Mechanism and prevention of structural valve degeneration and Bioprosthetic valve failure / 中华胸心血管外科杂志

Structural valve degeneration (SVD) and bioprosthetic valve failure (BVF) seriously limits the service life of biological valves. Exploring the molecular mechanism and pathological process of SVD and BVF is an important way to improve valve durability and prognosis of patients with biological valves replacement. In this review, we systematically summarized the definition, pathogenesis, related molecular pathways and prevention strategies of SVD and BVF. This review is expected to provide a theoretical basis for the study of the mechanism of SVD and BVF and the development of clinical intervention targets.

Strategies and ideas of comprehensive development and utilization of medicine and food homologous variety Phyllanthus emblica / 中国中药杂志

Phyllanthus emblica is a kind of traditional medicine and medicinal and edible plant, with rich variety resources and high development value. It is a key poverty alleviation variety in China at present. As P. emblica processing industry is rising gradually in recent years, in order to fully develop and utilize its industrial resources, this paper systematically introduces current comprehensive development and utilization of P. emblica, discusses the problems in P. emblica processing industry, and puts forward comprehensive development and utilization strategies and industrial models in terms of cultivation, breeding, grading, quality evaluation and waste recycling, so as to provide a certain reference for promoting the high-quality development of P. emblica industry in China.

Optimization and evaluation of intermediate uniformity in Chinese medicine pill powders based on particle design principle:exemplifying by Xiaojin Pills / 药学学报

Based on the principle of particle design, the powder of Xiaojin Pills was prepared, and the quality uniformity was investigated by means of powder characterizations and content uniformity. By studying the mixed crushing rules of the classified materials and the design principle of the powder particles of Chinese medicine, the powder of the Xiaojin Pills was prepared. At the same time, the manmade mixed powder and the control powder prepared by pharmacopoeia were prepared. The mixed homogeneity of the three powders was evaluated by particle size distribution and color difference. The GC-MS and LC-MS/MS were used to study the homogeneity of their contents. The best preparation process of particle design powder is:materials easily crushed are smashed for 50 min in the vibrating ultrafine mill with -15℃, then add the materials difficultly crushed into the mill and let them crushed together for 3 min. The particle size range of manmade mixed powder was the largest with the particle size difference being more than 100 microns, the RSD value being 26.07%. The particle size range was more than 50 microns in the powder prepared by pharmacopoeia, and the RSD was nearly 15%. The difference in particle size was only around 4 μm and the RSD value was 3.18%. The color difference test showed that the composite chromatism (dE*) value of the powder prepared by pharmacopoeia was the largest for the RSD was 84.56%. The RSD of manmade mixed powder and the powder prepared by Pharmacopeia were 53.83% and 32.83%, respectively. The RSD value of the particle designed powder's muscone content is about 50% of the other two kinds of powders. The contents of 10 components in powders were determined by LC-MS/MS. The RSD values of the particle designed powder were much smaller than other two kinds of powders. Results indicate that the uniformity of the particle designed powder is better than other two kinds of powders. Chinese medicine particle design technology can effectively improve the uniformity of traditional Chinese medicine powder.

A review on health inequ ality and related facot rs of the globa l elderly / 中国卫生政策研究

The rapidly aging population has attracted extensive attention to the health of elderly people .The elderly are a vulnerable group in society .Their adverse physical and mental health not only affects their own well-be-ing but also brings a heavy burden on families and society .Numerous studies have found that health inequality of the elderly is a problem throughout the world, and differences in gender, age, marital status, socioeconomic status, and social capital among the elderly are all contributing factors .This paper summarizes these factors through a literature review.We suggest that cross-sectional and longitudinal data should be combined and suitable indicators and mathe -matical models to Chinese conditions should be established in order to analyze the mechanisms of various factors and their effects on health inequality and serve as a reference for promoting the overall health of the elderly .

