ABSTRACT
BACKGROUND@#Andersson lesions (ALs), also known as spondylodiscities, destructive vertebral lesions and spinal pseudarthrosis, usually occur in patients with ankylosing spondylitis (AS). Inflammatory and traumatic causes have been proposed to define this lesion. Different surgical approaches including anterior, posterior, and combined anterior and posterior procedure have been used to address the complications, consisting of mechanical pain, kyphotic deformity, and neurologic deficits. However, the preferred surgical procedure remains controversial. The aim of this study was to illustrate the safety, efficacy, and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in AS.@*METHODS@#From June 2008 to January 2013, 23 patients (18 males, 5 females) at an average age of 44.8 years (range 25-69 years) were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our department. All sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the follow-up period. Assessment of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading system. Ankylosing spondylitis quality of life (ASQoL) and visual analog scale (VAS) scores were performed to evaluate improvements in daily life function and back pain pre-operatively and post-operatively. Paired t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric comparisons. The radiographic data change was evaluated by repeated measure analysis of variance.@*RESULTS@#The mean operative duration was 205.4 min (range 115-375 min), with an average blood loss of 488.5 mL (range 215-880 mL). Radiographical and clinical outcomes were assessed after a mean of 61.4 months of follow-up. The VAS back pain and ASQoL scores improved significantly in all patients (7.52 ± 1.31 vs. 1.70 ± 0.70, t = 18.30, P 0.05, respectively).@*CONCLUSIONS@#The modified posterior wedge osteotomy is an accepted surgical procedure for treating thoracolumbar kyphosis with ALs in AS and results in satisfactory local kyphosis correction, solid fusion, and good clinical outcomes.
ABSTRACT
Sharp injury is a common occupational injury occurs in hospital, it is also an important way for health care workers to be infected with blood-borne pathogens, standardized use of sharps containers can effectively prevent the occurrence of sharp injury.Sharps containers are widely used in China, but the specifications are limited and the products are single, there is still room for improving safety performance.In view of the problems existing in clinical use, Chinese scholars have made a lot of improvements on sharps containers.The author suggests that relevant units should consider the design concept of clinic to develop and popularize more reasonable safe sharps containers for clinical application, and take other comprehensive behavioral control measures, so as to effectively reduce the occurrence of sharp injury.
ABSTRACT
Objective To explore the expression of KL-6/MUC1 and the possible impact on alveolar development in lung tissue of newborn rats with hyperoxia-induced bronchopulmonary dysplasia (BPD).Methods Sixty-four newborn rats were randomly divided into 2 groups:hyperoxic group and control group.The rats in hyperoxic group were exposed to high oxygen volume fraction of 900 mL/L,and the rats in control group were exposed to normal oxygen volume fraction of 210 mL/L.The experimental control factors were the same in two groups.Eight rats were randomly selected from each group on day 1,3,7,and 14 after oxygen exposure.The alveolar development was evaluated by the number of radial alveolar count (RAC) and the alveolar area/pulmonary septal area ratio (A/S).The location,distribution,and expression of KL-6/MUC1 in the lung tissue were detected by the fluorescent immunoassay,Western blot,and reverse transcription polymerase chain reaction.Results Compared with the control group,the RAC in hyperoxic group decreased on day 3 and continued to decline on day 14.The A/S in hyperoxic group increased on day 7 and peaked on day 14 (P ＜0.05).KL-6/MUC1 expressed in both bronchial epithelial cells and alveolar epithelial cells of newborn rats.KL-6/MUC1 protein in hyperoxic group peaked on day 1 and decreased later,which was higher than that of the control group (P ＜ 0.05),the level of KL-6/MUC1 was positively correlated with RAC (r =0.707,P ＜ 0.05)and negatively correlated with A/S(r =-0.716,P ＜ 0.05).MUC1 mRNA in hyperoxic group was slightly higher than that in control group,but no significant inter-or intra-group difference was observed (P ＞ 0.05).Conclusions The highest expression of KL-6/MUC1 can be observed in the early phase of hyperoxic exposure,and it decreases to the lowest on the key point of pulmonary development.KL-6/MUC1 may play an important role in the alveolar development.