[Application status and prospects of telemedicine in the field of burns].

Telemedicine refers to two or more medical institutions using communication, computer, and network technology to provide remote diagnosis, treatment, and care for patients. The necessity and feasibility of applying telemedicine are determined by the characteristics of burn injury. This paper reviewed the application of telemedicine in burn surgery at home and abroad, then analyzed the significance and problems of using this technology in the field of burns, finally forecasted the future of application of telemedicine in burn surgery.

L6H21 prolonged rats survival after limb allotransplantation by inhibiting acute rejection.

OBJECTIVE: Preventing and reducing allograft rejection play a far more important role in limb allotransplantation. We previously found L6H21 could inhibit LPS-induced (lipopolysaccharide LPS) overexpression inflammatory factors in macrophages and specifically targets to MD-2 (myeloid differential protein-2 MD-2) required for TLR4 (Toll-like receptor 4 TLR4) activation and represented an important therapeutic target in inflammatory disorders. Therefore, we evaluated the effect and explored the mechanism of L6H21 in rats' limb allograft model. MATERIALS AND METHODS: The efficacy of L6H21 was evaluated in limb allograft rats and cyclosporine (CY-A) was used as a positive control agent. T-Lymphocyte in blood was analyzed and dendritic cells (DCs) separated from spleens using flow cytometry. ELISA was used to measure serum cytokine levels. Analysis of protein expressions was performed using Western blotting. RESULTS: L6H21 reduced the risk of acute rejection and prolonged survival of limb allograft rats. At 3 d and 5 d post-transplant, the ratio of CD4+/CD8+ was decreased in L6H21 group. L6H21 suppressed the content of IL-1α at 7d, IL-5 and IL-10 at both 3 d and 7 d after transplantation. L6H21 decreased the protein expressions of IRF3, p-IRF3, P38, p-P38 and p-IκBα while increased IκBα expression and decreased the ratio of p-IRF3/ IRF3, p-P38/ P38, p-IκBα/IκBα correspondingly. CONCLUSIONS: L6H21 could reduce the risk of acute rejection and prolong the survival of limb allograft rats through inhibiting the ratio of CD4+/CD8+ in blood and serum cytokine levels and suppressing protein expressions of IRF3, p-IRF3, P38, p-P38 and p-IκBα in DCs. So, it may serve as a potential candidate for the treatment of allograft rejection.

[Comparison of the outcomes between anterior cervical discectomy and fusion versus posterior laminectomy and fusion for the treatment of multi-level cervical spondylotic myelopathy combined with cervical kyphosis].

Objective: To compare the outcomes between anterior cervical discectomy and fusion (ACDF) and posterior laminectomy and fusion(LF) for multilevel cervical spondylotic myelopathy combined with cervical kyphosis. Methods: From January 2010 to June 2014, 54 patients with cervical spondylotic myelopathy combined with cervical kyphosis underwent surgical treatment.Among them, 29 patients were underwent ACDF, and 25 patients were underwent LF in Department of spine surgery, Tianjin Union Medical Centre. The operation time, intraoperative blood loss, fusion segments, Japanese Orthopaedic Association (JOA)score, Neck Disability Index (NDI), Visual Analog Scale (VAS), change of cervical curvature, range of motion(ROM)and complications were recorded and compared between the two groups. Results: Mean operative time was (162.7±21.3)min in the anterior approach group versus (176.3±29.8)min in the posterior group(P>0.05). Mean intraoperative blood loss was (135.6±27.8)ml in the anterior approach group and (255.2±32.3)ml in the posterior approach group(P<0.05). Mean fusion levels are (4.1±0.3)in the anterior approach group and (5.3±0.5) in the posterior approach group(P<0.05). The mean preoperative JOA score were(8.3±2.7)in the anterior approach group and( 8.9±2.1) in the posterior approach group (P>0.05). Mean postoperative JOA score were(13.6±2.5) in the anterior approach group and (14.0±1.7)in the posterior approach group at final follow-up(P>0.05). Mean improvement rate was (55.7%±16.3%)in the anterior approach group and (58.3%±15.7%) in the posterior approach group (P>0.05). Mean preoperative NDI score were(33.8±11.0)in the anterior approach group and (34.4±8.7)in the posterior approach group (P>0.05). Mean postoperative NDI score were (16.9±7.5) in the anterior approach group and (15.5±8.1) in the posterior approach group at final follow-up (P>0.05). Mean VAS score were (2.9±1.5) in the anterior approach group and (2.5±1.0) in the posterior approach group before operation(P>0.05), they are improved to (1.2±1.2) and (1.2±1.3), respectively(P>0.05). Mean Cobb angle of the operative site were (-24.3±4.4)°in the anterior approach group and (-22.7±3.7)° in the posterior approach group before operation(P>0.05). At final follow-up, the Cobb angle of the operative site were (13.7±3.2)°in the anterior approach group and (6.2±4.2)° in the posterior approach group(P<0.01). Mean preoperative ROM were (29.0±6.7)°and (30.4±5.4)° in the anterior approach group and posterior approach group, respectively(P>0.05). Mean postoperative ROM were (11.7±6.5)° and (8.2±5.9)°in the anterior approach group and the posterior approach group, respectively(P<0.05). There were 16 patients with complications in the anterior approach group and 7 patients with complications in the posterior approach group(P<0.05). Conclusion: For multilevel cervical spondylotic myelopathy combined with cervical kyphosis, ACDF can restore the lordosis better, fuse less levels but have more complications compared with LF. Patients treated with LF can get as good life quality as with ACDF and have less complications although fuse more levels compared with ACDF.