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Objective:To compare Jefferson-fracture reduction plate (JeRP) and micro titanium plate in the transoral single-segment fixation of unstable atlas fractures.Methods:From January 2008 to December 2020, 45 patients with unstable atlas fracture were treated by single-segment fixation through an oral approach with a JeRP or a micro titanium plate at Department of Orthopedic Surgery, General Hospital of Southern Theatre Command. They were 24 males and 21 females, aged from 15 to 67 years. By the Gehweiler classification, 11 atlas fractures were type Ⅰ and 34 type Ⅲ; by the American Spinal Injury Association (ASIA) classification, the spinal cord injury was grade D in 7 cases and grade E in 38 cases; by the Dickman classification, the atlas transverse ligament injury was type Ⅰ in 4 cases and type Ⅱ in 11 cases. Of the patients, 26 were treated by transoral single-segment fixation with a JeRP and 19 by transoral single-segment fixation with a micro titanium plate. The 2 groups were compared in terms of baseline data, operation time, blood loss, hospital stay, visual analog scale (VAS) for neck pain and atlas lateral mass displacement (LMD) before operation and at the last follow-up, and intraoperative and postoperative complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). All patients were followed up for 12 to 55 months (mean, 21.8 months). Wound dehiscence or infection was observed in none of the patients after operation. About 12 months after operation, all fractures achieved bony union, neck pain basically disappeared, and neck movement had no obvious limitation. The hospital stay was (13.9±2.2) d for the JeRP group and (14.2±2.9) d for the micro titanium plate group, showing no significant difference between the 2 groups ( P>0.05). The operation time was (203.5±173.4) min and the blood loss (167.3±138.6) mL in the JeRP group, significantly more than those in the micro titanium plate group [(121.5±50.5) min and (98.4±57.2) mL] ( P<0.05). In the JeRP group, the preoperative LMD was (6.7±1.7) mm and the preoperative VAS score (6.8±1.0) points, significantly higher than the last follow-up values [(0.7±0.6) mm and (0.7±0.6) points] ( P<0.05). In the micro titanium plate group, the preoperative LMD was (6.6±1.5) mm and the preoperative VAS score (6.7±0.9) points, significantly higher than the last follow-up values [(0.9±0.6) mm and (0.8±0.7) points] ( P<0.05). However, there was no significant difference in the preoperative or the last follow-up comparison between the 2 groups ( P>0.05). Implant loosening was observed in one patient in the JeRP group while foreign body sensation in the throat was reported in one patient after operation in the micro titanium plate group. Conclusions:Both JeRP and micro titanium plate in the transoral single-segment fixation can lead to effective treatment of unstable atlas fractures. Compared with JeRP, the micro titanium plate can effectively shorten operation time and reduce blood loss due to its smaller size and lower incision.
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Objective To study the CT features of the sero-hepatic type of hepatic tuberculosis.Methods This is a retrospective,multi-center and cross-sectional study.17 patients with the sero-hepatic type of hepatic tuberculosis from the Yueqing People' s Hospital (n =5),Second Affiliated Hospital of Wenzhou Medical College (n =5),and Wenzhou People's Hospital (n =7) were studied.All these patients were fasted for 8 h prior to CT scanning.They underwent enhanced after conventional CT breathless scanning with no abdominal pressure.Results The CT scans displayed 41 lesions in these 17 patients with the sero-hepatic type of hepatic tuberculosis,including a solitary lesion in 13 patients and multiple lesions in 4 patients.The diameter of the lesions varied from 0.8 to 4.7 cm,with a mean ± S.D.of 2.38 ± 4.82 cm.The CT features showed a localized spindle-shaped focal lesion just underneath the liver capsule with resultant concave compression of the adjacent liver tissue (n =22),spotted calcifications in the center of the focal nodules (n =1);and aggregation of multiple low density nodular foci (n =19).Additional CT features included focal nodules surrounded by a small amount of liquid (n =15),compression of adjacent liver tissue (n =22),a small amount of ascites (n =8),and retroperitoneal lymph nodes enlargement (n =2).These nodules showed moderate (n =5) and slight enhancement in the arterial phase (n =36);moderate (n =32) and mild enhancement in the portal venous phase (n =9);and moderate (n =32) and mild enhancement in the parenchymal phase (n =9),respectively.The nodules showed ring-shaped (n =26),honeycomb or multiple ring-shaped enhancement (n =15).The enhanced ring-shaped wall thickness varied from 0.2 to 0.9 cm,with a thin wall (n =30) and a thick wall (n =11).The center of the focal nodule was a low density sac-shaped area,with no obvious contrast enhancement.The CT value was 21 to 39 hu.The infiltrative liver tissues which surrounded the focal nodules were shown as lamellar areas of obvious arterial enhancement,with equidensity in the portal vein phase and equilibrium phase.Conclusions CT showed characteristic features of the sero-hepatic type of hepatic tuberculosis.Clinical and laboratory findings could provide important supplementary information to make the diagnosis.
