From July 1998 to May 2000, 31 cases of lumbar spondylolisthesis accompanied with lumbar stenosis were treated with spinal cord decompression, autograft interbody fusion and fixed by Dyna lok system. All the patients were followed up for 6 to 28 months, averaged 12 7 months. 29 of the 31 patients were recovered completely. 2 cases of cauda equina were recovered within 2 months. Lowback pain remained in 1 case of multi segements spondylolisthesis which had been fixed for 3 vertebrae. 1 patient accompanied with cervical spinal stenosis had some residual claudication. In conclusion, spondylolisthesis fixed with the Dyna lok system can achieve a satisfactory result.

12E7 Antigen ; Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Child ; Diagnosis, Differential ; Heart Neoplasms ; metabolism ; pathology ; surgery ; Heart Ventricles ; pathology ; Humans ; Male ; Neurilemmoma ; metabolism ; pathology ; Neurofibroma ; metabolism ; pathology ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adolescent ; Chondrosarcoma ; pathology ; surgery ; Douglas' Pouch ; pathology ; surgery ; Female ; Humans ; Peritoneal Neoplasms ; pathology ; surgery ; Soft Tissue Neoplasms ; pathology ; surgery

Objective To discuss the value and experience of the percutaneous vertebroplasty (PVP)in the treatment of vertebral body compression fracture(VCF)in aged osteoperosis.Methods PVP was performed in 44 cases with VCF including 28 with single vertebral compressed fracture,12 with double compressed fracture and four with triple compressed fracture,with 67 vertebrae,for clinical and radiologieal evaluation.Results The mean follow-up was 15 months(4-23 months).There could be seen immediate relief of pain in 40 cases,out-of-bed activities at operation day in 19 and out-of-bed activ- ities at second day after operation in 25.Postoperative X-ray showed uniformly distributed bone cement in the vertebral,without leakage.Conclusion PVP is a recommendable method for VCF,for it has ad- vantages of pain relief,vertebrae stabilization,minimal invasion and minor complications.

BACKGROUND: Chinese traditional osteopathy is long in history, unique in manipulation and miraculous in therapeutic effect. But people understand it more m perception rather than in theory, more in application rather than in development. There is little research truly on the bioseience.OBJECTIVE: To probe into the macro-idea of Chinese traditional osteopathy, micro-mechanisms on characters and mathematics-physics models, aiming to provide new principles and approaches of treatment for the daily increased bone trauma, fracture and sport injury.SETTING: Physics and machine-electron college of a university, and its affiliated hospital.METHODS: Based on the natural concept of "integration between heaven and human being" and new concept of holistic medicine in Chinese traditional osteopathy, the macro-idea and characters of reduction and union of fracture are generalized from the characters of natural therapy and the biomechanical mechanisms and characters of reduction and union of fracture are summarized from the micro-reaction of bone repair and union so as to discover biomechanical mechanisms and characters of reduction and union of fracture and further to set up biomechanical models and mathematics-physics expressions during the treatment.RESULTS: Chinese traditional osteopathy envelopes macro-idea of "initiative reduction-functional union" in fracture and micro-mechanism on "stress adaptability-functional adaptability" of bone repair and union.CONCLUSION: Chinese traditional osteopathy compiles with the natural,green and non-traumatic therapy in bio-natural law of bone repair and union and supports the theme of "high thought and high skill".

Giant cell tumor of bone (GCTB) seldom occurs in the head or face. This article reported a case that GCTB occurred simultaneously in the temporal bone and mandibular condyle, and analyzed their clinical and pathological features.
Bone Neoplasms ; Giant Cell Tumor of Bone ; Humans ; Mandibular Condyle ; pathology ; Mandibular Neoplasms ; Temporal Bone ; pathology

AIMThe clinical manifestation of chronic mountain sickness (CMS) is polycythemia, pulmonary hypertension and mionectic blood. However, the pathogenesis of it is not identified now. So it is necessary to investigate the effects of the angiogenic growth factors on the pathophysiologic development of CMS.

