Among all the road traffic injuries(RTI ),limb and spine fractures have a very high inci-dence.They can be caused by a variety of traumatogenic mechanisms,of whi ch crash is the most common.The distribution of types of fracture in RTI assumes a centrifugation-like p attern.Multiple fractures,homola teral limb injuries and violence-conducted in juries are common.The priority in RTI emergency is to treat serious concu rrent injuries and life-threatening comp lications.Only after the overall condition of the victim get stabilized can open injuries and fractures be treated ac tively.To treat victims of fracture s caused by RTI,especially those with a poor overall condition or an old age,appl ication of external fixation,espec ially a unilateral one,is a good consider-ation.And application of lockable i ntramedullary nailing to treat long tubular bone fractures has proved ve ry satisfactory.As for pelvis fractur es caused by RTI,external fixation c an be used initially while massive hemor-rhage resulted from the injury shoul d be treated vigorously.Internal fixation should be adopted as soon as th e vital signs get stabilized.To treat spine and spinal cord injuries,titanium a lloy is the first choice for fixation material.In most cases,anterior cervical fix ation and fusion with steel plate and screw is advisable for treatment of f ractures of cervical spine,while posterior i mmobilization with screw through pedicle of vertebra is usually suggested for treatment of fracture-dislocation of thoracolumbar vertebrae.

Objective To prevent wrong diagnosis and treatment of chronic inflammatory demyelinating polyneuritis(CIDP) by analyzing the clinical characteristics of CIDP and spine degeneration disorders. Methods In order to distinguish CIDP from spine degeneration diseases, we retrospectively reviewed 16 CIDP patients from December 2000 to December 2003 (male 10, female 6; range 38-58 years old, mean 49.1 years old) who were misdiagnosed as spine degeneration diseases. The duration of the disease was 2 months to 2 years and 8 months, with an everage of 106 months. All clinical data of the 16 patients were analyzed. The data included clinical manifestation, physical examination, protein content of cerebrospinal fluid (CSF) and upper-lower extremity electrophysiologic study(EPS). Comparing the clinical charateristics of CIDP with those of spine degeneration disease. Results All 16 patients of CIDP sufferred limbs sensory disturbance or abnormality, walking difficulty. Upper or lower extremity were involved at equal pace and symmetry; limb tendon reflexes weakened or dissappeared, but limbs muscular atrophy were not significant. X-ray showed degeneration of cervical or thoracic and lumbar spine; MRI showed that there were disc herniation in different intervertebral. The content of protein of CSF remarkably increased(mean 479.9 mg/L). There were significant deviation compare to normal. Electrophysiology study found that sensory nerve action potential(SNAP) wave amplitude were descending; motor nerve conduction velocity(MNCV) were slower. Conclusion We could rightly diagnose and distingnish CIDP from spine degeneration diseases by analyzing clinical manifestation, physical examination, cerebrospinal fluid and electrophysiological study. [

0.05). Conclusion Our finding suggests that it is reasonable to operate on elderly patients with lumbar stenosis who are different in body mass index, because little relation has been found between body mass and surgery outcome.

Objective:To further study the pathogenesis of classic Schm orl′s nodes based on clinical practice.Methods:A patient with severe low back pain was found that the irregularity of the endplates and the presence of Schm orl′s nodes in L2 - 3 and L3- 4spaces in lumbar radiographs.Two painful intervertebral discs with Schm orl′s nodes in their superior or inferior endplates were identified by discography and pain provocation.Two foci of Schnorl′s nodes were rem oved in en bloc via a retroperitoneal approach for histological examination.Meanwhile,anterior intervetebral body fusion of painful discs were undertaken.Results:The radiographic manifestation of Schmorl′s nodes was the end- plate indentation.Schmorl′s nodes in CT scan was shown as a round- like or multicystic irregular zone of bone density with an indistinct sclerotic margin beneath the cartilaginous endplate,which was sim ilar to the typical CT changes of osteonecrosis.The histological examinations of en bloc slices of Schm orl′s nodes revealed subchondral osteonecrosis.Conclusion:The current study indicate classic Schm orl′s node shown in radiograph is osteonecrosis zone beneath cartilaginous endplate,suggesting the necessity of further study on Schmorl′s node form ation. [

To further understand the function and biological activity of TGF ? 1, and to provide the basis for the production of biologically active TGF ? 1 protein, TGF ? 1 cDNA was cloned into procaryotic expression vectors--pBV220 and pQE30, and the monomeric form of the recombinant TGF ? 1expressed in E.coli DH5? and M15. Sephacryl S 100 HR and Ni + NTA agarose column were used to purify the TGF ? 1 protein. With digestion of the enzymes and sequencing, TGF ? 1 mature peptide gene was inserted into procaryotic expression vectors--pBV220 and pQE30. After purified, the expressed products of two plasmids in E.coli showed a single protein on SDS--PAGE, and their expression levels were about 15% and 20% of the total bacterial protein. The construction of recombinant plasmids and preparation of the monomeric protein of TGF ? 1 lay a solid foundation for further studying the function of TGF ? 1 and producing biologically active TGF ? 1 protein.

