Training of public health talents in China in the new situation / 上海预防医学

The epidemic of the coronavirus disease 2019 （COVID-19） has presented great challenges to the public health throughout the world. Therefore， it is crucial to foster high-level and multi-disciplinary public health talents to further improve public health. Herein， we summarize the current situation and challenges for public health education and prospect the requirements for training public health talents in China. Colleges and universities bear the responsibility for training public health talents， which is essential for the construction of public health system. In this context， we introduce the education for public health and the Doctor of Public Health （DrPH） program at Fudan university.

Thyroid hormone levels in healthy adults with non-occupational exposure to cadmium， lead and perfluoroalkyl substances / 上海预防医学

ObjectiveTo assess the effects of non-occupational mixed exposure to cadmium， lead and perfluoroalkyl substances （PFASs） on thyroid hormones （TH） in healthy adult residents in Shanghai. MethodsIn November 2018， adults in Shanghai Suburban Adult Cohort and Biobank study， who visited a community health service center for examination with no history of occupational exposure， thyroid diseases or chronic diseases， were recruited. A social-demographic information questionnaire survey was conducted and urine and blood samples were collected. Inductively coupled plasma mass spectrometry （ICP-MS） was used to measure their urinary cadmium （UCd）， blood cadmium （BCd） and blood lead （BPb） concentrations. Ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry （UPLC-Q/TOF MS） was used to measure 11 kinds of PFASs. Total and free triiodothyronine （TT3， FT3）， total and free thyroxine （TT4， FT4） and thyroid simulating hormones were measured by chemiluminescence enzyme-linked immunoassay. 436 participants were finally included and LASSO regression， multivariate regression and weighted quantile sum regression were used to evaluate the associations of these environmental pollutants with thyroid hormones. ResultsAmong the participants， 185 were male （42.5%） and the median age was 60 （P25‒P75： 50‒66）. The detection rates of urinary cadmium， blood cadmium and blood lead were all more than 95% and the detection rates of 7 PFASs （PFOS， PFOA， PFHxS， PFUnDA， PFNA， PFD， and PFBS） were more than 90%. The median exposure level of PFOA was the highest （49.6 µg‧L-1） among PFASs， followed by PFHxS （22.8 µg‧L-1） and PFOS （15.4 µg‧L-1）， and the median exposure levels of urinary cadmium， blood cadmium and blood lead were 0.7 μg‧g-1（Corrected for creatinine of urine）， 0.8 µg‧L-1， and 15.4 µg‧L-1， respectively. The results showed that UCd was negatively associated with TSH and BCd was positively associated with TT3， while PFASs mainly affected FT4， TT4， and TT3， with gender differences. In males， 7 PFASs had a significant negative mixture effect on TT3 and TT4， while the direction of effect of PFASs in females differed， with PFOS and PFUnDA having a significant positive correlation with FT4 and TT4 while PFDA having a significant negative correlation with FT4 and TT4. ConclusionIn a healthy population with no occupational exposure， co-exposure to cadmium， lead and PFASs affects different thyroid hormone indicators， and such effect could be gender-related， indicating that the effect of mixed exposure to metal and emerging compounds on thyroid functions warrants further attention.

Needs for curriculum and specialty development of public health nursing： an investigation of medical students during the COVID-19 pandemic / 上海预防医学