METHODSThe serum levels of basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) in 13 healthy Tibetan natives (Native), 17 healthy people in Xining (control group) and 35 CMS patients were determined by quantitative sandwich enzyme immunoassay. Meanwhile, the levels of Hb, Hct and SaO2 were determined.

RESULTSThe serum levels of bFGF (107.26 +/- 7.86) ng/L, PDGF (630.18 +/- 9.89) ng/L and VEGF (543.74 +/- 6.76) ng/L in CMS were significantly higher than those in Natives (37.01 +/- 9.16; 292.16 +/- 6.88; 125.51 +/- 7.26) ng/L, and in control group (40.58 +/- 5.34; 287.68 +/- 8.33; 76.26 +/- 4.60) ng/L, respectively (P < 0.01). There was no difference between the natives and the control group in bFGF and PDGF (P > 0.05), while there was predominant difference between the Natives and the control group in VEGF (P < 0.01). There was a predominant positive correlation between the serum levels of bFGF, PDGF or VEGF and hemoglobin concentrations in CMS respectively (P < 0.01). And there were positive relations between angiogenic growth factors each other.

CONCLUSIONThe serum levels of bFGF, PDGF and VEGF in patients with CMS significantly increase, these angiogenic growth factors may play important role on the pathophysiologic development of CMS; the VEGF level likely contributes to the adaptation to plateau hypoxia in healthy Tibetan natives; the elevated bFGF, PDGF and VEGF levels are likely associated with excessive erythropoiesis in CMS.

Adult ; Altitude Sickness ; blood ; Case-Control Studies ; Chronic Disease ; Fibroblast Growth Factor 2 ; blood ; Humans ; Male ; Middle Aged ; Platelet-Derived Growth Factor ; metabolism ; Vascular Endothelial Growth Factor A ; blood

The objective of this study was to detect the level of plasma stromal cell-derived factor-1 (SDF-1) and the expression of CXCR4 (SDF-1 receptor in bone marrow cells) in children with Acute Leukemia (AL) and to investigate the relationship between the expression of CXCR4 and extramedullary infiltration. 48 children with acute leukemia and 20 with non-hematologic malignancies were selected into the AL group and the control group respectively. The peripheral plasma and bone marrow cells were collected. The level of SDF-1 in peripheral plasma was detected by ELISA and the expression of CXCR4 in bone marrow cells was determined by flow cytometry. The results showed that the levels of SDF-1 in peripheral plasma and the expression of CXCR4 in bone marrow cells of AL group was significantly higher than that of control group, among which the level of SDF-1 of the acute lymphoblastic leukemia (ALL) group was also higher than that of the acute myeloid leukemia (AML) group, the expression level of CXCR4 in the bone marrow cells of the extramedullary infiltration (EI) group was higher than that of the non-extramedullary Infiltration (NI) group, and all the differences between the both groups were significant. It is concluded that SDF-1 and CXCR4 express a high level in children with AL, which closely relates with the type of leukemia and the migration and infiltration of leukemia cells in bone marrow.
Acute Disease ; Adolescent ; Bone Marrow ; metabolism ; Bone Marrow Cells ; metabolism ; Case-Control Studies ; Chemokine CXCL12 ; blood ; metabolism ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Infant ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism

OBJECTIVETo study the morphological, ultramicrostructural and pathological changes of tissues from a patient with severe acute respiratory syndrome (SARS).

METHODSOne autopsy case of diagnosed SARS was investigated. Lung puncture was performed immediately after the patient died, and the autopsy was done after 12 h. The specimens from lymph nodes, spleen, small intestine, colon and bone marrow were studied by immunohistochemical technique. The antibodies used included CD20, CD45RO (UCHL-1), CD4, CD8, CD68 and CD34.

