Anatomy of endoscopic odontoidectomy via submandibular approach / 解剖学报

Objective To provide the basis for endoscopic craniocervical junction surgery through cervical CT image and endoscopic odontoid process anatomy of atlas, axis and odontoid. Methods A total of 150 cases of cervical vertebrae were selected for high resolution thin slice plain CT measurement to evaluate the atlantoaxial structure and its adjacent structure, and to estimate the safe boundary of odontoid process resection. The atlantoaxial odontoid process was anatomized on 3 cadaver head specimens under endoscope through the submandibular approach using STORZ endoscopy system and endoscopic surgical instruments. Results The average length of atlas anterior arch and other anatomical marks were measured by CT, and the safety boundary area of odontoidectomy was estimated to be（240.9 ± 39.92）mm~2, male:（248.3 ± 49.64）mm~2, Female:（233.2 ± 24.54）mm~2. Through the submandibular endoscopic approach, the atlantoaxial anatomy and odontoidectomy anatomy made a transverse incision at the midpoint of the connecting line between one mandibular angle and hyoid bone to expose the submandibular triangle area. Under the endoscope, the digastric muscle and the greater angle of hyoid bone were exposed through the submandibular triangle area, and the retropharyngeal space was passively separated layer by layer to the prevertebral space to expose the prevertebral fascia. After removing the prevertebral tissue, the atlas, the dentate process of the axis, the atlantooccipital joint, the atlantoaxial joint, and part of the foramen magnum were fully exposed. Conclusion Estimating odontoid resection safety boundary area by CT image, in combination with endoscopic odontoidectomy anatomy via sunbmandibular approach, we can perform the surgery safely and efficiently under the bright of endoscope with surgical instruments, which can significantly reduce the incidence of cerebrospinal fluid leakage and postoperative infection while decompressing.

Diagnostic value of nucleic acid detection in schistosomiasis japonica: a meta-analysis / 中国血吸虫病防治杂志

Objective To quantitatively evaluate the diagnostic value of variable-temperature and isothermal nucleic acid amplification techniques in the detection of schistosomiasis japonica using a meta-analysis. Methods The publications pertaining to the nucleic acid detection of schistosomiasis japonica were searched in electronic databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed and ScienceDirect, and the compilations and proceedings of schistosomiasis were manually searched. In addition, the citations of publications associated with the nucleic acid detection of schistosomiasis japonica were traced using a document tracing method. The retrieved literatures were screened according to the inclusion and exclusion criteria, and data were extracted from the included literatures. The quality of the included literatures was assessed using the software RevMan version 5.3, and a meta-analysis was performed using the software MetaDiSc version 1.4. Results A total of 19 publications covering 24 groups of studies were enrolled, including 5 Chinese publications and 14 English publications. There were 17 groups of studies reporting the comparison between the variable-temperature nucleic acid amplification technique and the golden standard, and 7 groups of studies showing the comparison between the isothermal nucleic acid amplification technique and the golden standard. Assessment of the literature quality indicated a minor overall bias of the included literatures, and the Deek funnel plot showed a possible publication bias in the documents reports variable-temperature nucleic acid amplification techniques. There was a heterogeneity caused by non-threshold effect among the studies associated with the variable-temperature amplification technique, and the random effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the variable-temperature amplification technique were 0.81 (0.79 to 0.83) and 0.73 (0.71 to 0.74) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.944 3. There was no heterogeneity among the studies associated with the isothermal amplification technique, and the fixed effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the isothermal amplification technique were 0.96 (0.94 to 0.98) and 0.95 (0.94 to 0.97) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.989 9. Conclusions Both variable-temperature and isothermal nucleic acid amplification techniques have a high efficiency for the diagnosis of schistosomiasis japonica, and the isothermal amplification technique shows a relatively higher accuracy than the variable-temperature amplification technique.

Thinking on schistosomiasis control under the strategy of China’s Yangtze River Economic Belt / 中国血吸虫病防治杂志

The construction of Yangtze River Economic Belt has been included in the national strategy of China, aiming to improve the economic level of the whole population, and to build a green ecological corridor with the joint development of economy, balance, ecology and equity. Yangtze River Economic Belt is the main area where schistosomiasis is endemic. During the economic construction, the prevention and control of schistosomiasis should be strictly carried out to facilitate the progress towards schistosomiasis elimination in China. In this paper, the endemic situation of schistosomiasis in Yangtze River Economic Belt areas and the possible impact on the schistosomiasis control were analyzed. In addition, a few suggestions were proposed for schistosomiasis control in Yangtze River Economic Belt areas.

