BACKGROUND:At present, humeral fractures can be mainly treated by antegrade screwed intramedul ary nail and traditional interlocking intramedul ary nail, but above methods easily induce rotator cuff injury. Results of relevant study revealed that retrograde intramedul ary nailing can solve the above problems. OBJECTIVE:To analyze biomechanical test results of retrograde improved screwed nail and to provide a basis for the further clinical use. METHODS:(1) According to the anatomical characteristics of the human humerus, specimens of humerus were subjected to biomechanical test. (2) A total of 80 cases of humeral fractures were selected from the Orthopeadic Surgery of Xi’an Red Cross Hospital Affiliated to Xi’an Jiaotong University School of Medicine from December 2013 to January 2015. Patients were randomly divided into improved nail group and prototype nail group (n=40), which were given improved nail and prototype nail, respectively. RESULTS AND CONCLUSION:(1) Anti-axial compression, anti-tension, anti-torsion, and anti-bending functions were significantly better in the improved screwed nail than in the prototype nail (P<0.05). (2) The excel ent and good rate of clinical curative effects was significantly higher in the improved nail group than in the prototype nail group. No infection, metal fracture or internal fixation loosening occurred in al patients of the two groups. These findings suggest that compared with traditional screwed nail, retrograde improved screwed nail had more advantages, more reasonable biomechanical design, more simple operation, and lower incidence of complications, so it is fit for clinical application.

Objective To explorer effect of integrated traditional chinese and western medicine on hyperthyroidism and on blood glucose metabolism disorder. Methods 70 cases of patients with hyperthyroidism during March 2014 to March 2016 were randomly divided into two groups with 35 cases respectively ,and control group were treated with propylthiouracil,while observation group were treated with traditional chinese medicine on the basis of the control group.Before and after treatment,serum thyroid stimulating hormone(TSH), triiodothyronine(FT3), thyroxine(FT4 ) and fasting plasma glucose (FPG) , 2 hours postprandial blood glucose(2hPG)were detected respectively,the curative effect and adverse reactions were observed. Results After treatment,the levels of TSH,FT3 and FT4 of the both two groups were significantly ameliorative (P<0.05),and FT3 ,FT4 of the observation group were significantly more ameliorative than the control group (P<0.05).The levels of FPG,2hPG of two groups were significantly depressed (P<0.05),and those of the observation group were significantly lower than those of the control group (P<0.05).The clinical effective rate of the observation group was significantly higher than those of the control group (P<0.05).Adverse reactions of two groups were not significantly different. Conclusion The treatment of hyperthyroidism with traditional chinese and western medicine can significantly improve the clinical curative effect and regulate the blood glucose metabolism, and the safety is high.

Objective To discuss the surgical effect of adult lipomatous tethered cord syndrome (TCS). Methods The clinical data of 29 patients with adult lipomatous TCS were systematically analyzed. Eleven of male and 18 of female,who ranged from 20 to 59 years. All patients were performed filum terminale release and lipoma excision, the clinical outcome after operation was analyzed according to Hoffman grading criteria and visual analog scale (VAS). Results According to Hoffman grading criteria, 9 cases were obviously improved in leg muscle weakness, including 1 case with urination disturbance improved significantly. Also the lower back pain of patients were improved obviously: (2.63 ± 1.30) scores vs. (8.67±0.30) scores, there was significant difference (P<0.05). Conclusions Filum terminale release and lipoma excision can effectively improve the symptom of lower back pain of adult lipomatous TCS patients, meanwhile the symptom of paraparesis can improve appropriate postoperatively. But urinary deficits do not show a significant change.

Objective To determine the relation between the graduation and type of Modic change and low back pain. Methods Ninety-seven patients with low back pain associated with Modic change were enrolled, and the data of clinical were analyzed. The degree of back pain was evaluated by visual analog score (VAS) and Oswestry disability index (ODI). The relation between Modic change and the degree of low back pain was evaluated. Results In 97 patients, the type of Modic change:28 cases (28.9%) were type Ⅰ, 37 cases (38.1%) were type Ⅱ, 11 cases (11.3%) were Ⅱ/Ⅲ, and 21 cases (21.6%) were type Ⅲ. The graduation of Modic change:39 cases (40.2%) were minimal, 34 cases (35.1%) were moderate, and 24 cases (24.7%) were severe. The VAS of type Ⅰ, type Ⅱ, typeⅡ/Ⅲand typeⅢin patients with Modic change were (3.8 ± 0.4), (2.6 ± 0.2), (1.7 ± 0.5) and (1.0 ± 0.6) scores, and there were statistical differences (P<0.05). The ODI scores of type Ⅰ, type Ⅱ, type Ⅱ/Ⅲ and type Ⅲ in patients with Modic change were (11.8 ± 0.7), (8.4 ± 1.1), (5.7 ± 1.3) and (2.0 ± 1.0) scores, and there were statistical differences (P<0.05). Spearman correlation analysis result showed that the type of Modic change was negatively correlated with the intensity of low back pain (r=-0.342, P<0.01). There were no statistical difference in VAS and ODI score among the patients with minimal, moderate and severe of Modic change (P>0.05). Spearman correlation analysis result showed that the graduation of Modic change had no correlation with the intensity of low back pain (r = 0.351, P>0.05). Conclusions The graduation of Modic change does not directly correlate with the low back pain, but the type of Modic lesion is more important.