Effects of tyrosine kinase receptor B-brain-derived neurotrophic factor signal pathway on the secretion of vascular endothelial growth factor and matrix metalloproteinase-9 of neuroblastoma / 中国小儿急救医学

Objective To study the effects of tyrosine kinase receptor B-brain-derived neurotrophic factor (TrkB-BDNF) signal pathway on the secretion of vascular endothelial growth factor (VEGF) and matrix metalloproteinases-9(MMP-9) of neuroblastoma.Methods We used all-trans retinoic acid (ATRA) to induce the high expression of TrkB in the SH-SY5Y cell line,and then added the ectogenid BDNF to activate the TrkB-BDNF and its three downstream signal pathways.TrkB-BDNF signal pathway was inhibited by specific tyrosine kinase inhibitor K252a.The three downstream signal pathway was respectively inhibited by LY294002 (the phosphatidylinositol 3-hydroxy kinase (PI3 K) pathway inhibitor)、U73122 (the phospholipase C pathway inhibitor) 、U0126(the mitogen activated protein kinase pathway inhibitor).Enzyme linked immunosorbent assay was used to detect the concentration of VEGF and MMP-9 protein in the SY5Y cell culture supernatants.Results VEGF [(485.89 ± 109.99) pg/ml] and MMP-9 [(15.73 ± 1.72) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA + BDNF were significantly higher than that of the control group and ATRA alone group(P ＜0.05).VEGF [(272.42 ±86.33) pg/ml]and MMP-9 [(5.25 ± 1.44) pg/ml] protein levels in the group of ATRA + BDNF + K252a were significantly lower than those of the ATRA + BDNF group(P ＜ 0.05) and had no significant difference compared with the control group and the ATRA alone group(P ＞0.05).VEGF [(314.12 ±24.68) pg/ml] and MMP-9 [(4.91 ± 1.08) pg/ml] protein levels in the group of ATRA + BDNF + LY294002 were significantly lower than those of the ATRA + BDNF group(P ＜ 0.05) and had no significant difference compared with the control group and the ATRA alone group(P ＞0.05).VEGF [(444.08 ±64.49) pg/ml] and MMP-9 [(13.28 ±3.38) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA +BDNF + U73122 had no significant difference compared with the ATRA + BDNF group(P ＞ 0.05).VEGF [(429.97 ± 19.95) pg/ml] and MMP-9 [(13.96 ± 4.45) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA + BDNF + U0126 had no significant difference compared with the ATRA + BDNF group(P ＞ 0.05).Conclusion Activation of TrkB-BDNF signal pathway can increase the synthesis and secretion of VEGF and MMP-9 in human neuroblastoma cells.TrkB-BDNF signal pathway may be through activating its downstream PI3K pathway to increase the synthesis and secretion of VEGF and MMP-9 in human neuroblastoma cells.The synthesis and secretion of VEGF and MMP-9 can be inhibited by blocking the TrkB-BDNF signal pathway with K252a or blocking its downstream signal pathway PI3 K with LY294002.

Preliminary study for classification of spino-pelvic sagittal alignment in adult volunteers / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of the classification of the spino-pelvic sagittal alignment in adluts according to lumbar lordosis (LL) and inflection point (IP).</p><p><b>METHODS</b>Whole spine, standing radiographs of 223 adult volunteers were taken from July to August in 2011 .There were 111 cases(56 female and 55 male) enrolled in the study based on the inclusion criteria. The pelvic and spinal parameters, including thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), LL, sacral slope(SS), pelvic tilt(PT), pelvic incidence(PI), intervertebral endplate angle, sagittal vertical axis (SVA), spino-sacral angle (SSA) and IP were measured. The spino-pelvic sagittal alignment were classified in to 3 types according to LL and IP. Type I: LL > -40°, IP located below L2 ∼ 3; Type II: -60° ≤ LL ≤ -40°, IP located in L1 ∼ 2 or T12 ∼ L1; Type III: LL < -60°, P located above T11 ∼ 12. Pearson correlation analysis was used to test the correlation between the variables. The parameters in each type were compared by oneway-ANOVA respectively,then additional multiple comparisons were performed.</p><p><b>RESULTS</b>The mean value of LL was -49° ± 10°, TK was 36° ± 7°, TLK was 6° ± 7°, PT was 11° ± 7°, SS was 34° ± 8°, PI was 45° ± 9°, SSA was 127° ± 9° and SVA was (-2.7 ± 22.8)mm, respectively. Only LL had significant statistical correlation with all the other parameters. Negative correlation presented between LL and TK, PI, SS, SSA (r = -0.387, -0.536, -0.858, -0.801,P < 0.05). Positive correlation presented between LL and TLK, SVA, PT (r = 0.319, 0.296, 0.262, P < 0.05). All the volunteers were classified into the 3 types: Type I1 9 cases, Type II 75 cases,Type III 17 cases. Oneway-ANOVA results showed statistical difference in LL, TK, TLK, PT, SS, PI, SSA, SVA among the 3 types, (F = 164.559, 7.431, 14.099, 4.217, 53.856, 6.252, 35.995, 8.626, P < 0.05 ). Multiple comparisons showed that LL, SS, SSA, PI had statistical difference between each two types comparison (P < 0.05).</p><p><b>CONCLUSIONS</b>LL is the central parameter of the spino-pelvic sagittal balance. The patterns of the spino-pelvic sagittal alignment in adults could be classified into three types, according to LL and IP. The classification could describe the morphological differences and balance of the spino-pelvic sagittal alignment.</p>

