[Objective]To analysis the unstable pathogeny of the superior cervical congenital deformity for the operative method selection. [Methods]65 patients with congenital superior cervical deformity were treated from January 2003 to June 2007,in which there were 39 male patients,and 26 female patients. The X-ray,CT and MRI were examined generally before operation. In the images,there were 32 cases with formation failure deformity,18 cases with segmentation failure deformity,and 15 cases with abnormal structure deformity. 37 cases with easy reduction and no anterior compression were treated with posterior internal fixation and self cancellous bone graft for fusion. The other 28 cases with impossible reduction and anterior spinal cord compression were treated with anterior odontoid resection and decompression,and then posterior internal fixation and self cancellous bone graft for fusion.[Results]All of the operations were sucesseful without never and vascular injury and other serious complication. There were 47 cases following up 12 to 24 months in the 65 cases,and the mean follow up 15 6 months.One case's broken up titanium rod were treated with replacing new rod and bone graft,and the other cases showing bone fusion. There 28 cases following up in 34 cases with superior cervical pain and resticted movement,in which the pain was decreased or disappeared. There were 19 cases following up in 31 cases with numb limbs and superior never center injury. The preoperative Frankel score showed 5 cases B,8 cases C,and 17 cases D. The postoperative Frankel score of following up cases showd 5 cased C,6 cases D,and 8 cases E,and the score increased one or two degree.[Conclusion]The posterior,or anterior-posterior approach was selected by the condition of congenital superior cervical pathogeny,atlantoaxial reduction and spinal cord compression.

[Objective]To investigate the application of thoracolumbar injury classification and severity thoracolumbar injuty chassification and severityscdre(TLICS)score in spinal fracture caused by earthquake.[Method]Night-five patients with spinal fractures were treated in Chendu Army General Hospital and Chendu Air Force Hosptial by Wenchuan earthquake medical team from Chinese PLA General Hospital.There were 49 males and 46 females with mean age of 48.6 years.The general patient data,injury mechanism,and injury time were recorded.The different treatments were decided by the TLICS score.[Result]There were 107 vertebral fractures in the 95 patients,out of whom 76 patients were injured by building collapsed,and the other 19 by falling from buildings.TLICS score was more than 4 in 36 patients,4 points in 15 patients,less than 4 points in 44 patients.40 patients were treated with open operation,15 patients with vertebraplasty,and the other patients with conservative treatment.[Conclusion]The earthquake spinal fractures can be treated with different treatments based on the different TLICS scores.

cases with spondylotisthesis were treated with RF system. The types of spondylotisthesis were investigated and result was analysed. The results : follow up of an average of 5 years showed obvious relief of the symptoms. It suggested that RF system has the advantages of high reduction rate restoration of the intervertebral height and lumbo sacral physiological curvature and easy manipulation.

To evaluate the diagnosis and treatment of epidural neurilemmoma in the spinal canal, the diagnostic characteritics shown by X ray, MRI and CT were analyzed in 42 patients. Furthermore, peri operative conditions, operative time, blood loss and amount of blood transfusion during the operation, operative technique, changes in functions of the spinal cord before and after the operation were also analyzed. The results showed that there was marked recovery of nerve functions after the operation. MRI together with X ray and CT were in the diagnosis of the nature and site of the lesion. Excision of the tumor was done in all the patients. Among them, in 12 patients internal fixation was done at the same time. Follow up showed that the operation achieved good results. While radiologic examinations contributed greatly to the diagnosis, the final diagnosis depended on pathological examination. Internal fixation was optional depending on different situations.

Fourty-three cases with spinal tumors treated with vertebral resection were reviewed regarding the preoperative treatment, the operations, and the results, in order to evaluate the value of resection of the vertebral body in prolonging the survival time and in improving the life quality of the patients. All the patients showed neurological recovery after surgical decompression. The average improvement was 2 grades by Frankel system. A second operation was necessary in 3 cases with recurrent lesions. Pulmonary and urinary complications were found in 3 cases. Absorption of bone grafts, collapse of vertebrae and loosening of implants were found in 2 cases. Resection of the involved tissue or segments and re-establishment of stability have become the most important treatment modality for patients with spinal tumors. With the help of adjuvant therapy, the survival time and the life quality of patients have been greatly improved.

Objective To evaluate a new method of arthroplasty by transposing the greater trochanter together with a fascia flap pedicled by a branch of transverse lateral circumflex femoral artery. Methods On the basis of anatomical study, arthroplasty of the hip by transposition of the greater trochanter with fascia flap pedicled by a branch of transverse lateral circumflex femoral artery was performed in 17 patients (18hip). All the patients were followed up for six years and two months to eight years and two months. Results Pain vanished in 10 cases, slight pain remained in 1 patient, walking was nearly normal in 5 patients, and 2 patients were still limping with fast walk. Range of movement of the hip joint was as follows: flexion and extension 60?-120?, adduction 5?-15?, abduction 5?-10?, internal rotation 0?-5?, and external rotation 0?-5?. As shown by radiography, the joint space was obviously enlarged, the configuration of the femoral head was sharp, and the union between the greater trochanter and the femoral head was good. Conclusion Transposition of the greater trochanter with fascia flap pedicled by a branch of transverse lateral circurmflex artery to femoral head could result in a solid union with cartilagenous ossification and satisfactory recovery of function of the hip joint.

Objective To observe the effects of exogenous basic fibroblast growth factor (bFGF) on radiation-induced apoptosis of C17.2 neural stem cells(NSCs) and explore the relationship between bFGF and Hes1,RBP-JK protein.Methods The cell viability was assessed using the MTT assay.After the cells attach to the flasks they were irradiated by the linear accelerator.And 5 min later,different concentrations of bFGF in accordance with the experimental design and cultured cells 48 h.Extracted total protein of each group and Western blot analysis showed the changes of the Hes1,RBP-JK protein.Results Compared with the control group,irradiation group cell growth was inhibited,the OD of 0 ng/ml bFGF group was 0.61±0.81,the OD of 80 ng/ml bFGF group was 1.21±1.01 and the control group was 1.51± 1.13.Compared with the control group,all groups showed statistically significant difference (P＜ 0.05).Western blot analysis showed that with the increasing concentrations of bFGF,RBP-JK expression gradually decreased,but Hes1 expression gradually increased.Conclusion Exogenous basic fibroblast growth factor (bFGF) can inhibit apoptosis of C17.2 NSCs.bFGF can regulate Notch signaling pathway downstream proteins Hes1,RBP-JK expression and inhibit neural stem cell apoptosis which were irradiated.

42cases with spondylotisthesis were treated with RF system. The types of spondylotisthesis were investigated and result was analysed. The results : follow-up of an average of 5 years showed obvious relief of the symptoms. It suggested that RF system has the advantages of high reduction rate restoration of the intervertebral height and lumbo-sacral physiological curvature and easy manipulation.

Objective To observe the efficacy of monosialotetrahexosy lganglioside (GM1) in the treatment of vascular cognitive impairment (VCI). Methods Sixty patients with VCI were randomly divided into either a treatment group or a control group. The patients in the control group received conventional treatment and those in the treatment control group were treated with conventional treatment plus continuous intravenous infusion of GM1 (80 mg/d) for 2 weeks. The efficacy was evaluated by the Montreal Cognitive Assessment (MoCA) before and after the treatment, and the safety of the treatment was observed. Results After 2 weeks of treatment, the MoCA scores were significantly higher than those before treatment in both groups (all P ＜ 0. 05). The MoCA scores of the treatment group were significantly higher than those of the control group (20. 82 ± 1. 96 vs. 19. 61 ±2. 02, t =2. 315, P =0. 023). No obvious adverse reactions were found. Conclusions The efficacy of GM1 is positive in the treatment of vascular cognitive impairment, and there is no obvious adverse reactions. It is worthy of using widely in clinical practice.

OBJECTIVE To study the characteristic of nosocomial pulmonary infection to find out the measures for prevention and control.METHODS The patients with radiation brain injuries(RIB) from Oct 2004 to Jun 2007 underwent retrospective investigation.The reasons and sites of pulmoary infection were analyzed.RESULTS The incidence of pulmonary infection of patients with RIB after radiotherapy was 68.5%.Major factors of infection were bulb palsy,invasive treatment and hormone usage.The Gram-negative bacteria were the predominant pathogens.CONCLUSIONS The nosocomial pulmonary infection is related to many factors.Antibiotic usage according to drug susceptibility results and controlling of the risk factors are important measures to reduce the rate of infection.