ObjectiveThe purpose of this study is to investigate and analyze the needs of public health nursing courses and specialty settings under the COVID-19 pandemic. MethodsA total of 576 medical students majored in clinical medicine， preventive medicine， pharmacy， and nursing from a Shanghai university participated in this survey. The Questionnaire Star App was used to collect students' knowledge， attitude and behavior about public health safety and emergency preparedness， public health related curriculum and public health nursing specialty， through self-administered approach. ResultsThere were significant differences in the knowledge of emergency nursing among students with different majors and grades. Over 80% of the participants agreed that "public health popularization should be strengthened". Over 60% were willing to "invest more time and energy in learning and understanding public health-related disease prevention and control knowledge". The school has carried out corresponding training or practice activities in public health education. Compared with nursing major， students with other majors performed better in paying attention to and participating in the training or practical activities of public health education. More than 70% agreed that it was necessary to set up public health nursing courses， especially nursing specialty， with the approval rate as high as 92.3%. Students believed that "2 class hours per week"， and "1/10 of the total class hours" was appropriate. In terms of course teaching， nursing students put forward more expectations on teaching objectives， methods， and characteristic courses. ConclusionUndergraduates lack knowledge of public health nursing， but most of them， especially nursing undergraduates， have a strong desire to learn and have a positive attitude towards opening public health nursing courses. However， there are still problems such as insufficient attention to and insufficient understanding of the courses. More efforts should be made to enhance the public health nursing education on public health emergencies， optimize the relevant settings of courses， so as to train nursing personnel suitable for the current health service needs in China.

Research progress on exposure levels and toxic pathways of typical persistent organic pollutants in foods / 中华预防医学杂志

Dioxins, polybrominated diphenyl ethers, and benzo(a)pyrene are common organic pollutants in food. They have been of concern to academics and government administrations due to high residue and persistence, easy accumulation and strong harmful effects. The National Research Council of the United States of America published Toxicity Testing in the 21st Century: A Vision and Strategy in 2007, which proposed a new concept of toxicity testing that toxicity testing should take full consideration of population exposure data and base on in vitro tests, human cell lines, toxicity pathways and high-throughput screening. Meanwhile, systems biology, bioinformatics and rapid assay technologies will be used to better understand toxicity pathways—the cellular response pathways that can lead to adverse health effects when sufficient perturbing induced by chemicals exposure. The new toxicity testing strategy has changed the traditional testing pattern and has brought a wide impact on the international relevant fields. The European Union, the World Health Organization, and the United States Environmental Protection Agency, the Food and Drug Administration, and the National Center for Toxicological Research have organized relevant discussions and exploratory studies to address the new toxicity testing concept and how to evaluate and utilize the results of traditional toxicity test researches. Compared to the discussion, 'whether to do it’, ten years ago, the question, 'how to do it’, has become the concern of the current discussion. Therefore, how to respond to the concept of toxicity testing and how to effectively utilize and excavate traditional toxicity test data have been the focus of multi-disciplines and interdisciplinary academia such as toxicology, food hygiene and environmental science. Therefore, this article provides an overview of the exposure levels of dioxin, polybrominated diphenyl ethers and benzo[a]pyrene, which are typical persistent organic pollutants in food in China and the current research status of toxic pathways based on whole animal experiments. The exposure level, toxic effect and toxicity mechanism of three contaminants are analyzed and summarized in order to provide basis for future results based on the 21st century toxicity test compared with traditional tests and data mining analysis of these two kinds of data. Meanwhile, it also lays the foundation for the establishment of a toxicity testing framework based on exposure characteristics, toxic pathways, and biomarkers.

Management and safety assessment of nanomaterials in food: status and prospects / 中华预防医学杂志

The safety assessment of nanomaterials in food is essential for safeguarding supervision and maintaining public health. However, there are still no safety assessment procedures for nanomaterials established in national-level in China and no specific toxicology and safety assessment procedures about nanomaterials for food, too. These factors lead to restriction on food safety protection and supervision. Current methods of evaluating the safety of nanomaterials mainly rely on traditional toxicological assessment that are extrapolated based on animal experiment from high doses to low doses and from animals to humans. These uncertainties restrict the accuracy of safety assessment for nanomaterials and also limit the development of scientific and effective evaluation procedures and regulatory measures. Currently, the key issues need to be solved including exposure assessment and evaluation methods of nanomaterials in food and the established methods of the toxicity test for nanomaterials that are consistent with the objectives of toxicity test in the 21st century vision and strategy. In this article, we reviewed current administrative regulatory, situations, and existing issues of food nanomaterials either in China or some developed countries in order to provide a scientific basis in establishing safety assessment procedures for nanomaterials in food in the future.