RESULTSThe principal lesions of the SARS case consisted of acute lobular intrastitial pneumonia, hyaloid membranes of pulmonic alveoli and hyperplasia and shedding of alveolar epithelium of. Virus-like inclusions occasionally contained cytoplasm of the alveolar epithelium, which were positive by histochemical staining. The adjacent blood-vessels were changed by hyperplasia and enlargement. The structures of lymph nodes and spleen were damaged with lymph follicles depletion and splenic nodules atrophy. The specific changes included reduction of lymphocytes and hyperplasia of histiocytes, depletion of the follicles of small intestine and colon wall, decreased hyperplasia of the bone marrow and increased number of the megakaryocyte. Meanwhile, in the immunohistochemical study, CD(20)(+) B cells were fully expressed in lymph nodes and spleen, and the CD45RO (UCHL-1)(+) T cells were scatteredly expressed. The number of CD4(+) help T cell was markedly decreased, while the number of CD8+ poisonal T cells increased, and the ratio of the former and latter was no more than 0.5. Under the electronic microscopy observation, virus-like particles with 80 - 160 nm diameter and halo or garland envelope were found in mononuclear macrophage and cytoplasm of alveolar epithelium.

CONCLUSIONThe specific lesions of SARS consist of lobular intrastitial pneumonia with the formation of hyaline membranes of lung, haemorrhage, necrosis, inflammation of blood vessels and the damages of extralung lymphohemopioetic system. The damages were very similar to the pathological features of tissues infected by human immunodeficiency virus, in which numbers of T cells decreased and CD(4)(+) T cell/CD(8)(+) T cell ratio was no more than 0.5. According to the virus-like particles found in lung of the SARS case, it is considered that these virus-like particles may be a new kind of coronavirus which caused the "atypical pneumonia".

Humans ; Immunohistochemistry ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Microscopy, Electron ; Middle Aged ; Myocardium ; pathology ; Severe Acute Respiratory Syndrome ; pathology

OBJECTIVETo study the clinicopathologic features, immunophenotype and differential diagnosis of sclerosing epithelioid fibrosarcoma (SEF).

METHODSEight cases of SEF were investigated by light microscopy and immunohistochemistry.

RESULTSThere were five males and three females. Clinically, most patients presented as a slowly growing mass. Six tumors were located in the extremities or limb girdles, and two in the trunk. Grossly, most lesions were relatively well-circumscribed with a nodular or lobulated appearance. They ranged from 2.0 to 10.5 cm in size (mean 6 cm). On sectioning, they had a gray-whitish cut surface and were firm in consistency. Microscopically, the tumors were composed of uniformly round or polygonal epithelioid cells with clear to eosinophilic cytoplasm. The tumor cells were arranged predominantly in single strands or cords and embedded in a heavily hyalinized matrix. In some areas, nests, sheets, acini or alveolar structures were also noted. Nuclei atypia and brisk mitotic activity was not evident. The mitotic count measured less than 1 per 10 high power fields. However in two cases, focal areas exhibited increased cellularity, nuclei atypia and higher mitotic activity, resembling conventional fibrosarcoma. Immunohistochemically, the tumor cells showed diffuse and strong positivity for vimentin and focal or weak positivity for EMA. There was no expression for AE1/AE3, S-100 protein, HMB45, alpha-SMA, MSA, desmin, CD34, bcl-2, CD30 and LCA. Follow-up information in six patients revealed local recurrence in 3 cases and lung metastasis in 1 case.

CONCLUSIONSSEF is a rare variant of fibrosarcoma. Despite the relatively bland appearance and low mitotic activity, the tumor is capable of local recurrence and distant metastasis. Thus, it should be considered and treated as a low to intermediate grade sarcoma. SEF needs to be differentiated from a variety of benign or malignant tumors exhibiting epithelioid features and sclerotic stromal response.

Adult ; Diagnosis, Differential ; Extremities ; Female ; Fibrosarcoma ; metabolism ; pathology ; secondary ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Soft Tissue Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism