Objective To investigate the treatment of the complications of puncture lapsus after the percutaneous vertebroplasty (PVP) for osteoporotic fractures.Methods From December 2011 to November 2014,3 female patients with postoperative complications of PVP which were treated for osteoporotic fractures,aged from 71 to 82 years (average,78 years old) were involved.Each of them performed a revision surgery in our hospital.One of them was performed with PVP of the 12th thoracic vertebral due to the osteoporotic thoracic vertebral compression fracture.However,bone cement was leaked into spinal canal after PVP,and the patient suffered from left abdominal constriction and impaired of sensation in left inguinal region.She underwent anterior approach of decompression,cement removal and internal fixation one year after the first operation.The second case was performed with PVP of the 1st lumbar vertebral due to the osteoporotic lumbar vertebral compression fracture.In this case,bone cement was leaked into spinal canal after PVP,and the patient suffered from abdominal and lower extremity pain,paralysis,and hypoesthesia of lower limbs.This patient was treated with posterior approach of decompression,cement removal and internal fixation.The third case was performed with the 12th thoracic vertebral PVP due to the osteoporotic thoracic vertebral compression fracture.Subdural hemorrhage happened after PVP,and the patient suffered from paralysis and sensory loss of the two lower limbs.This patient was treated with posterior approach of laminotomy,hemostasis in the spinal canal and evacuation of hematoma.We performed a follow up from 21 to 29 months (average,24.7 months),to observe the recovery of the patients.Results one case' s abdominal constriction eliminated and the inguinal region pain improved after the revision surgery,and there's no internal fixation loosening with the follow-up of 21 months.The other case's abdominal and lower limb pain relieved,the lower limb muscle strength recovered to grade 4,and the tactile of lower limb recovered to normal after the revision surgery.There' s no internal fixation loosening with the follow-up of 29 months.One case of patients with slightly recovered of lower extremity muscle strength and feeling after surgery,and remained lower limb pain,died two years after the surgery.Conclusion Complications of spinal cord compression after percutaneous vertebroplasty (PVP) for osteoporotic fractures can get good outcomes by using appropriate revision surgeries,although revision surgery is difficult and risky.

Objective To investigate the clinical outcomes of sternoclavicular hook plate in treatment of the anterior sternoclavicular joint dislocation. Methods A new device named sternoclavicular hook plate was devised by our team. Between May 2002 and Octorber 2009, 66 patients with sternoclavicular joint anterior dislocation were treated with the new device, among whom there were 47 males and 19 females,aged 21-68 years old (average, 32.6 years old). Twenty-one cases were caused by crush injury, 5 cases by falling and 40 cases by traffic accident. Anterior fracture-dislocation was found in 41 cases. According to the Allman system, there were 35 cases of type Ⅱ and 31 cases of type Ⅲ. Patients were evaluated with serial clinical and radiographic examinations. Rockwood score were used after the operation to assess the curative effect. Results The average operative time was 33 min (range, 20-48 min). The mean blood loss was 60 ml (range, 20-90 ml). There were no vascular or peripheral nerve injuries in the patients. All incisions healed smoothly. The X-ray and CT showed that the reduction of sternoclavicular joint and the location of internal fixation were satisfactory. All the 66 patients were followed up for 12-37 months (average, 17 months). There was no internal fixation failure, redislocation or other complications. The sternoclavicular hook plate was removed 12 months after operation. The mean Rockwood's score was 13.2 (8 to 15). There were excellent in 50cases, good in 15 cases, and fair in 1 case. Conclusion The sternoclavicular hook plate is a new, safe and liable technique for sternoclavicular fracture-dislocation. This new technique is helpful for early functional exercises.

