Research progress in therapy drug monitoring of levetiracetam / 中国药房

Levetiracetam （LEV） is the second generation of broad-spectrum anti-epileptic drug. LEV has the advantages of rapid absorption， short half-life， precise efficacy， good tolerance and few drug interactions. In order to improve the clinical efficacy of LEV， and reduce the occurrence of adverse reactions， children， pregnant women， the elderly， and patients with renal insufficiency should receive therapeutic drug monitoring （TDM）. Clinically， the samples are usually plasma or serum， and the TDM methods are mostly immunoassay or chromatography. There is currently no consensus on the effective concentration range of LEV， and the correlation between plasma concentration and adverse reactions is also unclear. The main factors affecting LEV plasma concentration include age， pregnancy， and patient compliance. How to interpret TDM results and adjust dosage based on the results will be the focus of future work.

Characteristics of the Distance and Space Required for Knife Slashing Using a Motion Capture System / 法医学杂志

OBJECTIVES@#To investigate the relationship between the perpetrator's sex, victim's position and slashing location as well as anthropometric parameters on distance and space required for slashing, to provide the theoretical basis for the judgment of whether the crime scene was consistent with the criminal activity space.@*METHODS@#The kinematics data of 12 male and 12 female subjects slashing the neck of standing and supine mannequins as well as the chest of the standing mannequins with a kitchen knife were obtained by using a 3D motion capture system. The relationship between the perpetrator's sex-victim's position, the perpetrator's sex-slashing location, and anthropometric parameters and the distance and space required for the slashing were analyzed by two-factor repeated measures ANOVA and Pearson correlation analysis respectively.@*RESULTS@#Compared with slashing the neck of supine mannequins, the distance (L) and normalized L (l) of slashing the neck of standing mannequins were greater, while vertical distance (LVR) and normalized LVR (lVR) of the knife side were smaller. Compared with slashing the neck of standing mannequins, the L and l slashing the chest of standing mannequins were greater, while LVR and lVR were smaller. Horizontal distance (LHR) and normalized LHR (lHR) of the knife side in males were greater than that in females. Height and arm length were positively correlated with L, LHR, and LVR when striking the standing mannequins.@*CONCLUSIONS@#When slashing the neck of supine or standing victims, the slashing distance is shorter and the slashing height is greater. Furthermore, the distance and space required for slashing are correlate with anthropometric parameters.

ToxR represses the synthesis of c-di-GMP in Vibrio parahaemolyticus / 生物工程学报

Vibrio parahaemolyticus, the main pathogen causing seafood related food poisoning worldwide, has strong biofilm formation ability. ToxR is a membrane binding regulatory protein, which has regulatory effect on biofilm formation of V. parahaemolyticus, but the specific mechanism has not been reported. c-di-GMP is an important second messenger in bacteria and is involved in regulating a variety of bacterial behaviors including biofilm formation. In this study, we investigated the regulation of ToxR on c-di-GMP metabolism in V. parahaemolyticus. Intracellular c-di-GMP in the wild type (WT) and toxR mutant (ΔtoxR) strains were extracted by ultrasonication, and the concentrations of c-di-GMP were then determined by enzyme linked immunosorbent assay (ELISA). Three c-di-GMP metabolism-related genes scrA, scrG and vpa0198 were selected as the target genes. Quantitative real-time PCR (q-PCR) was employed to calculate the transcriptional variation of each target gene between WT and ΔtoxR strains. The regulatory DNA region of each target gene was cloned into the pHR309 plasmid harboring a promoterless lacZ gene. The recombinant plasmid was subsequently transferred into WT and ΔtoxR strains to detect the β-galactosidase activity in the cellular extracts. The recombinant lacZ plasmid containing each of the target gene was also transferred into E. coli 100λpir strain harboring the pBAD33 plasmid or the recombinant pBAD33-toxR to test whether ToxR could regulate the expression of the target gene in a heterologous host. The regulatory DNA region of each target gene was amplified by PCR, and the over-expressed His-ToxR was purified. The electrophoretic mobility shift assay (EMSA) was applied to verify whether His-ToxR directly bound to the target promoter region. ELISA results showed that the intracellular c-di-GMP level significantly enhanced in ΔtoxR strain relative to that in WT strain, suggesting that ToxR inhibited the production of c-di-GMP in V. parahaemolyticus. qPCR results showed that the mRNA levels of scrA, scrG and vpa0198 significantly increased in ΔtoxR strain relative to those in WT strain, suggesting that ToxR repressed the transcription of scrA, scrG and vpa0198. lacZ fusion assay showed that ToxR was able to repress the promoter activities of scrA, scrG and vpa0198 in both V. parahaemolyticus and E. coli 100λpir. EMSA results showed that His-ToxR was able to bind to the regulatory DNA regions of scrA and scrG, but not to the regulatory DNA region of vpa0198. In conclusion, ToxR inhibited the production of c-di-GMP in V. parahaemolyticus via directly regulating the transcription of enzyme genes associated with c-di-GMP metabolism, which would be beneficial for V. parahaemolyticus to precisely control bacterial behaviors including biofilm formation.

