Reinforced radiculoplasty for the treatment of symptomatic sacral Tarlov cysts: A clinical analysis of 71 cases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the safety and efficacy of reinforced radiculoplasty in the treatment of symptomatic sacral Tarlov cysts (TCs).@*METHODS@#A retrospective analysis was performed on the clinical data and follow-up data of 71 patients with symptomatic sacral TCs who underwent reinforced radiculoplasty in the Neurosurgery Department of Peking University Third Hospital from June 2018 to March 2021. All the operations were performed under neuroelectrophysiological monitoring. Intraoperative cyst exploration, partial resection of the cyst wall, narrowing of the leak, nerve root sleeve radiculoplasty and artificial dural reinforcement were performed. The incidence of postoperative complications and new neurological dysfunction was analyzed. Visual analogue scale (VAS) was used to assess the changes of pain before and after surgery. The Japanese Orthopedics Association (JOA) low back pain score was used to evaluate the changes in nerve function before and after surgery.@*RESULTS@#In the study, 71 patients had 101 TCs, 19 (18.8%) TCs originated from the left S1 nerve, 26 (25.7%) originated from the left S2 nerve, 3 (3.0%) originated from the left S3 nerve, 14 (13.9%) originated from the right S1 nerve, 33 (32.7%) originated from the right S2 nerve, 6 (5.9%) originated from the right S3 nerve, all the TCs underwent reinforced radiculoplasty. Deep infection (1 case), subcutaneous effusion (1 case), fat li-quefaction (1 case) and urinary tract infection (4 cases) were recorded postoperatively. The patients were followed up for 12-43 months (median, 26 months). Two cases had new urinary retention after operation, and the catheter was removed at the end of the first and second months respectively. One case had new fecal weakness, which improved after 3 months. Compared with preoperation, VAS decreased significantly at the last follow-up [median, 6 (4-9) vs. 1 (0-5), Z=-7.272, P < 0.001], JOA score increased significantly [median, 20 (16-25) vs. 27 (18-29), Z=-7.265, P < 0.001]. There were 18 cured cases (25.4%), 41 excellent cases (57.7%), 8 effective cases (11.3%), and 4 invalid cases (5.6%). The total efficiency was 94.4% (67/71). Two (1.98%) cysts recurred.@*CONCLUSION@#For patients with symptomatic sacral TCs, reinforced radiculoplasty can significantly improve the pain and nerve function, which is safe and reliable.

Study on surface electromyography characteristics of erector spinae muscles at different spinal anteversion angles of the scrapers / 中华劳动卫生职业病杂志

Objective: To simulate and evaluate the scraping and grinding work of workers with different spinal anteversion angles, and to explore the effects of different anteversion angles on the erector spinae muscles of scrapers. Methods: In November 2019, 16 male college student volunteers were recruited to simulate workers' scraping and grinding work. The parameters were 25°, 15 times/min, 15°, 30 times/min, 5°, 60 times/min respectively. The surface electromyography (sEMG) was used to collect the electromyographic signals of the erector spinae muscles, and the surface electromyographic characteristics of the erector spinae muscles were evaluated with Borg Scale. Results: There were significant differences between the maximum voluntary contraction percentage (MVE%) of the left and right erector spinae muscles groups in the three groups with different spinal anteversion angles (F(left)=13.41, P(left)<0.001; F(right)=4.74, P(right)=0.005) , and the EMG amplitude was higher at 25°, 15 times/min. At 15°, 30 times/min, MVE% of the left side was significantly higher than that of the right side (t=2.58, P=0.021) . There was significant difference in the mean power frequency (MPF) of the right erector spinae muscle in the three groups (F=9.42, P<0.001) , but there was no significant difference in the MPF of the left erector spinae muscle (F=0.30, P=0.823) . The fitting line showed that the left erector spinae muscle showed a downward trend at 5°, 60 times/min (t=-5.39, P=0.012) . Conclusion: Scrapers are less likely to be fatigued when the posture is 15°, 30 times/min, but they are more likely to be fatigued when working at 5°, 60 times/min.

Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom / 中国骨伤

OBJECTIVE@#To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom.@*METHODS@#A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc.@*RESULTS@#Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(P<0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference(P>0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment(P>0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group(P<0.05). There were no significant differences in other indexes(P>0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups.@*CONCLUSION@#Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.

