Repair of two soft tissue defects on the same finger by a pedicled tandem flap with first dorsal metatarsal artery-second toe tibial artery in series / 中华显微外科杂志

Objective:To investigate the technique and clinical effect of repairing 2 soft tissue defects on the same finger with a pedicled tandem flap of the first dorsal metatarsal artery and the second toe tibial artery.Methods:From March, 2018 to May, 2020, 8 patients, which were 5 males and 3 females, with 2 soft tissue defects in the same finger, were repaired with the first dorsal metatarsal artery flap in series with the second toe tibial flap. The causes of injury: 4 by crush, 2 by heavy object, and 2 by thermal press. There were 4 defects on index fingers, 2 on middle fingers and 2 on ring fingers. The defects ranged from 2.0 cm×2.5 cm to 2.5 cm×3.0 cm. All defects had exposed bone or tendon at varying degrees and 3 with phalanx fractures. Three patients underwent emergency surgery, the other 5 had sub-emergency surgery which were performed 3 to 5 days after the injury. The size of the flaps was 2.0 cm×2.5 cm to 3.0 cm×3.5 cm. The donor sites were sutured directly in 3 patients and 5 patients received skin grafting. The regular follow-up was performed. The survival of flaps, character, feeling and Total active motion(TAM), recovery of the foot donor area and complications were observed.Results:The operation time ranged from 2.0 to 5.5 hours, with an average of 3.5 hours. No vascular crisis occurred and all flaps survived after the surgery. All patients entered follow-up for 3-20 months, with an average of 8 months. The flaps had a good plump appearance, soft texture, good elasticity, and with a high similarity to the surrounding skin. The TPD of the flaps was 6-15 mm, with an average of 8 mm. The fingers had good flexion and extension functions. The incision in the donor site of the foot healed by first intention. The walking, running and jumping were normal without pain or discomfort.Conclusion:The first dorsal metatarsal artery-second toe tibial artery tandem flap has been used to repair 2 soft tissue defects in same finger. It simplifies the revascularisation of the flap together with exact surgical curative effect.

Transplantation of slice nail bed flap of great toe with vascular anastomosisin repairing nail bed and soft tissue defect of fingers / 中华显微外科杂志

Objective To discuss the clinical effect of transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers.Methods From January,2015 to March,2018,16 cases (16 fingers) of partial nail-bed defect at fingers were repaired with transplantation of slice nail bed flap of great toe with vascular anastomosis.All cases were combined with palmar soft tissue defect at distal segment fingers.The area of nail bed defects were from 0.8 cr×0.5 cm to 1.2 cm×1.0 cm.The area of soft tissue defects were from 1.2 cm×1.0 cm to 2.5 cm×1.5 cm.The average time from injury to operation was 3.6 hours after injuries (ranging from 1 hour to 8 hours).The area of slice nail bed flap incised during operation were from 2.5 cm×1.2 cm to 3.2 cm×1.8 cm,and the donor site was sutured directly.All patients were followed-up regularly for nail appearance,function and donor healing.Among them,11 cases were followed-up by clinic,4 cases by WeChat,and telephone follow-up was performed in 1 case.Results The nail-bed flap after transplantation survived successfully.The followed-up time were from 6 to 18 months,the average time was 9 months.Longitudinal spine and rough appearance occurred in 1 case.Others were flat,smooth,complete attachment of nail body and nail bed.The flaps had good appearance,texture and elasticity at 6 months after surgery,and two-point discrimination was 6-12 mm(average,8 mm).The toenails at donor sites grew well.No walk-associated pain after long-term following-up.Six months after surgery,according to standard for efficacy evaluation of nail regeneration,12 cases were excellent,3 cases were good and 1 case was acceptable.Conclusion Transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers is one of the effective methods for repairing nail-bed defect at fingers.

Hallux-nail flap with distal phalanx combined with iliac bone for reconstruction of thumb with Ⅲ degree defect / 中华显微外科杂志

