Middle-term clinical and radiological outcomes of self-locking and zero-profile cages in treating multi-segmental cervical spondylosis in elderly patients / 中华老年医学杂志

Objective To investigate the middle-term clinical and radiological outcomes of self-locking and zero-profile cages for the treatment of multi-segmental cervical spondylosis in elderly patients through anterior decompression and fusion approach.Methods A total of 39 old patients with multi-segmental cervical spondylosis who received anterior cervical decompression and internal fixation with self-locking and zero-profile cages from January 2013 to January 2015 were retrospectively analyzed.The operation time,intraoperative bleeding volume and post-operational complications were recorded.The functions of cervical spine before and 1-month,1-year,the last follow-up after treatment were evaluated by using the neck pain visual analogue scale(VAS) score,the Japanese orthopedic association (JOA)score and neck disability index (NDI)score.The subjective satisfaction at the final follow-up was evaluated by using Odom's criteria.The whole cervical spine curvature,the range of motion of cervical spine,the height of fused segment,Cobb angle of fused segment,C2～C7 line of force at sagittal view,Cage sedimentation rate and fusion rate before and 1-month and 1-year and the last follow-up after treatment were evaluated by using X-ray and CT and compared between the two groups.Results All patients were followed up,and the mean follow-up time was(35.0±5.3)months(24-48 months).The average operation time was(110.0±21.3)min(85-180 min).The average intraoperative bleeding volum was (50.3 ± 10.6)ml (20-150 ml).There were significant differences in JOA and NDI scores before versus at 1-month,1-year and the final follow-up after treatment(F=9.93 and 28.21,P=0.001 and 0.001).The VAS score of neck pain was lower at 1-month,1-year follow-up than at pre-treatment(P＜0.05),while there were no significant differences in VAS score before treatment versus at the final treatment(P＞0.05).The fineness rate by the Odom criteria was 84.6 ％ (33/39 cases)at the final follow-up.The whole cervical spine curvature,the height of fused segment,the Cobb angle of fused segment and C2-C7 line of force at sagittal view were significantly improved at 1-month,1-year and the final follow-up versus pre-treatment(P＜0.05).The improvements in whole cervical spine curvature and the height of fused segment were lost in some degree with the time extension of follow-up,and the degree of improvements losing was higher at the final follow-up than at 1-year follow-up.At last follow up and in all of patients,the rate of segment fusion were 87.2 ％ (102/117 cases) and Cage sedimentation rate was still 21.4 ％ (25/117 cases).Conclusions Self-locking and zero-profile cages can shorten the operation time,reduce the incidence of postoperative dysphagia,and have good clinical efficacy and fusion rate.But the improvements in cervical spine curvature and the height of fused segement are gradually lost,and the cage has a subsidence in some degree in the middle-term follow-up.Thus,a comprehensive consideration is still needed when choosing self-locking and zero-profile cages for clinical application.

Diagnosis and treatment of colorectal cancer by reduced port laparoscopic radical resection / 中华老年医学杂志

Objective@#To investigate the clinical efficacy of reduced port laparoscopic radical resection on colorectal cancer.@*Methods@#Clinical data of 46 patients with colorectal cancer undergoing reduced port laparoscopic radical resection were retrospectively analyzed.@*Results@#All of 46 patients underwent laparoscopic surgery, with an average operation time of 206 minutes, an average intraoperative bleeding of 56 ml, an average number of lymph nodes removement of 12/case (ranged from 6 to 21). One case had incision infection, 2 cases had anastomotic leakage, and they all recovered and discharged after treatment.@*Conclusions@#Reduced port laparoscopic radical resection of colorectal cancer is safe and feasible, reduces labor costs, and has a good clinical efficacy, which is worthy of clinical promotion.