Objective To investigate the application effect of zoledronic acid on PKP after osteoporotic vertebral compression fractures. Methods According to different treatment methods, 80 cases of patients from January 2015 to January 2017 in Xi'an City, Hong hui Red Cross hospital diagnosis and treatment of osteoporotic vertebral compression fractures parallel PKP were divided into two groups. The patients in the control group were not treated with zoledronic acid, and the patients in the observation group were treated with zoledronic acid.The treatment effect and adverse reaction rate were compared between two groups. Results The treatment effect of the observation group was better than that of the control group, and the improvement of the clinical symptoms of the observation group was better than that of the control group, and the incidence of adverse reactions was lower than that of the control group, the difference was statistically significant (P<0.05). Conclusion The effect of zoledronic acid treatment on osteoporotic vertebral compression fractures after PKP is remarkable, which can effectively improve the patients' clinical symptoms, less adverse reactions, is widely used in clinical osteoporotic vertebral compression fractures after PKP holds.

Anxiety disorder is one of the most common mental disorders and seriously impairs the physical and mental health of patients. Due to the efficacy of acupuncture for tranquilization, acupuncture displays its unique advantage on the treatment of anxiety disorder, but the relevant biological mechanism has not been elaborated. The modern medicine study has proved that the heart and brain have their own independent natriuretic peptide (NP) system. The dysfunction of ANP and its receptor are closely related to the occurrence of anxiety disorder. The ANP acts on anti-anxiety. Hence, focusing on the three aspects, named the anti-anxiety effect of acupuncture based on its tranquilizing effect, the anti-anxiety effect of ANP and the positive regulation of acupuncture on NP, the mechanism on ANP and its receptor was explored in anti-anxiety with acupuncture based on tranquilizing effect, and the idea was put forward on that the anti-anxiety effect of acupuncture was possibly based on its action of tranquilization through regulating the ANP and its receptor. As a result, it is expected to provide the theoretic support for the mechanism study on anti-anxiety with acupuncture based on its tranquilizing effect.
Acupuncture Therapy ; Animals ; Anti-Anxiety Agents ; metabolism ; Anxiety ; metabolism ; therapy ; Atrial Natriuretic Factor ; metabolism ; Humans ; Receptors, Atrial Natriuretic Factor ; metabolism

Objective To observe the efficacy of posterior atlantoaxial fusion for C1/C2 fractures combined with ponticulus posticus.Methods A retrospective case series review was performed on data of 12 cases of C1/C2 fractures combined with ponticulus posticus treated from January 2008 to January 2014.There were 7 males and 5 females,aged 35.5 (23.5-49.25) years.Three cases were diagnosed with C1 lateral mass fractures combined with other injury,seven type Ⅱ odontoid fractures,and two type Ⅲ odontoid fractures.Nine cases whose C1 pedicle height ≥4 mm in both sides underwent posterior C1-C2 screw-rod fixation and fusion,and three cases whose C1 pedicle height was ＜ 4 mm underwent posterior C1-C2 hook-screw fixation and fusion.Operation time,blood loss and complications were recorded.Variations in American Spinal Injury Association (ASIA) grade and Visual Analogue Scale (VAS) were compared before operation and at final follow-up.Position of internal implant,fracture healing and fusion were observed.Results Surgery was successful in all cases.Operation time was 145 (120-160) min,and blood loss was 200 (200-300)ml.No intraoperative injury to the vertebral artery injury,venous plexus,spine and nerve root occurred,and no cases showed ponticulus posticus after operation.Follow-up period was 24 (12-33) months.Postoperative imaging demonstrated satisfactory implant placement in all eases.Before operation,one case was rated as ASIA grade A,two as grade D and nine as grade E.One case was rated as ASIA grade A and 11 as grade E at the final follow-up.VAS was improved from preoperative 7 (6-8) points to 0(0-1) points at the final follow-up (P ＜ 0.05).Fracture healing and fusion were observed in all cases at the final follow-up.Conclusion Posterior atlantoaxial fusion for C1/C2 fractures combined with ponticulus posticus is a safe and effective procedure that can promote fracture union without increasing the risk of vertebral artery injury.