Objective To explore the clinical effect of using hallux-nail flap with the distal part of phalanx combined with iliac bone for reconstruction of thumb with Ⅲ degree defect.Methods From June,2011 to June,2016,7 patients with thumb Ⅲ degree defect were treated with the hallux-nail flaps with distal phalanx combined with iliac bone to reconstruct thumbs.According to the thumb defect indexing method reported by Cheng Guoliang,the type 1 of thumb Ⅲ degree defect was 4 cases,and the type 2 of Ⅲ degree defect was 3 cases.The donor site was covered with skin grafting in 1 case,free superficial iliac artery graft in 5 cases and free peroneal artery perforator flap in 1 case.All patients kept the number and length of donor toes.Regular follow-up was performed after operation to observe the function,shape,feeling of finger reconstruction,the survival condition of flaps or skin graft in donor site,etc.It was also observed if the pain by walking actually exists in the long-term effect.Results All of the reconstructed thumbs survived.One patient suffered the necrotic in the donor site repaired by superficial iliac artery flap,which was successfully covered with the skin graft.All patients were followed-up from 3 months to 18 months (mean,8 months).The reconstructed thumb with smooth nail had fine textile and good elasticity,good flexion and extension function of the palm,fingers and the metacarpophalangeal joint.The donor sites recovered with fine texture,and there were no difficulties in walking and running and no complaint about the pain and discomfort.According to the Trial Criteria of Upper Limb Functional Evaluation of Chinese Medical Association Hand Surgery Society,5 cases resulted in excellent,and 2 cases resulted in good.Conclusion The hallux-nail flap with the distal phalanx combined with iliac bone is an excellent option to reconstruct thumb with Ⅲ degree defect with the outcome of good function and appearance.The trauma of the donor site is small and the number and length of the toes are remained.The clinical effect is good.

Decorative repair of nail-bed defect at finger by partial nail-bed flap at second toe with blood-vessel anastomosed / 中华显微外科杂志

Objective To discuss the clinical effect of partial nail-bed flap at second toe with blood-vessel anastomosed in repair of different types of nail-bed defects at finger.Methods From July,2010 to July,2015,25 cases of partial nail-bed flap at second toe with blood-vessel anastomosed were treated,including 14 males and 11 females,with an age range from 18 to 45 years old (average 25 years old).Eleven cases at index finger,6 cases at middle finger,5 cases at ring finger and 3 cases at little finger.According to the classification of nail bed defect site,9 cases at lateral,5 cases at nail root and 11 cases at distal.All cases were combined skin and soft tissue defect.The area of defects were from 1.1 cm × 2.0 cm to 2.5 cm × 3.2 cm.The time from injury to admission were from 1 hour and 12 minutes to 3 hours and 12 minutes,the average time was 2.1 hours.The area of incised nail flap during operation were from 1.2 cm × 2.2 cm to 2.6 cm × 3.5 cm.The donor site was sutured directly or repaired with free skin graft.The toe length in all cases were retained.The nail shape,nail gloss,fine function of finger such as pinch,grip,grasp and restoration of the donor toes were compared in the follow-up.All patients were followed-up at regllar intervals.Results The nail-bed flap after transplantation and skin graft at donor site survived successfully,and primary healing of the wounds occured in all cases.The follow-up time were from 6 to 26 months(average 9 months).Longitudinal spine or transverse groove occurred in 3 cases at the nail-bed boundary between toe and finger,nail thickened and distal tilted occurred in 1 case,flat,smooth,no deformity nail and glossy deck occurred in others.The flap had good appearance,texture and elasticity.Two-point discrimination was 5-9 mm,averageal of 6 mm.The donor toe had no shortening and no pain after long-term following.According to effectiveness standard for fingernail regeneration:19 cases were excellent and 6 cases were good.Conclusion Partial nail-bed flap at second toe wih bloodvessel anastomosed in repairing nail-bed defects at finger,nail appearance is realistic and function recovered well postoperatively.

Blood Pressure Associated with Arsenic Methylation and Arsenic Metabolism Caused by Chronic Exposure to Arsenic in Tube Well Water / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The effects of arsenic exposure from drinking water, arsenic metabolism, and arsenic methylation on blood pressure (BP) were observed in this study.</p><p><b>METHODS</b>The BP and arsenic species of 560 participants were determined. Logistic regression analysis was applied to estimate the odds ratios of BP associated with arsenic metabolites and arsenic methylation capability.</p><p><b>RESULTS</b>BP was positively associated with cumulative arsenic exposure (CAE). Subjects with abnormal diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) usually had higher urinary iAs (inorganic arsenic), MMA (monomethylated arsenic), DMA (dimethylated arsenic), and TAs (total arsenic) than subjects with normal DBP, SBP, and PP. The iAs%, MMA%, and DMA% differed slightly between subjects with abnormal BP and those with normal BP. The PMI and SMI were slightly higher in subjects with abnormal PP than in those with normal PP.</p><p><b>CONCLUSION</b>Our findings suggest that higher CAE may elevate BP. Males may have a higher risk of abnormal DBP, whereas females have a higher risk of abnormal SBP and PP. Higher urinary iAs may increase the risk of abnormal BP. Lower PMI may elevate the BP. However, higher SMI may increase the DBP and SBP, and lower SMI may elevate the PP.</p>

