OBJECTIVETo investigate the clinical effects of 360 degree circular decompression and transpedicle screw fixation to treat the ossification of thoracic posterior longitudinal ligament by posterior approach.

METHODSFrom December 2009 to November 2013, 18 patients with ossification of thoracic posterior longitudinal ligament ossification were treated with 360 degree circle decompression and transpedicle screw fixation by posterior approach. There were 8 males and 10 females,ranging in age from 32 to 67 years old, with an average of 51 years old. Four patients were accompanied with ligamentum flavum ossification. Longitudinal ossifications in 5 cases were located in the upper thoracic vertebra and 13 cases in the middle and lower thoracic vertebra. Five cases were typical type, 4 cases were segmental type, 6 cases were continuous type and 3 cases were mixed type. All the patients had the posterior spinal canal decompression combined with longitudinal ligament resection, interbody fusion with bone graft and internal fixation surgeries. The operation time,blood loss and complications were recorded. JOA score were applied to evaluate the neurological function recovery pre-surgery, 2 days post-surgery and the latest follow-up. The surgery effects were evaluated by Epstein-Schwall method.

RESULTSThe operation time ranged from 3 to 6 hours (mean, 4.2 hours). The blood loss ranged from 800 to 4 000 ml (mean, 1 800 ml). All the patients were followed up, and the duration ranged from 6 months to 3 years, with a mean of 1.8 years. The JOA score increased from preoperative 4.30 ± 2.60 to 7.60 ± 2.40 2 days after surgery, and 7.80 ± 1.90 at the latest follow-up (t = 4.61, P < 0.001). The JOA scores between 2 days after surgery and the latest follow-up had no significant differences (t = 0.28,P = 0.78). The neurological recovery rate was 74% 2 days after surgery and 71% at the latest follow-up. There were 4 cases got an excellent result,10 good,3 fair and 1 poor according to Epstein-Schwall evaluation method. Four patients had cerebrospinal fluid leakage, 3 patients had intercostal nerve paralysis or pain, and 1 patient had superficial incision infection. The neurological function in 3 patients became worse in the second day posteratively , and among them, 2 patients were recovered at the latest follow-up and 1 patient had no changes. All the patients got fusion of bone graft and no internal fixation loosening and fractures occurred.

CONCLUSION360 degree circular decompression and transpedicle screw fixation can resect different types of thoracic longitudinal ligament ossification, and can achieve a good clinical effect.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; surgery ; Thoracic Vertebrae ; surgery

OBJECTIVETo evaluate the clinical effects of posterior spinal transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture in elderly.

METHODSFrom July 2009 to February 2014,26 patients with kyphosis caused by delayed osteoporotic vertebral fracture were treated with transpedicular wedge osteotomy. There were 10 males and 16 females,aged from 55 to 75 years old with an average of 67 years. There were 1 osteotomy in thoracic vertebra,21 osteotomies in thoracolumbar vertebrae and 4 in lumbar vertebrae. Total 29 vertebrae were involved, 23 cases with single vertebral fracture and 3 cases with double vertebral fractures. Preoperative Cobb angles were 32°~51° with the mean of (42.00 ± 4.75) ° and VAS scores were 6 to 9 points with an average of (8.40 ± 0.75) points. According to the Frankel grade of spinal cord function, 4 cases were grade D and 22 cases were grade E. Intraoperative bleeding, operation time and perioperative complications were recorded, and improvements of Cobb angle were evaluated by X-rays. VAS score and Frankel grade were respectively used to evaluate the pain and nerve function.

RESULTSThe average operation time were 155 min (ranged, 120 to 175) and the mean intraoperative bleeding were 1 100 ml (ranged,800 to 1 500). Postoperative at 2 days, Cobb angle and VAS score were (9.60 ± 2.50) ° and (4.00 ± 1.00) points, respectively, ranged from 5° to 15° and 1 to 5 points. VAS score and Cobb angle improved obviously compared with preoperative (P < 0.05), and the improvement rate of Cobb angle was 76%. Frankel grade of 1 case changed from grade E to C, and the others did not become worse. The follow-up period ranged from 3 to 24 months with an average of 16.4 months. At the final follow-up, Cobb angles and VAS score were (11.00 ± 3.50)° and (4.40 ± 1.25) points, respectively, ranged from 5° to 19° and 1 to 6 points. The patient whose Frankel grade E changed to C at 2 days after surgery and changed to grade D at the latest follow-up. Vertebral body fracture below the fusion level happened in 1 case at 3 months after surgery, vertebral body fracture above the fusion level happened in 1 case at 5 months after surgery, and their chest pain symptoms were relieved after symptomatic treatment and anti osteoporosis treatment. All osteotomy levels obtained fusion which confirmed by X-ray and no internal fixation loosening and breakage were found.

CONCLUSIONThe clinical effect of posterior transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture was satisfactory, but manipulation during the operation should be cautious and prevent adjacent vertebral body fracture should be pay attention to prevent.