OBJECTIVE Toexploretheantidepressanteffectsofalbiflorinandtheinvolvementof hypothalamic-pituitary-adrenocortical (HPA) axis function in its antidepressant potency.METHODS Two weeks after the olfactory bulbectomized (OB)surgery,albiflorin (2.5 ,5.0 ,10.0 mg·kg -1 ,ig) and imipramine 5.0 mg·kg -1 (ig)were given to rats twice a day for 14 d.The open-field test was con-ducted to evaluate the move ment distance,move ment ti me and velocity of olfactory bulbecto mized rats and sham-operated rats.The serum levels of corticosterone(CORT)and adrenocorticotropic hormone (ACTH)in rats were measured by the enzyme linked immunosorbent assay.The expression levels of glucocorticoids receptor (GR)in the hippocampus of the rats were analyzed using Western blot proce-dures.RESULTS Comparedwithsham-operatedrats,movementdistance,movementtimeandveloci-ty of the OB rats were significantly increased (P<0.01 ).Albiflorin 1 0.0 mg·kg -1 significantly reduced the movement distance,movement time and velocity of OB rats (P<0.05)after being given for 7 d. The movement properties were significantly reduced by albiflorin 5.0 and 10.0 mg·kg -1 when given for 14 d (P<0.05).The OB rats demonstrated significantly increased levels of serum CORT and ACTH (P<0.01 )and decreased GR expression in the hippocampus (P<0.01 ).Albiflorin 2.5,5.0 and 10.0 mg·kg -1 significantly reduced the serum CORT and ACTH levels (P<0.05),while albiflorin 5.0 and10.0mg·kg-1increasedtheexpressionofhippocampalGR(P<0.05).CONCLUSION Albiflorin may have re markable behavioral antidepressant effects on olfactory rats and one of the related mecha-nis ms may be its regulation of the hyperactivity of HPA axis function.

Objectives To analyze pathogen distribution and antimicrobial resistance of bacilli among children with otitis media. Methods Pathogenic bacteria was isolated from children with suppurative otitis media. The VITEK32 was used for iden-tification. The bacterial susceptibility testing was done by Kirby-Bauer method. According to CLSI standard the antimicrobial susceptibility was determined. Results From Jan 2010 to Dec 2012, 425 children with suppurative otitis media were examined. 347 strains were isolated, of which the detectable rate was 81.65%. The detectable rate of bacteria and fungus was 93.37%(324/347) and 6.63%(23/347), respectively. Among bacteria, the detectable rate of streptococcus pneumoniae was 40.92%(142/347) and staphylococcus aureus was 33.43%(116/347). The detectable rate of haemophilus influenza was 7.78%(27/347). The preva-lence of streptococcus pneumoniae is high in children aged 1-3years, with detectable rate at 47.09%. There was no statistical dif-ference among different age groups. The prevalence of methicillin-resistant staphylococcus aureus (MRSA) in middle ear secre-tion was 1.11%(5/45), 18.75%(9/48)and 30.43%(7/23)in 2010, 2011 and 2012 respectively, with no statistical difference (χ2=3.86, P=0.145). The prevalence of penicillin-resistant streptococcus pneumoniae (PRSP) in middle ear secretion was 9.26%, 3.92%and 27.03%in 2010, 2011 and 2012 respectively, with statistical difference (χ2=11.47, P=0.003). Conclusions Choosing correct therapy according to the result of middle ear secretion culture and antibiotics sensitive test can increase the recovery rate of otitismedia.

Objective To evaluate the efficacy of different treatment regimens for children with acute promye-locytic leukemia (APL)with positive PML -RARa fusion gene.Methods Thirty -two newly diagnosed APL patients were included in this study,treated either with all -trans -retinoic acid (ATRA)and chemotherapy (CT)(group A) or with ATRA and arsenic trioxide (ATO)(group B).Clinical situation and clinical efficacy were analyzed in patients in different groups.They were also separated into low risk group,intermediate risk group and high risk group according to different risk criteria.Clinical characteristics,complete remission,long -time survival and urine arsenic concentra-tion were analyzed and compared.Results (1 )Fourteen of 1 5 patients (93.3%)in group A achieved hematological complete remission (HCR)with a median time of 38 days (28 -63 days).Sixteen of 1 7 patients (94.1 %)in group B achieved HCR with a median time of 29 days (1 0 -42 days),which was significantly shorter than group A,and there was a significant difference between 2 groups(t =3.53,P =0.002).(2)The 5 -year event -free survival (EFS)of group A and group B was (60.0 ±1 2.6)% and (81 .9 ±9.5)%,respectively;the 5 -year EFS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =1 .1 5,P =0.28).The 5 -year overall survival (OS)of group A and group B was (72.2 ±1 1 .9)% and (94.1 ±5.7)%,respectively,the 5 -year OS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =2.88,P =0.1 6).(3)The 5 -year EFS of low plus intermediate group and high risk group patients was (74.0 ±1 0.1 )% and (64.8 ±1 4.3)%,the 5 -year EFS of low plus intermediate group was almost 1 0% higher than high risk group,but there was no significant difference between the 2 groups(χ2 =0.1 4,P =0.71 ).The 5 -year OS of low plus intermediate group and high risk group patients was (84.7 ±8.1 )% and (71 .3 ±1 4.1 )%,the 5 -year OS of low plus intermediate group was almost 1 0% higher than high risk group,while there was no significant difference be-tween the 2 groups(χ2 =0.36,P =0.55).(4)ATO related side effects were mild,including abnormal liver tests and e-lectrocardiogram,but were invertible after supportive therapy.At the end of each chemotherapy course,the urine arsenic concentration remained low and no chronic arsenic toxicity or second malignancies were found during the follow -up period.Conclusions The ATRA plus ATO regimen is a promising and better treatment for childhood APL with positive PML -RARa fusion gene compared with conventional chemotherapy.It was necessary to take risk stratification in APL patients.

