BACKGROUND:The self-locking ROI-CTM interbody fusion has zero profile design which can significantly reduce the impact on the esophagus and pharynx, and also simplify the operation procedure. However, there is no report whether it has satisfactory outcomes in the treatment of Hangman fractures.
OBJECTIVE: To compare the clinical effects of ROI-CTM or titanium plate internal fixation on postoperative cervical stability and fusion rate in the treatment of Hangman fractures.
METHODS:Twenty-one cases of Hangman fractures were included, including 13 males and 8 females, aged 25-62 years old. Fifteen cases were treated with titanium plate internal fixation, and the other five cases were treated with ROI-CTM fusion device. Cervical anteroposterior and lateral radiographs, lateral flexion extension radiographs and CT scanning were carried out before, 3 days and 3 months after repair to assess angular displacement, horizontal displacement and fusion rate; visual analog scale score and Bazaz dysphagia score were determined.
RESULTS AND CONCLUSION:At 3 days after operation, the ROI-CTM group was significantly better than the titanium plate group in visual analog scale scores and Bazaz dysphagia grade (P < 0.05), and there were no significant differences in angular displacement and horizontal displacement (P > 0.05). However, at 3 months after operation, there was no significant difference between the two groups in visual analog scale score, Bazaz dysphagia grade, angular displacement and horizontal displacement and fusion rate (P > 0.05). Postoperative complete reduction rate of spondylolisthesis was higher in the ROI-CTM group than the titanium plate group (P < 0.05). In each group, the angular displacement and horizontal displacement were significantly reduced at 3 day and 3 months after operation (P < 0.05), but there was no significant difference at 3 days and 3 months after operation (P > 0.05). No rejection reaction, internal fixation fracture and loosening occurred in the two groups. These findings indicate that the self-locking ROI-CTM fusion for treatment of Hangman fractures are characterized as higher reduction rate of spondylolisthesis, less dysphagia, and less neck pain.

Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011 and March 2014.The patients (11 males and 3 females) were aged between 22 and 46 years (mean,26.4 years).Nine patients sustained traffic injury,4 fall injury and 1 crash injury.Nine patients were classified as type Ⅱ and 5 type Ⅱ a according to the Levine-Edwards classification.All were completed cervical anteroposterior and lateral X-ray,CT scan,three-dimensional CT reconstruction and MRI examination after adnission.American Spinal Injury Association (ASIA) grade E was noted in all before operation.Clinical posttraumatic neck score,visual analogue scale (VAS) as well as angle deformity and displacement of the axis were recorded before operation and at the latest follow-up.Results All patients were operated successfully.Mean operation time was 61 min(range,45-116 min).There were no injuries of superior laryngeal nerve,hypoglossal nerve,throat wall and vessel during operation.Laryngeal edema,dysphagia,paralysis of tongue,hematoma and wound infection were not observed after operation.Mean period of follow-up was 24.2 months (range,4-32 months).All segments and fracture sites showed solid fusion after 3 months.No cages became subsided or displaced,no discs collapsed,and no malunion occurred at the latest follow-up.Data of preoperation and latest follow-up differed significantly with respect to clinical posttraumatic neck score[(53.1 ±7.2) points vs.(91.1 ±5.0)points],VAS[3.38(2.43,4.33)points vs.0.58(0,1.29) points],axis displacement[(4.0 ± 1.5) mm vs.(1.3 ± 1.2) mm],and angle deformityoftheaxis[(9.2±4.7)° vs.(2.1 ±1.9)°] (P＜O.05 or O.01).Conclusion Anterior cervical surgery with ROI-C implantation for type Ⅱ or type Ⅱa Hangman fracture provides good fusion rate and satisfactory clinical effect.

Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.

Objective To investigate the expression of connexin CX43 using hybridization techniques after GABA restraining receptor gene was transferred into the supramammillary of hypothalamus in Kainic acid(KA) induced epileptic rats.Methods Twenty-four male Wistar rats were divided into four groups: control group(n=2),surgery group(n=2),KA group(n=10) and GABA restraining receptor gene transferred group(GABA group)(n=10).No treatment was given to the control group.Physiological saline(1 ?L) was injected into right amygdala of rat in surgery group.In KA group,KA(1 ?L,1 ?g) was injected into the amygdala of rat to build epileptic model.In GABA group,the GABA restraining receptor gene(400 nL,40 ng) was transferred into the supramammillary of hypothalamus by HVJ-liposome 48 h before KA was injected into amygdala.The expressions of CX43 mRNA and morphological changes different time(3 h,6 h,24 h,3d,7d) were observed by in situ hybridization in each group.Results In control group and surgery group,the morphological manifestations were normal,and the hippocampus structures were complete.In KA group,swell and degenerative hippocampus neurons were showed and deteriorated with time.In GABA group,the degeneration and necroses of hippocampus neurons were relatively alleviated.The positive expression of CX43 mRNA was few in control group and surgery group.And in KA group it increased with time.In GABA group,the positive expression of CX43 mRNA was fewer than that of KA group at every period.Conclusion The expression of CX43 mRNA in hippocampus can be decreased by transferring GABA receptor gene into hypothalamus.

