Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.

Iridoids of wine-processed Corni Fructus / 中国中药杂志

A new iridoid glycoside, cornushmf A(1) and nine known iridoids(2-10) were isolated from the water extract of the wine-processed Corni Fructus by various column chromatographies. Their chemical structures were identified by comprehensive spectroscopic methods as 7β-O-(2″-formylfuran-5″-methylene)-morroniside(1), 7-dehydrologanin(2), sweroside(3), 7β-O-methylmorroniside(4), 7α-O-methylmorroniside(5), 7β-O-ethylmorroniside(6), 7α-O-ethylmorroniside(7), cornuside(8), sarracenin(9), and loganin(10).

Clinical diagnosis and treatments of type Ⅱ-Ⅳ congenital laryngotracheoesophageal cleft in 8 children / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical diagnosis and treatment of congenital laryngotracheoesophageal cleft (LTEC) in children. Methods: The clinical data of 8 children (including 7 males and 1 female)with congenital laryngotracheoesophageal cleft from January 2016 to June 2020 were retrospectively analyzed. The median diagnosing age was 3.75 months (5 days to 12 months). According to the modified Benjamin Inglis classification proposed by Sandu in 2006,there were 3 cases of type Ⅱ, 3 cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa. All children were followed up regularly. Results: Six patients were treated for recurrent bronchopneumonia and aspiration during feeding. The patients were first treated in the pneumology departmentt or intensive care unit. Six patients combined with other malformations. Endoscopic repair operations were performed in 6 cases (3 cases of type Ⅱ, 3 cases of type Ⅲ a), 1 case of LTEC was operated through cervical approach, and 1 case of type IVa LTEC associated with VACTERL was repaired under thoracoscope combined with suspension laryngoscope. Seven patients underwent tracheotomy before or during the repair operations. Gastrostomy was performed in 2 children. The operations were successfully performed in all cases. Three children with type Ⅱ LTEC recovered well and decannulated. One case of type Ⅲa was followed up for 5 months with occasionally choking while feeding. Two cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa died due to severe reflux, tracheomalacia or respiratory failure. Conclusions: Congenital LTEC is a rare congenital malformation which is difficult to diagnose for the poor specificity of clinical manifestations. LTEC needs to be classified by endoscopy examination under general anesthesia. Severe cases of LTEC have poorer outcomes than the mild cases, and the perioperative managements need multi-disciplinary cooperation to reduce the mortality.

Analysis of complications and outcomes of tracheotomy with different etiology in children / 中华耳鼻咽喉头颈外科杂志

Objective: To discuss the complications and postoperative outcomes of tracheotomy with different etiology in children. Methods: One hundred and eighty-six patients underwent tracheotomy were retrospectively analyzed from January 2016 to December 2018,including 117 males and 69 females. The children aged from 4 days to 14 years (median age 31.5months). One case was operated under local anesthesia in emergency room, 2 cases were operated under local anesthesia in pediatric intensive care unit, the rest 183 cases were operated under general anesthesia in operation room. The 186 children were divided into four groups according to their direct causes of tracheotomy. Group A(90 cases): Neuromuscular disease and severe infection,Group B(26 cases): Head and neck tumor,Group C(57 cases): Congenital malformation and upper airway obstruction,Group D(13 cases): Accidental injury. The basic information, surgical complications and postoperative outcomes were recorded and analyzed. All patients were followed up by clinic or by telephone. Spss 19.0 software was used for statistical analysis. Results: One hundred and eighty-six patients were followed up for one to four years. 33 children lost the follow-up and 46 died. Among the 186 patients, 23 cases had emergency tracheotomy (12.4%). The rate of emergency tracheotomy in group C(16 cases, 28.1%) was higher than that in the other three groups(χ2=28.08,P<0.05). The average age of patients and hospital stay in group C were significantly lower than those in the other three groups (F=33.76,P<0.05; F=14.95,P<0.05). Incision bleeding occurred in 11 cases, Subcutaneous emphysema occurred in 6 cases and accidental decannulation occurred in 10 cases (4 cases within 2 weeks and 6 after 2 weeks). Six patients underwent tracheocutaneous fistula closure operation after decannulation and the stoma healed spontaneously in other extubated children. Two patients underwent secondary tracheotomy due to accidental decannulation, and three patients underwent secondary tracheotomy for dyspnea after decannulation. In 107 cases of survival children, decannulation was successful in 65 patients and failed in 42 patients. The average duration of wearing tracheal tube was 8.8 months. The decannulation rates in the four groups were 55.6%, 45%, 69% and 77.8%, with no significant difference. Conclusions: The complications after tracheotomy in children are rare, and no severe complications occurred in long-term tracheotomy patients. The duration of wearing tracheal tube is related to the treatment of their primary disease.