Objective:To investigate the effectiveness and safety of middle-column preserved pedicle subtraction closing-opening wedge osteotomy for the treatment of stiff kyphosis.Methods:From January 2016 to April 2018, 12 patients with stiff kyphosis in our department were treated with middle-column preserved pedicle subtraction closing-opening wedge osteotomy. The patients' operative time, intraoperative blood loss, postoperative drainage, surgical complications, low back pain and leg pain visual analogue scale (VAS), Oswestry dysfunction index (ODI) score, and SF-36 were recorded.These parameters were compared at preoperative, postoperative, and at the final follow-up. Coronal parameters included lumbar scoliosis Cobb angle, C 7 vertebral body center to humeral vertical line distance (C 7PL-CSVL), whilesagittal parameters includedlumbar Lordosis (LL), sacral slope (SS), pelvic tilt (PT), and sagittalvertical axis (SVA). Results:All of 12 patients successfully completed the operation.The mean operation time was 238.20±65.95 min, the mean intraoperative blood loss was 440.50±133.60 ml.The patients’ODI score was 65.92%±6.96% at the preoperative, and 21.00%±3.19% at the final follow-up. The difference was statistically significant ( t=20.32, P<0.0001).The VAS score of back pain was 6.00±0.95 at preoperative, 2.33±0.89 at 3 months postoperatively, and 1.42±0.51 at the final follow-up. The VAS score of leg pain was 6.91±1.24 at preoperative, 2.50±1.00 at 3 months postoperatively, and1.50±0.52 at the final follow-up. There was significant difference in SF-36 at preoperative and at final follow-up ( P<0.05). The differences in LL, SS, PT and SVA at the preoperative and at final follow-up were statistically significant ( F=17.47, P<0.001; F=5.015, P=0.0125; F=14.66, P<0.001; F=81.11, P<0.001) . There was significant difference in lumbar scoliosis Cobb angle and C 7PL-CSVL at the preoperative and at final follow-up ( F=87.19, P<0.001; F=100.9, P<0.001) . Conclusion:The advantages of this surgical procedure includesimple operation, reducedsurgery time, and shorten intraoperative bleeding, which can effectively relief clinical symptoms, improve the quality of life, correctkyphosis, and maintain the patient's spinal-pelvic balance.

Objective To compare the effect of electro-acupuncture(EA) and warm-needle moxibustion(WNM) on the foot three-dimensional gait time-space parameters and surface electromyography of post-stroke patients with flaccid paralysis. Methods A total of 61 patients were randomly divided into EA group (N=30) and WNM group(N=31). Both groups were given post-stroke conventional treatment, and additionally EA group received EA while WNM group was given WNM. Before treatment and after 2 treatment courses, we detected the foot three-dimensional gait time-space parameters of pace race, stance phase, swing phase, bilateral stance phase, and step length, and surface electromyography parameters of root mean square(RMS), integrated electromyogram (iEMG) and co-contraction ratio(CR) of tibialis anterior muscle and gastrocnemius at the state of maximal isometric voluntary contraction(MIVC). Results(1) After treatment, the foot three-dimensional gait time-space parameters of the two groups were improved in various degrees (P<0.05 or P<0.01 compared with those before treatment) , and the improvement of EA group was superior to that of WNM group (P < 0.05). (2) After treatment, the RMS and iEMG of the gastrocnemius and tibialis anterior muscle as well as CR of dorsal extensor at MIVC state were improved in various degrees (P < 0.05 or P < 0.01 compared with those before treatment) , and the improvement of EA group was superior to that of WNM group(P < 0.05 or P < 0.01). Conclusion WNM exerts better effect on improving the parameters of three-dimensional gait time-space parameters and surface electromyography of post-stroke patients with flaccid paralysis than EA.