Reciprocal Regulation between Fur and Two RyhB Homologs in / 生物医学与环境科学（英文）

Objective@#To investigate reciprocal regulation between Fur and two RyhB homologs in @*Methods@#Regulatory relationships were assessed by a combination of colony morphology assay, primer extension, electrophoretic mobility shift assay and DNase I footprinting.@*Results@#Fur bound to the promoter-proximal DNA regions of @*Conclusion@#Fur and the two RyhB homologs exert negative reciprocal regulation, and RyhB homologs have a positive regulatory effect on biofilm formation in

Arsenic Trioxide Combining Leflunomide Activates Nrf2-ARE-HO-1 Signaling Pathway and Protects Heart Xenografts / 中国结合医学杂志

OBJECTIVE@#To investigate the molecular mechanisms underlying the effects of arsenic trioxide (As@*METHODS@#Transplantation of LVG hamster hearts to Lewis rats was performed by anastomosis of vessels in the neck using end-to-end anastomosis with a non-suture cuff technique. Four groups of recipient rats (n=6 in each) were treated with normal saline (control), As@*RESULTS@#Expression of Nrf2-ARE-HO-1 signaling pathway was upregulated in heart xenografts in rats treated with As@*CONCLUSION@#Combination treatment with As

Effect of early acupoint electrical stimulation on lower limb muscle strength in patients with septic shock / 中国针灸

OBJECTIVE@#To observe the effect of early acupoint electrical stimulation on the decline of lower limbs muscle strength in patients with intensive care unit-acquired weakness (ICU-AW) caused by septic shock.@*METHODS@#A total of 58 patients with ICU-AW caused by septic shock were randomly divided into an observation group (28 cases, 1 case dropped off ) and a control group (30 cases, 2 cases dropped off ). Patients in both groups received routine basic treatment. In the observation group, acupoint electric stimulation therapy was added at Huantiao (GB 30), Futu (ST 32), Zusanli (ST 36), Xuanzhong (GB 39) and Taichong (LR 3). Unilateral point with electrodes were applied, the SDZ-Ⅱ electronic instrument (discontinuous wave, frequency in 2 Hz, strength in 5 mA) was connected and changed to the other side after 30 min of unilateral treatment.The treatment was given 2 times daily, continued for 7 d or until the medical research council (MRC) score being 54 points or more. The changes of lower limb muscle strength MRC score, modified Rankin scale (MRS) score, bilateral quadriceps thickness and gastrocnemius pinnate angle of both groups were observed before treatment and on discharge. The time of admission to ICU, time of hospitalization, mortality during hospitalization, and mortality 28 d after discharge were compared between the two groups. The MRS scores of the two groups were followed up 28 d after discharge.@*RESULTS@#The MRC scores of lower limb muscle strength in the two groups on discharge were higher than those before treatment (@*CONCLUSION@#Early acupoint electrical stimulation can improve the lower extremity muscle decline in patients with ICU-AW caused by septic shock.

Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw for the treatment of acute type I transverse ligament injury in school-age children / 中国骨伤

OBJECTIVE@#To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children.@*METHODS@#From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Two of them were accompanied by nerve compression and ASIA grade D. The preoperative C₁,₂ angle averaged 20.7° to 23.4°. All patients received cranial traction and surgical treatment after complete reduction or atlantoaxial reduction. The changes of Japanese Orthopaedic Association(JOA) score, space available for the cord(SAC), neck disability index(NDI), ADI, ASIA classification(ASIA) injury classification(1992) and C₁,₂ angle before and after treatment were observed.@*RESULTS@#The average follow-up time was 8 to 156 months. Clinical and radiological follow-up showed that the atlantoaxial joint was completely relieved, the reduction was satisfactory and the arthrodesis was stable. Nerve and vascular injuries associated with this technique were not observed. JOA score, SAC, NDI, C₁,₂ angle of the last follow-up of the children were significantly improved. Two children of ASIA grade D recovered to grade E.@*CONCLUSIONS@#Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft is simple, less bleeding, strong stability and high fusion rate. It is an ideal surgical procedure for acute type I transverse ligament injury with atlantoaxial dislocation in school-age children.

Type Ⅱ odontoid fractures in the elderly: surgical or conservative method? / 中国组织工程研究

BACKGROUND: Upper cervical spine fractures are easy to lead to severe neurologic dysfunction in the elderly, and along with social progress, the incidence is on the rise. However, the diagnosis and treatment of type Ⅱ odontoid fractures in senile patients remain controversial.OBJECTIVE: To review the classification, treatment methods and clinical outcomes of type Ⅱ odontoid fractures in elderly patients.METHODS: A computer-based online search was performed in the PubMed and Wanfang databases for the articles concerning the diagnosis and treatment of type Ⅱ odontoid fractures in the elderly published from January 1996 to July 2016. The keywords were odontoid fracture, elderly, treatment, conservative, surgical in English and Chinese,respectively.RESULTS AND CONCLUSION: (1) The treatment goals of type Ⅱ odontoid fractures are different between elderly and young patients. (2) The incidence of nonunion in the conservative approach is higher than that in the surgical treatment, but for elderly patients, it makes no difference. (3) No significant differences are found in the incidence of complications and mortality between conservative and surgical methods in the elderly with type Ⅱ odontoid fractures. (4) Minimally invasive surgery is commended for the elderly suffering type Ⅱ fractures who cannot tolerate the conservative approach due to poor conditions or accompanied with other serious heart and lung diseases.

Finite-element analysis of a novel posterior atlantoaxial restricted non-fusion fixation system / 中国组织工程研究

