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Objective:To compare the clinical features, X-ray, CT, MRI imaging findings of C 3, 4 single segment cervical spondylotic myelopathy among the elderly group, the middle-aged group and the young group. Methods:The medical records and imaging data of 51 cases of single segment C 3, 4 cervical spondylotic myelopathy treated from January 2017 to December 2021 were retrospectively reviewed. There were 10 cases in the young group, including 8 males and 2 females, 23-44 years, with an average age of 35.8±7.62 years; 14 cases in the middle-aged group, including 9 males and 5 females, 48-60 years, with an average age of 53.21±4.14 years; 27 cases in the elderly group, including 24 males and 3 females, 61-84 years, with an average age of 68.04±5.97 years. Based on the medical record data, the differences in clinical manifestations among the three groups (initial symptoms, symptom distribution, pathological sign distribution and JOA score) were analyzed. Based on the imaging data, the static factors (cervical osteophyte, alignment and thickness of cervical ligamentum flavum) and dynamic factors [overall cervical range of motion (ROM), individual segment cervical ROM, cervical instability and cervical nuchal ligament calcification] were analyzed. Anatomical factors (C 2-C 7 Cobb angle, C 4-C 7 Cobb angle, C 3 vertebral canal diameter, C 4 vertebral diameter, C 3 Pavlov ratio, C 4 Pavlov ratio) and spinal cord compression (spinal cord signal, compression position and compression nature) were also analyzed. Results:There were no statistically significant difference in gender distribution and height in three groups of patients ( P>0.05). In terms of clinical manifestations, there were statistically significant differences among the three groups in initial symptoms and chief symptoms ( P<0.05). The elderly group had upper limb weakness as the first symptom, lower limb weakness and abnormal gait as the chief complaint; the middle-aged group had upper limb numbness as the first symptom, upper limb numbness and weakness as the chief complaint; the young group had upper limb pain as the first symptom, upper limb numbness as the chief complaint. There were statistically significant differences in Hoffmann sign and Babinski sign among the three groups ( P<0.05). Hoffmann sign and Babinski sign were more common in the elderly group than in the young group ( P<0.05). There were significant differences among the three groups in total JOA score, JOA score of motor and lower limb motor JOA ( P<0.05). The total JOA score in the elderly group was lower than that in the young group ( P<0.05), especially for motor JOA score ( P<0.05), and lower limb motor JOA score ( P<0.05). There were no significant differences in first symptoms distribution, symptoms distribution, biceps reflex, triceps reflex, radial reflex or knee tendon reflex among the three groups ( P>0.05). In terms of static factors, there was significant difference in alignment and thickness of cervical ligamentum flavum among the three groups (P<0.05). The elderly group was more prone to slip than the young and middle aged groups ( P<0.05). The thickness of ligamentum flavum in the elderly group (2.18±0.68 mm) was thicker than that in the young group (1.60±0.30 mm) and the middle-elderly group (1.60±0.62 mm) ( P<0.05). There was no significant difference in cervical osteophyte among the three groups ( P>0.05). In terms of dynamic factors, there were statistically significant difference in C 3-C 7 ROM, C 4-C 7 ROM, C 3, 4 ROM and ossification of nuchal ligament among the three groups ( P<0.05). In the elderly group, C 3-C 7 ROM (22.18°) was larger than that in the young group (21.27°) ( P<0.05), while in the elderly group C 4-C 7 ROM (9.60°) was smaller than that in the young group (14.19°) ( P<0.05). In the elderly group, C 3, 4 ROM (15.30°) was larger than that in the young group (9.97°) ( P<0.05), and the elderly group was more prone to nuchal ligament calcification than the young and the middle-elderly group ( P<0.05). There were no significant difference among the three groups in C 4, 5 ROM, C 5, 6 ROM, C 6, 7 ROM or cervical instability ( P>0.05). For spinal cord compression, there were statistically significant differences among the three groups in the compression nature, compression location and MRI T2WI spinal cord signal ( P<0.05). The elderly group was more prone to anterior and posterior bony compression. The elderly group was more likely to show high signal intensity on spinal cord MRI T2WI than the young group ( P<0.05). For anatomical factors, there were statistically significant differences in C 2-C 7 Cobb, C 3 vertebral diameter and C 3 Pavolv among the three groups ( P<0.05) . The C 2-C 7 Cobb of the elderly group (21.06°) was larger than that of the young group (16.45°) ( P<0.05), and the C 3 diameter of the elderly group (9.61±0.33 mm) was smaller than that of the young group (10.38±1.19 mm) ( P<0.05). The C 3 Pavolv of the elderly group (0.52±0.03) was lower than that of the young group (0.59±0.11) ( P<0.05). In the presence of lordosis, C 4-C 7 Cobb in the elderly group (4.96°±4.05°) was smaller than that in the young group (12.42°±4.83°) and the middle-aged group (10.07°±6.14°) ( P<0.05). In the presence of kyphosis, C 4-C 7 Cobb in the elderly group (4.02°±1.19°) was larger than that in the young group (0.06°±0.01°) and the middle-aged group (1.83°±0.93°) ( P<0.05). There were no significant differences in C 3-C 7 Cobb, C 4 vertebral diameter or C 4 Pavolv among the three groups ( P>0.05). Conclusion:Young patients mostly have anteriorly soft compression of disc herniation, and most of them complain of neck and upper limb pain, while spinal cord compression and clinical manifestations are relatively mild. For the elderly patients, most of them have C 3 retrolisthesis, with the pinching type bony compression of spinal cord from both anteriorly and posteriorly, and their complaints are usually upper limb numbness, mostly accompanied by radiographically severe spinal cord compression and clinically gait abnormalities. In the middle-aged patients, the rigid compression of anterior calcified disc herniation is the main reason, and the numbness of upper limb is the chief complain.
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Objective:To explore one-stage total knee arthroplasty (TKA) combined with open reduction and internal fixation (ORIF) for knee osteoarthritis complicated with tibial stress fracture.Methods:The 3 patients were retrospectively analyzed who had been treated for knee osteoarthritis complicated with tibial stress fracture at Department of Orthopedics, Ganzhou District People＇s Hospital from March 2018 to March 2020. They were all female, aged from 54 to 76 years (average, 66 years). There were 2 transverse fractures and one short oblique fracture; all of them had knee varus deformity. The Hospital for Special Surgery (HSS) scores averaged 37.6 (from 28 to 50) for the left knee and 28.3 (from 22 to 39) for the right knee. One-stage TKA was performed for the articular surface while ORIF for the right tibial stress fracture for all patients. Recorded were fracture union time, HSS knee score and range of articular motion.Results:The 3 patients were followed up for 25 to 44 months (average, 32 months).The fracture union time ranged from 4 to 7 months (average, 5 months). The last follow-ups revealed no such complications as prosthesis loosening, peri-prosthesis osteolysis or joint instability. Knee varus deformity was corrected in all patients. The HSS knee scores at the last follow-up averaged 89.6 (from 88 to 91) for the left knee and 88.3 (from 85 to 90) for the right knee.Conclusion:In the treatment of knee osteoarthritis complicated with tibial stress fracture, one-stage TKA combined with ORIF can restore the function of knee joint, leading to fine curative effects.
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Objective:To systematically evaluate the efficacy of low dose whole-lung irradiation in COVID-19 pneumonia based on the present evidence.Methods:All literature related to the application of low dose whole-lung irradiation in COVID-19 pneumonia were retrieved from Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar, Scoupus, CNKI, Wanfang database, VIP database until May 2022. Two researchers independently screened the literature. For the literature that met the inclusion criteria, both data extraction and literature quality evaluation were blinded. Revman 5.3 software was used for statistical analysis.Results:A total of 5 controlled clinical trials involving 194 patients met the inclusion criteria. No statistically significant differences were detected in the low dose whole-lung irradiation group compared with the best supportive care group for clinical recovery rates, intubation rates, radiographic improvement rates and 28 d-overall survival.Conclusions:In patients of COVID-19 pneumonia, low dose whole-lung irradiation conferred no significant benefit to clinical outcomes. Currently, the routine use of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia is not recommended.
