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 establish a method for simultaneous determination of 4 effective components in the couple of Coptidis Rhizoma and Evodiae Fmctus,and to investigate rational proportion of the couple.METHODS:HPLC method was adopted.The determination was performed on Welch XB C18 column with mobile phase consisted of acetonitrile-1.5 mmol/L sodium dodecyl sulfate solution (pH adjusted to 5.0 with phosphoric acid) (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 265 nm,and the column temperature was 30 ℃.The sample size was 10 μL.RESULTS:The linear ranges of berberine hydrochloride,martin hydrochloride,evodiamine and rutacarpine were 2.24-44.80 μg/mL(r=0.999 9),1.26-31.50 μg/mL(r=0.999 8),2.70-81.00 μg/mL(r=0.999 8),1.65-49.50 μg mL(r=0.999 9),respectively.RSDs of precision,stability and reproducibility tests were all lower than 3.0％.The recoveries were 98.11％-100.73％ (RSD=1.04％,n=6),96.54％-103.47％(RSD=1.86％,n=6),95.49％-102.36％ (RSD=2.05％,n=6),97.19％-103.24％ (RSD=2.19％,n=6),respectively.When the proportion of Coptidis Rhizoma-Evodiae Fructus(m/m) was 2∶ 1,the comprehensive content of each component was the highest.CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for simultaneous determination of 4 effective components in different compatibility proportions of the couple of Coptidis Rhizoma and Evodiae Fructus.The rational proportion of the couple of Coptidis Rhizoma and Evodiae Fructus is 2 ∶ 1.

Depression is a common mental and psychiatry disorder. Depression is easy to recur and hard to cure.These urgent problems origin from the limited understanding of this disease and the big heteroge-neity in its genology. Generalized from recent relative papers we discovered that the important onset and sus-taining basis of depression is neuroremodeling,which includes the persistent changes of histocytology,ultra-structure of synapse and abnormal expressions of gene and protein of neurons in key brain regions,and so on. These changes affect the correct dealing on the neural message which lead to depression and become the sus-taining biological basis. Therefore the key strategies to prevent and cure depression lie on preventing,individ-ual therapy and reversing neuroremodeling.

Objective To observe the effect of laser irradiation on the level of histamine (Hm) , 5- hydroxytryptamine(5-HT), interleukin-1 (IL-1), tumor necrosis factor α (TNF-α) in serum and β- endorphin (β- EP) in brain tissue in rat model of rheumatoid arthritis. Methods A total of 60 Wistar rats were randomly divided into four groups:a normal group, a model group (RA without treatment), a laser + drug treatment group (RA treated by laser and drug) and a drug treatment group (RA treated by drug alone). All the groups, except the normal one, were injected with complete Freund's adjuvant to make animal model of adjuvant arthritis. All the animals were then treated accordingly. The level of Hm, 5-HT, IL-1 and TNFα in serum and β-EP in brain tissue were measured. Results Laser downregulated the content of Hm, 5-HT, IL-1 and TNFα in serum and increased the content of β-EP in brain tissue. Conclusion Laser irradiation is an effective modality for treating the animal model of rheumatoid arthritis.

Objective To explore the clinical features of systemic lupus erythematosus (SLE) combined with antiphospholipid syndrome (APS) and cerebral thrombosis in a child. Method The clinical data of SLE combined with APS and cerebral thrombosis in a child was retrospectively analyzed, and the related literature was reviewed. Results This was a 12-year-old boy. The disease onset with recurrent fever, confusion and rash in cheek. He had anemia and thrombocytopenia, and positive antinuclear antibody (ANA) and anticardiolipin antibody (aCL). Magnetic resonance imaging showed multiple cerebral infarction. The diagnosis of SLE combined with APS and cerebral thrombosis was clearly made. Methylprednisolone, cyclophosphamide, warfarin, meropenem and acyclovir were used for the treatment. At the same time, the patient also received intravenous immunoglobulin. Conclusion SLE combined with APS and cerebral thrombosis in children was usually in a severe condition, the prognosis of which can be effectively improve by early diagnosis and reasonable treatment.