BACKGROUND:Atlantoaxial fusion is currently the main surgical treatment of atlantoaxial dislocation, but the premise is at the expense of atlantoaxial range of motion, especial y the rotation motion. Restricted non-fusion fixation is a method that can maintain the atlantoaxial stability, while retain the atlantoaxial range of motion. Further research should be performed to compare the biomechanical characteristics between the two methods. OBJECTIVE:To develop a three-dimensional finite element model of atlantoaxial instability, compare and determine the biomechanical properties of posterior atlantoaxial restricted non-fusion fixation system and posterior atlantoaxial screw-rod fixation system. METHODS:A verified intact finite element upper cervical (C0-C3) model was established and analyzed by Simpleware 3.0, Geomagic 8.0, Hypermesh 10.0, Abaqus 6.9, and Rhino 4.0 softwares based on the CT data col ected from a 31-year-old healthy male volunteer. The moment couple of 1.5 N?m was loaded, which made the model movement in flexion-extension, lateral bending, and rotating direction, respectively. The range of motion was recorded and compared with the in vitro biomechanical experimental data to verify the effectiveness of the model. The ranges of motion of the posterior atlantoaxial restricted non-fusion fixation system model and the posterior atlantoaxial screw-rod fixation system model were analyzed using the finite element method under flexion, extension, lateral bending, and axial rotation;meanwhile, stress nephograms of the posterior atlantoaxial restricted non-fusion fixation system model were observed. RESULTS AND CONCLUSION:(1) There were 206 747 elements and 72 500 nodes in the intact model of upper cervical spine (C0-C3) in this experiment, and the range of motion of intact model validated with the reported cadaveric experimental data. (2) The range of motion of the posterior atlantoaxial restricted non-fusion fixation system group was similar to which of the posterior atlantoaxial screw-rod fixation system group in flexion-extension direction. (3) In lateral bending direction, the range of motion of the posterior atlantoaxial restricted non-fusion fixation system model was obviously limited, respectively. The range of motion of the posterior atlantoaxial restricted non-fusion fixation system model was larger than that of the atlantoaxial dislocation model and basical y same as that of the normal atlantoaxial model. (4) As to the rotating direction, the range of motion of the posterior atlantoaxial restricted non-fusion fixation system mainly disappeared at the atlantoaxial segment;by contrast, a majority of rotating motion was stil retained in the posterior atlantoaxial restricted non-fusion fixation system group. (5) The stress concentration occurred in the contact part between the screw and the connecting rod in posterior atlantoaxial restricted non-fusion fixation system model. (6) Results suggest that posterior atlantoaxial restricted non-fusion fixation system is effective and useful for atlantoaxial fixation. It not only restricted atlantoaxial flexion-extension, but also preserved axial rotation and lateral bending at the atlantoaxial joint.

Diagnosis and treatment for intrathoracic gastroesophageal anastomotic leak: investigation of a new mode / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of a new mode to diagnose and treat intrathoracic gastroesophageal anastomotic leak.</p><p><b>METHODS</b>From January 2007 to December 2014, fifty-five patients were confirmed intrathoracic gastroesophageal anastomotic leak among those were performed surgical operation due to esophageal or cardiac carcinoma in the First Affiliated Hospital of Soochow University. To retrospectively analyze the clinical data of these patients, thirty-six male and nineteen female were included with the ages from 49 to 81 years (average age of (67±6)years). Among them, forty-two were middle esophageal carcinoma, eleven were lower esophageal carcinoma and two were cardiac carcinoma. According to the differences of diagnosis and treatment methods for anastomotic leak, fifty-five patients were divided into two groups. Thirty-one patients distributed from January 2007 to November 2011 were received conventional management (conventional group): to definitively diagnose by contrast swallow when suspected to be developing anastomotic leaks, to place an esophageal stent when the drainage was sufficient and the infection was controlled. Twenty-four patients distributed from March 2011 to December 2014 were received new-mode management (new-mode group): to perform a anastomotic radioscopy under digital subtraction angiography -guidance instantly when suspected anastomotic leak and find out the fistula, search the shape and size, place a drainage tube into the fistula to drain or lavage the vomica according to the exploration results, pull back the tube gradually and close the leak by clips under endoscope later. The pathoclinical features, the confirmation time (time from clinical signs emergence to leak confirmation), the hospital duration after confirmation, the incidence of severe complications and total mortality were compared between the two groups by t-test and χ(2) test or Fisher's exact test.</p><p><b>RESULTS</b>There was no significant statistical differences in pathoclinical features between two groups (P>0.05). The confirmation time was significantly reduced in new-mode group than that in conventional group ((1.2±0.8) d vs. (3.6±2.2) d, t=5.212, P=0.000), and so was the hospital duration after confirmation ((26±12) d vs. (55±25) d, t=4.992, P=0.000) and the incidence of severe complications (16.7% vs. 48.4%, χ(2)=6.019, P=0.014), although there was no statistical differences in total mortality (4.2% vs. 22.6%, P=0.119).</p><p><b>CONCLUSION</b>The new mode of early interventional diagnosis, early fistula drainage through nose and clipping under endoscope later is able to shorten diagnosis and treatment period, reduce incidence of severe complications.</p>

