OBJECTIVETo explore the surgical method and its effects of adjacent spinal segment degeneration after anterior cervical fusion.

METHODSFrom March 2000 to March 2011, 27 patients with spinal segment degeneration who had accepted the operation of anterior cervical fusion were treated with surgical treatment. There were 16 males and 11 females with an average age of 55.3 years (ranged from 48 to 72 years). JOA scores and image examination were used to evaluate the clinical effects.

RESULTSAll patients were followed up for 1.8 to 7.2 years with an average of 3.6 years. All pathological segments obtained fully decompression with good spinal bombe, no internal fixation loosening and cervical spine instability were found. Nerve root pain had disappeared and nerve function had significantly improved. Before operation, 3 days after operation and at last follow-up, JOA scores were 9.15 +/- 3.46, 13.96 +/- 2.79 and 13.52 +/- 2.91, respectively, and there was significant difference between preoperation and postoperation (P < 0.05). Intervertebral height and physiological curvature improved obviously than preoperation (P < 0.05).

CONCLUSIONIn order to relief spinal compression and rebuild spinal stability, a surgical treatment will be recommend to adjacent spinal segment degeneration combining spinal nerve symptoms and physical sign as soon as possible. Selecting an appropriate surgery to treat different compressed segment would receive satisfactory results.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; adverse effects

OBJECTIVETo investigate the application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis.

METHODSFrom July 2005 to June 2013, 25 patients with multi-segmental myelopathic cervical spondylosis were treated by the expanding forming under the plate through cervical spatium intermusculare approach including 16 males and 9 females with an average age of 56.5 years old ranging from 35 to 78 years old. Among them, 10 cases were onset without causes slowly, 7 cases were onset without causes suddenly, 8 cases were onset after mild trauma or tired. JOA scoring, incidence of postoperative axial symptoms and imaging studies were used to evaluate the effect.

RESULTSTwenty-five cases were followed up for 6 months to 7 years and 6 months with an average of 2 years and 9 months. There were no infection, cerebrospinal fluid leakage after the operation, and complications such as nerve damage were occurred. The operation time was 120 to 150 min, the bleeding was 300 to 500 ml. Imaging examination showed vertebral canal sagittal diameter increased, the vertebral canal increased significantly in the cross sectional area of the spinal cord, cervical curvature was straighten in 4 cases (2 cases of them became normal sequence). There were no more cases of cervical protruding and segmental instability increased. Postoperative walking ability enhanced, the finger activity of majority of patients improved on flexibility, grip strength, and accuracy of using chopsticks improved, numbness and chest waist band feeling had different degree of reduce, preoperative urine impairment were improved to varying degrees. Preoperative JOA scores were 3 to 13 points with an average of (8.86 ± 4.25) points; Postoperative 12 months' JOA scores were 7 to 17 points with an average of (13.76 ± 3.56) points, period was 60.19% in average, JOA score had statistically difference between before and after operation (P < 0.05). The result were excellent in 14 cases, good in 6 cases, and fair in 4 cases and poor in 1 case.

CONCLUSIONApplication of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis, through muscular clearance, can retain complete cervical back muscle, maintain stability of cervical spine, and vertebral canal can get effective decompression at the same time.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; Female ; Humans ; Laminectomy ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Spondylosis ; surgery

Objective To investigate the effects of lipopolysaccharide(LPS) on the expression of hypoxia inducible factor-1?(HIF-1?) and its target gene glucose transpoter-1(GLUT-1)in human monocyte lines THP-1. Methods THP-1 cells were stimulated with 1 ?g/mL LPS for 0,2,4,6 or 8 h.The expression of HIF-1? protein of THP-1 cells was detected by Western blotting,and RT-PCR was employed to detect the expression of HIF-1? mRNA and GLUT-1 mRNA.THP-1 cells were exposed to different concentrations of LPS(0,0.01,0.1 and 1 ?g/mL) for 6 h,and the expression of HIF-1? protein of THP-1 cells was detected by Western blotting. Results The expression of HIF-1? protein of THP-1 cells began to increase 2 h after being treated with 1?g/mL LPS,significantly increased after exposure for 4 h(P