Diagnosis and treatment of colorectal cancer by reduced port laparoscopic radical resection / 中华老年医学杂志

Objective To investigate the clinical efficacy of reduced port laparoscopic radical resection on colorectal cancer.Methods Clinical data of 46 patients with colorectal cancer undergoing reduced port laparoscopic radical resection were retrospectively analyzed.Results All of 46 patients underwent laparoscopic surgery,with an average operation time of 206 minutes,an average intraoperative bleeding of 56 ml,an average number of lymph nodes removement of 12/case (ranged from 6 to 21).One case had incision infection,2 cases had anastomotic leakage,and they all recovered and discharged after treatment.Conclusions Reduced port laparoscopic radical resection of colorectal cancer is safe and feasible,reduces labor costs,and has a good clinical efficacy,which is worthy of clinical promotion.

Sun′s tip-flexible ureterorenoscopy combined with holmium laser lithotripsy in treatment of renal and upper ureteral calculi / 中华全科医师杂志

Objective To evaluate the efficacy and safety of Sun's tip-flexible ureterorenoscopy (tf-URS) combined with holmium laser lithotripsy in treatment of renal and upper ureteral calculi.MethodsClinical data of 48 patients (29 males and 19 females) with renal and upper ureteral calculi treated by tf-URS with holmium laser lithotripsy in our hospital from November 2015 to May 2016 were retrospectively analyzed.Among 48 patients there were 29 males and 19 females with a mean age of (37.8±12.5) years (21-67), including 31 cases of upper ureteral calculi and 17 cases of renal calculi with a mean stone size of (1.4±0.6) cm (0.8-2.1).The tf-URS was advanced through the ureter under visual direction with rigid mode.When the endoscope reached the ueteropelvic junction, the inner flexible part was extended out to explore the pelvicaliceal stones and then the holmium laser lithotripsy was performed.The therapeutic results were evaluated by KUB 2 days after operation and color ultrasonography or CT 4 weeks after operation.Results The success rate of insertion of tf-URS was 94% (45/48).The calculi were detected in 45 cases, and laser lithotripsy succeeded in 43 cases (96%).The rate of total stone clearance was 87% (39/45).The procedure was transformed to laparoscopic or percutaneous nephrolithotomy (PCNL) in 3 patients with ureterostenosis or ureteral distortion.No serious complications occurred.Conclusion The tf-URS with holmium laser in the treatment of renal and upper ureteral calculi is safe,reliable and effective.

Protective effect of essential oils from Blumea balsamifera on sunburn induced by UVB in mouse skin / 中成药

AIM To study the protective effect of essential oils from Blumea balsamifera (L.) DC.(BBO) on UVB-induced sunburn in mouse skin and its mechanism of action.METHODS The model for sunburned mouse skin was established by acute UVB irradiation.Essential oils from B.balsamifera were applied to the surface of wound for external use.The pathological changes of sunburned skin tissue were observed by hematoxylin-eosin HE) staining.The activity of superoxide dismutase (SOD),and the contents of malondialdehyde (MDA) and glutathione (GSH) were measured.The levels of 8-hydroxy-desoxyguanosine (8-OHdG),interleukin-6 (IL-6) and nuclear factor kappa-B (NF-κB) in epidermis were detected by ELISA.Additionally,the expressions of tumor necrosis factor-alpha (TNF-α),P53 tumor suppressor protein and proliferation cell nuclear antigen (PCNA) were evaluated by immunohistochemistry (IHC).RESULTS Compared with the model group,treatment with essential oils from B.balsamifera significantly reduced the thickness of epidermis,and the activity of SOD and the contents of MDA,GSH in mouse skin were restored.In addition,the essential oils from B.balsamifera resulted in a significant decrease in levels of 8-OHdG,IL-6 and NF-κB,and an inhibition in expressions of P53 and PCNA.CONCLUSION The essential oils from B.balsamifera can alleviate UVB-induced sunburn.Its mechanism is related to enhanced antioxidant power,inhibited NF-κB signal passway,down-regulated release of IL-6 and reduced levels of 8-OHdG,PCNA.