Vacuolar Serine Protease Is a Major Allergen of Fusarium proliferatum and an IgE-Cross Reactive Pan-Fungal Allergen

PURPOSE: Fusarium species are among prevalent airborne fungi and causative agents of human respiratory atopic disorders. We previously identified a 36.5-kDa F. proliferatum component recognized by IgE antibodies in 9 (53%) of the 17 F. proliferatum-sensitized atopic serum samples. The purpose of this study is to characterize the 36.5-kDa allergen of F. proliferatum. METHODS: Characterization of allergens and determination of IgE cross-reactivity were performed by cDNA cloning/expression and immunoblot inhibition studies. RESULTS: Based on the finding that the 36.5-kDa IgE-binding component reacted with the mouse monoclonal antibody FUM20 against fungal vacuolar serine protease allergens, the cDNA of F. proliferatum vacuolar serine protease (Fus p 9.0101) was subsequently cloned. Nine serum samples from respiratory atopic patients with IgE binding to the vacuolar serine protease allergen of Penicillium chrysogenum (Pen ch 18) also showed IgE-immunoblot reactivity to rFus p 9.0101. The purified rFus p 9.0101 can inhibit IgE and FUM20 binding to the 36.5-kDa component of F. proliferatum. Thus, a novel and important Fus p 9.0101 was identified. The rPen ch 18 can inhibit IgE binding to Fus p 9.0101. It indicates that IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 also exists. Furthermore, neither rFus p 9.0101 K88A nor rPen ch 18 K89A mutants inhibited IgE binding to rFus p 9.0101. Lys88 was considered a critical core amino acid in IgE binding to r Fus p 9.0101 and a residue responsible for IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 allergens. CONCLUSIONS: Results obtained from this study indicate that vacuolar serine protease may be a major allergen of F. proliferatum and an important IgE cross-reactive pan-fungal allergen, and provide important bases for clinical diagnosis of fungal allergy.

Influence of arsenic exposure on menstruation / 中国地方病学杂志

Objective To study the influence of arsenic exposure on menstruation.Methods A cluster sampling method was applied to select the subjects of women aged 10 to 65 from Linhe,Hangjinhouqi and Wuyuan counties in Inner Mongolia in 2004.Drinking water samples were collected to detect arsenic levels,and menstrual related situation was surveyed.The subjects were divided into four groups according to drinking water arsenic concentration:control(≤0.01 mg/L),low(＞ 0.01-0.10 mg/L),moderate(＞ 0.10-0.20 mg/L) and high(＞ 0.20mag/L).Results A total of 602 women were surveyed.There were 83 subjects exposed to arsenic before menarche and their menarche age was (14.37 ± 1.54) years old.There were 90 people exposed to arsenic before menopause and the menopause age was (48.13-0.41) years old.The age of menarche and menopause were positively related to the years of arsenic exposure,and correlation coefficients were 0.268 and 0.278 (all P ＜ 0.05).Compared to control group(14.0％,16/112),menstrual abnormality rate decreased in low(12.1％,21/173) and high dose groups(10.2％,19/186),while increased in the moderate dose group(18.2％,16/88),but the differences were not statistically significant(x2 =3.664,P ＞ 0.05).Conclusions Long-term arsenic exposure delays the menarche and menopause age,suggesting that arsenic has certain endocrine disruption or estrogen-like effects.

Closed reduction and fixation for the treatment of Gartland type II and III supracondylar fracture of humerus in children / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the feasibility and results of closed reduction and fixation for the treatment of Gartland type I and III supracondylar fracture of humerus in children.</p><p><b>METHODS</b>From January 2004 to December 2011,110 children with supracondylar fracture of humerus were treated. Among them, 76 patients were boy and 34 patients were girl, ranging in age from 2 to 13 years old, averaged 7 years old. Ninety-eight patients were extension type and 12 patients were flexion type. There were 32 patients with fracture of Gartland type II and 78 patients with fractures of Gartland type III. Thirty-seven patients had distal rotational displacement. Under anesthesia, the upper arm and forearm of the affected limb were treated with contraction for several minutes. The patients were treated with closed manipulative reduction and plaster external fixation while the satisfactory reduction was confirmed by C-arm X-ray. After the reduction, 1 to 2 Kirschner pins were used through the radial side of the skin and plaster external fixation was carried out. Radiographic examination was conducted within 3 to 4 weeks after surgery,and the plaster and Kirschner pins were then removed, accompanied by rehabilitation training of the patients.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 3 to 18 months,with a mean of 12 months. All fractures healed within 6 to 8 weeks and the average healing time was 6.9 weeks. No complications such as cubitus varus deformity, neurovascular injury or Volkmann's contracture occurred. According to Flynn evaluation criteria,74 patients got an excellent result, 26 good and 10 fair.</p><p><b>CONCLUSION</b>Through carefully reading X-ray films,Gartland type II and III supracondylar fracture of the humerus in children can be treated with closed reduction, plaster external fixation combined with percutaneous pinning for unstable fracture, which is a simple, less-invasive and satisfactory treatment method.</p>

