BACKGROUND:We previously demonstrated that the acid fibroblast growth factor/fibrin gelatin implantation could greatly relieve denervated motor end-plate degeneration and myatrophy. OBJECTIVE:To study the effect of acid fibroblast growth factor/fibrin gelatin on preventing denervated motor end-plate degeneration using immunohistochemical method. DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed in Zhujiang Hospital,Southern Medical University from June to December 2006. MATERIALS:A total of 24 SD rats of clean grade were randomly divided into three groups:acid fibroblast growth factor/fibrin gelatin group,fibrin gelatin group,and blank control group,with 8 rats for each group. METHODS:Under the general anesthesia,right common peroneal nerves of rats in each group were cut off 1 cm away from the nerve muscle entry point. Acid fibroblast growth factor/fibrin gelatin group,perilemma was sutured and the compound was implanted into spatium intermusculare around denervated tibial muscle nerve region;fibrin gelatin group,perilemma was sutured and fibrin gelatin was implanted;perilemma was sutured without medication in the blank control group. MAIN OUTCOME MEASURES:After 6 weeks,neuromuscular junction of tibial muscle branch of common peroneal nerve and its peripheral muscles were separated. Acidic fibroblast growth factor receptor was detected by SP immunohistochemistry to observe expressive site of acidic fibroblast growth factor receptors,and count positive blood capillary. Gray scale of the acidic fibroblast growth factor receptor was detected using image analysis system. RESULTS:The acidic fibroblast growth factor receptor was mainly located in capillary vessel wall. High density of expressing area of acidic fibroblast growth factor receptor and intensive capillary vessels were in acid fibroblast growth factor/fibrin gelatin group. In contrast,low density of masculine expressing site of acidic fibroblast growth factor receptor in capillary vessel and rare capillary vessels were in fibrin gelatin group and blank control group. The positive percentage of acidic fibroblast growth factor receptor expression of capillary vessels in acid fibroblast growth factor/fibrin gelatin group was higher than fibrin gelatin group and blank control group. The expressing amount of acidic fibroblast growth factor receptor in acid fibroblast growth factor/fibrin gelatin group was also higher than fibrin gelatin group and blank control group CONCLUSION:Acidic fibroblast growth factor can protect motor end-plate by improving the surrounding blood circulation.

[Objective]To analyse the imaging findings of thoracic and lumbar fibrous dysplasia and evaluate the imaging characteristics.[Method]Among 5 cases of monostotic fibrous dysplasia of thoracic and lumbar spines,4 were imaged with CT scaning,2 with MRI and 5 with X-ray.All materials were analysed.[Result]Each X-ray revealed a round or oval radiolucent lesion surrounded by a distinct and thick rim of sclerosis.CT showed a round or oval low-density lesion with a high-density borderline between the lesion and normal vertebral bone tissue.Bone cortex remained intact in all cases.The lesion showed homogeneous long T1 signal on T1WI and hypo-or isointensity signal on T2WI.There was a characteristic hypointensity loop surrounded the lesion on T1WI,T2WI and PdWI.The lesion was demonstrated obviously in the contrast enhancement of scanning.[Conclusion]Monostotic fibrous dysplasia of thoracic and lumbar spine shows distinctive imaging characteristics that are different from dysplasia of limb bone or skull.These characteristics are decisive in the diagnosis of the lesion.

The X-ray radiograph, CT scan and MRI appearance of 5 patients with pathologically proven fibrous dysplasia in thoracic and lumbar spine vertebrae were retrospectively analyzed. Plain radiographs, CT scans and MR images showed the presentation of eccentric lesion with intact cortex bone and marginal sclerosis in vertebral bodies without involvement of vertebral appendix and extraosseous soft tissue. The lesion masses were round (one being oval-shaped) and radiolucent in plain radiographs and CT scans. Homogeneous long signal was observed on T1 weighted image and strongly enhanced when gadolinium was administered. On T2 weighted MRI, short signal was found in the anterior part of the mass, long signal in the posterior part, and short and slight long signal in the middle part, without partitioning and laminating change. There was a good correlation between radiological features and surgical findings. These findings may be useful to diagnose fibrous dysplasia in spine.
Fibrous Dysplasia, Monostotic/diagnosis ; Fibrous Dysplasia, Monostotic/*radiography ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Retrospective Studies ; Thoracic Vertebrae ; Tomography, X-Ray Computed ; Young Adult

