Objective To evaluate the role of the short-segment transpedicular instrumentation and fusion in the treatment of thoracic and lumbar spine unstable fractures. Methods We reviewed 121 patients of thoracic and lumbar vertebral fractures treated by short-segment transpedicular instrumentation (attachment of one level above the fracture to one level below the fracture) by using an AO Universal Spine System (USS), plus posterolateral fusion by using autogenous iliac crest bone graft. Results Out of the 121 cases, 104 had been followed clinically, radiographically, and functionally for 12 to 72 months (mean 31.3 months). Follow-up observations showed that, 101 patients (97.1%) had neurological function improvement more than one Frankel grade (3 no change), the average loss of vertebral body height basically reversed to normal (mean 58.3% preoperatively versus mean 3.2% postoperatively, with mean loss of 2.1% in follow-up), and the kyphotic angles were basically corrected (mean 29?preoperatively versus mean 3.4?postoperatively, with mean loss of 3.4?in follow-up). Conclusions The short-segment transpedicular instrumentation and fusion can provide excellent reduction and fixation, indirect decompression, and stabilization for unstable thoracic and lumbar fractures. The USS may be effectively employed in the short-segment fixation of thoracic and lumbar fractures.[

AIM: To evaluate the clinical outcomes and evaluate the application value of pedicle screw system internal fixation in short segment for the treatment of Hangman's fracture. METHODS: A retrospectively analysis was conducted in 17 cases of Hangman's fracture who were treated in Department of Orthopaedics, Sichuan Provincial People's Hospital since 2004. According to Levine-Edwards classification, 4 of them belonged to type II, 6 type IIA, 7 type III. According to Frankel classification in function of spinal cord, 12 cases of them belonged to Grade E and 5 cases D. All cases were fixed with C2,3 pedicle screw system short segment implantation materials (product of Medtronic Sofamor) after skull traction and reduction. RESULTS: No vertebra artery injury or spinal injury was found during operation. Postoperational photograph and CT detection revealed bilateral fracture had no reduction in 1 case and cerebrospinal fluid leaking occurred in 1 case who was cured after conventional therapy. All cases were followed up for 12-24 months (average 14.5 moths). All fractures healed within 6 months, and activities of cervical vertebra were not obviously limited. As for nerve function, 4 cases of Grade D recovered up to Grade E. Ti-alloy implant materials used in this study were well biocompatible to the human body. There were no blood, immune, histology reactions, or the corrosion and abrasion of Ti-alloy appeared. CONCLUSION: Pedicle screw fixation in short segment for the treatment of Hangman's fracture is satisfactory in fracture reduction, fixation and healing. There are little lose in function of cervical vertebrae and it promotes functional recovery of spinal cord.

BACKGROUND: Posterior transarticular screw fixation (Magerl’s) is recommended for atlantoaxial instability. However,some patients do not suit for Magerl’s fixation. OBJECTIVE: To evaluate the clinical outcomes of atlantoaxial pedicle screw system in the treatment of atlantoaxial instability from odontoid fracture. DESIGN,TIME AND SETTING: The retrospective case analysis was performed at the Department of Orthopedics,Sichuan People’s Hospital between July 2004 and June 2007. PARTICIPANTS: Twenty-one cases of atlantoaxial instability from odontoid fracture were selected. According to Anderson and D’Alonzo classification,9 of them belonged to type II odontoid fracture with atlantoaxial instability and 12 to type Ⅲ with severe atlantoaxial dislocation. All cases suffered pain at occipitocervical part and limited activities of cervical spine. According to Frankel classification in function of spinal cord,16 cases of them belonged to Grade E and 5 cases to D. METHODS: All cases were fixed with C1 and C2 pedicle screws system following skull traction and reduction. MAIN OUTCOME MEASURES: Biocompatibility between materials and host; bone graft fusion and functional improvement. RESULTS: No vertebral artery injury or spinal injury was found during operation,neither incision infection was. All cases were followed up for at least 8 months. Postoperative radiograph and CT detection revealed good positions of all screws with no loosening or breakage. All fractures healed within 5 months,and activities of cervical vertebra were not obviously limited except slightly limited rotation function. As for nerve function,5 cases of Grade D recovered up to Grade E. CONCLUSION: Posterior pedicle screw fixation system exhibits no specific biocompatibility responses. It greatly improves atlantoaxial stability and promotes functional recovery of spinal cord but has little influence on cervical function.

