Treatment strategy and curative effect analysis of os odontoideum complicated with atlantoaxial joint dislocation / 中国骨伤

OBJECTIVE@#To explore the treatment strategy and clinical efficacy for os odontoideum complicated with atlantoaxial dislocation.@*METHODS@#The clinical data of 17 patients with os odontoideum complicated with atlantoaxial dislocation surgically treated from January 2006 to January 2015 were retrospectively analyzed, including 7 males and 10 females, aged 17 to 53 (43.1±11.3) years old;course of disease was 3 to 27(10.2±6.9) months. All patients received cranial traction before operation, 12 of 14 patients with reducible dislocation were treated by posterior atlantoaxial fixation and fusion, and 2 patients with atlantooccipital deformity were treated by posterior occipitocervical fixation and fusion;3 patients with irreducible alantoaxial dislocation were treated by transoral approach decompression combined with posterior atlantoaxial fixation and fusion. The operation time, intraoperative blood loss and perioperative complications were recorded. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were used to evaluate the change of neck pain and neurological function. Atlantoaxial joint fusion rate was evaluated by CT scan.@*RESULTS@#The operation time of posterior fixation and fusion ranged from 86 to 170 (92.2±27.5) min, and the intraoperative blood loss was 200-350 (250.7±65.2) ml. No vertebral artery injury and spinal cord injury were recorded. Among the patients underwent atlantoaxial fixation and fusion, 1 patient with reducible dislocation fixed by C@*CONCLUSION@#Surgical treatment of os odontoideum complicated with atlantoaxial dislocation can achieve satisfactory results, improve the patient's neurological function and improve the quality of life, however the surgical options needs to be individualized.

Comparison of the effects of injured vertebra pedicle fixation combined with vertebroplasty and vertebra pedicle screw fixation combined with vertebroplasty in the treatment of osteoporotic thoracolumbar burst fractures / 中国骨伤

OBJECTIVE@#To assess the curative effects of injured vertebra pedicle fixation combined with vertebroplasty and short-segment pedicle screw fixation combined with vertebroplasty in treatment of osteoporotic thoracolumbar burst fractures.@*METHODS@#Seventy patients with osteoporotic thoracolumbar burst fractures who met the inclusion criteria were collected in the study from January 2015 to December 2017. Among them, 35 patients were treated with injured vertebra pedicle fixation combined with vertebroplasty (group A), including 20 males and 15 females, aged from 55 to 74 years with an average of (64.03± 7.82) years. Twenty-six cases were type A3 and 9 cases were type A4 according to the AO typing;another 35 patients were treated with short segment pedicle screw fixation combined with vertebroplasty (group B), including 18 males and 17 females, aged from 54 to 72 years with an average of (62.78±6.40) years. Twenty-eight cases were type A3 and 7 cases were type A4 according to AO typing. Operation length, intraoperative bleeding volume, complication, imaging parameters and clinical effects were compared between the two groups.@*RESULTS@#All the patients were followed up for at least 12 months. There were no significant differences in gender, age, injury site, preoperative VAS, Cobb angle, and injured vertebral height before surgery. There were no significant differences in operation length, intraoperative bleeding volume between two groups. In terms of VAS scores before surgery, 1 week after surgery, and at the final follow up, group A was 5.5 ±2.5, 1.8 ±0.8, 0.9 ±0.4, group B was 5.4 ± 2.3, 1.7±0.6, 1.2±1.8, respectively;injured vertebral height was (40.4±8.8)%, (92.0±4.9)%, (87.1±3.8)% in group A, and (41.2±6.6)%, (93.2±4.6)%, (80.0±4.3)% in group B;Cobb angle was (18.4±6.9) °, (2.8±2.2) °, (4.2±2.6) ° in group A, and (16.8±7.2) °, (2.7±2.5) °, (6.0±2.4) ° in group B. There were significant differences in the 3 parameters above before the operation and at the final follow up in all groups (<0.05). There were significant differences in the Cobb angle and injured vertebral height between 1 week after operation and at the final follow up (<0.05). At the final follow up, injured vertebral height in group A was obviously better than that in group B (<0.05). Internal fixation failure occurred in 2 cases from the group A, and occurred in 4 cases from the group B. There were no neurological complications in both groups.@*CONCLUSION@#For osteoporotic thoracolumbar vertebral burst fractures, injured vertebra pedicle fixation combined with vertebroplasty and vertebra pedicle screw fixation combined with vertebroplasty can achieve good clinical effects. However, injured vertebra pedicle fixation combined with vertebroplasty is better at maintaining postoperative vertebral height and sagittal arrangement, and reducing internal fixation related complications. The treatment strategy is worthy of application and promotion.

