Diagnosis and treatment strategy of lower cervical spine injuries based on modified Moore classification / 中华创伤杂志

ObjectiveTo investigate the modification method of Cervical Spine Injury Severity Score System and discuss diagnosis and treatment strategy of lower cervical spine injuries.Methods Treatments of lower cervical spine injuries were selected according to the injury severity graded by the modified Moore' s classification system.Conservative therapy could be adopted for the patients with stability quantification rating ＜ 3 points or for the those with stability quantification rating =3 points but without spinal cord or nerve root compression.Surgical treatment was recommendable for the patients with stability quantification rating =3 points and with spinal cord or nerve root compression.Surgical therapy could be required for the patients with stability quantification rating ≥4 points and with risk of lower cervical instability.The higher the stability quantification score implied the stronger the surgical indications.Lower cervical spine injury combined with spine cord or nerve root compression had absolute surgical indications.At the same time,therapies were selected based on patients' other factors.ResultsBased on basic principles of the modified Moore' s classification system together with opinions of the patients and their relatives,14 patients were managed with surgical treatment and 16 with conservative treatment.Among the patients with complete spinal cord injury (Grade A),two patients treated surgically showed no obvious signs of spinal function recovery,but their nerve root irritation symptoms disappeared; the other one patient who needed surgery but received conservative treatment had no change of the spinal cord function and nerve root irritation.The patients with incomplete spinal cord injury (Grades B,C and D) treated surgically obtained certain degree of spine cord function recovery,with their American Spinal Injury Association (ASIA) score raised by 0.5 grade on average.However,the patients who needed surgery but received conservative treatment gained average increase of ASIA score for 0.5 grade.Imaging examination showed that patients without combined spinal injuries obtained interbody fusion after surgery,with normal alignment and height of the cervical vertebra but without presence of vertebral shift or instability. ConclusionsThe modified Moore' s classification system takes patients' spiaal injury condition and other factors into consideration in selection of conservative or surgical treatment,which improves the Cervical Spine Injury Severity Score System to some extent and has prospect of clinical application.

The value of three-dimensional DSA in diagnosis and interventional treatment of Budd-Chiari syndrome caused by the obstruction of the inferior vena cava / 中华放射学杂志

Objective To investigate the value of three-dimensional digital subtraction angiography (3D-DSA)in the diagnosis and interventional treatment of Budd-Chiari syndrome caused by the obstruction of inferior vena cava(IVC).Methods Twenty-one patients with complex Budd-Chiari syndrome caused by the obstruction of IVC underwent 3D-DSA after two-dimensional-DSA(2D-DSA)was performed with posterior-anterior view.The images of 2D-DSA and 3D-DSA were independently reviewed by two senior interventional radiologists iu a double-blinded way.Percutaneous transluminal angioplasty or stent placement of IVC were performed according to the results of 2D-DSA and 3D-DSA.Results Different aspects of the IVC in all patients were demonstrated on the 3D-DSA images,including the mowhology and the location of obstructions,the origins of collateral vessels and their relationships to the IVC.Collateral vessels originated from the site of IVC occlusions in 9 patients were detected by the 3D-DSA.However.the 2D-DSA provided excellent visualization of the vascular structures of the IVC in 7 patients.and the collateral vessels origihated from the site of IVC occlusions were shown in 2 patients.The 3D-DSA was significantly superior to the 2D-DSA in detecting the IVC obstructions and the collateral vessels(P＜0.05).The virtual angioscopy of the 3D-DSA was able to visualize free IVC thrombosis in 3 paitents.and mural IVC thrombosis in 1 patient.The procedures were successful in all patients.There were no other complications except the rupture of IVC in 1 patient.Conclusion The 3D-DSA can offer valuable informations in diagnosis of IVC obstruction.and it may play an important role in interventional treatment of Budd-Chiari syndrome.

A new gene in systemic lupus erythematosus pathogenesis / 中华风湿病学杂志

Objective To explore the role of a new apoptosis related gene TFAR 19 in the pathogenesis of systemic lupus erythematosus (SLE) and the relationship between TFAR 19 and SLE.Methods ELISA was used to test if there is relation between TFAR 19 and SLE.Results It was found that in active SLE patients there was higher titer of TFAR 19 antibody than that in stability patients and normal controls.No significant difference was seen between stability patients and normal controls.Conclusion It is first put forward that TFAR 19 may be related with SLE pathogenesis and disease activity.

Apoptosis of Keratinocytes and Psoriasis / 中华皮肤科杂志

In order to study the status of cell apoptosis in psoriatic epidermis, we have investigated the changes of the lesions in various stages in patients with psoriasis vulgaris by using terminal deoxynueleotidyl transferase-mediation dUTP-biotin nick end labelling (TUNEL). The results showed that the highest frequency of apoptotic keratinocytes was observed in the early scaling papular lesions, and the frequency was reduced in the progressive maculo-papular lesions and the coalescent plaques successively. The frequency of hyperproliferation of epidermis was in the reverse order in comparison with the above results. These results suggest that increased apoptosis of keratinocytes is the initial change of psoriatic epidermis, then hyperproliferation of keratinoeytes follows.

The role of TF-1 cell apoptosis-related gene 19 in systemic lupus erythematosus / 中国病理生理杂志

AIM: To clarify the role of new apoptosis-related gene, TF-1 cell apoptosis-related gene 19(TFAR19), in the pathogenesis of systemic lupus erythematosis (SLE) and the relationship between TFAR19 and SLE. METHODS: DNA Ladder detection, Western blotting, immunological fluorescence method, ELISA and so on were used to test if ultraviolet B(UVB) could induce HaCaT cell apoptosis and TFAR19 expression. RESULTS: HaCaT cell apoptosis could be detected after 24 hours of 30 mj/cm 2 UVB irradiation. Also, we found that in active SLE patients, the TFAR19 antibody was increased, but not significant compared to the normal control. CONCLUSION: TFAR 19 is involved in the process of UVB induced ketatinocyte line HaCaT apoptosis and SLE pathogenesis.