Objective To compare medium-term therapeutic effect by bilateral and unilateral puncture plasma coblation nucleoplasty(PCN) in the lumbar disc herniation patients. Methods 90 cases confirmed no significant rupture of annulus fibrosus of lumbar disc herniation by CT or MRI were randomly divided into two groups. Bilateral and unilateral puncture plasma coblation nucleoplasty groups were respectively divided into group A and group B, and compared the JOA scores. Results 82 patients were followed up for 10 ～ 32 months,the average follow-up time was 16.2 months. Preoperative JOA scores of the two groups were not statistically significant(P ＞ 0.05) but the postoperative follow-up JOA scores were higher than preoperative(P ＜0.05) and the JOA scores of group A were higher than group B(P ＜0.05). Conclusion The medium-term therapeutic efficacy of bilateral puncture coblation nucleoplasty was superior to unilateral therpy.

Objective To evaluate the efficacy of Grosse Kempf interlocking intramedullary nailing (Grosse Kempf IIN) and AO plate in the treatment of tibial fractures. Methods A retrospective analysis was done on the recovery of 55 cases with tibial fractures treated with the Grosse Kempf IIN (Group A) and 40 treated with AO plate (Group B) from 1994. Results The 10 26 months follow up showed that the healing rate and the infection rate were 98.2% (54/55) and 1.8% (1/55) respectively in the Group A with a mean healing time for 5.6 months and 90.0% (36/40) and 12.5% (5/40) respectively in the Group B with a mean healing time for 7.5 months. Conclusions The Grosse Kempf IIN has obvious advantage of excellent biodynamics, reliable fixation, simple operation, less trauma on regional blood supply and is more effective in the treatment of tibial fractures than the AO plate. Nevertheless, I IN itself has limitation for further application.

24 hours. Results There were totally 192 patients met the criteria for the investigation. Group A consisted of 76 patients, group B 116 patients. No significant differences between the two groups were found in terms of associated injury, ISS, ICU length of hospital stay,complication or mortality, while significant difference existed between two groups in terms of associated shock (?2=6.078,P

BACKGROUND: In recent years, percutaneous kyphoplasty (PKP) has been widely used in the treatment of osteoporotic vertebral compression fractures, but there are still some complications, such as bone cement leakage and re-fractures, and a lack of follow-up treatment.OBJECTIVE: To investigate the effect of PKP with low-dose bone cement in combination with zoledronic acid on bone mineral density (BMD), vertebral height and low back pain after osteoporotic vertebral compression fractures.METHODS: Eighty patients with osteoporotic vertebral compression fractures were equally randomized into test group (treated with PKP with low-dose bone cement in combination with zoledronic acid) and control group (treated with PKP with conventional bone cement). Visual analog scale score, vertebral height, and Cobb angle were detected before, at 3 days after treatment and at the final follow-up visit. BMD and re-fracture incidence were reviewed 1 year after treatment.RESULTS AND CONCLUSION: Visual analog scale scores, vertebral height, and Cobb angle were significantly improved in both groups at 3 days after treatment and at the final follow-up visit (P < 0.05); however, there was no statistical difference between the test and control groups. One year after treatment, the BMD value was significantly increased in the test group (P < 0.05), but showed no change in the control group as compared with the pretreatment.Postoperatively adjacent vertebral fractures were found in one case of the test group, and five cases in five cases of the control group. These findings indicate that PKP with low-dose bone cement in combination of zoledronic acid can effectively relieve pain symptoms, restore the height of the vertebral body, significantly increase BMD value and reduce the incidence of adjacent vertebral fractures in patients with osteoporotic vertebral compression fractures.

Results of experimental studies with guinea pig showed that a strong blast may produce concussion of the vestibular apparatus. The parts injured include saccule and utricle and their maculas, semicircular canals and their cristas,and the nerves related to these organs.The most common pathological changes were hemorrhage, detachment of sensorial epithelium, collapse of membranous labyrinth, loss of oto-liths and degeneration of sensorial epithelial cells.The authors believe that these vestibular damages are produced by the combined action of strong noise and shock wave, being transmitted through the oral and round windows into the inner ear, producing a violent fluctuation of endolymph.

