Neck Injuries by Traffic Accidents: Diagnosis and Treatment (review) / 中国康复理论与实践

Neck injuries caused by traffic accidents increase by years, timely and effective treatment can greatly reduce the mortality rate. This paper summarized the characteristics, image features, evoked potential detection and serum markers detection of neck injury caused by traffic accidents. Then, the condition of injuries was comprehensively considered and analyzed, and the priorities were correctly judged. The injuries were classified and treated. It is conducive for the attending doctors to carry out precise individualized first aid and surgical treatment for the patients, in order to save lives to the maximum extent, reduce disabilities, and prevent and treat post traumatic stress disorders.

Cultivation, screening, identification and transplantation of Muse cell from human umbilical cord-derived for spinal cord injury in rats / 中国骨伤

OBJECTIVE@#To investigate multilineage-differentiating stress-enduring (Muse) by immunomagnetic bead screening from Wharton's jelly mesenchymal stromal cells(WJ-MSCs), and explore transplantation of Muse cell for safety and effectivensess of sub acute cord injury in rats.@*METHODS@#Donated Wharton's Jelly-mesenchymal stromal cells (WJ-MSCs) were successfully derived from a human umbilical cord by a series of procedures namely physical isolation of Wharton's Jelly from cord membrane, collagenase and trypsin treatment and density gradient centrifugation. Magnetic activated cell sorting was performed to specifically select SSEA3+ Muse cells, and flow cytometry and immunocytochemistry were used to identify further. In vivo, spinal cord contusion injury model in rats was induced by NYU-III impactor, and were randomly divided and equally into four groups, namely group A (sham), group B (control), group C (Non-Muse cells transplantation) and group D (Muse cells transplantation). Laminectomy was conducted in group A but no spinal cord contusion injury. Laminectomy and cord injury were performed in group B, C and D, 10 g trip rod was freely falling down from 12.5 mm. Two weeks later, group B, C and D were received PBS injection, Non-Muse cells transplantation and Muse cells transplantation respectively, four-point injection were performed in each cord with totally 4×10⁵ cells. BBB scores were evaluated on 1 day, 1, 2, 3, 4, 5 and 6 week after injury. Four weeks after cell transplantation, the rats were sacrificed, and immunohistochemistry were carried out to observe survival, migration and differentiation of the injected cells.@*RESULTS@#The expression of CD105, CD90 and CD73 were over 99.5% in the derived WJ-MSCs population, but CD45 and CD14 were lower than 0.5%, positive rate of SSEA3+ was 1.46% under flow cytometer, However, after MACS sorting, the percentage of 92.0% Muse cells expressed SSEA3 and CD105, and immunohistochemistry results of SSEA3 showed typically membrane morphology with special processes. In vivo, BBB scores was 21 in group A at different time points. One-way ANOVA and LSD analysis showed that BBB scores in group C and D were significantly higher than that in group B (=0.004, 0.002), but there was no significantly difference between group C and D. Further intra-group paired t test showed that BBB score was significantly higher at 4 weeks than that 3 weeks in group C (=0.005). However, in group D, BBB scores were significantly higher at 4 and 6 week than those at 3 and 5 weeks, values were 0.005 and 0.016 respectively. Immunohistochemistry results showed that both Muse cells and Non-Muse cells could survive for 4 weeks in rats and they migrated from the four-point injection to injury site. But there showed more Muse cells survival than Non-Muse cells in the cord.@*CONCLUSIONS@#Immunomagnetic bead screening is efficient to select large number of purified SSEA3+ Muse cells. Muse cells could survive and target-migrate in injured cord to improve BBB scores continuously. Muse cells are a novel kind of seed cells in the spinal cord injury treatment.

