Erythropoietin is a critical growth factor in development of erythrocyte. After binding to its receptor, eryhropoietin produces biological action through consequent activation of intracellular signal transduction systems, including JAK2-STAT5, sos-Ras-MAPK, IRS-2- PI 3-K + and Ca 2+ channel.

Objective To study the long term results of thoracolumbar fractures treatment with AF (atlas fixator) pedicle system. Methods The clinical results of 60 cases of thoracolumbar fractures treated with AF pedicle system from 1996 2000 were analyzed retrospectively. Results The follow ups lasted from 3 to 6 years, averaging 4 years. The neurological function improved by at least 2 ASIA grades in 27 cases and by 1 ASIA grade in 33 cases. The correction of the vertebral body height averaged 95.1%, and the correction loss averaged 19.7%. Degeneration and narrowing of the disc space next to the fractured vertebrae were common, and correction loss was most evident at the upper disc spaces. Conclusions The AF pedicle system can achieve good long term clinical results for the recovery of neurological function and the vertebral body height. But the rates of implant failure and correction loss are still high probably due to deficiency of bone grafting and delayed implant removal.

[Objective] To discuss the operation and clinical results about surgical treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.[Methods]From Jan 2001 to June 2007,15 patients were treated with one-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft.There were 6 males and 9 females with an average age of 21.2 years(range 16 to 24 years).All cases were segmented hemivertebrae.Hemivertebrae were located at T11(n=3)and T12(n=12).The status of the spinal fusion,correction rate and instrumentation were evaluated after surgery.[Results]All cases were followed up for 19 to 45 months with an average of 34 months.Cobb's angles of the main curve were 52.3??3.8?before surgery,10.2??1.4? after surgery.At the final follow-up there was 1.6? loss of correction.The mean height was increased by 3.76 cm.The district of bone graft showed good bone fusion.The time of vertebra fusion was 3 to 5 months(mean 3.6 months).No instrumentation,spinal fusion failure or other severe complications were noted.[Conclusion]One-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft can achieve a satisfactory result for the treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.It can be recommended in clinical practice because of a good stability of fixation and fine spinal fusion.

Through analyses of rare diseases management of several countries and regions , successful practice has been discussed .Legislation of rare diseases should be activated as soon as possible to release specific standard of rare diseases .Accelerating development of translational medicine is a feasible approach to improve the level of diag -nosis and treatment of rare diseases .Strengthening the orientation of management policy should be put into a more significant position to promote incentives of stakeholder in this area .Both enhancing the joint collaboration of differ-ent departments and perfecting medical insurance system could be forceful accelerants to create and optimize the management system of rare diseases in China .

BACKGROUND: Three-dimensional printing technology is a new technology which can quickly and accurately transform the virtual computer-aided design into the three-dimensional physical prototypes. Three-dimensional printing physical model method can replace the method of traditional preoperative planning and repair surgical simulation, with the characteristic of repeatable, which has been deepened day after day in clinical application of spine surgery. OBJECTIVE: To summarize the application status of three-dimensional printing technology in spine surgery and look forward to its future development directions. METHODS: The articles regarding the application of three-dimensional printing technology on clinical applications in spine surgery were retrieved from PubMed databases, Google Scholar, China National Knowledge Infrastructure and Wanfang Database from January 2000 to July 2015. The key words were 3D printing technology, rapid prototyping technology, spine, vertebra, department of orthopedics, fracture, joint, hand and foot, bone tumor, trauma, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, sacral vertebrae, pedicle of vertebral arch, vertebral body, intervertebral disc, and clinical application. A total of 50 articles with a good representation were selected and discussed after repetitive studies and reviews were excluded. RESULTS AND CONCLUSION: The three-dimensional printing technique has been applied in preoperative diagnosis, individualized orthosis customerization, the communication between doctors and patients, teaching, the formulation of individualized and high-accurate repairing plan, intraoperative navigation and individualized implant customization. These results suggest that with the rapid development of medical imaging, digital medicine and technologies of the cel and tissue culture and new materials, three-dimensional printing technology wil have a wide range of applications in spine surgery.

Angiogenesis plays an important role in the development process of tumor,and related microRNA(miRNA) in tumor cells can regulate tumor angiogenesis via the pathway of vascular endothelial growth factor(VEGF).Therefore,the further study of miRNA function will provide more effective targets to inhibit tumor angiogenesis,and provide more reliable basis for the clinical diagnosis and treatment of tumor.