Percutaneous pedicle screw fixation combined with limited-open decompression technique for thoracolumbar fractures with neurologic deficit / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of percutaneous pedicle screw fixation combined with limited open decompression technique for the treatment of thoracolumbar fractures with neurologic deficit.</p><p><b>METHODS</b>The clinical data of 76 patients with thoracolumbar fractures with neurologic deficit underwent percutaneous pedicle screw fixation combined with limited open decompression technique from June 2010 to June 2014 were retrospectively analyzed. There were 45 males and 31 femals, aged from 17 to 56 years with an average of 32.5 years old. According to the classification of Denis, 33 cases were type A, 26 cases were type B, 17 cases were type C. According to the criterion of American Spinal Injury Association(ASIA), 13 cases were grade A, 9 cases were grade B, 21 cases were grade C, 33 cases were grade D. The operative time, intraoperative blood loss, postoperative internal fixation lossening and breakage were recorded. The informations of the Cobb angle, the anterior height of injured vertebra, canal stenosis were observed before operation, 3 days after operation, and the final follow-up. The improvement of neurologic function were analyzed at final follow-up.</p><p><b>RESULTS</b>All the patients were followed up from 13 to 47 months with an average of 32.1 months. The mean operative time was 159 min (136 to 218 min) and the intraoperative blood loss was 225 ml(150 to 360 ml). The anterior height of injured vertebra was increased from (52.0±5.9)% before operation to (87.2±1.8)% at 3 days after operation, and (86.1±1.5)% at final follow-up (=45.27,=0.000); the Cobb angle was decreased from (29.7±8.2)° before operation to (5.7±2.9)° at 3 days after operation, and (5.9±3.6)° at final follow-up (=34.62,=0.000); the canal stenosis was decreased from (37.5±7.2)% before operation to (12.3±3.3)% at 3 days after operation, and (11.9±3.1)% at final follow-up(=37.02,=0.000); there was no significant differences between postoperative 3 days and the final follow-up about the above parametres(>0.05). According to ASIA criterion, the spinal cord function was classified as grade A in 13 cases, grade B in 0 cases, grade C in 10 cases, grade D in 21 cases and grade E in 32 cases at final follow-up. Internal fixation lossening and breakage occurred in 2 cases.</p><p><b>CONCLUSIONS</b>Percutaneous pedicle screw fixation combined with limited open decompression technique can obtain satisfactory clinical effect for patients with thoracolumbar fractures with neurologic deficit, and have a good recovery of nerve function can be observed.</p>

