ABSTRACT
BACKGROUND:Thoracolumbar fracture often accompanies with the injury of adjacent intervertebral disc. Traditional posterior short-segment fixation does not deal with the injured intervertebral disc, which may be the main reason for kyphosis in patients after surgery. OBJECTIVE:To investigate the effect of injured intervertebral disc on kyphosis angle in patients with single vertebral thoracolumbar fracture after treated with posterior short-segment fixation alone. METHODS:From January 2009 to June 2014, 40 cases of thoracolumbar fractures were treated in Jinan Central Hospital. They were folowed-up at preoperation, 2 and 12 months after operation and 6 months after internal fixation removal. Data were obtained from X-ray and MRI scanning. According to the preoperative MRI images, cases were assigned to observation group (17 cases) and control group (23 cases) according to injury and non-injury intervertebral disc. Data of vertebral wedge angle, sagittal plane kyphosis, proximal intervertebral disc angle, sagittal index and degeneration classification of proximal intervertebral disc angle from two different groups were analyzed at each folow-up time point (18-30 months, averagely 23.6 months). RESULTS AND CONCLUSION:(1) Imaging parameters: sagittal plane kyphosis was significantly severer at 6 months than that at 2 months in both groups (P < 0.05). Sagittal plane kyphosis, proximal intervertebral disc angle and sagittal index were greater in the observation group than in the control group at 12 months after surgery and 6 months after fixator removal (P < 0.05). (2) Degeneration classification of proximal intervertebral disc angle: Pearce degeneration grade of proximal intervertebral disc was significantly higher in the observation group than in the control group at 2 months after surgery and 6 months after internal fixation removal (P < 0.05). (3) Results suggested that kyphosis may appear in the patients with thoracolumbar fracture after a posterior short-segment fixation alone, and the injured disc may lead to more severe kyphosis.
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Objective To retrospectively assess the clinical manifestations and treatment of secondary syphilis with ocular impairment as the initial symptom. Methods Clinical data were retrospectively analyzed on secondary syphilis with ocular impairment as the initial symptom collected from September 1998 to October 2008. Results There were 11 syphilitic patients presenting acute ocular impairment as their initial manifestation. Skin eruptions developed simultaneously with ocular impairment in 2 patients, following ocular impairment in 9 patients. All patients were positive for rapid plasma reagent test (RPR) and treponema pallidum haemagglutination assay (TPHA), but negative for HIV. Of these patients, 9 suffered from uveitis (iridocyclitis, choroiditis or panuveitis), 2 from optic neuritis; 3 had unilateral ocular involvement, 8 had bilateral ocular involvement. After treatment with injected penicillin or ceftriaxone sodium, 9 patients experienced complete visual recovery, 2 partial visual recovery. Conclusions Ocular impairment occurs in patients with secondary syphilis at a low incidence, with no characteristic clinical manifestations. For patients who have no response to conventional ocular therapy, ocular syphilis should be considered and serological examination for syphilis is recommended.
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Objective:To investigate the application valve of bFGF to improve the viability of subdermal vascular network flap.Methods:Four white healthy pigs were used,each pig had 6 SVNF on back,16cm?4cm,totally 24 flaps were divided randomly into 2 groups:The bFGF groups and the control groups.On postoperative day 6,we observed the appearance of the flaps.The survival area of each flap was measured and the flap was harvested for histological analysis and the density of angiogenesis was also examined.Results:On postoperative day 6,the survival rates of the bFGF group and the control group were (81.2?1.7)% and (66.2?1.8)% respectively,the angiogenesis density of the middle and the distal segment in the bFGF group was (16.7?6.0)/mm2,(29.7?5.5)/mm2,(14.9?6.0)/mm2 respectively,while (16.6?4.0)/mm2,(21.4?5.2)/mm2,(3.5?5.1)/mm2 respectively in the control group.The bFGF group was superior to the control group in the appearance and histological analysis of the flaps.Conclusion:The results suggest that the injection of bFGF locally can promote the survival rate by accelerating the blood circulation of the SVNF’ bottom and edge,shorten the division time of SVNF and broaden the ratio of length and width.