OBJECTIVETo investigate clinical effects of three-column reconstruction via single posterior approach for the treatment of unstable thoracolumbar fractures accompanied by posterior column injury.

METHODSFrom December 2008 to May 2010,three-column reconstruction via posterior approach was implemented to 21 patients with unstable thoracolumbar fractures accompanied by posterior column injuries. There were 13 males and 8 females, ranging in age from 23 to 54 years old(averaged,35.5 years old). Injured vertebrae: 1 patient had injury in T11, 4 patients had injuries in T12, 8 patients had injuries in L1, 5 patients had injuries in L2, 3 patients had injuries in L3. The Cobb angle was (25.34 +/- 3.42) degrees. The operation time,blood loss during operation, Cobb angle and the bony fusion were observed.

RESULTSTwenty-one patients were followed up, and the duration ranged from 24 to 27 years old, with an average of 25.6 months. The operation time ranged from 135 to 275 min, with a mean of 185 min. The blood loss during operation ranged from 700 to 1 650 ml (averaged, 870 ml). All the patients had complete decompression. Postoperative Cobb angle was (4.01 +/- 2.03) degrees, and (4.34 +/- 2.38) degrees at the latest follow-up. All the patients got bony fusion.

CONCLUSIONTo the patients with unstable thoracolumbar fractures accompanied by posterior column injuries, three-column reconstruction via single posterior approach has both anterior approach and posterior approach advantages, which can obtain excellent clinical outcomes.

Adult ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; adverse effects ; methods ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; injuries ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

A bacterial strain which could grow well on the substrate of PAEs as the sole source of carbon and energy was isolated from contaminated sludge in the river of WeiFang in ShangDong province and it was designated as JDC-3. Based on the morphology,biophysical and biochemical properties as well as molecular characteristics,this isolate was preliminarily identified as Delftia sp.. A fragment of phthalate dioxygenase gene was successfully amplified from the genus of Delftia for the first time using a set of degenerate primers. Meanwhile,the degradation capability of JDC-3 was determined by HPLC using DMP as test substrate. The results showed that the optimal pH and temperature were at 7.0～8.0 and 30?C～35?C respectively. The degradation kinetics of JDC-3 was studied in different initial DMP concentration under optimal conditions. The results indicated that the degradation dynamic equation was ln C =-0.06837 t + A when DMP concentration was lower than 300 mg/L,with half life of 12.48 h. The degradation rate decreased and half life of JDC-3 prolonged as the initial concentration kept on increasing.

Objective To assess the effective length of jejunal graft when the 3~(rd) intestinal artery is u- tilized as vascular pedicle and afford a reliable theoretic base for clinical esophageal reconstruction.Methods In 32 formalin preserved and 21 fresh cadaver specimens,the diameter of 1st to 5th intestinal arteries and diameter of arterial arches are measured with linear calibre.Measure the length of jejunum that can be harves- ted as graft when the arches are extended.In the 21 fresh specimens,the 1st,2nd,4th and 5th intestinal ar- teries are ligated,acetic ester stained with red dye were injected into the lumen of 3rd intestinal artery via catheter.Extent of distribution of the arteries to the jejunum was observed.And then red ABS solution was in- jected into the 3rd intestinal artery to make into cast specimen.The blood supply distribution of jejunum through 3rd intestinal artery-arterial arch and communicating system were observed again.Results The di- ameter of the 3rd intestinal artery was the largest among the 1st to 5th intestinal arteries.The length of jejunum vascularized by 3rd intestinal artery can be as long as (142.2?62.3) (69.0～206.60cm) in acetic ester in- filtrated specimens.While in ABS east specimen,the average available extent of donor jejunum was(30.8?7.3) (23.0～37.3cm).Conclusion As observed by this applied anatomy study,the jejunum graft vascu- larized by 3rd intestinal artery alone has sufficient length to meet the need of esophageal reeonstrution.