BACKGROUND:Animal studies have shown that cauda equina compression can induce apoptosis of lumbosacral spinal cord anterior horn motor neurons.
OBJECTIVE:To explore the pathological change in lumbosacral spinal cord after acute cauda equina compression in dogs.
METHODS:A total of 27 dogs were randomly divided into nine groups, with three dogs in each group. There were one normal control group, seven experimental groups and one sham surgery group. In the experimental group, an empty water sac was implanted above epidural fat below L6 vertebral plate. Compression was given by injecting water at 4, 8, 12, 24, 48, 72 and 168 hours. In the sham surgery group, an empty water sac was implanted, but compression was not given. At the time of compression, the spinal cord sent out by cauda equina nerve and adjacent to the head end was subjected to histopathological examination.
RESULTS AND CONCLUSION:(1) Results of light microscope:at 4-48 hours of compression, spinal cord anterior horn motor neurons did not alter. At 72 hours, motor neurons became smal , cel membrane shrank and separated from surrounding tissues. Cel s were homogenous and darkly stained. At 168 hours, motor neurons disappeared, but spinal cord sections of the adjacent head end did not shown abnormal motor neurons in the spinal cord anterior horn. (2) Results of electron microscope:at 12 hours, spinal cord tissue began to swel , and the swel ing aggravated with prolonged time of compression. The swel ing of glial cel s was apparent. At 168 hours, myelin sheath structure dissolved;axons showed vacuolization;axoplasm spil ed, and exhibited inflammatory injury-like changes. (3) Apoptotic results of spinal cord anterior horn motor neurons:apoptosis appeared at 12 hours of compression, became increased, and showed an increased trend at 168 hours.

Objective In order to improve the medical quality of our hospital,we adopted the method to strengthen the construction of key disciplines.Methods Xi'an Honghui hospital were retrospectively analyzed from 2008 to 2008 in order to improve medical quality,to take in the discipline construction of main methods and results,and tries to summarize.Results The clinical medical treatment,teaching,scientific research and human resources allocation,etc.Work with key subject as the center,to other disciplines has played a significant radiation and driving effects,medical quality and level are improved significantly.Conclusions The key subject is the inner motive power of sustainable development of the hospital,is one of the important elements to build hospital brand,discipline construction is the key to promote the development of the hospital,is the core and soul of hospital management.

OBJECTIVETo analyze the effects of acupuncture on the level of atrial natriuretic peptide (ANP), C-type natriuretic peptide (CNP) in adrenal gland and the content of corticosterone (CORT) in plasma in rats withchronic emotional stress anxiety, and to explore the partial action mechanism of acupuncture on anxiety disorder.

METHODSThirty-two healthy Sprague-Dawley (SD) rats, after 7 days of feeding and domestication, were randomly divided into a blank group (10 rats), a model group (11 rats) and an acupuncture group (11 rats). The rats inthe model group and acupuncture group were treated with unpredictable chronic emotional stress (CES) method toestablish the model of anxiety. Rats in the acupuncture group were treated with acupuncture at "Neiguan" (PC 6)and "Shenmen" (HT 7), once every other day, 30 minutes each time. The model establishment and treatment lasted 15 days. Rats in the blank group were treated with identical immobilization but no treatment was given. Theelevated plus maze was used to test the behavioral changes of rats with anxiety; the level of CORT in plasma wasdetected by ELISA, and the expression level of CNP and ANP in adrenal cortex and medulla was detected by immunohistochemical method.

RESULTS(1) The percentage of open-arms time in total time (OT%) in elevated plus maze in the model group was significantly lower than that in the blank group (P<0. 05); the OT% in the acupuncture group was significantly higher than that in the model group (P<0.01). (2) The content of CORT in plasma in the model group was higher than that in the blank group (P<0. 05), while that in the acupuncture group was significantly lower than that in the model group (P<0. 05). (3) The expression of ANP in adrenal medulla and cortex in the model group was lower than that in the blank group (P<0. 01), while the expression of CNP in adrenal medulla and cortex in the model group was higher than that in the blank group (P<0. 01).

CONCLUSIONThe effects of acupuncture against anxiety are likely to be related to the regulation on the expression of ANP and CNP in adrenal medulla, affecting the release of CORT and inhibition on the activity !f hypothalamic-pituitary-adrenal axis (HPA axis).

Acupuncture Therapy ; Adrenal Glands ; metabolism ; Animals ; Anxiety ; blood ; psychology ; therapy ; Atrial Natriuretic Factor ; blood ; metabolism ; Behavior, Animal ; Corticosterone ; blood ; Humans ; Male ; Natriuretic Peptide, C-Type ; blood ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological