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1.
Chinese Journal of Trauma ; (12): 10-22, 2023.
Article in Chinese | WPRIM | ID: wpr-992568

ABSTRACT

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

2.
Chinese Journal of Organ Transplantation ; (12): 519-524, 2022.
Article in Chinese | WPRIM | ID: wpr-957870

ABSTRACT

Objective:To retrospectively analyze the BKV infection of recipients after kidney transplantation(RT)and provide references for diagnosing and treating BK virus infection post-RT.Methods:From January 1, 2018 to December 31, 2020, clinical and follow-up data were reviewed for 561 RT recipients(cadaveric and living donor kidney)at First Hospital of Jilin University. DNA loading of BK virus in blood and urine was determined by quantitative polymerase chain reaction(qPCR)and kidney allograft biopsy performed. Based upon the results, they are divided into four groups of A (372 cases), high-level BK viruria(group B, 128 cases), BK viremia(group C, 52 cases)and BK virus nephropathy(BKVN)(group D, 9 cases). The variables related to BK virus infection were screened by univariate analysis. Meaningful variables( P<0.1)are incorporated into the multi-factor ordered Logistic regression model for examining the independent risk factors of postoperative BK virus infection. Results:The incidence of high-level BKV viruria is 33.69%(189/561)at 18 months post-RT. The average detection time is(4.2±3.8)months, the incidence of BK viremia 10.87%(61/561)and the average detection time(5.2±3.6)months post-RT. The incidence of BKVN is 1.78%(9/561)and the average detection time(7.0±4.0)months post-RT. Univariate analysis showed that gender, age, immunotherapeutic regimen, history of acute rejection and type of donor are correlated with BKV infection. Multivariate Logistic regression analysis indicated that male recipient( P=0.013), immune maintenance regimen( P<0.001)and history of acute rejection( P=0.002)were independent risk factors for developing postoperative BKV infection. Conclusions:There is a high incidence of BKV infection within 12 months post-RT. Male recipient, history of acute rejection and immune maintenance regimen are independent risk factors for BKV infection post-RT.

3.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 194-199, 2022.
Article in Chinese | WPRIM | ID: wpr-940847

ABSTRACT

The basic pathological change of diabetic macroangiopathy is atherosclerosis, and the metabolism legacy effect of hyperglycemia will cause continuous damage to the large vessels. Oxidative stress is a common mechanism for diabetes and its chronic complications and it is also the basis of the metabolism legacy effect which keeps damaging the large vessels. Anti-oxidant therapy can delay the course of diabetic macroangiopathy. According to the theory of traditional Chinese medicine (TCM), the pathogenicity of hidden pathogen is concealing, lingering, and refractory. On the basis of the syndrome and treatment of collateral diseases, vessel-collateral theory, and hidden pathogen theory of TCM, the pathological changes of diabetic macroangiopathy are summarized as pathogen concealment-accumulation of sugar and lipids leading to phlegm and blood stasis-accumulation of toxins-damage to vessels and collaterals-hardening vessels. The core pathogenesis is the hidden pathogen damaging the collaterals, and the basic pathological change is vessel hardening. The toxins of sugar, lipid, phlegm, and stasis are the pathological products and the key to be treated. According to this theory, the medicinal materials with the functions of activating blood to dredging collaterals, resolving phlegm to clearing collaterals, Promoting qi to unblocking collaterals and removing toxins to shunting collaterals can be selected for prescription. These medicinal materials can inhibit the generation of reactive oxygen species, affect the oxidase activity, and enhance the antioxidant capacity, thereby regulating the oxidative stress response, protecting the vascular endothelial function, reducing the damage of the large blood vessels, and slowing down the progression of the disease. Such therapy is of great significance in clinical practice and research, providing a new idea for the prevention and treatment of diabetic macroangiopathy.

