[Objective]To compare the short term outcome in treatment of degenerative lumbar stenosis with Coflex implant versus laminectomy and posterior interbody fusion along with pedicle screw system. [Methods]Thirty patients with degenerative lumbar stenosis were randomly divided into two groups.Fifteen patients in the control group were treated with laminectomy and posterior interbody fusion along with pedicle screw system. The other 15 patients in the experiment group were treated with Coflex implant. The parameters for assessment included operation time,intraoperative blood loss,hospital stay,pre- and postoperative JOA score,improvement rate and complication rate.[Results]Compared to the control,significant reduction was found in terms of operation time,intraoperative blood loss,and hospital stay in the experiment group.No significant difference was found regard to the improvement rate and postoperative JOA score. In addition ,there was no complication in the Coflex group during the follow-up.[Conclusion]Coflex implant is an effective,save and minimally invasive surgical method for the treatment of degenerative lumbar stenosis.

BACKGROUND: Many studies thought that predegenerated nerve graft (PNG) is superior to fresh nerve graft (FNG).OBJECTIVE: To observe the effect of predegeneration on nerve functional recovery from histological,immunocytochemical,electrophysiological and microstructural aspects based on predegenerated nerve graft to common peroneal nerve at different time periods.DESIGN: Grouping and controlled experiment SETTING: General Center of Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University of Chinese PLA MATERIALS: Totally 42 rabbits, with body mass ranged from 2.3 to 2.6 kg,of either gender, were used in this experiment METHODS: This experiment was conducted at the General Center of Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA in 1996. Totally 42 rabbits were divided into 7experiment groups A, B, C, D, E, F, G for nerve grafts of different predegenerated periods. In groups A, B, C, D, E, F, both side of the rabbits peroneal nerves were allowed to undergo predegeneration for 0, 4, 7, 14,21, 28 days; common peroneal nerve of the rabbits in the Groups B, C, D,E and F were cut off; The skin of the animals in Group A was cut open,exposed but the nerve was not cut off. Only the right common peroneal nerve in Group G was cut off. The cut nerve in Groups B, C, D, E and F were re-exposed respectively at 4,7,14,21 and 28 days after operation. 1.5 cm-length degenerated distal nerve segment was chosen for transplantation and reparation contrafateral nerve. Two sides were transplanted mutually. Common peroneal nerve in Group A was re-exposed 2 weeks later, 1.5 cm-length nerve segment was cut in the same way for mutual transplantation. In Group G, the predegenerated nerve segment of the right side was transplanted to the fresh receptor of the left side 2weeks later. The fresh nerve segment of left segment was transplanted to degenerated receptor of the right side.Histological observation, passing rate of axon counting shortened significantly the initial delay period of axonal regeneration (from 3.04 to 0.04 day), accelerated the axonal growing rate (1.73-2.59 mm/d)as compared with FNG; Electrophysiological study showed that N-MCV in the Groups D, C and B was the fastest, followed by Group A and Group E,Group F was the slowest; there was no significant difference in passing rate appeared in the animals of Group D after operation, middle-quantity of myelin sheaths appeared in the Group C and few myelin sheaths in the Groups A, B, and F.CONCLUSION: PNG excels FNG at decreasing initial delay period of axonal regeneration, promoting regeneration velocity of axon, boosting up passing rate of axon and enhancing N-MCV. Nerve grafting for predegenerated for 14 days can enhance significantly nerve regeneration than fresh nerve grafts, then grafts degenerated for 7 days. Grafts degenerated for 4 and 21 days can also enhance axonal regeneration lightly.

[Objective]To investtgate the specific inhibition of Survivin gene expression by antisense RNA in human osteosarcoma cell line MG63.[Method]Total RNA was extracted from osteosarcoma cell line MG63 cells using Trizol reagent.Coding sequence of Survivin was amplified from MG63 mRNA by RT-PCR and then cloned into inducible eukaryotic vector pMDNA3.After the reducible smmvm antisense vector was construted,MG63 cells were transfected with control pMDNA3 vector or pMDNA3-anti-Survivin and selected by G418.Both of the control and Survivin antisense transfectants were treated with ZnSO_4.These cells cultured on cover slips were observed through immunohisto-chemistry staining,HE staining and electrn microscopy.At the same time,the above cells were cultured and the numbers were counted every other day,thus growth curve was drawn.Apoptosis was analyzed by Annexin V stammg.[Result]cDNA coding Survivin about 420 bp was generated by reverse transcription-PCR Survivin PCR product was cloned reversal into pMDNA3 vector.The MG63 stable tansfectants with either control vector pMDNA3,or pMDNA3-anti-Survivin were established.ZnSO_4 induction of Survivin antistense RNA suppressed the expression of endogenous Survivin mRNA.The cell growth curve showed MG63/pMDNA3-anti-survivm with ZnSO_4 induction proliferated slowly than other kinds of cells(P