Objective To evaluation of the result of transplantation of BDNF gene transfected olfactory ensheathing cells (OECs) to repair spinal cord injury (SCI). Methods The rat with SCI were divided into non-OECs, OECs and transfected OECs groups. The evidences of anatomical regeneration across the transection site were demonstrated by both neuronal tracing and immunohistochemical methods. Results 12w after implantation the retrograde labeling study with flurogold showed abundant labeled neurons in the superior part of CNS. There were a lot of labeled neurons in the intermediate zone and dorsal column of lower thoracic spinal cord rostral to the transection site. Labeled neurons were also observed in the upper thoracic and cervical spinal cord, reticular nucleus and raphe nucleus of oblongata, as well as reticular nucleus and parabrachial nucleus of pons. The anterograde labeling of PHA-L showed that regenerated fibers of upper neurons overcame glial scar and regrew into the distal part of spinal cord through the grafts. Some labeled fibers extended long enough to the caudal gray matter of the transected site. Conclusion The implantation of OECs transfected by BDNF gene may benefit the survival and regeneration of the injured axons, and accelerate the repair of the injured spinal cord in a more efficient way than that with OECs alone.

D and the differences between groups were statistically significant(P0.05).Proliferation index increased in the early phase and reached the peak at the 4th post-operative week.Level of proliferation index in four groups was gradiently decreased from group A to group D.At the 4th post-operative week,differences of proliferation index were statistically significant between groups(P0.05).The changing trend of ratio of CD4+/CD8+ was similar to that of proliferation index.Histological observations showed inflammatory cells infiltrated in early phase gradiently decreased from group A to group D.At the 4th post-operative week,histological observations showed neovascularization in group D.At the 8 weeks post-operatively,more new bone formation was observed in group D. The correlation analysis showed significant positive correlation between proliferation index,CD4+/CD8+ ratio at the 4th post-operative week and the content of total lipid (P

[Objective]To evaluate the indications,efficacy and safety of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation.[Method]From June 2005 to February 2008,41 patients with lower cervical fracture and dislocation received posterior total laminectomy decompression and reduction with pedicle screws.The patients(M=32,F=9)were 22-47 years old,with an average of 33.5 years old.There were 38 fresh and 3 old injuries.[Result]All the patients were operated on successfully without severe complications during perioperative period.Totally 252 (89%) screws were exactly implanted in the cervical pedicle.The everage surgery time was 3.1 h (2.5-4 h).The average blood loss during the operation was 460 ml (250-950 ml). The average time of follow-up was 27.5 months(24-36 months). All patients had satisfiactory reduction and no internal fixator failure.Thirty-two patients who were followed up for more than 24 months had complete fusion. The motor and sensory score (ASIA92) were improved significantly at 2 years follow-up(P

[Objective]To explore the influence of defatting procedure on osteogenicity of cancellous bone allograft.[Method]Thirty inbred Lewis rats were killed.Distal femoral metaphyses were resected as cancellous bone grafts.Grafts were randomly divided into four groups which were treated by four different procedures,respectively.Content of total lipid and total protein in grafts were measured.Twelve inbred Fisher344 rats were randomly divided into four groups according to different grouped grafts which were transplanted into femoral metaphysis bone defects of the recipients.Two different fluorochrome dyes were given subcutaneously to the recipients at 14th and 4th days before sacrifice respectively.All rats were killed at the 8th postoperative week.The experimental distal femoral metaphyses were harvested and nondecalcified sections were prepared.Sections were observed with a fluorescent microscope and bone histomorphometries were studied.The correlation analysis was performed between mineral apposition rate(MAR) and the content of total lipid.[Result]Results of measurement showed content of total lipid in four grouped grafts were different and the difference between groups were statistically significant(P

0.05). However, there was significant difference between the "open-window" or hemilaminectomy group and total laminectomy group. The time of returning to work and the rate of returning to previous work were 4.3 months and 84.6% in "open-window" group, 4.6 months and 86.4% in hemilaminectomy group and 4.4 months and 77.8% in total laminectomy group respectively. The height loss of involved disc spaces was discovered in the postoperative radiographs in all the patients. However, no segmental instability was found in the majority of these patients. Conclusion 1) "Open-window" or hemilaminectomy may achieve satisfactory long-term results for treatment of lumbar disc herniation. 2) No definite correlation exists between the height loss of involved disc space and segmental instability or nerve root entrapment. 3) Discectomy is still a reliable and effective surgical procedure for the treatment of lumbar disc herniation before the reliability of any disc replacement is confirmed in the long-term follow-up survey.