BACKGROUND: With the development of pedicle-screws,pedicle-screw internal fixation system has been widely used in the clinical treatment of thoracolumbar fractures because it can provide rigid internal fixation for injured spine to acquire more dimensional stabilization with little trauma and simple operation.OBJECTIVE: To investigate the long-term therapeutic effects of CD2 pedicle-screw intemal fixation in treatment of thoracclumbar burst fractures.METHODS: A retrospective analysis was made on 72 cases of thoracolumbar burst fractures who received treatment at the Department of Orthopedics and Traumatology of Nantong University of Traditional Chinese Medicine between January 2000 and January 2008.All these patients received CD2 pedicle-screw internal fixation treatment.All of them were checked with radiography prior to and after surgery and at the final follow-up.The anterior and posterior vertebral body height,the situation of bone graft fusion,and the change of cobb angle were observed after surgery and at final follow-up.CT examination was performed in 27 cases prior to surgery and at the final follow-up to evaluate the space occupying in the spinal canal.Frankel classification was performed to evaluate the recovery of nerve system and Oswestry Disability Questionnaire was used to score the back pain at the final follow-up.RESULTS AND CONCLUSION: 72 cases were followed up for an average of 48 months(range 0.5-8 years)after surgery.X-ray results showed that after surgery,the correction of antedor vertebral body height averaged 6.55 mm,posterior vertebral body height 2.69 mm,and cobb angle 25.7°,and at the final follow-up,correction loss averaged 2.29 mm in the anterior vertebral body height,1.74 mm in the posterior vertebral body height,and 2.6° in the cobb angle.Among 27 patients scanned by CT,the space-occupying rate of the vertebral canal was 10%-75% prior to surgery and it was declined to 5%-24% at the final follow-up.In the last survery,eggshell phenomenon was still observed in 20 cases.Neurological status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia,while no improvement was obtained in those who had preoperative complete paraplegia.Clinical curative effects were evaluated according to Oswestry Disability Questionnaire,results showed 0%in 23 cases,2% in 29 cases,3% in 5 cases,6% in 5 cases,8% in 4 cases,10% in 1 case,56% in 1 case,57% in 1 case,80% in1 case,and 87% in 2 cases.Nuts loosened in 2 cases,pedicle screws loosened in 2 cases,and sticks broken in 1 case.All these findings indicate that CD2 pedicle-screw internal fixation in treatment of thoracolumbar burst fractures can well restore vertebral heights,physiologic curves,and neurological functions.

OBJECTIVE:To get a clear idea about current situation and trend of the application of eye drops in hospital of Shanghai so as to provide the information for rational clinical application and development of new preparations.METHODS:The kinds and amount of commercial eye drops,used in 47 hospital in Shanghai for the years 1997～2001,were analysed and evaluated.RESULTS & CONCLUSION:The amount of consumption of eye drops was increased year by year.The new type with good quality was received by clinical physicians.

OBJECTIVE: To analyse the situation of use of therapeutic drugs for benign prostate hyperplasia(BPH) in hospitals of Shanghai and to make OBJECTIVE: evaluation as reference for production,sale and consumption departments.METHODS: To investigate the BPH drugs used in 47 hospitals of Shanghai during the 1999 - 2001 period in respect to the amunt of consumption, kinds, sum of money of consumption, DDDs and clinical evaluation .RESULTS: Consumption of BPH drugs was increasing in recent years, but kinds of drugs had no obvious change, major drugs for BPH were Finasteride, Tamsulosin and Prostat .CONCLUSION: Therapeutic drugs for BPH are common drugs, but price is very expensive.To speed up the reseach and development of drugs in our country and to advocate the use of domestic products are suggested.