Treatment of ossification of ligamentum flavum complicated with lumbar spinal stenosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the imaging characteristic and operation outcome of ossification of ligamentum flavum with lumbar spinal stenosis.</p><p><b>METHODS</b>January 2013 to January 2016, 9 patients with ossification of ligamentum flavum with lumbar spinal stenosis were treated, included 5 males and 4 females, aged from 51 to 63 years old with an average of 57 years old. All patients complained intermittent claudication and radiating pain at lower limb. The pathologic change regions examined by CT or MRI were as follows:2 cases in L₄,₅ and L₅S₁, 5 in L̀,̀, and 2 in L₅S₁. Four patients underwent simple laminectomy and 5 patients underwent laminectomy and discectomy, interbody fusion and internal fixation with pedicle screw. Clinical effects were evaluated according to JOA score, which items included subjective symptom, daily activity limitation, clinical sign and bladder function.</p><p><b>RESULTS</b>No complications such as infection or nerve injury were found after operation. The follow-up period was from 12 to 60 months with an average of 24 months. The low back pain and radiating pain at lower limb improved significantly and walking distance approached normal at final follow-up;and JOA scores improved obviously.</p><p><b>CONCLUSIONS</b>Ossification of ligamentum flavum has the special characteristic on CT scan, which decide the selection of operation method. The operative aim is effectively spinal decompression and rebuilding lower lumbar stability by minimally invasive surgery.</p>

Effect of vitamin D3 on maturation and antigen-presenting function of dendritic cells treated with Mycobacterium tuberculosis

Objective: To investigate the phenotypic characteristics and functional capability differences of mouse bone marrow-derived dendritic cells after stimulation with Mycobacterium tuberculosis in the presence or absence of vitamin D3. Methods: Mouse bone marrow-derived cells were cultured with GM-CSF (20 ng/mL). Then, one was added with 100 nmol/L of 25(OH)D3, while the other did not. On day 6, 5 μg/mL of BCG was added to stimulate the cells for 24 h. On day 7, suspension cells were harvested for phenotypic and functional analyses. Results: The percentages of CD86 dendritic cells (DCs) in the control group and 25(OH)D3 group were 66.97% ± 8.29% and 52.18% ± 8.52%, respectively; the mean fluorescence intensities of MHC-II in the control group and 25(OH)D3 group were 1 102.16 ± 371.02 and 681.62 ± 292.71. The expression levels of MHC- II and CD86 on the surface of the DCs in 25(OH)D3 group were significantly lower than those of the control group. The ability of the DCs to stimulate proliferation of T-lymphocytes was also significantly lower than that of the control group. Conclusions: These findings suggest that 25(OH)D3 modulates the immune response by affecting the maturation and function of DCs in Mycobacterium tuberculosis period.

Effect of vitamin D3 on maturation and antigen-presenting function of dendritic cells treated with Mycobacterium tuberculosis

OBJECTIVE@#To investigate the phenotypic characteristics and functional capability differences of mouse bone marrow-derived dendritic cells after stimulation with Mycobacterium tuberculosis in the presence or absence of vitamin D3.@*METHODS@#Mouse bone marrow-derived cells were cultured with GM-CSF (20 ng/mL). Then, one was added with 100 nmol/L of 25(OH)D3, while the other did not. On day 6, 5 μg/mL of BCG was added to stimulate the cells for 24 h. On day 7, suspension cells were harvested for phenotypic and functional analyses.@*RESULTS@#The percentages of CD86 dendritic cells (DCs) in the control group and 25(OH)D3 group were 66.97% ± 8.29% and 52.18% ± 8.52%, respectively; the mean fluorescence intensities of MHC-II in the control group and 25(OH)D3 group were 1 102.16 ± 371.02 and 681.62 ± 292.71. The expression levels of MHC- II and CD86 on the surface of the DCs in 25(OH)D3 group were significantly lower than those of the control group. The ability of the DCs to stimulate proliferation of T-lymphocytes was also significantly lower than that of the control group.@*CONCLUSIONS@#These findings suggest that 25(OH)D3 modulates the immune response by affecting the maturation and function of DCs in Mycobacterium tuberculosis period.