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OBJECTIVE To prepare quercetin-human serum albumin-nanoparticles （Que-HSA-NPs），and to evaluate the in vivo and in vitro inhibitory effects of Que-HSA-NPs on hepatic fibrosis of non-alcoholic steatohepatitis （NASH）. METHODS Que-HSA-NPs were prepared by desolvation-chemical cross-linking method ，their appearance characteristics were observed ，and their particle size ，polydispersity index （PDI），Zeta potential and drug loading were detected. Quercetin （Que）and Que-HSA-NPs were applied to murine HSC-T 6 cells. The effects of them on survival rate of HSC-T 6，mRNA expression of transforming growth factor β（TGF-β），Type Ⅰ collagen α1（COL1A1）and α-smooth muscle actin （α-SMA）were compared. Que and Que-HSA-NPs were applied to mice fed with low methionine and choline deficient high-fat diet. The serum levels of liver injury indexes ，liver pathological characteristics ，mRNA expressions of TGF-β，COL1A1 and α-SMA，protein expression of α-SMA in liver tissue were determined to evaluate the improvement effects of them on hepatic fibrosis of NASH in mice. RESULTS The prepared Que-HSA-NPs was spherical ，the particle size was （172.9±2.2）nm，the PDI was 0.233，the Zeta potential was －29.2 mV，and the drug loading was 2.99％. Que and Que-HSA-NPs were nontoxic to HSC-T 6 at concentrations of 0-250 μg/mL. Both of them could significantly decrease mRNA expressions of TGF-β，COL1A1 and α-SMA，especially Que-HSA-NPs （P＜0.05）. They also could significantly decrease the serum levels of liver inju ry index ，relieve liver injury and down-regulate mRNA expressions of TGF-β，COL1A1 and α-SMA and protein expression of α-SMA， especially Que-HSA-NPs （P＜0.05）. CONCLUSIONS Que- HSA-NPs is successfully prepared ，and confirm that its anti- NASH hepatic fibrosis effect is better than that of Que .
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Objective:To explore the relationship between the length of cervical spinous process and cervical motion and affected segment of cervical spondylotic myelopathy(CSM).Methods:Retrospective analysis was performed on 375 patients who underwent cervical surgical treatment due to single-segment cervical spondylotic myelopathy from January 2015 to January 2019. There were 200 males and 175 females, aged 50.72±9.39 (range 40 to 60) years. Several parameters, including the sagittal diameter of vertebral body, the sagittal diameter of cervical canal, the length of cervical spinous process, C 3-C 7 lordotic angle, range of motion (ROM) at C 3-C 7 and segmental ROM were measured via preoperative plain radiographs. All parameters were tested via Shapiro-Wilk method. Pearson correlation analyses was used to quantify the relationship between the lengths of C 3-C 7 spinous process and segmental ROMs. Receiver operating characteristic (ROC) curve was mapped to obtain the cut-off points according to the length of cervical spinous process which had significant differences. Patients were divided into two groups based on the cut-off points. χ2 test and t test were used to exclude the interference of age, gender and other anatomical factors and compare the differences in the affected segment of cervical spondylotic myelopathy between groups, so as to analyze the relationship between the length of cervical spinous process and affected segment of cervical spondylotic myelopathy. Results:There were significant differences of C 6 spinous process 27.82±6.01 mm and significantly negative correlation between the length of C 6 spinous process and the ROM at C 6,7 segment ( r=-0.338, P<0.001), while no significant correlations were found in other segments. ROC curves were mapped to obtain the cut-off points, and the cut-off point was 0.76. Group I: the ratio of the length of spinous process of C 6/C 7 (C 6/C 7 ratio, range 0.49 to 1.01) under 0.76, Group II: C 6/C 7 ratio more than 0.76. Compared with patients with longer-type C 6 spinous process (C 6/C 7 ratio ≥0.76), patients with shorter-type C 6 spinous process (C 6/C 7 ratio <0.76) had significantly bigger ROM at C 6,7 segment (10.11° vs 7.10°, P<0.001) and higher incidence of C 6,7 spinal cord compression ( χ2=16.642, P<0.001, OR=2.521), while differences in age, sex, sagittal diameters of vertebral body and spinal canal between two groups were not significant. Conclusion:The length of C 6 spinous process was significantly correlated with ROM at C 6,7 segment and the incidence of C 6,7 degenerative myelopathy. The length of C 6 spinous process can be considered as a predictor of development of C 6,7 degenerative myelopathy.
