[Objective]Microsurgical lumbar discectomy(MSLD)and microendoscopic discoectomy(MED)were compared in methods and curative effect for providing the experience and therapy evidence of lumbar disc herniation(LDH).[Method]It was retrospectively analyzed that mono-segment lumbar disc herniation were treated in minimal invasion in our hospital.MSLD was 45 cases and MED was 32 cases.Operation time,operation information,complication,hospital time and curative effect were compared.[Result]The satisfactory rate of two groups were both beyond 90% and no significant deviation was found.The incision of MED was obviously shorter than MSLD and the operation time of MED was longer than latter.[Conclusion]The curative effects of two minimal invasion methods are satisfactory.But the indication of MED is limited obviously and the method has not obvious predominance by compared with MSLD.MSLD is an more ideal minimal invasion operation at present.

Adult ; Ear Neoplasms ; Eustachian Tube ; Humans ; Male ; Neurilemmoma

With the rapid development and increased integration of Chinese economy with global economy, China assumes more responsibilities and obligations for global health, resulting in great poten-tial needs for professionals in global health. From the angle of global health talent need , this article deeply illuminated that the global health talent training was helpful to take advantage of international resources to solve the problem of health, serve China's peaceful development strategy, comply with development trend of public health, and remedy limitations of traditional medicine undergraduate. Training undergraduates in global health who are China-specific and global competent is the only way to meet the talent demand of China's future. Multi-level global health education will become an important part of medical education in future in China.

Objective To study and evaluate the ability of allogeneic bone marrow stromal cells(BMSCs) to survive and regenerate bone in muscles without using immunosuppressive agents. Methods A complete mismatch between donor BMSCs and recipient rabbit was confirmed by one way mixed lymphocyte reaction assaysprior to implantation. And then bone marrow aspirates were obtained from donor rabbits.BMSCs were isolated from the bone marrow, cultured in conditional medium to be ubdyced to become osteogenic, and then to examine these characteristics. After that the donor BMSCs were transplanted into the recipient rabbits. Immunological tests such as lymphocyte transformation rate and cell mediated cytotoxity, histological observation, seeding cells survival and bone formation were performed following transplantation. Results Allogeneic BMSCs transplantation did not actually elicit an adverse immune response, and bone regenerated at the transplantation area, and then the transplanted BMSCs marked with BRDU preoperatively were founded to be living 8 weeks later after transplantation using immunohistochemistric technique. Conclusion Allogeneic BMSCs would not elicit an adverse immune response in vivo without the immunosuppressive therapy, which could survive and form new bone tissue with the help of BMP-2 in the muscles.

A total of 33 non-neurological symptoms patients with thoracolumbar fractures underwent unilateral pedicle screw fixation plus short segment pedicle screw through para-vertebral muscles. Preoperative computed tomography ( CT) scan showed one side pedicle was complete.The average follow-up period was 22 (12-40) months.There was no internal fixation failure.The posterior paraspinal approach for unstable thoracolumbar fractures , retaining posterior ligament complex and fixation by unilateral pedicle screw fixation through the pedicle of fractured vertebra , is both safe and effective for thoracolumbar fractures.

OBJECTIVETo evaluate the feasibility and efficacy of unilateral pedicle screw fixation in treating thoracolumbar fractures through paraspinal approach.

METHODSFrom January 2006 to January 2009,21 patients with single level thoracolumbar fracture without neurological symptoms were treated with unilateral pedicle screw fixation through paraspinal approach. There were 14 males and 7 females,aged from 21 to 65 years old with a mean of 36.4 years. The duration from injury to operation ranged from 6 h to 5 d with an average of 3 d. According to the classification of Denis fracture, compression fractures happedned in 12 cases and burst fractures happened in 9 cases,including 1 case with T5 fracture, 2 cases with T7 fracture, 2 cases with T10 fracture, 3 cases with T11 fracture, 8 cases with T12 fracture, and 5 cases with L1 fracture. Based on the Flankel grade, all patients were classified as grade E. Anterior vertebral body height ratio, sagittal Cobb angle, condition of internal fixation failure, visual analogue score (VAS) were evaluated.