Chinese registry of rheumatoid arthritis: IV. Correlation and consistency of rheumatoid arthritis disease activity indices in China / 中华医学杂志(英文版)

BACKGROUND@#Disease activity indices (DAIs) including disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) have been widely used in clinical practice and research studies of rheumatoid arthritis (RA). The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA.@*METHODS@#A cross-sectional study, including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018, was conducted. The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots, quadratic weighted kappa, and discordance rates in the crosstab. For other indices, the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis.@*RESULTS@#A total of 30,501 patients were included, of whom 80.46% were women. Most individuals were with moderate disease activity or high disease activity. High correlations among DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP), SDAI and CDAI were observed. Similarly, the weighted kappa value among the indices was high. In Bland-Altman plots, a positive difference between DAS28-ESR and DAS28-CRP was observed, with an absolute difference of >1.2 in 3079 (10.09%) patients. In crosstab, approximately 30% of the patients were classified into different groups. Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR, DAS28-CRP, and CDAI were 3.06, 2.37, and 3.20, respectively.@*CONCLUSIONS@#Although DAIs had high correlations and weighted kappa values, the discordance between DAIs was significant in Chinese patients with RA. The four DAIs are not interchangeable.

Situations and opportunities of new drugs of Chinese materia medica under background of globalized research and development / 中草药

Since China joined International Conference on Harmonization (ICH) in 2017, the research and development standards of new drugs have been formally in line with the international standards, and the innovation and development of chemical and biological drugs in China have entered a new era. However, compared with chemical drugs and biological drugs, the research and development of new drug of Chinese materia medica (CMM) is slightly insufficient, the number of new drug applications and approvals is not large, and the growth of industrial output is slowing down, which is caused by the global economic slowdown and the improvement of research and development rules and standards with China's accession to ICH. At present, CMM is supported by national policies, and the coming of the era of great health has brought great opportunities for the development of traditional Chinese medicine (TCM). Pharmaceutical enterprises should follow the trend and strive to improve the supply side level of pharmaceutical products of TCM. At the same time, we should correctly understand the difficulties, challenges and opportunities in the development of CMM, and strengthen the pharmaceutical innovation and secondary research and development of CMM. It is of great significance for the healthy development of CMM industry in the new era to analyze the situation faced by the research and development of CMM under the background of globalization, and analyze the difficulties, opportunities and challenges in the research and application of new drugs of CMM.

Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden: A subgroup analysis of a nationwide survey in China / 中华医学杂志(英文版)

BACKGROUND@#Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income.@*METHODS@#This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction.@*RESULTS@#When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P 50% subgroup (all P 50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032).@*CONCLUSION@#Higher disease severity and higher financial burden were associated with lower patient satisfaction.