Effect of Xuanfu Daizhe decoction on stemness of esophageal cancer cells / 中国应用生理学杂志

Objective: To investigate the effect of Xuanfu Daizhe decoction on the stemness of esophageal cancer cells. Methods: The BALB/c nude mice were randomly divided into the control group and experimental group, 5 mice in each group, which were continuously administered with normal saline and Xuanfu Daizhe decoction (9.89 g/kg) by gastrogavage, respectively. Human esophageal carcinoma cells ECA-109 (5×106) were subcutaneously injected into the mice on the 8th day. Tumor volume was measured twice a week. The mice were sacrificed 4 weeks after injection, and the tumor tissue and mouse serum were collected. The expressions of the major stemness-regulating transcription factors, i.e., NANOG, OCT4 and SOX2, were detected by RT-qPCR, Western Blot and immunohistochemistry. ECA-109 cells were treated with 10% fetal bovine serum and serum from the above two groups of mice for 48 hours respectively, and three replicate wells were set in each group, and the expressions of NANOG, OCT4, SOX2 and the levels of AKT and p-AKT were detected by RT-qPCR and Western Blot, respectively. ALDH activity in tumor cells was detected by flow cytometry; the number of spheroids of tumor cells was detected by the spheroidization experiment. Results: Compared with the control group, the growth and size of esophageal cancer tumors were significantly inhibited by Xuanfu Daizhe Decoction; the expressions of NANOG, OCT4, SOX2, the ALDH activity, the number of spheroids, and the levels of AKT and phosphorylated AKT (p-AKT) in esophageal cancer cells were significantly reduced by Xuanfu Daizhe Decoction both in vivo and in vitro. Conclusion: Xuanfu Daizhe Decoction inhibits the stemness of esophageal cancer cells, it may be a potentially effective drug for the treatment of esophageal cancer and provides a theoretical basis for the exploration of new effective drugs for the treatment of esophageal cancer.

Minimally invasive treatment of cervical1-2 epidural neurilemmoma / 北京大学学报(医学版)

OBJECTIVE@#To explore the minimally invasive surgical method for cervical1-2 epidural neurilemmoma.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 63 cases of cervical1-2 epidural neurilemmoma from July 2010 to December 2018 were reviewed and analyzed. Pain and numbness in occipitocervical region were the common clinical symptoms. There were 58 cases with pain, 30 cases with numbness, 3 cases with limb weakness and 2 cases with asymptomatic mass. Magnetic resonance imaging (MRI) showed that the tumors located in the cervical1-2 epidural space with diameter of 1-3 cm. The equal or slightly lower T1 and equal or slightly higher T2 signals were found on MRI. The tumors had obvious enhancement. Individualized laminotomy was performed according to the location and size of the tumors, and axis spinous processes were preserved as far as possible. Resection of tumor was performed strictly within the capsule.@*RESULTS@#Total and subtotal resection of tumor were achieved in 60 and 3 cases respectively, and no vertebral artery injury was found. The operation time ranged from 60 to 180 minutes, with an average of 92.83 minutes. The hospitalization time ranged from 3 to 9 days, with an average of 5.97 days. All tumors were confirmed as neurilemmoma by pathology. There was no postoperative infection or cerebrospinal fluid leakage. There was no new-onset dysfunction except 9 cases of numbness in the nerve innervation area. The period of follow-up ranged from 6 months to 8 years (median: 3 years). All the new-onset dysfunction recovered completely. Pain disappeared in all of the 58 patients with pain. Numbness recovered completely in 27 patients while slight numbness remained in another 3 patients. Three patients with muscle weakness recovered completely. The spinal function of all the patients restored to McCormick grade Ⅰ. No recurrence was found on MRI. No cervical spine instability or deformity was found on X-rays.@*CONCLUSION@#It is feasible to resect cervical1-2 epidural neurilemmoma by full use of the anatomical space between atlas and axis and individual laminotomy. It is helpful to prevent cervical instability or deformity by minimizing the destruction of cervical2 bone and preserving normal muscle attachment to cervical2 spinous process. Strict intracapsular resection can effectively prevent vertebral artery injury.

