[Objective]To approach the unique characteristics and the choice of surgery of low lumbar spine burst fractures.[Method]In this group 23 patients with low lumbar spine burst fractures were included.They were classified into three types : type one: single vertebral body fracture,were treated with short segmental pedicel screw system.type two:multiple vertebral body fracture,treated with long segmental pedicel screw system;type three:type one or type two combined with sacral vertebra fractures,treated with lumbar-sacral-ilio combination pedicel screw system.The intervertebral height of the fractured vertebral body and lumbar lordosis were evaluated both before and after operation on X-ray.The spinal impingement of bone was evaluated on CT scan,the neurofunction was evaluated with ASIA system and the clinical outcome were evaluated with Charles system.[Result]All patients were followed up for 1～5 years.The intervertebral height of the fractured vertebral body increased from preoperative 34%(20%～50%) to postoperative 88%(70%～95%).The lumbar lordosis angel increased from preoperative 35??7?to postoperative 38??10?.The spinal impingement of bone area decreased from preoperative 55%(35%～90%)to postoperative 6%(0%～10%).ASIA score increased by 1-3 degree,the clinical outcome reached 85% according to Charles classification.[Conclusion]Instable low lumbar spine burst fractures should be treated with surgery as early as possible,according to different fracture segment,it can be treated with short-long segmental pedicel screw system or lumbar-sacral-ilio combination pedicel screw system respectively.

OBJECTIVETo study the clinical effects of gabapentin on the treatment of pruritus of scar resulting from deep partial-thickness burn.

METHODSA total of fifty-eight patients suffering from pruritus of scar after deep partial-thickness burn were hospitalized from January 2013 to January 2014. Patients were divided into placebo group (n =18, treated with oral vitamin C in the dose of 100 mg for 4 weeks, twice per day) , cetirizine group (n = 20, treated with oral cetirizine in the dose of 10 mg for 4 weeks, twice per day) , and gabapentin group (n = 20, treated with oral gabapentin in the dose of 300 mg for 4 weeks, twice per day) . Before treatment and on post treatment day (PTD) 3 and 28, the Visual Analog Scale (VAS) was used to assess the itching degree, and the mean scores were recorded. The remission rates of pruritus on PTD 3 and 28 were calculated. The adverse effects were observed during treatment. Data were processed with analysis of variance, q test, and chi-square test.

RESULTSCompared with that before treatment, the itching degree of patients with light, moderate, and severe itching in placebo group was not relieved after treatment; the itching degree of patients with moderate or severe itching in cetirizine group was alleviated after treatment, but not in patients with light itching; itching degree of all patients in gabapentin group was significantly relieved after treatment. There were no obvious differences in VAS scores among the 3 groups before treatment (F = 2.78, P > 0.05). On PTD 3 and 28, the VAS scores of patients in both gabapentin group [(2.3 ± 0.8) and (0.6 ± 0.3) points] and cetirizine group [(4.2 ± 1.7) and (2.8 ± 1.2) points] were lower than those in placebo group [(5.7 ± 2.0) and (5.7 ± 1.9) points, with q values from 6.70 to 7.75, P values below 0.05]. The VAS scores of patients in gabapentin group on PTD 3 and 28 were lower than those in cetirizine group (with q values respectively 6.30 and 6.90, P values below 0.05). The remission rates of pruritus of patients in gabapentin group on PTD 3 and 28 were respectively (66 ± 20)% and (91 ± 17)%, and they were higher than those in cetirizine group [(33 ± 8)% and (56 ± 14)%, with q values respectively 4.70 and 3.82, P values below 0.05]. The remission rate of pruritus of patients in placebo group on PTD 3 and 28 was 0, which was lower than that of the other 2 groups each (with q values from 3.94 to 6.76, P values below 0.05). During the course of treatment, 5 patients in gabapentin group suffered from adverse effects including mild-to-moderate drowsiness and dizziness, but they disappeared one week later. No adverse effects were observed in patients of the other two groups.

CONCLUSIONSFor patients with deep partial-thickness burn, gabapentin can effectively alleviate scar itching after wound healing with safety.

Amines ; administration & dosage ; therapeutic use ; Analgesics ; therapeutic use ; Ascorbic Acid ; administration & dosage ; Burns ; complications ; Cetirizine ; administration & dosage ; Cicatrix ; Cyclohexanecarboxylic Acids ; administration & dosage ; therapeutic use ; Humans ; Pruritus ; drug therapy ; Skin Transplantation ; Treatment Outcome ; Visual Analog Scale ; Wound Healing ; gamma-Aminobutyric Acid ; administration & dosage ; therapeutic use