To investigate whether accelerated blood clearance (ABC) phenomenon could be induced after repeated injection of mitoxantrone thermosensitive liposomes, LC-MS/MS and enzyme linked immunosorbent assay (ELISA) were used to measure the concentration of mitoxantrone and the anti-polyethylene glycol (PEG) IgM levels in rat plasma, separately. The drug was rapidly cleared away after the second administration. The anti-PEG IgM was detected after the first dose which was neutralized quickly after the second dose. It is proved that repeated administration of mitoxantrone thermosensitive liposomes in rat caused the ABC phenomenon.
Animals ; Antineoplastic Agents ; administration & dosage ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; Immunoglobulin M ; blood ; Liposomes ; administration & dosage ; blood ; pharmacokinetics ; Male ; Metabolic Clearance Rate ; Mitoxantrone ; administration & dosage ; blood ; pharmacokinetics ; Polyethylene Glycols ; administration & dosage ; chemistry ; pharmacokinetics ; Rats ; Rats, Wistar ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) with different imaging changes in children.Methods Hospitalized patients with MPP during September 2012 to August 2013 in Beijing New Century Children's Hospital were retrospectively reviewed.The data including clinical features,laboratory tests,treatment and prognosis were collected.The patients were divided into 3 groups according to the radiological findings,including interstitial infiltration (group 1),intralobular infiltration (group 2) and segmental or larger infiltration (group 3).The clinical data were compared among the 3 groups.Results The percentages of patients in the 3 groups were 18.8％ (36/191 cases) in group 1,39.8％ (76/19 cases) in group 2 and 41.4％ (79/191 cases) in group 3,respectively.In 144 cases of MPP patients older than 3 years old,48.6％ (70/144 cases) were segmental or larger infiltration.The incidence of higher fever,hypoxemia and elevated C-reaction protein and lactate dehydrogenase in group 3 [50.6％ (40/79 cases),87.3％ (69/79 cases),78.5％ (62/79 cases),29.1％ (23/79 cases)] were higher than those in group 1 [5.6％ (2/36 cases),61.1％ (22/36 cases),19.4％ (7/36 cases),0] and group 2 [10.5％ (8/76 cases),67.1％ (51/76 cases),14.5％ (11/76 cases),3.9％ (3/76 cases)],and the differences were significant(all P ＜ 0.01).Patients in group 3 had higher risk of cardiac and/or liver impairment,refractory MPP,and treated by glucocorticoids and bronchoalveolar lavage [41.8 ％ (33/79 cases),29.1％ (23/79 cases),94.9 ％ (75/79 cases),50.6％ (40/79 cases)].The hospital stay was (9.48 ±3.26) d in group 1,(9.24 ±2.97) d in group 2,and (12.09 ±3.01) d in group 3,respectively,and the difference was significant among 3 groups (F =19.348,P =0.005),the hospital stay in group 3 was longer than that in the other 2 groups (t =4.210,5.931,all P =0.000),while there was no difference between group 1 and group 2 (P ＞ 0.05).Patients in group 1 with wheeze were more co-mmon,and were treated by Azithromycin earlier than that in group 3 [(5.08 ± 3.43) d vs.(4.16 ± 2.20) d],the difference was significant(t =2.498,P =0.014),while the incidence of hypoxemia was common than that in group 2 (x2 =3.176,P =0.012).Conclusions MPP patients with segmental or larger infiltration are older than patients in the other groups,and present with severe complications,higher inflammatory factors,longer hospital stay,and higher risk for refractory MPP.Glucocorticoids and bronchoalveolar lavage are usually used in these patients.Patients with interstitial infiltration are prone to manifest with wheeze and hypoxemia,and its diagnosis and treatment by Azithromycin are usually delayed.Therefore,pediatrician should pay more attention to MPP patients with different imaging changes,in order to diagnose and treat the patients timely.

