Objective To discuss the characteristics, diagnosis and therapy of the spine fractures in adolescents. Methods 15 cases were treated from 1991 to 2002 in our hospital. The causes of injuries, fracture type, treatment methods and complications were analyzed. Results All the cases were followed up from 1 to 3 years. Satisfactory recovery of fractures was found, but Harrington hook dislocation occurred in 1 case and gradual kyphosis in 2 cases postoperatively. Conclusions The injuries were mostly caused by falling. Fracture-dislocation was the most common type. The spine cord injuries were usually serious and combined with other injuries. The operation mode and internal instrument should be selected according to fracture type and age. It is very important to recover the normal spine form in therapy. Care should be taken to treat the problem of gradually increasing kyphosis after the operation.

[Objective]To analyze the correlation between disk degeneration and development of isthmic spondylolisthesis in adults.[Method]Totally 156 patients who had spoondvlolvsis and spondylolisthesis were follow-up.There were 86 males and 70 females.All patients were made radiographs for lumbar discomfort or low back pain.Spondylolysis and spondylolisthesis were discovered.According to Meyerding slip degree;68 cases were spondylolysis,88 cases were spondylolisthesis in degree Ⅰ.All patients were under conservative treatment and observed the development of the disease.According to Boxall defined the development of spondylolisthesis.There were 40 patients with development of spondylolisthesis and aggravation of dies degeneration.24 males,16 females.[Result]All the patients were followed-up for 3~9 years,with an average of 6.3 years.Lumbar vertebra slippage increased about 11%~30%(average 18.5%),the height of intervertebral disk decreased about 45%~90%(average 72%)in the level of spondylolysis.x2 test was used for statistical treatment,There was a significant positive correlation between development of isthmic spondylolisthesis in adults and aggravation of disk degeneration.[Conclusion]There are development in adults of spondylolysis and spondylolisthesis,may be correlated to the disc degeneration.

[Objective]To analyse the significance of degenerative instability in pathogensis of cervical syndrome.[Method]A total of 216 patients who underwent neck and shoulder pain and/or cervical spondylotic radiculopathy(CSR)were followed-up.There were 143 males and 73 females,aged from 29 to 41,with the average of 37.8.Number of patients with neck and shoulder pain were 173,with cervical spondylotic radiculopathy were 28,with neck and shoulder and CSR were 15.According to cervical degenerative instable radiology standard,instable group included 82 cases,stable group included 134 cases.All patients were treated by physiotherapy and/or local caging therapy.[Result]All the patients were followed-up for 2～7 years,with an average of 4.3 years.In the instable group,4 patients were found osteophyma at the instable vertebra,3 were intervertebral disk hernia,6 were intervertebral disk hernia and osteophyma,3 were T_2 high intensive sign(T_2 HIS)in spinal cord at the instable vertebra.In the stable group,2 were found intervertebral disk hernia at C_(4~5),2 were found osteophyma at C_5 vertebra.The incidence of cervical syndrome was 19.51% in instable group and 2.99% in stable group.There was significant statistical difference(P

This study examined the effects of a combined surgery of sleeve gastrectomy (SG) and modified jejunoileal bypass (JIB) on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 (GLP-1) and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol: SG-JIB (n=12), SG (n=12), JIB (n=12) and sham surgery groups (n=10). In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum (25 cm from the ligament of Treitz) to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.

BACKGROUND:Recently, glucocorticoid-induced necrosis of femoral head has been much studied. However, the precise Wnt signaling pathway by which puerarin suppresses adipogenic differentiation of glucocorticoid-induced bone marrow mesenchymal stem cells adipogenic differentiation of glucocorticoid-induced bone marrow mesenchymal stem cells remains unconfirmed. OBJECTIVE:To investigate the expression of Wnt signaling pathway related genes and the key factor protein,β-catenin, during adipogenic differentiation of glucocorticoid-induced rat bone marrow mesenchymal stem cells treated by puerarin. METHODS:The third generation of bone marrow mesenchymal stem cells were cultured with Dulbecco’s modified Eagle’s medium containing blank serum (blank control group), dexamethasone (hormone group), dexamethasone with puerarin low dose group, the middle dose group and high dose group. After 6 days of culture, in the above five groups, the expressions of Wnt/β-catenin signaling pathway members, Wnt10b mRNA, GSK3βmRNA,β-catenin mRNA, were detected using RT-PCR assay, and the expression ofβ-catenin protein was detected using western blot assay.
RESULTS AND CONCLUSION:Compared with the control group, the Wnt10b mRNA,β-catenin mRNA andβ-catenin protein expressions were significantly higher in puerarin groups, but GSK3βmRNA expression was significantly lower in the puerarin groups. These findings suggest that puerarin effects on inhibition of adipogenic differentiation of glucocorticoid-induced bone marrow mesenchymal stem cells probably are realized through the activation of Wnt/β-catenin signal pathway and regulation of the key factor Wnt10b mRNA, GSK3βmRNA,β-catenin mRNA, andβ-catenin protein expressions. The mechanism by which puerarin prevents glucocorticoid-induced necrosis of femoral head not only improves local microcirculation of the femoral head, but also relates to its inhibitory effects on adipogenic differentiation of glucocorticoid-induced bone marrow mesenchymal stem cells.