Exposure to low-dose radiation (LDR,mostly less than 100 mGy) may reduce the vulnerability of exposed tissues to subsequent high-dose radiation (HDR)-induced damage,a phenomenon known as adaptive responses,which occurs via mechanisms including anti-inflammation and anti-oxidation.Alzheimer's disease (AD) is a type of dementia that causes problems with memory,thinking,and behavior.Using the available literature,this review will examine whether there is any effect of LDR on AD.The available evidence shows that although LDR can alter the expression of some genes related to AD such as Apbb1,Lrp1,and Il1α,these alterations do not cause AD-like syndromes in animals,suggesting that LDR may also simultaneously upregulate several protective mechanisms that prevent the eventual development of AD.Furthermore,LDR seems capable of improving the symptoms of AD,as evidenced by the experience of an 81-year-old female AD patient.This patient was diagnosed with AD more than 10 years ago and gradually progressed to advanced AD in 2015,despite routine treatment.The patient then received about 12 computed tomography scans (about 40 mGy each) up until Nov.2017,which significantly improved her quality of life and reduced several AD symptoms.The improvement in this patient's medical condition led to a few recent clinical trials investigating the effects of LDR on AD.To date,there is no efficient therapy available for AD,thus whether exposure to LDR at 100 mGy can provide a preventive or therapeutic effect for AD is an important issue.If LDR is a potential treatment for AD,as suggested by this reported case,this non-invasive approach would also bear the merit that it would be unlikely to cause a significant radiation health risk,as the LDR could be delivered locally to the head without any impact on other organs.

The structures of DICOM image and BMP image are introduced through the analyses of them and DICOM standard.The method of translating DICOM image into BMP one is also presented.

Objective To evaluate the effect of various herniorraphy in treating inguinal hernia. Methods The clinical data of 108 patients who underwent conventional Bassini herniorraphy (BH), tension free herniorraphy (TH), or laparoscopic herniorraphy (LH),respectively were analysed and comparated. Results The operation time in TH was less than that in BH, and in LH was longer than that in TH. The ability recovery, hospita stay and postoperative complication in TH and LH were less than those in BH.All the patients were followed up for at least 1 year.Of them, 1 recurred after BH, but there was no recurrence after TH and LH. The blood neutrophils, serum level of fibrin, C-reactive protein and alpha-1 antitrypsin increased significantly in the patients undergoing herniorraphy, which were significantly higher in the patients underwent TH and LH. Conclusions The curative effect of TH and LH is much better than that of BH in treating ingumal hernia. Application of marlex for herniorraphy might increase inflammation response, but it will not increase the incidence of infection.

Background Macular hole in high myopia has been paid tremendous attention in clinical research due to its high recurrence rate and unpredictable prognosis.Spectral domain optical coherence tomography (SD-OCT) is considered to be of a good evaluating value for macular hole,yet its application is compromised in patient with high myopia.High myopia might lead to retinal detachment which consequently prevents an accurate OCT.Therefore,it is important to assess the effectiveness of OCT on prognosis in these patients after surgical restoration of the detached retina.Objective The aim of this study was to evaluate the risk of reopening of a macular hole in highly myopic patient after removing silicone oil by SD-OCT.Methods A case-observational study was designed.Twenty-five highly myopic patients with monocular macular holes who underwent vitrectomy combined with internal limiting membrane peeling and silicone oil tamponade were included in this study.Four patients were male and 21 patients were female,with the average age (61.4±9.0) years old and diopter (-14.14 ±6.86)D.Regular ocular examination,axial length measurement,fundus photography and OCT were performed at the day before removing silicone oil and every month till the 6 months after operation.Retinal thickness,macular height index (MHI) and choroidal thickness were measured by OCT.Written informed consent was obtained from each patient.Results All 25 patients finished the follow-up of 6 months.Macular holes remained closure 6 months after operation in 19 patients (76％) and reopened in 6 patients macular holes were in 1-5 months (24％),with a mean time at (3.3± 1.4) months.The average foveal retinal thickness,MHI and the choroidal thickness at the middle of the macular hole were (216.5±95.6) μm,0.30 ± 0.09 and (122.9 ± 20.5) μm in the closed group,respectively,and those in the unclosed group were (113.5±28.7) μm,0.58±0.27 and (96.8±22.9) μm,with significant differences between the two groups (t=2.577,-4.143,2.669,P ＜ 0.05).The percentage of macular hole closure was 85.7％ in the MHI＜0.5 group and 25.0％ in the MHI ≥ 0.5 group,showing a significant difference (P =0.031).The base diameter in the unclosed hole group was significantly larger than that in the closed hole group (1070.2±393.6 μm versus 533.3±277.7 μm) (t =-3.700,P =0.001).Conclusions The measurements of the retinal thickness,MHI and the choroidal thickness at the central area of the macular hole are helpful for the evaluation of reopening risk of macular hole after removing silicone oil.