Analysis of spectrum-activity relationship among antioxidant parts of Lycii Fructus using three different chemometrics methods / 中国中药杂志

The chemical components of Lycii Fructus were analyzed by liquid chromatography( LC) and mass spectrometry( MS for the establishment of spectrum-activity relationship,on the basis of which its antioxidant active ingredients were determined. In this experiment,Lycii Fructus was extracted with different solvents and then separated into 80 samples by macroporous adsorption resin and reversed-phase chromatography,respectively. The antioxidant components were enriched into 11 samples and their scavenging abilities against DPPH free radical and ferric ion reducing antioxidant power( FRAP) were significantly stronger than those before the treatment( P<0. 05). The spectrum-activity relationship regarding the antioxidant activity in vitro of Lycii Fructus was established by Pearson correlation analysis,orthogonal partial least squares( OPLS) and elastic net regression. Six chromatographic peaks greatly contributing to the antioxidant activity in vitro of Lycii Fructus were identified as rutin( P6),quercetin( P35),scopoletin( P14),N-cis-feruloyl-4-O-β-D-glucopyranosyl-tyramine or N-( 4-O-β-D-glucopyranosyl-trans-feruloyl)-tyramine( P8), ferulic acid( P13) and1,3,5-dihydroxy-2-isoprenyl-3-xanthone( P23). The active components associated with free radical scavenging were rutin and quercetin both belonging to flavonoids. The reduction of Fe3+was based on phenylpropanoids such as ferulic acid,scopoletin,xanthone and phenolic amides. These results indicated that the antioxidant activity of Lycii Fructus was ascribed to the synergistic action of different products through different ways. Besides,the data analysis model should be chosen carefully for the establishment of spectrum-activity relationship,thus ensuring the reliability of results.

Nuclear Dbf2-related Kinase 1 functions as tumor suppressor in glioblastoma by phosphorylation of Yes-associated protein / 中华医学杂志(英文版)

BACKGROUND@#The Nuclear Dbf2-related (NDR1) kinase is a member of the NDR/LATS family, which was a supplementary of Hippo pathway. However, whether NDR1 could inhibit glioblastoma (GBM) growth by phosphorylating Yes-associated protein (YAP) remains unknown. Meanwhile, the role of NDR1 in GBM was not clear. This study aimed to investigate the role of NDR1-YAP pathway in GBM.@*METHODS@#Bioinformation analysis and immunohistochemistry (IHC) were performed to identify the expression of NDR1 in GBM. The effect of NDR1 on cell proliferation and cell cycle was analyzed utilizing CCK-8, clone formation, immunofluorescence and flow cytometry, respectively. In addition, the xenograft tumor model was established as well. Protein interaction was examined by Co-immunoprecipitation and immunofluorescence to observe co-localization.@*RESULTS@#Bioinformation analysis and IHC of our patients' tumor tissues showed that expression of NDR1 in tumor tissue was relatively lower than that in normal tissues and was positively related to a lower survival rate. NDR1 could markedly reduce the proliferation and colony formation of U87 and U251. Furthermore, the results of flow cytometry showed that NDR1 led to cell cycle arrest at the G1 phase. Tumor growth was also inhibited in xenograft nude mouse models in NDR1-overexpression group. Western blotting and immunofluorescence showed that NDR1 could integrate with and phosphorylate YAP at S127 site. Meanwhile, NDR1 could mediate apoptosis process.@*CONCLUSION@#In summary, our findings point out that NDR1 functions as a tumor suppressor in GBM. NDR1 is identified as a novel regulator of YAP, which gives us an in-depth comprehension of the Hippo signaling pathway.

Prevalence of Clonorchis sinensis infections in freshwater fish in mainland China: A meta-analysis / 中国血吸虫病防治杂志