Case-control study of pedicle screw fixation combined with vertebroplasty and injured vertebra pedicle fixation in treatment of osteoporotic thoracolumbar burst fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the curative effect of short-segment pedicle screw fixation combined with vertebroplasty and injured vertebra pedicle fixation in treating osteoporotic thoracolumbar burst fractures.</p><p><b>METHODS</b>A retrospective study was performed for 52 patients with thoracolumbar burst fractures from August 2010 to August 2015. Among them, 27 patients(group A) were treated with short-segment pedicle screw fixation combined with vertebroplasty, including 17 males and 10 females, aged from 54 to 68 years old with an average of(61.01±5.41) years, 16 cases were type A3 and 11 cases were type A4 according the new AO typing. Other 25 patients (group B) were treated with short-segment pedicle screw fixation combined with injured vertebra pedicle fixation, including 12 males and 13 females, aged from 55 to 66 years old with an average of (59.28±6.12) years, 18 cases were type A3 and 7 cases were type A4 according the new AO typing. Operation time, intraoperative bleeding volume, complication, image data and clinical effect were compared between two groups.</p><p><b>RESULTS</b>All the patients were followed up for 12 to 15 months with an average of (12.4±2.1)months. There was no significant difference in general data(including gender, age, injured site, preoperative VAS score, Cobb angle, injured vertebral anterior border height) between two groups. There was no significant differences in operation time, intraoperative bleeding volume between two groups. Preoperative, one week after operation and final follow-up, VAS scores were 5.2±0.5, 1.2±0.2, 0.8±0.1 respectively in group A and 5.0±0.6, 2.5±0.4, 1.3±0.2 in group B; injured vertebral anterior border height were (49.4±6.8)%, ( 94.5±1.2)%, ( 94.1±3.7)% respectively in group A and (48.2±7.0)%, ( 94.3±4.1)%, ( 90.0±2.3)% in group B;Cobb angles were (20.4±5.2) °, (2.5±1.8) °, (4.4±1.7)° respectively in group A and (19.8±6.8)°, (2.4±1.7)°, (7.0±1.2)° in group B. At final follow-up, VAS, Cobb angle, injured vertebral anterior border height in two groups were obviously improved(<0.05). Postoperative at 1 week and final follow-up, VAS score of group A was lower than that of group B(<0.05);and there was no significant difference in Cobb angle between two groups(>0.05); there was significant difference in injured vertebral anterior border height between two groups(<0.05). The complication of internal fixation failure had 1 case in group A and 4 cases in group B.</p><p><b>CONCLUSIONS</b>For the treatment of single osteoporotic thoracolumbar burst fractures, short-segment pedicle screw fixation combined with vertebroplasty is better than combined with injured vertebra pedicle fixation in clinical effect, it can relieve pain, maintain injured vertebral height and sagittal alinement, reduce the complications associated with internal fixation, and be worth spread in clinic.</p>

French door segmented laminectomy decompression for severe cervical ossification of posterior longitudinal ligament complicated with spinal cord injury / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of French door segmented laminectomy decompression for severe cervical OPLL complicated with spinal cord injury.</p><p><b>METHODS</b>The clinical data of 38 patients with serious cervical OPLL complicated with spinal cord injury were retrospectively analyzed and these patients were treated with French door segmented laminectomy decompression and internal fixation from June 2012 to June 2014. There were 25 males and 13 females, aged from 42 to 78 years with an average of 58.2 years. Of them, 35 cases suffered from aggravating neurological symptoms with a definite precipitating factor. Spinal cord injury was related to minor injury of the neck, such as hyperextension of the neck in 3 cases. Preoperative Japanese Orthopaedic Score (JOA) was 8.1±1.7 and Neck Disability Index (NDI) was 19.8±4.4. Preoperative CT scans showed the range of OPLL was more than three segments. The spinal canal was occupied 50% to 85% with an average of 70.7%.</p><p><b>RESULTS</b>All the patients were followed up for 10 to 24 months with an average of 15.6 months. The operative time was 90 to 150 min with an average of 120 min and blood loss was 300 to 800 ml with an average of (480±80) ml. At final follow-up, NDI and JOA were 7.5±2.5 and 13.5±2.0, respectively, and they were obviously improved compared with preoperation. Preoperative cervical Cobb angle was (8.10±2.70)° and at final follow-up was (15.60±1.80)°, and there was significant difference between preoperative and postoperative (<0.05). Deep infection occurred in 1 case, epidural hematoma in 1 case, C₅ nerve root palsy in 3 cases, and axial symptom in 8 cases after operation. No serious complications, such as vertebral artery injury, cerebrospinal fluid leakage, deterioration of neurological dysfunction, or internal fixation failure was found.</p><p><b>CONCLUSIONS</b>French door segmented laminectomy decompression is safe and feasible for severe cervical OPLL complicated with spinal cord injury, and it is worth to be popularized in future.</p>

The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease.</p><p><b>METHODS</b>From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning.</p><p><b>RESULTS</b>The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up(<0.05); ODI was decreased from preoperative (42.58±1.55)% to (12.55±0.84)% at final follow-up(<0.05). At final follow-up, CT scanning confirmed 8 cases completely fused and 5 cases partly fused;the intervertebral foramen area was increased from preoperative (94.86±2.44)mm2 to (150.70±7.02)mm2(<0.05).</p><p><b>CONCLUSIONS</b>Extreme lateral interbody fusion combined with percutaneous pedicle screw fixation is an ideal method and can obtain early good clinical effects in treating lumbar degenerative disease.</p>

