Volume 88  ·   Issue 17  ·  2008

：Objective To investigatethe effect of short-term continuous positive airway pressure (CPAP) treatment on thearterial stiffness in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Cardio ankle vascular index (CAVI) and blood pressure (BP) were measured beforeand after sleep in 60 non- hypertensive patients with OSAHS and gender and 60 age-matchedhealthy controls. CPAP was administrated in 22 of the 60 OSAHS patients. And on the firstand third days of the CPAP treatment CAVI and BP were measured in the morning, i. e. ,after sleep. Results In the morning,the CAVI of the OSAHS patients was 8.0 + 1.2 m/s,significantly higher than that before sleep (7.3±1.0,P=0.000), the diastolic BP (DBP) was(86±12) mm Hg, significantly higher than that before sleep (83±13 mmHg, P =0. 001 ), andthe mean BP (MBP) was (101±12) mm Hg, significantly higher than that before sleep (98±14,P =0.001 16). However, there were no significant differences in these parameters among thecontrols The systolic BP (SBP) of the OSAHS patients did not changed significantly aftersleep,however, there was a tendency to decrease in the controls [(123±14) vs (121±13) mmHg, P=0.074). After the first night treatment, the CAVI, SBP, DBP, and mean BP of the 22severe OSAHS patients decreased significantly (all P<0.05 ), and after three nightstreatment, only the CAVI showed further significant decrease (P<0.05). Conclusion Sleepinduces increase of artery stiffness in OSAHS patients, but not in the normal controls.Short-term CPAP may decrease CAVI without affecting the blood pressures. Earlyatherosclerosis in the patients with OSAHS may be reversed by CPAP therapy.

Objective To investigate the association between two estrogen receptor (ER) β gene polymorphisms and Parkinson disease (PD) as well as Parkinson disease with dementia (PDD) in Chinese people. Methods Peripheral blood samples were collected from 115 PD patients (including 26 PDD cases), 56 males and 55 females, aged 64±10, and 116 sex and age-matched healthy controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to analyze the polymorphism of the fifth exon RsaI and the eighth exon AluI of ERβ gene. Te relationship between each genotype or allele frequencies and PD/PDD was analyzed using chi-square test. Results There was no difference in the polymorphism of ERβ genes AluI and Rsa Ⅰ between the PD group and control group and between the PDD group and control group ( all P>0.05 ). Conclusion Genetic variations from AluI and RsaI digestion in ERβ gene do not affect the risk of PD and PDD.

Objective To analyze the clinical manifestations and imaging features of hemophilic pseudotumor. Methods Eight patients with hemophilic pseudotumor, all males, aged 26.1 (18-38),were hospitalized, underwent resection of pseudotumor and bone reconstruction, and followed up for 38.6 months (7months to 11 years). The clinical data were analyzed. Results Femur was involved in 4 patient, and fifth metacarpus, iliopsoas, quadriceps femoris, and gastrucnemius were involved in 1 patient respectively. No recurrence was found. Excellent healing was seen in 6 cases, claudication occurred in 1 case with shortening femur, while unpleasant outcome happened to 1 case because of formation of clotting factor inhibitor, together with poor wound-healing waiting for amputation. Conclusion Medical history and imaging features are essential for the diagnosis of hemophilic pseudotumor. It is the key for successful treatment to master its clinical characteristics.