Objective To understand the real prevalence of Clonorchis sinensis infections in the freshwater fish in mainland China, so as to provide insights into clonorchiasis control and detection of freshwater fish. Methods All literatures reporting the prevalence of C. sinensis infections in the freshwater fish, the second intermediate host of the parasite, were jointly retrieved in Chinese and English electronic databases from January 1, 2010 to December 31, 2020, including Wanfang Data, CNKI, PubMed, Web of Science, Embase and Cochrane Library. All studies were screened based on inclusion and exclusion criteria, and the quality of all enrolled literatures was evaluated. The pooled prevalence of C. sinensis infections in freshwater fish and its 95% confidence interval (CI) were estimated using the software Stata version 15.0, and subgroup analyses were performed to investigate the region-, season- and sample source-specific pooled prevalence of C. sinensis infections in freshwater fish. In addition, the sensitivity and publication bias of all included studies were analyzed. Results A total of 40 eligible literatures were included in this study, including 37 Chinese literatures and 3 English literatures, and there were 10 high-quality literatures, 27 moderate-quality literatures and 3 low-quality literatures. A total of 53 species containing 37 959 freshwater fish were reported in these 40 studies, and 73.58% (39/53) of freshwater fish species were identified with C. sinensis infections. Meta-analysis showed 23.5% [95% CI: (0.19, 0.28)] pooled prevalence of C. sinensis infections in freshwater fish in mainland China, and subgroup analyses higher prevalence of C. sinensis infections in freshwater fish in northeastern China [35.7%, 95% CI: (0.22, 0.50)] than in central [25.9%, 95% CI: (0.04, 0.48)] and southern China [20.6%, 95% CI: (0.09, 0.32)], higher prevalence of C. sinensis infections in freshwater fish sampled in spring [44.1%, 95% CI: (0.35, 0.53)] than in autumn [6.7%, 95% CI: (0.05, 0.08)] and summer [3.3%, 95% CI: (−0.01, 0.07)], and higher prevalence of C. sinensis infections in freshwater fish sampled from natural water [25.2%, 95% CI: (0.17, 0.33)] than from retail trades [22.2%, 95% CI: (0.17, 0.28)] and breeding chain [12.3%, 95% CI: (0.03, 0.22)]. However, all included studies had a publication bias with a low sensitivity. Conclusions The prevalence of C. sinensis infections is high in freshwater fish in mainland China, and there are still challenges for clonorchiasis control. Reinforcement of health education, diagnostics development and food safety supervision is recommended in future clonorchiasis control programs.

Clinical study of 21 cases of sacral cysts containing fila terminale / 北京大学学报(医学版)

OBJECTIVE@#To summarize the characteristics of sacral cysts containing fila terminale and to explore the surgical treatment methods.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 21 cases of sacral cysts containing fila terminale from July 2010 to March 2017 were reviewed and analyzed. Lumbosacral and perineal pain, weakness of the lower limbs and bladder and bowel dysfunction were the common clinical symptoms. MRI showed that the cysts located in the sacral canal. The lower T1 and higher T2 signals were found on MRI. There were fila terminale within the cysts which tethered the spinal cord. No enhancement was visible within the lesion. The key steps of operation included the resection of the cyst wall, the cutting off of the fila terminale, the release of the tethered cord and the reconstruction of the cisterna terminalis.@*RESULTS@#The total and subtotal resections of cyst walls were achieved in 14 and 7 cases, respectively. The fila terminales were separated and cut off in all the cases, and the tethered cords were released completely. The reconstructions of the cisterna terminalis were accomplished in all the cases. There was no new-onset dysfunction except for 7 cases of mild numbness around anus postoperatively. Pathological examinations confirmed that the cyst wall was fibrous connective tissue, and hyperplasia of fibrous tissue and/or adipose tissue was found within the thickened fila terminale. The lumbosacral and perineal pain disappeared. The weakness of the lower extremities and the bladder and bowel dysfunction gradually improved. The period of follow-up ranged from 3 months to 7 years (average: 2.25 years). The spinal function of all the patients restored to McCormick grade Ⅰ. Only 1 case encountered recurrence of cyst.@*CONCLUSION@#The sacral cysts containing fila terminale are rare. The common symptoms include lumbosacral and perineal pain and symptoms of tethered cord. MRI is helpful to the diagnosis, which shows the signal of cerebrospinal fluid and the fila terminale in the cyst as well as tlow-placed conus medullaris. Microsurgery should remove the cyst wall, cut off the fila terminale, release the tethered cord and reconstruct the cisterna terminalis.