Immunomodulation and liver protection of Yinchenhao decoction against concanavalin A-induced chronic liver injury in mice / 中西医结合学报

<p><b>OBJECTIVE</b>This study investigated the immunoregulatory and protective roles of Yinchenhao decoction, a compound of Chinese herbal medicine, in a mouse model of concanavalin A (ConA)-induced chronic liver injury.</p><p><b>METHODS</b>Female BalB/c mice were randomly divided into 4 groups: normal control, ConA model, ConA model treated with Yinchenhao decoction (400 mg/kg, orally), and ConA model treated with dexamethasone (0.5 mg/kg, orally). All treatments were given once a day for 28 d. Except of the normal control, mice received tail vein injection of ConA (10 mg/kg) on days 7, 14, 21, and 28, at 1 h after treatment with Yinchenhao decoction or dexamethasone or saline to induce chronic liver injury.</p><p><b>RESULTS</b>Repeated ConA injection induced chronic liver injury, which was evidenced by inflammatory cell infiltration and necrosis, increased serum alanine aminotranferease activities, decreased albumin levels, and an imbalanced expression of immunoregulatory genes in the liver tissues including significantly enhanced interferon-γ, interleukin-4, monocyte chemotactic protein-1, and cluster of differentiation 163 mRNA levels, and reduced tumor necrosis factor-α and interleukin-6 mRNA levels. Treatment with Yinchenhao decoction significantly reversed the ConA-induced changes in immunoregulatory gene expression in the liver tissues, reduced serum alanine aminotranferease activity, enhanced serum albumin level, and attenuated the extent of liver inflammation and necrosis. Furthermore, Yinchenhao decoction did not result in hepatocyte degeneration and spleen weight loss that were observed in mice received long-term treatment with dexamethasone.</p><p><b>CONCLUSION</b>Yinchenhao decoction treatment protected liver against the ConA-induced chronic liver damage and improved liver function, which were associated with the modulation of gene expression related to immune/inflammatory response.</p>

Nuclear medical molecular imaging of tumor angiogenesis: current status and future prospects / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the current status and progress on nuclear medical molecular imaging of angiogenesis.</p><p><b>DATA SOURCES</b>A literature search was performed in Medline and PubMed published in English up to May 31, 2012. The search terms were molecular imaging, nuclear medicine and angiogenesis.</p><p><b>STUDY SELECTION</b>Articles studying molecular imaging of angiogenesis using radionuclide were selected and reviewed.</p><p><b>RESULTS</b>Molecular imaging has been used for studying angiogenesis by targeting integrin αVβ3, VEGF/VEGFR, and matrix metalloproteinases (MMPs) with radionuclide-labeled tracers. The technology has been shown to be able to assess the angiogenesis status and/or predict the efficacy of anti-angiogenic therapy. Future directions of the research on the molecular imaging of angiogenesis include development of new tracers with better tumor targeting efficacy, desirable pharmacokinetics, and easy translation to clinical applications.</p><p><b>CONCLUSION</b>Advances in molecular imaging of angiogenesis using radioculcide will make the technology a valuable tool for personalized anti-angiogenesis treatment.</p>

Clinical study of correlation between the expression of ICBP90 and hematopoietic suppression in patients with chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the change of ICBP90 expression in patients with chronic benzene poisoning and explore the correlation between the expression of ICBP90 and benzene-induced hematotoxicity.</p><p><b>METHODS</b>The bone marrow samples were from 13 chronic benzene poisoning cases with hematopoietic suppression, 11 chronic benzene poisoning cases with hematopoietic regeneration and 10 controls. Western-blot was applied to detect the ICBP90 expression in bone marrow mononuclear cells (BMNCs). The correlation between ICBP90 expression and hematopoietic suppression in patients with chronic benzene poisoning was analyzed.</p><p><b>RESULTS</b>The ICBP90 expression of BMNCs in 13 chronic benzene poisoning cases with hematopoietic suppression was significantly lower than that in controls (P < 0.01). The ICBP90 expression of BMNCs in 11 chronic benzene poisoning cases with hematopoietic regeneration was significantly higher than those in controls and 13 chronic benzene poisoning cases with hematopoietic suppression (P < 0.05 or P < 0.01), respectively. There were good correlations between the expression of ICBP90 and white blood cell and platelet counts in patients with chronic benzene poisoning (r(1) = 0.555,P = 0.006; r(2) = 0.854,P < 0.01).</p><p><b>CONCLUSION</b>The ICBP90 expression of BMNCs in the chronic benzene poisoning cases with hematopoietic suppression decreased significantly, and the ICBP90 expression of BMNCs in the chronic benzene poisoning cases with hematopoietic regeneration increased significantly. There was good correlation between hematopoietic suppression and ICBP90 expression in patients with chronic benzene poisoning.</p>

