Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful osteoporotic vertebral compressive fractures. Methods From May 2000 to June 2002, 56 consecutive procedures were performed in 30 patients of painful osteoporotic vertebral compressive fractures with intact posterior vertebral body wall. Each procedure includes bilateral insertion of inflatable balloon, fracture reduction and fulfilled with bone cement. Preoperative and postoperative symptom levels, complications and radiographic findings were recorded and analyzed. Results All 30 patients tolerated the procedure well with immediate relief of their back pain in 48 hours. The mean loss of the anterior and mid vertebral body heights were (13.6?2.3) mm, (9.2?1.4) mm preoperatively and (4.7?1.5) mm, (3.4?1.1) mm postoperatively. The mean kyphosis was improved from 23.4??5.2? to 9.2??4.7?. Cement leakage and cerebrospinal fluid leakage occurred at one level respectively and resulted in no clinical symptoms, no other complication was found. Conclusion As a promising minimally invasive surgery, balloon kyphoplasty can provide early improvement of pain and function as well as spinal alignment in treatment of painful osteoporotic compressive fractures.

Objective: To compare the quality of life of schizophrenics treated with risperidone and clozapine Method: We followed 24 schizophrenics treated with risperidone and 26 with clozapine for 6 months All subjects were assessed with PANSS, TESS and WHO QOL-100 before treatment and 1, 2, 3, 6 months after Results: After 6 month, risperidone and clozapine had similar effects on positive and negative symptoms of schizophrenia Risperidone group had greater improvement in total score of PANSS Risperidone could significantly improve all aspects of quality of life of patients, except Domination While clozapine just improved some parts of that, it had no help to Physics, Psychology and Independence Conclusion:Risperidone is more favorable than clozapine for schizophrenics to return to society

Objective To review and analyze the complications of spondylolisthesis treated wi th BAK interbody fusion cages.Methods One hundred and eighteen patients wi th spondylolisthesis were treated with BAK interbody fusion ca ges,the intraoperative and postoperative complications were reviewed,which include dural tear,nerve root injury,unsatisfactory cage position,cage retropulsion,cage subsidence and postlaminectomy adhesive arachnoiditis.Results The intraoperative complication ra te was 11%and the most commonly seen were dural tear 4c ases(3.4%),nerve root damage 3cases(2.5%)and unsatisfactory cage position 9cases(7.6%),2cases had both dural tear and unsatisfactory cage position,1patient had both nerve root injury and unsatisfactory cage position.The postoperative c omplication rate was 7.6%,which chiefly consisted of cage retropuls ion 3cases(2.5%),cage subsidence 4cases(3.4%),and postlaminec-tomy adhesive arachnoiditis 2cases(1.7%),2cases of cage retropulsion and 2ca ses of cage subsidence show partial nonunion,2cases of cage subsidence had arachnoiditis.Conclusion As a new technique,lumbar interbody fusion with BAK cages are r apidly gaining popularity,however,the complications described here suggest the importance of selection s of surgical indications and proper manipulations.[

Objective To explore the difference of myeloperoxidase(MPO)detection results among different types of samples , anticoagulant selection and comparison of detection results .Methods The plasma samples containing EDTA‐K2 or heparin and ser‐um samples of common biochemical tube without containing anticoagulant were collected from 165 persons undergoing healthy physical examination .The MPO level in 3 kinds of sample was detected .Then the detection results in each group were performed the statistical analysis .Results The MPO detection results had statistical difference between plasma samples with different antico‐agulants and between plasma samples with different anticoagulants and serum sample without anticoagulant in the same person (P<0 .05) .Conclusion Different samples types have larger difference in M PO detection results .It is suggested that each laboratory should formulate the corresponding reference intervals according to different anticoagulants ;because EDTA‐K2 anticoagulation plasma is not affected by the release of MPO from in vitro leukocytes ,it is recommended to adopt EDTA‐K2 anticoagulation blood as the first selected of M PO level detection .

Objective To evaluate the long term outcome of spondylolytic spondylolisthesis treated with Steffee system and posterolateral fusion. Methods Thirty- four patients were followed up for an average of 77.2 months. The follow- up study include slipping percentage, slipping angle, heights of intervertebral space and foramen, fusion rate, screw broken rate and clinical outcomes. Results 1) Solid fusion was obtained in 88.2％ of patients. screw broken rate was 2.9％ . 2) Comparison of pre- and post- operative slip showed correction rate of 45.1％ . The heights of intervertebral space and foramen increased, slipping angle decreased. 3) During the period of follow- up, recurrence of deformity was found. 4) The subjective outcome was better than the objective outcome. Conclusion 1) Lumbar spondylolytic spondylolisthesis with radicular symptom need complete decompression and reduction as much as possible. 2) A positive slipping angle indicates significant shearing force and the need of an interbody fusion to restore the weight- bearing capacity. 3) Objective criteria is more suitable to evaluate surgical outcome.

Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful multi-vertebral osteoporotic compression fractures. Methods From October 2002 to April 2007, 42 patients (96 vertebrae) with painful multi-vertebral osteoporotic compression fractures underwent kyphoplasty. The group included 14 men and 28 women with an average age of 72.5 years (range 56-91 years). Each pro-cedure included insertion and insertion of balloon, fracture reduction and cement filling under "C"-arm monitoring. Preoperative and postoperative pain level, SF-36 score, vertebral height restoration, local kypho-sis correction and complications were recorded and analysed. Results All 42 patients tolerated the opera-tion well and were followed up for average 31.4 months (range 12-71 months). The mean VAS pain score decreased significantly from 7.1±2.4 preoperatively to 2.7±1.3 postoperatively, the mean height of anterior and medial vertebral body were (1.8±0.5) cm, (1.6±0.6) cm preoperatively and (2.3±0.6) cm, (2.2±0.7) cm postoperatively. No significant change of posterior vertebral height was recorded postoperatively.The mean correction of local kyphosis was 9.2°at each level. 6 of 8 subscahs measured by SF-36, including physical function, role function, bodily pain, vitality, role emotion, mental health, were significantly improved by the operation. Complications were found in 7 patients including 6 cases of cement leakage with no clinical symptoms (intradiscal cement leakage in two cases, paravertebral vessel leakage in two cases, paravertebral leakage in one case and cement leakage into canal in one case), and 1 case of pulmonary embelization with symptoms relieved after conservative treatment. Conclusion Kyphoplasty is effective and relatively safe for multi-vertebral osteoporotic compression fractures.

Objective To investigate the causes and clinical significance of cement leakage into disc space during kyphoplasty. Methods Since 2002, 178 patients with osteoporotic vertebral compression fractures underwent kypboplasty and 15 of them were detected intradiscal cement leakage and followed up more than 2 years (mean 2 years and 8 months). The mean injection of cement in these patients was 4.2ml.The series comprised 10 females and 5 males, with an average of 71.2 years old ( range, 54～84 years old).Visual analog scale was used to score back pain pre- and postoperatively. The height and MRI index of the involved disc were recorded and compared. Results The discs involved were as following: T10-11 for 4 cases,T11-12 for 1, T12L1for 4, L1-2 for 2, L2-3 for 3, L3-4 for 1. Cement leakage was detected in the disc above the fractured vertebrae in 10 cases, and in the disc below the fractured vertebrae in 5 patients. The back pain significantly alleviated and the average visual analog scale (VAS) score was decreased from 8.5±2.1 preoper-atively to 3.3±1.4 postoperatively (P< 0.05). The anterior disc height was (5.1±2.1)mm preoperatively and (4.8±1.9) mm at the final follow-up, the middle disc height was (7.4±3.2) mm preoperatively and (7.3±2.9) mm at the final follow-up, the posterior disc height was (4.9±2.5) mm preoperatively and (5.0±1.8) mm at fi-nal follow-up, the heights of intervertebral space were well maintained. The signal intensity decreased and became inconsistent in some discs, and the preoperative MRI index significantly decreased from 25482.4± 3467.5 to 18927.6±2519.4 at the final follow-up (t=1.967,P< 0.05). Conclusion Pain relief is impressive in patients with intradiseal cement leakage during kyphoplasty. However, cement leakage into disc space may accellerate the process of disc degeneration.

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of complex intraarticular calcaneal fractures.Methods A retrospective comparative study was performed on the 50 patients with intraarticular calcaneal fracture (Sanders types Ⅲ and Ⅳ) who had been treated by uniaxial locking plates (n =26) or polyaxial locking plates (n =24) between January 2013 and June 2015.Operation time,intraoperative bleeding,union time,radiological and functional outcomes and functions by the Maryland foot score were compared between the 2 groups.Results All the patients were followed up for 12 to 44 months(average,20.8 months).There were no significant differences between the 2 groups in average operation time (105.2 ± 18.2 min versus 95.5 ± 17.7 min),average intraoperative bleeding (125.2 ±23.4 mL versus 120.3 ±21.5 mL),or union time (12.1 ± 3.7 weeks versus 11.8 ± 3.7 weeks) (P ＞ 0.05).All patients obtained bony union.The polyaxial locking plates group displayed significantly better B(o)hler and Gissane angles at 3 and 12 months after operation than the uniaxial locking plates group (P ＜ 0.05).Evaluated by the Maryland foot score,the excellent and good rate for the polyaxial locking plates group [91.7％ (22/24)] was insignificantly higher than that for the uniaxial locking plates group [84.6％ (22/26)] (P =0.267).Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for complex intraarticular calcaneal fractures,but polyaxial locking plates may be superior in stability and functional recovery.

