[Minimally invasive percutaneous pedicle screw fixation for the treatment of thoracolumbar fractures and posterior ligamentous complex injuries].

OBJECTIVE: To evaluate the efficacy and safety of minimally invasive percutaneous pedicle screw for the management of neurologically intact patients with thoracolumbar burst fractures and posterior ligamentous complex injuries. METHODS: In the study, 35 patients were reviewed,including 20 males and 15 females, with an average age of 34.1 years (18 to 52), and the mean follow-up for 25.8 months (24 to 36). RESULTS: The duration of surgery was (95.8±12.3) minutes and intraoperative blood loss was (83.0±40.7) mL. There were no major perioperative complications, with the exception of 2 patients who developed a superficial wound infection. LKA and VBH were significantly improved immediately after surgery (P<0.001). No significant loss of correction was observed in all the patients(P>0.05). Screw misplacement was observed in 9/140 (6.4%) and no patient showed neurological deficit as a result of screw misplacement. CONCLUSION: The minimally invasive percutaneous pedicle screw has a good clinical outcome in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury, which could maintain the fracture reduction effectively, and minimize the iatrogenic soft tissue injury.

[Effects of glutathione ethyl ester on smoke inhalation lung injury].

OBJECTIVE: To investigate the effects of glutathione (GSH) precursor glutathione ethyl ester (GSEt) on smoke inhalation induced lung injury rats. METHODS: Sixty healthy male Sprague-Dawley (SD) rats were divided into groups by random digits table method, which included normal group, model group, GSEt high dose group and GSEt low dose group. Smoke inhalation induced lung injury rats model was established. GSEt treatments were given through intraperitoneal injection for 50 mg/kg or 150 mg/kg 5 minutes after the injury. Arterial blood gas analysis was monitored at 2, 12 and 24 hours after injury in each group. Rats were sacrificed for lungs, and bronchoalveolar lavage fluid (BALF) was collected for analysis of GSH activity; and the activity of GSH, catalase (CAT) and glutathione reductase (GR) were detected in pulmonary tissue homogenate.The changes of pulmonary tissue pathology was observed through light microscope. RESULTS: Compared to normal group, arterial partial pressure of oxygen (PaO(2)) in model group were decreased significantly in each time; the activity of GSH in BALF, and the activity of GSH, CAT, GR in lung tissue were also observed decreased significantly. Compared with model group, GSEt treatment (150 mg/kg) with the PaO(2) advanced at 12 hours (82.9±7.0 mm Hg vs. 63.9±6.5 mm Hg, P<0.05), the activity of GSH was increased at the 12 hours and 24 hours (12 hours: 2.19±0.41 mg/g vs. 0.79±0.21 mg/g, 24 hours: 1.75±0.47 mg/g vs. 0.67±0.10 mg/g, both P<0.05); the activity of CAT in GSEt low dose group (50 mg/kg) was increased at the 24 hours and the same increase was also observed in GSEt high dose group (150 mg/kg) at 12 hours and 24 hours (low dose group 24 hours: 70.1±5.5 U/g vs. 56.3±5.0 U/g; high dose group 12 hours: 90.9±8.1 U/g vs. 67.9±6.1 U/g, 24 hours: 94.7±7.7 U/g vs. 56.3±5.0 U/g, all P<0.05); the activity of GR in GSEt high dose group was increased at 24 hours (5.25±0.77 mmol/g vs. 4.37±0.64 mmol/g, P<0.05). The histological abnormality of lung tissue was alleviated after application of GSEt (150 mg/kg) 12 hours later, less inflammatory cells infiltration and no punctate hemorrhage in lung tissues. CONCLUSION: GSEt can enhance antioxidant capacity in lung tissues, it have a good protection for pulmonary injury.