Effect of different treatment on endophytic bacterial communities in continuous cropping of Chrysanthemum morifoliu / 中国中药杂志

To reveal the effect of rotation cropping and bacterial manure on the growth of Chrysanthemum morifolium and screen the beneficial endophytic, the diversity of endophytic and dominant genera of different treatment groups were analyzed. Four different treatments were continuous cropping, rotation, self-made organic fertilizer and commercially available fertilizer, respectively. Endophytic bacterial diversity and dominant genera in different organs were examined using Terminal Restriction Fragment Length Polymorphism (T-RFLP). The results showed that enzyme Hae III was more appropriate than enzyme Hinfl because the number of TRFs digested by enzyme Hae III was more than that of enzyme Hinfl. In comparison of diversity, the endophytic bacterial communities' diversity index in group of cropping rotation and fertilizer was higher than that of continuous cropping which indicated that the addition of exogenous microorganism in soil could increase the diversity of plant endophyte. 18 dominant species were selected, including 3 kinds of Firmicutes, 4 kinds of Actinomycetes and 11 kinds of Proteobacteria. The results of dominant species comparison showed that the number of dominant species in continuous cropping of Ch. morifolium was significantly less than that of the rotation group. Some dominant bacteria in rotation group and fertilizer group such as Arthrobacter, Streptomyces, Streptomyces, Flavobacterium and Mycobacterium were not found in the continuous cropping of Ch. mortfolium group. Dominant species of fertilizer treatment group was similar with the rotation group, and the continuous cropping group's dominant species was more abundant. It indicates that these bacteria may be able to mitigate hindrance in continuous cropping, especially the Flavobacterium which can decompose the pathogenic fungi is worthy of further attention. Compared with leaves, there are more dominant species in roots and stems. The diversity of edophytic bacterial communities in continuous cropping of Ch. morifolium stays below than that in the rotation of Ch. morifolium, and fertilizer treatment can increase the diversity of continuous cropping so that it could mitigate hindrance in continuous cropping.

Study on method of paeonia radix alba producing and concocting integration processing / 中国中药杂志

<p><b>OBJECTIVE</b>To study the origin pre-treating and processing integration techniques of Paeonia Radix Alba.</p><p><b>METHOD</b>Different processing integration techniques were adopted and compared with traditional processing techniques to determine drying rate, aqueous extracts and peoniflori content.</p><p><b>RESULT</b>Half-dry slices baked at 100 degrees C for 20 min and steamed at 100 degrees C for 10 min had the highest peoniflori contents. Half-dry slices baked at 100 degrees C for 20 min had the highest content of aqueous extracts. Products processed with conventional method and sulfur-fumigation had the lowest content of aqueous extracts.</p><p><b>CONCLUSION</b>The origin processing integration techniques of Paeonia Radix Alba lose less active ingredients than conventional processing methods.</p>

Curative effect evaluation and complication analysis of Bryan artificial cervical disc replacement / 中国骨伤

<p><b>OBJECTIVE</b>To observe the curative effects and complications of Bryan cervical disc replacement for cervical disc herniation.</p><p><b>METHODS</b>From Jannary 2005 to December 2008,39 patients with cervical disc herniation were treated with Bryan cervical disc replacement. There were 20 males and 19 females,with an average age of 47 years old (ranged, 35 to 59). Spinal compression symptom (20 cases) and nerve root symptom (19 cases) were main clinical symptoms. Single level disc was replaced in 35 cases and two-level replaced in 4 cases. Offset and activity of prosthesis,cervical physiological curvature, heterotopic ossification, prosthetic fusion were observed by dynamic X-ray. According to Odom's standard and JOA score,nerve function were evaluated; and depending on NDI standard,clinical symptom and daily function status were recorded.</p><p><b>RESULTS</b>All the patients were followed up from 16 to 36 months with an average of 24 months. Nerve function obviously improved and radiating pain of upper limb completely relieved. No patient with prosthetic anterior-posterior offset more than 2 mm was found. Prosthetic flexion and extention angle was (8.5+-1.8)degrees,left and right flexion range respectively were (3.5+/-1.2)degrees and (3.3+/-1.5)degrees. Cervical physiological curvature improved obviously or recovered normally. Three cases occurred in heterotopic ossification and 2 cases occurred in prosthetic fusion. According to Odom's standard,25 cases got an excellent results,9 good, 5 fair, the rate of excellent and good was 87.2%. JOA score increased from preoperative (8.26+/-1.32) to (15.71+/-1.89) at final follow-up and NDI decreased from preoperative (43.7+/-3.8) to (20.1+/-2.9) at final follow-up.</p><p><b>CONCLUSION</b>Treatment of cervical disc herniation with Bryan cervical disc replacement can get the good curative effects,which can obtain good nerve functional recovery,cervical stability and activity. Nevertheless,the operation has typical complication such as heterotopic ossification and prosthetic fusion. Thus,it is important in chosing indication and operative procedure.</p>

