Objective To explore the immunogenicity of a novel bionic scaffold of nucleus pulposus tissue engineering. Methods The biocompatibility of a subcutaneously implanted scaffold of nucleus pulposus tissue engineering was studied in SD rats by analyzing tissue reactions up to 3 months using histological and ultrastructural methods. The expression of IFN-?, IL-2, IL-4 and IL-10 mRNA was measured by RT-PCR, and the levels of serum antibodies to porcine type Ⅱ collagen were measured by ELISA. Results There was less inflammatory reaction in rats induced by subcutaneously implanted scaffold. By degrees, a granulation tissue had developed within the implant, which had disappeared by 3 months. The expression of IFN-?, IL-2 mRNA by RT-PCR was of no changes. But the expression of IL-4 and IL-10 mRNA increased, which meant the implant induced Th cell into Th2 cell and the induction inhibited the inflammatory reaction. No antibodies to porcine type Ⅱ collagen were found in the sera of implanted rats. Conclusion There was less immunogenicity in rats induced by implanted scaffold of nucleus pulposus tissue engineering.

Objective To assess the clinical diagnostic value of left atrial function index (LAFI) for heart failure with normal left ventricular ejection fraction (HFNEF).Methods One hundred and ten patients with HFNEF were divided into 3 groups by New York Heart Association (NYHA) cardiac functional grading:NYHA Ⅱ grade group (43 cases),NYHA Ⅲ grade group (40 cases) and NYHA Ⅳ grade group (27 cases),and another 33 healthy subjects were selected as control group.The 4 groups were examined by ultrasoundcardiogram,LAFI and E/E' were calculated,and the plasma brain natriuretic peptide (BNP)levels were determined.The relation between LAFI and NYHA cardiac functional grading and the correlation between LAFI and plasma BNP,E/E' were observed.Results The worse heart function,the higher plasma BNP and E/E',and the lower LAFI,and there were statistical differences [control group:(40.9 ± 26.1) ng/L,6.4 ± 2.0,0.73 ± 0.10,NYHA Ⅱ grade group:(230.1 ± 85.9) ng/L,10.0 ± 3.7,0.46 ± 0.30,NYHA Ⅲ grade group:(398.6 ±98.7) ng/L,16.9 ±4.0,0.26 ± 0.30,NYHA Ⅳ grade group:(680.3 ± 146.6) ng/L,23.8 ± 3.9,0.17 ± 0.20,P ＜ 0.05].The correlation analysis results showed that LAFI and plasma BNP,E/E' were negatively correlated in patients with HFNEF (r =-0.868,-0.873,P ＜ 0.01).Conclusions In HFNEF patients,there is significant correlation between LAFI and left ventricular diastolic dysfunction.LAFI can well diagnose diastolic heart failure early and evaluate the diastolic function of the left ventricle.

[Objective]To investigate the diagnostic methods and clinical effects of the management of spondylolithesis with adjacent segment degeneration.[Method]Between October 2000 and October 2005,16 consecutive patients(3 males and 13 females) aging 42 to 76 years(mean 59.1 years) received instrumented lumbar interbody fusion procedure using traditional posterior approaches for spondylolithesis with adjacent segment degeneration.Lumbar functions were assessed using Prolo system.Preoperative and follow-up lateral lumbar radiographs were studied for reduction of spondylolithesis,disc heights,lumbar lordosis,fusion rates and complications.[Result]Fourteen patients were followed up,with an average duration of 28(16–53) months.Clinical outcomes in terms of Prolo system was 7 points in 3 patients,8 in 7 patients,9 in 2 patients,and 4 in 2 patients at 3 months after operation with 85.7% being graded as good or excellent.Seven points in 4 patients,8 in 6 patients,and 9 in 4 patients at last follow-up(graded as 100% good or excellent).Fusion rate was 66.7%(8/14)at 6 months and 92.9%(13/14)at 12 months after operation.Ten patients(71.4%) fully recovered from spondylolithesis,4 had partial reduction,and their reduction status was unchanged according to plain radiographs at 12 months and last follow-up.The operative wound healed without complications in all patients.The mean Lordosis was 26.64??6.67?,33.29??3.39?and 32.71??2.80?before and at 3-month,or last follow-up after operation.The mean of fused Lordosis was 15.64??6.21?,28.29??3.28?and 32.36??3.91?before at 6 months or at last time follow-up after operation.The disc heights were 6.54?1.13mm and 9.62?0.81mm before and after operation.Statistics showed significant difference(P

Recent original articles about investigation and application minimally invasive posterior pedicle screw fixation in thoracolumbar fracture were extensively reviewed.It can be divided into three parts,such as the improvement of navigated pedicle screw placement accuracy,the melioration of the internal fixation instruments and the advance of endoscopic decompression technique.With the development of minimally invasive spinal syrgery,the combination of percutenous pedicle screw fixation and the computer assist surgery have been widely applied in the treatment of spinal fractures.The combination of minimally invasive posterior pedicle screw fixation and the computer assist surgery accelerates the treatment of the thoracolumbar fractures,there will be more and more thoracolumbar fracture patients willing to be treated by the minimally invasive surgery.