Circulating microRNAs as potential biomarkers for diagnosis of congenital heart defects / 世界急诊医学杂志（英文）

@#BACKGROUND: MicroRNAs are small non-coding RNAs of approximately 22 nucleotides in length, and play important regulatory roles in normal heart development and the pathogenesis of heart diseases. Recently, a few prospective studies have implicated the diagnostic role of microRNAs in congenital heart defects (CHD). DATA RESOURCES: This review retrieved the research articles in PubMed focusing on the altered microRNAs in cardiac tissue or serum of patients with CHD versus healthy normal controls, as well as the studies exploring circulating microRNAs as potential biomarkers for (fetal) CHD. RESULTS: Most of the studies of interest were conducted in recent years, implicating that the topic in this review is a newly emerging field and is drawing much attention. Moreover, a number of differentially expressed microRNAs between CHD specimens and normal controls have been reported. CONCLUSION: Circulating microRNAs may serve as potential biomarkers for diagnosis of CHD in the future, with more efforts paving the road to the aim.

Intraoperative reduction and internal fixation for atlanto-axial dislocation / 中华创伤骨科杂志

Atlanto-axial complex is the most important functional unit of the cervical spine.Atlanto-axial instability or dislocation,one of the most serious pathologies in spinal surgery,is often managed by posterior atlantoaxial fixation and fusion.Several posterior fixation techniques have been used to stabilize the atlanto-axial complex,including wire/cable-bone fixation,Halifax clamps,transarticular screw fixation,screw-plate fixation and screw-rod fixation.For atlanto-axial dislocation that cannot be reduced with skull traction before operation,intraoperative reduction is often needed.Current intraoperative reduction techniques can be classified into transoropharyngeal surgical release followed by posterior reduction and fixation,transoropharyngeal reduction and fixation,and posterior reduction and fixation using screw-rod system according to approaches.Furthermore,posterior reduction can be performed using elevating-pull,leverages,and cantilever techniques.This study reviews the intraoperative reduction and fixation techniques mentioned above.

A study on the mechanism of Gal - 1 promote gastric cancer cell migration and invasion by up - regulating MMP - 9 / 预防医学

Objective To explore the possible mechanisms of Galectin - 1(Gal - 1)protein in promoting the invasion and migration of gastric cancer cells. Methods After treated with different concentrations(0,1,5 μg/ mL)of Gal - 1 protein, the Trans - well model was used to analyze the invasion and migration ability of gastric cancer. WB and gelatin zymography method were used to detect the MMP - 9 expression and active form change in gastric cancer cells after Gal - 1 stimulate, in order to explore the possible molecular mechanisms of Gal - 1 protein in promoting the invasion and migration of gastric cancer cells. Results In cell migration assay,the number of gastric cancer cells BGC - 823 treated with 1and 5 μg/ mL Gal - 1 stimulate were 117 ± 8. 19 and 167 ± 7. 55,higher than that treated with 0 μg/ mL(P < 0. 05). The number of gastric cancer cells 7 901 treated with 1and 5 μg/ mL Gal - 1 stimulate were 151 ± 5. 13 and 190. 3 ± 6. 8,higher than that treated with 0 μg/ mL(P < 0. 05). In cell invasion assay,the number of gastric cancer cells BGC - 823 treated with 1and 5μg/ mL Gal - 1 stimulate were 51 ± 3. 6 and 76. 7 ± 9. 07,higher than that treated with 0 μg/ mL(P < 0. 05). The number of gastric cancer cells 7 901 treated with 1and 5 μg/ mL Gal - 1 stimulate were 74. 0 ± 7. 21 and 105. 3 ± 11. 37,higher than that treated with 0 μg/ mL(P < 0. 05). The migration and invasion level were significantly increased in gastric cancer cells after Gal - 1 stimulate. The MMP - 9 expression level and active form change in gastric cancer cells were also increased after Gal - 1 stimulate. Conclusion Gal - 1cound significantly promote gastric cancer cell migration and invasion by up - regulated the MMP - 9 expression and active its enzyme activity.

