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 study the epidemiological characteristics of diarrhea-predominant irritable bowel syndrome (IBS-D) as well as the relationship between the main syndromes and different factors. Method The relevant information of patients were collected by clinical epidemiological method and the relationship between the main characteristics of the IBS-D syndromes and different factors was explored with the major syndromes as the key link. Result Most of the cases aged 30～49 years old. Special hobbies of patients followed by drinking, smoking, addicting spicy, addicting coffee and so on. Poor emotion, mental stress and diet were the main inducements. Liver stagnation and spleen deficiency has the highest percentage (44.7%). The distribution of syndromes in different ages, different genders, different occupations and different education had no significant difference. Conclusion The number of IBS-D hospital visiting-patients is lower than the actual number of illness people. Mental factors are important internal factors, and dietary factors may be an important external factor. Different factors have no effect on the distribution of syndromes.

Objective To determine operation procedure according to Oddi's sphincter functions decteted by preoperative duodenoscopy combined with intraoperative choledochoscopy (IOC). Methods The duodenal papillae and Oddi's sphincter functions of 319 cases with hepatobiliary calculus were detected by preoperative duodenoscopy, ERCP and IOC. Results As for the functions of Oddi's sphincter, 79 cases were superior, 152 cases favorable and 88 cases poor. Conclusions For patients with hepatobiliary calculus whether Oddi's sphincter is reserved according to the Oddi's sphincter function.

Objective To analyze retrospectively long term follow up of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy in prevention and treatment of pulmonary embolism (PE) in 24 patients with deep vein thrombosis (DVT) Methods This study included 13 males and 11 females with an average age of 52 4 years (14-86 years) Percutaneous implantation of inferior vena cava filters was performed via a femoral vein in 24 patients with acute or subacute DVT, of whom two were given conjunctive catheter based urokinase thrombolysis After the procedure, 20 patients underwent intravenous urokinase thrombolysis with subcutaneous low weight molecular heparin for 10 days and subsequent oral warfarin for six months Results All patients underwent a successful interventional procedure with an average 15 month (10-48 months) follow up One week after the procedure, relief of symptoms related to DVT was achieved in all the 24 patients Neither filter migration and thrombolic occlusion of filter nor PE and major hemorrhage were observed in this series Conclusion The use of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy is a safe and effective treatment modality in patients with DVT, which can be used to prevent subsequent PE

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 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 examine current use, associated complications, and short-term outcomes in patients with acute myocardial infarction (AMI) requiring intra-aortic balloon pump (IABP) counterpulsation. Methods A single-centre registry was conducted between October 2004 and July 2008. Data were collected from 121 consecutive AMI patients treated with IABP counterpulsation at the 28th Division of Beijing Anzhen Hospital. Results Among 806 patients with AMI, IABP counterpulsation was employed in 121 patients. Placement of an IABP was indicated for hemodynamic support during high-risk catheterization and/or angioplasty (66.9%) and cardiogenic shock (27.3%). Balloon insertions were successful in 98.3% of patients and duration of mean use was 34.2?16.2 hours. No major IABP complications occurred in all the patients. Diagnostic catheterization was performed in all the patients inserted with IABP, and 93.4% underwent coronary revascularization before hospital discharge. The total in-hospital mortality was 13.2% (34.4% in patients with cardiogenic shock) and varied markedly by indication and use of revascularization procedures. Conclusion IABP counterpulsation may be successfully employed for a wide variety of conditions in the AMI setting, providing significant hemodynamic support with rare major complications in a high-risk patient population. IABP counterpulsation may reduce mortality in patients with AMI undergoing reperfusion therapy.