0.05).But there was a significant statistical difference among those parameters between Group A and Group B at final follow up(P

Objective To investigate the curative effect of granulated cancellous bone autograft in treatment of refractory bone nonunion after limited contouring of bone ends. Methods Between 2003 and 2006, 13 patients with refractory bone nonunion were treated with external fixation and granulated cancellous bone autograft after limited contouring of bone ends. Results The mean follow-up period was 22.6 months (19-30 months), which showed that all patients gained bone union and resumed com-plete weight loading or previous job at final follow-up. The mean fixation time of external fixators was 10.6 months (7-18 months). The intermittent or persistent pin-track infection occurred in eight patients and relieved by pin-track care and oral or parenteral antibiotics, with no infection after removing external fixator. Conclusion The granulated cancellous bone autograft after limited contouring of bone ends is an effective method for treatment of refractory bone nonunion.

Sixteen compounds including daphnoretin (1), isofraxidin (2), scopoletin (3), kaempferol (4), quercetin (5), guaijaverin (6), astragalin (7), quercetin-3-O-β-D-glucopyranoside (8), naringenin-7-O-β-D-glucopyranoside (9), 5-O-methylapi- genin-7-O-β-D-glucopyranoside (10), methyl gallate (11), prionitiside A (12), (2S)-2,3-dihydroxypropyl-1,6,8-trihydroxy-3- methyl-9,10- dioxoanthracene-2-carboxylate (13), 3,3'-di-O-methyl ellagic acid (14), 3'-O-methyl-3,4-O,O-metheneellagic acid-4'-O-β-D- glucopyranoside (15) and 3,4-methylenedioxy-3'-O-methylellagic acid (16), were isolated from the 70% acetone extract of Euphorbia dracunculoides Lam. Among them, compounds 1-3, 6-9, 11, and 14 were isolated from E. dracunculoides for the first time, and compounds 10, 12, 13, 15, and 16 were firstly obtained from the genus Euphorbia. Their structures were elucidated by spectroscopic analysis, including 1H-NMR, 13C-NMR, and ESI-MS.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Molecular Structure ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To analyze the influence of the Risser sign on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after anterior spinal fusion.Methods Between June 2002 and November 2006,43 adolescent idiopathic scoliosis(AIS)patients(Lenke 1)undergone anterior correction with a minimum 2 years follow-up were included in this study.The patients were divided into three groups according to the Risser sign:group A(Risser 0),group B(Risser 1-3),and group C(Risser 4-5).The preoperative,postoperative and follow-up sagittal profile were evaluated by the following radiological parameters measured on the lateral radiograph,including the thoracic kyphosis,the lumbar lordosis,the thoracolumbar junction kyphosis,the distal junctional kyphosis,and the sagittal vertical axis.Results In group A,the thoracolumbar junction kyphosis significantly changed from-1.7° preoperative to 6.6° at the final follow-up,with an average increase of 8.3°.Similarly,in group B,the thoracolumbar junction kyphosis changed from -7.3° before surgery to 0.6° at the final follow-up,with an average variation of 7.9°.No obvious change of the thoracolumbar junction kyphosis was observed in group C.At the final follow-up,the average thoracic kyphosis in three groups was 21.2°,18.4° and 14.7°,respectively.No significance of the variation of the thoracic kyphosis was observed in the three groups,however,in group A and B,the thoracic kyphosis showed an ascending trend during the follow-up without significant statistical difference,in addition; the ratio of the thoracic kyphosis increased in group A was higher compared with group B and C.Conclusion For AIS patients with low Risser sign,the increased thoracic kyphosis,and the thoracolumbar junction kyphosis may be ascribed to the decompensation of thoracolumbar region caused by the reconstruction of sagittal alignment due to the continued growth of posterior elements of the thoracic spine.