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Objective@#To explore differences in the detection rate of elevated blood pressure (BP) in children aged 6-8 years old, and to verify the apparent existence of white-coat hypertension (BP) in children.@*Methods@#Based on census data(PROC), and three subsequent BP readings were taken during follow-ups which were carried out from October 2018 to June 2019. A total of 1 785 children were included in the present study. Using updating blood pressure reference for Chinese children aged 3-17 years, compared the BP detection rate at baseline, at the first follow-up, and the average value of the last two BP readings. Fluctuations in the detection rate of elevated BP in children at different time-points were analyzed.@*Results@#The detection rates of the three elevated BP measurements of 6-8-year-old children were 57.65%, 25.88% and 15.46%, respectively, and the detection rate was higher among boys than girls. The detection rate of baseline BP was higher than that of the first follow-up BP measurements and the average of the last two BP measurements(P<0.01). Given the agreement in the diagnosis of high SBP, high DBP, high BP at baseline, and the average of the last two follow-up BP measurements, elevated BP at baseline was the lowest among the three groups and SBP was higher than DBP.@*Conclusion@#Blood Pressure fluctuations might be caused by transient tension that was experienced during the baseline BP measurement and during the first of the three follow-ups. Therefore, the average value of last two BP measurements may better reflect the real BP level in children.
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Objective@#To explore sex differences between weight and systolic blood pressure (SBP) changes among school-age children and adolescents in Beijing, and to provide a basis for priority intervention to control the rapid growth of body weight and blood pressure.@*Methods@#Anthropometric measurement data of 70 288 children and adolescents from primary and high schools in Shunyi District were collected from 2009 to 2018, and a longitudinal dataset with complete data related to weight and BP after individual data linkage was compiled. The age-specific weight and SBP growth rates were calculated, and a linear mixed-effects model was used to identify sex differences in chronological growth rates.@*Results@#Weight and SBP increased with age in both boys and girls, and the mean weight and SBP were higher in boys than in girls across all age groups. The result of the linear mixed-effects model indicated apparent sex differences in weight and SBP growth rates, with an age and sex interaction term(β=-0.35, -0.40, P<0.01). The age at peak weight velocity (PWA) was 12 years old and the age at peak SBP velocity was 13 years old in boys, which occurred one and three years later than for girls, respectively. In addition, the peak weight and SBP velocity were higher in boys than in girls. The curves of the SBP growth rate adjusted for the PWA, showed that the peak SBP velocity occurred two years before PWA and the second peak SBP velocity occurred at the PWA, which indicated "double peaks" in both boys and girls. The SBP growth rate was always higher in boys than in girls, and the rates declined after PWA.@*Conclusion@#Sex differences in weight and SBP growth rates were persistent and obvious in school-age children and adolescents in Beijing and the change in SBP was highly time synchronized with the increase in weight.
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Objective@#The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents.@*Methods@#Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individuallevel information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA).@*Results@#Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11 year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P<0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56，-47.46，3.22，P<0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty.@*Conclusion@#Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height.