Thinking on schistosomiasis control under the strategy of China’s Yangtze River Economic Belt / 中国血吸虫病防治杂志

The construction of Yangtze River Economic Belt has been included in the national strategy of China, aiming to improve the economic level of the whole population, and to build a green ecological corridor with the joint development of economy, balance, ecology and equity. Yangtze River Economic Belt is the main area where schistosomiasis is endemic. During the economic construction, the prevention and control of schistosomiasis should be strictly carried out to facilitate the progress towards schistosomiasis elimination in China. In this paper, the endemic situation of schistosomiasis in Yangtze River Economic Belt areas and the possible impact on the schistosomiasis control were analyzed. In addition, a few suggestions were proposed for schistosomiasis control in Yangtze River Economic Belt areas.

Treatment of sixty-one patients with coronary slow flow phenomenon by yiqi huoxue recipe combined Western drugs: a clinical research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy of treating patients with coronary slow flow phenomenon by Yiqi Huoxue Recipe (YHR) combined Western drugs, thus providing clinical evidence for further studies.</p><p><b>METHODS</b>Totally 61 patients with coronary slow flow phenomenon were randomly assigned to the treatment group (31 cases) and the control group (30 cases). Patients in the control group were treated with basic treatment of Western medicine, while those in the treatment group were treated with basic treatment of Western medicine and YHR. The therapeutic course for all was two months. Clinical symptoms were observed, and electrocardiogram examinations taken, and left ventricular ejection fraction (LVEF) were evaluated before treatment and at two months after treatment.</p><p><b>RESULTS</b>Patients' clinical symptoms and electrocardiogram examinations were significantly improved in the treatment group. Its effective rate of improved symptoms was 90.32% in the treatment group, superior to that in the control group (76.67%, P < 0.05). The effective rate of electrocardiogram examinations was 87.10% in the treatment group, superior to that in the control group (73.33%, P < 0.05). But there was no statistical difference in LVEF between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>YHR combined Western drugs could improve clinical symptoms and electrocardiographic ischemia in patients with coronary slow flow phenomenon.</p>

C(2) trans-laminar screws for atlantoaxial instability: preliminary clinical report of nine cases / 中华外科杂志

<p><b>OBJECTIVE</b>C(2) pedicle screw is the classic instrumentation for posterior C(2) fixation. But it could be dangerous in case of anatomical variation, such as high riding vertebral artery and small C(2) pedicle. C(2) trans-laminar screw could be an alternative choice. This retrospective study is to evaluate the feasibility of C(2) trans-laminar screw for atlantoaxial instability with anatomical variation.</p><p><b>METHODS</b>In our clinical work, we had nine atlantoaxial instability cases with C(2) pedicle malformation. If the malformation is unilateral, we inserted one C(2) trans-laminar screw and one C(2) pedicle screw in the normal pedicle; if the malformation is bilateral, bilateral trans-laminar screws were used. Then C(2) instrumentation could be connected with C(1) lateral mass screw or occipital screw in cases with C(1) occipitalization. Then atlantoaxial or occipitocervical fusion could be done with morselized autogenous cancellous iliac grafts.</p><p><b>RESULTS</b>Nine cases had C(2) trans-laminar screw, including 2 atlantoaxial fusion and 7 occipitocervical fusion. Six cases had unilateral trans-laminar screw and 3 had bilateral trans-laminar screw. Radiographs demonstrated all the screws were placed satisfactorily except one. There was no neurological deterioration or vertebral artery injury. All the cases had an average follow-up of 9 months (4 - 13 months). All patients attained solid fusion without screw failure. In the 8 cases with neurological deficit, 3 were excellent, 1 was good, 2 were fair and 2 had no change.</p><p><b>CONCLUSIONS</b>C(2) trans-laminar screw fixation could provide sufficient stability. This technique could be an alternative to standard C(2) pedicle screw in cases with pedicle malformation and high riding vertebral artery. It is safe and simple in experienced hands.</p>

Analysis of veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding.</p><p><b>METHODS</b>In the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass).</p><p><b>RESULTS</b>Among the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation.</p><p><b>CONCLUSION</b>Probing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.</p>