0.1), while in Yunnan Baiyao group, there were significant reductions in all scores (P

Objective To retrospectively describe the technique and review the surgical results of OsteoMed M3 titanium plate and screws used to secure the posterior elements in the open position after expansive unilateral opendoor laminoplasty.Methods Twenty-six patients with multilevel cervical disc herniation and canal stenosis were treated with an expansive unilateral open-door laminoplasty with OsteoMed M3 plate and screws.The follow-up period was over 1 year.The improvement of spinal function after surgeries under JOA was evaluated to analyse the effects and releated factors.Results All of 26 cases' follow-up period was over 1 year.The mean JOA score increased significantly from 9.40 ± 1.658 ( range,5 to 13 ) points before surgery to 13.80 ± 1.958 ( range,7 to 16) points at final follow- up ( t =- 21.137,P =0.000 ).Mean recovery rate was 57.9％.Postoperative radiography,magnetic resonance imaging and computed tomography scan demonstrated significantly increased sagittal diameter and canal expansion.Two cases without relief of nurological symptoms underwent an additional anterior multilevel corpectomy.One case with ossification of the posterior longitudinal ligament had not good enough neurologic improvement after surgery.No neurologic deterioration owing to hinge reclosure or major surgery-related complications were observed.It would reduce the recovery for those with old age,long history,worse symptoms,cervical kyphosis and abnormal signal in MR imaging.It was good for patients to do early active cervical exercises after surgery.Conclusion Unilateral open- door laminoplasty with OsteoMed M3 titanium plate and screws fixation effectively maintains expansion of the spinal canal and resists closure while preserving alignment and stability.This modified technique is easy to perform with a low complication,is and economic,and is good for clinical application.

Objective To observe the effect of early rehabilitation therapy on recovery from reoperation for recurrent lumbar disc herniation (RLDH).Methods Sixty-five cases who received surgery for RLDH between 2007 and 2009 were randomly divided into a rehabilitation group and control group.Both groups were treated with the same surgical approach and routine treatment.Early and comprehensive rehabilitation therapy was provided in the rehabilitation group during the perioperative period,including preoperative and postoperative muscle strength training,postoperative sitting and standing balance training,and acupuncture.The control group was instructed only in general exercise.Before the operation and 2 weeks and 3,6,12 and 24 months afterward,the surgical outcomes of all cases were assessed using the JOA score and the improvement rate in the JOA score.Any postoperative complications and intervertebral fusion were also observed.Results The average postoperative JOA scores of both groups were significantly higher than their preoperative scores.At all of the time points after the operation,the average JOA scores and all improvement rates in the rehabilitation group were significantly higher than those in the control group.Postoperative complications such as deep venous thrombosis,urinary retention and constipation were significantly less among the rehabilitation group than among the controls.All the intervertebral bone implants were well fused on time.Conclusion Early rehabilitation can significantly improve the effectiveness of RLDH reoperation and reduce the incidence of postoperative complications.It is recommended for clinical application.

ObjectiveTo investigate the biomechanical characteristics of different types of fixation with bioactive cervical fusion cage made of hydroxyapatite and poly L-lactic acid in cervical spinal fusion.MethodsIliac crest bone,bioactive cervical fusion cage and bioactive cervical fusion cage with plate fixation were used for anterior interbody implants after anterior discectomy across C5-6 in six fresh human cervical spine specimens respectively,and the range of motion of the cervical vertebrae interbody fusion were measured through the motional stability test.Results After discectomy,Bioactive Cervical Fusion Cage with plate fixation exhibited a significant increase in stability and a decrease of range of motion in angular motion than others in all motional directions ( P ＜ 0.005 ). Bioactive cervical fusion cage exhibited a decrease in stability and an increase of range of motion (6.25 ± 0.29) in angular motion than the intact spine (5.76 ± 0.40) in extension,but the difference was not significantly ( P ＞ 0.05 ).Bioactive cervical fusion cage exhibited a decrease in angular motion than iliac crest bone and a significant increase in stability in all motional directions except extension (P ＜ 0.005).ConclusionsBioactive cervical fusion cage' s biomechanical performance was excellent and bioactive cervical fusion cage with plate fixation was excellent in stability in all motional direction,and could remain initial stability of cervical vertebrae.