4.
Chinese Journal of Radiology ; (12): 569-573, 2019.
Article in Chinese | WPRIM | ID: wpr-754953

ABSTRACT

Objective To investigate the imaging features of epidermoid cyst within intrapancreatic accessory spleen (ECIPAS) to make benefits for differential diagnosis of pancreatic lesions. Methods We retrospectively reviewed the clinicalradiological and pathological data of 7 patients with pathologically confirmed ECIPAS. All the cases underwent plain and contrast enhanced CT scan, 2 cases underwent magnetic resonance cholangiopancreatography (MRCP), and 5 cases underwent ultrasonic examination. The imaging features of the lesions were analyzed. Results CT showed that 5 lesions were situated in the pancreatic tail while the other two located in the neck.The mean size of the lesions was (2.8± 1.2) cm,ranging from 1.5 to 4.8 cm. The cysts appeared multiocular in 2 cases. On plain CT, 2 cases showed well?defined low density foci, while 2 cases showed slightly high density. Calcification can be found in 2 cases. In 4 cases, the solid component surrounding the cyst displayed progressive enhancement on postcontrast CT. The enhancement was higher than the pancreatic parenchymaand similar to the spleen during both arterial and portal venous phases. On MRCP,no expansion was shown in pancreatic duct andit had no relationship with cyst in both 2 cases while slightly hypointensity could be found at the back and it pancreatic neck and body in 1 case. Five lesions were hypoechoic or anechoic and irregular?shaped on ultrasound. Conclusion ECIPAS is a rare benign lesion and the typical imaging manifestation is a cyst with surrounding solid component with enhancement similar to the spleen while higher than pancreas.

5.
Chinese Journal of Applied Clinical Pediatrics ; (24): 1278-1280, 2018.
Article in Chinese | WPRIM | ID: wpr-696577

ABSTRACT

With the increasing of incidence rate of pediatric drug-resistant tuberculosis in recent years,pe-diatric tuberculosis as a threat to global childhood public health was serious disease and attracted more and more pediatrician concern. Pediatric tuberculosis often can′t result to typical clinical symptoms and imaging findings because its quantity of tubercle bacillus was little in lesions of infection,meanwhile,golden standard mycobacterium tuberculosis detection was time-consuming and low positive rate,pediatric tuberculosis can′t get timely diagnosis and therapy,mo-lecular diagnostic techniques of pediatric drug-resistant tuberculosis got widely clinical application and development for its advantage of rapid,accurate,efficiency and easy operation etc,several common molecular diagnostic techniques in pediatric drug-resistant tuberculosis were summarized,which would provide useful guidance for molecular diagnose of pediatric drug-resistant tuberculosis.

6.
Chinese Journal of Orthopaedics ; (12): 110-119, 2018.
Article in Chinese | WPRIM | ID: wpr-708515

ABSTRACT

Objective To evaluate the sensitivity and specificity of Tag Array in detecting the clinical isolates of bone and joint tuberculosis.Methods Twenty-four strains of Mycobacterium tuberculosis having sequence differences in extracted plasmids of mutant strains.The plasmid was diluted into different concentrations,and then multiplex PCR amplification was performed to analyze the sensitivity and specificity of the chip system.A total of 187 clinical isolates were collected from patients with bone and joint tuberculosis.Among them,there were 50 strains of sensitive bacteria,and 137 strains of drug-resistant.Designed,optimized and prepared chip inspection system,sequencing and phenotypic drug susceptibility results were analyzed to evaluate the sensitivity and specificity of the gene chip.Results The mutants in accordance with sequencing result in the sets with 1 × 103copy/μl of template concentration and above;while 29 sets showed false negative result in the sets with 1 × 102 copy/μl.Among the 126 rifampicin phenotype drug resistance strains,119 strains appeared mutation in rpoB gene.In the rifampicin phenotype sensitivity strains,9 strains of rpoB gene showed mutation,the sensitivity was 94.40%,and specificity was 86.76%.Among the 118 isoniazid phenotype drug resistance strains,109 strains appeared mutation in relevant drug resistance gene locus,the sensitivity was 92.37%,and specificity was 81.16%.Among the 44 ethambutol phenotype drug resistance strains,27 strains appeared mutation in locus embB306,in the ethambutol phenotype sensitivity strains,the mutation in locus embB306 was detected in 6 strains,the sensitivity was 61.36%,and specificity was 95.80%.Among the 102 levofloxacin phenotype drug resistance strains,81 strains appeared mutation in gyrA gene,4 of the sensitivity strains were detected mutation in gyrA gene,the sensitivity was 79.41%,and specificity was 95.29%.Among the 112 streptomycin phenotype drug resistance strains,the chip detected 101 strains appeared mutation,the sensitivity of chip detection was 90.17%,and specificity was 84.00%.Since amikacin,capreomycin and kanamycin are in cross drug resistance,among the 67 phenotype drug resistance strains,52 strains appeared mutation in relevant drug resistance gene locus,its sensitivity was 79.10% and specificity was 90.83%.Conclusion Tag Array chip can achieve rapid,accurate and high-throughput detection of tuberculosis resistance,which has important clinical significance and feasibility.

7.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2772-2776, 2016.
Article in Chinese | WPRIM | ID: wpr-498203

ABSTRACT

Objective To investigate the effect of lineal polypeptide injection on immune function of severe sepsis patients in ICU.Methods 40 severe sepsis patients in ICU were randomly divided into two groups after signed the consent form:the treatment group (20 cases)and the control group (20 cases).On the 1st day of antibiotic therapy, the patients in the treatment group were simultaneously treated with lineal polypeptide intravenous injection,while the patients in the control group received the same routine treatment,but without lineal polypeptide injection,all with a 10 days treatment course.Blood bacteria culture and drug sensitivity test were completed after entering the hospital. The scores of Sequential Organ Failure Assessment(SOFA)before treatment and at day 3,7 and 10 of therapy were evaluated.The peripheral blood of patients was taken and send to the clinical laboratory.The WBC,NEU%,PCT, hs -CRP,IL -6,total T lymphocytes (CD +3 )and T lymphocyte subgroup (CD +4 ,CD +8 ,CD +4 /CD +8 )were detected in both the treatment group and the control group.Adverse drug events were also detected in the process of therapy. Results Compared with before treatment[(5.56 ±2.03)points],after 7 days of lineal polypeptide therapy,the SOFA score of the treatment group[(3.48 ±1.83)points]decreased significantly(t =2.793,P <0.05),and after 10 days therapy,the descending degree in the treatment group was more significantly and declined earlier than the control group (t =4.401,P <0.01 ).In the aspect of improving the inflammatory markers,two groups were all improved after therapy,but the degree of improvement in the treatment group was better than the control group.After 7 days therapy,IL -6 level was (37.61 ±7.51)mg/L in the treatment group,while (50.49 ±7.68)mg/L in the control group (t =1.969,P <0.01),and the improvement of NEU% was not found in control group.In the aspect of improving the immune function,the CD +3 ,CD +4 ,CD +4 /CD +8 ratios were increased significantly [before therapy:(41.27 ±6.91)%,(19.65 ±5.29)% and (0.96 ±0.42);after 3 days therapy:(46.57 ±7.11 )%,(24.99 ± 7.70)%,(1.27 ±0.39)],and CD +8 [before therapy:(25.62 ±5.18)%,after 3 days therapy:(23.51 ±3.19)%] was decreased dramatically after 3 days of lineal polypeptide injection treatment,there was significant improvement in time and degree in the treatment group compared with the control group (t =1.390,t =1.407,t =3.974,t =2.081, all P <0.05).No severe adverse drug events were found.Conclusion As an immune modulator,lineal polypeptide injection could effectively improve the immune function of severe sepsis patients in ICU.