Diagnosis and treatment of primary intraspinal abscess / 北京大学学报(医学版)

OBJECTIVE@#To summarize the feature and treatment of the primary intraspinal abscess in order to improve the prognosis.@*METHODS@#In the study, 13 cases of primary intraspinal abscess of the recent 20 years were retrospectively analyzed. The history, etiology, pathogen, surgical methods and prognosis were summarized.@*RESULTS@#The course of the illness ranged from 7 days to 6 months. All the cases began with pain. Of the 13 patients, 10 had limb weakness. Five had a fever and 8 had increased white blood cells. As for distribution, 1 was in cervical vertebra, 1 in cervicothoracic junction, 1 in thoracic vertebra, 4 in thoracolumbar junction, and 6 in lumbosacral segment. The results of bacterial culture were positive in 4 cases, 3 cases were diagnosed as tuberculosis by pathological examination, and 1 case was recognized as infection of Brucella melitensis bacteria because of prior brucellosis. The pathogen of the remaining cases were unclear. All the cases received surgical treatment and pathology examination. The surgical aim was mainly removal of the lesion, decompression and drainage. Postoperatively anti-infection and glucocorticoid therapy were performed according to the pathogeny results and clinical experience. Incision abscesses were seen in 2 cases and reoperations including debridement and repair with transferred muscle flap were performed. Postoperative follow-up ranged from 6 months to 3 years (mean 1.8 years). One case suffered postoperative recurrence and the abscess spread along the vertebral canal. Reoperation was performed. Infections of all the cases were recovered completely and the nervous system signs were all improved in different degrees.@*CONCLUSION@#The onset of primary intraspinal abscess is relatively urgent, mainly with pain. The lumbar and sacral vertebra is the predilection site. The bacterial culture is mostly negative. Early operation and use of sufficient amount of broad-spectrum antibiotic are recommended. If the incision abscess forms after the operation, it is advisable to transfer the muscle flap to repair the coloboma on the basis of debridement. In order to relieve edema of spinal cord and nerve root, the glucocorticoid can be used in the escort of antibiotics.

Intraspinal metastasis of alveolar rhabdomyosarcoma: A case report / 北京大学学报(医学版)

This paper reported a case of cervical intraspinal metastasis of alveolar rhabdomyosarcoma (ARMS). The clinicopathological features, surgical treatment, chemotherapy and prognosis were introduced and the current literature was reviewed. The diagnosis, differential diagnosis, treatment, molecular features and prognosis of the disease were comprehensively analyzed to improve clinicians' knowledge of this rare disease. The primary lesion appeared about 1 year ago which was painless mass of left hand whose size was about 2 cm×2 cm. After conservative treatment, the mass gradually enlarged and the mass was resected. Postoperative pathology revealed embryonic rhabdomyosarcoma. Postoperative chemotherapy with recombinant human endostatin, liposomal doxorubicin and ifosfamide was performed. The left neck mass was found about 3 months ago, and then the left neck mass was resected under general anesthesia. Postoperative pathological examination showed small round cell malignant tumors. Severe left upper extremity pain began about 2 weeks ago with nocturnal pain and supine pain. Non-steroidal anti-inflammatory drugs were needed to relieve pain which was accompanied by numbness and weakness of the left upper extremity. MRI showed a intraspinal tumor at C5. The left thumb and index finger were absent. Hypoesthesia, muscle atrophy and hypotonia of the left upper limb were confirmed. The muscle strength of biceps brachii and deltoid muscle of the left upper limb was grade 0, the muscle strength of extensor carpus and interphalangeal muscle was grade II, the muscle strength of intrinsic muscles of hands was grade I. The tendon reflex of the left upper limb disappeared. Intraspinal mass was removed and the pain was relieved. But there was no significant change in the muscle strength of the left upper limb. Pathological examination revealed small cell malignancies which were poorly differentiated with diffuse patchy distribution and disordered arrangement. The tumor cells had round, oval or irregular nuclei, and few cytoplasms were positive for Myogenin and MyoD1. FISH test of FOXO1 gene was positive. More than 50% of nuclei showed redgreen signal separation, and the distance between redgreen signals was larger than double diameter of the signal points, which supported ARMS. Total resection of intraspinal tumors was achieved and postoperative chemotherapy was admitted. But intraspinal disseminated metastasis occurred rapidly. ARMS was rare, aggressive tumor with poor prognosis. Subdural metastasis was rare. Correct diagnosis and classification can be made only with help of modern molecular diagnostic methods, which is effective to guide the treatment.

