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.

BACKGROUND: Functional dressings have been widely used in clinical practice, but so far none of existing dressings can meet the clinical needs in terms of gas permeability, biocompatibility, comfort, and degradability. OBJECTIVE: To systemically evaluate the biosafety properties of water-soluble chitosan lactate/hyaluronan sponge after modification. METHODS: In the study, there were 10 male BALB/C mice of SPF grade (6-8 weeks old), 20 Sprague-Dawley rats of SPF grade (7 weeks old, both genders), and 3 male New Zealand white rabbits (8 weeks old), all provided by Dongguan Songshanhu Pearl Animal Technology Co., Ltd. The chitosan lactate/hyaluronan sponge was prepared for cytotoxicity test. A blank control group was set. According to the GB/T16886 biological evaluation system, the rabbits were subjected to composite sponge stimulation and sensitization and intradermal reaction tests from the perspective of biosafety, and then divided into non-polar extract group, polar extract group and negative control group. The inoculation site was observed within 72 hours. The mice were subjected to acute toxicity test, and divided into experimental group (extraction solution) and control group (pure saline), and their manifestations were observed for 72 hours. The rats were subjected to subchronic toxicity test, and then divided into experimental group (subcutaneous implantation of composite sponge) and control group (making a skin incision on the back followed by suturing). The changes in body weight of the rats were observed, blood samples from the rats were taken intravenously for blood routine analysis at 13 weeks after testing, and the rats were anesthetized and executed in the next day for gross observations of the heart, liver, spleen, kidney, brain, pancreas, thymus, stomach, and bladder. RESULTS AND CONCLUSION: (1) The chemical structure of the modified composite sponge formed as expected. The cytotoxicity of the composite sponge was grade 1, which was not significantly different from the negative control group. (2) The skin irritation test showed no skin erythema and edema in the New Zealand white rabbits after being stimulated by the composite sponge, and the existing stimulation reactions were extremely mild. Almost no obvious sensitization reaction occurred. (3) No erythema and edema were captured in the intradermal reaction test, and intradermal reaction stimulation of the composite sponge was very weak. (4) In the acute toxicity test, no obvious toxicity symptoms such as hypocinesis, dyspnea and abdominal stimulation were observed in the mice. Furthermore, at the observational time point of 72 hours, no acute systemic toxicity occurred in the two groups. (5) In the subchronic toxicity test, no obvious difference was detected in the rat body mass between the experimental and control groups. The same conclusion was made in the hematology and organ coefficient tests. To conclude, the chitosan lactate/hyaluronate sponge has excellent biological properties and good biosafety, which can be applied for further clinical use.

Objective To evaluate the effect of facial enhanced fat injection technique in facial remodeling.Methods 36 patients with facial facial reconstruction surgery from February 2011 to October 2014 in our hospital were involved in this study.The clinical data of patients with sagging facial aging and type A botulinum toxin injection combined with autologous fat granule injection enhanced facial surgery were evaluated.After postoperative follow-up of 3 months to 2 years,the effects of combined surgery of facial reconstruction were analyzed.Results In the 36 patients three months after operation a significant rate was 97.22％;at six months significant rate was 91.67％;at 12 month efficacy rate was 80.56％;at 18 months curative effect rate was 55.56％;at 24 months effective rate was 41.67％.Conclusions The use of botulinum toxin type A injection combined with autologous fat granule injection face lifting technique for facial reconstruction of aging patients with severe,is simple operation,obvious curative effect and less complications,which is an ideal treatment method that can be extended in clinical application.