Clinical outcomes of single-level lumbar spondylolisthesis by minimally invasive transforaminal lumbar interbody fusion with bilateral tubular channels / 中华外科杂志

Objective@#To evaluate the clinical effectiveness of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-level lumbar spondylolisthesis treatment with bilateral Spotlight tubular channels.@*Methods@#A total of 21 patients with lumbar spondylolisthesis whom underwent MIS-TLIF via bilateral Spotlight tubular channels were retrospectively analyzed from October 2014 to November 2015. The 21 patients included 11 males and 10 females ranged from 35 to 82 years (average aged 60.7 years). In term of spondylolisthesis category, there were 18 cases of degenerative spondylolisthesis and 3 cases of isthmic spondylolisthesis. With respect to spondylolisthesis degree, 17 cases were grade Ⅰ° and 4 cases were grade Ⅱ°. Besides, 17 cases at L4-5 and 4 cases at L5-S1were categorized by spondylolisthesis levels. Operation duration, blood loss, postoperative drainage and intraoperative exposure time were recorded, functional improvement was defined as an improvement in the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) was also employed at pre and post-operation (3 months and the last follow-up), to evaluate low back and leg pain. Furthermore, to evaluate the recovery of the intervertebral foramen and of lumbar sagittal curvature, average height of intervertebral space, Cobb angles of lumbar vertebrae and operative segments, spondylolisthesis index were measured. At the last follow-up, intervertebral fusion was assessed using Siepe evaluation criteria and the clinical outcome was assessed using the MacNab scale. Radiographic and functional outcomes were compared pre- and post-operation using the paired T test to determine the effectiveness of MIS-TLIF. Statistical significance was defined as P<0.05.@*Results@#All patients underwent a successful MIS-TLIF surgery. The operation time (235.2±30.2) mins, intraoperative blood loss (238.1±130.3) ml, postoperative drainage (95.7±57.1) ml and intraoperative radiation exposure (47.1±8.8) were recorded. Different significance between 3 months post-operative follow-up and pre-operation was exhibited (P<0.01) in respects of lumbar VAS (t=11.1, P<0.01) and leg VAS (t=17.8, P<0.01). Moreover, final follow-up compared with pre-operation, and final follow-up compared with 3 months post-operative follow-up, VAS scores were also statistical difference (P<0.01). At the final follow-up, there were significant differences compared with pre-operation in ODI scores (t=30.1, P<0.01). Comparison between 3 months post-operative follow-up and pre-operation, statistical distinctions were demonstrated (P<0.05) in terms of mean height of intervertebral space (t=-10.9, P<0.01), the Cobb angles of lumbar vertebrae (t=-2.4, P<0.05), operative segments Cobb angles (t=-5.2, P<0.01) and Lumbar spondylolisthesis incidence (t=17.1, P<0.01). In addition, there was statistical difference between final follow-up and pre-operation (P<0.05) as well. For instance, mean height of intervertebral space (t=-10.5, P<0.01), the Cobb angles of lumbar vertebrae (t=-2.7, P<0.05), operative segments Cobb angles (t=-4.2, P<0.01) and Lumbar spondylolisthesis incidence (t=18.6, P<0.01) were involved. All spondylolisthesis vertebrae were restored completely. Lastly, at the last follow-up, 12 cases of grade 1 and 7 cases of grade 2 fusion were present as determined by the Siepe evaluation criteria. McNab scale assessment classified 17 patients having excellent clinical outcome, 3 patients in good and 1 patient having a better clinical outcome.@*Conclusion@#MIS-TLIF with bilateral Spotlight tubular channels is a safe and effective approach for single segment lumbar spondylolisthesis.

Application of combined saphenous nerve-great saphenous vein flap and cutaneous branches of posterior tibial artery flap in repair of chronic ulcer in foot / 中华医学美学美容杂志

Objective To evaluate the efficacy of the combined saphenous nerve-great saphenous vein flap and cutaneous branches of posterior tibial artery flap in repairing refractory wounds. Methods Eighteen cases of pedal chronic ulcers were treated with the combinedsaphenous nervegreat Saphenous vein flap and cutaneous branches of posterior tibial artery flap, in which the wounds were treated with vacuum suction techniques before the operation in 6 cases. Wounds were from 8 cm× 13 cm to 1 cm× 17 cm in zine after debricement, and the designed size of the flaps was from 8 cm× 14 cm to 11 cm× 18 cm. Results After the treatment, 18 cases were evaluated as excellent in 10 cases, and good in 8 cases, in which the primary sealing of the wounds was achieved in 17 cases, but one case presented with focal necrosis of smaal size owing to vein drainage disturbance in a distallypedicled flap, and was healed after flap transplantation. Follow-up for 6 months to 2 years showed that all the patients were satisfied with the results. Conclusions The combined flap has reliable blood supply, skin pedicle of the flap is longer, superior texture and satisfied appearance, and incisive area of the flap is larger. It is particularly useful in repairing refractory wound in foot.

Mechanism of increasing airway ciliary beating frequency by L-arginine / 中华麻醉学杂志

Objective To understand the modulating mechanisms in ciliary motility by NO signal pathway. Methods L arginine, the preferred substrate of NOS, was employed to act upon the cultured rat ciliated epithelia. After pre incubating with L NMMA, a NOS inhibitor, or ODQ,a sGC inhibitor, or Rp 8 Br cGMPS, an antagonist of PKG respectively, tissues were contacted with L arginine again. Ciliary beating frequency (CBF) was measured by phase contrast microscope and videotape analysis. Results L arginine increased CBF siginficantly. The effect of L arginine on CBF was blocked by L NMMA, ODQ or Rp 8 Br cGMPS.Conclusion L arginine may increase CBF via NO sGC cGMP PKG pathway.

An clinical study on nutritional support in severely burned patients with delayed fluid resuscitation / 肠外与肠内营养

Objectives:To investigate nutritional support in severely burned patients with delayed fluid resuscitation. Methods:From January 1990 through December 2000,62 cases with delayed fluid resuscitation were admitted to our burn department and were divided by different periods into two groups:group N(1990-1994,n=26) and group A(1995-2000,n=36).Group A was treated with recombinant human growth hormone(rhGH),early enteral feeding(EEF) and glutamine(Gln). Plasma albumin,pre-albumin,insulin,blood glucose and urine glucose levels were measured and lymphocyte was counted immediately after hospitalization and postburn day(PBD) 1,3,7,14,21,28. Results:①The survival rate in group A was very significantly higher than in group N.The complication in group A was significantly lower than in group N.②The time of wound healing in group A was shorter than in group N.③Plasma albumin,pre-albumin levels and lymphocyte count were decreased in two groups and was more serious in the group N(P

Effect of NO signal system on rat airway ciliary motility / 中华麻醉学杂志

Objective To understand the effects of NO signal system on the ciliary beating frequency (CBF) of airway epithelial cellMethods Nine normal male Sprague-Dawley rats were anesthetized with isoflurane Their tracheas were rapidly removed using aseptic technique The mucosa of trachea were cut into 1mm2 explants and cultured in DMEM The explants were divided into 5 groups as bellow: L-Arg group, 1-Hydroxy-2-oxo-3-(N-ethyl-2-aminoethyl)-3-ethyl-1-triazene (NOC-12) group, D-Arg group, 8-Br-cGMP group, and phosphate buffered saline (PBS)group Actively beating ciliated cells were observed, and their motion was quantified by measuring CBF using phase-contrast microscopy and videotape analysis Results L-Arg increased CBF from (7 43?0 75)Hz to(8 59?0 93)Hz (P