One-stage debridement and bone grafting with internal fixation via posterior approach for treatment of children thoracic spine tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the outcome of the children with thoracic spine tuberculosis who underwent radical debridement, reconstruction with bone autograft or allograft and internal fixation via posterior approach.</p><p><b>METHODS</b>From June 2005 to December 2010,9 children with thoracic spine tuberculosis underwent radical debridement, reconstruction with bone autograft or allograft and internal fixation via posterior approach including 7 males and 2 females with an average age of 7 years old ranging from 3 to 12 years. The course of the disease ranged from 3 months to 1 year (averaged 6 months). All the patients had continuous thoracic and back pain,intercostal nerve pain and kyphosis deformity, accompanied with low fever,night sweat and pathologic leanness. The predilection sites examined by X-ray, CT or MRI were in T4 to T9 segment. The kyphosis angle ranged from 35 degrees to 72 degrees (averaged 48.2 degrees) before surgery. The ASIA classification was as follows: 2 cases at grade B, 5 at grade C, 2 at grade D. All the patients underwent a standard one-stage operation via posterior approach. Radical debridement was performed, then iliac crest bone autograft or allograft was placed and transpedicular screw system internal fixation was done to reconstruct the spinal column. The change of kyphosis angle and fusion of bone grafting were reexamined by X-ray regularly. The neurological function were evaluated according to ASIA classification.</p><p><b>RESULTS</b>There was no injury of blood vessel or spinal cord during the surgery. Nine children were followed-up for 16 to 38 months (averaged 24 months). The tuberculosis symptoms disappeared after surgery and there was no tuberculosis recurrence,incision infection, sinus formation and internal fixation failure in any of these chiildren. ESR reexamination recovered normally. Bony fusion was obtained in all patients and internal fixation position was normal 4 to 8 month postoperatively. The kyphosis angle ranged from 12 degrees to 30 degrees (averaged 19.50) at final followed-up. The function of spinal cord improved postoperatively, the function of spinal cord recovered at different degrees: 2 cases at grade C, 2 at grade D, and 5 at grade E.</p><p><b>CONCLUSION</b>The one-stage posterior approach can provide direct and safe access to the lesion. The effect of vertebral canal decompression and kyphosis deformity correction were significantly. The structural iliac crest autograft or allograft and posterior transpedicular screw system could work effectively to stabilize the thoracic junction.</p>

