BACKGROUND:Pedicle screw fixation has been used in children with thoracic injury. Conventional method is screw implantation by hand. This method can meet the needs of surgery, but its accuracy was low, and incidence of complications was high. The application of digital image navigation aid module is possible. OBJECTIVE:To study accuracy and safety of digital image navigation aid module in thoracic pedicle screw placement. METHODS:Eight thoracic vertebral bodies were equal y and randomly assigned to the manual insertion group and the digital image navigation aid module group. Manual insertion group received manual screw insertion. In the digital image navigation aid module group, navigation aid module was made according to CT scan results combined with principle of reverse engineering and rapid prototyping. Pedicle screw was placed using the digital image navigation aid module. RESULTS AND CONCLUSION:(1) Success rate of once screw set was significantly higher in the digital imaging navigation aid module group than in the manual insertion group (P<0.05). (2) Twenty-eight screws were implanted in the digital image navigation aid module group and manual insertion group separately. The excellent and good rate of screw placement was 96%in the digital image navigation aid module group and 75%in the manual insertion group (P<0.05). (3) These findings suggested that digital image navigation aid module can effectively improve the success rate of pedicle screw insertion. Moreover, this method is simple, easy to operate, and can make a personalized nail placement program for each child.

Objective:To evaluate the efficacy and safety of temporary loop ligation of the infrarenal abdominal aorta for control ofintraoperative blood loss in patients with pernicious placenta previa.Methods:We retrospectively analyzed the clinical data of 14 patients with pernicious placenta previa,who underwent temporary loop ligation of the infrarenal abdominal aorta for control of blood loss during cesarean section between July 2013 and December 2014.Results:Eight patients received conservative management to preserve the uterus and 6 patients underwent cesarean hysterectomy.The occlusion time of the abdominal aorta was (31.42±12.67) min.The average estimated intraoperative blood loss was (1 117.85±745.13) mL.The volume of packed red blood cell transfusion was (3.91±3.24) units,and the volume of fresh frozen plasma transfusion was (192.85± 156.71) mL.Post-operative histologic diagnosis revealed 6 cases of placenta percreta,4 of increta,3 of accreta and 1 non-creta.All patients experienced an uneventful postoperative recovery.Conclusion:In patients with pernicious placenta previa,temporary ligation of the infrarenal abdominal aorta provide a safe and effective means for controlling intraoperative hemorrhage during cesarean section.Additionally,the procedure may provide an opportunity to preserve fertility by avoiding a cesarean hysterectomy.

Animals ; Burns ; drug therapy ; metabolism ; physiopathology ; Interleukin-18 ; genetics ; metabolism ; Lactulose ; therapeutic use ; Lipopolysaccharides ; blood ; Liver ; metabolism ; physiopathology ; Lung ; metabolism ; physiopathology ; Male ; Multiple Organ Failure ; prevention & control ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo explore clinical results of open reduction and internal fixation (ORIF) for posterior Pilon fracture through posterolateral approach.

METHODSSeventeen patients with posterior Pilon fracture were treated through posterolateral approach from February 2010 to April 2013. Among them,including 11 males and 6 females aged from 29 to 59 with an average of 43.4 years old. All fractures were associated with more than 20% of articular surface of distal tibial. The causes of injury included falling down (11 cases), traffic accident (4 cases) and sports injury(6 cases). Fracture classification was based on posterior pilon fracture by YU Guang-rong, including type I (6 cases), type II (2 cases) and type III (6 cases). Fracture healing time, fracture reduction and postoperative complications were observed, AOFAS score were applied to evaluate clinical efficacy.

RESULTSAll patients were followed up from 13 to 24 months with an average of 20.5 months. All incisions were healed at stage I, and fractures obtained healing,the time of fracture healing ranged from 12 to 21 weeks with an average of 15.2 weeks. No incision infection, neurovascular injury, bone ununion and fracture deformity were found after operation. Postoperative AOFAS score was 92.0 ± 10.2, and 14 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONPosterior pilon fracture through posterolateral approach could obtain effective reduction, stable fixation. It is a safe, simple and effective operation for treating posterior Pilon fracture, and it is worth popularizing.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lead ; blood ; Lead Poisoning ; blood ; epidemiology ; Middle Aged

Objective To explore the care burden and its influencing factors of primary caregiver of patients with spinal cord injury. Methods A total of 120 primary caregiver of spinal cord injury patients were selected as research object. The general information of SCI patients and their primary caregiver were investigated by SCI patient general data questionnaire and primary caregiver in SCI patient general data questionnaire, caregiver burden of spinal cord injury were investigated bycaregiver burden inventory. The relationship between the general information of patients and caregivers and the care burden analyzed. Results Caregiver burden of elderly patients was significantly lower than that of younger ones (F=54.053,P<0.01). The more serious of spinal cord injury, the higher of care burden (F=315.104,P<0.01). The patients with neck and multiple segmental spine injury and postoperative complications had a higher care burden (F=199.203,t=6.462, 32.195,P<0.01). When the caregivers were female, spouses or children, with poor health condition, with higher education degree, and as cadres or workers, caregiver burden was higher (t=6.061,F=22.073-52.392,P<0.01). Multiple linear regression analysis showed that the degree of spinal cord injury, complications, gender, and the relationship between the patients were the main factors that influenced the care burden. Conclusions The main factors influencing the care burden are spinal cord injury degree, complications, gender, and the relationship between the patients. Clinical managers needs to develop appropriate social support system for the factors which affect the caregiver, in order to ease the caregiver′s care burden.