Quality of life survey of inhabitants living in endemic arsenism areas after drinking-water improvement / 中国地方病学杂志

ObjectiveTo find out the quality of life of inhabitants living in endemic arsenism areas after drinking-water improvement and related influencing factors.MethodsCase group ( 118 people) of arsenicosis,and control group (237 people ) of nearby residents without arsenicosis in endemic arsenic areas after drinking-water improvement in Shanxi and Inner Mongolia and outside control group(116 people) not exposed to arsenic in nearby non-arsenic areas were selected to be interviewed using homogeneous validity and reliability of the World Health Organization quality of life(WHOQOL-BREF,Chinese Version) in 2010,and physical health,psychological,social relationships,environment scores and total score were calculated,respectively.Covariance analysis was used to find out the real difference in the three groups and multiple linear regression analysis was used to explore the influencing factors on quality of life.Results The scores of physical health,psychological,social relationships,environment and total score of case group were ( 12.14 ± 2.68),( 12.18 ± 2.22),( 14.81 ± 2.24),(11.33 ± 1.92),(69.27 ± 16.23) points,respectively,and those of internal control group were ( 13.39 ± 2.67),( 12.80 ± 1.88 ),( 15.16 ± 1.80),( 11.72 ± 1.62),(75.49 ± 14.50) points,respectively,those of control group were (13.91 ± 254),(13.67 ± 2.14),(15.07 ± 1.36),(12.64 ± 1.68),(78.41 ± 12.03) points,respectively.Them was significant difference in physical health,psychological,environment scores and total score among the three groups(F =7.57,10.74,13.44,10.77,all P ＜ 0.05),of which case group was significantly lower than those of the inside and outside control group(all P ＜0.01 ),while in the control group the psychological and environment scores were lower than those of the external control group(all P ＜ 0.01 ).Health,whether-or-not arsenicosis patient,annual per capita income,age and sex were influential factors of quality of life among inhabitants living in endemic arsenism areas after drinking-water improvement (all P ＜ 0.05 ).Conclusions Quality of life among inhabitants living in endemic arsenism areas after drinking-water improvement is lower than residents of non-arsenic areas.

Surgical treatment of severe scoliosis and kyphoscoliosis by stages / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although previous reports had reported the use of temporary internal distraction as an aid to correct severe scoliosis, two-stage surgery strategy (less invasive internal distraction followed by posterior correction and instrumentation) has never been reported in the treatment of patients with severe spinal deformity. This study aimed to report the results of the surgical treatment of severe scoliosis and kyphoscoliosis by two-stage and analyse the safety and efficacy of this surgical strategy in the treatment of severe spinal deformities.</p><p><b>METHODS</b>A total of 15 patients with severe scoliosis, kyphoscoliosis or kyphosis who underwent two-stage surgeries (less invasive internal distraction followed by posterior correction and instrumentation) were studied based on hospital records. Pretreatment radiographs and radiographs taken after first surgery (internal distraction by two small incisions), before second surgery (posterior correction, instrumentation and fusion), one week after second surgery and final follow-up were measured. Subjects were analyzed by age, gender, major coronal curve magnitude, flexibility of major curve, major sagittal curve magnitude before first surgery, after first surgery, before second surgery, after second surgery and at final follow-up. Complications related to two-stage surgeries were noted in each case.</p><p><b>RESULTS</b>The average major curve magnitude was 129.4° (range, 95° to 175°), reduced 58.9° or 45.4% after first stage surgery and reduced 30.6° or 24.6% after second stage surgery. The loss of correction during the interval between two surgeries was 7.1%. The total major coronal curve correction was 81.4° or 62.9%. At the final follow up, the average loss of correction of major coronal curve was 3.9° and the final average correction rate was 59.7%. The average major sagittal curve magnitude was 80.3° (range, 30° to 170°), and the total major sagittal curve correction was 48.2°. Loss of correction averaged 4.0° for major sagittal curve and the final correction averaged 42.2°. Clinical complications were noted in the peri-operative and long-term periods.</p><p><b>CONCLUSIONS</b>Two-stage surgery was a safe and effective surgical strategy in this difficult population. Using two-small-incision technique, the first stage surgery was less invasive. No permanent neurologic deficit was noted in this series.</p>