Objective To evaluate the diagnostic value of dobutamine?stressed cardiac morphing ( CM) MPI ( CMMPI) for coronary artery disease ( CAD) in middle?aged patients. Methods A total of 97 middle?aged patients (52 males, 45 females, age 40-65 (52.98±7.74) years) from March 2011 to Febru?ary 2015 with chest distress, cardiopalmus and chest pain symptoms ( suspected CAD) were retrospectively studied. Informed consents were signed by patients before examination. All patients underwent one?day dobu?tamine?stressed/rest CMMPI and CAG within one month. The diagnostic value of CMMPI was assessed and compared with CAG. Results CMMPI revealed 42 abnormal cases and 9 normal cases in 51 cases with cor?onary artery stenosis by CAG. CMMPI found 11 abnormal cases and 35 normal cases in 46 cases with normal coronary artery by CAG. In comparison with CAG, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CMMPI were 82.35%(42/51), 76.09%(35/46), 79.38%(77/97), 79.25%(42/53)and 79.55%(35/44) respectively. The side effect was slight and transient with an inci?dence of 82.47%(80/97). Conclusion The dobutamine?stressed CMMPI has an important value for the diagnosis of CAD and the assessment of myocardial damage in middle?aged patients.

Objective To discuss prenatal ultrasound features and fetal outcomes of meconium peritonitis.Methods This is a retrospective study of all cases of fetal meconium peritonitis (n=26) registered in the Department of Obstetrics,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 1,2004 to December 31,2014.Prenatal ultrasound features,surgical findings and fetal outcomes were discussed.Variance analysis,Chi-square test or Fisher's exact test were applied for statistics.Results Among the 26 cases,25(96.2％) were diagnosed prenatally,24 (92.3％) underwent neonatal surgery,and 24 (92.3％) survived.Prenatal ultrasound findings included bowel dilatation (88.5％,23/26),intra-abdominal calcification (42.3％,11/26),fetal ascites (30.8％,8/26),intra-abdominal pseudocysts (15.4％,4/26) and polyhydramnios(50.0％,13/26).Surgical findings confirmed the diagnosis of meconium peritonitis was due to jejunal atresia[16.7％(4/24)],ileal atresia[75％(18/24)],and atresia of jejunal and ileal junction [8.3％(2/24)],respectively.However,no statistical significance was shown in the incidence of bowel dilatation,intra-abdominal calcification,fetal ascites,pseudocysts and polyhydramnios among the three groups of different etiology (all P＞0.05).Conclusions The prenatal ultrasound features of meconium peritonitis may vary a lot.But bowel dilatation combined with intra-abdominal calcification,fetal ascites or pseudocysts prompts the diagnosis of meconium peritonitis.Early surgical intervention in neonatal period could reduce the neonatal mortality remarkably,thus comprehensive and standardized perinatal management are necessary to improve fetal outcomes.

Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .

Objective To investigate the serum asymmetric dimethylarginine (ADMA)expression in patients with acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction admitted to the Department of Neurology,the First Affiliated Hospital of Xi′an Medical College from March 2013 to August 2015 were enrolled retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS)scores,they were divided into three groups:mild infarction (n =21;<4),moderate infarction (n =49;4 -15),and severe cerebral infarction (n = 30;> 15);100 healthy subjects without cerebrovascular disease in the same period were used as a control group. Enzyme linked immunosorbent assay was used to detect the plasma ADMA concentration,and the levels of plasma ADMA among the groups were compared. Results The concentrations of plasma ADMA of the mild,moderate,severe cerebral infarction,and the control groups were 0. 80 ± 0. 16,1. 14 ± 0. 28,1. 33 ± 0. 33,and 0. 52 ± 0. 16 μmol/ L,respectively. There were significant differences among the groups (F = 2. 32,P < 0. 05). Multivariate logistic regression analysis suggested that ADMA was an independent risk factor for cerebral infarction (OR,1. 140,95% CI 1. 078 -1. 212,P = 0. 045). Conclusions The expression levels of plasma ADMA increased gradually in patients with mild,moderate,and severe cerebral infarction. The higher the ADMA levels,the severe the neurological deficit would be. ADMA might be an independent risk factor for cerebral infarction.