Roles of cytochrome C and Caspase-9 in steroid-induced avascular necrosis of the femoral head / 中国组织工程研究

BACKGROUND: Steroid-induced avascular necrosis of the femoral head (SANFH) may be associated with apoptosis of osteocytes, but its regulatory mechanism remains unclear. Cytochrome C and Caspase-9 are key factors in the mitochondrial apoptosis signaling pathway, and their roles in SANFH still need further investigation. OBJECTIVE: To investigate the roles of cytochrome C and Caspase-9 in the SANFH. METHODS: Twenty New Zealand white rabbits were randomly divided into experimental and control groups (n=10 per group). Rabbits in the experimental group were injected with 7.5 mg/kg methylprednisolone, twice weekly, and those controls were subjected to the injection of same amount of normal saline. The treatment period was 8 weeks in both group.The rabbits were then sacrificed by air embolism to remove the bilateral femoral head specimens for histological and transmission electron microscope observations. The apoptotic cells were detected by TUNEL method and the expression levels of cytochrome C and Caspase 9 were detected by immunohistochemistry. RESULTS AND CONCLUSION: Eight weeks after intervention, compared with the control group, the experiment group had loose femoral head, thinned trabecular bone, increased adipocytes in the medullary cavity, and increased percentage of empty lacunae (P ＜ 0.05); the apoptotic bodies were formed, and the apoptosis rate was increased (P ＜ 0.05); and the positive expression rates of cytochrome C and Caspase-9 were significantly increased (P ＜ 0.01). Correlation analysis results showed that the apoptosis rate was positively correlated with the empty lacunae rate and the positive expression rates of cytochrome C and Caspase-9 (P ＜ 0.01). These findings indicate that the abnormal release of cytochrome C and high expression of Caspase-9 are related to the apoptosis of osteocytes in SANFH.

Tumor Necrosis Factor-alpha Induced Protein 3 Interacting Protein 1 Gene Polymorphisms and Pustular Psoriasis in Chinese Han Population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Psoriasis is a common immune-mediated inflammatory dermatosis. Generalized pustular psoriasis (GPP) is the severe and rare type of psoriasis. The association between tumor necrosis factor-alpha induced protein 3 interacting protein 1 (TNIP1) gene and psoriasis was confirmed in people with multiple ethnicities. This study was to investigate the association between TNIP1 gene polymorphisms and pustular psoriasis in Chinese Han population.</p><p><b>METHODS</b>Seventy-three patients with GPP, 67 patients with palmoplantar pustulosis (PPP), and 476 healthy controls were collected from Chinese Han population. Six single nucleotide polymorphisms (SNPs) of the TNIP1 gene, namely rs3805435, rs3792798, rs3792797, rs869976, rs17728338, and rs999011 were genotyped by using polymerase chain reaction-ligase detection reaction. Statistical analyses were performed using the PLINK 1.07 package. Allele frequencies and genotyping frequencies for six SNPs were compared by using Chi-square test, odd ratio (OR) (including 95% confidence interval) were calculated. The haplotype analysis was conducted by Haploview software.</p><p><b>RESULTS</b>The frequencies of alleles of five SNPs were significantly different between the GPP group and the control group (P ≤ 7.22 × 10-3), especially in the GPP patients without psoriasis vulgaris (PsV). In the haplotype analysis, the most significantly different haplotype was H4: ACGAAC, with 13.1% frequency in the GPP group but only 3.4% in the control group (OR = 4.16, P = 4.459 × 10-7). However, no significant difference in the allele frequencies was found between the PPP group and control group for each of the six SNPs (P > 0.05).</p><p><b>CONCLUSIONS</b>Polymorphisms in TNIP1 are associated with GPP in Chinese Han population. However, no association with PPP was found. These findings suggest that TNIP1 might be a susceptibility gene for GPP.</p>

One-stage dorsal lingual mucosal graft urethroplasty for the treatment of failed hypospadias repair / 亚洲男科学杂志(英文版)

