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Objective To evaluate the clinical efficacy and safety of short-segment pedicle screw fixation combined with vertebroplasty for the treatment of thoracolumbar osteoporotic compression fractures.Methods A retrospective case control study was conducted on 63 patients with fresh thoracic or lumbar osteoporotie compression fractures who were surgically treated from January 2010 to December 2013.There were 26 males and 37 females,with age of 63-87 years [(76.3 ± 5.7) years].According to the surgical method,the patients were assigned to simple vertebroplasty group (Group A),short-segment pedicle screw fixation group (Group B),and short-segment pedicle screw fixation group combined with vertebroplasty group (Group C),with 21 cases in each group.Length of hospital stay,operation time,and blood loss were recorded.The visual analog scale (VAS),anterior vertebral body height,angle of the kyphotic deformity,and complications before operation,immediately after operation,3 months after operation,and at the last follow up were compared among three groups.Complications of each group were recorded.Results The hospital stay,operation time,and blood loss in Group C were significantly higher than those in Group A (P ＜ 0.05),but there were no significant differences between Group B and Group C (P ＞ 0.05),except for a longer operation time in Group C.The pre-operative VAS showed no significant difference among three groups (P ＞ 0.05).However,the mean VAS in Groups A,B and C at the last follow up were 1.0(0.0,2.0)points,1.0(0.0,2.0)points,0.0(0.0,1.0)points,respectively.The VAS in Group C was significantly lower than that in Group B or A (P ＜ 0.05).The mean anterior vertebral body height and angle of the kyphotic deformity in Group C had no significant difference from that in Group A or B before operation and immediately after operation (P ＞ 0.05).At the last follow up,the mean anterior vertebral body height and angle of the kyphotic deformity in Groups A,B and C were (68 ±14.7)％,(72.3 ±9.0)％,(81.5 ±5.6)％ and (10.6 ±3.9)°,(10.7 ±5.0)°,(7.4 ± 5.0) °,respectively.The loss of anterior vertebral body height and angle of the kyphotic deformity correction in Group C were significantly less than that in Group A or B (P ＜ 0.05).Superficial infection was found in Groups B (n =2) and C (n =1),and the infection was cured after antibiotic therapy and dress change.Bone cement leakage was found in Groups A (n =8) and C (n =5),with no nerve compression.Internal fixation failure was seen in Group B (n =3),and the implant was removed directly.Conclusion Short-segment pedicle screw fixation combined with vertebroplasty can effectively reduce the loss of anterior vertebral body height and angle of the kyphotic deformity and hence enhance the clinical efficacy.
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Objective To survey and analyze the PBL lessons in the course of Clinical Transfusion Medicine.Evaluate the effect and problems in PBL lessons and explore more effective models.Methods A questionnaire was designed according to the purpose of the survey,4 teachers and 89 students of medical laboratory science in Shanghai Jiaotong University School of Medicine were investigated.Results Students gave high evaluate of both the case and the teachers.Main suggestion was to reduce the class time.When the students were told that the evaluation results will be added to their total score and compared to the teachers' evaluation,they will be more objective.The results were statistically significant.Conclusion PBL cases for Clinical Transfusion Medicine should not be too long.Paying attention to the meaning and feedback of evaluation can greatly improve the enthusiasm and objectivity of the students.
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Objective To investigate the correlation between XRCC1 R280H,XRCCl TSS+29C/T genetic polymorphisma and susceptibility to non-Hodgkin lymphoma (NHL). Methods The MassARRAY method was applied to detect the DNA repair gene XRCC1 genetic polymorphisms in 73 cases of NHL and 540 cases of normal healthy controls. Chi-square test was performed to calculate the adjusted odds ratios (OR) and 95% confidence intervals (CI). Results For XRCCl R280H genotypes, there was a significant difference between frequencies of the G and A among patients and controls (P=0.001). However, XRCCl TSS+29C/T genotypes had no statistical difference as for the T and C frequencies between patients and controls (P = 0.383). The frequency of XRCCI R280H with at least one A genotype was lower in the NHL cases than in controls, indicating a decreased risk for NHL development (OR=0.309, 95 % CI =0.168-0.567), comparing with GG genotype. In XRCC1 TSS+29C/T genotypes, the frequeney of TC and CC genotype was higher in NHL cases than in controls and associated with an increased risk of NHL development (P=0.472, OR =1.262, 95 % CI =0.669-2.379). Conclusion DNA repair XRCCl gene possesses significant correlation with NHL.
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Objective To investigate the efficacy of Kurokawa s open door expansive laminoplasty for the treatment of cervical spinal stenotic myelopathy. Methods Sixty seven patients admitted to Zhongshan hospital with cervical spinal stenotic myelopathy undergone Kurokawa s procedure in the last 6 years were included in this study. All of the patients were followed up after operation. The follow up period ranged from 10 months to more than 6 years. The average age at operation was 55.2 years. Japanese Orthopedic Association (JOA)score were used to measure the severity of cervical spinal stenotic myelopathy and recovery rates. Results JOA scores increased from 7.1 to 12.5, 12.9 and 12.8 at the first, third, and fifth postoperative year respectively(P
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PurposePresent study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.Methods Between Jan. 1995 and Dec. 1996.16 patients with 17 hips( rheumatoid arthritis 14, aseptic necrosis of femoral head 3) were resurfaced with hybrid metal on metal surface replacement prothesis. Patients were evaluated by self assessment form,hip function examination. Radiographs and Harris hip score. The average follow up time was 58.2 months. ResultsNo patient received revision. Radiographs showed that all implants were in position satisfyingly. No loosening were revealed. The result of self assessment showed that patients were satisfied with 16 hips. The Harris score rose from preoperative 44(31 - 52) to postoperative 91 (79- 96). ConclusionsThe metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.
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Objective To evaluate the effectiveness of laparoscopy in anterio r lumbar interbody fusion. Methods Twenty-three laparoscopic anterior lumbar int erbody fusions were performed in the period between December 2000 and December 2 002. There were 9 males and 14 females with a mean age of 52 years (range, 46 to 66 years). In this group, there were 18 of spondylolisthesis, 3 of lumbar spina l instability and 2 of degenerative disc treated with anterior lumbar interbody fusion using Syncage and autograft with balloon-assisted endoscopic extraperiton eal gasless exposure. The main complaints were low back pain radiating to leg. 1 3 cases were fused at L4,5 and 10 at L5S1. The Oswestry Disability Index (ODI) w as recorded to evaluate the function preoperatively, and in the 2nd week, 3rd, 6 th and 12th month postoperatively. X-ray was taken to observe the fusion and the subsided cage. Results The operative time ranged from 50 to 180 min with a mean of 120 min, and the bleeding volume ranged from 50 to 300 ml with a mean of 80 ml. There were complications in 2 cases, one which was caused by laparoscopic mi sguidance, and the other was bleeding due to a small vessel injury. All the case s were followed-up from 12 to 24 months, with a mean of 16.6 months. The ODI was found with significant difference comparing preoperatively to at 2nd week, 3rd, 6th and 12th month postoperatively (P