method for the treatment of Kummell's disease,though it has long-term deterioration of adjacent vertebral fractures and kyphosis,but it can provide spinal stability and relieve pain in the short term,which is conducive to the recovery of patients.

Objective To investigate whether the polylactic acid(PLA)membrane can reduce the scar size and or improve the clinical outcome of the patients after lumbar disc herniation surgery,and the association between peridural scarring and recurrent pain after lumbar disc herniation surgery.Methods Seventy-two patients treated with lumbar disc herniation surgery were collected and randomly divided into two groups, including 38 cases were treated with PLA membrane,and 34 cases as the control group.All patients underwent MRI at 12 months after surgery for grading the size,location and development of the scar.NRS was used to assess the severity of lower limb pain before and 12 months after surgery.The modified Macnab scale was used to assess the clinical outcomes of the patients.Results For 9 cases(23.7%)in the PLA membrane group,the scar tissue had an effect on the nerve root,while 16 cases(47.1%)in the control group experienced the same,the difference was statistically sigificant(χ2=4.326,P=0.038).There was significant difference in scar score between the two groups(Z=2.340,P=0.019),but there was no significant difference in leg pain degree between the two groups(t=0.687,1.014,0.426,0.000,P=0.532,0.324,0.675,1.000).There was no significant difference between the two groups in modified Macnab classification grading(χ2=1.202,P=0.273).Conclusion PLA membranes used in lumbar disc herniation surgery could reduce peridural scar formation,but it does not significantly improve the clinical results.

Objective To evaluate the effect of recombinant human erythropoietin (rhEPO) combined with methylprednisolone sodium succinate (MPSS),compared to MPSS alone,in the treatment of neurological function of patients with acute spinal cord injury (SCI).Methods Twenty-one patients presenting in hospital within less than 8 hours after acute SCI were randomly divided into two groups,the control group (10 cases) and the intervention group (11 cases).The control group was treated by MPSS combined with placebo,while the intervention group received MPSS with rhEPO.Both groups received MPSS 30 mg/kg within the first hour,and if the patient was admitted within 4 hours,MPSS would be applied in the treatment with 5.4 mg/kg per hour in the subsequent 23 hours and till 47 hours if the patient was admitted within 4-8 hours after injury.The intervention group received 500 U/kg rhEPO on admission and another 500 U/kg in the next 24 hours,compared with the control group where placebo was used.The evaluation on neurologic function recovery was made on admission,24 h,72 h,one week,2 months and 6 months later,and statistical analysis was performed.Results The change in ASIA score: in the control group,the increase was seen from admission to 6 months after injury in terms of exercise,algesia and tactile sensation ((31.2±6.6) points vs.(57.8±9.8) points,(41.4±9.5) points vs.(64.3±10.6) points, (39.2±6.8) points vs,(61.5±11.3) points),the increase also took place in the intervention group ((29.5±7.2) points vs.(77.4±10.3) points,(39.7±7.2) points vs.(82.3±12.1) points,(37.4±6.2) points vs.(78.6±12.4) points).As time went on,the increase range in the intervention group became larger,compared with the control group.The difference between the two groups in ASLA score was statistically significant (P<0.05).There was no significant difference in red blood cell count and hemoglobin content of routine blood test between the two groups (P>0.05).Conclusion The application of MPSS combined with rhEPO within 8 hours after acute spinal injury may be more effective than MPSS with placebo in the neurologic dysfunction recovery.

non-myeloablative BuCy+fludarabine conditioning regimen,and another one was treated with TBI+VP-1 6 +CTX+CCNU conditioning regimen.Only one case received short-term MTX,cyclosporin A and ATG regimen for prevention of graft-versus-host disease (GVHD).The GVHD prevention regimens of the other patients were based on short-term MTX,cyclosporin A,ATG and mycophenolate mofetil regimen.The hematopoietic reconstitution, complications and prognosis were observed.Results One patient died of intracranial hemorrhage,and hematopoi-etic reconstitution was achieved in the other 20 patients.The median time for hematopoietic reconstitution shortened by one day in large-dose group compared with that in low-dose group.Adverse reactions included high fever, shivering,gastrointestinal tract adverse reaction,liver injury,oral mucositis and other rare side effects.GVHD occurred more frequently in patients with HLA mismatched transplantation.Nine patients with aGVHD and 9 patients with cGVHD recovered after effective treatment.Within 100 days after transplantation,18 patients had bacterial or fungal infection,mainly upper respiratory tract infection;7 patients had cytomegalovirus infection;2 had EB viremia,and one had urinary BK virus infection.Only one patient died of VOD.Hemorrhagic cystitis occurred in 5 patients and improved after treatment.The median survival time was 24 months (ranging from 136 days to 9 years).One-year and 3-year overall survival rates were 85.2% and 63.9%,the disease free survival rates were 81% and 23.8%,recurrence free survival rates were 71.4% and 14.3%,respectively.Conclusion URD-HSCT was an effective method to treat leukemia.Conditioning regimen of BuCy and modified BuCy2 were safe and effective,the adverse reactions were reversible and well tolerated.Hematopoietic reconstitution time shortened in large-dose MNC and CD34 + cell number groups compared with that in low-dose group.The occurrence rate of GVHD with HLA mismatched transplantation was more than that of HLA matched transplantation.Low-dose heparin,prostaglandin E1 and Danshen injection can effectively prevent VOD.