8.
Chinese Journal of Orthopaedics ; (12): 699-708, 2016.
Article in Chinese | WPRIM | ID: wpr-493603

ABSTRACT

Objective To analyse the phenotypes of the drug?resistant tuberculosis, and investigate the outcomes of the individualize surgery and chemotherapy for these patients. Methods From January 2009 to June 2012, we retrospectively ana?lyzed 49 patients with drug?resistant tuberculosis spondylitis admitted in Southwest Hospital. 33 were initial cases and 16 were re?curring cases. All the 49 patients received individualized open operation or CT?guided percutaneous drainage and local chemother?apy depending on the characteristics of the focus. Individualized chemotherapy regimens were tailored for all patients according to the drug?resistant spectrum and all patients were followed up successfully at least 24 months. All the clinical data were collected and analyzed by statistical methods. Results Among the 49 patients, 14 were monoresistance tuberculosis, 11 were polyresis?tance tuberculosis, and 24 cases were multi?drug resistant tuberculosis. Frequence of the drug?restistance from high to low was Iso?niazid, Rifampicin, Streptomycin, Levofloxacin, Dipasic/Rifapentine, Ethambutol, Protionamide, Capreomycin, Paza?aminosalicy?late, and Amikacin. 43 patients received open operation and 6 patients received CT?guided percutaneous drainage and local che?motherapy. Time of the percutaneous drainage was (48±11) days (39-60 days), and all patients received Individualized chemother?apy with an average of (29.5±2.5) months (24-36 months) postoperatively. At the last follow?up, all patients had remarkable pain remission, 44 patients with paraplegia got slight or remarkable recovery and 17 patients with kyphosis got significant correction. Conclusion The main drug?resistant spectrums are Isoniazid、Rifampicin、Streptomycin、Levofloxacin. The individualized sur?gery combined with individualized chemotherapy made according to the drug?resistance is a feasible treatment for the drug?resis?tant tuberculosis especially the multi?drug resistant tuberculosis.

9.
Chinese Journal of Orthopaedics ; (12): 662-671, 2016.
Article in Chinese | WPRIM | ID: wpr-493600

ABSTRACT

Objective To study the efficacy and safety of four surgical techniques of tuberculosis of lumbosacral junction retrospectively. Methods Between Jul 2001 and Jan 2013, 79 patients with lumbosacral spinal tuberculosis underwent surgery. Antituberculous chemotherapy and nutrition support prior to surgery were used for at least two weeks. 45 patients underwent single stage radical debridement, fusion and anterior instrumentation (A group). 18 patients underwent combined anterior and posterior spinal surgery (AP group), 10 patients underwent transpedicular drainage, posterior instrumentation, and fusion (P group), and 6 patients underwent anterior radical debridement (D group). All the patients were treated by antituberculous chemotherapy for 18 months and followed regularly. The operation duration, blood loss, clinical status, ESR, VAS, ODI, roentgenogram and 3D?CT were concerned to estimate the progress of tuberculosis. Radiographs were analyzed before surgery, immediately after surgery, and at the final follow?up examination to assess the result of anterior fusion and maintenance of correction. Results There was no inju?ry of blood vessel, ureter or cauda equina during surgery. The mean follow?up period was 23 months (range 18-42 months). No obvious loss of deformity correction was observed. There was no recurrence, no tuberculous peritonitis, and no incidence of im?potence or retrograde ejaculation in any of these patients. The average operating duration(min) were 144.31 ± 23.18, 444.72 ± 141.63, 351.50 ± 85.25, 90.00 ± 29.66, respectively; The average blood loss(ml)were 266.67 ± 104.45, 988.99 ± 488.26, 890.00 ± 306.23, 200.00±104.88, respectively; The average Pre?op VAS were 4.71±1.79, 5.22±1.48, 3.30±1.64, 2.50±1.52, respectively;The average last follow?up VAS were 0.89±0.68, 0.90±0.74, 1.00±0.63, respectively; The average Pre?op ODI(%)were 29.64± 7.85, 32.17±7.59, 28.20±4.26, 20.67±4.63, respectively; The average last follow?up ODI(%)were 5.09±3.59, 4.78±3.78, 4.80± 3.39, 4.00 ± 1.18, respectively; The average Pre?op lumbosacral angle(°)were 20.61 ± 4.92, 23.78 ± 5.84, 25.10 ± 4.28, 21.67 ± 4.27, respectively; The average Post?op lumbosacral angle were 27.17±3.66, 30.56±5.31, 32.10±4.01, 24.83±2.32, respectively;The average last follow?up lumbosacral angle were 23.89 ± 3.12, 27.00 ± 5.46, 29.00 ± 4.85, 23.33 ± 2.50, respectively. Conclu?sion Single stage anterior interbody fusion with anterior instrumentation worked effectively to stabilize lumbosacral junction (less invasive, short surgical duration, no injury of posterior column). Anterior interbody fusion combined with posterior instrumentation was recommended for patients with extensive bone defect and low iliocava junction.