· AIM: To study the in situ relative intraocular position of the iris-claw phakic intraocular lens (PIOL)for high myopia using an anterior chamber optical coherence tomography (AC OCT)prototype.· METHODS: Six PIOLs (11.50 to 22.00D lens powers) were implanted in phakic myopic eyes. Using AC OCT, tomography was taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens.· RESULTS: Preoperative anterior chamber depth ranged from 3.27 to 3.91 mm and the postoperative endothelial-optic distance measured 2,07 to 2,24 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.82 to 1.32 mm. Several tomography revealed the position of the PIOL on the iris, The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL.· CONCLUSION, The original anterior chamber depths were reduced by 36,1% to 44.6% after implantation. This study of 6 eyes revealed that tomography taken by AC OCT are useful in verifying the intraocular position of the PIOL within the anterior chamber. Adequate space was maintained between the iris-fixated phakic intraocular lens and the corneal endothelium, angle, and crystalline lens.

Objective To investigate the clinical value of spinal nonfusion interspinous Coflex system for the degenerative lumbar spinal stenosis.Methods From March 2008 to August 2009,26 patients with degenerative lumbar spinal stenosis were treated by decompression with posterior spinous process and interspinous implant Coflex folder method,including 11 males and 15 females,with the mean age of 65.4years(range,45-78 years).L3,4 segment in 7 cases,L4,5 segment in 13 cases,concomitant L3,4,L4,5 segment stenosis in 6 cases.Patients were scanned by MRI and CT confirmed L3,4 and(or)L4,5 segments of the ligamentum flavum thickening,proliferation of small-joint bone,merger disc herniation causing central tube and lateral fossae stricture,nerve root or coccygeal plexus compression.Lumbar anteroposterior,lateral and flexion-extension X-ray films preoperatively,and at follow-up were used to measure the following parameters by eFilm and CAD software:the anterior and posterior disc space height,the range of motion at surgical level,and the segment of the spinal canal area of responsibility.Postoperative standard Japanese Orthopaedic Association(JOA)score for preoperative and postoperative scores.Results Patients were followed up 12-24months.The pain relieved in all patients.The JOA scores improved from(15.46 ±4.30)preoperatively to (24.50±1.58)postoperatively,the vertebral canal area of the affected segment was(218.4±16.2)mm2 before the operation,(264.6±9.9)mm2 after the operation.Single segment anterior disc space height did not change significantly,the difference was not statistically significant.The disc space posterior height increased compared with the preoperative height,and gradually decreased with time.No patients suffered Coflex loosening,fracture and emerge.Conclusion The treatment of lumbar spinal stenosis with Coflex system has satisfactory effect in minimal invasiveness and high security,which provides a safe and effective therapy for degenerative lumbar spinal stenosis.

Objective To induce cord blood derived endothelial progenitor cells(EPCs)into endothelial cells,and investigate the feasibility of these cells as the seed cells of tissue engineering cardiovascular replacement.Methods Mononuclear cells were isolated from fresh cord blood by 6%HES and density gradient centrifugation.Isolated cells were cultured in medium supplemented with vascular endothelial growth factor(VEGF).Attached cells were identied by morphology,immunofluorescence staining and flow cytometry.Results The percentage of mononuclear cells isolated from fresh cord blood was(3.4?2.1)?10~7/mL.The morphology of attached cells changed while being cultured and inducted,from small-sized round cells to spindle-like cells,to a typical cobblestone morphology,and the total number of cells was 10~7.After 7 days of culture,immunofluorescence staining showed that the vWF and VEGFR-2 were expressed.Compared with the original,cell markers CD_133 decreased(3.11%?1.05%) to(0.09%?0.02%),P

ObjectiveTo evaluate the potential value of acoustic radiation force impulse (ARFI)elastography in the characterization of solid liver tumors.MethodsForty-three patients with 56 liver tumors were evaluated with ARFI,which included 21 patients with hepatocellular carcinoma (HCC),8 patients with metastase,5 patients with cholangiocarcinoma(CCC),and 9 patients with hemangioma.The shear wave velocity of the tumor and background liver parenchyma were calculated,and results were compared with 30 healthy subjects.Statistical analysis was performed on the shear wave velocity for differentiation of normal liver,background liver parenchyma,and tumors.ResultsHCC and CCC had greater stiffness than metastase (P ＜0.05),there were no statistical differences between HCC and CCC (P = 0.179).Malignant liver tumors had significantly greater stiffness than hemangioma and normal liver (P = 0.000).34.5% (9/26) HCC and 33.3% (4/12) hemangioma appeared softer than the background liver.With a cut-off value of 1.5 m/s for the shear wave velocity,the sensitivity,specificity,positive predictive value and negative predictive value for malignancies were 79.5%,83.3%,94.5% and 52.6%,respectively.ConclusionsARFI elastography quantification is a promising noninvasive technique for assessing solid liver tumors.Use of ARFI elastography quantification may lead to new quantitative tissue characterization parameters for differentiating hemangioma and malignant liver tumors.