A three-phase depletion/repletion/depletion feeding study was designed to investigate the changes of Se levels and glutathione peroxidase (GSH-Px) activities in tissues and blood in rats fed for 6 weeks low-Se diet (6 ppb Se) from a Keshan disease area during the supplementations of Se as Ziyang high-Se wheat (1.175 ppm Se) or sodium selenite (dietary Se 219 and 223 ppb respectively) and after the supplements were discontinued, and to evaluate the relative bioavailability of Se in the wheat. The resalts showed that the average bioavailability of Se in high-Se wheat derived from the values at wk 2, 4 and 6 of supplement was close to that in selenite when plasma, erythrocyte, kidney, liver and cardiac Se contents were used as the response criteria, the relative bioavailabilities being 98%, 104%,100%,96% and 101% (sodium selenite = 100%) respectively. The bioavailability was lower for Se in high-Se wheat (70% or 90%) than for selenite when estimated by erythro-cyte or cardiac GSH-Px activities. However, the bioavailabilities of high-Se wheat Se in various tissues were not all the same at different stages of supplement. In addition, the effect of Se in high-Se wheat in maintaining either Se levels in heart, liver and erythrocyte or GSH-Px activity in heart was superior to that of selenite 3 weeks after the Se supplements were withdrawn.

BACKGROUND:Spine infection models are rarely reported in the literature. There are fewer reports on the imaging and histological observations of the animal model of spinal infection.
OBJECTIVE:To develop a canine model of pyogenic spinal infection.
METHODS:Twelve Chinese dogs were adopted in the study. The dogs were in the right arm recumbent. The surgery was conducted by retroperitoneal approach to expose T12/L1 intervertebral space. The intervertebral discs that exposed the intervertebral space were partial y removed, and the end plate of the adjacent two vertebrae was deliberately curetted out. Suspension with different concentrations of Staphylococcus aureus and sodium morrhuate were injected into the dog intervertebral space. The aim of removal of partial intervertebral discs and destruction of endplate was to make the vertebral body bone better in contact with the bacteria. The same operation was conducted in L5/6 clearance of the animal spine. At 14 days after surgery, animals were sacrificed. The infected intervertebral disc and adjacent vertebral bodies were taken out. Bacterial contents of specimens were quantitatively determined. During sacrificing, partial liver tissues and blood samples were col ected for bacterial culture. The occurrence of systemic infection was observed.
RESULTS AND CONCLUSION:(1) Spondylodiscitis of the lumbar spinal column was consistently produced in 90%(9/10) the sites chal enged with 102 colony-forming units (CFU) Staphylococcus aureus. Liver biopsy and blood culture did not show any signs of systematic infections. (2) Two out of four animals implanted the suspension with a concentration higher than 103 CFUs died within 3 days post-implantation. (3) These results suggested that a new canine model of pyogenic spinal infection was developed. This model could be used to test the efficacy of different anti-infection strategies.

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

BACKGROUND:Animal model of infection is established using bioluminescent gene-labeled bacteria, which stimulate local environment of spine infection and reveal the pathophysiological mechanism of spine infection.
OBJECTIVE:To evaluate the feasibility and safety of anterior one-stage debridement, autogenous iliac bone grafting and titanium plate internal fixation in the management of pyogenic spinal infections in spine.
METHODS:Total y 24 Chinese dogs were adopted in the study to develop a canine model of acute pyogenic spondylodiscitis using a bioluminescent strain of Staphylococcus aureus Xen29. The animal models were detected by X-radiography, CT and MRI examinations. After 4 weeks of modeling, al the animals underwent one-stage debridement, autogenous iliac bone grafting and anterior titanium plate internal fixation. Antibiotics contained Cefazolin and Gentamicin were administrated daily since perioperative period to 4 weeks after surgery. The titanium plate and adjacent vertebra were removed surgical y at various postoperative time points (4, 8, 12, 24 weeks) when the dogs were kil ed. The excised tissues and retrieved implants were cultured with conventional bacteria, bacteria 16S rRNA and specific Nuc gene of Staphylococcus aureus. PCR and bioluminescence imaging technique were used to detect the presence of bacteria.
RESULTS AND CONCLUSION:The surgical wound was healed uneventful y. Gross observation and MRI examination of the specimens showed that there was no abscess formation or signs of infection recurrence. The infection rate was 41.7%(10/24) and 75%(18/24) in the procedure of conventional bacteria and bacteria 16S rRNA cultivation. The results showed that the sensibility of PCR technique used to detect the presence of bacteria by amplifying the highly conservative gene sequence of 16S rRNA was significantly higher than that of conventional bacterial cultivation procedure (P<0.05). The PCR detection of specific Nuc gene of Staphylococcus aureus showed the existence of Staphylococcus aureus (1/24). However, Staphylococcus aureus Xen29 with genetic marker was not detected around the implant by bioluminescence imaging technique (0/24). Al of the results showed that bacterium adhering to prosthesis in vivo is an universal phenomenon. The bacteria identified from prosthesis which was taken during the surgery and the bacteria by which the spine was infected before the surgery was not homologous. The one-stage debridement, autogenous bone grafting and anterior titanium plate internal fixation is safe and effective in the management of pyogenic spinal infections. Using of internal fixator can not lead to recurrence or persistence of infection.