To analyze a case of severe avian influenza A (H5N6) virus infection resulting in severe pneumonia and acute respiratory distress syndrome (ARDS) was admitted to Guilin Municipal Hospital of Traditional Chinese Medicine on July 6, 2023. The clinical data and treatment of this patient were analyzed retrospectively. The initial clinical manifestations of the patient were fever, cough, and expectoration, and the antigen test for influenza A virus was positive. Chest CT showed: double lung texture increased and thickened, and multiple patchy high-density shadows with air-containing bronchial shadows were found in the left lung, especially in the left upper lobe; a few patchy increased-density shadows were also seen in the lower lobe of the right lung, along with left-sided pleural effusion. Metagenomic next-generation metagenomic sequencing (mNGS) of bronchoalveolar lavage fluid was performed to identify the pathogen as influenza A virus H5N6. On the 4th day of admission, the patient's condition rapidly progressed to ARDS, which could not be improved by high-flow oxygen therapy, mechanical ventilation, and prone position ventilation. Subsequently, with the assistance of veno-venous extracorporeal membrane oxygenation (VV-ECMO), the patient's lung function gradually improved. Extracorporeal membrane oxygenation（ECMO） was withdrawn after 25 days, and the patient recovered and was discharged after a hospital stay of 41 days. Patients with severe avian influenza A (H5N6) usually have critical illness and rapid progression, often rapidly progressing to ARDS. When conventional mechanical ventilation cannot correct hypoxemia, VV-ECMO auxiliary treatment should be administered as early as possible. In addition, mNGS can help to quickly identify the diagnosis and differential diagnosis of avian influenza A (H5N6) in the early stage of the disease, particularly suitable for the diagnosis of severe and emergency infections.

Objective To perform digital 3D measurement of anatomic parameters associated with vertebral units fixed by ribs and pedicle fixation of T4-T10,providing evidence for clinical application.Methods Spiral CT scan of T4-T10 vertebrae was conducted in 15 normal adults without spinal disorder.The data were imported into computer to establish units and disc models of thoracic and rib vertebrae T4-T10 using Mimics 16.0 software and Ansys 11.0 finite element software.The following data were measured in the vertebral pedicle-rib unit fixation group (group A) by software:transverse diameter of vertebral pedicle-rib unit,length of the outside pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw;the following data were also measured in the pedicle fixation group (group B) by software:pedicle transverse diameter,length of pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw.The corresponding parameters were compared between groups A and B.Results In both groups,the transverse diameters and screw lengths gradually increased with the increase in the vertebral sequence while the inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw decreased with the increase in the vertebral sequence.All the parameters in groups A were significantly larger than the corresponding ones in group B (P ＜ 0.05).Conclusions Of the spinal segment of T4-T10,the rib vertebral unit fixation can provide greater safe screw angles and screw diameters for clinical surgery.This is of vital significance for reducing the surgical complexity and improving screw prehension.

Objective To compare the efficacy of laparoscopic-assisted hemicolectomy with that of open hemicolectomy for right colon carcinoma and to explore the safety and effectiveness of the formor procedure. Methods The clinical data on 46 patients who had undergone laparoscopic-assisted hemicolectomy and 68 patients who had received open hemicolectomy between December 2009 and December 2013 in our department were retrospectively analyzed. Length of postoperative hospital stay, surgical duration, amount of intraoperative blood loss, number of lymph node dissection, time to postoperative anal exhaust, surgical costs, postoperative complications, and survival rate were compared between the two groups. Results There were no statistical differences between the two grounps in gender, age, body mass index, pathological typing, depth of invasion, and total number of lymph node dissection. Length of hospital stay was 6.84 days in the group of laparoscopic-assisted hemicolectomy and 11.72 days in the group of open hemicolectomy , with a statistical significance. Surgical duration and treatment costs did not differ significantly between the two groups; while amount of intraoperative blood loss (76.63 mL vs. 141.5 mL) and time to postoperative anal exhaust differed significanly. Conclusions Laparoscopic-assisted hemicolectomy is safe and effective for treatment of colon cancer , It has advantages of small trauma, rapid postoperative recovery, and a nice-looking surgical incision.

BACKGROUND:At present,there is lack of relevant biomechanical model for the T6-T7-T8 rib-vertebral fix unit.In addition,there is no support of parameters of basic studies on reasons and reasonable explanation of screw breakage,poor quality of bone fusion and adjacent segment degeneration.OBJECTIVE:To develop a three-dimensional finite element model of bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8),and to analyze the stress so as to improve it.METHODS:Spiral CT data of one male patient (172 cm,71 kg,39-year-old) with T7 vertebral tuberculosis were imported into computer to develop a three-dimensional finite element model of bone graft with vertebral debridement and posterior vertebral unit fixed system through tuberculosis of T6-8 by Mimics 13.0 and Ansys 11.0 finite element software.500 N pressure and 10 N?m torque were loaded to the vertebral body by 3 kinds of physiological loads which simulated flexion,extension and lateral bending.The stress distribution of fixation devices under different loads was compared.RESULTS AND CONCLUSION: At the positions of anteflexion and extension,the stress mainly concentrated to screw tail,and the stress of upper screw was greater than the middle and lower screws.For connecting rods,the stress of the middle was always less than the lower middle and the middle stress was zero.At lateral bending position,the stresses of upper and middle screw tail were quite,and the unilateral stress of connecting rod was also equivalent.For three different dynamics at the same point,the stress of middle connecting rod increased in the lateral bending motion,and the stress of lower screw tail was equivalent.These data suggested that it is prone to fatigue fracture at upper screw tail by bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8) at the three positions of anteflexion,extension and lateral bending.The lower connecting rod at the positions of anteflexion and extension and the middle connecting rod at the position of lateral bending easily cause fatigue fracture.