Biomechanical changes of sheep cervical spine after unilateral hemilaminectomy and different degrees of facetectomy / 北京大学学报(医学版)

OBJECTIVE@#To establish animal models and investigate the impact of unilateral hemilaminectomy (ULHL) and different degrees of facetectomy (FT) on the cervical spinal biomechanics.@*METHODS@#Twenty sheep were randomly and evenly divided into 4 groups. No operation was performed for group A, right C4-C6 ULHL was performed for group B, right C4-C6 ULHL and 50% ipsilateral C4-C5 FT was performed for group C, right C4-C6 ULHL and 100% ipsilateral C4-C5 FT was performed for group D. Animals of group A, B, C and D were sacrificed 24 weeks after operating and fresh cervical spine specimens were acquired, biomechanically tested and these data were compared to determine whether ULHL and different degrees of FT led to long-term differences in range of motion.@*RESULTS@#(1) Changes of the total range of motion of cervical spine 24 weeks after surgery: the total range of motion of group D (60.2°±8.6°) was significantly greater than group A (40.7°±6.4°) and group B (41.2°±13.1°) under flexion-extension station, the total range of motion of group D (81.5°±15.7°) was significantly greater than that of group A (56.7°±12.2°) and group B (57.7°±12.8°) under lateral bending station, and the total range of motion of group D (38.5°±17.5°) had no obvious increase compared with group A (26.4°±9.9°) and group B (27.1°±10.9°) under axial rotation station. The total range of motion of group C had no obvious increase compared with group A and group B under flexion-extension station (44.1°±11.7°), lateral bending station (73.6°±11.4°) and axial rotation station (31.3°±11.5°). (2) Changes of the intersegmental motion 24 weeks after surgery: the intersegmental motion of group D (20.3°±4.6°) at C4-C5 was significantly greater than that of group A (11.7°±3.4°) and group B (11.9°±2.1°) under flexion-extension station, the intersegmental motion of group D (26.8°±3.5°) at C4-C5 was significantly greater than that of group A (15.2°±3.1°) and group B (16.2°±3.2°) under lateral bending station, the intersegmental motion of group D (15.2°±3.5°) at C4-C5 was significantly greater than that of group A (6.6°±2.3°) and group B (7.1°±1.9°) under axial rotation station. The intersegmental motion of group C (21.2°±4.1°) at C4-C5 was significantly greater than that of group A and group B under lateral bending station, the intersegmental motion of group C at C4-C5 had no obvious increase compared with group A and group B under flexion-extension station (15.7°±3.7°) and axial rotation station (10.3°±3.1°).@*CONCLUSION@#ULHL does not affect cervical stability, ULHL and 50% ipsilateral FT does not affect the long-term cervical stability, ULHL and 100% ipsilateral FT can lead to long-term instability under lateral bending and flexion-extension station.

Comparative Analysis on the Operation of Physical Examination Centers in State-owned Hospitals and Private Hospitals / 中国卫生经济

Objective:With the increasing awareness of physical examination,the physical examination market met a great opportunity.Under the background of the government encouraging private capital to enter the medical market,it studied the business differences between physical examination in state-owned hospitals and private hospitals.Methods:Synthetically compare service capacity,business income and cost benefit of physical examination in state-owned hospital with that in private hospital were compared to study medical center's business advantages and disadvantages in different operation modes.Results:Physical examination in state-owned hospitals and private hospitals had their own advantages and disadvantages.Conclusion:Under the new situation,it needed to adhere to the public interest nature of physical examination in state-owned hospital,support the healthy development of physical examination in private hospitals,encourage state-owned hospitals and private hospitals to cooperate in physical examination,which had complementary advantages.

A novel vitrified cryopreservation method for the establishment of tumor tissue biobank / 中国组织工程研究

BACKGROUND: Vitrified cryopreservation is a novel method for specimen preservation, which has a potential application value in the establishment of tumor biopsy biobank. OBJECTIVE: To investigate the effectiveness of vitrified cryopreservation and the feasibility in the establishment of tumor biopsy biobank. METHODS: The fresh biopsy specimens of liver metastasis from rectal cancer were randomized into vitrified cryopreservation and control groups. Then, the biopsy specimens from each group were implanted subcutaneously into the mouse back to establish the humanized mouse xenograft model. The biological characteristics and histological changes of tumor tissues in each group were detected by Calcein-AM/Hoechst33342 staining, as well as immunohistochemistry and hematoxylin-eosin staining. Totally 105 biopsy tissues of liver metastasis from rectal cancer were preliminarily collected and cryopreserved to establish the tumor biopsy biobank. RESULTS AND CONCLUSION: No significant differences in biological viability or histological features of tumor biopsy was detected before and after cryopreservation (P > 0.05), suggesting that vitrified cryopreservation can effectively preserve tumor biopsy and is favorable for the establishment of tumor biopsy biobank.