Objective To compare the clinical value of two kinds of imunoassay method including CLIA and ELISA in the detection of related antibody of patients with HCV.Methods 60 patients with HCV were chosen as study subjects,and the related antibodies of patients were detected by CLIA and ELISA.The positive rates of anti HCV antibody,anti-3E antibody,anti-GP210 antibody,anti-SP100 antibody,anti-PML antibody and anti-AMA -M2 antibody detected by CLIA and ELISA were compared.Results The positive rates of anti-HCV antibody detected by CLIA and ELISA were 83.33％ (50/60),98.33％ (59/60),respectively.The anti-HCV antibody detected by CLIA was significantly higher than by ELISA (x2 =4.73,P =0.03).The positive rates of anti-3E antibody,anti-GP210 antibody,anti-SP100 antibody,anti-PML antibody and anti-AMA-M2 antibody detected by ELISA were 11.67 ％ (7/60),6.67 ％ (4/60),11.67 ％ (7/60),10.00 ％ (6/60),11.67 ％ (7/60),respectively,those detected by CLIA were 73.33 ％ (44/60),50.00％ (30/60),38.33 ％ (23/60),58.33 ％ (35/60),80.00％(48/60),respectively.The positive rates of anti-3E antibody,anti-GP210 antibody,anti-SP1O0 antibody,anti PML antibody and anti-AMA-M2 antibody detected by CLIA were significantly higher than by ELISA(x2 =18.81,11.51,13.23,15.08,13.75,all P＜0.05).Concelusion Compared with ELISA,CLIA in the detection of related antibodies of patients with HCV can efficiently higher the positive rate of anti-HCV and autoantibody.

ObjectiveTo study the treatment efficacy and practicality of emergency bedside endoscopic nasobiliary drainage(ENBD) for senile severe acute cholangitis (SAC). MethodsTwenty two senile SAC patients undergone emergency bedside ENBD without X ray guidance. The ENBD tube,with the help of straightened curl tailed guide wire, was put into bile duct directly at preestablished depth.ResultThe procedure was finished in all patients within 2?hrs after admission. The symptom immediatly ameliorated in all patients, and temperature began to subside. After 24 hrs patients were all able to eat liquid food.There was no mortality in this group and all patients were discharged. Conclusion Emergency bedside ENBD has special advantages in the treatment of senile SAC .

To explore the therapeutic effects and toxic side-effect of 131I-McAb (S102, T9, CL-3) in the treatment of hepatocellular carcinoma (HCC). 131I-McAb, which was labelled by IODO-GEN method, with 50-70mCi of 131I, was percutaneously injected into the tumor under B-ultrasonic guidance in 116 patients. The results showed that the effective rate (CR+PR) was 29.3% (34/116), the overall effective rate (CR+PR+MR) was 53.4% (62/116), the one-year survival rate was 38.2% (39/102), the mean survival time was 34.7 weeks, and the mean tumor developing phase was 12 weeks. The results suggested that the use of 131I-McAb in the treatment of HCC is a low toxic, effective and minimal invasive operation.

Objective To study the pathological and ultramicrostructural characteristics of organ tissues in relation to the clinical course of severe acute respiratory syndrome (SARS). Methods Post-mortem tissue samples of organs (lungs, heart, liver, spleen, kidneys, pancreas, stomach ) were obtained by needle biopsy from four SARS patients who died in middle and late stages 3-5 weeks after the onset of the disease. The pathological samples were studied by light and electron microscope, immunohistochemistry, histochemistry and indirect immuno-fluorescent antibody test. Results The main pathological features were early interstitial pulmonary fibrosis or organizing pneumonia. Fibroblasts were increased in the interalveoli septa and young connective tissue was found to fill the alveoli. Diffuse alveolar damage (DAD) with alveolar pneumocytes proliferation and an increase in macrophages were found. Desquamative alveolitis also existed at the same time. Squamous metaplasia and syncytial giant cells with multinuclei could be seen. CD3 + and CD20 + lymphocytes were markedly decreased and CD68 + macrophages and S-100 + dendritic cells increased in spleen. Proliferation of bone marrow cells became restrained . Hepatocytes were vacuolated with fatty degeneration. Electron microscopy showed the presence of coronavirus-like particles 80-60nm in diameter enveloped in the cytoplasm of the type Ⅱ pneumocytes, endothelial cells and lymphocytes. Conclusions A novel coronavirus is the cause of the newly recognized severe acute respiratory syndrom (SARS). The main target organs are lung and immune system. Different pulmonary pathological features were found in patients dying from the disease in different stages. All of specimens showed positive reaction of SARS-fluorescence antibody.

Objective To study the relationship between arousal and sleep apnea in old people with sleep apnea syndrome(SAS). Methods Sixty-two aged patients were diagnosed of SAS after polysomnography (PSG). Records included total sleep time, apnea-hypopnea index(AHI),total arousal number(TAN), arousal index(AI), total respiratory-related arousal number(TRAN), total number of arousal lasted over 15 seconds (T15AN) and the severity of hypoxemia (desaturation). Sixty-four non-aged patients were included in control group. Ten aged patients were intervened with nasal continuous positive airway pressure (nCPAP) treatment. Data were compared with that before treatment. Results The results for the above parameters of the aged and the non-aged SAS patients were( 35.1?23.2)/h and (39.1?27.2)/h respectively for AHI, (15.8?11.4)/h and (20.4?13.0)/h for AI, 44.1% and 51.3% for the ratio of TRAN/TAN, only 6.1% and 6.7% for ratio of T15AN/TAN. 50% of 62 aged and 64 non- aged SAS patients were in severe desaturation. The AI and TRAN of the aged patients were significantly lower than that of non-aged patients (P