Analysis of neurological deficits complications in the treatment of spinal deformity with posterior spinal osteotomy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the incidence and causes of neurologic deficits complications in the treatment of spinal deformity with posterior spinal osteotomy.</p><p><b>METHODS</b>From January 2007 to December 2010, 321 cases of scoliosis or kyphosis patients were treated with posterior spinal osteotomy. There were 124 male and 197 female with an average age of (19 ± 11) years (2 - 56 years). The average preoperative main Cobb angle was 108° ± 33° (48° - 175°), the average kyphotic angle was 74° ± 29° (53° - 170°) before operation. Pedicle subtraction osteotomy was used in 226 cases, 95 cases with vertebral column resection. Pedicle screw-rod system was used for fixation. The patients were monitored by Somatosensory-evoked potentials monitoring and Stagnara wake-up test.</p><p><b>RESULTS</b>There were 11 cases with varying degrees of new neurologic deficits and the total incidence was 3.4%. The causes were as followed, spinal translation in 2 cases, compromised by close of resected areas in 2 cases, residual bone compression in 1 case, inadvertent operation in 2 cases, screw malposition in 1 case, hematoma compression in 1 case and spine elongation in 2 cases. There was significant difference between the patients with preexisting neurologic deficits (20.0%) and the patients with intact neurologic function (2.6%) (χ(2) = 13.060, P = 0.011), no significant differences in different classes of the age, etiology, deformity, osteotomy type and surgical type (P > 0.05). But the incidence of neurologic deficits was 4.6% in congenital scoliosis, 7.1% in neuromuscular scoliosis, 5.1% in kyphosis, 5.9% in adult deformity and 5.9% in Cobb angle more than 100°, which was higher than other classes. All the 11 cases were given emergent Methylprednisolone, neurotrophic drugs and hyperbaric oxygen therapy, 4 cases were underwent surgical exploration again. After treatment, 7 cases recovered completely, 2 cases recovered partially and 2 cases failed to improve at the last follow-up.</p><p><b>CONCLUSIONS</b>Severe spinal deformity could be effectively treated with posterior spinal osteotomy. But the procedure is technical demanding and risky for neurologic deficits. The high risk factor is preexisting neurologic deficits.</p>

Analysis of risk factors of skin lesion of population exposed to arsenic via drinking water in Inner Mongolia / 中国地方病学杂志

Objective To study the risk factors of skin lesion (keratosis and abnormal skin pigmentation) of population exposed to arsenic via drinking water in Inner Mongolia.Methods A cluster sampling method was used to select 902 cases from Linhe district,Hanghou and Wuyuan county in Inner Mongolia and physical examination was done.They were interviewed for information by questionnaire.The sample of fingernails and drinking water were collected.Water arsenic (As) was analyzed by inductively coupled plasma mass spectrometry (ICPMS); fingernail As and Se content were analyzed by instrumental neutron activation analysis(INAA).Data were analyzed by univariate and multivariate non-conditional Logistic regression.Results Single factor analysis showed that risk factors of keratosis were age,pesticide,arsenic in nails,smoking,years of smoking,drinking of alcohol,arsenic content in drinking water,fluorosis and duration of drinking arsenic-containing water,while occupation,nail selenium content and vitamin were protective factors.There were 10 risk factors for pigment abnormalities,which were age,pesticide,arsenic in nails,smoking,years of smoking,numbers of cigarette smoked daily,drinking of alcohol,fluorosis,the arsenic content in drinking water and duration of drinking arseniccontaining water,while sex,occupation and nails with selenium were protective factors.The multivariate factor analysis showed that the risk factors of keratosis were age,pesticide and arsenic content in drinking water(OR =1.387,1.583,1.321,all P ＜ 0.05),while occupation and vitamin were protective factors(OR =0.307,0.260,all P ＜ 0.05).The risk factors of abnormal skin pigmentation were age,pesticide,arsenic in nails,fluorosis and arsenic content in drinking water(OR =1.724,2.636,2.741,3.699,1.863,all P ＜ 0.05),while sex was protective factor(OR =0.255,P ＜ 0.01 ).Conclusions Many factors have influence on endemic arsenism and a composite measure should be implemented to prevent it such as excluding arsenic from drinking water,health education,and a reasonably intake of nutrients.