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In recent years, CRISPR/Cas9-mediated base editing has been developed to a powerful genome editing tool, providing advantages such as without introducing double-stranded DNA break, a donor template and relying on host homologous recombination repair pathway, and has been widely applied in animals, plants, yeast and bacteria. In previous study, our group developed a multiplex automated base editing method (MACBETH) in the important industrial model strain Corynebacterium glutamicum. In this study, to further optimize the method and improve the base editing efficiency in C. glutamicum, we first constructed a green fluorescent protein (GFP) reporter-based detection system. The point mutation in the inactivated GFP protein can be edited to restore the GFP fluorescence. By combining with flow cytometry analysis, the base-editing efficiency can be quickly calculated. Then, the base editor with the target gRNA was constructed, and the editing efficiency with the initial editing condition was (13.11±0.21)%. Based on this result, the editing conditions were optimized and the result indicated that the best medium is CGXII, the best initial OD₆₀₀ of induction is 0.05, the best induction time is 20 h, and the best IPTG concentration is 0.01 mmol/L. After optimization, the editing efficiency was improved to (30.35±0.75)%, which was 1.3-fold of that in initial condition. Finally, endogenous genomic loci of C. glutamicum were selected to assess if the optimized condition can improve genome editing in other loci. Editing efficiency of different loci in optimized condition were improved to 1.7-2.5 fold of that in original condition, indicating the effectiveness and versatility of the optimized condition. Our research will promote the better application of base editing technology in C. glutamicum.
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Finite element method (FEM) was used to investigate the biomechanical properties of three types of surgical fixations of U-shaped sacral fractures. Based on a previously established and validated complete lumbar-pelvic model, three models of surgical fixations of U-shaped sacral fractures were established: ① S1S2 passed through screw (S1S2), ② L4-L5 pedicle screw + screw for wing of ilium (L4L5 + IS), and ③ L4-L5 pedicle screw + S1 passed through screw + screw for wing of ilium (L4L5 + S1 + IS). A 400 N force acting vertically downward, along with torque of 7.5 N·m in different directions (anterior flexion, posterior extension, axial rotation, and axial lateral bending), was exerted on the upper surface of L4. Comparisons were made on differences in separation of the fracture gap and maximum stress in sitting and standing positions among three fixation methods. This study showed that: for values of separation of the fracture gap produced by different operation groups in different positions, L4L5 + S1 + IS was far less than L4L5 + IS and S1S2. For internal fixators, the maximum stress value produced was: L4L5 + IS > L4L5 + S1 + IS > S1S2. For the intervertebral disc, the maximum stress value produced by S1S2 is much larger than that of L4L5 + S1 + IS and L4L5 + IS. In a comprehensive consideration, L4L5 + S1 + IS could be prioritized for fixation of U-shaped sacral fractures. The objective of this research is to compare the biomechanical differences of three different internal fixation methods for U-shaped sacral fractures, for the reference of clinical operation.
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Humans , Biomechanical Phenomena , Finite Element Analysis , Fracture Fixation , Methods , Lumbar Vertebrae , Pedicle Screws , Sacrum , Wounds and Injuries , Spinal Fractures , General Surgery , Spinal FusionABSTRACT
Objective To investigate the application value of magnetic resonance diffusion tensor imaging (DTI) in auditory pathway of sensorineural hearing loss (SNHL) infants caused by cytomegalovirus (CMV) infection.Methods Thirtyone SNHL infants caused by CMV infections were included,and were divided into bilateral hearing loss (BPHL;n=13) group and unilateral hearing impairment (UPHL;n=18) group (including damaged side [lpsi subgroup] and the undamaged side [contrast subgroup]).Thirty-one infants without hearing loss as control group.The fractional anisotropy (FA),the mean diffusivity (MD),the axial diffusivity (AD) and the radial diffusivity (RD) of bilateral inferior colliculus (IC)and lateral lemniscus (LL) were obtained with DTI technique.The statistical analysis was performed.Results Compared with the control group,the FA value reduced and the RD value increased at LL and IC in the BPHL group (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and the RD value increased at IC and LL in lpsi subgroup (all P＜0.001).Compared with the control group,the FA value reduced at LL in the lpsi subgroup,and FA values reduced and RD value increased at IC (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and RD value increased at LL,and RD value increased at IC in the BPHL group (all P＜0.001).The FA value at IC was negatively correlated with auditory threshold (r=-0.966,P＜0.001).No matter in IC or in LL,the MD and AD had no statistical differences (all P＞0.05).Conclusion White matter of auditory pathway of SNHL infant caused by CMV infection is obviously altered,suggesting white matter myelination or myelin dysplasia.
