Objective To evaluate the clinical efficacy of monosegmental pedicle instrumentation in management of thoracolumbar burst fractures. Methods A total of 67 patients with traumatic thora-columbar burst fractures (type A3.1 and A3.2) were treated with monosegmental pedicle instrumentation in our department from October 2003 to February 2008. Imageologic effect was observed by measuring sagittal index and wedge index via X-ray and clinical outcomes evaluated by using low back outcome score. Results All operations were performed successfully, with average operation duration of 93 mi-nutes and average intraoperative blood loss of 157 ml. Of all, 65 patients were followed up for 4-27 months (average 19.8 months), which showed that all the patients achieved bony fusion, with no implant failure except for one with screw loosening. The sagittal index and wedge index were 13.06°and 42.9% preoperatively and 4.47° and 21.78% postoperatively, with statistical difference (P <0.01). The final follow-up showed no significant correction loss except for two patients (P < 0.05). The low back outcome scores of all patients at follow-up were improved significantly (P < 0.05). Conclusions Monoseg-mental pedicle instrumentation has advantages of minimal invasion, short operative duration, less blood loss and less vertebral motion segment loss and hence is an effective and reliable operative technique for thoracolumbar burst fractures.

ObjectiveThe aim in this study was to evaluate the efficacy of the ball tip probe technique in placing pedicle screws in patients.MethodsFrom May 2009 to June 2010,we used ball tip probe technique in pedicle screw placement in patients with scoliosis,spondylolisthesis,spinal fractures and other diseases.The ball tip probe consisted of a metal shaft with a metal ball-shaped tip whose size included 1.5,2.5,3.0,3.5 mm in diameter.The ball tip probe with a diameter of 1.5mm owned a high rigidity and certain flexibility.Ball tip probe technique:A high speed bur was used to remove cortical bone and create a starting point,and then the ball tip probes is tapped gently by a hammer for making a guide hole through the pedicle into the vertebral body.The accuracy of the pedicle screw placements was evaluated on postoperative axial CT scanning The pedicle screw placements was compared between the the ball tip probe group and conventional freehand technique group.ResultsThree hundred and twelve screws were evaluated in the ball tip group and 276 in the conventional freehand group.All the screws (100％) were in the desired pedicle in the ball tip group and 215 (78％) in the conventional group.In the conventional group,23 screws(8.3％) were classified as medial violation; 38(13.7％) as lateral violation.A significant difference was determined between the 2 groups regarding the pedicle breaches.No vascular,pulmonary,or neurological injuries caused by pedicle screws placement was found in either group.ConclusionThis study demonstrates the accuracy and reliability of the ball tip probe technique in pedicle screw placement.This technique can probably reduce the risk of complications of screw misplacements.

BACKGROUND: Posterior lumbar non-fusion devices have been developed to control vertebral column movement, change load pattern of instability segment, restrict abnormal action, as well as avoid adjacent segment degeneration.OBJECTIVE: To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar vertebrae instability.METHODS: Ten cases suffering from lumbar instability were selected, including 3 males and 7 females, aged 43-65 years. One patient sustained L_(1/2) and L_(4/5) segmental instability, one was L_(2/3) and another was L_(3/4), and the others were L_(4/5). Two patients complicated with lumbar disc herniation and 7 patients combined with lumbar spinal stenosis at the same affected segment, and 3 patients associated with lumbar spinal stenosis at adjacent segment. All unstable segments were treated with decompression, posterior implantation of Wallis dynamic stabilization system. Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores for low back pain and Oswestry disability index (ODI) were used to evaluate clinical outcomes. In addition, therange of motion (ROM) at the instrumented segment and adjacent segments and posterior disc height (PDH) in standing and extension position at L_(4/5) segment were also measured.RESULTS AND CONCLUSION: All the patients were followed-up for 2-13 months, mean 9.2 months. The mean operation duration was 128 minutes (90-185 minutes), with bleeding volume of 264 Ml (50-600 Ml). Sings and symptoms of all patients were improved significantly after operation, except one patient with recurrence of L_(4/5) lumbar spinal stenosis at 3 month after surgery, whose symptoms relieved by revision with fenestration and decompression. The postoperative VAS was dramatically decreased than that of preoperation (P=0.003); the JOA score was obviously increased (P=0.002), and the ODI score was decreased (p=0.008). The postoperative range of motion decreased significantly (P<0.05). However, there was no obviously difference between preoperative and postoperative L_(3/4), L_5/S_1 and posterior disc height (P>0.05). Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.