Balloon inflating and cement filling for treatment of avascular necrosis of the femoral head: a three-dimensional infinite-element study / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the biomechanical changes of balloon inflating and cement filling in avascular necrosis of the femoral head using finite-element analysis.</p><p><b>METHODS</b>The procedure of percutaneous balloon inflating and cement filling was simulated in fresh specimen of human femoral head. CT scan and three-dimensional reconstruction were used to establish the three-dimensional model of the femoral head. The physiological load was analyzed using three-dimensional finite element model to simulate the load and calculate stress on the hip during walking. Finite element analysis was performed on the avascular necrosis model and balloon inflating and bone cement filling model to measure the Von-Mises force at the top, neck and weight-bearing area of the femoral head. Another 8 fresh specimens of femoral head necrosis of human were obtained to stimulate balloon inflating and bone cement filling procedures, and the displacement of the femoral head under different loads was recorded before and after the procedures.</p><p><b>RESULTS</b>After bone cement filling in the necrosis area, the load reduced significantly in the weight-bearing area of the femoral head, and the load distribution became more uniform at the femoral neck and the top of the head. The anti-deformation ability of the necrosis femoral head increased after bone cement filling. The infinite-element analysis and specimen biomedical test showed similar results.</p><p><b>CONCLUSION</b>Percutaneous balloon inflating and bone cement filling in the necrosis area can change the biomechanics mechanism of the femoral head and neck, improve the supporting capacity under load, and prevent the progression of head collapse.</p>

Clinical application of posterior paramedian approach in low back surgeries / 中华外科杂志

<p><b>OBJECTIVE</b>To prospectively evaluate the clinical effects of posterior paramedian approach in nerve root decompression and reducing muscle damage in low back surgeries.</p><p><b>METHODS</b>Study group included 30 cases treated from January 2007 to May 2008, DDD 8 cases, spondylolisthesis 6 cases, LDH 11 cases, Low back surgery failure re-operation 5 cases. Based on the comprehensive understanding of modern spine anatomy, we abandoned laminectomy in our procedure, applied a mid-waist skin incision, dissect to the paraspinal muscles where you could easily reach the facets by separating between the multifidus and longissimus, enlarge the canal by performing resection along ligamentum flavum and the inner broader of the articular process, remove enough tissue till you could expose the traversing root and the disc space, this method could achieve a limited but precise and effective decompression with not taking out all of the articular process. Once the anatomy mark of the pedicle is located (usually would be at the central area of the incision), pedicle screws placement would be precise and easy without struggling with muscle traction. The following procedures would be Spondylolisthesis reduction, discectomy and interbody fusion.</p><p><b>RESULTS</b>Post-op patients of study group all showed significant improvement of pain symptoms, VAS reduced from 7.14 + or - 1.8, pre-op to 1.39 + or - 0.72 post-op, narrowed disc space regained height, spondylolisthesis reached anatomic reduction, no complications such as pedicle screw misplacement and nerve root damage were found, the lumbar spine regained it's physiological lordosis structure. Significant difference is discovered (P < 0.001) in statistic study concerning the rate of intractable low back pain between pre-op and post-op.</p><p><b>CONCLUSIONS</b>Applying low back surgery through posterior para-median approach could directly reach the inferior/superior facets and the "soft" structures of the spinal canal, expose the exact decompression region and anatomy mark of the pedicle in the central surgical field without strong retraction on the para-spinal muscles. This approach has the advantage of lowering the surgical difficulty of implantation, reducing the risk of nerve damage and is also a minimum invasive procedure. In many cases, laminectomy is unnecessary, leaving the lamina intact could preserve the physiological anatomy of the spine.</p>

Molecular epidemiological analysis of class I Newcastle disease virus isolated from China in 2008 / 病毒学报

Thirteen isolates of Class I Newcastle disease virus obtained from healthy poultry in China during 2008 were characterized genotypically in this study. All the isolates were proved to be lentogenic strains based on the deduced amino acid sequence of the Fusion protein gene. Molecular epidemiological analysis showed that 13 isolates could be subdivided into 2 distinct genotypes, 11 isolates belonged to genotype 2, and other 2 isolates belonged to genotype 3. Results indicated two genotypes of Class I Newcastle disease virus might widely exist in domestic poultry in China.