A case of parapharyngeal space infection followed abdominal pain / 临床耳鼻咽喉头颈外科杂志

Descending necrotizing mediastinitis that has an abdominal pain as a main clinical manifestation is seldom. Here one case is reported. At the beginning, the patient had pharyngalgia and his swallowing was not smooth. After that, abdominal pain became a main symptom. Pharyngalgia relieved . However CT showed mediastinal infection. Surgical drainage,antibiotics treatment and nutritional support were performed. The patient was cured.

Genetic analysis and prenatal diagnosis for non-syndromic hearing impairment / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect genetic mutations underlying non-syndromic hearing impairment (NSHI) and establish a method for prenatal diagnosis.</p><p><b>METHODS</b>Sixty six NSHI patients were included in this study. DNA was extracted from peripheral blood. Genetic mutations were detected by gene chip analysis and direct sequencing of GJB2 gene. For 7 pregnant women at high risk, prenatal genetic diagnosis was provided.</p><p><b>RESULTS</b>Fourteen cases (21.21%) were found to have GJB2 mutations by both methods (homozygous 235delC mutation in 3 cases, homozygous 176del16 mutation in 2 cases, 235delC and 299delAT compound heterozygous mutation in 2 cases, 299delAT and 176del16 compound heterozygous mutation in 1 case, c.339T > G and 313del12bp compound heterozygous mutation 1 case, and 235delC heterozygous mutation in 5 cases). 13 (19.70%) had SLC26A4 mutations (IVS7-2 A >G homozygous mutation in 2 cases, IVS7-2 A > G homozygous mutation in 2 cases, IVS7-2 A > G and 2168A > G compound heterozygous mutation in 3 cases, 2168A>G heterozygous mutation in 3 cases, and IVS7-2 heterozygous mutation in 3 cases); and 3 had mtDNA12S rRNA mutation (1555A > G mutation in 2 cases, 1494C > T mutation in 1 case). Prenatal diagnosis suggested that 3 fetuses have carried a heterozygous mutation. Two fetuses were detected as normal and confirmed to have normal hearing after birth. Two fetuses were found to have carried compound mutations of GJB2.</p><p><b>CONCLUSION</b>Gene chip combined with GJB2 gene analysis is an accurate and effective method for the diagnosis of NSHI. The results can facilitate accurate prenatal diagnosis.</p>

Surgical treatment of severe scoliosis and kyphoscoliosis by stages / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although previous reports had reported the use of temporary internal distraction as an aid to correct severe scoliosis, two-stage surgery strategy (less invasive internal distraction followed by posterior correction and instrumentation) has never been reported in the treatment of patients with severe spinal deformity. This study aimed to report the results of the surgical treatment of severe scoliosis and kyphoscoliosis by two-stage and analyse the safety and efficacy of this surgical strategy in the treatment of severe spinal deformities.</p><p><b>METHODS</b>A total of 15 patients with severe scoliosis, kyphoscoliosis or kyphosis who underwent two-stage surgeries (less invasive internal distraction followed by posterior correction and instrumentation) were studied based on hospital records. Pretreatment radiographs and radiographs taken after first surgery (internal distraction by two small incisions), before second surgery (posterior correction, instrumentation and fusion), one week after second surgery and final follow-up were measured. Subjects were analyzed by age, gender, major coronal curve magnitude, flexibility of major curve, major sagittal curve magnitude before first surgery, after first surgery, before second surgery, after second surgery and at final follow-up. Complications related to two-stage surgeries were noted in each case.</p><p><b>RESULTS</b>The average major curve magnitude was 129.4° (range, 95° to 175°), reduced 58.9° or 45.4% after first stage surgery and reduced 30.6° or 24.6% after second stage surgery. The loss of correction during the interval between two surgeries was 7.1%. The total major coronal curve correction was 81.4° or 62.9%. At the final follow up, the average loss of correction of major coronal curve was 3.9° and the final average correction rate was 59.7%. The average major sagittal curve magnitude was 80.3° (range, 30° to 170°), and the total major sagittal curve correction was 48.2°. Loss of correction averaged 4.0° for major sagittal curve and the final correction averaged 42.2°. Clinical complications were noted in the peri-operative and long-term periods.</p><p><b>CONCLUSIONS</b>Two-stage surgery was a safe and effective surgical strategy in this difficult population. Using two-small-incision technique, the first stage surgery was less invasive. No permanent neurologic deficit was noted in this series.</p>

