Objective To investigate the clinical value of the intervertebral disc morphous in patients with thoracolumbar vertebral compression fracture. Methods The MRI, X-ray and CT data of 75 patients with thoracolumbar vertebral compression fracture were retrospectively analyzed. The intervertebral disc damage degree was observed, and its correlation with vertebral fracture degree and endplate damage degree was studied. The vertebral body leading edge height, intervertebral space height and back convex Cobb angle in patients with different intervertebral disc damage degree were measured. Results The intervertebral disc damage degree height was positively correlated with endplate damage degree (P<0.01), and the intervertebral disc damage degree was positively correlated with fracture degree (P<0.01). With the increase of the intervertebral disc damage degree in patients with Ⅰ - Ⅳtype intervertebral disc damage, the vertebral body leading edge height and intervertebral space height gradually became smaller: (0.68 ± 0.05), (0.61 ± 0.03), (0.58 ± 0.03), (0.42 ± 0.05) mm, and (0.31 ± 0.06), (0.29 ± 0.03), (0.24 ± 0.06), (0.22 ± 0.02) mm, and there were statistical differences (P<0.05). There was no statistical difference in back convex Cobb angle in patients with different intervertebral disc damage degree (P>0.05). Conclusions It is more important to observe the morphological changes of the intervertebral disc in patients with thoracolumbar vertebral compression fracture, and the damage degree is closely related with the vertebral fracture degree and endplate damage degree.

The force of hospital culture is a kind of flexible spiritual productivity.First,it can improve in a comprehensive way the quality of a team and the ideological level of all the employees,make the cultural content permeate the various layers within the organizational framework,and ensure that the employees fulfill quality and quantity requirements in completing their tasks.Second,it can impel people to have a sense of identification,mission and pride concerning the hospital's overall objectives,increase the initiative of both individuals and the organization,and result in the exercise of self-control and self-management on the basis of mechanisms and ideology.Third,it can create a life-learning environment for the employees,raise their awareness of and capability for innovation and the hospital's mechanisms for innovation,and bring about enduring spiritual support to the core values of the hospital.Finally,it can make patients associate the hospital with a unique image of service,create a unique culture of service,and increase patients' trust in the hospital.

Objective To investigate the effects of pre-ischemic administration of L-NAME on brain protective effects of simvastatin against focal cerebral ischemic/reperfusion injury in rats. Methods ① Animals were subjected to transient 2-hour middle cerebral artery occlusion(MCAO)with the use of the intraluminal filament method previously described by Zea Longa. ② 54 male rats were treated with simvastatin or vehicle by gavage two weeks before MCAO, and L-NAME was injected into laterar ventricle of rats 45 minutes before MCAO. After neurological deficit was assessed at 22 hours of reperfusion, rats were killed, and the brains were rapidly removed. The coronal sections of the brains were prepared and stained with 2% TTC, and the infarct volumes were determined. Another 54 male rats were performed as description above except that the brain tissues were made into homogenate at 22 hours of reperfusion, and the contents of lactic acid(LA) and MDA, and the activities of superoxide dismutase(SOD) in the brain tissues were also measured. Results Administration of simvastatin significantly reduced the size of brain infarct, improved neurological deficits, decreased the contents of LA and MDA and increased the activities of SOD, but L-NAME could abrogate these effects. Conclutions L-NAME could abrogate the protection of simvastatin against ischemic/reperfusion injury,which may be by inhibiting the expression and activity of endothelial NO synthase(eNOS) up-regulated by simvastatin.

Objective To study the effect of Simiaoyongantang on human umbilical vein endothelial cells(HUVECs) injury induced by hypoxia.Methods The HUVECs were divided into normal group,model group and Simiaoyongantang group,and the hypoxia model was established at the latter two groups.The livability of HUVECs was measured by MTT assay.The transudation of LDH in the medium was measured by biochemistry and the positive expression of VEGF was detected by immunofuorescence chemistry.Results The level of LDH was reduced significantly and the cell activity indicated by MTT was increased.The number of the cells stained by VEGF increased in the treatment group of Simiaoyongantang.Conclution Simiaoyongantang has protective effect on hypoxia injured HUVECs,which may be related to its effect of increasing the cells livability,reducing the injury induced by hypoxia,up-regulating expressions of VEGF and promoting angiogenesis.