Objective To construct and analyze the model of the sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB) on non-obese Goto - kakizaki (GK) rats. Methods GK rats were randomly divided into SG/MJIB, sham-SG/MJIB, pair-fed (PF) and controls group. Before and after surgery, the changes of weight, food intake, fasting glucose, oral glucose tolerance test (OGTT), insulin tolerance test (ITT), fasting plasma Insulin and the histological changes in islet were dynamically observed for 16 weeks. Results From the 4th week postoperative, the weight changes of SG/MJIB significantly decreased compared with sham-SG/MJIB and PF group (P＜0.01). Fasting glucose concentration of SG/MJIB animals was lower than sham-SG/MJIB, PF and controls group (P＜0.05). The OGTT of SG/MJIB rats was obviously improved compared with the sham-SG/MJIB, PF and controls group （P＜0.01). Two weeks after operation, glucose tolerance was better improved in SG/MJIB than preoperative, the area under the curve (AUC) of blood glucose concentration decreased by about 38.9% (P＜0.01). Postoperative insulin levels in SG/MJIB group were obviously lower than sham-SG/MJIB group throughout the experiment(P＜0.05). In the 16th week, the morph of pancreatic islet of SG/MJIB was obviously improved. In the SG/MJIB group, the number of positive β-cell and mature acinus was significantly increased, while sham surgery groups had no obvious changes as mentioned above. Conclusions SG/MJIB was directly linked to the reduction in glucose levels in GK rats, independently weight loss and caloric intake, and it can be served asa stable long-lasting hypoglycemic surgery model to research the mechanism for the treatment of type 2 diabetes.

AIM: To investigate the changes of the redox status and the antioxidative capability in the tissue of malignant tumors. METHODS: The carcinoma tissues collected from 42 patients with primary cancer in digestive tract (13 cases of esophageal cancer, 14 cases of gastric cancer and 15 cases of colorectal cancer),the corresponding paratumor mucosa tissues were taken as the control samples. The content of oxidized and reduced glutathion (GSSG and GSH), oxidized and reduced coenzyme II (NADP+ and NADPH) were measured, the GSH/GSSG, NADPH/NADP+ ratios, and the GSH/GSSG, NADPH/NADP+ redox potentials were calculated according to Nernst formula. RESULTS: The levels of GSH and NADPH in cancer tissues were significantly higher than those in corresponding paratumor tissues (P0.05). CONCLUSIONS: The significant increase in GSH and NADPH contents in cancer tissues indicates a notable enhancement of its antioxidative capability compared with the corresponding paratumor tissues. Based on this changes, the redox potential in the cancer tissues has only slightly reductive shift, which may suggest an apparent oxidative stress existed in the cancer tissues.