The aim of this study was to retrospectively investigate the outcomes of patients who underwent one-stage onlay or inlay urethroplasty using a lingual mucosal graft (LMG) after failed hypospadias repairs. Inclusion criteria included a history of failed hypospadias repair, insufficiency of the local skin that made a reoperation with skin flaps difficult, and necessity of an oral mucosal graft urethroplasty. Patients were excluded if they had undergone a failed hypospadias repair using the foreskin or a multistage repair urethroplasty. Between January 2008 and December 2012, 110 patients with failed hypospadias repairs were treated in our center. Of these patients, 56 underwent a one-stage onlay or inlay urethroplasty using LMG. The median age was 21.8 years (range: 4-45 years). Of the 56 patients, one-stage onlay LMG urethroplasty was performed in 42 patients (group 1), and a modified Snodgrass technique using one-stage inlay LMG urethroplasty was performed in 14 (group 2). The median LMG urethroplasty length was 5.6 ± 1.6 cm (range: 4-13 cm). The mean follow-up was 34.7 months (range: 10-58 months), and complications developed in 12 of 56 patients (21.4%), including urethrocutaneous fistulas in 7 (6 in group 1, 1 in group 2) and neourethral strictures in 5 (4 in group 1, 1 in group 2). The total success rate was 78.6%. Our survey suggests that one-stage onlay or inlay urethroplasty with LMG may be an effective option to treat the patients with less available skin after failed hypospadias repairs; LMG harvesting is easy and safe, irrespective of the patient's age.

Review and reflection on re-evaluation system of Chinese patent medicine / 中草药

There has been more than 60000 approval numbers of Chinese patent medicines (CPM), among which a large portion were approved by provincial agencies before the Ministry of Health promulgated and implemented them in 1985. One drug was produced by many companies and the available drugs' quality varied among different producers. Drugs with low quality and low price have been flooded into the medicinal market, which has resulted the drugs in high quality are closed outside the market. The benign competition in CPM market has been influenced. Many measures to improve the quality of the marketed drugs have been taken by State Food and Drug Administration, including checking the approval numbers, re-registration, and quality improving actions, so as to strengthen the listed medicine value promotion, effectively promote the CPM listed in the market after the re-evaluation system construction and perfect. But there are still the disconnect between improving the quality standard and enhancing the clinical value of the quality and efficiency; The market is still filled with a large number of low quality and low cost of proprietary CPM, the re-evaluation work of CPM and other issues need to be improved. Nonetheless, to put forward the suggestion on that the approval numbers should be held by payment, the comprehensive evaluation system on drug safety, effectiveness, quality, and the economic value should be improved, the evaluation by the third party should be intervened, and the re-evaluation of CPM and GAP adminstration of genuine medicinal materials should be effectively linked up. We expect the improvement of industrial level of CPM and the cultivation with a large variety of CPM through the re-evaluation and re-study.

Case-control study on therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy.</p><p><b>METHODS</b>From January 2009 to June 2010,34 patients with anterior or posterior cruciate ligament injuries were divided into two groups : group A and group B. There were 24 patients in group A, including 19 males and 5 females,with an average age of (31.83±9.57) years old. The patients in group A were treated with anterior cruciate ligament reconstruction under arthroscopy; Rigidfix cross pins and Intrafix pins were used to fix femoral and tibial side respectively. Among the 10 patients in group B, 8 patients were male and 2 patients were female, with an average age of (27.20+7.59) years old. The patients in group B were treated with posterior cruciate ligament reconstruction under arthroscope; Intrafix pins and Rigidifix cross pins were used to fix femoral and tibial side sepectively. The drawer test and Lachaman test were used to evaluate postoperative knee stability. All the patients were followed up at least 18 months. Lysholm and Tegner knee scores were used to evaluate the clinical therapeutic effects.</p><p><b>RESULTS</b>All the 34 patients were followed up, and the duration ranged from 18 to 26 months,with an average of (20.79±2.39) months. All the patients obtained good pain relief and knee stability. In group A,Lysholm scores significantly increased from 43.04±7.57 preoperatively to 85.41±4.68, 92.50±3.05, and 93.45±2.57 at 6,12, and 18 months postoperatively; Tegner scores significantly increased from 2.62±0.92 preoperatively to 7.45±1.14, 8.58±0.77, and 8.95±0.55 at 6, 12, and 18 months postoperatively. In group B,Lysholm scores significantly increased from 46.20±8.27 preoperatively to 86.40±5.14,90.40±2.67,and 92.00±3.85 at 6,12,and 18 months postoperatively ;Tegner scores significantly increased from 2.00±0.66 preoperatively to 7.10±0.99, 8.60±0.84, and 8.80±0.42 at 6,12, and 18 months postoperatively. There were no differences in Lysholm and Tegner scores between group A and B at different times during follow-up. Lysholm scores of all patients significantly increased from 43.97±7.79 preoperatively to 85.70±4.76,91.88±3.06,and 93.02±3.01 at 6,12,and 18 months postoperatively. Tegner scores of all patients significantly increased from 2.44±0.89 preoperatively to 7.35±1.09, 8.58±0.78, and 8.91±0.51 at 6,12,and 18 months postoperatively. During the follow-up period,there were no serious immunological rejection and complications.</p><p><b>CONCLUSION</b>Reconstruction of anterior or posterior cruciate ligament under arthroscopy with Rigidfix cross pins and Intrafix pins fixation is feasible therapy for anterior or posterior cruciate ligament injuries, and the fixation is rigid. The therapy restores knee stability and provides a satisfactory short-term results.</p>