Analysis of neurological deficits complications in the treatment of spinal deformity with posterior spinal osteotomy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the incidence and causes of neurologic deficits complications in the treatment of spinal deformity with posterior spinal osteotomy.</p><p><b>METHODS</b>From January 2007 to December 2010, 321 cases of scoliosis or kyphosis patients were treated with posterior spinal osteotomy. There were 124 male and 197 female with an average age of (19 ± 11) years (2 - 56 years). The average preoperative main Cobb angle was 108° ± 33° (48° - 175°), the average kyphotic angle was 74° ± 29° (53° - 170°) before operation. Pedicle subtraction osteotomy was used in 226 cases, 95 cases with vertebral column resection. Pedicle screw-rod system was used for fixation. The patients were monitored by Somatosensory-evoked potentials monitoring and Stagnara wake-up test.</p><p><b>RESULTS</b>There were 11 cases with varying degrees of new neurologic deficits and the total incidence was 3.4%. The causes were as followed, spinal translation in 2 cases, compromised by close of resected areas in 2 cases, residual bone compression in 1 case, inadvertent operation in 2 cases, screw malposition in 1 case, hematoma compression in 1 case and spine elongation in 2 cases. There was significant difference between the patients with preexisting neurologic deficits (20.0%) and the patients with intact neurologic function (2.6%) (χ(2) = 13.060, P = 0.011), no significant differences in different classes of the age, etiology, deformity, osteotomy type and surgical type (P > 0.05). But the incidence of neurologic deficits was 4.6% in congenital scoliosis, 7.1% in neuromuscular scoliosis, 5.1% in kyphosis, 5.9% in adult deformity and 5.9% in Cobb angle more than 100°, which was higher than other classes. All the 11 cases were given emergent Methylprednisolone, neurotrophic drugs and hyperbaric oxygen therapy, 4 cases were underwent surgical exploration again. After treatment, 7 cases recovered completely, 2 cases recovered partially and 2 cases failed to improve at the last follow-up.</p><p><b>CONCLUSIONS</b>Severe spinal deformity could be effectively treated with posterior spinal osteotomy. But the procedure is technical demanding and risky for neurologic deficits. The high risk factor is preexisting neurologic deficits.</p>

School refusal reason inventory for children and adolescents: development, reliability and validity / 中华行为医学与脑科学杂志

ObjectiveTo develop school refusal reason inventory (SRRI)for children and adolescents in China and assess its reliability and validity.MethodsThe primary SSRI was made based on clinical interviews and literatures.Pretest was carried out in a small sample from a clinic.Then the final SSRI was developed after qualitative analysis and item analysis.SRRI,the Screen for Child Anxiety Related Emotional Disorders(SCARED) and Child Depression Inventory(CDI) were administered to school refusers from 7 schools in Shenyang.All the schools were selected from Shenyang City and its countryside by cluster sampling.Some of the students were retested after one month.Descriptive statistics and exploratory factor analysis were carried out to examine the reliability and validity of SRRI based on all the data.Results Item analysis indicated correlation coefficients between all the items and the total marks were higher than 0.3,and they were significant.All the critical ratios of the items were higher than 0.3.The 43 items were divided into six factors ( educational modality,factor of teachers,relationship with classmates,separated anxiety,study attitude and study environment) by exploratory factor analysis.The factor loading values were 0.372 ～0.848.The cronbach's α of each factor was 0.827,0.831,0.759,0.623,0.821 and 0.808.Retest reliability was 0.644 (P ＜ 0.01 ).Its correlation coefficient with SCARED was 0.452 and 0.548 with CDI.ConclusionAccording to Chinese cultural back ground,the SSRI corresponds with psychometric indexes.There are good reliability and validity.It is helpful to understand the reasons of school refusal behavior in children and adolescents.