Development and applications of the extracorporeal control point module on multi-mode medical images / 中国医疗器械杂志

This paper introduces a display module which can be used on multi-mode medical images. The module has a small size and can be easily used for point-selecting puncture diagnosis and treatment, and registration for image fusion control points.

Clinical study of ESHAP regimen for relapsed or refractory aggressive non-Hodgkin lymphoma / 肿瘤研究与临床

Objective To evaluate the efficacy and safety of ESHAP regimen,as a salvage regimen, in treating patients with relapsed or refractory aggressive NHL.Methods 38 patients with relapsed or refrac- tory aggressive NHL were selected to be treated by ESHAP regimen.Results The 38 patients received ES- HAP regimen with a range of 2～6 cycles. The total RR was 55.3 % with complete response(CR)rate of 26.3 %.The major toxicity was myelosuppression with infection,which was tolerable.Conclusion ESHAP regimen is one of safe and effective salvage regimens for the patients with relapsed or refractory aggressive NHL.

Apoptosis induced by hydroquinone in bone marrow mononuclear cells in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effect of hydroquinone on apoptosis of bone marrow mononuclear cells, and to evaluate the toxic effect of benzene on stem cells.</p><p><b>METHODS</b>Cell morphology was observed by HT fluorescent stain method, and DNA fragments were analyzed by agarose gel electrophoresis. Anti-Annexin V FITC plus PI staining for apoptotic and necrotic rate was examined by flow cytometer.</p><p><b>RESULTS</b>After adding different concentrations of hydroquinone to the cells for 6 h culture, the fluorescent intensity of nucleus increased, the color of nucleus became deep and inhomogeneous, and the chromatin was condensed and distributed around the neucleus. DNA ladder was detected in all samples. Cell apoptotic rate in different concentration of hydroquinone groups was significantly higher than that in blank control group (P < 0.05). With the increase of the concentration of hydroquinone, the apoptotic and necrotic rate also increased. The optimal concentration of hydroquinone was 50 micro mol/L. When it was >or= 75 micro mol/L, the necrotic rate increased significantly. Hydroquinone-induced apoptosis was associated with culture time at the concentration of 50 micro mol/L, and the peak apoptotic time was 10 h, then the apoptotic rate decreased and necrotic rate increased.</p><p><b>CONCLUSION</b>Hydroquinone can induce apoptosis of bone marrow mononuclear cells in vitro with dose-effect and time-effect relationship.</p>

The protective effect of amifostine on hydroquinone-induced apoptosis in bone marrow / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the protective effect of amifostine on hydroquinone-induced apoptosis of bone marrow mononuclear cells in vitro.</p><p><b>METHODS</b>The mononuclear cells were separated and divided into four groups: blank control, amifostine group, hydroquinone group, amifostine + hydroquinone group. The cell apoptotic rate was examined in separated group at different time point, and apoptosis was detected by HT stain, then cell morphology was observed under fluorescent microscope and DNA fragments was tested by agarose gel electrophoresis. In addition, apoptotic and necrotic rate was detected by flow cytometer.</p><p><b>RESULTS</b>After 10 hour culture, DNA ladder was detected in the hydroquinone group, but not in other groups. The apoptotic rate was not significantly different between amifostine group and blank control group at different culture time (P > 0.05). After 8 - 12 hour culture, the apoptotic rate in amifostine + hydroquinone group was significantly lower than that in the group of hydroquinone alone (P < 0.01). After 18 - 48 hour culture, the necrotic rate in amifostine + hydroquinone group was lower than that in the group of hydroquinone alone (P < 0.05).</p><p><b>CONCLUSION</b>Amifostine can protect cell from hydroguinone-induced bone marrow damage through inhibition on cell apoptosis, and decrease in cell necrosis.</p>