10.
Chinese Journal of Orthopaedics ; (12): 177-182, 2014.
Article in Chinese | WPRIM | ID: wpr-443276

ABSTRACT

Objective To set the criteria of mild spinal tuberculosis and investigate the ettect of standard chemotherapy regimen for further establishing the clinical classification of spinal tuberculosis and standardizing management.Methods According to the criterion,a total of 89 patients with mild spinal tuberculosis were enrolled for outpatient conservative management and follow-up.Ambulant treatments were carried out in all patients,including nutrition support and standard chemotherapy regimen.The regimen was consisting of four first-line antituberculosis drugs (rifampicin,isoniazid,ethambutol and pyrazinamide).All patients were followed up one month later,then every 3 months for the following 12 months,and subsequently at intervals of half a year.The clinical manifestations,kyphosis progression,neurological status,erythrocyte sedimentation rate and liver function were analyzed.Results A mean of 30.62± 13.20 (range,18-46) months' follow-up was achieved in 85 patients,whose tuberculosis lesions were cured completely.Another 4 patients,who were diagnosed with drug-resistant tuberculosis later,had underwent surgery for progressive bone destruction and no response to chemotherapy.The mean visual analogue scale score and Cobb's angle was 5.6± 1.6 and 6.25°±3.11° before chemotherapy,and 2.1 ± 1.1 and 12.36° ±6.31 °at the last follow-up time,respectively.Signals of vertebral body and intervertebral disc returned to normal in 6 patients,while solid bony fusion of adjacent segment was achieved in 79 patients.Asymptomatic mild kyphosis was observed in 69 patients.2 patients with sinus before treatment all healed.No neurological deficit was found.Conculusion For patients early diagnosed with mild spinal tuberuclosis,standard chemotherapy regimen could work safely and effectively for healing the tuberculous lesion,avoiding surgery as well as preventing kyphosis,vertebral instability and neurological deficit.Mild spinal tuberculosis that was early diagnosed could be considered as a subtype of spinal tuberculosis.

11.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2278-2279,2280, 2014.
Article in Chinese | WPRIM | ID: wpr-572219

ABSTRACT

Objective To observe the applicated value of recombinant human growth hormone ( r-hGH) ther-apy in improving difficult weaning .Methods 40 patients with difficult weaning were randomly divided into the treat-ment group (20 cases) and control group (20 cases).The control group received routine ICU treatment .The treat-ment group was given the conventional treatment and subcutaneous injection of r -hGH 8IU,1 time a day,a total of 14 days.The serum total protein,albumin,oxygenation index,peak of blood glucose,independent tidal volume changes were observed before and after treatment , the success rate and mortality rate were compared .Results After treat-ment,the total protein,albumin,tidal volume of the treatment group were (68.1 ±13.4) g/L,(40.8 ±6.0) g/L, (432 ±57)mL,which were significantly higher than those before treatment [(52.3 ±12.5)g/L,(28.4 ±4.5)g/L, (278 ±54)mL](t=3.856,7.394,8.771,all P0.05).The success rate was 85% in the treatment group,which was higher than 50% in the control group(χ2 =4.103,P<0.05).In the treatment group,3 cases died,in the control group 9 cases died,there was statistically signif-icant difference between the two groups (χ2 =4.286,P<0.05).Conclusion r-hGH can improve the nutritional sta-tus of critically ill patients ,increase the strength of the respiratory muscles ,improve lung function ,help to improve the weaning rate .