Objective To develop social integration scale of the disabled,and to test the reliability and validity of the scale.Methods 511 disabled persons were investigated by self-made social integration scale and Chinese version of positive and negative affect schedule (PANAS-C).Results The Scale was composed of three factors:self integration,relationship integration and affection integration,and they explained 47.39％ of variance.The theoretical model fit could be accepted (x2/df =2.051,P＜0.001;RMSEA =0.046;GFI =0.884;CFI =0.926;IFI =0.927).The factors had significant correlated with positive affect (r=0.34-0.55,P＜0.01)and positive affect (r=-0.12--0.32,P＜0.01).The high score group and low score group of social integration had significant differences in positive affect (t=13.77,P＜0.01)and negative affect(t=-7.58,P＜0.01).The cronbach's alpha coefficients of the scale and the three factors were 0.94,0.92,0.87 and 0.89 respectively,and the seven sub-factors'cronbach 's alpha coefficients were from 0.76 to 0.87.Conclusion The theory construct of social integration of the disabled is multi-hierarchical and multi-dimensional.The scale has acceptable reliability and validity,and can be used to assess the degree of social integration of the disabled.

Objective To explore the characteristics of resilience and the relationships between resilience and social integration of disabled people.Methods By convenient sampling,a total of 702 disabled people were investigated by Connor-Davidson Resilience Scale,Social Integration Scale of the Disabled and self-made general questionnaire.Results The score of resilience of disabled people(53.27± 18.21) was lower than chinese community people(65.4± 13.9,t=-13.19,P＜0.01).The resilience scores were significantly lower of the disabled people who came from rural areas,younger(≤ 24 years old) or older(≥ 60 years old),and were disabled from birth had poor family economic conditions,and had no insurances(P＜0.05,P＜0.01).But the disabled people who had university degree or above,married,working,and had warm and harmonious family atmosphere,had significantly higher resilience scores (P＜0.05,P＜0.01).The vesilience and three sub-factors were significantly correlated with social integration (r=0.38-0.66,P＜0.01).The high resilience group had higher score in integration and three dimensions compared with the low resilience group(t=11.60-19.02,P＜0.01).Tenacity and strength directly influenced the three dimensions of social integration (the path coefficient were 0.18-0.46,P＜0.01).Conclusion The resilience of the disabled people is lower,and there are close relationships between resilience and social integration.The training of tenacity and strength is beneficial to social integration of the disabled people.

Objective To observe the ultrastructure of the neurovascular Unit (NVU) in chronic compressive cervical myelopathy rat model at different stages.Methods From March, 2014 to March, 2015, 32 rats were divided into two groups: sham control group (n =8) and compressive spinal cord injury group (n =24).The model was established by inserting the compression sheet made of polyurethane at the level of C6.BBB and somatosensory evoked potentials (SEP) were used to evaluate the spinal cord function status of model rat.Transmission Electron Microscopy (TEM) examination of compressive cervical spinal cords was performed separately at the 14th, 21st, 28th and 42nd day after modeling.Results At the 14th, 21st, 28th and 42nd, the BBB score were 17.571 ± 0.870, 15.952 ± 0.870, 15.476 ± 0.602 and 16.190 ± 0.632 were significantly lower than those in the control group (the BBB score of 4 points were 19.600 ± 0.516, 19.500 ± 0.527, 19.600 ± 0.699 and 19.800 ± 0.6232 respectively) (P ＜ 0.05).Latency prolongation and amplitude reduction of somatosensory evoked potentials (SEP) were presented in the compressive spinal cord injury group.At the 14th day, edema around the capillaries was observed, the morphological structure of endothelial cells and basement membrane was normal, the tight junction between endothelial cell was intact, the mitochondria in the axons, oligodendrocytes and astrocyte foot processes were edematous.At the 21st day, extensive edema, even partial necrosis around the capillaries were found, the surrounding structure were arranged loosely, partial loss of endothelial cells and basement membrane, cavitation occurrence in endothelial cells, basal membrane density was significantly lower, mitochondria vacuoles and shrinkage in the cytoplasm, axon myelin loose or broken;at the 28th day, the edematous range surrounding capillaries narrowed, low density of basement membrane and endothelial cells, vacuoles in endothelial cells, loose axon myelin, while some mitochondrias backed to normal.At the 42nd day, capillary integrity, no abnormalities were found in endothelial cells, basement membrane, tight junction and mitochondria, double layers of endothelial cells and basement membrane could be seen, local broken and loose structure were presented in part of the axons;The TEM of the sham control group showed normal ultrastructure of NVU.Conclusion The ultrastructure of NVU in chronic cervical spinal cord compression presented various in the different periods, NVU disruption were found in the early stages (14th-28th days), and compensatory and repair process were developed incompletely later.

Objective To investigate the change of oxidation system and antioxidation system in mesangial proliferative glomerulonephritis(MsPGN) induced by anti-Thy1.1 antibody,and further to study the intervention of rosmarinic acid(RAD).Methods Anti-THy1.1 serum was produced,and then intravenously injected into rats for establishing an experimental model of MsPGN.The experiment was designed for control with or without RAD,glomerulonephritis with or without RAD,respectively.The activity of superoxide dismutase(SOD) and the content of malondialdehyde(MDA) in tissue homogenate were detected by spectrophotomerty.Results The activity of SOD significantly decreased,while the content of MDA increased in MsPGN.RAD could inhibit oxidation in the mesangial cells.Conclusion Lipid peroxidation participates in MsPGN and RAD can control the changes of the mesangial cells and show the activity of antioxidation.