Regulation of motility of Salmonella enterica serovar Typhi by QseBC / 军事医学

Objective To study the impact of QseBC on the motility of Salmonella enterica serovar Typhi ( S.Typhi ) . Methods The motility of wild-type ( WT) and null mutants (ΔqseB and ΔqseC) at mid-log phase was investigated by swimming assay.Quantitative RT-PCR was carried out to calculate the transcriptional variation of flhD and qseB among WT,ΔqseB andΔqseC.QseB overexpressing strain was constructed to compare its motility and flhD expression with the wild-type control.Results The result of motility assay showed that the motility of ΔqseB was similar to that of the WT strain , while the motility of ΔqseC was much lower than that of WT .qRT-PCR revealed that compared with WT , the expression of flhD was significantly decreased in ΔqseC while the expression of qseB was increased considerably .The motility of QseB overex-pressing strain was lower .Conclusion The expression of flhD may be regulated by QseBC which has an effect on the motil-ity of S.typhi, and the overexpression of QseB may inhibit the motility .

A prospective randomized control study about indication of chest tube removal following a VATS lobectomy / 中华胸心血管外科杂志

Objective This study assesses a feasible and safe volume threshold for chest tube removal following a VATS lobectomy.Methods The study included 168 consecutive patients who underwent VATS lobectomy or bilobectomy with two insicion between August 2012 and February 2014.Eligible patients were randomized into 3 groups:Group A (chest tube removal at the drainage volume of 150 ml/d or less.n =49) ; Group B (chest tube was removed when the drainage volume was less than 300 ml/d.n =50) ; Group C(chest tube removal when the drainage was less than 450 ml/d.n =51).And there were 18 patients who were excluded.All patients got the same postoperative care with a clinical pathway,and all patients were followedup 7 days after discharge from hospital.The time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic,incidence of complications and thoracocentesis were measured.Results There were no statistically significant differences among 3 groups with general information and incidence of complication (P ＞ 0.05).And there were statistically significant differences between Group A and Group B with the time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic(P ＜ 0.05).But there were no statistically significant differences between Group A and Group B with incidence of thoracocentesis(P ＞0.05).Analysis of data showed no statistically significant differences between Group B and Group C with postoperative hospital stay,postoperative VAS values and dosage of analgesic (P ＞ 0.05),but there were statistically significant differences for incidence of thoracocentesis (P ＜ 0.05).Conclusion A 300 ml/d volume threshold for chest tube removoal after VATS lobectomy is feasible and safe,and it can bring more advantages than the 150 ml/d volume threshold.On the other hand,a 450 ml/d volume threshold for chest tube removoal after VATS lobectomy may increase the risk of thoracocentesis.

Design and biomechanical evaluation of atlantoaxial lateral mass fusion cage / 中华骨科杂志

Objective To design an atlantoaxial lateral mass fusion cage and evaluate its biomechanical stability when it is combined with atlantoaxial vertebral pedicle screw fixation.Methods Forty-six sets of CT 3D reconstruction pieces of the normal atlantoaxial junction were chosen to measure sagittal diameter and transverse diameter of atlantoaxial lateral mass joint,sagittal diameter and transverse diameter of epistropheus lateral mass and space height of atlantoaxial lateral mass joint.An atlantoaxial lateral mass fusion cage was designed on this basis.Six fresh human cadaveric cervical spines (C0-C4) were used as samples to measure 3D motion range of C1,and 2 segments under 1.5 N · m load.3D motion range of samples under the following situations was measured at random:intact state,unstable state (ligament around odontoid process was cut off),fixation with atlantoaxial joint screw+Gallie steel wire,atlantoaxial pedicle screw,atlantoaxial lateral mass joint fusion cage+atlantoaxial vertebral pedicle screw.Results Corresponding width/length of fusion cage is 8/11,9/12,10/13 mm,respectively,and the height is designed to 3.5,4.0,and 4.5 mm,respectively.The motion range of three internal fixation methods is less than that under intact state and unstable state.The difference has statistical significance.The C1+C2+cage fixation produces the least motion range in lateral bending and axial rotation directions and generates the highest motion range in flexion/extension direction.But,the difference has no statistical significance.Conclusion The C1+C2+cage internal fixation technique has similar stability with common atlantoaxial intemal fixation method and can provide extra atlantoaxial fusion spots.Thus,it may be a feasible alternative for atlantoaxial fusion when the posterior arch of the atlas is absent.

