Objective To investigate the diagnosis and treatment of delayed infection after pedicle screw internal fixation via posterior approach. Methods The management of 17 cases of delayed infection after posterior pedicle screw internal fixation was retrospectively analyzed. Imaging examination was done before operation in all the patients. In petients whose operation was done within 9 months and non-fusion of bone graft was proved, debridement and suction-irrigation were given. For the patients in whom bone graft had fused, the implant was removed, followed by debridement, irrigation, and wound closure. Specimens were taken during operation for bacteriological study. Intravenous antibiotic was given after operation in all the patients. When 3 successive bacterial culture of wound drainage were proved to be negative and total drainage fluid was less than 50ml in 24h, drainage tube was removed. Results Wounds healed in all the patients. In 8 of 12 cases wound healed after debridement and irrigation-suction. In 9 patients fusion of the bone graft was confirmed, and internal fixators were removed, followed by debridement, irrigation-suction and primary closure of the incisions. In 4 cases infection recurred 3-18 months after first stage debridement and irrigation-suction, but X-ray confirmed that there was fusion of the bone graft. In 11 of 17 cases bacterial cultures were positive. Conclusions Delayed infection is a severe complication after internal fixation of the spine. Debridement and irrigation-suction are effective in controlling infection, and at the same time, it allows fusion of the bone graft. Removal of the internal fixators is not indispensable.

Objective To investigate the effect of surgical decompression on lumbar spinal stenosis in senile people. Method 175 senile patients with lumbar spinal stenosis were admitted from Jan. 1997 to Dec. 2003. Among them, the data of effect of surgical decompression in 106 cases, including 49 males and 57 females, age ranged from 70 to 82 years, all of them having a disease history of 4-10 years, and followed-up for 2-6 years after the operation. Their data were analyzed retrospectively. All the patients had been treated conservatively. 42 patients were complicated by one internal disease, and 55 complicated by at least 2 internal diseases. In all the patients continuous movement could not last longer than 15 min before operation. Lamina decompression was done in 95 patients, and a combined operation of lamina decompression, pedicle fixation and post-lateral bone grafting in 11 patients. Result All the patients survived the operation. Complications occurred in 38 cases, and the patients recovered after effective treatment. During follow-up, lumber complaint was improved in 37 cases, numbness in both legs was improved in 63 cases, and no satisfactory improvement was seen in 6 cases. In 66 cases the Oswestry score was lower than 20%, and in 34 cases it was lower than 10%. The result of surgical decompression was satisfactory in 94% of cases, and the average continuous movement was prolonged to over 30 min after operation. Conclusion Based on the effective control of complicated disease, the operative treatment of lamina decompression with fusion or no fusion played an important role in the recovery of neurological function in senile patients with lumbar stenosis.

OBJECTIVE:To study the action mechanism of the self-made Wuhuang tang(Chinese medicine)in the treatment of type Ⅲ prostatitis(chronic nonbacterial prostatitis,CNBP)so as to promote the action mechanism of traditional Chinese medicine to the molecular level.METHODS:90 patients with CNBP were divided into two groups(n=45 each):one group received western medicine alone,another group received integrated Chinese and western medicine(ICWM)(Wuhuangtang plus western medicine).The indicators such as the expressed prostatic secretions(EPS)routine,IL-1?,and TNF-? before and after the treatment were analyzed statistically.RESULTS:The levels of IL-1? and TNF-? in ICWM-treated group decreased significantly and the clinical symptoms of these patients improved significantly as compared with those treated with western medicine alone.CONCLUSION:The self-made Wuhuang tang can markedly alleviate the symptoms of CNBP patients and decrease levels of IL-1? and TNF-? in patients' EPS,thus it is an effective clinical empirical prescription for CNBP.

Fourty-three cases with spinal tumors treated with vertebral resection were reviewed regarding the preoperative treatment, the operations, and the results, in order to evaluate the value of resection of the vertebral body in prolonging the survival time and in improving the life quality of the patients. All the patients showed neurological recovery after surgical decompression. The average improvement was 2 grades by Frankel system. A second operation was necessary in 3 cases with recurrent lesions. Pulmonary and urinary complications were found in 3 cases. Absorption of bone grafts, collapse of vertebrae and loosening of implants were found in 2 cases. Resection of the involved tissue or segments and re-establishment of stability have become the most important treatment modality for patients with spinal tumors. With the help of adjuvant therapy, the survival time and the life quality of patients have been greatly improved.

Objective To explore the best treatment program for neurogenic dysphagia (ND) by observing the efficacy of three different rehabilitation programs.Methods Eighty-two dysphagic patients were randomly divi-ded into a swallowing training group (which received mouth,facial,and tongue function training along with cold sti-mulation of the pharynx,Mendelson's swallowing training,and swallowing behavior coordination training) and a group which received neuromuscular electrical stimulation (NMES) only.Low-frequency NMES was applied at the location of the swallowing obstacle using a biphase square wave 700ms long at 30-80 Hz with a current intensity of 0-15 mA.There was also a combined treatments group which received swallowing behavior therapy combined with NMES.All three groups were treated for 30 min daily for 20 days.Videofluoroscopy (VFSS) was conducted before and after treatment to assess swallowing function.Results After 20 days of treatment,swallowing function had improved in all three groups.The effectiveness rate was 73% in the swallowing training group,83% in the NMES group and 94% in the combined treatment group.The average VFSS score in the combined therapy group was significantly higher than that of either the swallowing training or NMES group.Conclusions NMES combined with swallowing behavior the-rapy can greatly improve swallowing function in patients with neurogenic dysphagia,especially those with pseudosupranuclear paralysis.