Objective To investigate the preoperative evaluation of pulmonary function and protocol for scoliotic patients with respiratory failure. Methods From September 2000 to June 2008, sixteen patients suffered from respiratory failure were recruited into this study. There were two males and three females who were diagnosed as idiopathic scoliosis with a mean age of 13.5 years (range, 10-16 years). The other eleven patients were diagnosed as congenital scoliosis, including five males and six females with a mean age of 12.4 years (range, 10-14 years). The mean preoperative Cobb angle was 126.6°±15.5° with a mean height of 137.6 cm (range, 120-160 cm) and a mean weight of 32.5 kg (range, 18-40 kg). Decision was made depending on the severity of pulmonary impairment and spinal deformity. Preoperative treatment included respiratory training, noninvasive positive pressure ventilation therapy and halo-gravity traction. Results All patients received corrective surgery; ten patients were extubated tracheal tubes successfully 1 hour after surgery and six patients had to stay in intensive care unit (ICU) for 24 hours. Pulmonaryedema occurred in two cases and pneumonia in one case. The Cobb angle had improved to 72.0°±13.2° after surgery with a correction rate of 43%. All patients recovered well after surgery with no major cardiac or pulmonary complications.Conclusion Patients with preexisting respiratory failure can tolerate deformity correction operation with few complications after receiving a set of preoperative respiratory training modalities.

Objective To prospectively explore the techniques and correction results of the method of vertebral coplanar alignment (VCA) in posterior correction for thoracic scoliosis. Methods Between June 2008 to March 2009, 27 patients with idiopathic thoracic scoliosis were selected to undergo posterior pedicle screw fixation with assistance of Coplanar system. There were 26 females and 1 male with the average age of 15.9 years(ranged 11-23 years). There were type 1 in 25 cases and type 2 in two cases. The levels of fusion were established according to the Lenke criteria. The average preoperative coronal Cobb angle was 49°(ranged 40°-70° ). During the procedure, the pedicle screws were inserted in each involved levels on the convex side, an extended Coplanar tube was screwed in line with screw axis to each screws. Then two rigid bars were inserted through the uppermost part of the slotted tube sequentially. As the bar was gently driven down toward the bottom end, the pedicle screws axis started to converge in the straight line, correcting translation and rotation. Spacers were inserted into the slots of the tubes to achieve the ideal physiologic thoracic kyphosis. Once the rod was fixated in the concave side of the main curve, the Coplanar system could be removed. Results The mean postoperative Cobb angle was 14° (ranged 6°-25°), representing the correction rate of 70.7%. The average duration of surgery was 245 min (ranged 210-300 min) and a mean estimated blood loss was 1500 ml (ranged 600-2100 ml). The duration of follow-up averaged 15 (12-18) months. The loss of correction at last follow-up was 3° with the loss of correction rate of 6.1%. In the sagittal plane, the thoracic kyphosis was restored from 18° to 25°. No coronal or sagittal plane decompensation occurred. No thoraeoplasties were necessary to correct the residual rib hump. There was no death, infection and neurological complications. Conclusion The Coplanar is a new technique for the correction of scoliosis, its advantage lies in excellent and modulatable three-dimensional correction with a single and standardized maneuver.

Objective To evaluate the clinical value of MRA on the abnormal vessels in Moyamoya and cerebral revascularization , and to evaluate PWI in the observation of cerebral hemodynamics before and after cerebral revascularization.Methods Twenty-four patients with Moyamoya disease ascertained by DSA received cerebral revascularization on one side.MRA and PWI were performed for all patients before and after the operation , while DSA was performed after operation in nine patients to compare the images of MRA and DSA by three experienced radiologists.Perfusion parameters in terminal branches of middle cerebral artery ( MCA) on the operative side were compared with those on the contralateral sides and the cerebellum , including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and delay time ( DT) , as well as relative ratio ( values on the operative side/values on the contralateral side , and values on the operative side/values on the cerebellar region ) of perfusion parameters (rCBF, rCBV, rMTT and rDT) were calculated.Comparisons of the data between different groups were performed using paired Student′s t test.Results MRA was similar to DSA in displaying the internal carotid artery , main branches stenosis, Moyamoya vessels, and cerebral revascularization.DSA was better in displaying collateral vessels than MRA, but primary images of MRA provided anatomic and pathologic information of cerebral parenchyma.After the operations , rCBF (1.30 ±0.27) and rCBV (1.26 ±0.21) of MCA perfusion regions on the operative and the contralateral sides were higher than rCBF (0.73 ±0.15) and rCBV (0.98 ±0.12) before the operation significantly (t=-7.19,-6.64,P<0.05).rMTT (1.06 ±0.20) and rDT (1.07 ± 0.18) after the operation were lower than rMTT(1.53 ±0.34)and rDT (1.40 ±0.26) before the operation (t=5.62,5.40,P<0.05) .In MCA perfusion regions on the operative and cerebellar sides , rCBF(1.93 ± 0.34)and rCBV(2.25 ±0.35)were higher than rCBF(0.88 ±0.18)and rCBV(1.16 ±0.22)(t=-3.04,-3.06,P<0.05) before the operation.rMTT (1.13 ±0.29) and rDT (1.29 ±0.12) were lower than rMTT (1.88 ±0.19 ) and rDT ( 3.29 ±0.47 ) before the operation ( t =4.01, 4.72, P <0.05 ).Conclusions MRA is a safe , reliable method to evaluate abnormal vessels and cerebral revascularization after the operation in moyamoya disease.PWI can detect poor cerebral perfusion , and can be used for assessment of the effect of cerebral revascularization.