Effect of adipose tissue-derived mesenchymal stem cell transplantation in treatment of liver fibrosis and possible mechanism / 中华肝脏病杂志

Objective@#To investigate the effect of adipose tissue-derived mesenchymal stem cell (ADSC) transplantation in the treatment of liver fibrosis rats and possible mechanism.@*Methods@#Subcutaneous adipose tissue in the inguinal region of rats was collected to isolate ADSCs. The rats with liver fibrosis induced by intraperitoneally injected carbon tetrachloride were divided into cell transplantation group and phosphate buffer saline (PBS) injection group, and the rats which were fed normally were enrolled as negative control group. The rats in the cell transplantation group were given tail vein injection of ADSCs, and those in the PBS injection group were given injection of 0.5 ml PBS. At 7 days after transplantation, blood samples were collected from the inferior vena cava to evaluate liver function; liver tissue was collected to measure the protein expression of hepatocyte growth factor (HGF) and alpha-smooth muscle actin (α-SMA); Masson trichrome staining was used to evaluate intrahepatic collagen deposition. Hepatic stellate cells (HSCs) were collected from the rats with liver fibrosis, and indirect co-culture of HSCs and ADSCs was performed in vitro to analyze the influence of ADSCs on the proliferation and apoptosis of HSCs. The independent samples t-test was used for comparison between groups, and an analysis of variance was used for comparison of means between multiple samples.@*Results@#ADSCs were found in liver tissue in the transplantation group, and compared with the PBS injection group, the transplantation group had significant alleviation in hepatocyte necrosis, vacuolization, and area of fibrosis and significant reductions in the serum levels of aminotransferases, while there was no significant difference in the level of albumin between the two groups. Compared with the PBS injection group, the transplantation group had significant upregulation in the protein expression of HGF and significant downregulation in the protein expression of α-SMA (both P < 0.05). In vitro co-culture for 72 hours showed that ADSCs inhibited the proliferation of HSCs, and there was a significant difference between the co-culture group and the control group with HSCs cultured alone. Caspase-3 immunostaining showed that after co-culture for 72 hours, there was a significant difference in the apoptosis rate of HSCs between the co-culture group and the control group with HSCs cultured alone (23.42% ± 3.02% vs 14.82% ± 3.93%).@*Conclusion@#ADSC transplantation can upregulate the expression of HGF in the liver, promote the apoptosis of HSCs, and thus alleviate liver fibrosis.

Education via WeChat improves glucose control and pregnant outcomes in women with gestational diabetes mellitus / 中华围产医学杂志

Objective To evaluate the effect of strengthening nutrition intervention in gravidas with gestational diabetes mellitus (GDM) with WeChat on blood glucose control and pregnant outcomes.Methods A total of 410 gravidas,diagnosed with GDM and treated in the Department of Clinical Nutrition of Shanghai General Hospital from October 2015 to April 2016,were enrolled and randomly divided into two groups (n=205).The control group received traditional nutrition clinic education only,while the intervention group was given strengthened nutrition education through WeChat in addition to traditional education.Blood glucose level and insulin dosage were followed up after one,two and four weeks of intervention.Pregnant outcomes and patient satisfaction were investigated on 42 d after delivery.T test,Chi-square test and non-parametric test were used for statistical analysis.Results (1) Two weeks after the intervention,the average 1-hour postprandial blood glucose in the intervention group was lower than in the control group [(7.46± 1.01) vs (7.68± 1.06) mmol/L,t=2.243,P=0.025].After 4 weeks,both 1-and 2-hour postprandial blood glucose levels of the intervention group were lower than those of the control group [(7.03±0.65) vs (7.33±0.63) mmol/L,t=4.629,P＜0.05;(6.00±0.65) vs (6.21 ±0.62) mmol/L,t=3.153,P＜0.05] and more gravidas achieved euglycemia [79.9％ (151/189) vs 60.8％ (113/186),x2=16.483,P＜0.001].(2) Compared with the control group,the intervention group had a higher vaginal delivery rate [38.7％ (72/186) vs 50.5％ (95/188),x2=5.288,P=0.021] and a lower rate of postpartum complications [9.1％ (17/186) vs 2.1％ (4/188),x2=7.394,P=0.007].All of the gravidas in the intervention group were satisfied with the WeChat intervention except one lost to follow up [99.5％ (203/204)].Conclusions Strengthening nutrition education through WeChat is much more effective than traditional nutritional outpatient education alone in order to achieve a better control of blood glucose and improve pregnant outcomes in GDM women.This intervention is highly acceptable to gravidas and can be further extensively applied in nutrition clinic.

