Nogo receptor is specific inhibiting factor conjuncted with myelin of central nervous system(CNS).After spinal cord injury,oligodendroglial cell and Nogo-A released from myelin inside cells inhibited the axonal regeneration.To analyze the intervention for Nogo receptor through molecule outside cell,information inside cell and gene,make clearing the inhibiting action of myelin-associated inhibiting factor-1,provide new thoughts and methods about axonal regeneration after spinal cord injury.

Objective To study the incidence of venous thromboembolism (VTE) between complete and incomplete spinal cord injured patients. Methods 177 cases of acute cervical spinal cord injury were observed from April 2007 to July 2010. According to ASIA classification, 52 cases of grade A involved in observation group, while 125 cases of grades B~D involved in control group. Intervention included low molecular weight heparin and rehabilitation training. Incidence of VTE in two groups was compared. Results There was 11 cases complicated with VTE in the observation group (21.2%) while 6 cases in the control group (4.8%). There was a difference in incidence of VTE between two groups (P<0.05). Conclusion There is a higher incidence of VTE in complete than incomplete cervical spinal cord injury

To explore the feasibility and accuracy for evaluating mitral regurgitation (MR) severity with MR jet volume (MRvol) by means of general imaging three-dimensional quantification (GI3DQ). Methods: A total of 93 MR patients were divided into 2 groups: Central MR group, n=41 and Eccentric MR group, n=52. According to real-time three-dimensional echocardiography (RT3DE) examined planimetry of effective regurgitation orifice area (EROA), the patients were graded into mild MR, moderate MR and severe MR. MRvol was directly measured by GI3DQ. Results: In Central MR group, ROC analysis showed that as GI3DQ measured MRvol>16.2 ml, AUC=0.93, P<0.0001, the sensitivity and specificity for distinguishing mild MR and moderate MR were 96.0% and 70.0%respectively; as MRvol>44.5 ml, AUC=0.96, P<0.0001, the sensitivity and specificity for distinguishing moderate MR and severe MR were 97.6% and 91.7% respectively. In Eccentric MR group, as MRvol>14.2 ml, AUC=0.77, P=0.0243, the sensitivity and specificity for differentiating mild MR and moderate MR were 91.8% and 62.5% respectively; as MRvol>40.5 ml, AUC=0.83, P<0.0001, the sensitivity and specificity for differentiating moderate MR and severe MR were 82.3% and 77.9% respectively. Conclusion: Taking RT3DE examined EROA as reference, GI3DQ directly measured MRvol could more accurately assess MR severity especially in patients with central MR, it may distinguish moderate MR and severe MR with the higher sensitivity and specificity.

Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.

Objective To study X-ray and CT methods of diagnosis of unilateral dislocation of the lower cervical vertebra(C_(3～7)).Methods 15 cases of the injury of unilateral dislocation of the lower cervical vertebra were reviewed from August 2002 to June 2008,X-ray and CT findings were observed.Results Lateral projection of X-ray showed:the anterior displacement of dislocated vertebra was less than 25% in 15 cases,the distance of posterior border of lateral mass of below vertebral body to line of neural scute changed rapidly in 13 cases,sign of "bow tie" of processus articularis superior in 12 cases.Antero-posterior projection showed that spinal process was lateral deviation.Oblique projection showed that intervertebral joints were dislocation or interlocking. CT showed:the "hamburger" sign were destroyed in 7 cases,fracture of unilateral articular process in 8 cases,rotation of vertebral body of dislocation and its superior vertebral body in 13 cases, "double ring" sign in 12 cases.Conclusion The signs of X-ray and CT in combination with the mechanism of injury and clinical situation,the unilateral dislocation of the lower cervical vertebra can be diagnosed accurately.

Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to September 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treatment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Results All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior dislocation, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mechanism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical examination with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.

Objective To investigate the effect of rehabilitation on cervical fracture-dislocation following spinal cord injury.Methods126 patients with cervical fracture-dislocation following spinal cord injury from August, 2002 to March, 2009 in our hospital had undergone cervical anterior surgical treatment. 22 cases were picked up as control group, who missed rehabilitation after surgery. 22 cases were chosen randomly from the rest of 104 cases as rehabilitation group, who had undergone rehabilitation. Prognosis was evaluated by Japanese Orthopaedic Association Scores score(JOA).ResultsFollow-up time was 8-32 months，mean time 18 months. The limb function of rehabilitation group improved significantly. JOA score and quality of life were much higher in rehabilitation group than in control group.ConclusionRehabilitation is very beneficial to improve the quality of life and prognosis, and reduce complications of patients with cervical fracture-dislocation following spinal cord injury at the early stage.