Objective To observe the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) by Quadrant channel for grade Ⅱ and Ⅲ spondylolisthesis. Methods Forty-eight patients with grade Ⅱ and Ⅲ spondylolisthesis were treated with MIS-TLIF by Quadrant channel. The patients were followed up for 12 months, The visual analog scale (VAS), Oswestry disability index (ODI), intervertebral height and lose drop of anterior slippage reduction were assessed. Results Surgery was successfully completed in all the patients. The VAS, ODI, intervertebral height and vertebral slippage 1 week after operation were significantly improved compared with that before operation:(4.5 ± 0.8) scores vs. (8.6 ± 1.2) scores, (32.0 ± 1.3) scores vs. (46.0 ± 3.7) scores, (10.5 ± 2.2) mm vs. (4.6 ± 2.1) mm and (2.1 ± 2.0) mm vs. (11.2 ± 1.7) mm, and there were statistical differences (P<0.05). Compared with that of 1 week after operation, there was no significant change in 12 months:(2.1 ± 2.0) scores, (11.0 ± 1.1) scores, (9.8 ± 2.5) mm and (2.2 ± 2.0) mm, P>0.05. Patients did not have the complications such as nerve damage, loosening of internal fixation. Conclusions The MIS-TLIF is a safe and effective minimally invasive treatment for grade Ⅱ and Ⅲ spondylolisthesis by Quadrant channel.

BACKGROUND:Fragile bone in senile osteoporosis patients easily weakened pedicle screw fixation capacity. Therefore, bone cement leakage and screw removal cannot be solved during pedicle screw repair in osteoporotic patients with degenerative lumbar spine. OBJECTIVE:To investigate the biomechanical properties of novel pourable pedicle screws and bone cement application effect in osteoporotic patients with degenerative lumbar spine. METHODS:Six lumbar specimens (T11-L5) at the mean age of (72.9±4.2) years were selected, total y 42 vertebrae. The average bone density was 0.696 g/cm2. Any side of al vertebrae was inserted with pourable pedicle screws. 2 mL of bone cement was perfused under the X-ray fluoroscopy with cement push rod and fil ing cylinder. The same number of conventional screws was inserted into the opposite side of the samples. Three-point bending test was performed in two kinds of screws. The maximum vertebral axial pul out force test and the maximum spin torque test were conducted in vertebra to observe the destruction of the vertebral body and implanted effect. RESULTS AND CONCLUSION:(1) The ultimate strength and yield load of novel pourable cement pedicle screws were significantly more than conventional screws (P<0.05). Ultimate displacement and yield displacement were significantly less in novel pourable cement pedicle screws than in conventional screws (P<0.05). (2) The maximum vertebral axial pul out force and the maximum spin torque were significantly higher in novel pourable pedicle screws than in conventional screws (P<0.05). (3) In summary, novel pourable cement pedicle screw is simple to operate, can effectively control bone cement penetration, and improve screw stability in osteoporotic vertebrae. Moreover, after treatment, the removal of screws is convenient, cannot evidently destroy vertebral body or screw channel, and promote early recovery.

Objective To evaluate the efficacy and safety of mNGF to peripheral neuropathy induced by n-bexane. Methods 54 cases were treated with mNGF (18 μg i. m qd.) and the period of treatment is 56 days. 15 severe cases treated with two periods of treatment. Subjects received symptoms and signs of nerve system and activi-ties of daily living (ADL) scale were examined before and every 14 days after treated, The efficacy of mNGF was as-sessed by score increase of each index before and after treatment himself. To evaluate the safety, subjects received Is-boratory examinations before and every 28 days after treated, recorded adverse events everyday. Results During the trial, The indexes had improved remarkably in two weeks after the treatment , There were highly significant differ-ences in score increase after 4 ～ 8 weeks of treatment(P < 0. 01). It indicated that treatmented with mNGF was effec-tive. There were no severe adverse events (SAE) found among 54 trial subjects. There were no evident abnormalities in laboratory examinations before and after treatment. Pains of the injected sites are the main ADR, the incidence was 68.5% (37/54). Conclusion The results of the research indicated that mNGF clinical application could be consid-ered as safe and effective.