ObjectiveTo explore the change of spino-pelvic parameters following pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis secondary to ankylosing spondylitis(AS).MethodsTwenty-one AS patients with thoracolumbar kyphosis,who underwent PSO at L1 level from July 2006 to October 2010 in our hospital,were retrospectively reviewed.There were 18 males and 3 females with a mean age of 35.6 years (range,21-53 years).The pre- and post-operative thoracic kyphosis(TK),lumbar lordosis (LL),globe kyphosis (GK),angle of the fusion levels (AFL),sagittal imbalance (SVA),pelvic incidence (PI),sacral slope (SS) and pelvic tilting (PT) were measured.ResultsSignificant differences were observed in terms of the improvement of LL,PT,SS,SVA,GK and AFL (P＜ 0.01).The alteration of LL showed significant correlation with the change of PT (r=0.59,P=0.005),SS (r=0.64,P=0.002),SVA (r=0.49,P=0.025),and AFL (r=0.60,P=0.004).The change of PT exhibited cardinal correlation with the change of SS(r=0.94,P=0.000).The improvement of AFL significantly correlated with the improvement of SS(r=0.61,P=0.003),PT (r=0.59,P=0.005).ConclusionThe change of the sagittal spino-pelvic profile following PSO in AS-related thoracolumbar kyphosis is closely related with the improvement of LL.

Objective To investigate the application value of the Perclose Proglide vascular devices in the thoracic endovascular aortic repair (TEVAR) of aortic dissection.Methods Retrospective analysis of 106 patients who underwent TEVAR for Standford B type aortic dissection were performed.The femoral lumen was measured by CTA be fore,1 month and 1 year after TEVAR.Results A total of 223 Perclose Proglide vascular closure devices were used in the 106 patients,including 97 patients with 2 devices,7 patients with 3 devices,2 patients with 4 devices.The puncture femoral artery diameters had no significant differences between before and 1 month,1 year after TEVAR (all P ＞0.05).Conclusion Per close Proglide vascular closure devices can be effectively and safely used in the TEVAR,which has little influence on the femoral artery diameter,and is worth to be applied in the clinics extensively.

Objective To explore the main influence factors(heart rate,rotation speed,and reconstruction algorithm)on the image quality of coronary artery with 40 mm VCT(64-detector row helical CT)using a pulsating cardiac phantom.Methods An adjustable pulsating cardiac phantom(GE) containing predetermined simulated coronary arteries was scanned using a 40 mm VCT(GE LightSpeed CT) with cardiac pulsating rates of 40,45,50,55,60,65,70,75,80,85,90,95,100,105,110,and 115 beats per minute(bpm).The variable rotation speeds technique of 0.35 s,0.40 s,and 0.45 s were used, respectively.The raw data were reconstructed using both one-sector and multi-sector reconstruction algorithm at optimal window of the R-R interval.The image quality score(IQS)was evaluated by two radiologists according to the same evaluation standard of reformated image.The correlation between heart rate(HR), roation speed,reconstruction algorithm,and IQS were analyzed.The IQS as independent variable and the HR,rotation speed,reconstruction algorithm as dependent variables were analyzed by multiple linear regression analysis.Restllts The heart rate and the reconstruction algorithm had significant influence on IQS.The rotation speed(0.35s,0.40s,and 0.45s)didn't have significant influence on IQS.There was linear regression relationship between heart rate,reconstruction algorithm and IQS(P