Preliminary clinical results of endoscopic assisted anterior lumbar interbody fusion / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experiences of endoscopic assisted anterior lumbar interbody fusion (ALIF) with self-locking cage via retroperitoneal approach through small incision lateral to abdominal rectus.</p><p><b>METHODS</b>There were 47 cases of endoscopic assisted ALIF from April 2010 to April 2012 were reviewed retrospectively, including 28 male and 19 female patients whose age ranged from 39 to 65 years, averaged of (48 ± 11) years. Of 47 cases, 17 cases were founded instability in lumbar spine, 16 cases of discogenetic low back pain, 7 cases of degenerative spondylolithesis, and 7 cases of recurrent disc herniation. The level involved included 7 cases at L3-4 level, 33 cases at L4-5 level, 7 cases at L5-S1. X-ray and/or 3D CT scan were done in each patient at post-operative day 4, 1 month, 3 months, and 6 months. The height and angle of disc space, angle of lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were recorded and measured, as well as length of incision, operation time, blood loss, complications and ratio of bone graft fusion. The clinical outcomes were evaluated by Oswestry disability index (ODI) and visual analogue scale (VAS).</p><p><b>RESULTS</b>Average length of incision was (6.2 ± 0.8)cm (5.3-7.8 cm) , average blood loss was (81 ± 20)ml (50-150 ml) , mean operation time was (96 ± 10)minutes (65-122 minutes) . There were significant improvement of ODI(48% ± 10% vs. 14% ± 5%), the VAS of back pain(6.3 ± 1.1 vs.0.7 ± 0.7) and VAS of leg pain(3.4 ± 2.1 vs.0.6 ± 0.6) during preoperative and postoperation last follow-up (t = 20.78, 25.92 and 8.74, P = 0.000). The disc height of operative segments were all recovered significantly (F = 18.971, P = 0.000) postoperatively, from preoperative (10.3 ± 2.4)mm to postoperative (12.6 ± 2.1)mm. For complications, 5 cases had peritoneum tear, 19 cases had bone donor site pain, 14 cases had abdominal distension and 5 cases had lower limb paraesthesia, which were all treated with supportive managements. Bony intervertebral fusion was obtained in all cases in 6 months postoperatively.</p><p><b>CONCLUSIONS</b>The advantages of endoscopic assisted ALIF with self-locking cage via retroperitoneal approach are less damage, rapid recovery, and less blood loss. Comparing with traditional ALIF procedure, the view of operative field is also improved.</p>

Perinatal risk factors associated with neurobehavioral development of full-term small for gestational age newborn infants / 中国小儿急救医学

Objective To explore perinatal risk factors associated with the neurobehavioral development of small for gestational age (SGA) full-term neonates.Methods This prospective cross-sectional study included 111 full-term newborn infants from Apr 2008 to Apr 2010 born in Yan-tai Yuhuangding Hospital.Detailed clinical data in perinatal period of all subjects were recorded.Infants aged 3 ～ 7 days were assessed with neonatal behavioral neurological assessment (NBNA) for neurobehavioral development.Logistic regression analysis was used to explore risk factors associated with the score of NBNA.Results Significant differences (P ＜ 0.05) were found between full-term SGA (10.72 ± 1.41,7.13 ± 0.96,7.32 ± 0.74,37.16 ±1.32) and normal neonates (11.27 ± 1.04,7.89 ± 0.72,7.62 ± 0.64,39.12 ± 0.76) in terms of capacity,active and passive muscle tension and NBNA score.Full-term SGA neonates had lower score than control.Univariate logistic regression showed that delivery,placenta abnormalities,umbilical cord abnormalities,infection in perinatal period,gestational hypertension,twin pregnancy,hyperbilirubinemia affected neurobehavioral development of full-term SGA infants.Multivariate logistic regression showed that mothers' infection in perinatal period (OR =2.175,95 ％ CI 1.981 ～ 2.408,P ＜ 0.05),twin pregnancy (OR =1.936,95％ CI 1.517 ～2.368,P ＜ 0.05) and hyperbilirubinemia (OR =1.518,95％ CI 1.072-2.149,P ＜ 0.05) were risk factors for neurobehavioral delay of full-term SGA infants.Conclusion Full-term SGA neonates showed poorer quality in neurobehavior.Risk factors associated with neurobehavior of full-term SGA infants included mothers' infection in perinatal period,twin pregnancy and hyperbilirubinemia.