Objective To study the effect of 2-methoxyestradiol (2-ME) on proliferation,apoptosis and its mechanism.Methods K562 cells were treated with 2-ME of different concentrations and time in vitro.Cell apoptosis rate was measured by flow cytometry(FCM).Activity of NF-Kappa B in nucleus was detected by electrophoretic molility shift assay(EMSA).Results After treatment with 2-ME,K562 cells apoptotic rate increased significantly.After treatment with 4μmol/L 2-ME for 24h、36h、48h,the activity of Caspase-3 and Caspase-9 were significantly higher and activity of NF-Kappa B in nucleus was significantly lower.Conclusion The present study showed that 2-ME induced apoptosis of K562 cells via active Caspase-3 and Caspase-9 and inhibit the activity of NF-kappa B in nucleus.This study provided useful experimental data for clinical application of 2-ME.

Objective To discuss the protective effects and mechanisms of dexamethasone and Shenfu sepa-rate and joint administration of flap after ischemia-reperfusion injury. Methods 40-month-old fairly healthy rats were randomly divided into 4 group as A, B, C, D, and to product the abdominal island flap, then blocking the flow of blood of the pedicle artery respectively before 30 minutes when injecting with normal saline (1 ml/kg), dexametha-sone (1 ml/kg), Senate (10 ml/kg), joint injection with dexamethasone (1 ml/kg) and Shenfu (10 ml/kg). 4 groups of animals' blood samples were collected from the pedicle vein before the time of I hour when blocking vascu-lar pedicle and reperfusion after the time of 1 h, 6 h, 12 h, 24 h, respectively. Then the plasma concentration of TNF-α was measured. Results The concentration of TNF-α in the treatment group was significantly lower than the blank group(P <0.01). And the group D and the group B、C has significant differences either(P <0.01). Conclu-sion Using Dexamethasone, Shenfu injection in early can reduce the concentration of TNFα in repeffusion injury of flap and has a protective effect on the flap, but make better effect in combined.

Objective To observe the effect of scalp acupuncture plus body weight support treadmill (BWST) training on motor function and ambulation of lower limbs in spastic cerebral palsy. Method Sixty-six eligible subjects with cerebral palsy were divided by using random number table into group A (n=20), group B (n=23), and group C (n=23). Group A was intervened by regular rehabilitation training, group B was by BWST in addition to the treatment given to group A, and group C was intervened by scalp acupuncture in addition to the treatment given to group B. The dimension D and E of Gross Motor Function Measure (GMFM) scale and Activities of Daily Living (ADL) were adopted for evaluation before treatment and after 3-month treatment. Result Before treatment, there were no significant differences in comparing the indexes among the three groups (P>0.05). After 3-month treatment, the D-dimension scores of GMFM were respectively (25.38±4.85), (29.54±5.70), and (32.37±6.58) in the three groups; the E-dimension scores were respectively (55.35±11.64), (60.80±12.47), and (65.74±13.50); the ADL scores were (60.24±14.49), (68.25±13.74), and (76.30±14.58); the scores were significantly increased in all three groups after intervention (P＜0.01), and the D-dimension and E-dimension scores of group B and C were significantly higher than those of group A (P＜0.05), and the scores of group C were significantly higher than those of group B (P＜0.05). Conclusion Scalp acupuncture plus BWST can improve the motor function and walking ability of lower limbs in spastic cerebral palsy, and thus enhance of ADL of the patients.

Atopic dermatitis (AD) is an inflammatory skin disease closely related to impairment of skin barrier function.Hereditary factors,life style and exposure to the environment all contribute to the occurrence of AD.Even though AD occurs mostly in infants,sometimes it may initially occur in adults,which is called adult-onset AD (AOAD).There are evident differences in types,immunological mechanisms and association with other diseases between childhood AD and AOAD.The lesional distribution of AOAD is similar to that of childhood AD,while AOAD is characterized by subacute and chronic dermatitis,and mainly manifests as dry hypertrophic lesions rarely complicated with exudation.Th1/Th2 imbalance and hyperfunction of antigen-presenting cells are immunological basis of AD occurrence.Moreover,FLG gene mutations are associated with the occurrence of AD.Acquired expression defect in the FLG gene induced by elevated levels of interleukin-13 (IL-13) only occurs in adults,suggesting that AOAD is different from AD that initially occurs during infancy and continues into adulthood.Infection,changes of bacterial flora in the skin and intestinal tract,and smoking are all important causative factors of AOAD,thus enquiries about histories of related diseases and smoking are helpful for the diagnosis of AOAD.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.