RESULTSAll patients were followed up from 12 to 36 months with an average of 20.5 months. No internal fixation failure was found. Anterior vertebral body height ratios at preoperative 3 days after operation and last follow-up were 54.3 +/- 2.8, 92.9 +/- 1.5, 93.8 +/- 1.7, respectively;sagittal Cobb angle at the three timepoints were (27.8 +/- 2.5) degrees, (5.3 +/- 0.8) degrees, (6.3 +/- 1.4) degrees, respectively; the difference was statistical significant (P < 0.05). VAS was (1.2 +/- 0.4) points at last follow-up and had obviously improved (P < 0.05).

CONCLUSIONTreatment of thoracolumbar fractures with unilateral pedicle screw fixation through paraspinal approach is safe with the advantages of micro-trauma and less blood loss,which can not only completely retain the posterior spinal complex structure, reinforce the spinal stability, raise the reductional quality, but also improve the strength of fixation and the distribution of stress force.

Adult ; Bone Screws ; Feasibility Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Young Adult

Abstract? AIM: To evaluate the efficiency of two different operation ways, vitrectomy and vitrectomy combined with inferior scleral buckling, for a complex kind of retinal detachment.?METHODS:The complex kind of retinal detachment were diagnosed in 100 cases ( 100 eyes ) , with the common features:1)the course of more than 1mo;2) at least one retinal hole located in the inferior marginal retina;3) the detachment of retina was found proliferated, there was at least 1 retinal fold in retinal detachment area. The patients were randomly divided into two groups: the treatment group ( 50 eyes ) who received vitrectomy combined with inferior scleral buckling;the control group ( 50 eyes ) who received vitrectomy without scleral buckling. The retinal anatomic reattachment, visual function recovery, macular central fovea thickness and complications in two groups were observed.? RESULTS: There were 49 eyes ( 98%) with retinal anatomic reattachment in the treatment group while 42 eyes(84%)in control group(χ2=4.2605, P<0.05);the best corrected visual acuity ( BCVA) was 0.254 ±0.238 in the treatment group while it was 0.219±0.229 in control group (t=1.8879,P>0.05);the macular central fovea thickness was 272 ±32.21μm in the treat group while it was 316 ± 33.46μm(t=12.597,P<0.01).Intraocular pressure in 12 eyes ( 24%) was more than 30mmHg in the treatment group while 4 eyes ( 8%) in control group within 1wk postoperation (χ2=4.7619,P<0.05); intraocular pressure in 100 eyes were controlled below 21mmHg 1mo postoperatively.? CONCLUSION: It is a more effective method to vitrectomy combined with inferior scleral buckling than the single vitrectomy for the special kind of retinal detachment.It can increase the rate of retinal anatomic reattachment and reduce macular edema.

Objective To investigate MR imaging features of femoral marrow in treated ?-thalassemia major.Methods MR imaging of the proximal femoral marrow was performed in 35 cases of ?-thalassemia major and 45 age-and sex-matched normal children as control.Coronal images of femoral marrow with the techniques of spin echo and fast field echo(FFE)were obtained.On T_1-weighted imaging the red and yellow femoral marrow were judged and marrow distribution was classified into five groups.The hemosiderosis of marrow was judged on the basis of signal intensity of marrow on FFE imaging.The marrow distribution classification and the hemosiderosis on MR imaging were correlated with clinical features.Results On FFE,marrow hemosiderosis occurred in 15 patients with a marked hypo-intensity signal and was related to the age(P=0.032).On T_1-weighted imaging,the femoral marrow in 35 patients was classified as groupⅢand IV,while the marrow distribution was groupⅠorⅡin all normal children,there was statistically significant difference(P

