Objective To investigate the correlation between lumbar curvature and lumbar intervertebral disc herniation.Methods 160 cases of young and mid-aged lumbar disc herniation patients were collected.All patients were divided into two groups accord-ing to the curvature.The age,sex,course of disease,occupation and MRI manifestations were recorded.Also,the recurrence and the arch top distance were recorded in 6 months after treatment.Results The age,sex,course of disease were similar between the two groups.70% of the patients in curvature straighten group were sitting or standing for long time in life,while in the other group more people were engaged in traditional manual work(P<0.05).The arch top distance increased in the curvature straighten group when rechecked(P<0.05).There were more patients with L4/L5 segment intervertebral disc herniation in the curvature straighten group,while more patients with L5/S1 segment intervertebral disc herniation in the other group(P<0.001).The recurrence rate was higher in the curvature straighten group,and the arch top distance was less in the patients with recurrence in both groups(P<0.05).Conclusion The patients with curvature straightening have a higher rate of recurrence and intervertebral disc herniation in L4/L5 segment.The recovery and reconstruction of the balance of the lumbar spine biomechanics is beneficial to the patients’cura-tive effect and functional recovery.

Objective To explore the effectiveness of modified Sundaresans method, including exposure through the incision involving both of the sternoclavicular joint and lower cervical region with sternum retention, in the treatment for upper thoracic spinal tumor. Methods From January 1999 to October 2003, 14 patients, 9 males and 5 females, aged from 26 to 65 years with a mean of 43 years underwent the modified Sundaresans procedure. The anterior cervico-thoracic incision was made, the medial part of clavicle close to the sternoclavicular joint was removed. After the exposure of the tumor, the involved vertebral body and contiguous discs were resected, the spinal cord was decompressed, then followed by implanting part of resected clavicle or titanium mesh with an anterior locking plate system. Neurological status was graded according to Frankel grading system. Results The duration of follow-up ranged from 6 months to 2 years with an average of 10 months. This approach displayed the upper thoracic region clearly for removal of the tumor and internal fixation,in avoiding the neurological injury. All patients had their neurological improvement at different level. According to Frankel grading system, one patient improved from grade A pre-operation to B post-operation, while another patient from B to D. Of 2 cases with grade C before operation, one improved to D and the other to E. Of 4 patients with grade D, 2 improved to E, while the other 2 left unchanged. There were 6 cases keeping the same grade before and after operation. Resection of sternoclavicular joint almost had no effect on the movement of shoulder. The abduction of the shoulder joint in 14 patients from 90?-130?(average, 125?) preoperatively became 80?-120?(average, 110?) postoperatively. Conclusion The modified Sundaresans method for the upper thoracic tumors has many advantages, such as satisfactory outcome, less invasion and no loss of the shoulder function. It is especially indicated to the tumors, where the spinal compression is located anteriorly.

Objective To investigate the predictable value of susceptibility weighted imaging (SWI)in hemorrhagic transforma-tion (HT)of ischemic stroke.Methods 48 patients with ischemic stroke were involved.The presence and features of HT on CT, T1 WI,DWI and SWI were observed,as well as the distribution and signal features of cerebral microbleeds (CMBs),abnormal visi-bility of venules on SWI sequence.The correlation between those imaging findings and HT were analyzed.Results HT was detected in 19 of 48 patients (39.6%).The sensibility of T1 WI,DWI,SWI in detecting HT were 68.4%,36.8%,100%,respectively.HT was significantly associated with abnormal visibility of venules within the infarction region.The incidence of HT greatly increased with the aggravation of CMBs.Conclusion SWI can be a sensitive predictor for HT,and it’s helpful in making clinical strategy for ischemic stroke.

Objective To study compatibility stability of Danshen injection combined with dopamine injection in 5% glucose injection. Methods The relative contents of tanshinol sodium, protocatechuic aldehyde, rosmarinic acid,salvianolic acid B in Danshen injection and Dopamine hydrochloride in dopamine injection were determined by HPLC in 6h after the compatibility in the above infusion at 5 ℃,25℃,35 ℃ under dark and light,and the changes in pH value,appearance and insoluble particles were also observed.ResuIts There were no significant changes in appearance and pH value at 5℃,25℃,35 ℃ under dark,insoluble particles were in line with Chinese Pharmacopoeia,and the relative content of tanshinol sodium, protocatechuic aldehyde, rosmarinic acid,salvianolic acid B and Dopamine hydrochloride were above 99%(compared with 0h) in 6h.In the light conditions,as the temperature raised,the extension of storage time,the relative content of Dopamine hydrochloride was not significantly decreased,but the content of tanshinol sodium, protocatechuic aldehyde, rosmarinic acid and salvianolic acid B had declined,while pH value also had a certain degree of reduction,the insoluble particles had no obvious change.ConcIusion The mixture of Danshen injection and dopamine injection in 5%glucose injection is stable under dark conditions in 6h, illumination and temperature maybe the main factor affecting the stability of Danshen injection combined with dopamine injection.