Influence of mesenchymal stem cell transplantation on stereotypic behavior and dopamine of Tourette syndrome rats / 中华行为医学与脑科学杂志

ObjectiveTo investigate the effect of mesenchymal stem cell transplantation on stereotypic behavior and level of dopamine of Tourette syndrome(TS) rats.MethodsWistar rats were randomly divided into three groups namely sham group (microinfused with normal sera),TS group (microinfused with TS sera)group and TS plus MSC transplantation group.Auto-immune TS rat model were established and MSC suspension labeled with BrdU was injected into the striatum of TS rats.DA were measured by high performance liquid chromatography and electrochemical detection.ResultsTS rats with MSC grafts exhibited significantly decreased stereotypic behaviors (7d:117.3 ±8.4,14d:94.8 ±7.9,28 d:78.8 ±7.4)and level of DA in striatum(7 d:(898.2 ± 143.2) ng/g,14d:(812.4 ±92.2)ng/g,28 d:(757.9 ± 82.4)ng/g) at 7,14 and 28 days after transplantation compared to model group( ( 129.3 ± 9.8,116.5 ± 8.5,106.8 ± 6.4 ; ( 1209.3 ± 182.3 ) ng/g,( 1033.5 ± 114.7 ) ng/g,(994.8 ±112.6) ng/g,P＜0.01).DA in plasma of TS rats with MSC grafts also decreased at 7 and 14 days(7 d:(530.2 ±86.2)ng/g vs (690.3±72.7) ng/g;14d:(562.4 ±64.2) ng/g vs (689.4±83.9) ng/g,P＜0.01).ConclusionsTransplantation of MSC could reduce stereotypic behaviors in TS rats and regulate the metabolism of DA.

The use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy.</p><p><b>METHODS</b>From April 2008 to March 2010, anterior cervical discectomy and fusion with self-locking cages were performed on 45 patients who suffered from multi-segmental cervical myelopathy, among of them there were 23 male and 22 female, aged from 32 to 67 years (average 53 years). Recording the Japanese Orthopedic Association (JOA) scores and SF-36 scores in the protocol time point, in order to investigate the clinical outcome, meanwhile, accumulating the pre-operation and postoperation X-ray films of cervical spine for measuring the height of intervertebral space, whole curvature of cervical spine and the rate of fusion by repeated measures analysis of variance.</p><p><b>RESULTS</b>The mean follow-up time was 28.4 months (24 - 35 months). JOA scores ascended from preoperative 6.5 ± 3.1 to postoperative 13.4 ± 1.7 (F = 17.84, P = 0.001), the 7 scores of SF-36 improved significantly after operation (t = 1.151 - 12.207, P < 0.05), but mental health not. The fineness rate was 91.1%. Height of disc space ascended from preoperative (5.5 ± 1.8) mm to postoperative (8.3 ± 0.8) mm (F = 11.71, P = 0.043), globle curvature of cervical spine ascended from preoperative 5° ± 7° to postoperative 10° ± 14° (F = 234.53, P = 0.000), the change of the two index was significantly, respectively. Fat necrosis in one case and hematoma in another case at the bone donor-site were found, both of the two cases were cured by physiotherapy. All of the 45 cases (111 segments) achieved bone fusion.</p><p><b>CONCLUSION</b>The use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy possess many advantages as follows: satisfactory clinical outcome, minimally invasive, higher fusion rate, higher orthopaedic ability.</p>

