Ventral release and posterior screw/rod implant fusion for irreducible atlantoaxial dislocation:one-year follow-up / 中国组织工程研究

BACKGROUND:Transoral ventral release and posterior fusion have predominated in the treatment of irreducible atlantoaxial dislocation, but there is no consistent conclusion on the clinical efficacy. OBJECTIVE:To explore the clinical outcomes of transoral ventral release and posterior fusion and screw/rod implantation in the treatment of irreducible atlantoaxial dislocation. METHODS:A total of 32 patients with irreducible atlantoaxial dislocation undergoing thetransoral ventral release and posterior fusion were selected. After treatment, they received cervical anteroposterior and lateral digital DR and cervical MRI examinations to understand the conditions of nerve compression and bone fusion. The recovery of nerve function was evaluated using Japanese Orthopaedic Association before treatment, 6 months after treatment and during final fol ow-up. RESULTS AND CONCLUSION:Post-treatment, 29 patients were fol owed-up for an average period of 12 months. (1) Al the patients obtained perfect atlantoaxial joint reduction and bone fusion. This achieved reduction and reconstruction of spinal column stability. (2) Spinal compression was obviously lessened after treatment in al patients, and nerve functions were improved to different degrees. Significant differences in Japanese Orthopaedic Association score were detected between 6 months post-treatment, final fol ow-up and pre-treatment (P<0.05). (3) There were no serious intraoperative complications such as spinal cord or vertebral artery injuries. Postoperative complications such as infection or burst were also not found. (4) Imaging evaluation revealed that transoral ventral release and posterior fusion is safe and effective for treatment of irreducible atlantoaxial dislocation.

Prolonged chronic phase in chronic myelogenous leukemia after homoharringtonine therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Homoharringtonine (HHT) is effective in treating late stage chronic myelogenous leukaemia (CML), but little is known about long term maintenance during complete cytogenetic response. Long term efficacy and toxicity profiles of low dose HHT were evaluated in this study.</p><p><b>METHODS</b>One hundred and six patients with CML received 1.5 mg/m(2) of HHT alone by continuous daily infusion for seven to nine days every four weeks. Of 79 patients in the control group, 31 were treated with interferon alpha (IFN-alpha) and 48 with hydroxycarbamide. For 17 patients who failed to achieve cytogenetic response within 12 months' treatment of IFN-alpha, HHT was administered. Quantitative RT-PCR was used to detect the BCR-ABL mRNA expression in 36 Philadelphia positive CML patients enrolled after 2007. Haematological and cytogenetic responses were evaluated in all patients at the 12th month of follow-up. Long term efficacy was assessed in a follow-up with a median time of 54 months (12 months-98 months).</p><p><b>RESULTS</b>After 12 months of therapy, cytogenetic response rate of the HHT, IFN-alpha and hydroxycarbamide groups were 39/106, 14/31 and 3/48, and corresponding molecular cytogenetic response rates 6/18, 3/8 and 0. Of the 17 patients who received HHT as salvage treatment, 6 achieved cytogenetic response (3 major). At the 48 months' follow-up, cytogenetic response was maintained in 32/39 patients treated with HHT. Patients who had cytogenetic response in HHT group or treated with IFN-alpha also showed longer median chronic durations, which were 45 months (12 months-98 months) and 49 months (12 months-92 months) respectively, indicating a longer survival time.</p><p><b>CONCLUSIONS</b>Low dose HHT alone showed considerable short term and long term efficacy in the treatment of late stage CML. It may also be a good choice for patients who have failed imatinib, IFN-alpha treatment or haematopoietic stem cell transplantation or cannot afford these treatments.</p>

Influence of methylprednisolone on cell component of donor graft and on H-2 haploidentical hematopoietic stem cell transplantation in mice / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the influence of methylprednisolone (MP) on cellular component in donor graft and on H-2 haploidentical hematopoietic stem cell transplantation (HSCT) in mice.</p><p><b>METHODS</b>A murine model of H-2 haploidentical HSCT was established by using of c57BL/6J male mouse as donor and (c57BL/6J x LB/C) F1 female mouse as recipient. The donor mouse received peripheral-blood (PB) progenitor cells mobilization regimens consisted of recombinant human granulocyte colony-stimulating factor (rhGCSF) alone (control group) or combined with MP in dose of 2 mg/kg daily [small-dose (SD) group], 10 mg/kg daily [middle-dose (MD) group], and 50 mg/kg daily [large-dose (LD) group] respectively. Percentage of T cell subsets, DC1 (HLA-DR+CD11c+) and CD34+ cell in the grafts were detected by flow cytometry. Transplant rejection,severity of GVHD and survival time were observed.</p><p><b>RESULTS</b>The percentages of CD3+ T cell in donor grafts in the three groups were significantly lower than that in control group (P < 0.05). The percentage of CD3+ CD4+ T cells decreased more significantly than that of CD3+ CD8+ T cells, and CD4/CD8 ratios decreased significantly. The percentage of CD4+ CD25+ T cells increased significantly, the percentage of DC1( HLA-DR+CD11c+) decreased and the percentage of CD34+ cells increased in all the three groups than in control group. There were significant differences in the percentage of CD3+ T cells, CD3+ CD4+ T cells and CD34+ cells in donor grafts among SD group, MD group and LD group (P < 0.05). The engraftment rates in control, SD, MD and LD groups were 90%, 100%, 100% and 80% respectively. Severity of aGVHD in each study group decreased significantly compared with that in control group (P < 0.05). There were statistical differences among different dosage groups (P < 0.05). Survival time after transplantation in all study groups were significantly longer than that in control group (P < 0.05), and in MD group was significantly longer than in SD group and LD groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Addition of methylprednisolone to routine donor mice HSC mobilization regimen has a definite effect in alleviating aGVHD and prolonging survival time of mouse after H-2 haploidentical HSCT. With a suitable dosage addition of methylprednisolone to donor mice HSC mobilization regimen could avoid the increasing risk of graft rejection.</p>