Balloon inflating and cement filling for treatment of avascular necrosis of the femoral head: a three-dimensional infinite-element study / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the biomechanical changes of balloon inflating and cement filling in avascular necrosis of the femoral head using finite-element analysis.</p><p><b>METHODS</b>The procedure of percutaneous balloon inflating and cement filling was simulated in fresh specimen of human femoral head. CT scan and three-dimensional reconstruction were used to establish the three-dimensional model of the femoral head. The physiological load was analyzed using three-dimensional finite element model to simulate the load and calculate stress on the hip during walking. Finite element analysis was performed on the avascular necrosis model and balloon inflating and bone cement filling model to measure the Von-Mises force at the top, neck and weight-bearing area of the femoral head. Another 8 fresh specimens of femoral head necrosis of human were obtained to stimulate balloon inflating and bone cement filling procedures, and the displacement of the femoral head under different loads was recorded before and after the procedures.</p><p><b>RESULTS</b>After bone cement filling in the necrosis area, the load reduced significantly in the weight-bearing area of the femoral head, and the load distribution became more uniform at the femoral neck and the top of the head. The anti-deformation ability of the necrosis femoral head increased after bone cement filling. The infinite-element analysis and specimen biomedical test showed similar results.</p><p><b>CONCLUSION</b>Percutaneous balloon inflating and bone cement filling in the necrosis area can change the biomechanics mechanism of the femoral head and neck, improve the supporting capacity under load, and prevent the progression of head collapse.</p>

Computerized three-dimensional reconstruction of cochlear microstructures / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore an useful and practical method for three-dimensional reconstruction of cochlear microstructure.@*METHOD@#A digital image dataset of magnified forty times of human cochlear tissue can be get from the serial sections of transverse cedukol images of male cadavers temporal bone. Photoshop 6.0 and Amira 3.0 software were used to deal with the digital image dataset, such as image-connecting and image inner-location and three-dimensional reconstruction of cochlear and scala media.@*RESULT@#The result of three-dimensional reconstruction of the cedukol images represents the anatomy of human cochlear and scala media transparently and objectively.@*CONCLUSION@#The three-dimensional reconstruction technique used in the study is practical for three-dimensional of inner ear microstructure.

Clinical application of posterior paramedian approach in low back surgeries / 中华外科杂志

<p><b>OBJECTIVE</b>To prospectively evaluate the clinical effects of posterior paramedian approach in nerve root decompression and reducing muscle damage in low back surgeries.</p><p><b>METHODS</b>Study group included 30 cases treated from January 2007 to May 2008, DDD 8 cases, spondylolisthesis 6 cases, LDH 11 cases, Low back surgery failure re-operation 5 cases. Based on the comprehensive understanding of modern spine anatomy, we abandoned laminectomy in our procedure, applied a mid-waist skin incision, dissect to the paraspinal muscles where you could easily reach the facets by separating between the multifidus and longissimus, enlarge the canal by performing resection along ligamentum flavum and the inner broader of the articular process, remove enough tissue till you could expose the traversing root and the disc space, this method could achieve a limited but precise and effective decompression with not taking out all of the articular process. Once the anatomy mark of the pedicle is located (usually would be at the central area of the incision), pedicle screws placement would be precise and easy without struggling with muscle traction. The following procedures would be Spondylolisthesis reduction, discectomy and interbody fusion.</p><p><b>RESULTS</b>Post-op patients of study group all showed significant improvement of pain symptoms, VAS reduced from 7.14 + or - 1.8, pre-op to 1.39 + or - 0.72 post-op, narrowed disc space regained height, spondylolisthesis reached anatomic reduction, no complications such as pedicle screw misplacement and nerve root damage were found, the lumbar spine regained it's physiological lordosis structure. Significant difference is discovered (P < 0.001) in statistic study concerning the rate of intractable low back pain between pre-op and post-op.</p><p><b>CONCLUSIONS</b>Applying low back surgery through posterior para-median approach could directly reach the inferior/superior facets and the "soft" structures of the spinal canal, expose the exact decompression region and anatomy mark of the pedicle in the central surgical field without strong retraction on the para-spinal muscles. This approach has the advantage of lowering the surgical difficulty of implantation, reducing the risk of nerve damage and is also a minimum invasive procedure. In many cases, laminectomy is unnecessary, leaving the lamina intact could preserve the physiological anatomy of the spine.</p>