Objective To explore the correlation of tip perfusion index (TPI) with the hemodynamics and catechalomines and to assess the value and meaning of TPI for monitoring stress responses in general anesthesia. Methods Twenty patients who were to receive selective neurosurgery underwent induction and maintenance of propofol and remifentanil by target controlled infusion (TCI). A 60mA-5OHz5s electrostimulus was applied before tracheal intubation and head holder setting respectively. TPI, SBP,diastolic blood pressure (DBP), heart rate (HR), and bispectral index (BIS) were recorded at nine time points: before induction (baseline), before and after electrostimulation, before and after tracheal intubation, before and after electrostimulation, and before and after head holder setting. The changes of parameters (△TPI,△SBP,△DBP,△HR, and △BIS) were calculated after each stimulation. Five out of 20 patients were selected randomly to monitor the plasma concentration of catecholamine at the above time points. The responses to tracheal intubation and head holder setting were defined as the SBP increasing >15mm Hg over the baseline value. Results △TPI was significantly correlated with △SBP and △DBP (r=0.623 and 0.317, P<0.01 and 0.05). The responses to tracheal intubation and head holder setting were inhibited effectively when the △TPI caused by electrostimulus was less than 10% of the pre-electrostimulus TPI. TPI was significantly negatively correlated with the plasma Concentrations of norepinephrine and epinephrine (r=-0.679, and r=-0.364, P<0.05 and 0.O1). Conclusion (1)The TPI change is correlated well with the blood pressure change during stresses, and the TPI change caused by electrostimulus can predict the blood pressure change caused by tracheal intubation and head holder setting. (2) The TPI change reflects the norepinephrine plasma level indirectly.

Objective To evaluate the triage value of high risk human papilloma virus (hrHPV)detection in the women with abnormal cervical cytology. Methods 28 650 women anderwent thinprep cell test (TCT) to screen cervical cancer. 694 of the 2433 patients with abnormal cervical cytology were randomly selected to undergo hrHPV HC Ⅱ test to detect high risk HPV. 275 of these 694 patients received colposcopy and biopsy, 71, 149, and 55 of which were diagnosed as with atypical squamous cell (ASC),low squamous intraepithelial lesion (LSIL), and high squamous intraepithelial lesion (HSIL) respectively.The triage value of hrHPV detection was analyzed. Results Among the 694 patients, the incidence rates of hrHPV infection of those with ASC, LSIL, and HSIL were 68.4% (252/368) , 87.6% (219/250) , and 93.4% (71/76) respectively. Among the 275 cases who received colposcopy and biopsy the percentages of histopathologic lesion CIN2 in those with ASC, LSIL, and HSIL were 22.5% , 30. 2% , and 70.9%respectively. When with CIN2 + as terminal, the sensitivity and specificity of hrHPV test were 93.8% and 23.6% in the ASC group; 93.1% and 10.6% in the LSIL group, and 97.4% and 25.0% in the HSIL group. Histopathologic lesions CIN3 or worse were seen in 7.0% of the patients with ASC, 12.2% of the patients with LSIL, and 36.4% of the patients with HSIL. When with CIN3 + as the terminal the sensitivity and specificity of hrHPV test were 100% and 21.2% in the ASC group; 100% and 10.7% in the LSIL group; and 95.0% and 11.4% in the HSIL group. Conclusion hrHPV infection is associated with preinvasive cervical cancer and invasive cervical cancer, hrHPV test is a good triage approach for the patients with ASC, able to decrease about 50% of colposcopic referral. For the patients with LSIL and HSIL, hrHPV test is not an appreciate triage test and immediate colposcopy is recommended.