The application of cervical arthroplasty with Mobi-C for treatment of cervical spondylotic radiculopathy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effectiveness of cervical arthroplasty with Mobi-C prosthesis for treatment of cervical spondylotic radiculopathy.</p><p><b>METHODS</b>From March 2008 to November 2009, a group of 67 patients with cervical spondylotic radiculopathy were analyzed retrospectively. The short form-36 physical component summary (SF-36) and visual analogue scale (VAS) score were used to compare clinical outcome pre- and postoperatively. The follow-up was performed at 3 d, 3 months, 6 months and 1 year postoperatively. Static and dynamic radiography were taken to evaluate height of disc space, range of motion (ROM) and heterotopic ossification (HO) of index levels.</p><p><b>RESULTS</b>Fifty-one cases were followed up, 16 cases were lost. Average follow-up was for 19.7 months (13 - 31 months). All of patients had improvement for clinical symptoms. There was a significant difference on SF-36 between pre- and postoperatively. The significant difference was found in VAS score in which neck pain was decreased from preoperative 4.6 ± 0.4 to postoperative 2.0 ± 0.5 (P < 0.05), arm pain was decreased from preoperative 6.5 ± 0.4 to postoperative 1.3 ± 0.4 (P < 0.05). There was a significant difference in height of disc space which was increased from preoperative (6.5 ± 1.1) mm to (7.7 ± 0.9) mm (P < 0.05). ROM was increased from preoperative 7.2° ± 3.1° to latest follow-up 8.1° ± 3.2°, however, no significant difference was found concerning ROM pre- and postoperatively (P > 0.05). No other complications were met during follow-up period other than the 17 cases of heterotopic ossification in ClassI, the 7 cases in Class II in 1 year postoperatively, but no any correlation were found between the radiographic finding in HO and clinical symptoms.</p><p><b>CONCLUSIONS</b>Cervical arthroplasty with Mobi-C could improve neurofunctional symptoms, maintain ROM of index level and height of disc space. For accurate patient selection, long term follow-up is still needed in prospective randomized study.</p>

Severe sepsis as an initial presentation in children with Wernicke' s encephalopathy: report of a case and literature review / 中华儿科杂志

<p><b>OBJECTIVE</b>Wernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The disorder is still greatly underdiagnosed in children because of either a relatively non-specific clinical presentation in some cases or unrecognized clinical setting. The aim of this literature review was to provide knowledge of pediatric WE in an effort to assist in early diagnosis, thereby reducing the morbidity and mortality.</p><p><b>METHODS</b>The clinical manifestations, characteristic magnetic resonance imaging (MRI), diagnosis and treatment of one case and the other 35 cases reported in the last decade in children were summarized.</p><p><b>RESULTS</b>Thirty-six cases (22 boys and 14 girls, 2-month to 16-year-old) were analyzed. All the other 35 cases except for our case had underlying diseases: improper feeding in 25/35 cases, long-time vomiting in 5/35 cases, immunosuppressive therapy in 4/35 cases, long-time total parenteral nutrition without multivitamin preparations supplementation in 3/35 cases and anorexia nervosa in 1/35 case. The classic triad (mental-status changes, nystagmus and ophthalmoplegia, and ataxia) was seen in 6/36 cases. The other clinical manifestations included consciousness disturbance in 24/36 cases, infection in 22/36 cases, pathological reflex and muscular tension changes in 18/36 cases, convulsion in 17/36 cases, developmental delay in 4/36 cases and failure to thrive in 2/36 cases. Cerebrospinal fluid examination was performed in 31/36 cases, and a slightly raised protein concentration was seen in 7/31 cases. The cerebrospinal fluid lactate levels were detected in 4/36 cases (all increased), serum lactic acid levels in 7/36 cases (6/7 cases increased), serum pyruvate in 4/36 cases (all increased), thiamine pyrophosphate effect (TPPE) in 9/36 cases (all increased), and serum thiamine in 2/36 cases (increased in 1/2 cases). The brain computed tomography (CT) scan was conducted in 20/36 cases and 16/20 cases showed abnormal hypodensity in bilateral basal ganglia, one case revealed diffuse cortical atrophy. The brain MR scan was conducted in 13/36 cases and all the 13 cases revealed symmetrical abnormal signal in bilateral mamillary body and basal ganglia, and 7/13 cases showed abnormal signals in the tegmentum of midbrain, cerebral aqueduct and white matter around the third and fourth ventricles. The diagnosis of WE was confirmed by MR in 12 cases, triad combined with MR in 3 cases, autopsy in 1 case among the 13 cases who underwent MR scan. The diagnosis of WE was confirmed by the TPPE and/or lactate levels in 9/11 cases. The initial thiamine was given by intravenous or intramuscular infusion in 33/36 cases, unknown method in 1 case, orally in 1 case and no thiamine was used in 1 case. The dosage of thiamine was 100 mg daily in 29/35 cases, unknown in 3/35 cases, 50 mg daily in 2/35 cases, 600 mg daily in 1/35 case. 34/35 patients' clinical symptoms improved during 24 hours to 1 week after initial treatment, and 1 case died due to no response to thiamine. Nineteen patients were followed up for 2-2.5 months and 17 cases recovered completely.</p><p><b>CONCLUSION</b>Wernicke's encephalopathy can be difficult to diagnose because of a relatively non-specific clinical presentation. The characteristic MRI findings and the dramatic response of neurological signs to parenteral thiamine will assist early clinical diagnosis. Early and timely thiamine supplementation could reverse the clinical features and improve the prognosis in most cases.</p>