ObjectiveTo explore the effect of Vitalstim neuromuscular electrical stimulation on neurogenic swallowing dysfunction. Methods82 patients were divided into three groups: group A received swallowing behavior therapy, group B received Vitalstim neuromuscular electrical stimulation, group C received Vitalstim neuromuscular electrical stimulation and swallowing behavior therapy, 10 times as one course. ResultsTotal efficiency was 72.7% for group A, 82.6% for group B, and 94.5% for group C, after 1～2 courses. Scores of videofluorocopic swallowing study (VFSS) was significantly higher in group C than in the other groups (P=0.000). ConclusionVitalstim neuromuscular electrical stimulation on the basis of swallowing behavior therapy can improve swallowing function of neurogenic dysphagia, especially in pseudobulbar palsy.

Objective To investigate the morphological features of reproductive system of adult Schistosoma japonicum under an optical microscope.Methods Adult schistosomes were obtained from infected mice with cercariae shedding from Oncomelania snails.The adult worms fixed with 10% formalin,dehydrated,imbedded in paraffin,cut at 3 ?m thick,stained by HE staining and then observed under an optical microscope.Results The reproductive organs of adult Schistosoma japonicum such as testicle,ovary,fallopian tube,vitellarium,yolk duct and hystera were displayed distinctly and typically.Conclusions The morphological features of reproductive system of adult Schistosoma japonicum are distinct and typical by using routine pathological techniques preparing and HE staining,which establishes a morphological foundation for the morphological teaching of schistosomes and reproductive biology research.

BACKGROUND: An effective preservation method must preserve the integrity of tissue structure. OBJECTIVE: To compare the effects of vitrification and cryopreservation method on the artery morphology and mechanical properties. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was done at the Department of Orthopedics, General Hospital of Chinese PLA, between September 2001 and August 2004. MATERIALS: Eighteen New Zealand rabbits were randomly divided into vitrified artery group, cryopreserved artery group and fresh artery group, with 6 rabbits in each group. METHODS: Femoral arteries were removed from rabbits and put in balanced solution. Arteries in the vitrified artery group were immersed in the 25%, 50% and 100% gradient vitrified solution at 4 ℃ and then were put in liquid nitrogen. Arteries in the cryopreserved artery group were cooled from normal temperature to 0, -20, -70 ℃, and balanced for 60 minutes, then were put in liquid nitrogen. Samples were preserved in liquid nitrogen for more than 14 days. MAIN OUTCOME MEASURES: The morphology changes of preserved arteries observed through naked eye and microscope; hysteresis loop; stress relaxation; breaking strength. RESULTS: Artery structures were all preserved well in the three groups, the integrity rate of vitrified artery group was 91.67%, which was significantly better than 54.17% of cryopreserved artery group (P 0.05). CONCLUSION: There influences of vitrification and cryoprsesrvation on the artery morphology and mechanical properties were not significant, while arteries preserved by vitrification had less tissue ruptures, so vitrification is suitable for preserving long vessels.

ObjectiveTo investigate the clinical efficacy and safety of solifenacin for female overactive bladder (OAB) who failed in toherodine treatment. MethodsFrom Jan 2010 to Oct 2010,48 cases of female OAB were treated with 5 mg/d solifenacin for 4 weeks after the failure of tolterodine treatment.The improvement of the perception of bladder condition as well as the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. ResultsAfter 4-week solifenacin treatment,the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were respectively decreased from the baselines ( 8.7 ± 1.5),(3.4 ± 2.1 ),( 2.4 ± 1.8 ),(2.1 ± 1.8 ) and (2.2 ±1.6) to be (7.2 ±2.5),(2.0 ±1.8),(1.5 ±1.2),(1.2 ±0.8) and (1.4 ±0.8).The perception of bladder condition was improved in 42 cases.The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth.No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.

Purpose To investigate the expression of miR-134 in breast carcinoma and its c1inica1 significance,and to ana1yze the as-sociation between its expression with bio-markers of epithe1ia1-mesenchyma1 transition( EMT). Methods The expression of miR-134 in 97 breast cancer samp1es was detected by in situ hybridization and the expression of E-cadherin,N-cadherin,and vimentin was de-tected by MaxVision two-step method of immunohistochemistry,to ana1yze the re1ationship between their expression and c1inicopatho1og-ica1 characteristics. Results The expression of miR-134 in breast cancer was negative1y associated with higher histo1ogica1 grade, HER-2 overexpression,1ow expression of E-cadherin as we11 as high expression of N-cadherin and vimentin. Both 1ow-expression of E-cadherin and up-expression of N-cadherin and vimentin in breast cancer were positive1y corre1ated with higher histo1ogica1 grade,1ymph node invo1vement and HER-2 overexpression,whi1e negative1y associated with the expression of ER and PR. Conclusion The expres-sion of miR-134 in breast cancer tissue is negative1y re1ated to both the ma1ignant progression and EMT,indicating that it might be a potentia1 bio-marker for breast cancer.