Objective To assess the modulation of TLR9 on anti-tumor immune responses in peripheral blood monouclear ceils (PBMC) from patients with non-small-cell lung cancer (NSCLC).Methods PBMCs were isolated from 36 NSCLC patients. Lung cancer cells were isolated from these patients and further enriched. PBMCs were cultured in RPMI-1640 medium (blank control group), and medium with cytosine guanine oligodeoxynucleotide (CpG ODN, an TLR9 agonist) or control ODN for 72 h;and then flow cytometry was used to examine the expression of CD69 antigen on the surface of CD3+cells,[3H]-thymidine incorporation method was used to examine the cell proliferation, and the IFN-α level in the supernatant was measured. Another PBMCs were cultured in medium with interleukin (IL)-1 and then CpG ODN, control ODN, and. CpG ODN+chloroquine or inhibitory ODN were added respectively for 24-48h.Then the IFN-α in the supernatant was measured. Subsets were assessed by flow cytometry and the expression of TLR9-mRNA in freshly isolated PBMC was detected by RT-PCR. The production of interferon (IFN)-α in the PBMCs was measured by ELISA. The proliferation of the PBMCs was determined by [3H]-thymidine incorporation. The PBMCs co-cultured with CpG ODN and autologons lung tumor cells treated with mitomycine C were used as effector cells, and K562 cells and autologous tumor cells were used as target cells flow cytometry was used to detect the capacity of PBMCs to kill autologous lung tumor cells and K562 cells.Meanwhile we investigated the intracellular expression of IFN-γ and IL-4 in CD8+ T. Results The expression level of TLR9 of the PBMCs from patients was not significantly different from that of the PBMCs from the healthy donors. The proportion of CD69 antigen expr4essing CD3+ T cells of the CpG ODN group was (39.5±8.9)%, significantly higher than those of the blank control group [(8.8±1.2)%, t=40.30,P=0.00]ands control ODN group [(10.6±1.0) %, t=41.85, P=0.00]. Examination with beta liquid scintillation counter showed that the cpm value of the CpG ODN group was (1.61±0.20)×104,significantly higher than those of the blank control group [(0.27±0.14)×104, t=20.43,P=0.00] and control ODN group [(0.34±0.13)×104,t=20.20,P=0.00]. Chloroquine and inhibitory ODN dosedependently inhibited the IFN-αlevels in the supernatant. The CD4+T/CD8+T of the CpG ODN group was (3.44±0.20), significantly higher than those of the control ODN group (1.73±0.27, t=19.85, P=0.00) and blank control group (1.69±0.13, t=29.32, P=0.00). The IFN-γ positive CD8 + T cells of the CpG ODN group was (18.5±4.2)%, significantly higher than those of the control ODN group [(4.2±1.0)%, t=24.12,P=0.00] and blank control group [(3.1±1.2)%, t=25.1, P=0.00]. There was no significant differences in the proportion of IL-4 positive CD8 + T cells among different groups. When the E/T was 40:1 the killing capacity of PBMCs against the K562 cells was (19.5±1.0), significantly higher than those of the control ODN group (7.9±1.1 ,t=19.9,P=0.00) and blank control group (5.1±1.6,t= 21.9,P=0.00), and the killing capacity of PBMCs against the autologous lung tumor ceils was(29.8±2.1), significantly higher than those of the control ODN group (8.1±0.9, t=36.9, P = 0.00) and blank control group (5.7±1.6, t = 35.7, P = 0.00). Conclusion TLR9 signal takes part in the immunomodulation of PBMCs. The activation of TLR9 results in enhanced anti-tumor response in the PBMCs against autologous lung cancer cells and K562 cells.

Objective To observe the hemodynamie changes, recovery profiles, and side effects of propofol and remifentanil anesthesia by target controlled infusion (TCI). At different neurosurgical stages in patients undergoing neurosurgieal operations. Methods 230 patients were scheduled for elective craniotomy in five hospitals in Beijing, Changsha, and Guangzhou. During the general anesthesia the plasma targetconcentration of propofol remained unchangeable and the dose of remifentanil changed at different stages before skin incision, during skull opening, during intracranial procedure, and at skull closing. The hemodynamies changes and anesthetic recovery profiles were recorded. Results The plasma targetconcentrations of remifentanil were set to 3.0, 3.5, 3.6 and 3.4 ng/ml respectively. The time of consciousness loss during induction was (2.0±0.9) min. The mean arterial pressure (MAP) and heart rate (HR) decreased after induction (both P<0.05) and increased after intubation. The hemodynamic changes were stable at different surgical stages and the HR was significantly lower than the baseline value (P<0.01). MAP and HR increased gradually when the spontaneous breathing was recovered. 80, 41,9, and 12patients received nicardipine, atropine, esmolol, and ephedrine respectively during the operation. The times of recovery of spontaneous breathing, eye opening, extubation, and orientation were (12±9) min, (13±7) min, (16±8 ) min, and (21±8 ) min respectively. Conclusion When combined with 3 μg/ml propofol, the plasma target-concentrations of remifentanil, 3.0, 3.5, 3.6, and 3.4 ng/ml before skin incision, during skull opening, during intracranial procedure, and at skull closing respectively, can provide rapid induction, faster emergence , and better hemodynamic stability.