Effect of intravenous immunoglobulin on immunity and outcome for sepsis in children / 中国小儿急救医学

Objective To explore the effect of intravenous immunoglobulin (IVIG) on immunity and outcome for sepsis in children.Methods Eighty-four children who met the diagnosis of sepsis were included in study and divided into treatment group (36 cases) and control group (48 cases ).The patients in teatment group were administered IVIG with the dose of 1 g/kg.Peripheral venous blood samples of patients in both groups were collected before (0 h),24 h,72 h and 5 d after administration to detect the numbers of immunocyte including CD3 +,CD4 +,CD56 +,CD19 +,CD8 +cells by flow cytometry and the levels of cytokines including tumor necrosis factor (TNF)-at,interleukin (IL)-10,IL-1 7 by enzyme linked immunosorbent assay.The numbers of immunocyte and levels of cytokines and TNF-a/IL-10 were compared and the mortality at 28 days was assessed between two groups.Results The numbers of CD3 +,CD4 +,CD56 +,CD19 +cells and the levels of TNF-a,IL-17 and TNF-α/IL-10 of patients in teatment group were significantly decreased than those in control group at 24 h,72 h and 5 d afte administration ( P ＜0.05 ) and showed downtrend.However,the level of IL-10 increased significantly (P ＜ 0.05 ) and showed uptrend in treatment group.The number of CD8+ cells had no change.No difference of mortality was observed between two groups (27.7％,10/36 vs 16.6％,8/48,x2 =1.50,P =0.169,OR =1.92,95％ CI:0.671 ～5.510).Conclusion IVIG can suppress the immunity of children with sepsis and has no survival benefit.

Transplantation of bone marrow mesenchymal stem cells in rat model of Tourette syndrome / 中华行为医学与脑科学杂志

ObjectiveTo investigate the effect of mescenchymal stem cell (MSC) transplantation on Tourette syndrome(TS)model rats.MethodsStereotypies can be successfully induced in rats by intrastriatal microinfusion of TS sera.MSC suspension was bilaterally injected into the striatum.Survival and differentiation of transplanted MSC were tested through immunohistochemical analyses.ResultsFlow cytometry results demonstrated that the cells strongly expressed CD29(95.2％ ),CD105(97.2％ ),CD44(96.3％ ) and CD106 (94.1％).TS rats with MSC grafts exhibited significantly decreased stereotypic behaviors at 10 and 14 days(95.5 ±6.6,73.1 ± 6.5 vs.114.1 ± 6.0,108.0 ± 6.4).Immunohistochemistry analyses revealed survival of transplanted MSC and differentiation into neurons and astrocytes in the rat brain.ConclusionIntrastriatal transplantation of human MSC can provide therapeutic potential for TS.

Effects of intrastriatal microinfusion of sera of patients with Tourette syndrome on stereotypic behaviors in rats / 中国心理卫生杂志