First isolation of quang binh-like virus from mosquitoes in China / 病毒学报

This study aims to investigate the distribution patterns of mosquito-borne viruses in Menghai County, Xishuangbanna Prefecture, Yunnan Province, China and to provide evidence for the prevention and control of mosquito-borne diseases. Mosquito samples were collected using mosquito lamps. Viruses were isolated from the samples by cell culture, and the isolates were identified by RT-PCR. The genomes of isolates were sequenced for phylogenetic analysis. In July 2012, a total of 1468 mosquitoes were captured in Daluo Town of Menghai County; they were divided into 32 pools, including Culex tritaeniorhynchus (28 pools, 1383 mosquitoes), Culex quinquefasciatus (2 pools, 66 mosquitoes), and Anopheles (2 pools, 19 mosquitoes). Golden hamster kidney cells (BHK-21) and Aedes albopictus cells (C6/36) were used for virus isolation. The results showed that C6/36 cells were susceptible to two isolates recovered from Culex tritaeniorhynchus (BNDL1205 and BNDL1227), with marked cytopathic effect (CPE) of cell fusion. By contrast, the two isolates could not cause CPE in BHK-21 cells. RT-PCR was performed for the two isolates using the flavivirus-specific primers FU2/cFD3, and a 800-bp amplicon was obtained from both of them. Phylogenetic analysis showed that the two isolates shared the same evolutionary branch with the Quang Binh virus (QBV) strain VN180, which had been isolated from Vietnam, with nucleotide sequence homologies of 83.4% and 82.9%, respectively. However, there existed relatively large differences in nucleotide sequence between them and other Culex flavivirus strains previously isolated in China and other regions. In light of the similarity between the two isolates and QBV, BNDL1205 and BNDL122 were referred to as Quang Binh-like virus, which were first reported in China.