ObjectiveTo explore the effect of estrogen on osteoblast apoptosis induced by serum hungry in vitro.MethodsOsteoblasts of second or third generation from newly born SD rats calvaria were divided randomly into the control group, serum hungry group and serum hungry with estrogen group. Cells of each group were incubated for 24 h, 48 h, 72 h, 5 d, 7 d and 14 d, then labeled using TUNEL staining and examined for morphological characteristics of apoptotic cell under light microscopy after incubated for 72 h. The rates of apoptotic cells of each group were examined with flow cytometry.ResultsThe cells of the control group showed normal appears, the serum hungry group had many cells with purple and blue particles in nuclei, but serum hungry with estrogen group had less such cells. The rate of apoptotic cell significantly increased in serum hungry group and decreased in serum hungry with estrogen group compared with the control group examined with flow cytometry (P<0.05).ConclusionEstrogen can repress osteoblasts apoptosis of rats induced by serum hungry.

ObjectiveTo explore the mechanism of estrogen inhibiting osteoblast apoptosis induced with serum hungry.MethodsOsteoblasts of the second or third generation from newly born SD rats calvaria were divided randomly into three groups: control group,serum hungry group,serum hungry with estrogen group.Cells of each group were incubated for 1,2,3,5,7 or 14 d,and then were stained immunohistochemically.The rates of positive cells of each group were analyzed.ResultsThere was a little positive expression of Bax,Bcl2 and Fas in control group.The expression of Bax and Fas were significantly increased(P<0.05)in serum hungry group,peak time was 14 d,but the expression of Bcl-2 were not affected.Compared with that of serum hungry group,the expression of Bax and Fas significantly decreased(P<0.05) in serum hungry and estrogen group,peak time was still 14 d,while that of Bcl-2 increased(P<0.05).ConclusionSerum hungry can increase the expression of Bax and Fas in osteoblast,that can be inhibited by estrogen.Estrogen can also increase the expression of Bcl-2 in osteoblast.All of these may play a role in inhibiting osteoblast apoptosis induced with serum hungry.

BACKGROUNDElevated levels of serum C-reactive protein (CRP) have been reported to have prognostic significance in lung cancer patients. This study aimed to further identify CRP-bound components as prognostic markers for lung cancer and validate their prognostic value.

METHODSCRP-bound components obtained from the serum samples from lung cancer patients or healthy controls were analyzed by differential proteomics analysis. CRP-bound serum amyloid A (CRP-SAA) was evaluated by co-immunoprecipitation (IP). Serum samples from two independent cohorts with lung cancer (retrospective cohort, 242 patients; prospective cohort, 222 patients) and healthy controls (159 subjects) were used to evaluate the prognostic value of CRP-SAA by enzyme-linked immunosorbent assay.

RESULTSCRP-SAA was identified specifically in serum samples from lung cancer patients by proteomic analysis. CRP binding to SAA was confirmed by co-IP in serum samples from lung cancer patients and cell culture media. The level of CRP-SAA was significantly higher in patients than in healthy controls (0.37 ± 0.58 vs. 0.03 ± 0.04, P < 0.001). Elevated CRP-SAA levels were significantly associated with severe clinical features of lung cancer. The elevation of CRP-SAA was associated with lower survival rates for both the retrospective (hazard ration [HR] = 2.181, 95% confidence interval [CI] = 1.641-2.897, P < 0.001) and the prospective cohorts (HR = 2.744, 95% CI = 1.810-4.161, P < 0.001). Multivariate Cox analysis showed that CRP-SAA was an independent prognostic marker for lung cancer. Remarkably, in stages I-II patients, only CRP-SAA, not total SAA or CRP, showed significant association with overall survival in two cohorts. Moreover, univariate and multivariate Cox analyses also showed that only CRP-SAA could be used as an independent prognostic marker for early-stage lung cancer patients.

CONCLUSIONCRP-SAA could be a better prognostic marker for lung cancer than total SAA or CRP, especially in early-stage patients.

Biomarkers ; C-Reactive Protein ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lung Neoplasms ; Multivariate Analysis ; Prognosis ; Prospective Studies ; Proteomics ; Retrospective Studies ; Serum Amyloid A Protein

Standardization is the universal language of the world, and standardization of traditional Chinese medicine (TCM) is essential for its communication in China and globally. However, the principles and methods of TCM acupuncture standardization have been unclear and inadequate in the early stages. Based on an investigative approach to understanding the current status, identifying problems, and finding solutions, our team has established basic principles of TCM acupuncture that embody Chinese wisdom, evaluated the international strategic environment systematically, proposed the principle of “importance of harmony and exercise of impartiality”, and established basic working principles. A series of methods for TCM acupuncture standard development and evaluation have been constructed, including general standards for the revision of TCM acupuncture standards, the first TCM acupuncture clinical research management specification, a shared full chain technology platform, a data center, and an evaluation research base for TCM acupuncture clinical research. Evaluation criteria for ancient literature and expert experience, a recommendation method for the “three main and three auxiliaries” TCM guideline for prevention were established, and quantifiable assessment methods of TCM standard applicability were proposed. These findings provide methodological guidance for TCM acupuncture standardization.