Objective To explore the therapeutic effect of combined endoscopic embelization and variceal ligation (EVL) for management in cirrhotic patients with gastroesophageal variceal bleeding. Meth-otis One hundred and fifty-six cases of active gastric fundal variceal bleeding combined with esophageal var-ices of over degree Ⅱ, and with other causes leading to upper digestive tract bleeding excluded, were ran-domized into therapeutic group (n = 80) and control group (n = 76). For the therapeutic group, endoscopic cyanoacrylate injection for embelization of gastric fundal varices and EVL for esophageal varices were per-formed simultaneously. For the control group, EVL was performed 2 months after embolization. Results There was no complication in beth groups. The rate of hemostasis in therapy group was 96. 3% (77/80), and that in control group was 97. 4% (74/76, P >0.05). There was significant difference between two groups, regarding the rates of early re-bleeding [6. 4% (5/78) vs 21.3% (16/75), P < 0. 05] and re-bleeding at 6 months [13.0% (9/69) vs 25. 4% (17/67), P < 0. 05]. There was no significant difference between two groups, regarding the effective rate in disappearance of gastric fundus varices (61.6% vs 59. 1%), and in that of esophageal varices (74. 0% vs 67.9%). Conclusion Endescopic embelisation of gastric fundus vaxices, combined with EVL for esophageal varices, is a safe and effective procedure for the treatment of gastroesophageal variceal bleeding, and it can reduce the rate of re- bleeding.

Objective To evaluate the effect on treatment of multiple myeloma complicating femoral neck fracture by surgical intervention combined with drugs.Methods Twelve patients with multiple myeloma complicating femoral neck fracture were treated by cemented total hip arthroplasty femoral head shank.All of patients were received zoledronic acid treatment,at the same time,7 cases of them treated by MPT regimen (melphalan,methylprednisolone and thalidomide),3 by bortezomib combined with dexamethasone,and 1 by autologous peripheral blood stem cell transplantation.Results Twelve patients could tolerate surgery,postoperative pain was significantly reduced.Assessed by using Harris hip function score after 6 months operation,2 cases were excellent,7 cases were good,3 cases were common,excellent and good rate was 75％ (9/12).All patients were followed up for 8 months to 3 years,1 case of local recurrence after 13 months.1-year overall survival rate was 100％,2-year overall survival rate was 83％,and 3-year overall survival rate was 67％.Conclusions Multiple myeloma complicating femoral neck fracture,using bone cement in total hip arthroplasty femoral head shank to clear the local tumor lesions,receive reconstruction capability,rapid postoperative recovery,pain relief,and opportunities for further comprehensive treatments.The bisphosphonate can promote new bone formation and prevent further fractures.The surgical intervention combined with chemotherapy could relieve the symptoms,reduce tumor cell burden,improve quality of life and prolong survival time.

Objective:To develop a mental status scale in non psychiatric settings (MSSNS) and to test its reliability and validity.Methods:Based on the common negative emotions in non psychiatric settings confirmed by nursing specialists and international scales, the MSSNS was constructed with psychological testing and statistical techniques. The reliability and validity were examined with 1 010 patients in non psychiatric settings.Results: The MSSNS consisted of 38 items. The reliability coefficients were 0.932 9 for internal consistence(Cronbach ?) and 0.894 0 for split half. Using the principle component analysis with varimax rotation, we got 4 factors: anxiety, depression, anger and loneliness. The correlation between MSSNS and related factors of HAD were 0.652 and 0.533 respectively. Conclusion: With its good reliability and validity, MSSNS is an ideal rating scale for total and convenient rating of patients' mental status in non psychiatric settings.