Objective:To explore the relation of cognitive function correlates to P50 sensory gating in patients with schizophrenia.Methods:Totally 106 patients with drug-na¨ive first-episode schizophrenia and 86 healthy con-trol subjects matched for age,sex and education were recruited.All patients met the Diagnostic and Statistical Man-ual of Mental Disorders,Fourth Edition (DSM-IV)criteria for schizophrenia.Their cognitive function were assessed with the MATRICS Consensus Cognitive Battery (MCCB).The P50 auditory gating potential were recorded in all subjects using conditioning-testing stimulus paradigm and stimulus train paradigm.The P50 components were meas-ured in S1 S2 latency,S1 S2 amplitude and P50 suppression ratios.Results:Compared with the controls subjects, the patients with schizophrenia had significantly longer S1[60.8 ±7.8)ms vs.(56.3 ±7.0)ms,P <0.05]S2 la-tency [(59.1 ±10.2)ms vs.(55.7 ±10.7)ms,P <0.05],lower S1 amplitude [(2.8 ±1.8)μV vs.(3.5 ±1.6)μV,P <0.05],less amplitude difference (S1-S2)[(1.5 ±1.8)μV vs.(2.2 ±1.4)μV,P <0.05]and higher P50 suppression ratios (S2 /S1 )[(59.7 ±65.6)vs.(37.6 ±30.0),P <0.05].Schizophrenia patients had lower score than control subjects in all cognitive domains of MCCB (Ps <0.05).No differences in neurocognitive performance were found between subjects in the normal P50 ratio and the abnormal in healthy controls or patients with schizo-phrenia (Ps >0.05).No significant correlation was found between P50 gating measures (P50 ratio and P50 ampli-tude difference)and neuropsychological measures in MCCB scores (Ps >0.05).Conclusion:There may be no as-sociation between P50 deficits and cognitive measures in patients with drug-na¨ive first-episode schizophrenia.

Objective To evaluate cognitive impairment and performance-based skills and to explore their rela?tionships with clinical phenotypes in drug-na?ve first-episode patients with schizophrenia. Methods One hundred and forty-five inpatients and 65 healthy controls matched for age, gender and education were recruited. The MATRICS Con?sensus Cognitive Battery (MCCB), Stroop, digit span test, emotional recognition test, University of California, San Diego, Performance-based Skill Assessment (UPSA) and Positive Negative Syndrome Scale scale (PANSS) were used to evaluate cognitive function, life skill and symptoms, respectively. Results Compared with the controls, total score of MCCB and scores of 10 subscales, scores of digit span, emotional recognition and Stroop were significantly lower in patients (all P<0.05). The UPSA total score and scores of financial skill and communication skill were lower in patients than in controls (all P<0.05). Verbal memory, visual memory , Stroop, communication skill scores and total UPSA standard score were sig?nificantly higher in patients with paranoid subtype of schizophrenia than in patients with non-paranoid subtype of schizo? phrenia (all P<0.05). The score of MCCB associated with education years (OR=1.29, 95%CI: 1.13~1.47) and PANSS (OR=0.95, 95%CI:0.92~0.97). Conclusions First-episode, drug-naive patients with schizophrenia have markedly cog?nitive and performance-based skills deficits, which are associated with clinical symptoms. These deficits are differences between paranoid subtype and non-paranoid subtype of schizophrenia.

Objective To explore the risk factors for retreatment of spinal tuberculosis and to provide a theoretical basis for the formulation of clinical prevention and treatment measures. Methods the clinical data of 114 patients who received spinal tuberculosis operation from January 2011 to June 2014 were retrospectively analyzed. Among them, 13 cases were divided into group A after operation, and 101 cases without recurrence after operation were divided into B group. The clinical data of the two groups were compared and the multiple factor Logistic regression was used to analyze the risk factors for retreatment of spinal tuberculosis. Results In group A, preoperative albumin level, after standard anti-tuberculosis treatment, the proportion of complete removal of the lesion was significantly lower than that in group B, and tuberculosis in other parts of the proportion, the emergence of resistant strains, proportion of adverse conditions were significantly higher than those in group B (P＜0. 05). Multivariate Logistic regression analysis showed that preoperative albumin < 35g/L, without fusion, patients who did not receive regular anti-tuberculosis treatment, debridement is not complete, with other parts of tuberculosis, drug resistant strain and adverse conditions were risk factors of postoperative spinal tuberculosis retreatment (P＜0. 05). Conclusion Many factors can affect the incidence of relapse after spinal tuberculosis surgery, and clinical intervention should be carried out to reduce the risk of relapse after spinal tuberculosis operation.

Objective To develop a rapid method for the identification of inactivated C.albicans by surface-enhanced Raman spectroscopy (SERS).Methods Live C.albicans cultures were exposed to heating, formaldehyde and fungicidal drug (amphotericin B).The corresponding SERS spectra were acquired for the investigation and comparison.Results The spectra acquired with three different inactivation methods exhibited similar features of dead C.albicans, which showed significant difference from the spectra of the live culture.Conclusion This SERS method can identify the inactivated C.albicans rapidly.Hopefully it will provide a convenient tool for quick identification of other inactivated pathogenic microorganisms.