Objective To evaluate the imaging methods,characteristics,diagnostic value of multi- slice CT urography(MSCTU)in congenital abnormities of urinary system.Methods To collect 33 urinary congenital abnormities cases in three years and to analyses these MSCTU images.All examinations were performed with a multi-slice spiral CT scanner.The patients were intravenously injected with 90 ml of Iohexol 300 with a power injector at the rate of 3 ml/s.Nephrographic-phase images were obtained at 75 s after initiation of the injection of contrast material,the appropriate delay time is according to Kidney's enhancement extent and nephrohydrosis degree.Excretory-phase images were obtained through the abdomen and pelvis from 10 min.to 23 h after initiation of the injection of contrast material without abdominal compression.Excretory-phase images were transferred to the workstation and performed maximun intensity projection(MIP),multiplanar reconstruction(MPR),volume rendering(VR),and virtual cystoscopy (VC).Results The urinary congenital abnormities diagnosed by MSCTU in 33 cases,including 1 ectopic kidney,1 horseshoe kidney,1 renal malrotaion,2 supernumerary kidneys,2 ureteral valves,2 retrocaval ureters,4 congenital megaureters,6 ureteropelvic junction stenosis,9 pelviureteric duplication malformations and 5 bladder diverticula.The displaying rate of ureter was 91%(61/66).The scanning time of excretory-phase was less than 20 seconds in All cases.The average CT value of contrast media in displayed ureter lumens was 520 HU.The postprocessing images had clear,dimensional feature and It was satisfy the diagnosis.Conclusion MSCTU has clear,dimensional feature and has strong ability of displaying total anatomy shape and tiny pathology change of congenital abnormities in the urinary system.It is a very useful method for detecting the congenital abnormities in the urinary system.

Objective To evaluate the diagnostic value of brain SPECT imaging with a novel Aβ plaque probe,131 I-2-(4'-dimethylaminophenyl) -6-iodoimidazo[ 1,2-α ] pyridine ( 131 I-IMPY) in early AD.Methods Thirteen patients with AD (3 males,10 females,age ranged 52 - 79 y),11 with mild cognitive impairment (MCI,4 males,7 females,age ranged 48 - 67 y) and 14 normal controls (6 males,8 females,age ranged 42 - 67 y) were enrolled in this study.131I-IMPY SPECT imaging was acquired in 2 -3 h after the agent injection.ROIs were drawn on cerebral lobes and cerebellum.The ratios of mean radioactivity of cerebral lobes over cerebellum (Rcl/cb) were calculated.The t-test was used for data analysis.Results In patients with MCI,Rcl/cb ratios were increased in parietal gyrus,temporal gyrus and frontal gyrus (right:1.15±0.18,1.18±0.12,1.14±0.14; left:1.16±0.11,1.19±0.18,1.15±0.09)compared with those in normal control group ( right:1.02 ± 0.12,1.05 ± 0.14,1.01 ± 0.12 ; left:1.03 ±0.13,1.05 ±0.13,1.01 ±0.14; t:2.1642 to 2.8757,all P ＜0.05).Rcl/cb ratios of basel ganglia and occipital gyms in MCI group (right:0.92 ±0.18,1.12 ±0.15; left:0.94 ±0.15,1.13 ±0.17) showed no statistical difference compared with those in normal control group (right:0.82 ±0.15,1.06 ±0.18;left:0.85 ±0.16,1.08 ±0.15; t:0.7805 to 1.4344,all P＞0.05).In patients with AD,Rcl/cb ratios were increased in parietal,temporal,basal ganglia and occipital lobes (right:1.16 ±0.19,1.24 ±0.17,1.16 ±0.13,1.14±0.11,1.23±0.10; left:1.17±0.21,1.25±0.15,1.18±0.08,1.17±0.16,1.25±0.11)compared with those in normal control group( t:2.1001 to 6.2789,all P ＜0.05).Rcl/cb ratios of parietal,temporal and frontal lobes in AD group showed no statistical difference compared with those in MCI group (t:0.1316 to 0.9806,all P ＞ 0.05 ),while Rcl/cb ratios of basal ganglia and occipital lobes in AD group were increased compared with those in MCI group ( t:2.0850 to 3.6772,all P ＜ 0.05 ).Conclusion 131 I-IMPY as a β- amyloid plaque probe for brain SPECT imaging may be potentially helpful for early diagnosis of AD.