Objective To study the influence of bleeding after using low molecular weight heparin （LMWH） to prevent deep vein thrombosis (DVT) in patients with thoracolumbar spinal bursting fracture and spinal cord injury operated by rear internal fixation. Methods 120 cases were divided into the observation group (64 cases) and control group (56 cases). The observation group accepted hypodermic injection of LMWH to prevent DVT, while the control group did not. Results The volume of bleeding and blood transfusion, the change of red blood cell count (RBC) and hemoglobin were compared between two groups before and after operation. There is no statistical significance. Conclusion During the period of the operation of rear internal fixation, low molecular weight heparin cannot increase the bleeding and is safe to prevent deep vein thrombosis.

Objective:To investigate the clinical efficacy of a new 3D printed guide plate in the minimally invasive treatment of fresh closed Achilles tendon rupture.Methods:From January 2019 to January 2020, 14 fresh closed Achilles tendon ruptures were treated by minimally invasive surgery at Department of Foot and Ankle Surgery, Xuzhou Renci Hospital. There were 13 males and one female, with an average age of 39.1 years (from 18 to 63 years). The rupture of the Achilles tendon body, 3 cm in length on average, was located 2 to 6 cm above the attachment of the calcaneal tuberosity. The ruptured Achilles tendon was repaired by suture with the aid of the new 3D printed guide plate. After operation, in cooperation of the Rehabilitation Department, we performed rehabilitation exercise under the guidance of the concept of Enhanced Recovery After Surgery (ERAS). The length of incision, operation time, intraoperative blood loss, ankle function at the last follow-up and follow-up complications were recorded.Results:In this cohort, incision length averaged 2.5 cm (from 2.0 to 3.5 cm), operation time 45 min (from 30 to 60 min), and intraoperative blood loss 15 mL (from 10 to 20 mL). The 14 patients were followed up for 13 to 16 months (average, 14 months) after operation. In one patient, the epidermis at the incision edge became black and necrotic, which was healed after dressing change. Follow-ups observed no such complications as suture rejection, sural nerve injury, or Achilles tendon re-rupture. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores at the last follow-up averaged 98 points (from 93 to 99 points), yielding 13 excellent cases and one good case; according to the Arner-Lindholm evaluation, the efficacy was excellent in 12 cases, good in one and poor in one.Conclusion:The minimally invasive treatment of fresh closed Achilles tendon rupture with our new 3D printed guide plate has exhibited advantages of minimally invasive incision, limited complications, simple manipulation, good functional recovery of the ankle joint and strong reproducibility of surgical operations.

Objective To study of short-term rehabilitation index and its relationship with medium-term function in male rectal cancer after laparoscopic surgery. Methods A retrospective analysis was made of 60 cases with rectal cancer who received laparoscopic radical resection in our hospital. In the observation group,the pelvic autonomic nerves were retained in 30 cases,and 30 cases in the control group were not retained. The levels of se-rum prealbumin(PA),C reactive protein(CRP),white blood cell count(WBC)and blood cortisol(Cor)were compared between the 2 groups. The independent influence factors of erectile and ejaculatory disorder were fol-lowed up at 6 months after operation. Results Postoperative exhaust time,defecation time,postoperative extuba-tion time,ambulation time,postoperative hospitalization time in the observation group were significantly shorter than those in the control group(P < 0.05). The level of serum CRP,WBC and Cor in the observation group was significantly lower than those of the control group at 3 d after operation,and the level of PA was significantly high-er than that of the control group(P < 0.05).The independent influence factors of erectile dysfunction were the level of PA and CRP at 3d after operation(P < 0.05).The independent influence factors of ejaculatory dysfunction were PA level at 3D after operation(P < 0.05). Conclusion Pelvic nerve protection in laparoscopic surgery is helpful to promote the postoperative recovery. High PA at short term after operation may be one of the medium-term protec-tion mechanisms for sexual function.