Craniocervical junction zone malformations often have an insidious onset, a variety of clinical phenotypes, and are often combined with multiple malformations, making their systematic classification and staging more difficult.At present, craniocervical junction area malformations are often classified into congenital and acquired, and can also be classified into skull base malformations, atlantoaxial malformations, and cardinal malformations according to their locations. For patients with obvious occipitocervical or atlantoaxial instability, combined with symptoms of high cervical spinal cord damage, internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature, and the treatment strategies for some of these malformations are still controversial, with different perceptions and treatment concepts in the national and international literature.

Craniocervical junction zone malformations often have an insidious onset, a variety of clinical phenotypes, and are often combined with multiple malformations, making their systematic classification and staging more difficult.At present, craniocervical junction area malformations are often classified into congenital and acquired, and can also be classified into skull base malformations, atlantoaxial malformations, and cardinal malformations according to their locations. For patients with obvious occipitocervical or atlantoaxial instability, combined with symptoms of high cervical spinal cord damage, internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature, and the treatment strategies for some of these malformations are still controversial, with different perceptions and treatment concepts in the national and international literature.

Objective: Under hypoxic conditions, the survival and apoptosis of human amniotic mesenchymal stem cells (hAMSCs) were observed by transient transfection of hypoxia-inducible factor 1α (HIF-1α) gene, to investigate the effect of HIF-1α on hypoxic tolerance of hAMSCs.

Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.

Objective To observe the effect of acupuncture on ghrelin,estradiol (E2) and bone mineral density (BMD) in postmenopausal osteoporosis rats.Methods According to the random number table method,60 female Sprague-Dawley rats aged 3 months,were randomly divided into surgery group (40 rats) and sham group (20 rats).The osteoporosis model was established by bilateral ovariectomy.Three months after the operation,a significant decrease in BMD of lumbar vertebrae and femur of the model rats as measured by dual energy X-ray absorptionmetry against the sham group indicated successful establishment of the osteoporosis model.Then surgery group was randomly divided into a model subgroup,a acupuncture subgroup and an estrogen subgroup,with 10 rats in each subgroup.The acupuncture subgroup was treated with electroacupuncture,estrogen subgroup with subcutaneous injection of estradiol benzoate,sham group and model subgroup without any treatment.After 3 months of intervention all the rats were sacrificed,BMD of the lumbar vertebrae and femur was measured,ghrelin and E2 were determined.Results Serum ghrelin in acupuncture subgroup (399 pg/ml) and estrogen subgroup (276 pg/ml) were significantly lower (P ＜ 0.01) than that in model subgroup (546 pg/ml); serum E2 in acupuncture subgroup (128.02 pg/ml) and estrogen subgroup (182.89 pg/ml) increased significantly (P ＜ 0.05) than that in model subgroup (72.10 pg/ml) ;lumbar vertebrae BMD in acupuncture subgroup (0.212 g/cm2) and estrogen subgroup (0.231 g/cm2) increased significantly (P ＜ 0.05) than that in model subgroup (0.191 g/cm2),but in acupuncture subgroup the effect on improving the level of E2,ghrelin and lumbar vertebrae BMD was less than that in estrogen subgroup (P ＜ 0.05).Conclusions Acupuncture intervention can improve lumbar vertebrae BMD and serum E2 level of postmenopausal osteoporosis rat model,down regulate serum ghrelin level,but the overall effect of acupuncture is less than estrogen.