Objective To investigate the CT findings of Madelung's disease in the head and neck region,and to evaluate the value of CT in demonstrating the Madelung's disease in the head and neck region.Methods CT findings of Madelung's disease in the head and neck region in 7 cases were analyzed retrospectively.All were males,with the age from 36 to 60 years,mean 51 years.All patients were underwent CT native scan,and enhanced CT scan was performed on 3 of them.Results CT images in the neck of all patients showed accumulation of nonencapsulated fat within the subcutaneous tissue and(or) deep to the platysma,and(or)within the spaces between the muscles.The fat deposits were ill-defined and symmetrical.In most cases the fat deposits involved the anterior part of the neck(infrahyoid and suprahyoid),submandibular region,the subcutaneous tissue of the nape and deep to the stenomastoid muscles.Conclusions Madelung's disease in the head and neck region have characteristic CT findings,and CT has great value in qualitative and quantitative diagnosis in Madelung's disease.

Objective To evaluate the efficacy and safety of memantine in the treatment of patients with Alzheimer' s disease (AD).Methods This was a 16-week,multi-center,randomized,double blind, placebo-controlled clinical trial (Study 10116).A total of 258 AD patients (MMSE score 5—18) were randomized in a 1:1 ratio into either memantine 10—20 mg/day (MEM,n=128) or placebo (PBO,n= 130) group for 16 weeks.Efficacy was primarily assessed in terms of changes of severe impairment battery (SIB) score in patients from baseline up to SIB assessment in the 16th week (16-week completers set, CS16).While ehanges of MMSE,ADCS-ADL_(19),and NPI (neuropsychiatric inventory) were evaluated as secondary efficacy parameters on both CSI6 and full-analysis set (FAS).Safety was assessed by physical examination,lab assays,ECG,and adverse events.Results 236 subjeets (CS16:MEM n=117,PBO n=119) were eligible for the efficacy assessment.No statistically significant difference between the treatments was observed on the primary and seeondary efficacy analysis,although both treatment groups had a slight increase from baseline in SIB total score.Post hoe evaluation of the data identified two bias factors that had a significant impact on the results of the pre-protoeol specified primary and secondary analyses.In a re-analysis of the data (CS16_(modified),MEM n=94,PBO n=95) excluding patient data affeeted by these factors,memantine-treated patients showed a statistically significant improvement related to placebo in the 16th week on the SIB (MEM 2.2 vs PBO 0.3,P=0.04),MMSE (MEM 1.0 vs PBO 0.1,P=0.03),and ADL (MEM 0.1 vs PBO-1.6,P=0.02) scales,indicating that memantine improved the cognitive function of AD patients and stabilized the activity of daily life.Memantine was well tolerated with an adverse event profile similar to that of placebo.Conclusion This study provides further support for pre-existing data,showing that memantine is efficacious,safe,and well-tolerated in patients with moderate to severe AD.

OBJECTIVE: To investigate the changes of anti-apoptotic protein Bcl-2 expression in neurons and activation of brain astroglial cells, and the relationship between astrocytes and neurons in mice after a single intracerebroventricular (ICV) stereotaxic injection of lipopolysaccharide (LPS). METHODS: C57BL/6J mice of different ages were divided into a control group and an experiment group. Immunohistochemistry to Bcl-2 and that to GFAP were conducted to observe the expression of Bcl-2 protein in neurons and GFAP in astrocytes in the brain at different time-points after the LPS injection. The glial cell type expressing Bcl-2 was characterized with immunofluorescence double labeling. RESULTS: GFAP-immunoreactive cells in the control mice were observed mainly within hippocampal formation, piriform, entorhinal cortex, septum, striatum, amygdaloid nucleus, subcortical white matter, as well as in the main fiber tracts. At 24 h after the LPS treatment there was no obvious difference in GFAP immunoreactivity compared with the controls. Astrocytes were markedly activated in periventricular brain regions such as hippocampus, the hypothalamic parenchyma surrounding the third ventricle, with larger cell body and hypertrophic processes 2 days after the endotoxin treatment. After the LPS injection, Bcl-2 positive cells were distributed widely in the brain, such as in the cortex (primary and secondary motor cortex, somatosensory cortex), hypothalamic parenchyma surrounding the third ventricle, diagonal band, hippocampus, septum and the red nucleus of the midbrain. At these sites, Bcl-2 induction increased significantly 2 days after the ICV LPS injection, with some subregional differences, peaking on 4th day. No immunofluorescent double labeling cells for GFAP and Bcl-2 were observed in the brain of the mice after the LPS administration, but merging GFAP positive astrocytes and Bcl-2 positive neurons were seen. Double staining for Bcl-2 and GFAP also showed that the projections of activated astrocytes were found in the sheath of Bcl-2 positive neurons 4 days after the ICV LPS administration. CONCLUSION LPS can activate astroglial cells and upregulate of Bcl-2 expression in the neurons in the mouse brain, which may participate in the administration of central nervous system to central-immunity stimulated regulation and the protective response to the inflammatory stimulus. The projections of activated astrocytes are found in the sheath of Bcl-2 positive neurons, indicating that there is close relationship between astrocytes and neurons.
Animals ; Astrocytes ; cytology ; drug effects ; metabolism ; Brain ; cytology ; drug effects ; metabolism ; Fluorescent Antibody Technique ; Glial Fibrillary Acidic Protein ; biosynthesis ; Immunohistochemistry ; Injections, Intraventricular ; Lipopolysaccharides ; administration & dosage ; pharmacology ; Mice ; Mice, Inbred C57BL ; Neurons ; cytology ; drug effects ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; Random Allocation