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Objective To explore the effect of comorbidities on the surgical outcomes of elderly patients with hip fracture. Methods The Age,gender,weight,type of fracture,preoperative comorbidities and surgical outcomes of 117 patients aged 80 yr or over who undergoing hip fracture surgery in our hospital were recorded. Patients were divided into rehabilitation group and postoperative in-hospital death group ac-cording to surgical outcomes. The potential predictors of postoperative in-hospital death were identified by univariate model and were then entered into multiple Logistic regression analysis. Results Twenty three patients(19. 7%)had no comorbidity,94 patients(80. 3%)had one or more comorbidities. Ten patients(8. 5%)died in hospital after the operation. Predictors of postoperative in-hospital death were preoperative respiratory diseases and three or more comorbidities. Conclusion Surgical outcomes of elderly patients with hip fracture may be predicted by analysing preoperative comorbidities. Preoperative preparations must be sufficient in order to ensure successful operation.
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Objective To explore the most effective formula to predict the catheterization length of the right internal jugular vein by an-terior approach. Methods Sixty-seven cases performed with right internal jugular vein catheterization from January 2013 to June 2013 were enrolled in this study and 4 formulas were selected to predict the catheterization lengths. Comparing their predicted lengths with the actual lengths defined as the lengths of the internal catheters which terminals were inserted to a accurate position,and analyse their predictive validi-ty. Results The predictive error percentages of the 4 formulas were all less than 15%. Comparing the predicted lengths and the actual lengths, there was no difference between the predicted length of the 1st formula and the actual one(P>0. 05),and the predicted lengths of the other three formulas were significantly less than the actual ones(P0. 05). Conclusion The predictive error of all the 4 formulas is less than 15%, and the 1st formula is simple,practical and associated with a much smaller error,more suitable to estimate the length of the right internal jugular vein catheterization by anterior approach.
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BACKGROUND: Effects of Pericarpium aurantiin water extract on sleeping and spontaneous activity in Kunming mice has been investigated in three experiments, that is, the experiments of sleeping time due to supraliminal and subliminal dosage of sodium pentobarbital, and shaking cage for energy transducer, respectively.OBJECTIVE: To observe the influence of Pericarpium aurantiin water extract on sleeping and spontaneous activity of Kunming mice.DESIGN:Randomized controlled trial.SETTING: The Staff Rooms of Pathology, Physiology and Pharmacology in Gannan Medical College.MATERIALS: The experiment was conducted in the Central Laboratory of Science Research, Gannan Medical College from January through February 2005. Ninety adult Kunming mice, grade of clearness, were enrolled and randomly divided into three groups with 30 mice for each experiment:10 in control group, 10 in large-dosage group and 10 in small-dosage group.METHODS: ① In energy transforming trial, spontaneous activity of mice was recorded, small wave with wave amplitude ＜ 5 mm was considered as the waveform of gentle activity in mice, such as fur licking and tickling; middle wave with wave amplitude of 5-10 mm as the waveform of moderate activity, such as walking, standing, climbing up and down;large wave with wave amplitude ＞ 10 mm as the waveform of intensive activity, such as running, jumping up and down. Mice in the small-dosage group, large-dosage group and control group were respectively given intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline, and placed into the cage after 15 minutes. Then, 3 minutes later, waveforms of mice within 15 s was recorded. ② In the experiments on duration of sleep in mice due to supraliminal or subliminal dosage sodium pentobarbital, 0.02 mL/g or 0.01 mL/g sodium pentobarbital (2.5 g/L) were administrated intraperitoneally into mice in the small-dosage, large-dosage and control group 15 minutes after intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline were given to the three groups, respectively. Subsequently, comparisons of the number of sleeping mice, time to falling asleep, and sleeping time were carried out among the three groups.MAIN OUTCOME MEASURFS: ① Times of spontaneous activity, ②Sleeping time due to supraliminal dosage of sodium pentobarbital, ③ Duration of sleep due to subliminal dosage of sodium pentobarbital.RESULTS: All the mice were involved in the result analysis without loss.① There were fewer middle and large waves in the small-dosage and largedosage groups as compared with that in the control group (90.5±14.7,58.3±12.5, 45.6±10.1, t=2.341-3.215; P ＜0.05 or P ＜0.01), indicating that Pericarpium aurantiin water extract can evidently inhibit spontaneous activities in mice. ② In comparison with the control group, the time to falling asleep and the duration of sleep due to supraliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively,in the small-dosage and large-dosage groups. ③ In comparison with the control group, the time to falling asleep and duration of sleep due to subliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively, in the small-dosage and large-dosage groups.CONCLUSION: Pericarpium aurantiin water extract can prolong the duration of sleep and inhibit the spontaneous activities of Kunming mice,which is in cooperation with sodium pentobarbital in central inhibition.