Analysis the reasons of pulmonary embolism after spine surgery in eleven patients / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the clinical characteristics, early diagnosis and treatment for pulmonary embolism after spine surgery.</p><p><b>METHODS</b>From January 1995 to May 2006, 11 cases suffered pulmonary embolism after spine surgery in the total of 10 993 patients. The clinical characteristics, diagnosis and treatment of these 11 cases were retrospectively analyzed.</p><p><b>RESULTS</b>The incidence of pulmonary embolism was 0.1% after spine surgery. Pulmonary embolism was found during 5 to 14 days after spine surgery (mean 9.8 days). All of them show characteristic syndrome of pulmonary embolism, such as difficult breathe, cardiopalmus, thoracodynia, hemoptysis. Five patients died, and the mortality was 45.5%. The earlier use of pulmonary angiography and embolectomy by catheter device, the lower mortality will be. It is significantly.</p><p><b>CONCLUSIONS</b>Pulmonary embolism is one of the serious complications after spine surgery. It is the period of high happening on deadly PE and the mortality during 1 to 2 weeks after spine surgery. Pulmonary angiography and interventional therapy take an important part in the early diagnosis and treatment.</p>

Effect of bioactive glass filling defective alveolar bone on tooth movement / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the movement of rat's tooth in the area of defective alveolar bone filled with bioglass in comparison with contralateral tooth.</p><p><b>METHODS</b>Forty female Wistar rats were selected. Defects in alveolar bones were created and filled with bioglass. Orthodontic appliances were fixed to mesially guide the maxillary first molars.</p><p><b>RESULTS</b>The rats' teeth were mesially moved in the area filled with bioglass. There were no significant differences between two sides in movement distance of the first molars and in thickness of periodontal tissues with paired t-test (P > 0.05).</p><p><b>CONCLUSIONS</b>The rat's tooth can be mesially moved in the area filled with bioglass.</p>

Diagnosis and treatment of esophageal fistula in anterior cervical spine surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the causes, diagnosis, treatment and prevention of esophagocutaneous fistula in anterior cervical spine surgery.</p><p><b>METHODS</b>Thirteen cases with esophagocutaneous fistula in anterior cervical spine surgery were studied.</p><p><b>RESULTS</b>The causes includes: (1) During the operation, esophagus was oppressed by a clasp for so long time that made a pressure necrosis of the esophagus; (2) Esophagus was injured by loose plates and screws; (3) Loose bone grafts oppressed esophagus; (4) Esophagus was injured by operative appliance in the operation; (5) Esophagus was oppressed by the plate.</p><p><b>DIAGNOSIS</b>After anterior cervical spine surgery if patients had a high fever, sore throat, swelling incision, and food sediment was found in the incision, esophagocutaneous fistula should be considered. The final diagnosis could be done by esophageal radiography.</p><p><b>TREATMENT</b>Fasting cure, nasogastric tube and wound drainage should be used; When the inflammation ended, patients should undergo operation of closure of the esophageal fistula.</p><p><b>CONCLUSIONS</b>The esophagocutaneous fistula in anterior cervical spine surgery has several causes mentioned above. We should take precautionary measures to avoid the complication, and use appropriate treatment to cure when it happens.</p>

Preparation of surface functional magnetic microspheres and their application in nucleic acid separation and enzyme immobilization / 中国医学科学院学报

<p><b>OBJECTIVE</b>To Prepare surface functional magnetic microspheres for the separation of vascular endothelial growth factor (VEGF) nucleic acid and lactase enzyme immobilization.</p><p><b>METHODS</b>Using suspension polymerization methods to copolymerize MA-styrene containing magnetite nanoparticles and GMA-styrene also containing magnetite nanoparticles, respectively. Both the carboxyl-modified magnetic microspheres and epoxy-modified magnetic microspheres were obtained. In addition, the chloromethyl-modified magnetic microspheres were prepared by seedy microemulsion. The magnetic microspheres bound with b-gamma IgG were determined by radioimmunoassay (RIA), and the separation of VEGF nucleic acid and lactase enzyme immobilization were performed by carboxyl-modified magnetic microspheres.</p><p><b>RESULTS</b>Transmission electron microscopy (TEM), energy-dispersive spectroscopy (EDS) and infrared (IR) spectra showed that the products of polymer magnetic microspheres were monodispersed and that the magnetic particles were uniformly distributed in the microsphere with special functional group on the surface of the microsphere. RIA showed that three kinds of magnetic microspheres could be bound with b-gamma IgG and the absorption of b-gamma IgG reached 75 micrograms/mg, especially for the carboxyl-modified magnetic microspheres. The carboxyl-modified magnetic microspheres can be used for the separation of VEGF nucleic acid by coupling with corresponding primer. Moreover, the immobilized enzyme was proportional to the amount of the carboxyl-modified magnetic microspheres.</p><p><b>CONCLUSIONS</b>The surface functional magnetic polymer microspheres can be bound with active bio-substance, and have a wide application prospect in the fields of biology and medicine.</p>