12.
Modern Clinical Nursing ; (6): 8-11, 2013.
Article in Chinese | WPRIM | ID: wpr-671704

ABSTRACT

Objective To investigate the soft contact lens related knowledge and wearing behaviors.Method Two hundred outpatients in the ophthalmologic clinic wearing SCL involved in the survey by the questionnaire to investigate the SCL-related knowledge and the wearing behaviors.Results In the 200 SCL wearer,73.50% did not make any examinations by specialists and only 18.00% of them took regular examinations.The wearers were good at the knowledge of selecting SCL diopter and positive and negative lens.The wearers with a history of less than 6 months were better than those wearing SCL more than 6 months in respect of hand cleaning,lens check,lens wearing, and lens cleaning.The wears with the education of two-year vocational training were significantly better than those with the education of three-year or more collegiate training in respect of wearing duration,sleep with lens,hand cleaning and lens cleaning(all P<0.05).Conclusion Contact lens wearers know less about SCL related knowledge and their wearing behaviors needs improvement.

13.
Chinese Journal of Trauma ; (12): 744-747, 2012.
Article in Chinese | WPRIM | ID: wpr-427590

ABSTRACT

ObjectiveTo investigate the design and mechanical properties of bone cement injectable canulated pedicle screw (CICPS) so as to provide a safe and effective internal fixation for osteoporotic spinal disorder.Methods ( 1 ) Bone cement injection test was performed in vitro,and within osteoporotic cancellous bone models and osteoporotic vertebrae respectively.The distribution of bone cement and screw-bone interface were observed by X-ray films and CT.(2) Ten CICPSs already injected with bone cement and ten conventional pedicle screws were respectively examined by shear strength test.(3) CICPS in the cancellous bone models was augmented with 2-3 ml of bone cement.Then,the maximum axial pull-out strength of the CICPS was measured and were compared with that of conventional screws.ResultsBone cement overflowed from each side hole of the CICPS and distributed only around the front of screws in an even and extensive way.Also,no bone cement leakage was founded.The mean shear load of CICPS and conventional screws was ( 10 600.8 ± 360.1 ) N and ( 15 458.1 ± 31 1.4) N respectively ( P <0.05 ).The mean maximum axial force at pull-out was ( 209.3 ± 13.3 ) N for the CICPS and ( 27.0 ± 5.0) N for the conventional screws ( P < 0.05 ).Conclusions By dispersing bone cement uniformly,CICPS reduces the risk of cement leakage and significantly improves the pullout strength of screws in osteoporotic vertebrae.CICPS with good efficacy and safety provides theoretic basis for its clinical application.

14.
Chinese Journal of Trauma ; (12): 509-512, 2012.
Article in Chinese | WPRIM | ID: wpr-426594

ABSTRACT

Objective To evaluate the long-term clinical efficacy of iliac bone block allograft in anterior reconstruction of thoracolumbar fractures.Methods A follow-up study was carried out on 93 patients with thoracolumbar fractures treated by anterior decompression and interbody fusion with iliac bone block allograft from February 2004 to March 2007.The radiographic and clinical outcomes were retrospectively assessed.Results Sixty-six patients were followed up for 60-97 months (mean,78 months).The effective interbody fusion rate was 100%,with the fusion time of 6-12 months (mean,10 months).The Cobb' s angle corrected from pre-operative (21.6 ± 8.3)° to post-operative (5.8 ±5.2)°,but when the infusion became effective,the angle showed average loss of 2.4°.All the 66 patients were associated with various degrees of neurological deficiency,but the patients with incomplete nerve dysfunction obtained different degree of recovery.Conclusions Iliac bone block allograft is effective in reconstruction of spinal anterior-middle column stability with the aid of internal fixation instruments.Thereby,it may be a potential alternative to autograft in the treatment of thoracolumbar fractures and can attain early and late stage persistent spinal stability.