The applications of enhanced recovery after surgery in laparoscopic hepatectomy: a retrospective cohort study / 中华普通外科杂志

Objective To investigate the safety and effectiveness during perioperative period in patients undergoing laparoscopic hepatectomy under ERAS program.Methods A retrospective study was carried out,in 40 patients under ERAS programs from Sep 2016 to Aug 2017 compared with 40 patients in control group from Sep 2015 to Aug 2016 in intraoperative central vein pressure,blood loss,postoperative stress indicators,the incidence of moderate to severe pain,exhaust time,oral feeding time,ambulation time,complications,hospital stays and costs and patient satisfaction.Results Compared with control group,the intraoperative blood loss was decreased by controlling central venous pressure (t =2.556,P =0.013),earlier exhaust,oral intake of food and ambulation (P ＜0.001),lower incidence rate of moderate to severe pain (x2 =11.314,P ＜ 0.001),and higher patient satisfaction (t =6.816,P ＜ 0.001) in ERAS group,though there were no significant differences in extubation time (t =0.336,P =0.738).The average hospital stays were 2.8 days shorter (16.6 ± 3.0 vs.19.4 ± 6.4,t =2.514,P =0.015),and hospital expenses were (￥)6 000 less than control group (5.4 ±0.7 vs.6.0± 1.5,t =2.338,P =0.023).Conclusion ERAS programs applied to patients undergoing laparoscopic hepatectomy can safely and effectively accelerate patient recovery.

Quantitative structure-activity relationship prediction of carcinogenicity of N-nitroso compounds based on category approach and read-across / 中华预防医学杂志

Objective@#New quantitative structure-activity relationship (QSAR) method was used to predict N-nitroso compounds (NOCs) carcinogenicity. This could provide evidences for health risk assessment of the chemicals.@*Methods@#Total 74 chemical substances of NOCs were included as target chemicals for this validation study by using QSAR Toolbox based on category approach and read-across. The included 74 NOCs were categorized and subcategorized respectively using "Organic functional groups, Norbert Haider " profiler and "DNA binding by OASIS V.1.1" profiler. Carcinogenicity of rat were used as target of prediction, the carcinogenicity@*results@#of analogues in chemical categories were cross-read to obtain the carcinogenic predictive results of the target chemicals. Results 74 NOCs included 26 nonclic N-nitrosamines, 24 cyclic N-nitrosamines and 24 N-nitrosamides The sensitivity, specificity and concordance of the category approach and read-across for predicting carcinogenicity of 74 NOCs were 75% (48/64), 70%(7/10) and 74% (55/74) respectively. The concordance for noncyclic N-nitrosamines, cyclic N-nitrosamines and N-nitrosamides were 88% (23/26), 71% (17/24) and 63% (15/24) respectively.@*Conclusion@#QSAR based on category approach and read-across is good for prediction of NOCs carcinogenicity, and can be used for high-throughput qualitative prediction of NOCs carcinogenicity.