One stage treatment of infected tibial defects combined with skin defects with Ilizarov technique / 中国骨伤

<p><b>OBJECTIVE</b>To explore the therapeutic effectiveness of Ilizarov technique in treatment of infected tibial defects combined with overlaying skin defects.</p><p><b>METHODS</b>Twenty-one cases with infected tibial defects combined with skin defects were treated between 2001 and 2008 includeing 18 males and 3 females with an average age of 31 years ranging from 19 to 43 years. The length of bone defect ranged from 3 to 13 cm (means 6 cm). Skin defect area was from 3 cm x 3 cm to 6 cm x 10 cm; 11 cases combined with drop foot, 5 cases with arthrocleisis of knee. Preoperative X-ray of the affected limb was performed and zone of skin necrosis was marked, then the point and length of osteotomized bone, and scope of bone and soft tissue need for removing were determined. The internal fixation were removed. Opening irrigation, vacuum sealing drainage (VSD), and dressing changing were appllied. The skin was fixed with Kirschner wire and bone was transferred with Ilizarov technique in all patients. The lengthening of bone and skin was carried out for 4 to 7 days after surgery, 1/6 to 1/4 mm once, 4 to 6 times a day. The clinical effectiveness was determined mainly through wound and lengthening of skin.</p><p><b>RESULTS</b>All patients were followed up for from 6 to 62 months (means 49.5 months). Fourteen of 21 cases received one stage treatment, there was still secretion from end of bone in 3 patients whose bone healed after debridement, the other 4 patients were cured via trimming end of bone and compression fusion. The defects of bone were extended to full length in 18 patients. Abutting end was slightly absorbed and became rattailed in 2 cases, there was lack of blood supply to abutting ends in one patient who was cured via bone graft from iliac bone. Skin defects was cured in 18 patients with one stage treatment, the other 3 patients were cured after infection was controlled. The deformity of drop foot were corrected in 11 patients, and function of knee was improved in five patients. The external fixator was removed at 1.2 to 2.6 years after surgery. At last, bone infections were cured, defects of bone and skin recovered in all patients.</p><p><b>CONCLUSION</b>One stage treatment of infected tibial defects combined with skin defects using Ilizarov technique has minimal invasion with less complex surgeries, could reduce the time and expense of treatment.</p>

Clinical analysis of 33 cases of neurilemmomas of the head and neck / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of neurinoma of the head and neck.@*METHOD@#The clinical data of 33 patients with neurinoma of the head and neck, from 1980 to 2004, were retrospectively reviewed and analysed.@*RESULT@#The tumors of all the cases were totally resected. Thirty of thirty-three cases have been followed up. Twenty-seven cases were fully recovered without any serious complication. One case with malignant tumor were died. The other 2 cases were died of other diseases.@*CONCLUSION@#Tumor resection is still the most effective treatment available for patients with neurilemmomas of the head and neck. Resection of tumor should be performed as soon as possible with careful protection of the function of the nerve. Extensive resection should be performed to treat malignant tumors.

Treatment of specific foreign bodies in tracheobronchial / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To improve effectiveness of diagnosis and therapy in patients with tracheobronchial specific foreign body.@*METHOD@#Fourty-six cases with specific foreign bodies in the trachea and bronchi, admitted from March 1998 to June 2006, were analyzed retrospectively.@*RESULT@#Forty-one of 46 the specific foreign bodies were successfully removed through bronchoscopy. Three cases were removed by chest surgery. Two cases were died.@*CONCLUSION@#Suitable surgical instrument should be well selected and the best operation should be applied according to different conditions of the foreign bodies. Rigid bronchoscopy for removal of specific foreign bodies under general anesthesia is a main measure presently.