Kanamycin induced ototoxicity in three kinds of mouse strains and its effects on the expression of na-K-2Cl co-transporter-1 in stria vascularis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish a mice model of aminoglycoside antibiotics (AmAn) induced ototoxicity. Then to investigate the sensitivity of AmAn induced ototoxicity in three mouse strains and effect of kanamycin on the expression of Na-K-2Cl co-transporter-1 (NKCC1) in stria vascularis.</p><p><b>METHODS</b>C57BL/ 6J, CBA/CaJ, NKCC1 +/- mice (each of twenty-four) were randomly divided into four experimental groups A, B, C and D (A kanamycin alone, B kanamycin plus 2, 3-dihydroxybenzoate, C 2, 3-dihydroxybenzoate alone, D control group). Mice were injected with kanamycin or/and 2, 3-dihydroxybenzoate for 14 days. Auditory function was measured by auditory brainstem response (ABR) and morphology of cochlea was observed by succinate dehydrogenase staining. Expression of NKCC1 was detected by immunohistochemistry.</p><p><b>RESULTS</b>Mice in group A developed significant ABR threshold shifts (P < 0.01), which were accompanied by out hair cells loss. Mice in group B significantly attenuated ABR threshold shifts with out hair cells loss (P <0.01). The immunostaining of NKCC1 in stria vascularis was attenuated significantly in group A compared with group D (P < 0.01) while the immunostaining in group B was enhanced than which in group A (P < 0.01). CBA/CaJ mice has the highest sensitivity to AmAn in three mouse strains.</p><p><b>CONCLUSIONS</b>An mouse model of AmAn induced ototoxicity could be established by administration of kanamycin. Kanamycin could inhibit the expression of NKCC1 in stria vascularis. 2, 3-dihydroxybenzoate could attenuate AmAn induced ototoxicity maybe by enhancing the expression of NKCC1. Mice that had the characteristic of presbycusis didn't show additional sensitivity of AmAn induced ototoxicity.</p>

Aminoglycoside ototoxicity in three murine strains and effects on NKCC1 of stria vascularis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>After establishing a murine model of aminoglycoside antibiotic (AmAn) induced ototoxicity, the sensitivity of AmAn induced ototoxicity in three murine strains and the effect of kanamycin on the expression of Na-K-2Cl cotransporter-1 (NKCC1) in stria vascularis were investigated.</p><p><b>METHODS</b>C57BL/6J, CBA/CaJ, NKCC1(+/-) mice (24 of each strain) were randomly divided into four experimental groups: A: kanamycin alone; B: kanamycin plus 2, 3-dihydroxybenzoate; C: 2, 3-dihydroxybenzoate alone; and D: control group. Mice were injected with kanamycin or/and 2, 3-dihydroxybenzoate twice daily for 14 days. Auditory brainstem response (ABR) was measured and morphology of cochlea delineated with succinate dehydrogenase staining. Expression of NKCC1 in stria vascularis was detected immunohistochemically.</p><p><b>RESULTS</b>All three strains in groups A and B developed significant ABR threshold shifts (P < 0.01), which were accompanied by outer hair cell loss. NKCC1 expression in stria vascularis was the weakest in group A (A cf D, P < 0.01) and the strongest in groups C and D (P < 0.05). CBA/CaJ mice had the highest sensitivity to AmAn.</p><p><b>CONCLUSIONS</b>Administration of kanamycin established AmAn induced ototoxicity. Kanamycin inhibited the expression of NKCC1 in stria vascularis. 2, 3-dihydroxybenzoate attenuated AmAn induced ototoxicity-possibly by enhancing the expression of NKCC1. Age related hearing loss did not show additional sensitivity to AmAn induced ototoxicity in murine model.</p>