Analysis of postoperative recurrence reason and observation of reoperation outcome for spinal tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the reason of postoperative recurrence of spinal tuberculosis and observe the clinical outcome of these patients in reoperation.</p><p><b>METHODS</b>From January 2002 to May 2010,27 patients with postoperative recrudescent spinal tuberculosis were treated. There were 15 males and 12 females with an average age of 36.5 years old (ranged, 21 to 65). The risk factors and effect strength associated with postoperative recrudescent spinal tuberculosis were compared by Logistic regression analysis. Individual operation was performed according to the major reason. Re-operative methods including debridment in 5 cases, debridment and sinuses resection in 7 cases, one stage debridement and bone grafting via anterior approach and internal fixation via posterior approach in 8 cases, one stage bone grafting and internal fixation via posterior approach combined with CT-guided percutaneous catheter drainage and local chemotherapy in 2 cases, CT-guided percutaneous catheter drainage and local chemotherapy in 5 cases. Antituberculosis drugs were regularly used in all patients after operation. The ESR, X-ray and 3D-CT were regularly performed to estimate the progress of tuberculosis and condition of bony fusion.</p><p><b>RESULTS</b>The risk factors associated with postoperative recrudescent spinal tuberculosis were complicated, including no regularly used antituberculosis drugs before and after operation, no early diagnosis and treatment of the postoperative fluidify, malnutrition, no thoroughly debridement during operation and poor spinal stability after operation, according to effect strength to arrange. There was no injury of blood vessel,spinal cord or ureter during reoperation. The follow-up period was from 12 to 36 months with an average of 24 months. Tuberculosis symptoms disappeared after reoperation and no complications such as tuberculosis recurrence, infection of incision, sinuses formation and internal fixation failure were found in the patients. ESR recovered normal in follow-up and bone graft obtained fusion at 8 to 12 months after operation and internal fixation position was normal.</p><p><b>CONCLUSION</b>The reoperative reasons of spinal tuberculosis are complicated and multifactorial. The diagnosis and treatment are difficult. It is important to analyze the recrudescent reasons thoroughly before operation,emphasize the application of regularly antituberculosis drugs and individual operation, meanwhile, reinforce nourishment and supportive treatment.</p>

Debridement and bone grafting with internal fixation via the anterior approach for treatment of cervicothoracic tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the outcome of radical debridement, reconstruction with bone autograft or allograft and plate internal fixation via the anterior approach for the treatment of cervicothoracic tuberculosis.</p><p><b>METHODS</b>From Jun. 2000 to Dec. 2010, 20 patients with cervicothoracic tuberculosis were treated by debridement and bone grafting with internal fixation via the anterior approach. They included 17 males and 3 females who ranged in age from 25 to 46 years (mean 38 years). The course of disease ranged from 3 months to 2 years (mean 12 months). The onset of the disease was chronic in all patients, with main complaints of persistent pain, and cervical stiffness and deformity accompanied with low fever,night sweating and pathologic leanness. Preoperative X-ray, CT or MRI showed that the pathologic change occurred in C7-T1 segment in 10 cases, T1 segment in 6 cases, T1-T3 segment in 3 cases,and T2-T3 segment in 1 case. The Cobb angle ranged from 25 degrees to 60 degrees (mean 35 degrees) before surgery. The Frankel classification was as follows: 2 cases at grade A, 4 cases at grade B, 7 cases at grade C, 2 cases at grade D, and 5 cases at grade E. All the patients underwent a standard cervical approach by combined partial median steotomy and transverse steotomy through the synostosis between the manubrium and body of the sternum to expose the lesion adequately. Radical debridement was performed, and then a tricortical iliac crest bone autograft or allograft was placed and secured by internal fixation to reconstruct the spinal column. The change in Cobb angle and fusion of bone grafting were reexamined by X-ray regularly. The clinical symptoms and neurological function were evaluated according to NDI (neck disability index) score and Frankel classification.</p><p><b>RESULTS</b>There was no injury to blood vessels, spinal cord or recurrent nerve during surgery. All patients were followed-up from 16 to 39 (mean 25) months. The tuberculosis symptoms disappeared after surgery and there was no tuberculosis recurrence,incision infection, sinus formation and internal fixation failure in any of these patients. ESR re-examination recovered normally. Bony fusion was obtained in all patients and internal fixation position was normal at 3 to 6 month postoperatively. The Cobb angle ranged from 10 degrees to 16 degrees (mean 12 degrees) and NDI was reduced from (48.2 +/- 2.9) to (22.5 +/- 3.1) at the final followed-up. Except for 2 patients at grade A showing no recovery preoperatively, the Frankel classification of the other patients raised 1.5 grade on average at the final followed-up, and the nerve function of the spinal cord recovered at different degrees: 2 at grade A, 1 at grade B, 1 at grade C, 3 at grade D, and 13 at grade E.</p><p><b>CONCLUSION</b>The anterior approach can provide direct and safe access to the lesion. The decompression effect of the vertebral canal is significant. The structural iliac crest autograft or allograft and anterior instrumentation could work effectively to stabilize the cervicothoracic junction.</p>