Antisperm-antibodies induced by testicular torsion and its influence on testicular function / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the changes of antisperm antibodies (AsAb), sexual hormones, and inhibin B (INH B) in patients before and after testicular torsion, as well as the effects of these factors on testicular function and reproduction.</p><p><b>METHODS</b>Ten patients with single acute testicular torsion (left side 9 and right side 1), aged 16-45 years (19.6 on average), disease course of 3-6 days (averaging 4.7 days), underwent surgical removal of the damaged testis. Before and after the operation, serum AsAb (IgG, IgM, IgA) and INH B were measured by ELISA, and serum follicle-stimulating hormone (FSH), luteotropic hormone (LH), and testosterone (T) determined by chemoluminescence autoanalyzer.</p><p><b>RESULTS</b>After the operation, the AsAb levels rose significantly and remained high for at least 26 weeks. The level of INH B was the lowest in the 3rd week and restored to normal in the 12th week, with significant difference between preoperation and the 3rd or the 6th week after the operation. The levels of LH and INH B in the 26th week were elevated significantly compared with the 6th.</p><p><b>CONCLUSION</b>Testicular injury induced the elevation of AsAb, which would last a very long time. The change of INH B was closely related with the injury of the testis, which reflected the degree of testicular injury and functional restoration of the patients after the operation. Our study showed that AsAb and INH B can be used as useful tools for monitoring testicular function and reproduction.</p>

Application of titanium mesh fusion device in treatment of thoracolumbar burst fractures / 中华创伤骨科杂志

Objective To explore the surgical method, clinical result, biomechanical property, and surgical indication of treatment of thoracolumbar burst fractures with titanium mesh fusion device. Methods 22 patients with the thoracolumbar burst fracture and paralysis were treated by anterior decompression and spinal stability reconstruction with titanium mesh fusion device and a titanium plate. In this group, the fracture was at the 12th thoracic vertebra in 7 cases, the 1st lumbar in 14, and the 2nd lumbar in 1. According to Frankel’s classification, 4 cases were of Grade A, 6 of Grade B, and 12 of Grade C. 20 patients experienced the kyphosis deformity. The kyphosis angles varied from 12 to 29 degrees with a mean of 19.5 degrees. Results The period of postoperative follow up varied from 0.6 to 2 years with an average of 1.2 years. The neural function was improved for more than 1 grade. 15 cases could control urination after the surgery. The kyphosis angles were reduced to 3 to 8 degrees with a mean of 5 degrees. The complications caused by the implants were not found. Conclusions To treat the thoracolumbar burst fractures with paralysis, the compressive elements from anterior side of the spinal cord should be completely removed. Since the titanium mesh fusion device plus a plate can reconstruct the spinal stability that satisfies spinal biomechanical property, it presents important application value.

An experimental study of apoptosis of the intervertebral disc cells of diabetic rats / 中华骨科杂志

Objective To study the apoptosis of the intervertebral disc cells and its related factors. Methods Thirty-six 4 months old male Sprague-Dawley(SD) rats weighing 230-261 g were randomly divided into streptozotocin (STZ)-induced group and control group. There were 18 rats in each group. The diabetes mellitus (DM) was induced by a single intraperitoneal injection of STZ solution (40 mg/kg), while in the control group, the same volume of the sodium citrate buffer was injected. The blood glucose level was measured 72 hours later by testing the blood samples from the tail vein. The standard for the diabetes mellitus was above 16.7 mmol/L. The rats were sacrificed 1, 3 and 4 months later with 6 at each time interval in two groups respectively. One lumbar intervertebral disc was obtained for the measurement of the apoptotic percentage with the flow cytometry, two discs for the measurement of the pentosidine with high performance liquid chromatography for each rat. Results The blood glucose levels of all the rats in the STZ-induced group were above 16.7mmol/L [(23.71?2.69) mmol/L] and was significantly higher than those of the control rats(P