Objective To investigate the distribution of atherosclerotic steno-occlusive lesions in Chinese patients with ischemic cerebrovascular disease and the risk factors for occlusive lesions of intracranial and extracranial arteries. Methods 583 consecutive patients with ischemic cerebrovascular disease, 449 males and 134 females, aged 18 -86, 415 with cerebral infarction and 168 with transient ischemic attack (TIA), underwent angiography, The angiographic findings and relevant clinical; data were analyzed. Results Fifty of the 583 patients had normal findings in angiography and 527 had occlusive lesions of different degrees, among which 24.3% had only extracranial artery disease (EAD), 36.8% had only intracranial disease (IAD), and 38.9% had both EAD and IAD. In total the incidence of IAD was 75.6%, higher than that of EAD (63.2%). In the carotid TIA patients the percentage of IAD was significantly higher than that of the EAD (P=0.005), and in the cerebral infarction patients the percentage of IAD was higher than that of the EAD, but now significantly. In the patients with TIA of vertebrobasilar artery the incidence of IAD was significantly higher than hat of the EAD (P＜0.01). The proportion of pure IAD alone was high in patients aged≤40 was 75.5% with the middle cerebral artery as the most frequently involved site, while the proportion of coexistence of IAD and EAD was high in the middle-aged and old-aged groups (39.4% and 48.0% respectively, P＜0.001) with the origin of internal carotid artery as the commonest site of lesions. Multivariable Logistic regression identified age, diabetes, hyperlipidemia, and coronary artery disease as the independent risk factors for EAD, and hypertension, diabetes, and hyperlipidemia for IAD. The patients with EAD were significantly elder and had an increased frequency of coronary artery disease compared with those with IAD. Conclusion In general, the morbidity of IAD was higher that that of EAD in the Chinese patients with ischemic cerebrovascular disease, and presents symptoms of both extracranial and intracranial arteries; however, pure EAD is not uncommon. The distribution pattern of occlusive disease differs among different groups of patients. The patients with EAD are often elder and have an increased frequency of coronary artery disease.

Objective To discuss the correlation between characteristics of interictal epilepiform discharge(IED) and histopathological changes in epilepsy patients with focal cortical dysplasia(FCD) in order to explore the epileptogenicity of various IED. Methods Twenty-two consecutive patients suspected as with FCD who were to undergo epilepsy surgery received intracranial electrode implantation and long-term video-EEG monitoring before the resective surgery and the postoperative pathology proved the diagnosis of FCD. According the long-term EEG monitoring results, the IEDs were divided into four catalogs: isolated spike, slow repetitive spike, repetitive spike, and paroxysmal fast. The possible epileptogenic cortex with intense lED was reseeted in the operation to undergo histopathologic study and hemi-quantificational scoring of parvalbumin (PV) by immunocytochemistry. Results The reseeted specimens of 20 cases were studied.There were not significant differences in the PV quantificational score between any 2 IED subtypes (F=1.198, P =0.342). However, the spike type had the highest PV score: 8.00, while the repetitive spike type had the lowest PV score:5.60. On the other hand, FCD of different severity in terms of pathological changes tended to have different kind of IED. Conclusion Despite the insignificant differences between various kinds of IED, isolated spike has the highest PV scores meaning lower epileptogenicity. Slow repetitive spike, repetitive spike, and paroxysmal fast tend to occur in more severe FCD patients which mean a great possibility of epileptogenicity.