Therapeutic efficacy of drug susceptibility test-guided individualized anti-tuberculosis chemotherapy for spinal tuberculosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of individualized anti-tuberculosis chemotherapy guided by drug susceptibility testing for spinal tuberculosis through analyses on the post-operative follow-up outcomes.</p><p><b>METHODS</b>The diagnoses of spinal tuberculosis were established by clinical, radiological and histological evaluation in 132 patients who were admitted from August 2005 to January 2010, 62 patients (37 male and 25 female) with follow-up more than 12 months in this study. The average age was 33.6 years (ranging from 4 - 67 years). The infected samples were collected during surgery. After processed in a routine laboratory procedure, the samples were inoculated into vials of the BACT/ALERT 3D system. The drug susceptibility testing was performed using absolute concentration method, which included 11 first-line and second-line drugs. Four or five anti-tuberculosis drug regimen was chosen according to the results of drug susceptibility testing. All the patients were followed up a month later, and then once 3 months in the following 11 months, and subsequently at intervals of half a year. The clinical status, erythrocyte sedimentation rate (ESR), roentgenogram, MRI and 3D-CT were concerned to estimate the progress of tuberculosis.</p><p><b>RESULTS</b>The culture positive rate was 45.2% (28/62). The average detection time was 42 d (ranging from 28 - 58 d). The drug susceptibility testing showed a total drug resistance level of 24.2%:12.9% for isoniazid, 4.8% for rifampicin, 3.2% for ethambutol, 9.7% for streptomycin, 6.4% for pasiniazid, 14.5% for levofloxacin, 1.6% for rifapentine. The mean follow-up period was 21 months (ranging from 12 - 44 months). According to Bridwell criteria, grade I bony fusion was obtained in all patients in 8 - 12 months.</p><p><b>CONCLUSION</b>Guided by drug susceptibility testing, individualized anti-tuberculosis chemotherapy for 12 to 18 months is effective for spinal tuberculosis.</p>

Comparative analysis of sequence alignment of SH3GL1 gene as a disease candidate gene of adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To identify whether SH3GL1 gene serves as a disease associated gene of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>Positioning candidate cloning: "case-sibling or case-family control design" research scheme based on family constellation was designed. Fifty-six AIS patients (15 male and 41 female, mean age 15 years old, ranged from 8 to 22 years old, Cobb angle from 25 degrees to 110 degrees , average Cobb angle of 67.5 degrees ) from November 2007 to December 2008 were recruited. In all patients, blood preparation was collected, and genome DNA was extracted. According to nucleotide sequence of gene SH3GL1, primer pair for PCR amplification, cloning, and sequencing with 10 exons as emphasis was designed. Sequence comparative analysis for exon sequencing result between sib pairs or family pairs, and that between sib pair or family pairs and NCBI (National Center for Biotechnology Information) were conducted through Vector NTI Advance 10.3 software to judge whether basic group mutation occurred or not. Amino acid sequence comparative analysis for prediction was made.</p><p><b>RESULTS</b>Ten exons of the candidate gene SH3GL1 were successfully amplified and cloned in genome DNA of an AIS sib pair and family pairs, and the sequencing obtained positive results. Twelve basic group mutations were found in 10 exons of the candidate gene SH3GL1 of patients with AIS. These mutations were located in the second exon (3 mutations), the fourth exon (1 mutations), the fifth exon (4 mutations), the sixth exon (1 mutations), the eighth exon (1 mutations), and the tenth exon (2 mutations, noncoding region). If basic group in 515 of mRNA was mutated to T, termination codon(TAG) came into being and open reading frame was altered. The sequence of protein showed brachytmema protein was encoded, which could cause changes of primary structure.</p><p><b>CONCLUSION</b>SH3GL1 is possibly one of the disease associated genes of AIS.</p>