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Objective To investigate the application value of magnetic resonance diffusion tensor imaging (DTI) in auditory pathway of sensorineural hearing loss (SNHL) infants caused by cytomegalovirus (CMV) infection.Methods Thirtyone SNHL infants caused by CMV infections were included,and were divided into bilateral hearing loss (BPHL;n=13) group and unilateral hearing impairment (UPHL;n=18) group (including damaged side [lpsi subgroup] and the undamaged side [contrast subgroup]).Thirty-one infants without hearing loss as control group.The fractional anisotropy (FA),the mean diffusivity (MD),the axial diffusivity (AD) and the radial diffusivity (RD) of bilateral inferior colliculus (IC)and lateral lemniscus (LL) were obtained with DTI technique.The statistical analysis was performed.Results Compared with the control group,the FA value reduced and the RD value increased at LL and IC in the BPHL group (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and the RD value increased at IC and LL in lpsi subgroup (all P＜0.001).Compared with the control group,the FA value reduced at LL in the lpsi subgroup,and FA values reduced and RD value increased at IC (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and RD value increased at LL,and RD value increased at IC in the BPHL group (all P＜0.001).The FA value at IC was negatively correlated with auditory threshold (r=-0.966,P＜0.001).No matter in IC or in LL,the MD and AD had no statistical differences (all P＞0.05).Conclusion White matter of auditory pathway of SNHL infant caused by CMV infection is obviously altered,suggesting white matter myelination or myelin dysplasia.
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Objective:To observe the effect of icariin on the osteoporosis of the ovariectomized rats,and to explore the mechanism.Methods:Fifty female rats aged 6 months were randomly divided into sham operation group, model group,positive drug group,low dose of icariin group and high dose of icariin group (n= 10).The rats in positive drug group were given with 1 mg· kg-1 nilestriol every week;the rats in low and high doses of icariin groups were given with 50 and 100 mg · kg-1 icariin every day.The bilateral ovaries of rats were excised by operation to establish the osteoporosis models.2 weeks after operation,the rats were treated with icariin for 12 weeks,and then they were sacrificed by drawing blood from abdominal aorta under anesthesia condion.The bone mineral density (BMD),serum biochemical indicators,bone histomorphology and the expressions of apoptosis-related proteins were detected.Results:Compared with sham operation group,the BMD of the rats in model group was decreased (P <0.01),the serum calcium level was decreased (P <0.05),and the serum phosphorus level was increased (P <0.05),and the serum BGP,ALP,NO and NOS levels were significantly decreased (P <0.05 or P <0.01).Compared with model group,the BMD of the rats in positive drug group and high dose of icariin group were obviously increased (P < 0.01 ), the serum calcium levels were increased, the phosphorus levels were decreased (P <0.05),and the BGP and ALP levels were increased significantly (P < 0.05 ). Compared with control group,the cortical in model group was thinned,the width of bone trabecula was reduced,the Bax and Caspase-3 expression levels in bone tissue were increased,and the Bcl-2 expression level was decreased.Compared with model group,the cortical in icariin group was thicked,the width of bone trabecula was increased,the Bax and Caspase-3 expression levels were decreased,and the Bcl-2 expression level was increased (P <0.05 or P <0.01). Conclusion:Icariin can protect the osteoporosis of ovariectomized rats,the function may be related to the inhibition of apoptosis.