The patient was a 25-year-old male, who had right waist and leg discomfort for 3 months without obvious trigger. He had no history of tumor, tuberculosis and trauma, and had previous history of appendicitis surgery. Physical examination: normal lumbar movement, no tenderness or percussion pain, reduced skin sensation on the lateral dorsum of the right calf, weakened right deep thumb muscle strength, 50° positive straight leg elevation test of right lower limb and positive enhancement test. Laboratory examination was not special. Imaging examination: CT plain scan showed a type of round soft tissue density nodule in the right part of the L4~5 spinal canal, 1.1 cm ×1.0 cm in size, CT value 35~39 HU, compression of the dural sac and annihilation of the right lateral crypt (Figure 1). MRI plain scan showed a circular epidural mass in the right part of the L4~5 spinal canal, with clear boundary and uniform signal, low signal in T1WI (Figure 2) and high signal in T2WI (Figure 3), arcuate compression of the dural mater, and normal state of the L4 nerve root. Enhancement examination of gadopentetate meglumine (Gd-DTPA) showed obvious annular enhancement of the mass, but no intra-annular enhancement (Figure 4).

Objective To investigate the correlation between Pokemon gene and cisplatin mechanism. Methods Human lung adenocarcinoma cells of the lines A549 and AGZY83-a, human lung squamous carcinoma cells of the line HE-99, and human giant cell lung cancer cells of the line 95D were cultured and cisplatin was added into the medium. Other lung cancer cells of the above mentioned lines were cultured in the medium without cisplatin and were used as control groups. RT-PCR and Western blotting were used to detect the mRNA and protein expression of Pokemon. Results Pokemon mRNA and protein were expressed highly in all the 4 cell lines. The Pokemon gene expression did not changed significantly after cisplatin treatment groups. There were not significant differences in the mRNA and protein expression of Pokemon among the 4 experiment groups and the control groups ( all P>0.05 ). Conclusion Cisplatin has no effect on the Pokemon gene expression of the human lung cancer cells.

Objective To investigate if increase of adhesion function and capability to destroy and decrease of phagocytosis of neutrophils occur after cardiopulmonary bypass (CPB). Methods 12 mongrel dogs were randomly divided into two equal groups : CPB group, weaned from CPB after 100 min of CPB ; and sham group standing for 100 min without CPB. All dogs were observed for another 4 hrs. Blood samples were collected from the femoral vein before heparinization and by the end of experiment to measure the white blood cell count and classification, and expression of CD11b and CD18. Tissue samples of the right and left lungs were collected before heparinization and by the end of experiment. The expression of CD11b/CD18 in neutrophils, myeloperoxidase (MPO) activities in lung tissue, and pulmonary function were determined to access the adhesion function of neutrophils and the injuries to tissues. The phagocytotic activities, the release of MPO and the generation of oxygen free radical induced by IL-8 were surveyed to access the immune function of neutrophils. Results The fluorescence level of CD11b of the neutrophils in the CPB group was (2675±479) and the fluorescence level of CD18 of the neutrophils was (1574±262 ), both significantly higher than those before heparinization and those of the sham group ( all P<0.05 ). Four hours after CPB, the MPO activity of lung tissue of the CPB group was (55.02±21.04 U/100g wet tissue) ,significantly higher than those before heparinization and that of the sham group ( both P<0.05 ) ; the ratios of PaO2/FiO2 of the CPB group was (319±79 ), significantly lower than those before heparinization and that of the sham group (both P<0.05 ). Transmission electron microscopic examination revealed tentacle protrusion on the neutrophil in the CPB group, while the neutrophils were intact in the sham group. Contrary to the increase of adhere function, the numbers of neutrophil with phagocytic function of the CPB group was 35%±11%, significantly lower than that of the sham group (74%±9%, P<0.01) the number of bacteria phagoeytized by neutrophils per ml blood of the CPB group was ( 1484±238), significantly lower than that of the sham group (3106±714). There were no differences in the accumulated points of MPO in neutrophils, release of MPO, and generation of oxygen free radical between these 2 groups. Conclusion CPB eauses neutrophil function disorder, ineluding increase of adhesion function and reduction of phagocytic function.