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures.</p><p><b>METHODS</b>Twenty patients who suffered from nonadjacent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutaneous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre-and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed.</p><p><b>RESULTS</b>All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolumbar spine was restored satisfactorily. No patient had neurologic deterioration after surgery, and 9 patients with incomplete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively.</p><p><b>CONCLUSIONS</b>Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advantages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thoracolumbar fractures.</p>

Effect of laparoscopic surgery on the immune function of patients with endometriosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of laparoscopic surgery on the immune function of patients with endometriosis.</p><p><b>METHOD</b>Blood samples were obtained from 36 patients undergoing laparoscopy for endometriosis before and 1 day and 3 days after the operation. Peripheral blood T-cell subsets CD3, CD4, and CD8 were determined with flow cytometry, the levels of IgM, IgG, IgA, Complement (C)3, C4, C-reactive protein and (CRP) were detected with turbidimetry, and the levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured with enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>No significant variation were found in the T-cell subsets, IgM, IgA, C4 after the operation (P>0.05). The levels of IgG and C3 1 day after the operation were significantly lower than the preoperative levels (P<0.05) and nearly recovered the preoperative level 3 days after operation. Serum concentration of IL-6, TNF-alpha, and CRP 1 day after the operation were significantly higher than the preoperative levels (P<0.01) and decreased 3 days after the operation.</p><p><b>CONCLUSIONS</b>The immune function of patients with endometriosis is mildly affected by laparoscopic surgery and recover rapidly, which may be one of the reasons for quick recovery of patients after laparoscopy for endometriosis.</p>

Effect of environmental factors on growth of Huperzia serrata / 中国中药杂志

<p><b>OBJECTIVE</b>To establish and optimize the cultivation systems for wild Huperzia serrata, through assessing the effects of environmental factors on its growth.</p><p><b>METHOD</b>H. serrata was planted under natural field condition, the growth status of H. serrata under different light intensities, temperatures, relative humidity (R. H.), fertilizer levels, and so on were investigated and analyzed.</p><p><b>RESULT</b>H. serrata grew nicely under following environmental conditions: temperature ranging from 18.9-26.3 degrees C, R. H. ranging from 81%-90% and 1330-3000 lx light intensity. A cultivation system, in which H. serrata was planted in the bamboo forest and did not occupy the arable land, was established through the study.</p><p><b>CONCLUSION</b>Concluded that light intensity and R. H are the two factors which greatly confine the growth of H. serrata. As long as the levels of the above two factors meets the demands, H. serrata could be cultivated.</p>

Arthroscopic Bankart lesion repair by double-row vertical mattress suture with anchors for anteroinferior glenohumeral instability / 中华外科杂志

<p><b>OBJECTIVES</b>To introduce a new arthroscopic Bankart repair by vertical mattress suture with anchors, and to evaluate its clinical effectiveness.</p><p><b>METHODS</b>A new arthroscopic Bankart repair by vertical mattress suture with anchors was performed, including to insert only 2 anchors at 3 o'clock and 5 o'clock position and make vertical mattress suture of labrum-ligament complex at 2, 4 and 6 o'clock of labrum, and to shift up the anterior-inferior capsule. Nine cases of anterior glenohumeral instability without severe glenoid bone defect were followed-up for an average period of 14 months (range from 6 to 26 months). The average surgery age was 28 years (range from 21 to 46 years).</p><p><b>RESULTS</b>The average surgery time was 51 min (40 - 75 min). Clinical scores as evaluated by the modified Rowe score advanced from 40 +/- 16 points to 92 +/- 19 points (75 - 94). There was no any recurrence and complication. External rotation was reduced by 5 degrees at 0 degrees adduction and by 3 degrees at 90 degrees of abduction.</p><p><b>CONCLUSIONS</b>The arthroscopic Bankart repair by vertical mattress suture with anchors for anteroinferior glenohumeral instability is favorable as an easy, short-time surgery with excellent clinical results in short-term follow-up.</p>