OBJECTIVE:To discuss the choice of artificial thigh bone prosthetic material and curative effects of artificial thigh bone prosthesis for treating femur intertrochanteric comminuted fracture of senior patients.METHODS:We retrieved China National Knowledge Infrastructure (CNKI) in Chinese (1977/2009) and Medline database in English (1977/2009) with the key words of "femur intertrochanteric fracture;artificial femoral head arthroplasty;elderly patient".Totally 83 articles were retrieved,and 34 articles were included in accordance with inclusion and exclusion criteria.Literatures addressing artificial thigh bone prosthesis,intertrochanteric fracture in elderly patients and artificial femoral head replacement in treatment of femur intertrochanteric fracture were summarized,and curative effect of artificial thigh bone prosthesis for treating intertrochanteric fracture in elderly patients was explored.RESULTS:Artificial thigh bone prosthesis had been widely used in treatment of various femur intertrochantedc fractures.There are many types of artificial thigh bone prosthesis such as metal material,high polymer polyethylene,ceramic material and carbon material,which had obtained significant outcomes.Function of artificial thigh bone prosthesis was improved gradually,and became widely in clinic.Artificial thigh bone prosthesis has presently been an optimal method for treating femur intertrochanteric comminuted fracture in elderly patients.However,this method exist many problems that require to be solved such as high operation risk and many complications.CONCLUSION:There are many materials for choosing artificial thigh bone prosthesis,with various advantages and disadvantages.Presently,complex artificial thigh bone prosthesis is commonly used in clinic.Artificial thigh bone prosthesis is an ideal method to treat femur intertrochanteric comminuted fracture of elderly patients.

Objective:To evaluate the value of improved pulmonary ultrasonography in the follow-up assessment of lung damage in patients who recovered from corona virus disease 2019(COVID-19).Methods:Twenty-two patients who were cured of COVID-19 in Quanzhou First Hospital from January to May 2020 were randomly selected and divided into 7 mild cases, 12 moderate cases and 3 severe cases according to the first high-resolution CT (HRCT) at admission. Six months after recovery, modified lung ultrasonography and HRCT were used prospectively to assess the lung damage and evaluate the correlation and consistency between the two techniques.Results:①There were significant differences in lung damage between the mild group and the moderate group, severe group (all P<0.05), while there was no significant difference between the moderate group and severe group ( P>0.05). ②There was good consistency between the improved lung ultrasound examination and HRCT (Kappa=0.776, P<0.001). ③There was a positive correlation between the score of improved pulmonary ultrasound examination and HRCT Warrick score ( r=0.755, P<0.001). Conclusions:Improved pulmonary ultrasonography can be used as a priority in the evaluation of pulmonary damage follow-up in patients with COVID-19 recovery, reducing the use of CT, and providing favorable evidence for further clinical management.

Diabetes is the most important comorbidity of cardiovascular disease, and cardiovascular disease is the main cause of mortality and disability of patients with type 2 diabetes. In order to standardize the diagnosis and treatment of patients with diabetes and cardiovascular disease, the National Health Commission Capacity Building and Continuing Education Center organized the experts from the field of cardiology and endocrinology systematically reviewing the research progresses and expert experiences of relevant disciplines from home and abroad, and formulated this consensus. This consensus covers the diagnosis, drug treatment, and risk factor management for patients with diabetes and cardiovascular disease (including atherosclerotic cardiovascular disease and heart failure) from the perspective of cardiovascular disease and diabetes management aiming to strengthen the comprehensive management of patients and ultimately to improve the prognosis of patients. The management of cardiovascular diseases mainly includes the management of blood pressure, blood lipids, anti-thrombosis, anti-myocardial ischemia, anti-ventricular remodeling and so on. Diabetes management mainly includes lifestyle intervention (including diet, exercise, weight loss, etc.), anti-hyperglycemia therapy (including drugs and insulin), blood glucose monitoring, and hypoglycemic prevention. In addition, specific clinical recommendations are given to patients with special health care needs such as diabetic nephropathy, elderly (>75 years), and cardiovascular critical illness.

