Thoracolumbar burst fractures account for more than half of all thoracolumbar fractures,which often result in neurologic deficit,kyphosis deformity and significant disability.The management of thoracolumbar burst fractures differ with the types.Nowadays,the accepted methods of treatment of thoracolumbar burst fractures include conservative therapy,posterior reduction and instrumentation,anterior decompression and instrumentation,combined anterior-posterior approach and minimally invasive approach.Howerer,the optimal technique is not always evident.There is no precise classification system to determine which surgical procedure is the best.The following review summarizes the recent advances in treatment of thoracolumbar burst fractures.Recent clinical evidence shows that there is no significant difference between conservative therapy and surgical treatment for thoracolumbar burst fractures without neurologic deficit,and that surgical treatment should be considered for unstable fractures with neurological injuries.Some other clinical evidence shows that short segment combined fractured vertebra plasty with various manners has gained popularity,because it can reconstruct anterior column and decrease the failure of internal fixation and the occurrence of long-term spinal kyphosis deformity.In accordance with the principles of biomechanics and taking into account the occurrence of degeneration of adjacent segment,surgeons gradually applied non-fusion technology in clinical practice,and yet its long-term results need to be confirmed by further studies.

Objective To explore the method, safety, and efficacy of laparoscopic intracorporeal sutured gastrojejunostomy.Methods Three children with gastric outlet obstruction underwent laparoscopic sutured gastrojejunostomy from May to September 2005. Of them, two patients with pyloric stenosis secondary to peptic ulceration received a concomitant highly selective vagotomy. A suitable segment of jejunum was lifted over the transverse colon and apposed to the gastric antrum. A continuous 4/0 suture was conducted at the seromuscular layer making the two organs together. Then the stomach and adjacent jejunum were incised with an ultrasonic scalpel. A side-to-side gastrojejunostomy was performed with full-thickness continuous suture of gastric and jejunal wall followed by anterior interrupted suture of seromuscular layers. Results All the intracorporeal sutured gastrojejunostomies were completed successfully under laparoscope. The operating time was 135, 150, and 180 min, respectively. The postoperative hospital stay was 6 d. There was no surgical complications. Postoperative follow-up at 8, 10, and 12 months, respectively, showed that all patients had normal diet and nutriture. Conclusions Laparoscopic sutured gastrojejunostomy is a safe and feasible technique, with advantages of minimal invasion, rapid recovery, and good cosmetic outcomes.

0.05).Compared to OA group,the patients in the LA group had shorters periods of absolute diet and hospital stay(P=0.000,P=0.000).Conclusions LA has less influence on the humoral immunity and protein metabolism in children.Meanwhile the procedure is minimally invasive,patients recover quickly and are discharged earlier after the operation.

Objective To explore the feasibility and efficacy of laparoscopic rectopexy with peritoneal strips for severe complete rectal prolapse (SCRP) in children. Methods From August 2004 to October 2008,6 patients (aged 2 to 6 years with a mean of 3.5) with SCRP were treated in our hospital. The clinical data of the patients were reviewed. Under the laparoscope,two L-shaped peritoneal strips with the pedicle were cut from the incrassated and slack peritoneum of the pelvic cavity on bilateral sites of the rectum,and then were folded and sutured with the lateral wall of the free rectum with the ends being stitched on the fascia in front of the sacral promontory to suspend the rectum. Afterwards,the incisal margin of the peritoneum was sutured together with the anterior wall of the rectum in order to embed the peritoneal strips and reconstruct the pelvic peritoneum. Results All of the 6 cases of laparoscopy were completed successfully with a mean operation time of (120?24) min (ranged from 95 to 210 min). The blood loss was less than 10 ml in all of the cases. The patients received a mean of 28-month follow-up (range,6 to 54 months),during the period,none of them had recurrence or abnormal bowel movement. Conclusions Laparoscopic rectopexy with peritoneal strips is an effective and satisfactory treatment for SCRP with minimal invasion,quick recovery and a low-recurrence rate.

Objective To evaluate the effectiveness of laparoscopic sutured anastomosis of the duodenum for children with congenital duodenal obstruction (CDO). Methods From February 2003 to July 2008,13 patients (aged 2 days to 12 years) with CDO underwent laparoscopic sutured anastomosis of the duodenum in our hospital. Among the cases,7 were newborns,3 were infants,and 3 were children. Laparoscopy showed duodenal atresia or stenosis in 7 cases,annular pancreas in 2 cases,superior mesenteric artery syndrome (SMAS) in 3 cases,and preduodenal portal vein in 1 case. Results Excepting the patient with preduodenal portal vein,who was converted to mini-laparotomy for duodenojejunostomy,all the cases were treated by laparoscopy. In 5 cases,the diaphragm was excised partially after a vertical incision was made at the anterior part of the duodenum,and then a transverse suture was completed; the 2 patients with duodenal atresia and the 2 with annular pancreas received diamond-shaped side-to-side duodenoduodenal anastomosis under a laparoscope; and the 3 cases of SMAS were treated by Roux-en-Y duodenojejunostomy. The mean operation time in this series was (97.0?18.2) min (range,75 to 180 min). No intraoperative complications occurred. The patients started oral intake in 2 to 5 days after the surgery,and resume a normal diet in 7 to 9 days. Before being discharged from the hospital,upper gastrointestinal tract imaging showed no evidence of obstruction in the patients.A follow-up up to 6 months to 4 years were available in 11 patients,among which 8 were followed for more than 1 year. During the period,the patient developed well. Conclusions The laparoscopic sutured anastomosis of the duodenum is feasible and effective for children. It can be performed in neonates securely as an excellent minimally invasive treatment for congenital duodenal obstruction.