Clinical analysis of 10 patients with severe acute pancreatitis with peripancreatic necrosis treated by minimally invasive technique of retroperitoneal approach / 中华胰腺病杂志

Objective To evaluate the efficacy of minimally invasive technique by retroperitoneal approach in the treatment of severe acute pancreatitis with peripancreatic necrosis.Methods The clinical data of 10 patients with severe acute pancreatitis combined with peripancreatic necrosis who underwent retroperitoneal drainage by aspirating and placing tube under B ultrasound guidance on the basis of routine therapy in the First Affiliated Hospital of University of South China from January 2016 to September 2016 were analyzed.Results All of the 10 patients successfully underwent puncture.Drainage was good after puncture and tube placement in 7 patients.The amylase activity was normal within 3 ～ 7 days,and the symptoms of abdominal pain and bloating were alleviated in 2 ～ 4 days.Among them,3 cases had poor drainage after catheterization due to a large necrotic area,and the percutaneous nephroscope was performed to remove the necrotic tissue of the pancreas.Bacteria was detected in the drainage fluid of 7 patients.The complications of pneumothorax,hemothorax and organ injury were not found in all the patients.The average hospitalization time was 19.4 days (10 ～ 34 days).Conclusions Minimally invasive retroperitoneal approach is safe and effective in curing severe acute pancreatitis with peripancreatic necrosis with good efficacy,which is worth for clinical recommendation and application.

The study on influence factors of the grade point average of degree courses among Master gradu-ates in medicine / 中华医学教育探索杂志

Objective To understand the grade point average (GPA) of degree courses and its in-fluence factors in Master postgraduates in China. Method A cross-sectional study was carried out to collect the data on GPA and the student information in the management system of postgraduates who graduated from Graduate School of Public Health from 2013 to 2015. SPSS 20.0 was used to describe the basic situa-tion, and the data were analyzed by one-way ANOVA, Pearson correlation analysis and multivariate analysis of variance. Results During 3-year, totally 213 Master students were graduated with the average GPA of (3.19±0.30). The female had higher GPA than the male subjects [(3.24±0.29) vs. (3.05±0.29), F=17.11, P=0.000], those enrolled by the recommendation than those enrolled by the graduate entry examinations [(3.36±0.25) vs. (3.11±0.28), F=39.36, P=0.000], those graduated from the university of 985 were better than the graduate students from other universities [(3.30±0.29) vs. (3.11±0.28), F=22.14, P=0.000], those with the academic degree than those with the professional degree [(3.31±0.25) vs. (2.99±0.27), F=72.38, P=0.000], and there was a negative relationship between the total credits and GPA of degree courses (r=-0.48, P=0.000). Further, sex, enrollment way, undergraduate university, and total credits of degree courses were independent influence factors under multivariate analysis of variance (all P<0.05). Conclusion These master graduates in medicine have better GPA of degree courses and it can be statistically related to sex, enrollment way, undergraduate university, and total credits of degree courses. Some measures should be developed to enroll more students from better university, improve the master programs, and raise the quality of graduate education management.

Expression and significance of Axin2 in pancreatic cancer cells / 临床肝胆病杂志

ObjectiveTo investigate the expression of Axin2 in pancreatic cancer cells, and to observe the influence of Axin2 on the proliferation, invasion, and migration of human pancreatic cancer cells (PANC-1). MethodsQuantitative real-time PCR was used to measure the expression of Axin2 in pancreatic cancer cell lines with different invasive abilities (PANC-1, Mia PaCa-2, and BxPC-3) and immortalized normal pancreatic cells (H6C7). PANC-1 cells with low expression were transfected with over-expressed Axin2 plasmid by transient transfection. MTT assay, Transwell assay, and scratch assay were used to determine the proliferation, invasion, and migration of cells transfected with over-expressed Axin2. One-way analysis of variance was used for comparison between multiple groups, and SNK-q test was used for comparison between any two groups. ResultsThe relative expression levels of Axin2 in PANC-1, BxPC-3, Mia PaCa-2, and H6C7 cells were 0.13±0.01, 0.42±0.05, 0.24±0.011, and 1.00±0.00, respectively, and PANC-1 cells had the lowest expression level of Axin2, with significant differences compared with the other cells (all P＜0.05). When PANC-1 cells were transfected with over-expressed Axin2 plasmid, the cells in the over-expression group had a significant increase in the expression level of Axin2 compared with those in the blank group and the negative control group (both P＜0.05). Compared with those in the non-transfection group and the blank group, PANC-1 cells in the over-expression group showed significant reductions in the proliferation, invasion, and migration abilities. ConclusionThe expression of Axin2 is down-regulated in pancreatic cancer cell lines and decreases with the increasing invasion ability, suggesting the role of tumor suppressor gene. High expression of Axin2 can reduce the proliferation, invasion, and migration abilities of PANC-1 cells.