Significance of abnormal expression of Rb,p53 and PCNA in patients with bladder carcinoma / 肿瘤研究与临床

Objective To discuss the significance of abnormal expression of Rb,p53 and PCNA in patients with bladder carcinoma and the correlation with the tumor grade,clinical stage and relapse.Meth- ods Immunohistochemical method was used to detect the Rb,p53 and PCNA gene expression in 60 cases with bladder carcinoma.Results The positive rates of p53,PCNA in 60 cases of bladder cancer is both 40.0 %.There were 27(45 %)cases lack of Rb expression.Multiple altered expression was found in 30 cases (50.0 %).The abnormal expression of Rb,p53 and PCNA was closely related to the tumor grade,clinical stage and relapse.Conclusion The detection of multiple gene is more valuable than that of single gene. Multiple altered expression of Rb,p53 and PCNA and their synergistic action might play an important role in the genesis and development of bladder cancer.

Ultrafiltration Applied in Low Flow Venovenous Extracorpareal Membrane Oxygenation in Sheep / 实用儿科临床杂志

0.05.Conclusions The UF effectively removed BUN in sheep with low flow VV-ECMO.The application of UF didn't cause blood shunt in ECMO.The low flow VV-ECMO effectively eliminated carbon dioxide and rerformed oxygenation.

Balloon kyphoplasty: an experience of 38 patients with painful osteoporotic vertebral compressive fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine.</p><p><b>METHODS</b>A retrospective analysis was conducted in 38 consecutive patients (28 females, 10 males), whose ages ranged from 56 to 82 years (mean age 72 years). The symptom- and sign-positive spinal segment was identified by MRI. The time between onset of symptoms and surgical intervention ranged from 2 days to 1 year. 62 segments (36 thoracic, 26 lumbar) were treated in this cohort. The pain score estimated by Visual Analog Scale and activity degree were assessed immediately after operation and at 1-, 6-, and 12-month postoperative follow-up. Preoperative and postoperative anterior, midline vertebral heights in fractured vertebrae were measured on lateral radiographs to evaluate the effect of the procedure.</p><p><b>RESULTS</b>The method achieved a swift pain relief associated with an evidently increased weight-bearing ability. The pain score was reduced from 8.2 to 2.4 points. The anterior and midline vertebral heights in 62 fractured vertebral bodies increased up to 82.76%+/-26.84%, 88.82%+/-21.75% and the wedge decreased from 15 to 8 degrees. This effect persisted at least over a period of two years. The procedure did not induce narrowing of the spinal canal and no severe complications occurred.</p><p><b>CONCLUSIONS</b>Balloon kyphoplasty can result in immediate clinical improvement of mobility and pain relief, increase vertebral body height, and quickly return patient's activity. The short-term results are approved excellent, and the long-term results need further judgment.</p>

Selection of surgical procedure for the treatment of idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVES</b>To discuss and evaluate the selection of surgical procedure for the treatment of idiopathic scoliosis according to the location and degree of the deformity.</p><p><b>METHODS</b>175 patients with idiopathic scoliosis underwent surgical treatment with correction and fusion. The patients were divided into four groups according to the location and degree of the deformity and four different procedures were used for each group. For each group, the blood loss, surgery time, correction rate, loss of correction at final follow up and complications were compared and analyzed.</p><p><b>RESULTS</b>All patients underwent surgery safely and no neurological complication occurred. The correction rate was 81% for Group I, 86% for Group II, 68% for Group III and 72% for Group IV. All patients were followed up at least 2 years and the average time was 38 months (24 approximately 52).</p><p><b>CONCLUSION</b>Proper selection of surgical procedure according to the location and degree of the scoliotic deformity, satisfactory results can be achieved in the treatment of idiopathic scoliosis.</p>