Treatment of high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of less invasive surgical treatment for high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation.</p><p><b>METHODS</b>From January, 2003 to May,2006, 16 cases of high-energy tibia plateau fracture were treated with half-ring external fixation combined with minimum internal fixation including 10 cases of type V and 6 cases of type VI according to Schatzker's classification. The average age of the patients was 42.4 years (range 25 to 50 years).</p><p><b>RESULTS</b>All patients were followed for an average of 16 months (range 5 to 27 months). All the fractures healed after an average time of 3.5 months. Two patients developed infections of the pin holes. According to the criteria of Rasmussen, excellent results were achieved in 10, good results in 4 cases, moderate in 2, and poor in none.</p><p><b>CONCLUSION</b>Half-ring external fixation combined with minimum internal fixation can be ideal for treatment of complex tibia plateau fracture.</p>

Expression and effect of Caspase-3 in neurons after tractive spinal cord injury in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate Caspase-3 expression and its role in neuronal apoptosis.</p><p><b>METHODS</b>The T13-L2 spinal cord of rats was injured by traction after the amplitude of P1-N1 wave, monitored by a cortical somatosensory evoked potential (CSEP) monitor, decreased to seventy percent of that before operation. Then rats were killed in 6 h, 1 d, 4 d, 7 d, 14 d and 21 d respectively after operation. Flow cytometer terminal deoxynucleotldyl transferease-mediated biotinylated deoxynuridine triphosphate nick end labeling (TUNEL), Caspase-3 activity assay and immunohistochemical method were applied to investigate Caspase-3 expression in the spinal cord tissue and to study neuronal apoptosis in rats.</p><p><b>RESULTS</b>After spinal cord injury, apoptotic cells detected by flow cytometry and TUNEL-positive cells were significantly more, and positive immunohistochemical staining of Caspase-3 and Caspase-3 activity were significantly higher in Group injury than in Groups control and laminectomy, respectively (P > 0.05, P > 0.01). Similar trend of changes was noticed in apoptotic cells, TUNEL-positive cells and positive immunohistochemical staining of Caspase-3, all of which reached their respective peak 7 days after operation. Caspase-3 activity reached its peak, however, 4 days postoperatively.</p><p><b>CONCLUSIONS</b>Increased expression and activity of Caspase-3 protein in neurons after tractive spinal cord injury is the biochemical signal of early spinal cell apoptosis. It is of great significance for understanding the mechanism of spinal cord injury.</p>

Preparation of controlled release microspheres of vascular endothelial growth factor & calcium alginate and their effects on proliferation of human umbilical vein endothelial cells / 中华创伤杂志

Objective To prepare controlled release microspheres of vascular endothelial growth factor(VEGF)& calcium alginate and observe their effect on proliferation of human umbilical vein endo- thelial cells(HUVEC)in order to provide theoretical basis for controlled release of VEGF facilitating an- giogenesis of tissue engineering bone.Methods VEGF-calcium alginate microspheres were prepared by using the needle extrusion/external gelation method to investigate physicochemical character and in vitro release of VEGF.According to the different ingredients added into the culture medium,the seconda- ry cultured HUVEC were divided into four groups,ie,control group,microsphere group,VEGF group and VEGF-calcium alginate microsphere group,in which the proliferation of the cultured HUVEC was ob- served with cell counting method,MTT method and flow cytometry.Results The calcium alginate mi- crospheres were revealed as spherical shape and evenly distributed,with mean grain diameter of(560?50)?m,carrying capacity of 0.72 ng/mg and the encapsulation efficiency of 54%.Smooth controlled re- lease in VEGF-alginate microspheres lasted for more than 10 days.Proliferation of the cultured HUVEC was accelerated the most in VEGF group at the beginning but in EGF-calcium alginate microsphere group at midanaphase compared with other groups,with statistical difference(P＜0.05).There was no statis- tical difference upon cell counting,cell activity and time point of cell cycle between control group and mi- crosphere group.Conclusion VEGF-sodium alginate microapheres can continue activity of VEGF,re- lease VEGF for over 10 days and promote proliferation cultured HUVEC for a long time.