15.
Chinese Journal of Trauma ; (12): 488-495, 2012.
Article in Chinese | WPRIM | ID: wpr-426559

ABSTRACT

Objective To evaluate the efficacy of internal fixation with or without fusion in the treatment of thoracolumbar burst fractures.Methods Clinical controlled trails related to the application of pedicle screw instrumentation with or without fusion for thoracolumbar fractures before March,2012were obtained by searching PubMed,Science Direct,Medline and CNKI.Quality evaluation was made on the included literature,from which data were extracted to integrate various rescarch results by using RevMan 5.1.The quantitative data were analyzed based on the effect scale of mean difference (MD) and bilateral 95% confidence interval (CI).The numeration data were analyzed in the use of effect scale of odds ratio (OR) and bilateral 95% CI.The merging of some data was manually completed.Results After retrieving,eight English and one Chinese papers of the clinical controlled trials,and two related Meta analysis were obtained.With exclusion of one repetitive research,eight papers were involved in the review.Meta analysis demonstrated that fusion and non-fusion fixation had no significant differences in aspects of correction of kyphotic angle,correction and correction loss of vertebral body height,neurological function improvement,complication rate,and length of hospital stay.While compared with the fusion fixation,non-fusion fixation showed a more serious correction loss of kyphotic angle,a fewer blood loss and a shorter operation time.Conclusions Non-fusion fixation shows the similar efficacy with fusion fixation in the treatment of some thoracolumbar burst fractures pertaining to releasing compression,restoring spinal stability and preventing complications,but it can also significantly decrease operation time and blood loss.Furthermore,non-fusion fixation may markedly improve patients' quality of life since it restores motion of the instrumented segment after removal of implant and decreases the risk of adjacent segmental degeneration.

16.
Chinese Journal of Trauma ; (12): 743-747, 2009.
Article in Chinese | WPRIM | ID: wpr-393403

ABSTRACT

Objective To observe the osteogenic effect of tissue-engineered bone constructed by poly-L-lysine-demineralized bone matrix (PLL-DBM) enriched bone marrow stem cells in the space of goat transverse process bone fusion model and explore a new tissue-engineered bone construction method. Methods PLL was used to decorate goat DBM to prepare a matrix material (PLL-DBM). The osteo-genic effect of tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells ( Group Ⅰ A) was detected in goat lumbar intertransverse graft bone model; autogenous iliac bone (Group Ⅰ B), DBM enriched bone marrow (Group Ⅱ C) and DBM (Group Ⅱ D) were used as controls. The osteogenesis of the bones in the fused segments of four groups were compared and evaluated by X-ray, three-dimensional CT, CT value testing and biomechanical testing. Results The results of X-ray showed that the fusion ranges in groups ⅠA and ⅠB were basically the same, which were significantly wider than that in Group Ⅱ, with no fusion detected in Group Ⅱ D. The CT value was (696.76±10275) HU in Group Ⅰ A and (766.03±69.24) HU in Group B, which were significantly higher than that in Group Ⅱ C (P <0.05), but there was no statistical difference in CT value between Groups Ⅰ A and Ⅰ B (P > 0.05). The CT val-ue in Group Ⅱ C was significantly higher than in Group ⅡD (P <0.01). There was no statistical differ-ence between Groups Ⅰ A and Ⅰ B in the maximum load and bending strength (P > 0.05). The maxi-mum load and bending strength in Groups Ⅰ A and Ⅰ B were significantly higher than that in Group Ⅱ C (P < 0.05), and the two indices in Group Ⅱ C were significantly higher than that in Group Ⅱ D (P <0.01). Conclusion Tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells is an ideal tissue engineered bone and its osteogenic potential is similar to that of autologous bone.

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