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Objective To assess the efficacy of one-stage posterior median incision via costotransverse joint in treating thoracic spinal tuberculosis.Methods Thirty three patients with tuberculosis of thoracic spine undergoing one-stage posterior thoracic spine debridement,bone grafting fusion and posterior instrumentation from July 2011 to October 2013 were included in the study.There were 18 males and 15 females.The age was from 17 to 39 years old with an average of 29.5.The course was from 5 to 11 months with an average of 7.3.The Cobb angle was from 19° to 42° with an average of 29.8°.There were 5 in upper thoracic spine,17 in middle thoracic spine and 11 in lower thoracic spine.6 were in Frankel scale grade C,11 were in grade D and 16 were in grade E before surgery.Postoperative kyphosis correction,recovery of neurological function and bone fusion were observed.Results All the surgeries were completed successfully.The operation time was from 120 to 230 min with an average of 183.The blood loss during operation was from 480 to 700 ml with an average of 530.All 33 patients were followed-up for 12-36 months with an average of 22.7 months.The Cobb angle was from 8° to 15° with an average of 10.2°,the correction rate was 77％.The Frankel scale of 11 patients recovered from D to E,2 recovered from C to D and 4 recovered from C to E.The postoperative kyphosis correction and Frankel scale were significantly improved,all patients had a 100％ bone fusion rate and there were no internal fixation loosened or shift of graft bone at the last follow-up.ESR and CRP were returned to the normal range and the tuberculosis symptoms disappeared.Conclusions One-stage posterior median incision via costotransverse joint can complete surgery by the same position and the same incision in treating thoracic spinal tuberculosis with safety and good clinical efficacy.
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Objective To investigate the mid?term follow?up results of bone grafting pedicled with the femoral quadra?tus augmented with a titanium mesh for alcohol?induced osteonecrosis of the femoral head and to analyze the technical factors affecting the surgical outcome. Methods Twenty cases (24 hips) treated with bone grafting pedicled with the femoral quadratus augmented with a titanium mesh between January 2008 and September 2009 were retrospectively reviewed. Control group includ?ed 18 cases (20 hips) treated with bone grafting pedicled with the femoral quadratus alone in the same period. All the hips were al?cohol?induced femoral head necrosis and were classified as ARCOⅡC or ARCOⅢA stage. The one hundred points method was used for outcome evaluation. Statistical analysis was performed using SPSS statistical package 13.0(SPSS Inc., USA). Results The titanium group has a longer operative time and more estimated blood loss than the bone?grafting group with statistical signifi?cance. For the twenty cases in the titanium group, two cases were lost to follow?up with another one case receiving total hip arthro?plasty due to severe collapse, and the rest were followed for an average of 62.7 (58 to 66) months. For the eighteen cases in bone-grafting group, one case was lost to follow?up with another one case receiving total hip arthroplasty due to severe collapse, and the rest were followed for an average of 61.3 (57 to 64) months. At the last follow?up, the titanium group had a successful rate of 85.7%(excellent in 13, good in 5 and fair in 2) with a five?year survival rate of 95.2%(20 out of 21 hips) and the bone?grafting group had a successful rate of 84.2%(excellent in 13, good in 3 and fair in 2) with a five?year survival rate of 94.7%(18 out of 19 hips). Clini?cal and radiographic outcomes were not statistically significant different between the two groups. Mild collapses were noted radio?graphically in both groups, with 7 out of 20 in titanium group and 5 out of 18 in the bone?grafting group. Among these mildly col?lapsed cases, the cases in titanium group had a relatively better clinical outcome than those in the control group and the cases with a larger mesh supporting area had an even better clinical outcome. Conclusion The mid?term follow?up results of bone grafting pedicled with the femoral quadratus augmented with a titanium mesh for alcohol?induced osteonecrosis of the femoral head were satisfactory. Factors affecting surgical outcomes included the placement of the titanium mesh, and the bone?grafting technique.
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Objective To evaluate the therapeutic efficacy of the comprehensive auricular point therapy in treating post-stroke urinary incontinence. Method A hundred patients with post-stoke urinary incontinence were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by comprehensive auricular point therapy, while the control group was by rehabilitation training. The therapeutic efficacies were evaluated after 2 treatment courses. Result The total effective rate was 82.0%in the treatment group versus 62.0%in the control group, and the difference was statistically insignificant (P>0.05). Conclusion Comprehensive auricular point therapy is effective in treating post-stroke urinary incontinence.