OBJECTIVETo investigate safe range of acetabular prosthesis angle and the optimum combination of cup and neck in the range of activities of daily living (ADL).

METHODSA three-dimensional generic parametric and kinematic simulation module of THA was developed. Range of motion (ROM) of flexion > or = 110 degrees, internal-rotation > or = 30 degrees at 90 degrees flexion, extension > or = 30 degrees and external rotation > or = 40 degrees were defined as the normal criteria for desired ROM for activities of daily living (ADL), and ROM of flexion > or = 120 degrees, internal-rotation > or = 45 degrees at 90 degrees flexion, extension > or = 30 degrees and external rotation > or = 40 degrees as the severe criteria. The range of the changes in the general head-neck ratios (GR), the femoral neck anteversion (FA), the operative anteversion (OA) and operative inclination (OI) of the cup component were 2-2.92, 0 degrees-30 degrees, 0 degrees-70 degrees, 10 degrees-60 degrees respectively. For the collodiaphyseal angle (CCD) of 135 degrees, the corresponding OA related to the OI which every 5 degrees was calculated, and described using dots and lines in a coordinate system in which OI of acetabular cup was the horizontal ordinate and OA of acetabular cup was the vertical ordinate. All data was analyzed by SAS 6.12 software.

RESULTSLarge GR greatly increased the size of safe range and it was recommended that GR be more than 2.37 when the CCD-angle was 135 degrees as it further increases the size of safezone. The size of cup safety range of the severe criteria was smaller than normal criteria. When the CCD-angle was 135 degrees, the optimum relationship between OA of acetabular and FA of the normal criteria and the severe criteria can be estimated by the formula: Y1=-0.816X1 + 39.76 (R2=0.993), Y2=-0.873X2 + 47.04 (R2=0.999) respectively.

CONCLUSIONLarge GR greatly increases the size of safe-zone and it is recommended that GR be more than 2.37, so it extends the acceptable range of error that clinicians cannot avoid it completely. The larger range of the hip motion, the smaller size of the cup safe-zone,but can retrieve by increase the GR. The OA is negative with FA.

Activities of Daily Living ; Arthroplasty, Replacement, Hip ; methods ; Humans ; Range of Motion, Articular

Objective To study the dynamic changes of the intestinal function of neurogenic bowel dysfunction rats caused by spi-nal cord injury using X-ray radiography. Methods Twenty-four female Sprague-Dawley rats were divided into control group (n=12) and spinal cord injury group (n=12). The T10spinal cord injury model was established using aneurysm clip (70 grams calibration force) for 60 seconds. The control group exposed the dura only. X-ray Barium was used to observe the dynamic changes of in-testinal function, and HE staining was used to observe the pathology of the colon before and four weeks after modeling. Results Compared with the control group, gastric emptying and intestinal transit function significantly reduced in the spinal cord injury group (P<0.05). Conclusion The spinal cord injury model can be successfully duplicated with aneurysm clip in rats; neurogenic bowel dysfunction occurs after spinal cord injury, gastric emptying and intestinal transit function are weakened.