Objective To evaluate the effect and feasibility of one-stage hemivertebra excision and internal fixation in treating congenital spinal deformities caused chiefly by hemivertebra through a single posterior procedure. Methods 11 cases with congenital spinal deformities caused chiefly by hemivertebra were treated by one-stage hemivertebra excision and internal fixation through a single posterior procedure between October 1998 and June 2003. There were 5 boys and 6 girls with an average age of 15.4 years (range, 2.5 to 23 years). The location of hemivertebra was at thoracic region in 4 cases, thoracolumbar region in 4 cases, and lumbar region in 3 cases. Of these cases, there were 7 cases with a fully segmented hemivertebrae, 2 cases with multiple hemivertebra, and 2 cases associated with contralateral bar or rib fusion. The average Cobb's angle of scoliosis was 60.5? preoperatively, and 3 cases were associated with kyphosis with the Cobb's angle 13?, 27? and 48? respectively. The average trunk shift was 21.2 mm(range, 4 to 36.7 mm). Internal fixations, which were used for the correction of the deformities, included TSRH in 6 cases, CD in 2 cases, China Great wall in 2 cases, and SYNERGY in 1 case. Results The follow-up ranged from 8 months to 4 years and 8 months with an average of 1 years and 10 months. The average fused vertebra was 8.4 segments (range, 2 to 11 segments). The postoperative average Cobb's angle of scoliosis was 18.7?(range, 0? to 24?), and the Cobb's angle of kyphosis was -11?, -8? and 0? respectively. The mean improvement rate was 69.1%. The average trunk shift was improved to 6.2 mm (range, 0 to 16.3 mm). There was no significant correction loss of the scoliosis, kyphosis and the trunk shift at final follow-up evaluation. The intraoperative complications included laminar and pedicle fractures in 2 cases, 1 case had exudates of incision and instability after surgery. There was no other complication happened during follow-up. Conclusion The effect of one-stage posterior hemivertebra excision and internal fixation through a single posterior procedure was satisfactory and reliable in the treatment of congenital spinal deformities caused chiefly by hemivertebra.

BACKGROUNDAlveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis (E. multilocularis) and is a rare but life-threatening disease. This disease commonly is characterized by an infiltrative, tumor-like growth of the E. multilocularis metacestode in the liver of human. Liver transplantation is an effective therapy for end-stage of hepatic AE, but the characteristics of host immunity associated with E. multilocularis infection with organ transplantation are poorly defined. We hereby aimed to study the immunological status and allograft heart survival in inbred rats with E. multilocularis infection.

METHODSRat models of AE were established by injecting the E. multilocularis suspension made from E. multilocularis infected tissues into the abdomen of Lewis (LEW) rats. Three months later, in the experimental group, allograft heart transplantation was performed from Brown-Norway (BN) rats to the E. multilocularis infected LEW rats. In the control group, we transplanted hearts from BN rats to healthy LEW rats. The influence of the disturbed immune system in E. multilocularis infected rats on the heart transplantation was assessed, including observation of allograft heart survival time, histopathological examination of grafts and immunohistochemical examination of infiltrating cells (CD4(+) T cells, CD8(+) T cells and eosinophile granulocytes), measurement of interleukin (IL)-4 and interferon (IFN)-γ in the serum by enzyme-linked immunosorbent assay (ELISA) and analysis of CD4(+)CD25(+) regulatory T cells in peripheral blood by fluorescence activated cell sorting (FACS) flow cytometric analysis.

RESULTSThe survival time of recipients in the experimental group was prolonged compared with those in the control group. The numbers of graft infiltrating CD8(+) T cells were decreased whereas the graft infiltrating eosinophil granulocytes (CD15(+)) were increased in grafts in the experimental group (P < 0.05). Furthermore, the proportion of CD4(+)CD25(+) regulatory T cells in the peripheral blood was 10.8% on average in the experimental group, which was significantly higher than that in the control group (6.1%). In addition, the level of serum IL-4 in E. multilocularis infected rats was higher than that in the control group rats, whereas the level of serum IFN-γ in experimental group was lower than that in the control group when graft rejection occurred (P < 0.05).

CONCLUSIONSThis study suggests that E. multilocularis infection could prolong the allograft survival time through the polarization of Th1/Th2-type cells and induction of CD4(+)CD25(+) regulatory T cells. This strategy may provide a new idea for establishing transplantation tolerance.

Animals ; Echinococcosis ; blood ; immunology ; Echinococcus multilocularis ; immunology ; pathogenicity ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Gerbillinae ; Heart Transplantation ; Immunohistochemistry ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Rats

The clinical data of 4 patients with peripheral vascular rupture admitted in the Hetian Regional People′s Hospital from March 2012 to October 2017 were retrospectively analyzed. The 4 patients were all males, aged 17-59 years. Among them, 2 cases caused by firearm injury, 1 case was caused by a car accident and 1 case was caused by a sharp injury; 2 cases were incompletely ruptured in femoral artery, 1 case was completely ruptured in popliteal artery, and 1 case was completely ruptured in axillary artery. All patients underwent successful reconstructive surgical procedures, and the skin temperature, skin color, and arterial pulse of the affected limb returned to normal after operation. The followed-up time was 28-95 months, with an average of 47.8 months. Blood flow in the reconstructed vessel was unobstructed. There were no complications. It is indicates that for peripheral vascular rupture if the diagnose and treatment are timely, the satisfactory results can be achieved.