Objective To explore the significance of mast cells-fibroblast like synoviocytes (FLS) interaction in the pathogenesis of rheumatoid arthritis (RA). Methods Frozen sections of RA synovia from 4 patients were made to observe the distribution of mast cells by immunochemistry. FLSs were isolated from 4 samples of RA synovia and co-cultured with the human mast cells of the line LAD-2 for 0,12, 24, and 48h, and 7 d. ELISA was used to detect the interleukin (IL)-6, an important proinflammatory cytokine. 4%formaldehyde was used to fix the FLS and LAD-2 cells and then detect the IL-6 levels in the supernatant.Other FLS and LAD-2 mast cells were put into the upper and lower chambers of Transwell system to be cocultured in isolate condition, an important proinflammatory cytokine. Results Microscopy showed that FLSs were adjacent to the mast cells. The IL-6 content of the FLS/LAD-2 cell co-culture supernatant was 7150μg/L±114 μg/L, significantly higher than that of the FLS supernatant (3019 μg/L±57 μg/L, P＜0.01). LAD-2 cell number dose-dependently increased the IL-6 content in the supernatant. Almost no IL-6secretion was found in the supernatant of the co-culture with fixed FLSs and non-fixe4d LAD-2 cells, and the IL-6 secretion in the supernatant of the c0-culture with fixed LAD-2 cells and non-fixed FLSs was similar to that of the single FLS group and far lower than that of the FLS-LAD-2 co-cuhure group. Transwell system test showed that there was no significant difference in the IL-5 level between the direct mixture co-culture group and indirect mixture co-culture. Conclusion Mast cell/FLS interaction increases the IL-6 secretion via soluble mediators, thus playing an important role in the pathogenesis of RA.

Objective To investigate the differential protein expression profiles of human prostatic carcinoma cells with different metastatic tendency and to screen the osseous metastasis associated proteins and investigate their function. Methods Proteomics and Western blotting were applied to screen and identify the differentially expressed proteins in the prostatic carcinoma cells of different lines: line T3B with high osseous metastasis potential, line P2-4 with high lymphatic metastasis potential, and their common parent cell line PC-3. The eukaryotic expression vector carrying human Pgenesil-1/HMGB1siRNA was constructed and transfected into T3B cells by Lipofectamine 2000 and the positive clones was screened by G418. Pgenesil-1/HMGB1siRNA/T3B, Pgenesil-1/T3B, and T3B cells were inoculated into the left ventricles of nude mice. Twelve weeks later the mice were killed. The number of osseous metastatic nodules and osseous metastasis inhibition rate were calculated. The mice metastatic tumor cells were identified by immunohistochemistry. Result Six differential expressed proteins, correlated with cystoskeleton,transcriptional control, cellular metabolism, and phosphorylation were identified by proteomics and Western blotting. The recombinant plasmid Pgenesil-1/HMGB1siRNA was successfully constructed. The HMGB1 expression of the T3B cells transfected with Pgenesil-1/HMGB1siRNA was significantly lower than those of the other 2 groups (both P<0.05 ). The number of osseous metastatic nodules of the mice inoculated with Pgenesil-1/HMGB1siRNA/T3B was significantly less than those of the other 2 groups (both P<0.05). The metastatic osseous tumor cells were identified as the human prostatic carcinoma cells. Conclusion Osseous metastasis associated proteins exist in prostatic carcinoma cells of the line with high osseous metastasis potential. HMGB1 is closely related to the osseous metastasis of human prostatic carcinoma cells, siRNA targeting HMGB1 specifically suppresses the expression of HMGB1 gene in the human prostatic carcinoma ceils with high osseous metastasis potential and effectively inhibits the osseous metastasis.