Objective:To establish animal model on the basis of the autoimmune etiology for a subset of cases of Tourette syndrome.Methods:Blood samples were drawn from patients with TS(by DSM-IV)and were sent for further enzyme-linked immunosorbent assays(ELISA)to a laboratory.Eight serum samples with the highest concentration of anti-neural antibody were selected for TS model group,and 8 serum sampled with the lowest concentration of anti-neural antibody were selected for the control group.Osmotic mini pump filled with undiluted TS or control serum were microinfused into the rat striatum at a rate of 0.5 μl /h for 72 h.Stereotypic movements were recorded at 1 d,7 d,14 d and 21 d after microinfusion.Several categories of stereotypy including bites(teeth touching the cage,wood chips,vacuous chewing or other objects except the body),taffy pulling(raises of the forepaw to the mouth and face),self-gnawing,licking not associated with grooming,grooming,head shaking,paw shaking,rearing and episodic utterances(EU)were recorded.Results:The anti-neural antibody serum concentration used for TS model was(0.29±0.06) U/L,and that used in control group was (0.10±0.04) U/L.After infusion of TS sera,stereotypic behaviors in rats was increased significantly[(37.2±7.1) vs.(106.3±11.7),P=0.000].Significant difference were observed in stereotypies scores of TS rats compared to control rats after microinfusion[(106.3±11.7) vs.(31.2±6.2),P=0.000].Conclusion:Stereotypic behaviors are increased in rats after intrastriatal microinfusion of Tourette Syndrome sera under noninflammatory conditions.

Analysis on predictive factors of survival to in-hospital children with post-cardiorespiratory arrest / 中国小儿急救医学

Objective To identify predictive factors of survival to in-hospital children with post-cardiorespiratory arrest.Methods Eighty-seven patients who had cardiorespiratory arrest(CRA)and received cardiopulmonary resuscitation(CPR)were reviewed from January 2006 to December 2008.The clinical data was analyzed to identify predictive factors of survival by Pearson X~2 test and multivariate and unconditioned Logistic regression analysis.Results Forty-three of eighty-seven cases received return of spontaneous circulation,the initial sunvival rate was 48.3%,31(35.6%)cases survived for 24 hours,19(21.8%)cases survived to hospital discharge.Primary diseases and complications,the type of arrest,tracheal intubation or not,the duration of CPR,the dose of adrenaline,the body temperature post-resuscitation for 24 hours,the glucose post resuscitation for 6 hours and complications were obviously associated with both initial and long-term survival.Logistic regression analysis revealed that primary diseases and the duration of CPR were predictive factors of both survival for 24 hours and hospital discharge,additionally,the body temperature post-resuscitation for 24 hours were predictive factor of survival to hospital discharge.Conclusion Initial and long-term survival rate of in-hospital children with post-resuscitation was both low.Primary diseases and complications,good quality CPR and management of post-resuscitation affect survival,especially primary diseases and the duration of CPR may predict initial survival and primary diseases,the duration of CPR and the body temperature post-resuscitation for 24 hours may predict long-term survival.

Unilateral pedicle screw fixation plus interbody fusion by Quadrant system through spatium intermuscular of multifidus / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical outcome of unilateral pedicle screw fixation plus single cage interbody fusion through spatium intermuscular of multifidus by Quadrant system.</p><p><b>METHODS</b>From April 2008 to April 2009, 47 patients underwent unilateral pedicle screw fixation plus single cage interbody fusion through spatium intermuscular of multifidus. There were 22 males and 25 females with the mean age of 58.2 years (range, 46-74 years). Among them 12 cases had far-lateral lumbar disc herniation, 7 cases had post-discectomy recurrence, and 28 cases had degenerative instability. Thirty-seven cases were treated with lumbar interbody fusion through transforaminal approach, 10 cases through posterior approach. After surgery, the radiography was carried out to demonstrate the fusion status, and the Nakai criterion was used for assessment.</p><p><b>RESULTS</b>The average skin incision length was 3.2 cm (range, 3.0 to 3.5 cm), the average operative time was 90 min (range, 70 to 160 min), and the average blood loss was 130 ml (range, 90 to 360 ml). All cases were followed up for 8 - 20 months (average 13.6 months). Postoperative radiography showed no evidence of instrument failure, and 43 cases got bone fusion, 4 cases got suspicious fusion. At final followed-up the average leg pain VAS decreased from 7.4 ± 1.1 preoperatively to 2.4 ± 1.3 postoperatively, the average low back pain VAS decreased from 6.7 ± 1.3 preoperatively to 1.8 ± 1.5 postoperatively. According to Nakai criterion, 31 cases were rated as excellent, 11 cases as good, and 5 cases as fair with the total excellent and good rate of 89.4%.</p><p><b>CONCLUSIONS</b>Unilateral pedicle screw fixation plus single cage interbody fusion through spatium intermuscular of multifidus has some advantages of minimal invasiveness, less blood loss, less complications and reliable curative effect. It is a satisfactory lumbar fusion method under suitable indication.</p>