Co-culture of ginsenosides Rg1 and neural stem cells：promoting proliferation role and protective effect / 中国组织工程研究

BACKGROUND:Chinese herb extracts can restore and protect the nervous system of rats through intervention of neural stem cels. OBJECTIVE:To explore the role of ginsenosides Rg1 in the proliferation and protection of neural stem cels. METHOD:Sprague-Dawley rats at pregnant 19 days were dissected to take out fetal rats, and then the hippocampal tissues from fetal rats were isolated to extract neural stem cels. Neural stem cels were co-cultured with DMEM/F12 medium containing 50 g/L ginsenosides Rg1 as intervention group, with DMEM/F12 medium as blank control group, and with DMEM/F12 containing 0.64% phenol as positive control group, respectively. MTT assay was used to detect the proliferation of neural stem cels in each group, and western blot method to detect the protein expression of brain-derived neurotrophic factor and transforming growth factor-β in neural stem cels. RESULTS AND CONCLUSION:Rat neural stem cels were round single cels with clear border at early period after isolation but at 2 days after inoculation, the cels were adherent and aggregated into smal cel spheres. Compared with the blank control group, the proliferative rate of neural stem cels was significantly increased in the ginsenosides Rg1 group (P < 0.05), but decreased in the positive control group (P < 0.05). Compared with the blank control group, in the ginsenosides Rg1 group, the expression of brain-derived neurotrophic factor was elevated, and the expression of transforming growth factor-β was reduced, indicating ginsenosides Rg1 has a certain effect to promote the proliferation of neural stem cels as wel as to protect the neural stem cels.

Effect of Ginsenoside Rg1 on transformation growth factor-beta and brain-derived neurotrophic factor expression in spinal cord injury rats / 中国组织工程研究

BACKGROUND:Transformation growth factor-β(TGF-β) and brain-derived neurotrophic factor (BDNF) are the main regulatory factors in the process of spinal cord injury. There are many researches for TGF-βand BDNF pathogenesis in the spinal cord injury, but the regulation of Ginsenoside Rg1 intervention on TGF-βand BDNF in the spinal cord injury is rarely reported. OBJECTIVE:To observe the effect of Ginsenoside Rg1 intervention on TGF-βand BDNF expression at themolecular protein levels, and to study the protection effect of Ginsenoside Rg1 on the spinal cord and nerve function after spinal cord injury. METHODS:Experimental rats were randomly divided into blank control group, model group and Ginsenoside Rg1 group. In the model and Ginsenoside Rg1 groups, spinal cord injury model was established with the impact method in rats. In the Ginsenoside Rg1 group, rats were intraperitoneal y injected with 10 mg/kg Ginsenoside Rg1 24 hours after modeling, once per day, for 14 days. Rats in the blank control and model groups were injected with equal saline. RESULTS AND CONCLUSION:Compared with the control group, serum malondialdehyde levels increased, the content of superoxide dismutase decreased, TGF-βexpression levels in spinal cord tissue increased, and BDNF expression levels decreased in the model and Ginsenoside Rg1 groups. Compared with the model group, serum malondialdehyde levels decreased, the content of superoxide dismutase increased, TGF-βexpression levels in spinal cord tissue decreased, and BDNF expression levels increased in the Ginsenoside Rg1 group. Ginsenoside Rg1 can protect the injury spinal cord in rats after spinal cord injury.

Advantages of an anterior cervical Zero-P implant for cervical spondylosis / 中国组织工程研究

BACKGROUND:The application of anterior cervical plate for anterior cervical discectomy and fusion wil induce some complications such as dysphagia after treatment. OBJECTIVE:To observe the clinical efficacy of the new implant Zero-P system for cervical spondylosis patients and its effect on reducing complications after treatment. METHODS:A total of 51 cervical spondylosis cases underwent anterior cervical discectomy and fusion using Zero-P system. Neurological function was evaluated by neck/arm visual analogue scale, neck disability index and Japanese Orthopaedic Association scores pretreatment, at 3 days, 3, 6 months, 1, 2 years post-treatment. The incidence of postoperative dysphagia was evaluated using dysphagia score. Anteroposterior&lateral and dynamics X-ray films were used to evaluate the efficacy of graft fusion and internal fixation-related complications. RESULTS AND CONCLUSION:The patients were fol owed up for 6-30 months, averagely 15.4 months. After treatment, their incision achieved stage I healing. Pain was relieved and muscle force was restored in al patients after treatment. Visual analogue scale and neck disability index scores were apparently improved. Improvement rate of Japanese Orthopaedic Association score was 85.7%. At 2 days after treatment, seven patients experienced mild and moderate dysphagia. During fol ow up, implant subsidence was not observed. No complications, such as screw loose, breakage or fixator displacement, were found. Results suggested that the new cervical stand-alone anterior fusion device in anterior cervical discectomy and fusion procedure for the treatment of cervical spondylosis has offered an excellent clinical outcome. Its design has the advantages of cervical interbody fusion and anterior cervical plate. There were less relevant complications.

One-stage foci debridement for cervical tuberculosis / 中华骨科杂志

Objective To evaluate the effectiveness of one-stage debridement for cervical tuberculosis at different segments.Methods Clinical data of 54 patients (male 20,female 34) with cervical tuberculosis treated by one-stage debridement from Jan 1998 to Dec 2011 were reviewed retrospectively.The average age of these patients was 45.4 years (range,26-75 years).Among them,12 cases were involved in single level (C2 1 case,C4 2 cases,C5 3 cases,C6 4 cases,C7 2 cases); 36 cases in the adjacent two levels (C1,2 3 cases,C2,3 2 cases,C3,4 5 cases,C4,5 6 cases,C5,6 14 cases,C6,7 5 cases,C7T1 1 case); 5 cases in three levels(C4 6 2 cases,C5-7 2 cases,C3,5,6 1 case)and 1 case in four levels (C4-7).Five cases were involved in other spinal levels (T6 1 case,T 3 cases,L3,4 1 case).Comorbidity of cervical ossification of the posterior longitudinal ligament was found in 1 case.Before surgery,the mean VAS and JOA scores were 5.9 (range,4-9) and 10.5 (range,7-12) respectively and the mean Cobb angle of lesion segment was 26.7°± 9.1°.All cases underwent regular anti-TB treatment preoperatively,and surgical treatment were performed when blood sedimentation (ESR) was lower than 50 mm/1 h.According to the segmental involvement,different surgical approaches were performed including anterior debridement with anterior or anterior-posterior internal fixation and fusion,submandibular approach debridement with posterior occipital cervical fusion or atlantoaxial fusion.Results Mean follow-up duration was 27.3 months (range,13-52 months).Symptoms were improved significantly in all cases.Mean time of union was 3.2 months (range,2-4 months).At the last follow-up,the mean VAS and JOA scores were 5.9 (range,4-9)and 10.5 (range,7-12) respectively,and the mean Cobb angle of lesion segment was 6.8°.Regular anti-TB treatment was performed postoperatively for 18 to 20 months.Intraoperative esophageal injury was found in one case of upper cervical tuberculosis which was cured uneventfully after gastrointestinal tubation for 1 week.No cervical tuberculosis recurrence,graft loosening or pseudarthrosis was found in follow-up.Conclusion With preoperative anti-TB treatment,cervical tuberculosis can be treated by one-stage foci debridement according to the segmental involvement and deformity.Postoperative regular anti-TB treatment is a crucial factor for the final recovery of cervical tuberculosis.