[Objective]To discuss incidence of nerve root stretch injury and threshold value of traction injury in lumbar interbody fusion from posterior rout approach. [Method]Totally patients were treated by lumbar interbody fusion performed with posterior approach using the safe nerve root retractor,the force of dragging nerve root and the retracting time were showed on the display device,while the latency and amplitude of the DSEP wave were measured with Keypoint to monitor the status of the neural function.JOA scores were followed up 10 days,1 month,3 months and 12 months after operation respectively.[Result]Nineteen cases occurred latency prolongation and wave amplitude digression during the operation,when the tensile strength to nerve root was(4.1? 0.45) N and accumulating strength was(42.89?2.96) N*min.The tensile force of aggravation groups exceed stable and improvement groups obviously,incidence of FBSS was higher than the other two groups.[Conclusion]Stretch injury of nerve root during operation is the main cause of earlier period FBSS after interbody fusion.Master single tensile force less than(4.1? 0.45) N or accumulating strength less than(42.89?2.96) N*min is presumed safety.

[Objective]To evaluate the incidence of postoperative residual numbness and the factors that influenced numbness in lumbar canal stenosis(LCS).[Method]Eighty patients with LCS including 24 males and 32 females,who were 27～78 years of age with an average age of 61.3,were operated by posterior decompression,and followed 10 days,1 month,3 months,1 year and 2 years after operation.All patients were examined by neurological findings and residual symptoms.[Result]In LCS,there were 82.1% of patients who complained numbness preoperativety.The incidence of residual numbness was 43.6%,39.1%,36.6%,35.3% and 35.7% after 10 days,1 month,3 months,12 months and 24 months,respectively.The factors that influenced residual numbness were related to stenosis types;JOA score before operation and the type of spinal canal stenosis were independent of age and nerve root diameter.[Conclusion]The lower limbs numbness recovered within 1 month postoperatlvely.The incidence of postoperative residual numbness was 35.3% and 35.7% in LCS after 1 year and 2 years.It is speculated that the potential of recovery of neural tissue is important for lower limbs residual numbness.

Objective To observe the effect of epidural injection with different dose of butorphanol on the rats' neurological function.Methods A PE-530 catheter was inserted into the epidural space of all the SpragueDawley rats (male, weighting 180 ～210 g) at L1-2 level.After three days, a total of 32 rats without any motor dysfunction were randomly divided into 4 groups as follows saline(NS) group (group C, n= 8 )and butorphanol injection (B) group( B1∶ n=8;B2∶ n=8;B3∶ n=8).Rats in group C were epidurally injected NS 30 μl each ,and rats in group B1, B2 and B3 were respectively epidurally injected Butorphanol 60 μg/30μl, 120 μg/30 μl,240 μg/30 μl (all diluted with NS) ,and 1 time per day for5 days.The neurological function of rats was recorded before injection (T0) and 6h after injection on day 1 ～4(T1 ～T 4) and 6h,24h and 72h after injection on day 5 (T5 ～T7) by BBB (BASSO,BEATTIE and BRESNAHAN ) Score and the inclined plane test .Results Compared with group C ,the BBB score and the inclined plane test of group B1 showed no significant difference throughout the experimental period(P＞ 0.05 ).There was also no significant difference at T0 ～ T3 of group B2 and group B3 compared with group C (P ＞ 0.05 ), while at T4, the BBB score ( ( 18.50 ± 2.00 ) points, ( 16.38 ± 2.33 ) points) and the inclined plane test( (58.75 ± 5.17 )°, (59.38 ± 3.20) ° ) of the two groups were both obviously decreased when compared with group C( (21.00 ±0.00) points, (65.00 ±3.78)°, P＜0.05) ,and the same significant differences appeared at T5,T6 and T7 (P ＜ 0.05 ).Conclusion Repeated epidural injection of butorphanol 60 μg have no effect on neurological function of rats,while repeated epidural injection of butorphanol 120 μg and 240 μg could impaire the neurological function.