Twenty-seven-year nonunion of a Hoffa fracture in a 46-year-old patient / 中华创伤杂志(英文版)

A Hoffa fracture is an uncommon clinical entity typically seen in adults after high-energy trauma. Nonunion of a Hoffa fracture appears to be even more uncommon. To our knowledge, only three cases of nonunion of a Hoffa fracture have been documented in the literature to date, including two children and one adult. This article presents a case of an adult who had nonunion of a Hoffa fracture for 27 years and was treated by open reduction and internal fixation, and the varus deformity corrected with xenogenous bone graft. An excellent result has been achieved to date. This unusual case reminds us that we cannot neglect the possibility of nonunion of a cancellous bone fracture, especially the Hoffa fractures of the medial femoral condyle if they are treated nonoperatively. It also demonstrates that internal fixation with bone graft is effective, even for the 27-year Hoffa fracture.

Paying attention to optic nerve injury disease and optic nerve regeneration study / 中华实验眼科杂志

Glaucoma,optical neuritis and trauma are optic nerve injury-related diseases.These ocular diseases cause irreversible damage of the vision and even blindness.The study on optic nerve regeneration is a powerful approach for rescuing vision and improving the quality of life of patients.Therefore,how to promote optic nerve regeneration is always the focus in ophthalmology.In recent years,great progression has achieved by modulation of cellular signal pathway,usage of glial cells,stem cells and neurotrophic factor,etc,which lays a basis for the treatment of optic nerve injury.Ophthalmologist should trace and participate in these researches to promote the development of regeneration medicine.This review summarizes these new approaches after discussing factors effecting optic nerve regeneration briefly and proposes questions to answer.

Ginkgolide B promotes axonal growth of retina ganglion cells by anti-apoptosis in vitro / 生理学报

One common feature of glaucoma, optic neuritis and some other optic nerve diseases is sustained and irreversible apoptosis of retinal ganglion cells (RGCs). Ginkgolide B is believed to protect neurons in brain and contribute to neurite outgrowth and synapse formation. The aim of the present study was to explore the effects of Ginkgo biloba extract (EGB761) and ginkgolide B on axonal growth of RCGs. Retina explants were cultured in three-dimensional tissue culture system, and the number and length of neurites were analyzed. Immunohistochemistry staining was performed to confirm that the neurite observed was axon of RGCs. TUNEL and activated caspase-3 staining were also applied to observe RGCs apoptosis. The result shows that neurites of RGCs treated with EGB761 or ginkgolide B were more and longer than those in control. The neurite is proved to be the axon of RGCs by immunostaining. Furthermore, compared with control group, RGCs treated with ginkgolide B showed decreased cellular apoptosis and inhibited caspase-3 activation. These results suggest ginkgolide B can promote RGCs axon growth by protecting RGCs against apoptosis.

The correlations between air quality and heart rate variability in aged susceptible people during Beijing Olympic Games 2008 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the variations of the concentrations of air pollutants and explore the correlation between the heart rate variability (HRV) of the aged people and the air quality during Beijing Olympic Games 2008.</p><p><b>METHODS</b>A panel study design was adopted. A total of twenty-six over 55-year-old patients with coronary heart disease or angina pectoris or a symptom of myocardial ischemia at least for one year were enrolled as a panel and followed up five times by measuring HRV index and other related indexes from June to September in 2008. The correlations between the HRV of the aged people and the air quality was analyzed with the linear mixed-effect models according to the data of air pollutants and meteorological conditions collected simultaneously from Beijing Environmental Protection Bureau and Beijing Meteorological Bureau.</p><p><b>RESULTS</b>In single-pollutant mixed-effect models, the significant correlation was observed in the reduction of ambient PM(10), SO(2) and NO(2) with the improvement of the total power and high-frequency power (HF) of HRV in the panel subjects, and a 10 microg/m(3) decrease in PM(10), SO(2) and NO(2) level was correlated with 2.51% (95%CI: -3.80% - -1.22%, t = -1.99, P = 0.0497), 31.39% (95%CI: -52.24% - -10.53%, t = -1.99, P = 0.0497) and 42.72% (95%CI: -75.06% - -10.38%, t = -1.99, P = 0.0497) rises in total power of HRV respectively. A 10 microg/m(3) decrease in PM(10), SO(2) and NO(2) level was correlated with 3.46% (95%CI: -5.14% - -1.77%, t = -2.11, P = 0.0378), 40.63% (95%CI: -68.70% - -12.56%, t = -2.11, P = 0.0378) and 53.76% (95%CI: -97.97% - -9.56%, t = -2.11, P = 0.0378) rises in high-frequency power (HF) of HRV respectively.</p><p><b>CONCLUSION</b>It suggests that the air pollution reduction could improve the cardiovascular functions of the susceptible population.</p>