Objective To assess the feasibility and clinical results of video-assisted high anterior transcervical approach (Smith-Robinson) in treatment of spinal lesions of the craniovertebral junction. Methods Between April 2007 to October 2009, nineteen consecutive patients with spinal lesions of the craniovertebral junction were included in the study. There were 9 males and 10 females aged from 16 to 62 years old with a mean of 32 years. The primary pathologies included 4 cases with chronic odontiod fracture, 2 cases with purely irreducible atlantoaxial dislocation, 6 cases with os odonteideum, 1 case with Marfan synd rome, 1 case with primary basilar invagination from Kippel-Feil syndrome, 3 case with axis tumor and 1 case with irreducible rheumatoid atlantoaxial dislocation. All of the patients underwent combined video-assisted high anterior transcervical procedure and posterior fixation at one-stage. The anterior procedure included atlantoaxil release and reduction (8 cases), odontoidectomy (8 cases), and intralesional extracapsular excision and reconstruction (3 tumor cases). The posterior technique were C1-C2 pedicle screw fixation (13 cases), C1-C3 pedicle screw fixation (2 cases), and occipitalcervical fusion (4 cases). Results Anatomical reduction was achieved in eight cases with anterior release and reduction. Tumors were completely removed in three cases with axial tumor. The mean follow-up was 14 months (6-36 months). All of them achieved solid bone fusion. In the 14 patients with symptoms of spinal cord dysfunction, the average Japanese Orthopaedic Association (JOA)score had improved from 9.1±3.3 preoperatively to 14.1±2.9 postperatively. The improvement rate was excellent for 7 cases, good for 5 cases, fair for lcase and poor for 1 case. One patient experienced leakage of cerebrospinal fluid which was resolved by bioprotein gelatin blocking and lumbar subarachnoid continuous drainage within 1 week. Dysphagia which occurred in 3 cases responded well to dexamethason and mannitol.No infection and hardware failure were observed. Conclusion Video-assisted high anterior transcervical procedure is a safe and effective alternative for treating spinal lesions in the craniovertebral junction.

Objective: Our purpose was to explore the change regularity of β-glucuronidase (β-G) in body of patients with Non-Hodgkin malignant lymphoma. Methods: β-G was examined synchronously both in the serum and in the tumor tissue of 13 cases patient with Non-Hodgkin malignant lymphoma by using the method of enzymlinked immunsorbent assay (ELISA) and immunohistochemistry separately. Among them, 3 cases were studied by using the immuno electron microscopic technique. Results: β-G was highly expressed both in the serum and tumorous tissue in patients with non-Hodgkin malignant lymphoma and there was obviously difference as compared with the control group (P<0.01). Conclusion: The combined detection with functional and morphological methods to β-G, it may be assistant target to early discovery and early diagnosis of Non-Hodskin malignant lymphoma.

BACKGROUND:Schwann cell is one of the major seed cells In peripheral nervous system and plays an important role in neural injury and neural disease.However,the source of Schwann cells is limited.And the purity of Schwann cells is affected due to the pollution of fibroblasts.Many purified methods have been proposed,but every one has its defect to satisfy the clinical demand.OBJECTIVE:To compare the differences among differential adhesion purified method,cold jet purified method,immunomagnetic beads selection purified method and G418 selection purified method to purify Schwann cells of neonatal rat in vitro.METHODS:Bilateral sciatic nerves of SD rats were harvested under sterile condition.Schwann cells were purified respectively using differential adhesion purified method,cold jet purified method,immunomagnetic beads selection purified method and G418 selection purified method.Cell viability was compared,and cell purity was determined by immunohistochemistry.RESULTS AND CONCLUSION:The purity of Schwann cells separated by differential adhesion method was low,but the viability was fair.The purity and viability of cells following cold jet method immunomagnetic beads selection method was high.The purity of cells separated by immunomagnetic beads selection methods was similar to that of cold jet method immunomagnetic beads selection method,but the cell viability was worse.The cell viability following G418 selection method was bad,but the purity was high.