Clinical application study of modified Moore classification in lower cervical spine injuries / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the clinical application of modified Moore classification in lower cervical spine injuries.</p><p><b>METHODS</b>Modified Moore classification was applied in the morphologic description of 200 patients (including 165 males, 35 females,age ranging from 19 to 88 years,with an average age of 52 years) with lower cervical spine injuries from August 2006 to March 2010, cervical spine injury severity score (quantification of stability) in combination with yes/no neurological injury status to classify their clinical diagnosis and management. The treatment was selected according to the fracture type, stability, compression injury of spinal cord or nerve roots, stability of ligamentous injury and other reference factors. According to the ASIA score, 130 cases with injury of spinal cord or nerve root (i.e. 6 cases in Grade A,13 cases in Grade B,43 cases in Grade C, 68 cases in Grade D); and 70 cases with no injury of spinal cord or nerve root. The ASIA score was applied in the evaluation of curative effect in cases with injury of spinal cord or nerve root. Radiodiagnostics was used to observe sequential measurement of cervical vertebrae and height in cases without spinal cord or nerve root injuries.</p><p><b>RESULTS</b>The cervical spine injury distribution is that 35 cases of anterior, left, right lateral and posterior column injury; 33 cases of anterior column injury; 90 cases of anterior and posterior column injury; 5 cases of anterior, left lateral and posterior column injury; 3 cases of anterior, right lateral and posterior column injuries; 3 cases of anterior, left and right lateral column injuries; 2 cases of anterior and right lateral column injuries; 5 cases of anterior and left lateral column injury; 12 cases of posterior column injury; 7 cases of left lateral column injury; 5 cases of right lateral column injury. Surgery operation was given in 98 patients out of 200 cases. Non-surgical treatment was given to 102 patients (including 39 patients who are qualified to receive operation, but patient's relative required non -surgical treatment). Three cases of complete injury of spinal cord showed no recovery of the spinal cord function after operation, no change on the ASIA score, but pain and numbness of limb relieved slightly. Three non-surgical treatment cases showed no change after the treatment. Cases of incomplete injury of spinal cord showed certain recovery on spinal cord function after operation, and the ASIA score was raised 1.2 grades averagely. The ASIA score of cases of incomplete injury of spinal cord after non-surgical treatment was raised 0.3 grades averagely. The alignment and height of cervical vertebras were normal on post-operative radiodiagnostics in patients without injury of spinal cord or nerve root.</p><p><b>CONCLUSION</b>According to modified Moore classification, when the stability quantification score is higher than or equal to 4, it indicated that the cervical vertebras are instability in lower cervical spine injuries. Surgery operation is required in higher score and less stability cases. Cases associated with neurological injury must receive surgery operation. Cases with stability quantification score equals to 3 and neurological injury should also receive surgery operation in general. Surgery operation is not required in cases of stability quantification equal to 3 and without neurological injury,or cases of stability quantification score lower than 3. Applying modified Moore classification in the treatment of lower cervical spine injuries is beneficial for the clinical standardization, diagnosis and treatment and receives satisfactory therapeutic effects.</p>

Recapping laminoplasty for the treatment of severe burst fractures of thoracolumbar vertebra complicated with spinal stenosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate operation skills, therapeutic effects and indications of racapping laminoplasty for the treatment of severe burst fractures of thoracolumbar vertebra complicated with spinal stenosis.</p><p><b>METHODS</b>In the study, 41 patients with severe burst fractures of thoracolumbar vertebra complicated with spinal stenosis were treated with recapping laminoplasty. After the treatment, the size of vertebral canal, spinal stability, altitude recovery of vertebral body and rehabilitation of nerve function were observed.</p><p><b>RESULTS</b>All the patients were followed up and the duration ranged from 1 to 3 years. The anterior height of compressed vertebral bodies restored from preoperative 58% to postoperative 97%, posterior height was from preoperative 76% to postoperative 98.7%. The Cobb angle was corrected from preoperative 24.6 degrees to postoperative 1.8 degrees, and the size of vertebral canal restored from preoperative 43% to postoperative 93%. According to Frankel classification, 1 patient who were at A grade had no changes and others improved by 1 to 3 degrees.</p><p><b>CONCLUSION</b>This is an ideal operation method for treating burst fractures of thoracolumbar vertebra with spinal stenosis, which is simple, safe and enlarging vertebral canal, at the same time completely decompressing the dura mater and nerve roots. This method eliminated secondary spinal stenosis, reconstructed posterior column and increased spinal stability.</p>

The effect of ultra high molecular weight polyethylene particles on macrophage / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of ultra high molecular weight polyethylene (UHMWPE) particles on macrophages and evaluate the expression of NFAT2, a key transcriptional factor for osteoclast differentiation.</p><p><b>METHODS</b>From November 2004 to February 2005, macrophages were co-cultured with UHMWPE particles. When observed at different times, the proliferation activity of macrophages was analyzed by MTT and the expression of calcineurin (CaN) and NFAT2 by immunohistochemical and RT-PCR method respectively.</p><p><b>RESULTS</b>The macrophages phagocytosed UHMWPE particles in an early time, the expression of CaN and NFAT2 was increased, while the proliferation activity was not enhanced.</p><p><b>CONCLUSIONS</b>UHMWPE particles can stimulate macrophages to phagocytose significantly, and enhance the expression of the transcriptional factor NFAT2.</p>