Effects of gingival fibroblasts transfected with human transform growth factor-beta1 gene on improving the periodontal tissue regeneration / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of gingival fibroblasts (GF) transfected with hTGF-beta1 gene on improving the periodontal tissue regeneration for the repair of degree II artificial furcation defects.</p><p><b>METHODS</b>The gingival fibroblasts transfected with hTGF-beta1 gene was compounded to the cuttlebone-transformed nanometer hydroxyapatite (CBHA) material from the cuttlefish in vitro, the degree II furcation defects on the premolars of dogs were produced surgically, and the compound was to implanted into the defect (transfected group), and compared with the compound of periodontal ligament cells (PDLC) with nanometer HA material and the compound of untransfected GF with HA. The results were examined histologically 8 weeks after operation.</p><p><b>RESULTS</b>In the transfected group and the positive control group, more new attachment was found compared with the negative control (P < 0.01), and the NC, NB and NC of the transfected group and the positive control group were: (2.97 +/- 0.50), (4.29 +/- 0.26) and (4.73 +/- 0.06) mm; (3.09 +/- 0.26), (4.46 +/- 0.25) and (4.69 +/- 0.10) mm, respectively. There was no significant difference between the two groups (P > 0.05). Although the alveolar bone regeneration was found in the untransfected group [NB = (3.46 +/- 0.32) mm], the root resorption was observed. The tracing experiment showed that the transfected GF were found in the new alveolar bone and the periodontal membrane.</p><p><b>CONCLUSIONS</b>GF transfected with hTGF-beta1 gene can significantly improve the periodontal tissue regeneration in treatment of degree II furcation defects and is involved in the formation of the new alveolar bone and the new periodontal membrane.</p>

Influence of transfection with human transforming growth factor-beta1 gene on the osteogenic potential of the cultured human gingival fibroblast / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the influence of transfection with human transforming growth factor-beta1 (hTGF-beta1) gene on the osteogenic potential and differentiation of the cultured human gingival fibroblast (GF).</p><p><b>METHODS</b>Enzyme kinetics method was used to measure the effects of the transfection on the alkaline phosphatase (ALP) activity. Immunohistochemistry stain and image analysis were applied to evaluate the alteration of the content of osteopontin (OPN), bone sialoprotein (BSP), osteonectin (ON), osteocalcin (OC) in the GF with transfection. Mineralization nodules formation in vitro was also used.</p><p><b>RESULTS</b>The ALP activity of the GF after transfection was higher than the GF without transfection significantly (P<0.05), and was close to that of the PDLCs (P>0.05). The content of OC in GF was not improved after transfection, was similar with that of PDLCs (P>0.05). Under immunohistochemistry stain, the contents of OPN, ON, BSP expressed in GF with transfection were higher than those of GF without transfection (P<0.05), but similar to those of PDLCs (P>0.05). In the mineralized cultured medium, the nodules were observed in the GF with transfection and PDLCs after 21 days and 24 days alternatively. After von Kossa stain, purple mineralization nodules were observed.</p><p><b>CONCLUSION</b>The GF transfected with pcDNA3-hTGF-beta1 could express some osteogenic characters, though these characters are restricted.</p>

Treatment of lumbar intervertebral disc protrusion and remaining bulk ligamentum flava by micro-endoscope / 中国骨伤

<p><b>OBJECTIVE</b>To investigate operative skill and recent clinical effects of remaining bulk ligamentum flava and treatment of lumbar intervertebral disc protrusion by micro-endoscope.</p><p><b>METHODS</b>Fifty-two cases with lumbar intervertebral disc protrusion included 31 males, 21 females; aged from 28 to 45 years,mean 36 years; L(4,5) in 24 cases, L5S1 in 28 cases. Under the micro-endoscope, all patient were excised the vertebral plate partly, decompressed the nerve root, remaining bulk ligament flava and excised the herniated nucleus pulposus.</p><p><b>RESULTS</b>Forty-six of 52 patients were followed up for 5 to 51 months with an average of 34.5. According to the effect of Nakai standards,the results were excellent in 34 cases, good in 9 cases, fair in 3 cases. The operation time was 45 to 75 minutes and bleeding was 40 to 80 ml. There were no nerve root injury and endorachis tear complications.</p><p><b>CONCLUSION</b>The bulk ligamentum flava remaining cure intervertebral disc protrusion by micro-endoscope, demic natural anatomic structure is retained through technically manipulate and spinalis constancy is kept.</p>