OBJECTIVE:To get a clear idea about the situation of application of hypolipemic agents in hospitals of Shanghai so as to provide information for departments of production,sale and consumption METHODS:The kind,amount,sum of money and DDDs of hypolipemic agents,used in 47 hospitals in Shanghai during the period 1999～2001,were analysed RESULTS:Vastatin,Fibrate and Chinese materia medica were the most commonly used drugs;Simvastatin,Zhibituo and Fenofibrate occupied the front places in amount of consumption;The sales volume of Zocor(Simvastatin)Pravachol and Xuezhikang was at the top of list;Simvastatin,Fluvastatin,Xuezhikang and Fenofibrate revealed increasing tendency and Gemfibrozil,Zhibituo,Duoxikang and Chondroitine showed decreasing tendency in clinical use CONCLUSION:The market prospects of hypolipemic agents will be wide and bright

Objective To observe the morphology of thoracolumbar spinal nerve roots and their surrounding structures, in order to find out their anatomical relationship and to improve surgical procedures as well as to reduce the operative injury and complications. Methods 16 adult cadavers were studied anatomically. The diameters of spinal nerve roots from T10 to L3 at the outlet of intervertebral foramen, the percentages of the distance from spinal nerve roots to the upper border of corresponding vertebral bodies in vertebral height, the angles between spinal nerve roots with lateral border of vertebrae were measured and analyzed. The surgical incision and procedure for the treatment of thoracolumbar fracture were designed and applied in 58 patients of thoracolumbar injury. Results The diameters of spinal nerve roots increased gradually from T10 to L3 in the intervertebral foramen. The percentages of the distance from spinal nerve roots to the upper border of vertebrae in vertebral height gradually became larger too. The angles between spinal nerve roots with vertebral bodies diminished gradually. Around intervertebral foramen, the pattern of spinal nerves and blood vessels was arranged in order as vein, nerve and artery from above down below. The nerves and vessels extended out of the intervertebral foramen together. In clinical practice, 58 cases of thoracolumbar injury were surgically treated with traditional anterior approach and "renal" incision in 35 cases, and with modified anterior approach in "┑" shape in 23 cases. Prior to the modification of surgical techniques, the mean amount of blood loss was 670 ml, the mean operation time was 199 min; however, by the modification of surgical procedures, the mean amount of blood loss decreased to 435 ml, and the mean operation time reduced to 137 min. In an average follow-up of 9 months, the spine recovered to normal curvature and alignment in all cases; the fusion rate was 100%; no failure of implant occurred; neurological function was improved at least one grade in 94.5%. Conclusion Modified anterior approach is helpful to reduce operative injuries and complications. It makes surgical manipulation feasible comparing to the traditional approach.

OBJECTIVE:To analyse the situation of the drugs used in hospitals of Shanghai and to make objective evalua?tion.METHODS:To make a survey of the use of drugs in47hospitals of Shanghai in period2000～2002in respect to the sum of money of sales,main kinds,amount and clinical use of the drugs.RESULTS:The trend of total consumption increased in the past three years,however,the increasing rate declined.The antibiotics occupied the front10places in sequence of the sum of money of sales.The changes in proportion of domestic,joint venture made and imported drugs were not obvious.The gap in kinds of drug consumption was narrowed between domestic and world market,however,the difference in structure was still large.CONCLUSION:Hospital should pay attention to general trend of market of drugs and intensify rational use of drugs.

Objectives To investigate the process and the result of the repair of the sciatic nerve in rat by chitosan tube and polyglycolic fiber Methods The left sciatic nerves of rats were transected with 10 mm gap, then repaired with the nerve grafts in combination of NRF Walking track analysis, immunohistochemical and transmission electron microscopic examinations were carried out at different time after the operation Results Fibrous membrane and capillary could be observed on the surface of the grafts at the first week after the operation; at the 4th week, the regenerated nerve fibers grew more than half of the distances of the gap; at the 8th week, regenerated nerve fibers overcame the gap, many myelinated nerve fibers and thick myelin sheathes could be observed; at the 16th week, the grafts almost degraded and were substituted by the regenerated nerve Walking track analysis showed that sciatic nerve function recovery appeared at the 8th week, and that at the 16th week, approximately 60% of the sciatic nerve function was recovered Conclusion The nerve graft with NRF can stimulate the growth of vessels and the formation of the fibrous membrane, and is useful to the migration of Schwann cells and regeneration of axons, and degrade after the nerve regeneration

OBJECTIVE:To analyse the situation of use of antihistamine agents in hospitals of Shanghai and to make objective evaluation as reference for production,sale and consumption departments METHODS:To investigate the antihistamine agents used in 47 hospitals of Shanghai during the 1999～2001 period in respect to the kinds,dosage sum of money of consumption,DDDs,clinical evaluation and ARDs RESULTS & CONCLUSION:Consumption of antihistamine agents decreased in 2001,but kinds of drugs had no obvious change The commonly-used antihistamine agents were Cetirizine,Loratadine and Kitotifen Incidence of cardiotoxicity is very low,but we must take care of it

BACKGROUND: The anterior thoracolumbar internal fixation devices can be divided into two main categories: the stick system such as kaneda,and the plate system such as Z-plate. Both categories have satisfactory biomechanical properties, but the devices of these types are all imported and so expensive that they exceed the affordability of domestic patients:Based on various anterior throacolumbar internal fixation devices and the spinal characteristics of the Chinese people, the author designed a new brand of anterior thoracolumbar internal fixation device for Chinese people:New Ti-plate (NTP).OBJECTIVE: Biomechanical properties of three anterior thoracolumbar internal fixation devices were compared in an attempt to provide a scientific and theoretical basis for clinical applications.DESIGN: A sampling investigation.SETTING: The Department of Orthopaedics of the Second Affiliated Hospital of Soochow University and Department of Radiology of Nantong Hongqiao Hospital.PARTICIPANTS: This study was carried out at the Biomechanical Engineering Research Institute of Shanghai University between May and August 2003. Fifteen fresh spinal samples from the healthy adults (T12-S1) were used in this study.METHODS: Fifteen spinal (T12-S1) specimens were obtained from fresh bodies to induce injuries to anterior and middle columns, which were fixed with Dunn Ⅲ, NTP and Z-plate respectively to compare the strength, rigidity, and the stability of the spine.MAIN OUTCOME MEASURES: Changes of load-straining and loaddisplacement of the three groups of specimens under the conditions of axial decompression, anteflection, post-extention, and lateral flexion.RESULTS: Fifteen fresh adult spinal specimens were involved in this study and all entered the stage of result analysis. Under the maximal load of 500 N,the average straining for Z-plate, NTP and Dunn Ⅲ was 410 uε,430 uε, 477 uε respectively. The average longitude displacement for the above three devices was 2.23 mm, 2.38 mm and 2.85 mm respectively.The thoracolumbar fracture was fixed with three anterior internal fixation devices and it was proved that Z-plate and NTP fixations were better than fixation with Dunn Ⅲ in respect of spinal strength, rigidity and stability (P ＜ 0.05), but the difference between Z-plate and NTP had no statistical significance (P ＞ 0.05).CONCLUSION: NTP and Z-plate devices are conformed to the spinal biomechanical principles and were capable of reconstructing spinal biomechanical stability effectively, and it is a preferable anterior spinal internal fixation device.

Objective To study the effect of medically activated charcoal on serum phosphorus level and calcium-phosphorus products in dialysis patients with poorly controlled hyperphosphatemia. Methods A single-center,prospective,self-controlled study was performed.Medically activated charcoal was administered 4.5-7.2 g per day with meals for three months to hemodialysis or peritoneal dialysis patients with hyperphosphatemia after taking calcium-based phosphate binders.The levels of blood phosphorus,calcium,calcium-phosphorus products,intact parathyroid hormone (iPTH),albumin and hemoglobin were detected before and after the treatment.The results were analyzed using paired t-test. Results After 3 months of treatment,the patients' serum phosphorus level was significantly reduced from (2.16 ±0.34) mmol/L (pretreatment) to (1.85±0.30) mmol/L (post-treatment) (P＜0.01).Similarly,the serum calciumphosphorus products were lowered from pre-treatment level of (63.93 ±8.83) mg2/dl2 to posttreatment of (54.12±8.37) mg2/dl2 (P＜0.01).Serum albumin level was slightly reduced from (41.7±2.9) g/L to (40.1±2.2) g/L (P=0.001).In contrast,there were no significant changes in serum calcium and iPTH levels when compared pre- to post-treatment values (P=0.734 and P=0.665,repectively). Conclusion In combination with calcium-based phosphate binder therapy,oral medically activated charcoal can effectively reduce the levels of blood phosphorus and calciumphosphorus products in dialysis patients with refractory hyperphosphatemia.