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Adult atlantoaxial complex fractures, an acute injury which is rare in clinic, may lead to neurological damage or even death. Their current treatments can be conservative or surgical. The conservative treatment may involve collar bracket, Halo bracket, and sterno-occipital mandibular immobilizer (SOMI) while the surgical treatment mainly involves anterior cervical fixation and posterior cervical fixation. This review expounds on the current literature concerning the treatment of adult atlantoaxial complex fractures so as to provide reference for correct choice of treatment methods for this kind of fractures.
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Objective To study the therapeutic effects of non-myeloablative cord blood stem cell for hormone resistent ulcerative colitis ( UC )and endoscopic changes. Methods Eleven UC patients(6 males,5 females), aged 18 to 61 years old, and unresponsive to high-dose prednisolone therapy more than 3-28years, were included. Four cases were left-sided colitis, 7 were pancolitis. Ten were severe cases and 1 was moderate, others were active. Stem cells of CD34+, CD117+, CD133+ , C-kit+ and Sca-1+ were extracted from a total of 60-120 ml cord blood with the isolation kit. The total account was more than 1.0 × 108,andthe cell activity was more than 96%. The stems cells were prepared with normal saline (10 ml) to suspension, which was injected into inferior mensenteric artery via femoral catheterization. Those who received pretreatment corticosteroid resumed their previous therapy . Hormone administration gradually decreased and then ceased at the relief of symptoms. Results After 12 weeks of treatment with stem cell, the total clinical effects were completely remission in 7 cases, improvement in 3 patients, and inefficiency in one case. The clinical symptomatic remissions were complete remission in 7 cases, partial in 3, and inefficiency in 1. The colonoscopic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. And the histologic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. Bowel movements decreased from 11.5 times to 1.6 per day, erythrocyte sendimentation rate decreased from 44. 5mm/h to 11.5 mm/h and C reaction protein decreased from 22. 3 mg/L to 6. 1 mg/L. The Sourtherland disease active index (DAI) decreased from 11.1 to 2. 32. Hormone administration ceased in 10 cases and decreased in 1. There were no complications. The patients were followed up for 12 months, and complete remission in 5 patients, improvement in 3 others and relapse in 2 were observed. Conclusion Non-myeloablative Cord blood stem cell treatment for hormone resistent ulcerative colitis , safe and effective, is of help to relieve symptoms, heal lesions, improve histology, decrease DAI. Therefore, corticosteroid can be withdrawn.
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Objective To investigate the role of bone marrow mesenchymal stem cells (MSC) in early acute necrotizing pancreatitis (ANP) complicated with multiple organ dysfunction (MODS). Methods Fifty Sprague-Dawley (SD) rats weighing 180 ～ 220 g were randomly assigned into 5 groups (n = 10). Group A was the normal negative control without any treatment, ANP was induced in Group B rats by intraperitoueal injections with L-arginine 2.5 g/kg body weight twice, Group C received Hoechst33258 labeled autologous bone marrow mMSCs one day after ANP model induction, Group D was the group of mMSCs transplantation, in which the mice were given the isolated mMSCs via the tail vein 3 days prior to the ANP induction, Group E was the stem cell mobilized group treated by the injection of granulocyte-colony stimulating factor (G-CSF) into rats 33258 and transplanted into the arigiual cavity or via the tail vein. Three days after the injury was induced, the rats were sacrificed, the tissues of pancreas, liver and intestine were harvested and the morphological changes were examined. A part of samples were snap-frozen and the presence of labeled MSC in the cryostat prepared was examined directly by fluorescence microscopy. The positive sections were chosen for further immunofluorescence assay. Anti-CK19 immunofluorescence staining was performed in pancreatic and liver sections;and Pan Cytokeratin immunofluorescence staining were performed in intestinal sections. The mortality rates within 30 days were recorded. Results The control group had normal tissue structures, with no death. 3 hour after ANP induction, there were mass hemorrhagic ascites, pefi-pancreas saponification, pancreatic disorganization, necrosis, phlogocyte infiltration;liver and intestine involvement and necrosis in rats in Group B and C with a mortality rate 40%. 3 hour after ANP induction, there were less ascites, mild pancreatic edema, intact acinns lobula, no interstitial tissue exudation, less pancreatic hemorrhage and necrosis, less phlogocyte infiltration;less liver and intestine injuries in rats in Group D and E with a mortality rate 10%. The pancreatic, liver, and intestinal sections in the control group and ANP group had no flavo green fluorescence;while the sections in Group C had some flavo green fluorescence but they were negative for immunofluorescence staining;in addition, the sections in Group D and E had plenty of flavo green fluorescence and CK19 (+) cells were present in pancreatic and liver tissues and Pan Cytokeratin (+) cells were present in intestinal tissues. Conclusions MSC played an important role in the process of pathological repair in ANP complicated with MODS, autologous or transplanted MSC had protective effects.
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To study the expression of adhesion molecules on tissues and peripheral lymphoeytes in patients with ulcerative eolitis(UC),CD_(44),CD_(54)were assessed using flow cytometry in 34 UC patients and 20 healthy volunteers.Results showed that increments of CD_(44)on tissues and blood cells in UC were 20.3?8.2% and 19.4?6.3% respectively,that of CD_(54)being 37.2?8.9% and 18.3?8.9% as compared with the controls'(9.7?4.6%,7.8?4.5%,8.8?4.2% and 6.2?3.7% correspondingly,P
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Objective:To investigate the effects of mucosal strengthening treatment on preventing recurrence of closedvarices. Methods: In 264 patients with esophageal varices obliteration by banding ligation and sclerotherapy, of 136 patientswere gone on to treat with strengthening mucosa, and 128 patients without strengthening treatment. All patients had beenobserved out of hospital for 1-13 years. Results: There were no recurrence and rebleeding of esophageal varices in the groupwith strengthening treament. But in the group without strengthening treatment, 25 patients (19. 5%) had isolated or strip-like varices with red colour signI small veins grew thick and part of mucosa appeared clear hyperaemia in 21 patients(16.4% ); 6 patients (4.7% ) rebleeded. There were significant differences between two groups (P