Objective To explore the feasibility and efficiency of the treatment of lumbar degenerative diseases after transforaminal lumbar interbody fusion(TLIF)and posterolateral fusion(PLF)procedures in which unilateral pedicle screw fixation was used.Methods From December 2006 to August 2008,78 cases with the lumbar degenerative diseases who received lumbar posterolateral fusion were analyzed.There were 48 cases of which underwent TLIF and PLF procedures with unilateral pedicle screw fixation(unilateral group),including 25 males and 23 females with an average of 47.6 years;and 30 cases of which underwent TLIF and PLF procedures with bilateral pedicle screw fixation(bilateral group),including 21 males and 9 females with an average of 50.5 years.The clinical effects between the two groups were evaluated with Oswestry disability index and visual analogue score(VAS)index.The operation time,blood loss,fusion rates and intervertebral collapse rates were also compared.Results Oswestry disability index,low back pain VAS index and skelalgia VAS index in both groups showed statistical significance between preoperation and 3 months,or 3 months and 1 year postoperatively.There was no difference in score improvement between the two groups.There were difference in operation time,blood loss and cost of hospitalization between unilateral and bilateral group.The former was lower.There was no difference in postoperative length of stay between the two groups.The fusion rate of unilateral group and bilateral group were 91.7%(44/48)and 93.3%(28/30),respectively.Conclusion Auto graft combined with unilateral pedicle screw fixation provids better spinal instant stability.TLIF and PLF with unilateral pedicle screw fixation was a satisfactory method in treating degenerative disease of lumbar vertebrae.

Objective To evaluate the outcomes of thumb reconstruction with dorsal thumb rotated single pedicel reverse island flap.Methods 49 thumb-tip defects cases with dorsal thumb rotated single pedicel reverse island flap were analyzed retrospectively.37 dorsal thumb reverse island flap were performed,and 12 ulnar-dorsal reverse island flaps were performed.Results The operation time was 40-60 minutes.The mean time was 45 minutes.All 49 cases survived completely.The color of the flaps was purple,and blisters in the surface of the flaps after 1-2 days in 2 cases.After took out stitches partly,the blisters were dried and crusted,the color of the flaps with better blood circulation was normal.The follow-up period was 3-24 months,all thumbs had satisfactory appearances and functions.The two-point discrimination was 6-9mm in flaps inosculated with nerve,that was 8-10 mm in flaps inosculated without nerve.The color,texture and elasticity of flaps were excellent,and the donor sites had not been defected.Conclusion Dorsal thumb rotated single pedicel reverse island flap is a reliable option to restore function as well as appearance,long vascular pedicle with skin strap,wide rotation angle,high rate of survival.It avoided damages to the well-known arteries and nerves.It is a relatively facile procedure that can be applied toward resurfacing thumb tip defects.

Objective:To observe the path and anatomic distribution of cutaneous branch of second dorsal metacarpal artery(SDMA) from the back of hand to the web of the fingers, and to explore the feasibility and clinical effect on the transfer of free flap of SDMA.Methods:Between June 2018 and September 2018, with perfusion of red latex, 22 hand specimens were dissected to explore the course, vessel calibre and distribution of cutaneous branches of SDMA, and to discover the existence of an innervation of cutaneous nerve in Department of Hand Surgery of Tangshan Second Hospital. Later on, from February 2019 to July 2020, 2 thumb pulp defects of 2 patients were reconstructed with the free flaps of SDMA. One defect was in the left thumb and the other in the right, both were male and compression injuries. Size of thumb pulp and a skin defect was at 3.5 cm×2.0 cm in 1 patient, and 2.0 cm×2.5 cm in the other. There was no neurovascular injury, but 1 patient had a distal phalangeal fracture and a nail bed laceration. The sizes of the flaps were 3.8 cm×2.3 cm and 2.8 cm×2.5 cm. Functional exercises started from 3 weeks after surgery. Patients attended postoperation follow up regularly by outpatient visit, telephone or internet interviews. Follow-up observations included the appearance, texture, sensory recovery of the flaps and thumb functions.Results:Multiple perforating branches (4-9 branches) were found from SDMA, which distributed in the distal 1/3 of SDMA in the anatomic study. It was found that the outer diameter of SDMA was 0.76 mm±0.25 mm at the intersection of extensor tendon of index finger and that of the digital web artery was 0.71 mm±0.12 mm. The length of digital web artery was 11.00 mm±1.27 mm. The 2 surgically transferred flaps were all survived. One patient showed the function of thumb in excellent with two-point discrimination (TPD) at 7.0 mm, at 18 months of follow-up. The other patient showed good thumb movement, soft and elastic skin of the flap and with a 7.5 mm in TPD, at 15 months of follow-up. According to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, the results of the 2 flaps were all excellent.Conclusion:The flap of SDMA has a constant cutaneous nerve and a long vascular pedicle with an ideal vessel size. It is suitable for free transfer and can be used to reconstruct soft tissue defects of thumb.