Objective To investigate the technique and clinical effects of pedicle screw fixation in treatment of unstable Hangman' s fractures in comparison with the conservative managements. Methods From January 1999 to July 2005, 36 patients with unstable Hangman' s fractures were treated in our department. Based on Levine- Edwards classification, 15 of them were treated with skull traction, and others with internal fixation with posterior pedicle screws (C2,3 fusion in 10 cases and C2- 4 fusion in 11 cases). After a posterior midline incision and clear exposure of posterior structure, the C2 screw was inserted through the center of the posterior aspect of lateral mass, inclining usually 20? to 30? towards the head of the transverse plane and 25? to 35? inwards to the medial incline of the sagittal plane. For C3,C4 screw insertion, the drilling was parallel to the joint plane of the relevant vertebra and inclined 35? to 40? outwards to the medial incline of the sagittal plane. The whole procedure was performed under the monitoring of C- arm screen for safety and accuracy. Results A mean follow- up time was 18 months (5 to 28 months). 6 cases treated by skull traction lost their anatomic reduction. Of the 21 cases treated by the pedicle screw fixation, 2 had loosened internal fixation but 19 experienced no screw loosening and their fractures were cured entirely without limited function of the cervical vertebra. Conclusions In treatment of unstable Hangman' s fractures, C2,3 or C2- 4 pedicle screw fixation is an effective method to achieve rigid reduction and early rehabilitation. However, there is no remarkable difference between C2,3 fusion and C2- 4 fusion

Objective To investigate the quality of current domestic HIV antibody detecting kits and to assure the credibility of experimental results.Methods The sensitivity and specificity of three kinds of domestic HIV antibody detection ELISA kits made in three different years were evaluated and compared by testing the serum panel from National AIDS Reference Laboratory.Results The sensitivity of kits produced by three domestic manufacturers in 2001 is significantly better than the kits produced in 1998 and 1999.The false negative rates were apparently decreasing.Conclusions The quality of domestic HIV antibody detecting kits has been improving steadily.The sensitivity of double antigen sandwich ELISA assay is apparently better than the indirect ELISA assay.

OBJECTIVETo study the usage of viral load and CD4+ cell count methods in evaluating the effects of clinical treatment in HIV infected people.

METHODSTotally 73 cases of HIV infected persons were studied with clinical observation and laboratory examinations, six cases were treated with cocktail therapy, 36 cases with chinese herbs and the other 31 cases were untreated.

RESULTSThe results indicated that the viral load levels in cocktail therapy group were significantly lower than the other two groups within 3 months and then kept at very low level. The CD4+ T lymphocyte levels showed a significant increase after 3 months and kept rising up. The chinese herb group, however, had no significant difference in viral load level and CD4+ T lymphocyte level as compared with untreated group. But in clinical observation chinese herbs showed the effect of improving clinical status in some cases.

CONCLUSIONSThe authors conclude that the viral load and CD4+ count are efficient methods in clinical evaluation of HIV treatment, especially in routine anti-HIV therapy. As for the chinese herbs treatment, these two monitors did not reflect changes in clinical status.

Anti-HIV Agents ; therapeutic use ; CD4 Lymphocyte Count ; Drugs, Chinese Herbal ; therapeutic use ; Follow-Up Studies ; HIV Infections ; drug therapy ; immunology ; virology ; Humans ; Phytotherapy ; Treatment Outcome ; Viral Load