Objective To investigate the role of micro-RNAs (miR-101 and miR-125a-5p) in autophagy of lipopolysaccharide (LPS) derived human THP-1 macrophages.Methods Human monocytic leukemia cell line THP-1 was cultured in vitro,and it was differentiated into macrophages after being induced with phorbol (50 μg/L) for 48 hours.THP-1 macrophages were stimulated with LPS in 0,250,500,1 000 μg/L respectively for 12 hours,miR-mimic was transfected into THP-1 macrophages as induced by Lipofectamine RNAiMAX,and the transfection efficiency of miRNA was determined with fluorescence microscopy.Enzyme linked immunosorbent assay (ELISA) was used to determine the levels of tumor necrosis factor-α (TNF-α) and monocyte chemotaxis protein-1 (MCP-1) in the supernatants of culture.Western Blot was used to detect the protein expressions of autophagy proteins ATG4D,Beclin1,and LC3 Ⅱ.The expression levels of miR-101 and miR-125a-5p were determined by quantitative reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Results ① The releasing levels of TNF-α and MCP-1 induced by LPS with 250,500,1 000 μg/L were significantly increased as compared the cells without LPS stimulation [TNF-α (ng/L):1 336.1 ± 18.5,1 340.6±24.8,1 364.5± 14.9 vs.47.6±4.4;MCP-1 (ng/L):996.3 ±51.3,934.6±84.3,974.2±69.5 vs.21.3±6.5,all P ＜ 0.01],but no significant differences were found among the three LPS stimulation groups.The protein expressions of ATG4D,Beclin1 and LC3 1Ⅱ were up-regulated in the presence of different LPS concentrations (0,250,500,1 000 μg/L) for 12 hours in THP-1 macrophages (when compared with the cells without LPS stimulation,t value of ATG4D was 8.103,38.410,52.020,P value was 0.015,0.001,＜ 0.001;t value of Beclin1 was 3.026,5.328,3.482,P value was 0.047,0.034,0.037;t value of LC3 Ⅱ was 3.836,6.200,4.665,P value was 0.018,0.003,0.010),and the optimal concentration was 500 tg/L LPS.When THP-1 macrophages were stimulated with 500 μg/L LPS for 12 hours,the expression levels of miR-101 and miR-125a-5p were down-regulated significantly as compared with the cells without LPS stimulation [miR-101 (2-△ △Ct):0.68 ± 0.08 vs.1.95 ±0.26,t =8.047,P =0.001;miR-125a-5p (2-△ △Ct):0.23 ± 0.06 vs.1.69± 0.42,t =5.975,P =0.004].② The higher transfection efficiency was showed under fluorescence microscope.Westem Blot results showed the protein expressions of ATG4D,Beclin1 and LC3 Ⅱ were down-regulated as induced by an over-expression of miR-101 or miR-125a-5p in THP-1 macrophages,and more obviously down regulated by co-transfected with miR-101 and miR-125a-5p (compared with negative control group,t value was 14.550,5.855,14.180,P value was 0.005,0.014,＜ 0.001).Conclusion miR-101 and miR-125a-5p can inhibit the autophagy in LPS challenged THP-1 macrophages,and the potential mechanism might be related to target regulation of ATG4D.

BACKGROUND:Posterior cervical open-door expansive laminoplasty is one of the simple and effective methods to treat cervical spinal diseases, has satisfactory results but low complications. However, the imbalance of sagittal plan, loss of lordosis or axial pain is often reported recently. OBJECTVE:To analyze the correlation between cervical sagittal alignment and clinical outcomes after laminoplasty. METHODS:Between January 2011 and June 2015, 122 cases of cervical spinal disease, who were treated with open-door expansive laminoplasty with mini-titanium plate, were retrospectively analyzed. Clinical outcomes were evaluated by Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale. Radiographic results were assessed by C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope. The correlation between sagittal alignment and clinical outcomes were analyzed. RESULTS AND CONCLUSION:(1) Al patients were fol owed up for 7-32 months. (2) Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale scores were improved in the final fol ow-up (al P<0.001). No significant difference in upper limb Visual Analogue Scale scores was determined (P=0.142). In the final fol ow-up, C2-7 sagittal vertical axis increased (P=0.036), but neither the C2-7 Cobb angle nor the C7 slope significantly changed (P=0.092, P=0.184). (3) There were no correlations between sagittal alignment parameters (C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope) and clinical outcomes (Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale) (al P>0.05). (4) These findings indicated that posterior cervical open-door expansive laminoplasty with mini-titanium plate can significantly improve the neurological function of patients. However, there is no correlation between cervical sagittal alignment and clinical outcomes.