Clinical Features of Multicenter Autoimmune Glial Fibrillary Acidic Protein Astrocytosis / 罕见病研究

  Objective  To investigate the clinical features of autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.  Methods  We collected and analyzed the clinical and laboratory data and obtained the clinical characteristics of diagnosis and treatment from fifteen patients with positive GFAP antibody tested by cerebrospinal fluid and diagnosed autoimmune GFAP astrocytopathy by the multi-centers.  Results  The mean age of the first onset of autoimmune GFAP astrocytopathy was 39.73 years old (range 4-65 years), with no significant gender difference. In terms of clinical manifestations, we found the whole brain symptoms including abnormal mental behavior, disturbance of consciousness, epileptic attack accounting for more than 50, , meningitis accounting for 66.7%, myelitis (53.3%), limb tremor (53.3%), vision loss (33.3%); systemic symptoms including fever(100%) and fatigue(86.7%). 46.7% of patients were initially diagnosed with tuberculous meningoencephalitis and were treated with diagnostic antituberculous therapy. The MRI showed 46.7% of patients showed brain linear perivascular radial gadolinium enhancement in the white matter perpendicular to the ventricle.  Conclusions  Autoimmune GFAP astrocytopathy are acute or subacute dieases and the main clinical features include encephalitis, meningitis, myelitis and optic neuritis. They are likely to be misdiagnosed as tuberculous meningoencephalitis and can manifest progressive loss of consciousness in early phase, which is even life threatening.

Research progress of interbody fusion cage and its materials / 中国组织工程研究

BACKGROUND:With the rapid development of technology, most interbody fusion cages have been applied in clinic, but some are stil in experimental stage. Al fusion cages hold their own distinct characteristics as wel as advantages and shortcomings. OBJECTIVE:To clarify the development course of interbody fusion cages and analyze their types in detail, thereby paving ways for its improvement. METHODS:A computer-based search for literatures in CNKI and PubMed databases published from January 1989 to March 2016 was performed using the keywords of“interbody fusion cage, PEEK, TMC”in English and Chinese, respectively. A total of 106 articles were retrieved and 38 articles were in accordance with the inclusion criteria. RESULTS AND CONCLUSION:Intervertebral fusion is a major method to treat spinal degenerative diseases. There are a variety of fusion cages in clinic, such as pyramesh, polyetheretherketone and absobable fusion cages. Implants used for fusion cages include autogenous, al ogenic and artificial bones as wel as bone morphogenetic protein. We introduce the development process of fusion cages in detail, emphasize the commonly used fusion cages and analyze its development in future. In the end, we give our opinions about the development of intervertebral fusion cages.

Pars repair by internal fixation and bone graft through the Wiltse approach via Quadrant channel / 中华骨科杂志

Objective To investigate the clinical effects of pars repair by the pedicle screws,laminal hooks and auto iliac bone graft through the Wiltse approach via Quadrant channel for the treatment of the adolescent spodylolysis.Methods From November 2007 to April 2011,pars defects of 11 patients (10 males and 1 female) were repaired with pedicle screws,laminal hooks and auto iliac bone graft via Quadrant channel through the Wiltse approach.The mean age of 11 patients was 17.3 years (range 15-19).Mean course was 9.9 months (range 6-14 months).All patients have bilateral pars defect of L5.There was no poroma across the pars that have been proved by X-ray film and 3-D CT before the operation.There were 4 patients with Ⅰ grade spondylolisthesis.The degeneration of the intervertebral disc assessed by Pfirrmann grade of all patients was no more than Ⅰ grade.Visual analogue scale (VAS) and Oswestry disability index (ODI) were compared before and after operation.The fusion of pars defect was observed by X-ray film and 3-D CT.Results The mean operation time was 85.5±12.3 min (range 70-110 min); intraoperatve blood loss was 80-150 ml (mean 105 ± 19.4 ml).Two patients were lost in follow-up after operation and the others had been followed up for 12 to 24 months (mean 16 months).All patients had significant pain relief and function recovery after operation.Mean postoperative VAS score was 1.5± 1.0 compared with 4.5± 1.0 of preoperation (t=4.603,P=0.002).ODI was decreased from 49.3％± 14.2％ of preoperation to 12.0％±4.9％ of the last follow-up (t=7.344,P=0.000).With the Macnab grades,7 patients are excellent,2 patients are good.3-D CT showed that all pars defect were fused in the last follow-up.Conclusion Pars repair by the pedicle screws,laminal hooks and auto iliac bone graft through the Wiltse approach via Quadrant channel can protect the paravertebral muscle,relief patients from pain,and improve function.

Diagnosis and treatment of the posterior margin separation of lumbar vertebral epiphysis / 中国矫形外科杂志

[Objective]To study the pathogenesis,clinical manifestation and surgical treatment of the posterior margin separation of lumbar vertebral epiphysis.[Method]Sixteen patients suffering from the posterior margin separation of lumbar vertebral epiphysis were followed up.The clinical manifestation and radiologic examination were analyzed and results of surgical treatment were evaluated.[Result]The patients were usually young and manifested with the sign and symptom of lumbar disc herniation and/or lumbar stenosis.CT was helpful for the accurate diagnosis of this disease.The different surgical measures were taken for the treatment according to the type and range of protrusion.[Conclusion]The posterior margin separation of lumbar vertebral epiphysis were divided into three types:end plate separation and moving into posterior margin,Schmorl node and avulsion fracture.The good results can be obtained with surgery.

Initial detection and analysis of neuro-information from amputee / 生物医学工程学杂志

By detection and analysis of neuro-information from amputee in experiments, a research on the correlations of three main nerves (median nerve, radial nerve and ulnar nerve), on the patterns for discharging information, and on the mechanics about how neuro-information dominates movements was performed. These researches would contribute to the development of neuroprosthesis.