Correlation between the expression level of coiled-coil domain-containing protein 80 and obesity / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between expression of coiled-coil domain-containing protein 80(CCDC80) and obesity in serum and adipose tissues.</p><p><b>METHODS</b>A cross-sectional survey was conducted in a hospital in Tangshan in September 2010. 100 people including 78 healthy people and 22 with type-2 diabetes were recruited. Another 36 female patients with benign tumor of Obstetrics and Gynecology were also recruited. Demographic characteristics and serum samples were collected from all subjects, basic biochemical indicators were tested. All subjects were divided into 'Normal Weight' and 'Overweight and Obese' according to their BMI (BMI <24.0 kg/m(2); BMI≥24 kg/m(2)). Serum CCDC80 of the 100 subjects was detected by ELISA. Visceral and subcutaneous fat were derived from the other 36 female subjects, and Real-time PCR was used to detect CCDC80 mRNA expression in adipose tissues. Pearson correlation and multiple linear regression were used to analyze the correlation between serum or adipose CCDC80 expression and waist, BMI, and other biochemical indicators.</p><p><b>RESULTS</b>The age of 100 subjects was (52.9±8.4) years old. 44% of them were women (44 cases) and 56% of them were men (56 cases). After dividing them into three groups according to their BMI, covariance analysis were conducted, and age and gender were adjusted. The HDL-C level was significantly different among three groups (F = 10.73, P < 0.001): 'Overweight and obese combined with diabetes' group ((0.90±0.06) mmol/L)< 'Overweight and obese' group ((1.14±0.04) mmol/L) < 'Normal weight' group ((1.28±0.05) mmol/L). The adjusted expression of serum CCDC80 of the 100 subjects was (5.84±0.16) pg/ml, (5.81±0.98) pg/ml among men and (5.97±0.89) pg/ml among women, and there was no significant difference (t = -0.812, P = 0.419) between genders. ANOVA revealed that there was no significant differences of the expression of serum CCDC80 among three groups (F = 1.06, P = 0.351), 'Normal weight' group was (5.84±0.16) pg/ml, 'overweight and obese' group was (6.11±0.14) pg/ml, and 'Overweight and obese combined with diabetes' group was (5.84±0.19) pg/ml. The analysis showed that FBG had a negative correlation with serum CCDC80 (R(b) = -0.223, P = 0.026). Multivariate linear regression had a similar result, with 1 mmol/L increase of serum FBG, serum CCDC80 decreases for 0.24 pg/ml (β = -0.24, 95% CI: -0.21--0.02). There was also a negative correlation between serum CCDC80 and FBG in overweight and obese people (R(a) = -0.368, P = 0.013). Besides, CCDC80 mRNA was detected in both subcutaneous and visceral adipose tissue of 36 cases, the expression level was 0.06±0.02 for subcutaneous fat, was 0.05±0.04 for visceral fat, and the expression in visceral fat was lower (0.05±0.03) than that in subcutaneous fat (0.06±0.03) (t = 2.50, P = 0.025) among overweight and obese group. There was a negative correlation between waist and visceral CCDC80 mRNA expression (r = -0.472, P = 0.035).</p><p><b>CONCLUSION</b>This study suggested that CCDC80 may be involved in energy and insulin metabolism, and plays a protective role in obesity and diabetes.</p>

The effect and mechanism of microRNA in the invasion and metastasis of pancreatic cancer / 国际肿瘤学杂志

Evidence has shown that the abnormal expression of specific microRNAs (miRNAs) is associated with the occurrence,development and prognosis of pancreatic cancer,which is the potential target of forecast about invasion and metastasis of pancreatic cancer.There is close relation between miRNAs and biological characteristics of pancreatic cancer invasion and metastasis.Therefore,miRNAs are expected to become the new research targets of the mechanism of invasion and metastasis of pancreatic cancer.