Objective To investigate the feasibility and role of single-dose three-dimensional dynamic contrast-enhanced magnetic resonance angiography(SD 3D DCEMRA)in evaluating soft-tissue hemangioma of limbs.Methods The transit time(TT),signal intensity of peak enhancement(SPE)and duration of peak enhancement(DPE)of the femoral,popliteal and anterior tibial arteries at the level of the middle section were assessed in 30 healthy volunteers after intravenous bolus injection of single-dose contrast media at the rate of 3 ml/s.Forty-five patients with soft-tissue hemangioma and 9 patients with schwannoma of the extremities underwent both conventional MRI and SD 3D DCEMRA.The acquisition time of SD 3D DCEMRA ranged from 10 to 12 s,and early arterial,late arterial and venous phases of SD 3D DCEMRA images were acquired consecutively.The conventional MRI and SD 3D DCEMRA findings of the 45 patients with hemangioma were observed and compared with those of the 9 cases of sehwannoma.Results(1)The TT,SPE and DPE of the femoral,poplitcal and anterior tibial arteries were(15?5)s,(400?50),(11.9? 2.6)s;(19?7)s,(320?45),(16.8?3.6)s and(27?10)s,(270?39),(22.0?6.6)s respectively. The comparison of TT(F=6.91,P0.01).The tumoral feeding artery was visualized in all cases(100%).(3)Two cases of hemangioma missed on conventional MRI were correctly diagnosed on SD 3D DCEMRA owing to the visualization of both the tumoral mass and the feeding artery.(4)For schwannoma,neither the dynamic visualization of tumoral mass nor the feeding artery was demonstrated on SD 3D DCEMRA.Conclusion SD 3D DCEMRA is technically feasible to evaluate the limb soft-tissue hemangioma.Dynamic visualization of tumoral mass and demonstration of the tumoral feeding artery are the characteristic features of the tumor on SD 3D DCEMRA.

BACKGROUNDAfter injury, axonal regeneration of the adult central nervous system (CNS) is inhibited by myelin-derived growth-suppressing proteins. These axonal growth inhibitory proteins are mediated via activation of Rho, a small GTP-binding protein. The activated form of Rho, which is bound to GTP, is the direct activator of Rho kinase (ROCK) through serial downstream effector proteins to inhibit axonal regeneration. The objective of this study was to observe the therapeutic effect of inactivation of the Rho-ROCK signaling pathway to promote neurologic recovery after spinal cord injuries in rats.

METHODSOne hundred and twenty adult female Sprague-Dawley rats were randomly divided into three groups. Laminectomies alone were conducted in 40 rats in the sham group. Laminectomies and spinal cord transections were performed in 40 rats in the control group (treated with normal saline administered intraperitoneally). Laminectomies and spinal cord transections were performed in 40 rats in the fasudil-treated group (treated with fasudil administered intraperitoneally). Neurologic recovery was evaluated before surgery and 3 days, and 1, 2, 3, and 4 weeks after surgery using the Basso-Beattie-Bresnahan (BBB) scale of hind limb movement. At the same time, the expression of RhoA mRNA was determined with RT-PCR. Histopathologic examinations and immunofluorescence staining of NF were performed 1 month after surgery.

RESULTSCompared with the control group, the BBB scores of the fasudil-treated group were significantly increased and the expression of RhoA mRNA was significantly decreased. In the fasudil-treated group, a large number of NF-positive regenerating fibers was observed; some fibers crossed the slit of the lesion.

CONCLUSIONInactivation of the Rho-ROCK signaling pathway promotes CNS axonal regeneration and neurologic recovery after spinal cord injuries in rats.

Animals ; Female ; Fluorescent Antibody Technique ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; physiology ; Spinal Cord Injuries ; pathology ; physiopathology ; psychology ; therapy ; rho-Associated Kinases ; antagonists & inhibitors ; physiology ; rhoA GTP-Binding Protein ; antagonists & inhibitors ; physiology