Objective To investigate the charateristics of pathological changes in hippocampal subregions in rats with epilepsy induced with different doses kainic acid(KA) ,discuss the etiology and pathway of epileptic wave.Methods 30 male Wistar rats were randomly divided into control group,low(0.025 ?g) and high(0.1 ?g) dose KA injection groups with 10 rats each.KA was focally injected into the right amygdala by a glass micropipette connected to an air pressure system to make epilepsy model.The pathological characteristics in hippocampal subregions in rats with epilepsy induced with different doses KA were observed.Results Compared with control group,high dose KA injection mainly caused neuron loss in the CA3 region,while pyramidal and dentate granule cells were evenly distributed with normal shape and size.Low dose KA injection caused severe damage in both CA1 and CA3 regions.Dentate granule cells didn't show any pathological change and neuron loss in low dose injection.Conclusion The pathological changes in hippocampal subregions in rats with epilepsy induced with KA are different with different doses KA,it might be related to the pathway of epileptic wave and the specific properties of hippocampus.

Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.

Objective To investigate the cardiovascular risk factors in perimenopausal women and evaluate the risk for cardiovascular disease. Methods A total of 692 perimenopausal women permanent residents in a community of Zhengzhou from September, 2014 to May, 2015 were selected using multi-stage random sampling. Their age, blood pressure, body weight, smoking history, history of diabetes and fast-ing blood glucose, blood lipid and other information were collected. They were assessed with The National 10-Year Risk Assessment for Ischemic Cardiovascular Disease (ICVD). Results Prevalence of the cardiovascular risk factors screened for were as follow:hypertension 14.3%, dyslipidemia 32.1%, overweight or obesity 59.2%, type 2 diabetes mellitus 7.9%, smoking 0.6%. The absolute risk for ICVD in the next 10 years averaged as (2.01 ± 3.04)%, and increased with age. The incidence of high blood pressure, high total cholesterol, smoking, as well as the level of risk for ICVD were different among various age groups. Conclusion The cardiovascular factors are not controlled ideal-ly in the perimenopausal women, and result in high risk of cardiovascular disease, which need a set of intervention as their risk stratification.

Objective To explore the association between body mass index and blood pressure , blood glucose, blood lipids and the 10-year risk of ischemic cardiovascular disease (ICVD) among the middle-aged population and to provide theoretical evidence to prevent cardiovascular disease among overweight and obese mid-dle-aged population in the community. Methods A total of 1,628 middle-aged residents having health examina-tions in Hangdong and Nanguan Community Health Service Center in Guancheng District of Zhenghzou City from September 2014 to September 2015 were selected as subjects and were divided into three groups: normal group , overweight group, and obesity group according the size of the body mass index. The relationship among BMI , blood pressure, blood glucose, blood lipids and the 10-year risk of ICVD was explored. Results The preva-lence of overweight and obesity in the population was 47.97% and 15.72% respectively. There was significant dif-ference in body mass index , systolic blood pressure , fasting blood glucose , blood lipids and the distribution of the 10-year risk for ICVD (all P < 0.05). The incidence of hypertension, hyperglycosemia and hyperlipidemia increased with the increase of BMI (all P < 0.05). Multivariate logistic regression analysis showed that over-weight and obesity were independent risk factors of hypertension , hyperglycosemia and hyperlipidemia (OR =2.144, 1.911, 2.028). Conclusions The prevalence of overweight and obesity among middle-aged population is high in Guancheng District of Zhengzhou City. Overweight and obesity co-exit with other cardiovascular risk factors. Normal BMI is important to reduce the level of risk for CVD and the 10-year risk of ICVD.

To design a military hospital bonus accounting system. The system used Java as the fore-ground development tool and SQL Server 2005 as the background database, which extracted data from the military hospi-tal cost accounting management system to calculate the bonus with some formula. The system had four functional modules to complete department benefit accounting, bonus calculation, bonus summarization and bonus inquiry. The system decreases the workload and contributes to the standardized management of the accounting.

Objective To investigate the preliminary clinical result of thoracolumbar fracture combined with posterior ligamentous complex injuries repaired by posterior transpedicular screw fixation.Methods A retrospective review was performed on 22 patients with thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries treated with transpedicular screw fixation from July 2008 to March 2013.There were 16 males and 6 females with mean age of 39 years (range,23-62 years).After medically stable,posterior pedicle screw fixation was performed under intravenousinhalational anesthesia.According to the degree of fracture displacement and types of ligament injury,posterolateral bone grafting or intervertebral fusion at the level of injury was conducted.Vertebral height restoration,Cobb' s angle and American Spinal Injury Association (ASIA) score were reviewed preoperatively,at postoperative 3 days and at the last follow-up.Results All the patients were operated on smoothly.There were no complications during operation.All the patients were followed up for 5-51 months (mean,26.5 months).Fracture reductions were satisfied with the closure of vertebral posterior element.Mean anterior vertebral height and Cobb' s angle improved by 20.6％ and 10.60°respectively after operation (P ＜0.01).Eight patients with neurological dysfunction showed some recovery after operation with the mean sensory score improved by 20.7％ (P ＜ 0.05) and mean motor function score improved by 30.9％ (P ＜ 0.0l).All bone grafts were healed,without pain,loosening or breakage in the fixation system.Conclusions Posterior pedicular screw fixation attains good short-term outcome for thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries.The surgery provides satisfactory reduction and instant spinal three-column stability for the unstable spine fracture.Sufficient bone graft is the guarantee to permanent stability.