Objective To explore the effects of siRNA on survivin gene expression in osteosarcoma cell line MG63 using siRNA eukaryotic expression vector,and on the cell cycle of osteosarcoma.Method The specific RNA interference(RNAi)fragments targeting survivin gene were synthesized,and they were cloned into pSilencer 3.0-H1 neo plasmid vector.After the vector was constructed,MG63 cells were transfected with negative control vector or RNAi vectors and selected by G418.Expression of protein of survivin in the stable transfected cells was determined by Western blot.These cells which were cultured on cover slips were observed with electron microscopy.Apoptosis analysis was performed with flow cytometry and Hoechst staining.Results Specific siRNA eukaryotic expression vector PsiS targeting survivin gene was constructed successfully.The stable transfectants containing negative control vector and PsiS were obtained.Protein expression of survivin was inhibited significantly in MG63/PsiS cells,whereas survivin gene expression levels were hardly changed in normal MG63 and negative control cells.There were much more pyknotic nuclei found in MG63/PsiS pool than those in MG63 and control.Analysis of DNA content in PsiS transfectants revealed a 7-fold increase in the fraction of sub-G1 peak(apoptotic peak)as compared with other transfectants under the same experimental conditions(P

Objective To investigate the risk factors of cerebral hemorrhage in hypertensive intracerebral hemorrhage,and to provide a reference for clinical treatment.Methods The clinical data of 118 patients with hyper-tensive cerebral hemorrhage treated in our hospital were analyzed retrospectively.The clinical data of patients was col-lected and statistical analysis was carried out,and the risk factors of edema around the hematoma were analyzed by Logistic regression analysis.Results Multivariate non conditional logistic regression analysis showed that,the course of hypertensive cerebral hemorrhage of edema around the hematoma was the risk factor,the longer the duration,the more risk of hypertensive cerebral hemorrhage edema around the hematoma enlargement.There was no significant correlation between sex,age,bleeding site,broken into ventricles and the edema around the hematoma in hypertensive intracerebral hemorrhage.Diastolic blood pressure was a risk factor for the edema around the hematoma in hypertensive cerebral hemorrhage,the diastolic blood pressure control was not good,and the swelling of the edema around the hema-toma was increasing.While the systolic blood pressure,pulse pressure difference and hypertensive cerebral hemorrhage hematoma around the hematoma showed no obvious correlation.Use of amlodipine and vascular tension angiotensin converting enzyme inhibitor in hypertensive cerebral hemorrhage were the protective factors of edema around the hematoma, early application of amlodipine,vascular and nervous angiotensin converting enzyme inhibitor to control blood pressure helped to reduce hypertensive cerebral hemorrhage edema around the hematoma volume.Conclusion Amlodipine and vascular tension angiotensin converting enzyme inhibitors help to reduce hypertensive cerebral hemorrhage edema around the hematoma volume,while long course,poor control of diastolic blood pressure can promote hypertension cerebral hemorrhage edema around the hematoma volume increase.We should pay attention to the development of hypertensive cerebral hemorrhage and the control of diastolic blood pressure,as soon as possible to stabilize the patient's condition and avoid the expansion of the volume of edema around the hematoma.

Humans ; Maxillofacial Injuries ; therapy ; Patient Care Team

Objective:Before the radiotherapy was performed, patients with pelvic tumors were analyzed for the consistency of bladder filling in the three steps of " Immobilization" , " CT Simulation" and " X-ray Simulation" .Methods:In 2014, 105 patients (68 cases of cervical cancer, 32 cases of rectal cancer, 3 cases of vaginal cancer and 2 cases of prostate cancer) with pelvic tumor radiotherapy were randomly assigned to monitor bladder urine volume to a target urine volume of 400 ml. First, patient were exhorted to empty the bladder, and the bladder volume meter BVI 9400 was used to measure the urine volume of the patient after emptying of the bladder. The patient immediately drank about 540 ml of water and suppressed urine, measurements were taken every 0.5 h. At the same time, when the patient complained of " urgency of urine" , bladder urine volume would be measured again and the time would also be recorded. Every other half an hour (emptying, 0.5 h after emptying, 1.0 h after emptying), when complaining of " urgency of urine" , when actually performing urine volume and time were described as: U 0 and t 0, U 0.5 and t 0.5, U 1.0 and t 1.0, U t and t, U T and T. Results:There was a statistically significant difference in gender and age, and women had stronger ability to urinate than men U 1.0( P=0.003), young people had stronger ability to urinate than middle-aged U 1.0( P=0.002). In the three-step comparison, there was no statistically difference between 1 hour after emptying urine volume U 1.0( P=0.177) and the actually performing urine volume U T ( P=0.052). And the final urine volume was concentrated at 298-526 ml. After the patient emptied the urine volume and complained of " urgency of urine" , the time slot was t=(75.2±49.9) min, with the urine volume of U t=(331.2±140.3) ml. And there was no statistically difference between U t and U T ( P=0.198) at X-ray Simulation. Conclusions:The patient emptied the bladder and immediately drank 540 ml of water. After 1 hour of suppressing urine, he complained of " urgency of urine" and achieved the target urine volume (400 ml). At this time, the bladder urine volume U 1.0 was consistency in the immobilization, CT Simulation, and X-ray Simulation.

Objective To assess the effect of lumbar continued drainage (LCD) and lumbar puncture (LP) for patients with subarachnoid hemorrhage (SAH). Methods Searched Chinese and foreign databases, the randomized controlled tri-als(RCTs) about LCD/LP were included. The quality of the articles was assessed. The data was input and analyzed by RevMan 5.0 software. Results Nineteen randomized controlled trials(RCTs) (1898 patients) met the inclusion criteria. Meta analysis results showed according to GOS prognostic score, well recovery rate of LCD was better than that of LP, complication rates of LCD were lower than that of LP. Conclusion In mastering its indicatio cases, LCD is more safe and effective.