Objective To investigate the effects of sodium butyrate (NaB), a histone deacetylase inhibitor (HDACI), on the proliferation of human gastric cancer cells and the expression of pl6 , an important negative-regulatory factor of the cell cycle G1. Methods Human gastric cancer ceils of the lines SGC7901 and BGC823 were cultured in RPMI1640 medium and treated with NaB of different concentrations:5×10-4, 1×10-3, 3×10-3, and5×10-3 mol/L for 24 h or 72 h. MTT assay, flow cytometry, and annexin V-fluorescein isothiocyanate staining were performed to analyze the cell proliferation activity, cell cycle, and apoptotic rate. RT- PCR, Western blotting, and methylation-specific PCR (MSP) were used to detect the e mRNA and protein expression and methylation state of p16 gene respectively, Results Exposure to different concentrations of NaB inhibited the growth of the SGC7901 and BGC823 cells. Treated with NaB of the concentrations of 1×10-3, 3×10-3., and 5×10-3 mol/L respectively for 72 h, the numbers of the SGC7901 and BGC823 ceils at G0/G1 stage increased significantly and those at S stage decreased significantly (all P<0.01), which showed that the cell cycle was blocked at G1 phase. The apoptosis rates of the SGC7901 and BGC823 cells treated with NaB of different concentrations for 72 h all increased significantly (all P<0.01). P16 was expressed in the SGC7901 and BGC823 cells at low levels,and hypermethylation was detected in its promoter region in both cells before the treatment of NaB. After treated with NaB the mRNA and protein expressions of pl6 gene were increased in both ceils. Conclusion NaB inhibits the growth of human gastric cancer cells by blocking cell cycles, inducing apoptosis and upregulating the expression of pl6 gene by increasing acetylation and reducing methylation.

In recent years, the problem of many complications after traditional cervical fusion has become a difficult problem for clinicians. In order to solve the problem of abnormal stress acting on the adjacent segments after fusion [1], "non-fusion fixation technique", also called "dynamic fixation", has appeared. Cervical disc replacement surgery is a relatively mature solution developed under this concept, especially cervical disc replacement has achieved excellent clinical results [2]. As a digital simulation analysis, it is different from the previous models based on cadaver modeling to adopt solid-based modeling, which can fully reflect the biological characteristics of human body, especially the simulation of ligament and artificial disc prosthesis is closer to the real structure [3]. We analyzed the movement of the model in the normal range of flexion, extension, lateral bending and other working conditions by mechanical analysis method, and understood its movement characteristics, and compared with the movement conditions of cadaver test and follow-up results, so as to evaluate the movement of lower cervical spine after recovery of cervical disc replacement patients.

Cardiac output (CO) is one of the important parameters to reflect cardiac function. For patients with possible massive hemorrhage, vascular surgery, and patients with reduced ventricular function and valvular disease, accurate measurement of cardiac output and related hemodynamic indexes is beneficial to reflect the state of cardiovascular system in time and guide the treatment. After pulmonary artery catheter monitoring technology was introduced into clinic in 1970, surgeons and anesthesiologists can perform surgical and clinical anesthesia for those patients with high risk of death. Thermal dilution method of pulmonary artery floating catheter to measure cardiac output is the most accurate method to judge cardiac function in clinic, but its wide application is limited because of its high cost, complicated operation and some serious complications.

With the increase of aging population, osteoporosis as a degenerative disease has gradually become one of the health problems that seriously threaten the quality of life of the elderly.The disease is characterized by many factors leading to osteopenia, bone microstructure destruction, increased bone fragility and prone to fracture.The onset is hidden and the consequences are serious.Especially in females, the incidence rate is three times that of males.Recently, there are endless drugs to prevent and treat osteoporosis. Besides sex hormone therapy (HT), bisphosphate, selective estrogen receptor modulator (SERM), calcitonin and other drugs to inhibit bone resorption, and parathyroid hormone and other drugs to promote bone formation, the relationship between vitamin K as a natural nutrient and osteoporosis has gradually attracted widespread attention in the medical field.

A 59-year-old female was admitted to hospital for "recurrent dull pain in the left side of the head for 10 years, aggravated for 5 years with low mood". In 1997, the patient developed dull pain in the left side of the head without obvious inducement. At first, the headache lasted for several minutes to more than ten minutes, with an interval of 2~3 days, and recurred. Then, the duration of the headache prolonged, and the number of attacks increased day by day. Since 2002, the headache was persistent, with interstitial aggravation.