OBJECTIVE: To analyze the reasons for the failure of thoracolumbar spine internal fixation after burst fracture, and to discuss the strategy for revision surgery. METHODS: From January 2005 to September 2010, 21 patients with thoracolumbar burst fracture received revision surgery after the failure of internal fixation. The etiology included loose of the fixation after anterior surgery in 4 patients, involving malunion with severe kyphosis in 1 patient, pedicle screw malposition in 3, fracture of adjacent segment vertebra in 2, broken of the fixation as non-union of the fracture vertebra in 10 comprising obvious kyphotic deformity in 5, and 2 had developing kyphosis for over distraction of the vertebra followed by pseudarthrosis after removing the internal fixation. After the first operation, symptoms remained in 6 patients, deteriorated in 7, light to moderate improved in 8. Surgical procedures such as anterior corpectomy and reconstruction, replacement of the internal fixation and canal decompression, vertebroplasty, and posterior pedicle subtraction osteotomy were directed based on individual situation. RESULTS: Patients were followed-up for 6-68 (27.0±13.2) months, and demonstrated solid fusion 6 to 12 months postoperatively. No failure of the internal fixation reccurred. No major complications or deterioration of neurologic status were noted. At the last follow-up, the improvement of Frankel grade was 0-2 (1.3±0.7). The mean visual analog scale (VAS) dropped down from 7.6 to 2.1, and the mean oswestry disability index (ODI) decreased from 48.7 to 10.3. Preoperative angle of 7 kyphotic deformity patients was 10 degree-75 degree (42.5 degree±15.3 degree), and was improved to -3 degree-10 degree (2.3 degree±3.7 degree). At the last follow-up, the loss of correction was 0 degree-1.3 degree (0.7 degree±0.3 degree), with the correction rate of 92.3%. CONCLUSION Solid reconstruction of the anterior and middle column of the spine is the imperative procedure to prevent failure of internal fixation in thoracolumbar burst fractures. Revision surgery with reasonable strategy is beneficial and rewarding with few complications.
Bone Screws ; Decompression, Surgical ; Fracture Fixation, Internal ; Humans ; Kyphosis ; Lumbar Vertebrae ; Prosthesis Failure ; Spinal Fractures ; Spine ; Thoracic Vertebrae ; Treatment Outcome ; Vertebroplasty

OBJECTIVE: To analyze the accuracy of free-hand thoracic pedicle screw placement in severe idiopathic scoliosis via CT scan. METHODS: Twenty patients with complete CT data were chosen out of 58 patients of severe idiopathic scoliosis from June 1996 to December 2006. The Cobb angle of the main thoracic curve was from 82 degree to 142 degree (96.3 degree +/- 14.3 degree). The kyphotic angle in the main curve was 66.2 degree +/- 12.4 degree. The placement of thoracic pedicle screw was completed free-handedly, and the accuracy of screws placement was evaluated with CT thin-slice scan postoperatively. RESULTS: Altogether 174 thoracic pedicle screws were inserted, 157 (90.2%) of which were fully contained within the cortical boundaries of the pedicle.The other 17 screws (9.8%) were misplaced in 9 patients: 11 screws (6.8%) were lateral, 9 of which had a breach 0.05). There was no neural complication in all patients. CONCLUSION It is fairly accurate place thoracic pedicle screw in severe idiopathic scoliosis free-handedly, with some misplacements.
Adolescent ; Bone Screws ; Female ; Humans ; Male ; Orthopedic Procedures ; methods ; Scoliosis ; diagnostic imaging ; pathology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVE: To analyze the etiology and prevention of complications related to the pedicle screw technique in the treatment of thoracic scoliosis. METHODS: There were 183 thoracic deformity patients 110 idiopathic scoliosis, 32 adult scoliosis, 28 congenital kyphoscoliosis, 8 Marfan syndrome with scoliosis, and 6 others. All patients' Cobb angles were evaluated preoperatively, intraoperatively, and postoperatively by roentgenograms. The deformity correction rate was calculated. All radiographic evaluations were carried out in a double-blind fashion. The complication rate was analyzed perioperatively and postoperatively. RESULTS: The deformity correction rate was 72%, better than others treated with hook-rod system. The perioperation complication rate was 8.4% (pedicle fracture 1.5%, infection 3.8%, pneumothorax and plural effusion 1.6%, transitory neurological damage 0.5%, and over-bleeding shock 1%). The complication rate at follow-up was 3.6% (infection 0.5%, fatigue fracture 1%, loss of deformity correction 1.6%, and transitory neurological damage 0.5%). Compared with those treated with hook-rod system, the perioperation complication rate, loss of deformity correction, permanent damage, and complications related to the internal fixation were all low. CONCLUSION The complication rate of pedicle screw fixation system was low in the treatment of thoracic deformity. When surgeons are thoroughly familiar with the technique and related pathoanatomy, and with the spinal cord function wardship by SEP, complications related to the pedicle screw technique in the treatment of thoracic scoliosis will be well controlled.
Adolescent ; Adult ; Bone Screws ; adverse effects ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Internal Fixators ; adverse effects ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Postoperative Complications ; epidemiology ; prevention & control ; Scoliosis ; surgery ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; surgery ; Young Adult