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Seven meroterpenoids and five small-molecular precursors were isolated from Penicillium sp., an endophytic fungus from Dysosma versipellis. The structures of new compounds, 11beta-acetoxyisoaustinone (1) and isoberkedienolactone (2) were elucidated based on analysis of the spectral data, and the absolute configuration of 2 was established by TDDFT ECD calculation with satisfactory match to its experimental ECD data. Meroterpenoids originated tetraketide and pentaketide precursors, resepectively, were found to be simultaneously produced in specific fungus of Penicillium species. These compounds showed weak cytotoxicity in vitro against HCT-116, HepG2, BGC-823, NCI-H1650, and A2780 cell lines with IC 50 > 10 micromol x L(-1).
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Objective To study the clinical application value of microsurgery in treatment of tentorium meningioma.Methods 53 patients with tentorium meningioma were chosen,they all underwent microsurgical treatment,the extent of resection of the tentorium meningioma and treatment efficacy were observed.The mortality,causes of death of tentorium meningioma patients after microsurgery were analyzed.Spitzer index was compared before and after treatment,the life quality of the patients was evaluated.Results There was no death after microsurgical treatment.The tentorium meningioma tumor removal rate was huge tumor ＜ tumors ＜ medium-sized tumors ＜ small tumor.There were 9 cases excellent,14 cases good in Spitzer index before treatment,26 cases excellent,14 cases good after treatment,there was significant difference between them (x2 =19.15,P ＜ 0.01).Conclusion Microsurgical treatment for the patients with tentorium meningioma has better clinical efficacy and can greatly improve patients' quality of life,which is worthy of further clinical research and promotion.
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Objective To discuss the anatomical and radiographic characteristics of acetabular fossa,and evaluate their value as a reference for achieving the anticipated inclination of the acetabular cup.Methods Sixteen adult normal pelvic specimens were studied.Central axis of acetabular fossa and its intersection with fossa edge and acetabular rim were marked.The radiographic appearance of the two intersections was evaluated.With radiographic templating,the relationship between the top of acetabular fossa and the central axis of acetabular cup at anticipated inclination was identified.Implantation of cementless acetabular cup was performed bilaterally on the pelvic specimens.The acetabular fossa was used as a reference for implantation on one side,and the acetabular positioning device was used on the other side.The discrepancy of acetabular inclination was recorded before and after operation in the two groups.Results Intersection of central axis of acetabular fossa with fossa top edge and acetabular rim corresponded to the most medial and lateral aspect of acetabular sourcil respectively on standard anteroposterior pelvic radiograph.There was close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40°±5°.For the group of using acetabular fossa as reference,the mean difference of inclination was 0.19°±3.14°(-6°-5°)before and after operation,and the discrepancy was 2.75°±2.89°(-2°-8°)for the control group.The difference between the two groups was statistically significant(t=-2.453,P=0.027).Conclusion In primary total hip replacement,if normal anatomy of acetabulum was found,the anticipated inclination of acetabular cup can be accurately obtained,based on the relationship between the top of acetabular fossa and anticipated inclination of acetabular cup on preoperative templating.
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Objective To investigate the variations of tendency of drug-resistance from Jan 2006 to Dec 2008. the origin and the distributing of Acinetobacter baumannii and provide basis for selection of clinical drugs.Methods The characteriztion and sensitivity to antibiotics of Acinetobacter baumannii were analysed using VTTEK-32 system.Results 107 strains of Acinetobacter baumannii were separated and characterized during the three years.The rates of resistance to antibiotics were Imipenem 0.9%,Amikacin 5.6%,Ampicillin/Sulbactam 6.5%,Ampicillin 74.8% Ceftriaone 63.6%,Cefotaxime 38.3%,Aztreonam 25.2%.The resistance rate of Acinetobacter baumanii increased from 2006 to 2008,showed increasing tendency.Conclusion Acinetobacter baumannii showed good sensitivity to Carbapenems,Aminoglycosides,β-lactam antibiotics,Acinetobacter baumanii are widely distributing in hospital and are widely resistant to many kinds of antibiotics,The results suggested that the resistance of Acinetobacter baumannii to antibiotics should be continuously monitored,it will be beneficial for infection-control to collect antibiotics basing on the results of drug-sensitive test.