The effect of perioperative enteral nutritional support for the liver cancer patients undergoing precise resection under fast track process model / 实用医学杂志

Objective To evaluate the effect of enteral nutritional support for the liver cancer patients with precise hepatetomy under fast track process model. Methods 82 patients were prospectively randomized into enteral nutrition group (n = 41) and parenteral nutrition (n = 41). The hemoglobin (HB), total protein (TP), albumin (ALB) and total lymphocyte count (TLC) were measured on 3 days before operation and 7 days after operation respectively. The two groups were compared in terms of time for anal exhaust and defecation after surgery , the postoperative hospital stay, the gastrointestinal adverse reactions and complications after surgery. Results The nutrition and immunity indicators on day 7 after operation were significantly poorer and lower than on day 3 before operation in the parenteral nutrition group (P0.05). Conclusion Enteral nutritional support under fast track process model for the liver cancer patients undergoing precise resection could improve clinical outcome.

Clinical application of anterior lumbar interbody fusion assisted with laparoscopic / 中华骨科杂志

ObjectiveTo evaluate the clinical outcomes of anterior lumbar discectomy and interbody fusion with cage under laparoscopic assistant.MethodsFrom January 2006 to June 2009,37 cases with degenerative low back pain were entered the study,including 22 males and 15 females with an average age of 43.7 years(range,16-55).The responsible discs were determined according to the three dimensional computed tomography of artery and vein angiography of anterior lumbosacral spine and discography,including L5S1 in 21 cases,L4-5 in 11,L3-4 in 2,L2-3 in 2,and L1-2 in 1.All cases underwent anterior lumbar discectomy and interbody fusion with cage under laparoscopic.ResultsThe operation time was 100 min in average (range,60-140),the blood loss was 120 ml in average(range,50-300).There was no case with severe complications of retrograde ejaculation and injury of great vessels or nerves.Delayed intestinal obstruction was discovered in two intraperitoneal route patients.The average follow-up time was 18.7 months(range,6-35).According to the back pain grading criteria of Chinese Medical Association Orthopedics Society of Spine Group,the results were excellent in 23 patients,good in 11,and fair in 3.The interbody fusion was obtained in 3 months later in 23 cases and 6 months later in 12 cases.Cage subsidence occurred in 2 cases in 6months after operation,in which the height loss of intervertebral space was 1.3 mm and 1.9 mm,but no obvious symptoms of discomfort.No fixation displacement or loosening occurred.ConclusionThe anterior discectomy and interbody fusion by internal fixation with laparoscopic technique is feasible with low complications rate,less trauma and shorter bedtime.Postoperative ileus by abdominal approach is relatively common.The surgeons experience and the anatomy of artery and vein of anterior lumbosacral spine should be considered before the choice of surgical approach.

STUDY OF REGULATING EFFECTS OF INTERLEUKIN-6 AND PIOGLITAZONE ON URB GENE EXPRESSION / 营养学报

Objective To observe the expression of novel URB gene in the differentiation display of 3T3-L1 preadipocytes and the effects of interleukin-6 (IL-6) and pioglitazone (PIO) on URB mRNA expression in 3T3-L1 adipocytes at different times. Method The 3T3-L1 adipocytes were treated with IL-6 and PIO under different concentration and different time phase, and real-time fluorescence monitoring RT-PCR was conducted to measure the URB mRNA level. Fat droplets were verified by oil red O staining. Results 1. URB mRNA level was increased gradually in the whole differentiation process. 2. The expression levels of URB mRNA was decreased along with the treatment of IL-6 in a dose-dependent manner in 3T3-L1 preadipocytes and adipocytes. 3. PIO increased the level of URB mRNA in 3T3-L1 adipocytes, and the reducing effect of IL-6 on URB mRNA could be corrected by PIO. Conclusion URB may be an important adipocytokin which affects energy metabolism and may work as a pharmacological gene target in the future.