ObjectiveTo study the effect of comprehensive treatment on lumbar interveretebral disc syndrome.Methods227 patients with lumbar interveretebral disc syndrome were randomized into two groups. Control group(127 patients) only accepted lumbar vertebra traction, while treatment group(100 patients) accepted comprehensive treatment, including lumbar vertebra traction, hot magnet, Maitland manipulation, and Mckeizie back muscles train. ResultsEffect of treatment group was obviously better than control group (P<0.05). Conclusions Comprehensive treatment on lumbar interveretebral disc syndrome can get better effect than simply traction.

Objective To investigate characteristics of cage migration after transforaminal lumbar interbody fusion (TLIF) and related risk factors.Methods A retrospective study was conducted to review cage migration in 512 patients who had undergone TLIF procedure from January 2010 to June 2011 in 5 spinal research centers.There were 255 males and 257 females,aged from 37 to 77 years (average,54.7 years).All patients were followed up at 3,6,12 months after operation.The clinical outcomes were evaluated using the visual analogue scores (VAS) and Oswestry disability index (ODI).X-rays and 3D CT scans were used to analyze the incidence and related risks factors of cage migration in these patients.Results Cage migration was found in 6 of 512 patients,the total incidence was 1.17％.Significant difference was found between each center.Cages with different shapes had different incidence.The analysis showed that the incidence of migration of rectangular-shaped cage (3.11％,5/161) was significantly higher than that of kidney-shaped cage (0.28％,1/351).The cage in double-segment TLIF (5.75％,5/87) was easier to migrate than that in monosegment TLIF (0.24％,1/425); furthermore,linear type endplate(3.50％,5/143) was remarkably easier to migrate than concave-concave one (0.27％,1/369).Conclusion Difference in operative skills,cage shape,number of fused segments,adjacent endplate shape,and lumbar spondylolisthesis might be risk factors for cage migration after TLIF.

Objective To study the effects of cryopreservation on the immunogenicity of human umbilical vein endothelial cells(HUVEC).Methods HUVEC were isolated ex vivo and cryopreserved.Lymphocyte stimulation index(SI)was analyzed by MTT in lymphoeyte-endothelial cell co-culture.Both HLA-ABC and HLA-DR antigen expression on fresh or cryopreserved HUVEC,and the effects of IFN-γ treatment on HLA antigen expression in both groups were determined by using flow cytometry.Results No difference in SI was observed between fresh prepared and cryopreserved HUVEC(1.716±0.181 vs 1.686±0.145,P>0.05).The percentage of HLA-ABC expression was(96.6±1.9)%and(96.0±1.4)%in fresh and cryopreserved HUVEC(P>0.05),and the mean intensity for HLA-ABC expression was 84.1±5.7 and 82.4±4.8 in fresh and cryopreserved HUVEC(P>0.05),respectively.However,no HLA-DR expression was observed in both groups.When treated with IFN-γ,HLA-ABC expression was significantly up-regulated,and HLA-DR expression was induced in a dose-dependent manner.No significant difference was found in the HLA-ABC expression between fresh and cryopreserved HUVEC(P>0.05),while the HLA-DR expression in cryopreserved HUVEC was remarkably lower than in fresh HUVEC with the increase of IFN-γ(P<0.01).Conclusion The immunogenicity of HUVEC remains stable by cryopreservation without IFN-γtreatment or treated with low concentration of IFN-γ(≤50 U/ml).However,the HLA-DR expression in HUVEC was remarkably reduced in eryopreserved cells treated with a high concentration of IFN-γ(≥100 U/ml).These data indieated that the effects of cryopreservation on immunogenicity of HUVEC may result from the decreased responses of HLA-DR expression by the stimulation of IFN-γ treatment.