ObjectiveTo investigate the effect of patient-controlled epidural analgesia(PCEA) with opioids on serous myelin basic protein(MBP) and somatosensory evoked potential(SEP) of lower limbs in puerperants.MethodsA total of 120 puerperants,after receiving cesarean section,were divided into four groups by random number table method as group B,BR,MR and R randomly,and each group included 30 cases.After surgery,each case received PCEA:group B received 0.008％ butrophanol;group BR received 0.008％ butrophanol + 0.2％ ropivacaine;group MR received 0.004％ morphine +0.2％ ropivacaine and group R received 0.2％ ropivacaine only.VAS score,OAA/S score,adverse effect occurrence,concentration changes of serous MBP,SEP of both lower limbs and neurological function were observed at 2h(T1 ),4h(T2),8 h(T3),12h(T4),24 h(T5) and 48h (T6) after surgery.ResultsVASscoresofgroupBR(1.64±0.38,1.86±0.62,1.93±0.67) and MR( 1.74 ±0.39,1.91±0.58,1.98 ±0.63) at T3,T4,T5 were lower than those of group B(4.6 ±0.5,4.6 ±0.3,4.7 ±0.3)and R(2.64 ±0.41,2.83 ±0.91,3.37 ±0.87) (P＜0.05).There was no significance in four groups in OAA/S score at each point (P ＞ 0.05 ).Incidence of nausea ( 6 cases),vomiting ( 2 cases) and abdominal distention ( 5cases) of group M was higher than that of other three groups(P＜0.05).There was no significant difference in concentrations of serous MBP,SEP and neurological function in all four groups between preoperative time and 48h after operation(P＞0.05).ConclusionLower-dose and lower- concentration opioids used for PCEA have no influence on serum MBP and SEP.

BACKGROUND:Previous studies have shown that composite scaffold of chitosan and poly-L-lactic acid has good biocompatibility with some cells. OBJECTIVE:To study the biocompatibility of poly-L-lactic acid reinforced by chitosan and olfactory ensheathing cells. METHODS:In experimental group, olfactory ensheathing cells from Sprague-Dawley rats aged 1-3 days were incubated onto chitosan-reinforced poly-L-lactic acid film. And in control group, olfactory ensheathing cells were co-cultured with poly-L-lysine. The proliferative ability of olfactory ensheathing cells was detected and the cells were observed with immunofluorescence histochemical staining at 1, 3, 5, 7 days after culture. RESULTS AND CONCLUSION:Olfactory ensheathing cells could survive on the chitosan-reinforced poly-L-lactic acid film, and the cytotoxic grade wasⅠ. Morphology of the cells in the experimental group was round or oval, with little processes and the cells aggregated into groups. One day after implantation, the periphery cells of the mass extended short projections and gradual y spread outward;3 days after implantation, the cells spread and most of the cells generated projections, most of which were bipolar or tri-polar;5 days after implantation, cel processes significantly extended, most cells were bipolar and tri-polar cells, while some were oval cells and irregular triangular cells;7 days after implantation, the cel density increased, and cel processes extended. Cel morphology of the control group had similar characteristics as the experimental group. There was no obvious difference between the control and the experimental group in number, perimeter or area of the cells (P>0.05). It showed that chitosan-reinforced poly-L-lactic acid had good biocompatibility with olfactory ensheathing cells.

Objective To study the feasibility of percutaneous pedicle screw fixation in treatment of thoraco-lumbar fractures.Methods Twenty-two patients with thoraeo-lumbar fractures were treated with the posterior percutaneous or open pedicle screw fixation respectively.Operation time,the bleeding volume,the height of the anterior border,the cobb angles of seoliosis,the late loss of correction,and complications were compared.Results All patients were followed up for mean 19 months(13 to 22 months).In percutaneous group,the mean time of operation was 102 minutes,the anterior height of compressed vertebral bodies was restored from 52% to 95% of the normal height,and the Cobb angle was corrected from 16?to 6.3?,the mean late loss of correction was 13% in percutaneous group,and there were no significant differences between the two groups(P＞0.05).The mean bleeding volume in the percutaneous group and open group was 102 ml and 290 ml respectively,which showed significant difference(P＜0.05).Conclusion Posterior percutaneous pedicle screw fixation in treatment of thoracolumar fractures,which didn't need vertebral canal decompression,was a perfect and effective method.Compared with open method,it had such strongpoints as quicker recovery and less invasive.