Objective To design and construct a new bionic scaffold of nucleus pulposus tissue engineering. Methods The collagen-hyaluronic acid (HyA) matrices were prepared, and mixed with Collagen type Ⅱ (pH 1-2) and lyophilized. 6-chondroitin sulfate (CS) was covalently attached to collagen using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS). Afterwards the initial structure of bionic scaffolds was evaluated. Results The bionic scaffolds were porous structure, of which the pore size was 89-132 ?m, the porosity was 94.8%. Water-binding capacity of resulting matrices was 79.2%, and the denaturation temperature was 74.6 ℃. Glycosaminoglycan (GAG) content was 224 mg/g, and the elastic modulus was 0.673 MPa. Conclusion Composition and tissue structure between the scaffolds are similar to the extracellular matrices of nucleus pulposus. The bionic scaffold is an ideal scaffold material of nucleus pulposus tissue engineering in structure. Further experiment is required on the biocompatibility of the novel scaffolds.

Objective To summarize the technique and evaluate the effect of anesthesia for off-pump coronary artery bypass surgery (OPCAB). Methods From 1997 through March of 2005, five hundred and forty-three consecutive patients undergoing OPCAB were retrospectively studied. Anesthesia was induced with midazolam 0.05～0.12mg/kg, ketamine 0～0.5mg/kg and fentanyl 5～15?g/?kg. Anesthesia was maintained with isoflurane 0.3%～1.5% and oxygen, combined with propofol 1～3mg/(kg?h). Intraoperative hypotension resulting from either surgical procedure or anesthetics should be dealt with inotropes immediately. Results Intraoperative hemodynamics deviation was tolerated with the support of inotropics. The mean extubation time was 5.8?1.6h. The ICU stay was 0.5 to 2.0 day. The patients were discharged in 8.0?1.2 days. Two patients met sudden death in the second postoperative day. Conclusion Rational use of anesthetics and inotropics to stabilize hemodynamics during operation plays a key role in successful OPCAB.

Objective To review the preliminary experience on managing the patients suffering from lumbar disc herniation with lateral recess stenosis by microedoscopic discectomy.Methods A total of 79 patients affected with lumbar disc herniation with lateral recess stenosis were treated by MEDⅡ in our hospital from Jan 2002 to Sep 2004.Results All patients were discharged within 7 d postoperatively and no complications occurred.The average duration of follow-up was 12.3 months and the successful clinical outcome was 99%.Conclusion Microendoscopic discectomy is a minimum invasive procedure.The successful clinical outcome could be achieved in properly selected patients.The microendoscopic discectomy is an effective procedure in managing lumbar intervertebral disc herniation with lateral recess stenosis.

ObjectiveTo study the feasibility and effect of microendoscopic discectomy on the central type of enormous intervertebral disc herniation.MethodsFrom 2003 to 2006,23 patients(18 males,5 females) were diagnosed with enormous central type lumbar disc herniation and treated by microendoscopic discectomy.Their clinical data were restropectively analyzed,and postoperative outcomes in hip function were evaluated by Macnab scoring system.ResultsBeing followed up for 3-12 months,21(86.9%) patients were rated as good or excellent for their outcome,and the other two as fair.ConclusionMicroendoscopic discectomy through interlaminar approach achieves satisfied outcome for enormous central type lumbar disc herniation.

0.05). VAS and ODI were significantly improved in the 2 groups compared with those before operation (P

Objective To analyze the epidemiologic features of traumatic spinal fracture so as to improve its prevention and treatment levels.Methods A total of 1393 patients with spinal fractures(955 males,438 females,at age range of 4-89 years,mean 45.5 years)treated between May 2001 and May 2011 were reviewed to statistically analyze their epidemiologic characteristics.Results The age of all the patients was mainly focused at 30-49 years,accounting for 49.7％(692/1393).Males exceeded females in number among the five age groups below 59 years old,but the opposite tendency appeared in the two age groups above 60 years old.Fall from height and traffic accidents were the main injury causes,which accounted for 59.4％(827/1393).Among 1963 injury segments,cervical vertebral injury,thoracic vertebral injury,lumbar vertebral injury,sacrum and coccyx injury accounted for 23.8％(468/1963),31.9％(627/1963),43.9％(861/1963)and 0.4％(7/1963)respectively.Spinal fractures occurred largely in thoracolumbar segment(T10-L2),which accounted for 55.4％(1087/1963),and L1,T12 and L2 occupied 22.5％(441/1963),5.4％(303/1963),11.1％(218/1963)respectively.The predilection sites of fractures in cervical vertebrae were C2(6.4％,123/1963),C5(5.3％,105/1963)and C6(4.0％,78/1963)respectively.Of the patients with multiple level spinal fractures,the injury resulted from fall from height and traffic accidents accounted for 35.9 ％(78/217)and 17.1％(37/217)respectively.Of the patients with combined injury,the injury caused by fall from height and traffic accidents occupied 48.1％(176/366)and 25.1％(92/366)respectively.According to the American Spinal Injury Association(ASIA)scale,the injury degree of all the patients was mainly grade E(52.6％,733/1393),D(21.0％,293/1393)and A(15.3％,213/1393).A total of 1038 patients had surgical treatment.Their spinal function was mainly graded as level E(48.0％,498/1038),D(22.2％,231/1038)and A(17.1％,177/1038)pre-operatively,but the rates of patients with level E spinal function increased to 56.6％(588/1038)three weeks post-operatively.Conclusions The epidemiologic survey reveals that fall from height and traffic accidents are the main factors for spinal fractures and can easily lead to multi-level spinal fractures and systematic complications.Thereby,prevention and treatment methods should be designed according to the injury characteristics.