Cerebrospinal fluid dynamics in Chiari malformation associated with syringomyelia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>About 50% - 70% of patients with Chiari malformation I (CMI) presented with syringomyelia (SM), which is supposed to be related to abnormal cerebrospinal fluid (CSF) flow around the foramen magnum. The aim of this study was to investigate the cerebrospinal fluid dynamics at levels of the aqueduct and upper cervical spine in patients with CMI associated with SM, and to discuss the possible mechanism of formation of SM.</p><p><b>METHODS</b>From January to April 2004, we examined 10 adult patients with symptomatic CMI associated with SM and 10 healthy volunteers by phase-contrast MRI. CSF flow patterns were evaluated at seven regions of interest (ROI): the aqueduct and ventral and dorsal subarachnoid spaces of the spine at levels of the cerebellar tonsil, C2 - 3, and C5 - 6. The CSF flow waveforms were analyzed by measuring CSF circulation time, durations and maximum velocities of cranial- and caudal-directed flows, and the ratio between the two maximum velocities. Data were analyzed by t test using SPSS 11.5.</p><p><b>RESULTS</b>We found no definite communication between the fourth ventricle and syringomyelia by MRI in the 10 patients. In both the groups, we observed cranial-directed flow of CSF in the early cardiac systolic phase, which changed the direction from cranial to caudal from the middle systolic phase to the early diastolic phase, and then turned back in cranial direction in the late diastolic phase. The CSF flow disappeared at the dorsal ROI at the level of C2 - 3 in 3 patients and 1 volunteer, and at the level of C5 - 6 in 6 patients and 3 volunteers. The durations of CSF circulation at all the ROIs were significantly shorter in the patients than those in the healthy volunteers (P = 0.014 at the midbrain aqueduct, P = 0.019 at the inferior margin of the cerebellar tonsil, P = 0.014 at the level of C2 - 3, and P = 0.022 at the level of C5 - 6). No significant difference existed between the two groups in the initial point and duration of the caudal-directed CSF flow during a cardiac cycle at all the ROIs. The maximum velocities of both cranial- and caudal-directed CSF flows were significantly higher in the patients than those in the volunteers at the aqueduct (P = 0.018 and P = 0.007) and ventral ROI at the inferior margin of the cerebellar tonsil (P < 0.001 and P = 0.002), as so did the maximum velocities of the caudal-directed flow in the ventral and dorsal ROIs at the level of C2 - 3 (P = 0.004; P = 0.007).</p><p><b>CONCLUSIONS</b>The direction of CSF flow changes in accordance with cardiac cycle. The syringomyelia in patients with CMI may be due to the decreased circulation time and abnormal dynamics of the CSF in the upper cervical segment. The decompression of the foramen magnum with dural plasty is an alternative for patients with CMI associated with SM.</p>

The Progress of Treatment and Pathogenesis of Primary Biliary Cirrhosis / 中国慢性病预防与控制

Primary biliary cirrhosis (PBC) is considered to be an autoimmune liver disease. Its etiology is unknown. Pathogenesis of PBC is associated with many aspects such as genetic factors, environmental factors, independent activity of target antigen, T-cell autoreactive immune responses and so on. Recently, new materials that involved in the morbidity of PBC have been identified constantly. Antimitochondrial antibodies (AMA) are characteristic of PBC. In particular, AMA-M2 is highly positive for the serological diagnosis mark of PBC. At present, treatment still cannot be for the etiology of PBC. Symptomatic treatment and support treatment are main measures. Ursodeoxycholic acid (UDCA)is the only one recognized medication with specific effect on the PBC. At present, the liver transplant can increase the survival rate and extend their survival time for end-stage of patients with PBC. This article emphasis on the progress of pathogenesis and treatment of the PBC are reviewed to explore research.