BACKGROUND:Hydrolysis in vivo is the key mechanism of degradation in DL-polylactic acid (PDLLA). When it is combined with hydroxyapatite (HA), could the biodegradation and weight loss rate be improved? OBJECTIVE: To observe the changes in the interface and structure of HA/PDLLA composite after in vivo implantation into rabbit femoral defects.DESIGN: Randomized grouping and controlled observation.SETTING: Biomedical Materials and Engineering Research Center, Wuhan University of Technology.MATERIALS: Forty healthy adult Japan White Rabbits of 2.0-2.5 kg, either male or female were provided by the Animal Experimental Center of Hubei Province (No. SCXK. 2003-0005).METHODS: The experiment was conducted in Biomedical Materials and Engineering Research Center, Wuhan University of Technology from June 2005 to March 2006. ①The rabbits were randomly divided into two groups: HA/PDLLA group and PDLLA control group with 20 animals in each group. After anesthetized with ketamine and proazamine, the sample rods of HA/PDLLA and PDLLA were respectively implanted into the drilled bone cavities (φ5 mm × 8 mm) among condyles of femur sites of the rabbits, and the rod could be slightly higher than the surface of bone substance. The samples were covered by periosteum and skin, and then the skin and periosteum were repositioned. ②The complete implants and peripheral bone tissues were taken out respectively after 3, 6, 12 and 24 weeks implantation. The changes in the interface and structure of HA/PDLLA composite after in vivo implantation were observed by using scanning electron microscope (SEM, JSM-5610LV, Japan).MAIN OUTCOME MEASURES: Changes in the interface and structure of HA/PDLLA composite after in vivo implantation.RESULTS: Totally 40 rabbits were involved in the result analysis. After the materials were implanted, HA granules shed from the material surface, some fibroblasts grew into the tissue and a little new osteotylus was formed, indicating HA/PDLLA composite had capabilities of bone-formation and bone-connection. After 24 weeks implantation, the material was divided and wrapped by tissues, neogenetic bone tissue grew into the material, and the fracture healed well,indicating HA/PDLLA composite had good biocompatibility. As for biodegradable PDLLA polymer, hydrolysis in vivo is the most main mechanism of degradation; the degradation speed was decreased owing to being compounded with HA.CONCLUSION: HA/PDLLA composite has capabilities of bone-formation and bone-connection; the biocompatibility of the composite is improved accordingly on account of the decrease of the degradation speed. HA/PDLLA composite is suitable for clinical application as absorbable materials for internal fixation.

Objective To investigate the preventive effect of spironolactone on hepatic fibrosis. Methods Ninety SD rats were randomly divided into three groups. Control group consisted of 8 rats that , fed by normal food, were injected with peanut oil subcutaneously. Model group consisted of 42 rats whose liver fibrosis was induced by compound factors. Spiro nolactone-prevention group consisted of 40 rats that were given 100 mg?kg -1 spironolactone per day, by the same methods of making models as those of the model group. At the end of weeks 2, 4, 6 and 8, 8 rats were randomly taken out of model group and spironol actone group and then were sacrificed. The expressions of TGF- ? 1 , PDGF- BB and ? -SMA in hepatic tissues were detected with immunohistochemical met hods. Results The expressions of TGF- ? 1 , PDGF-BB a nd ? -SMA in spironolactone group decreased greatly than those in model gro up ( P

ObjectiveTo study the effect of TCM diagnostic method flow reconstruction and optimized management in the mass injuries emergency previewing reception.MethodsWorking mode of TCM optimized receiving and dispatching flow were established and enforced.Results27 batch of 216 cases were received by emergency previewing reception in 2009～2010.Compared to 2009,patient dispatching time was shorten by 3.0 min,area dispatching time was shorten by 2.9 min in average.Emergency treatment satisfaction was elevated from 65％ to 95％ and rescue successful rate was increased from 82.3％ to 89.6％.ConclusionTCM diagnostic method flow reconstruction and optimized management improved the level of management of in the mass injuries emergency previewing reception and obtained better results.

Objective To detect whether the cardiomyocyte-like cells differentiated from human marrow mesenchymal stem cells (hMSCs) could produce action potential (AP). Methods Isolated and cultured hMSCs were induced into cardiomyocyte-like cells with 5-Azacytine in vitro. They were measured for their AP by patch clamp technique, and compared with those of hMSCs of the same generation and beating cardiomyocytes (CMs) derived from 2 day-old SD rats. Results 6/30 cardiomyocyte-like cells produced AP. The CMs produced significant AP, hMSCs appeared no AP, and cardiomyocyte-like cells appeared weak AP. Conclusion The hMSCs manifested the potential to differentiate into CMs in the electrophysiology characteristics following 5-Azacytine induction.