BACKGROUND: Fibrin glue has been demonstrated to function as a kind of biomaterial with high quality. It has been used in nerve tissue engineering and proved to be a kind of scaffold for some cells.OBJECTIVE: To explore the biocompatibility of fibrin glue and olfactory ensheathing cells (OECs).DESIGN, TIME AND SETTING: An in vitro control trial based on cytology was performed at the Institute of Neurobiology,Nantong University from August 2007 to February 2008.MATERIALS: Fibrin glue was made of fibrin and catalyst, and OECs derived from rats' olfactory bulb were normally primary-cultured.METHODS: OECs were divided into control (OECs clone spheres were cultured alone) and in fibrin glue (OECs clone spheres were cultured and combined with fibrin glue) groups. After 1 week of culture, the proliferation of OECs were observed by convert microscope and detected by S-100 immunofluorescence histochemical staining.MAIN OUTCOME M EASURES: OECs morphology, cell count, the area of the cell bodies and the perimeter of the cell were determined.RESULTS: OECs could survive, migrate in fibrin glue, and float in the fibrin glue in the lower layer. After 7 days of incubation, cell body exhibited fusiform or triangle, predominantly bipolar or bipolar. The number of the S-100 positive cells was more, and cell bodies were larger in fibrin glue group than control group (P < 0.05). However, there was no obvious difference between two groups in cell perimeter (P > 0.05).CONCLUSION: Fibrin glue has good biocompatibility with OECs, and OECs can survive and migrate in fibrin glue.

Objective: To explore the turnover intention of nurses in Quzhou and its influential factors. Methods: From July to August in 2017 cross-sectional study and self-filled questionnaire are used to investigate 980 nurses from 7 hospitals in Quzhou, including two third-level hospitals and five second-level ones. T-test, F-test, Pearson and linear regression are used in data with the method of statistical analysis. Results: The total score of turnover intention of nurses was (14.95±3.17) points, and the index value was 62.27%, of which the turnover intention was above 78%. The analysis of Single factor showed that age (F=4.895) , Department (F=2.971) , title, nursing age (F=5.863) , self-assessment of physical conditions (F=4.092) were closely related to nurses’ turnover intention(P<0.05). According to Person’s correlation analysis, there are positive correlations between turnover intention and source of stressor, and moral distress (P<0.05) . Multiple linear regression showed that the nurses’ turnover intention was age, Department, health selfevaluation, stressor and moral distress. Conclusion The turnover intention of nurses is high, which is related to age, Department, self-evaluation of health, stressor and moral distress.

The present research was aimed to explore the biocompatibility of IKVAV self-assembling peptide nanofiber scaffold with olfactory ensheathing cells (OECs) of rats. The OECs were seeded onto the surface of coverslips covered with IKVAV self-assembling peptide nanofiber scaffold hydrogel (2D culture system), and implanted within IKVAV self-assembling peptide nanofiber scaffold hydrogel (3D culture system), respectively. The adhesion, viability of OECs were observed with inverted microscope. Then the characteristics for survival and adhesion of cells by image processing were observed, and statistical analysis on the number of S-100 positive cell, the area of the cell bodies and the perimeter of the cell and MTT method were carried out. It was found that the OECs could survive and migrate in IKVAV self-assembling peptide nanofiber scaffold. The result of the cell MTT exam, of the shape and quantity of cells had no significant difference compared to those of the OECs cultured with poly-L-lysine (PLL). It has been proved that IKVAV self-assembling peptide nanofiber scaffold has good biocompatibility with rat OECs.
Animals ; Animals, Newborn ; Biocompatible Materials ; chemistry ; Cell Proliferation ; Cells, Cultured ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Laminin ; chemistry ; Nanofibers ; chemistry ; Olfactory Bulb ; cytology ; drug effects ; Peptide Fragments ; chemistry ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

Objective To investigate the effects of duration of surgery on flash-induced visual evoked potentials (VEP) in patients undergoing spinal surgery in prone position.Methods Eighty-two ASA Ⅰ or Ⅱ patients of both sexes aged 20-76 yr weighing 43-96 kg undergoing spinal surgery in prone position were divided into 3 groups according to the duration of surgery:group S≤2 h ( n =34) ; group M 2-4 h ( n =38) and group L≥4 h ( n =10).VEP was monitored using protektor VEP monitoring device (Xltek Co.,Canada).The latency,amplitude and recovery time of wave P100 were recorded before and 10 min after induction of anesthesia and at the end of surgery.Results Compared with group S,the amplitude of wave P1000 was significantly decreased at the end of surgery in group M,the lantency of wave P100 was significantly prolonged,while the amplitude of wave P100 was decreased at the end of surgery in group L ( P ＜ 0.05).Compared with group M,the lantency of wave P100 was significantly prolonged,while the amplitude of wave P100 was decreased at the end of surgery in group L ( P ＜ 0.05).Compared with groups S and M,the recovery time of wave P100 was significantly prolonged in group L ( P ＜0.05).There was no significant difference in the recovery time of wave P100 between groups S and M ( P ＞ 0.05).Conclusion Duration of surgery (≥4 h) can affect flash-induced VEP,the longer the duration,the stronger the effects.