Objective: To study the effect of palate repair operation on middle ear function. Methods: Cleft palate was repaired with double-opposing Z-plasty(DOZ) in 20 cases and with routin method (RM ) in 23 cases. Secretory otitismedia (SOM), high negative pressure (HNP), stapedial reflex(SR) and low acoustic compliance (LAC) were determined 3d before and 6 months after operation respectively. Results: Of the total 86 ears, before operation the persentages of SOM, HNP, SR and LAC were 61. 63, 75. 58, 29. 07 and 65. 15; after operation those were 31.39, 43.02, 66.28 and 33.72, respectively. Of the 40 ears of the cases treated with DOZ the persentages of those were 20.00, 27.50, 72.50 and 25.00) while of the 46 ears of the cases treated with RM those were 41.30, 56.52, 60.87 and 41.30 respectivellly. Conclusion: Middle ear function can be improved by palate repairs surgery, better results may be achieved with double opposing Z-plasty technique.

0.05). After treatment the incidence of ED in therapy group was decreased to 46.3% vs control group of 63.7%(P

ObjectiveTo study the effect of anterior decompression and autograft fusion under video-assisted thoracoscopic to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.MethodsEleven patients who suffered from lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury were treated with anterior decompression and autograft fusion under video-assisted thoracoscopic from December 2005 to May 2008.The involved vertebrae included T12 in 5cases,T11 in 4 cases,T10 in 1 case and Ts in 1 case.According to the AO classification,4 patients were A2.2and 7 were A3.According to the Frankel classification,5 patients were rated as grade A,2 as grade C,2 as grade D and 2 as grade E.ResultsEvery patient underwent successful operation.The operation time was 3.5-8 h(average,5.2±1.6).The blood loss was 600-3800 ml(average,1195±576).One patient got intercostal neuralgia after operation,which disappeared after treating with analgesic drugs for 7 days.All patients were followed up for 36-65 months (average,49.5±5.9).All patients got bony fusion according to the CT scans 24month after operation.There were no neurological function deterioration and other instrument complications happened.At the last follow-up,5 patients were rated as grade A,2 as grade D and 4 as grade E,according to the Frankel classification.ConclusionAnterior decompression and autograft fusion under video-assisted thoracoscopic is an effective method to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.However,this method needs higher technology and has a long study-curve.

Objective To evaluate neurofunctional and radiographic results of transpedicular screw fixation reduction and anterior column fixation with use of screw-red system in treatment of multiple segment lumbar pedicle and vertebral body fractures combined with spondylolisthesis. Methods A consecutive series of 12 patients with unstable multiple segment lumbar pedicle fracture, vertebral body fracture, spondylolisthesis and neurologic deficit were managed with posterior transpedicular screw fixation including fractured pedicle and anterior screw-rod fixation instrumentation from January 2002 to December 2007. Results Patients were followed up for 24-30 months (mean 26 months). All the patients with incomplete neurologic deficits got improvement by at least one Frankel grade. Transpedicular screw brought satisfactory reduction. At the time of the latest follow-up, no screw breakage occurred. Con-clusions Excellent reduction of unstable multiple segment lumbar pedicle fractures combined with spon-dylolisthesis can attain better reduction and maintenance by means of selective pedicle screw fixation via fractured pedicle and anterior screw-rod instrument.

Objective To observe the changes of the peripheral blood T lymphocyte subsets following acute spinal cord injury and investigate the possible mechanism of these changes. Methods The SCI models of rats were made by Allen's method. Forty SD rats were divided into four groups, ie,normal control group, sham operation group, 100 g·cm group and 200 g·cm group. The expressions of CD4 and CD8 subsets of the peripheral blood T lymphocyte of the injured rats were determined by immunofluorescence labelling and flow cytometry at different times after injury. Results It was found that the expression of CD4 was significantly reduced to (30.40±4.76)% in 100 g·cm group and to (26.54± 9.34) % in 200 g·cm group, which were significantly lower than that of normal control group ( P ＜0.01 ). At 36 hours after injury, the ratio of CD4/CD8 was significantly reduced to 1.81 ± 0.55 in 100 g·cm group and and 1.29 ± 0.50 in 200 g·cm group, with statistical difference (P ＜ 0.05).Conclusions The immunoreaction is significantly depressed at the early stage of acute spinal cord injury. The severer injury results in more significant decrease of CD4 and ratio of CD4/CD8. The changes of CD4 and CD4/CD8 ratio can be used to indicate the severity of spinal cord injury.

ObjectiveTo identify the correlation factors for urosepsis shock after endourology surgery and analyze its clinical characteristics.MethodsFifty-eight patients with urosepsis without shock and 15 patients with shock were studied.Factors which may be correlated with the development of sepsis were analyzed including age,sex,ASA physical status,history of urinary tract infection,preoperative leukocyturia,urine bacteria culture,prophylactic antimicrobial treatment,pyonephrosis,type of surgery,duration of operation,blood leukocyte count and concentration of creactive protein at the end of surgery,the time when the signs of infection (shivering,agitation,nausea or vomiting) first appeared.Changes in BP in patients with urosepsis shock,scores for multiple organ dysfunction syndrome as well as treatment and prognosis were also recorded.ResultsFemale sex and early emergence of signs of infection after surgery were correlated with urosepsis shock.Abrupt hypotension was usually the first manifestation of urosepsis shook.The lowest systolic BP was positively correlated with the time when diagnosis of shock was made and negatively correlated with the length of ICU stay and the highest multiple organ dysfunction syndrome scores but not correlated with shock correction time.All patients with urosepsis shock recovered completely when discharged from hospital.ConclusionFemale sex and patients with early emergence of signs of infection are prone to develop urosepsis shock after endourology operation.The prognosis of urosepsis shock is good if diagnosed and treated in time.