Role of ion channel Na-K-2Cl and alpha2 Na, K-ATPase in cochlear potassium cycling and auditory function / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the auditory function and the role of NKCC1 and alpha2 Na, K-ATPase in the potassium recycling of cochlea.</p><p><b>METHODS</b>NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice model was established from NKCC1(+/-) and alpha2 Na, K-ATPase(+/-) mice. The auditory function of all strain mice were detected by auditory brainstem response (ABR) and endocochlear potential (EP) to investigate the role of NKCC1 and alpha2 Na, K-ATPase in the potassium recycling of cochlea. Furosemide and ouabain were applied to block the two channels in Castel mice line which can long-time maintain normal auditory function and then their auditory function was detected by ABR to authenticate the mode of potassium recycling in vivo and the relationship between cochlear potassium recycling and NKCC1(+/-) and alpha2 Na, K-ATPase.</p><p><b>RESULTS</b>The mean value for ABR thresholds in response to stimulus was elevated in NKCC1(+/-) and alpha2 Na, K-ATPase (+/-) mice [(38.49 +/- 12.29) dB and (53.32 +/- 7.62) dB) ] respectively, which was significantly increased compared with that observed in wild type mice [(23.13 +/- 3.78) dB, P < 0.05) ]; The EP value of NKCC1(+/-) [(78 +/- 7) mV] and alpha2 Na, K-ATPase(+/-) mice [(71 +/- 14) mV] was decreased compared with that of NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice [( 86 +/- 11) mV]. The auditory function of NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice could simulate the model of cochlear potassium recycling well. NKCC1 and Na, K-ATPase were great of importance in the potassium recycling, while the two ion channels were in restrict dynamic equilibrium. Castel mice line after administration with furosemide developed significant ABR threshold shifts (P < 0.05) compared with control group. Castel mice line after administration with ouabain also developed greatly significant ABR threshold shifts (P < 0.05) compared with control group. ABR threshold shifts in mice after administration both furosemide and ouabain was attenuated compared with only administration with furosemide (P < 0.01).</p><p><b>CONCLUSIONS</b>Ion channel NKCC1 and alpha2 Na, K-ATPase played important roles in the inner ear potassium recycling. Dysfunction of either of them could influence potassium concentration in the endolymph and lead to hearing loss subsequently. The role of NKCC1 and alpha2 Na, K-ATPase in cochlear potassium recycling was authenticated in vivo. The two ion channels contribute the key role for dynamic equilibrium in cochlear potassium recycling and are of great importance for the metabolism of potassium in the inner ear to maintain the normal auditory function.</p>

Association of age-related hearing loss with mice which expressed only one copy of gene encoding NKCC1 co-transporter / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To generate transgenic mice of NKCC1 +/- (heterozygous) and NKCC1 +/+ (wild-type) that have a targeted disruption in the NKCC1 gene in order to investigate the relationship of one copy of NKCC1 gene (NKCC1 +/-) and age-related hearing loss (AHL) and to study the possible pathogenesis of AHL METHODS: Auditory function of NKCC1 +/- mice was detected regularly by auditory brain response (ABR) and endocochlear potential (EP). Morphology of cochlea was observed by scanning electron microscope and content of NKCC1 protein was detected by Western blot.</p><p><b>RESULTS</b>The mean value for ABR thresholds was elevated in NKCC1 +/- mice more than that of NKCC1 +/+ mice (P < 0.01). A progression of age-related hearing loss was found in NKCC1 +/- mice. Compared with younger NKCC1 +/- mice, the mean value for ABR thresholds in aged NKCC1 +/- mice was significantly increased (P < 0.05). The EP of NKCC1 +/- aged mice was also significantly decreased more than that of the younger NKCC1 +/+ mice (P < 0.05). And content of NKCC1 protein were reduced with the growth of the age. The scanning electron microscope showed a kind of scattered punctiform absence of outer hair cells in elder NKCC1 +/- mice cochlea.</p><p><b>CONCLUSIONS</b>NKCC1 gene maybe takes part in the pathogenesis of AHL. Mice that expressed only one copy of NKCC1 could lead to AHL. AHL may be correlative with the amounts of NKCC1 protein and its function and also with the loss of outer hair cells perhaps.</p>

Detecting internal carotid artery stenosis by using the cerebral blood flow reduction index in rabbit mode / 中国脑血管病杂志

Objective: To establish an experimental unilateral internal carotid artery stenosis model in New Zealand albino rabbits that can be detected in vivo. Methods: A 2 F Foley's tube was inserted into unilateral carot id artery for performing intimal injury in 5 rabbits, and causing intimal hyperplasia and angiostenosis. The hemodynamic changes of unilateral carotid artery were detected by transcranial Doppler (TCD); the reduction of cerebral blood flow (CBF) after stenosis was calculated by mathematical formulas. The degree of stenosis was confirmed by digital subtraction angiography (DSA), and the arterial intimal hyperplasia and stenosis were confirmed by pathological examination. Results: Two rabbits survived after the procedure. TCD, DSA and pathological examination showed that the model of experimental unilateral internal carotid artery stenosis in rabbits was established successfully. The reduction of CBF after unilateral internal carotid artery stenosis was calculated in the 2 rabbits, they were 17% and 45%, respectively. Conclusion: The rabbit model of unilateral internal carot id artery stenosis has been established successfully, and the severity of stenosis can be detected and evaluated in vivo.