Comparison of isotretinoin and viaminate in the treatment of moderate to severe acne vulgaris:a multiple-centre,randomized,double-blind,comparative clinical trial / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of isotretinoin and viaminate for the treatment of moderate to severe acne vulgaris.Methods A multiple-centre,double-blind,double-analog comparative clinical trial was conducted.Patients diagnosed with moderate to severe acne by GAGS (global acne grading system) were randomly divided into isotretinoin group (10 mg,bid) and viaminate group (50 mg,tid);treatment was done for a total of 6 weeks.All subjects were evaluated before treatment,and at 2,4,6 weeks after the initiation of treatment,for evaluation of lesion count,and for observation of thera- peutic effects and side effects.Results A total of 217 patients were enrolled this trial,of which,213 could be evaluated in a FAS (Full Analysis Set) analysis and 200 in a PPS (per protocol) analysis.There was no significant difference in the efficacy at 2,4,6 weeks after the initiation of treatment between the isotretinoin group and viaminate group (6.0% vs 5.0%,29.0% vs 20.0%,57.0 % vs 51.0 %,respectively). However,the inflammatory papules and pustules decreased more rapidly in the isotretinoin group than in the viaminate group at each of the follow up evaluations (all P＜0.05).There was no obvious difference in the rate of clearance of comedones and nodules between the two groups.Both the occurrence rate (68.81% vs 36.53%,P＜0.001) and severity (P＜0.05) of side effects were higher in the isotretinoin group than in the viaminate group.The main adverse events included mouth dryness,dizziness,etc,occurred more fre- quently in the isotretinoin group than in the viaminate group.Conclusion For the treatment of moderate to severe acne,the efficacy of isotretinoin is similar to that of viaminate;however,isotretinoin has more imme- diate effect with more side effects than viaminate.

The influence of continuous renal replacement therapy on the plasma levels of endotoxin and cytokines in severely burned patients with sepsis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of continuous renal replacement therapy (CRRT) on the plasma levels of endotoxin and cytokines in severely burned patients with sepsis.</p><p><b>METHODS</b>Ten burn patients who received CRRT and another 10 without CRRT were investigated in terms of the changes in their plasma concentrations of endotoxin and some cytokines (TNFalpha, IL-1beta, IL-6, IL-8).</p><p><b>RESULTS</b>The plasma concentrations of endotoxin and all the cytokines (TNFalpha, IL-1beta, IL-6, IL-8) after CRRT treatment were significantly lower than those before the treatment (P < 0.01), and the plasma levels of the above factors at all the time points after CRRT treatment than those in patients were evidently lower by routine treatment (P < 0.05 - 0.01).</p><p><b>CONCLUSION</b>CRRT treatment could effectively lower the plasma levels of endotoxin and some cytokines (TNFalpha, IL-1beta, IL-6, IL-8).</p>

Effect of Ti-6AL-4V particles on morphology and function of osteoclasts:an in vitro study / 中华创伤杂志

Objective To observe the effect of Ti-6AL-4V particles on morphological and func- tional changes of osteoclast in vitro.Methods Mature osteoclasts separated from New Zealand Rabbits were cultured on glass slices and cortical bone slices.The experimental group was stimulated by Ti-6AL- 4V particles at concentration of 0.1 mg/ml.The cells were stained with TRAP at different culture time to observe the morphological variety.The bone resorption pits on bone slices were stained by toluidine blue and the resorption areas analyzed by computer image analysis software.Results Osteoclasts phagocy- tosed the particles,with irregular shapes,deeper TRAP stain and earlier apoptosis.Stimulation by Ti- 6AL-4V particles brought about larger area of bone absorption lacuna.Conclusion Osteoclasts have the ability to phagocytose Ti-6AL-4V particles,which leads to morphological and functional changes and enhances bone resorption.