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BACKGROUD: According to the record of Compendium of Herbology of herbs epimedium, Berberidaceae barrenwort genus, herbs epimedium has the effects of supplementing essence qi, consolidating bones and tendons, tonifying bruise of loin and strengthening cardiac ability, etc. In recent years, its clinicalapplications and pharmacological effects have been reported more frequently.OBJECTIVE: To investigate the effects of herba epimedium extract on spontaneous activity and sleep function of mice under the intervention of suprathreshold and subthreshold dose of pentobarbital sodium with the method of jiggle-cage transducer.SETTING: Department of Mathematics and Physics, Laboratory of Analysis, Department of Pharmacology, Gannan Medical College.MATERIALS: A total of 110 healthy adult Kunming male mice of clean grade, with a body mass between 18 g and 22 g.METHODS: The experiment was conducted in Laboratory of Scientific Research Institute of Gannan Medical College from August to September 2004. ① The mice (n=30) were injected intraperitoneally with 1 000 g/L herbs epimediu extract(0.01 mL/g) and put into hanging cage 15 minutes later, after a 3-minute stabilization period, waveforms of spontaneous activity within 15 s after the administration of drug were recorded. ②The mice (n=40) were intraperitoneally injected with 1000 g/L herba epimediu extract(0.01 mL/g), 15 minutes later, injected intraperitone ally with 0.02 mL/g suprathreshold dose of pentobarbital sodium (2.5 g/L), and then observe the disappearance time of righting reflex of the mouse. ③ The mice (n=40) were injected intraperitoneally with 1 000 g/L herba epimediu extract(0.01 mL/g), 15 minutes later,intraperitoneally injected with 0.01mL/g subthreshold dose of pentobarbital sodium (0.25%),and then observe the disappearance time of righting reflex of the mouse.MAIN OUTCOME MEASURES: Frequency of spontaneous activity of the mice; sleeping time of the mouse with suprathreshold and subthreshold dose of pentobarbital sodium.RESULTS: All the 110 mice entered result analysis. ① Herba epimedium extract (0.1 mL/10 g) could significantly inhibit the spontaneous activity of the mice, and the frequencies of large waves and moderate waves decreased obviously (7.4±6.5, 47.1±18.7; t=3.265, P ＜ 0.01). ② Herbs epimedium extract (0.01mL/10g) could shorten the time for falling asleep and prolong the sleeping time of the mouse with suprathreshold dose of pentobarbital sodium, and there was significant difference as compared with the control group [(3.9±2.8), (219.7±87.2); (5.8±2.9), (113.0±77.4) minutes; t=2.452, 2.501, P ＜ 0.05]. ③ Herba epimedium extract (0.01 mL/10 g)could significantly prolong the time for falling asleep and the sleeping time of the mouse with subthreshold dose of pentobarbital sodium, and there was significant difference as compared with the control group [(6.6±5.2),(60.3±71.7); 0, 0 minute; t=3.275, P ＜ 0.01]. Herba epimedium extract and pentobarbital sodium had synergistic effect of central inhibition.CONCLUSION: Herba epimedium extract has the effect of significant central inhibition, which could inhibit the spontaneous activity of mice ,remarkably shorten the time for falling asleep,and obviously prolong the sleeping time of the mouse with suprathreshold dose of pentobarbital sodium, prolong the time for falling asleep of the mouse with subthreshold dose of pentobarbital sodium and increase the amount of animals falling asleep.
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Aim To investigate the inhibitory effects of xanthotoxol(XT) on neutrophil infiltration and brain edema induced by focal cerebral ischemia-reperfusion injury in rats.Methods Focal cerebral ischemia-reperfusion model in rat was induced by transient occlusion of the middle cerebral artery for 2 hours and followed by 24 hours of reperfusion.XT(2.5,5 and 10 mg?kg-1,ip)was administered at 1 hour and 12 hours after the onset of ischemia,respectively.After 24 hours of reperfusion,the influence of XT on neurological deficit score,brain edema and infarct size were evaluated;the activity of Na+,K+-ATPase,Ca2+-ATPase and myeloperoxidasse(MPO) in the ischemic hemisphere cortex of the middle cerebral artery area was assayed by spectrophotometry;the expression of intercellular adhesion molecule-1(ICAM-1) and E-selectin was measured with immunohistochemistry.Results XT significantly reduced the neurological deficit score,brain edema and infarct size,enhanced activity of Na+,K+-ATPase and Ca2+-ATPas,suppressed the injury-induced upregulation of MPO activity and cell adhesion molecules(ICAM-1 and E-selectin) expression in the brain tissue.Conclusion XT attenuates brain damage following focal cerebral ischemia-reperfusion in rats and its mechanism may partly be due to the inhibition of inflammation and brain edema induced by ischemia-reperfusion.
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Aim To explore the therapeutic effects of 3′-daidzein sulfonate sodium(DSS) on isolated myocardial ischemia/reperfusion injury and the relation of its mechanism to anti-oxidation.Methods An isolated rat myocardial ischemia/reperfusion injury was made,and the injury was treated with DSS.Following the treatment,the coronary blood flow levels,left ventricular systolic pressure,and activities of enzymes(LDH,SOD,GSH-Px) were measured.Results After treatment,the isolated myocardial tissue showed an increase in the volume of perfusion and an increase in the enzymatic activities of LDH,SOD,GSH-Px in the myocardial tissue.Conclusion DSS has a therapeutic effect on isolated myocardial ischemia/reperfusion injury because it enhances anti-oxidative activity in myocardial tissue.