Aged ; Female ; Humans ; Kyphosis ; etiology ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; complications ; surgery ; Osteotomy ; methods ; Spinal Fractures ; complications ; surgery ; Visual Analog Scale

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Objective To evaluate the right ventricular (RV) systolic function in patients with systemic lupus erythematosus (SLE) by speckle tracking imaging (STI).Methods A total of 40 cases with SLE were divided into two groups,SLE (24 cases) and SLE complicated with pulmonary arterial hypertension (PAH) (16 cases).Meanwhile,35 healthy subjects were used as control group.Longitudinal peak systolic strain (PSS) of the basal,mid,apical segments of the free wall of right ventricular and interventricular septum and suben-docardial myocardium of the whole right ventricular were measured by STI respectively.Every parameter was compared.And the main factors affecting the strain of the whole right ventricule were analyzed.T test,one-way ANVOA,SNK-q,Spearman's correlation and Pearson's correlation analysis were used for statistical analysis.Results ① In SLE group,strains of the whole RV(GLS RV) [(-22±4)％] and all segments of RV wall[the basal segments of free wall (bas FW) (-27±8)％ were lower than that of the control group (-26±4)％,(-33±6)％,respectively (t=-4.815,P=0.000; t=-3.619,P=0.001)].Tricuspid valve orifice peak velocity E/A and right ventricular ejection fraction were significantly different between SLE group and control group (P＜0.05).② In terms of conventional parameters and the strain of all segments of RV wall,bas FW and GLS RV were different between the SLE group [(-30±7)％,(-23.7±3.5)％,respectively] and SLE with PAH group [(-22±6)％,(-18.4±2.3)％,respectively] (t=-3.581,P=0.001; t=-5.769,P=0.000).③ The RV anterior wall thickness of the moderate-severe subgroup was significantly higher than that of the mild group [(5.0±0.8) mm,(4.3±0.8) mm; t=-2.49,P=0.017].GLS RV[(-19±4)％,(-24±7)％;t=-3.016,P=0.015],bas FW [(-22±9)％,(-35±6)％; t=-3.125,P=0.03] and bas IVS [(-19±6)％,(-24±6)％; t=-2.272,P=0.029] were significantly lower than that of the mild group.Conclusion Right ventricular function is decreased in patients with SLE.STI can be used objectively to assess the right ventricular longitudinal systolic function.

Objective To compare the efficacy between three-dimensional radiotherapy (3DRT) combined with chemotherapy and radiotherapy alone for patients with esophageal squamous cell carcinoma.Methods A retrospective analysis was performed for 1257 patients with esophageal squamous cell carcinoma who were admitted to our hospital from July 2003 to June 2012 and met the inclusion criteria;362 patients were treated with 3DRT combined with chemotherapy (chemoradiotherapy group) and 895 patients were treated with radiotherapy alone (radiotherapy group).The short-term outcome, overall survival (OS) rate, and causes of death were analyzed.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The response rate was 99.1%(346/349) in the chemoradiotherapy group and 99.0%(813/821) in the radiotherapy group (P=0.397).The 1-, 3-, and 5-year OS rates were 74.0%,42.0%,and 32.9% in the chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000), and were 75.6%,43.5%,and 33.2% in the concurrent chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000).There were no significant differences in 1-, 3-, and 5-year OS rates between the concurrent chemoradiotherapy group and the sequential chemoradiotherapy group (P=0.583).The sequential chemoradiotherapy group had an insignificant increase in 1-, 3-, and 5-year OS rates compared with the radiotherapy group (P=0.065).Tumor recurrence and local control failure were the main causes of death, followed by distant metastasis.The chemoradiotherapy group had a significantly lower proportion of patients who died of local control failure than the radiotherapy group (7.4% vs.14.7%, P=0.003).Conclusions For patients with esophageal squamous cell carcinoma, chemoradiotherapy leads to significantly improved overall survival compared with radiotherapy alone;compared with radiotherapy alone, sequential chemoradiotherapy results in an increasing trend in OS rates, while concurrent chemoradiotherapy results in significantly increased OS rates.Chemoradiotherapy can reduce the deaths due to local control failure compared with radiotherapy alone.

ObjectiveTo investigate the concentration of water fluoride and the application of water defluoridation projects in Suizhou,and to provide a basis for water improvement and prevention of the disease.MethodsCross-sectional study was carried out to investigate completely the water defluoridation projects built between 1986 and 2009 in the area under Suizhou's jurisdiction; 3 source water and terminal water samples of the projects in use were collected,respectively; 1 water sample was collected,respectively in the 3 projects with out-ofcommission or discarded water sources that used to be major water supply,for detection of fluoride,chloride,total hardness,heavy metals and other indicators.ResultsA total of 21 projects were investigated,14 projects were in normal use (66.7％),7 projects were out of order and abandoned (33.3％).Of the 14 projects normally used,13projects with water fluoride concentration ≤ 1.0 mg/L(92.9％)and 1 project with water fluoride concentration higher than 1.0 mg/L(7.1％),the concentration of water fluoride in the 7 abandoned projects was higher than 1.0 mg/L(100％).Arsenic and lead levels of all the water samples were normal.There were two water samples with iron content exceeded the standard,and one total hardness of water samples exceeded the standard in the normally used 14 peripheral water sources.One chloride content exceeded the standard,one manganese content exceeded the standard,two iron content exceeded the standard and three total hardness exceeded the standard in the seven abandoned projects.ConclusionsSome defluoridation projects are stopped using and abandoned in Suizhou,and the water fluoride exceeds the standard.

Objective:To study the correlation between HBV Pre-S1 antigen,HBeAg levels and HBV DNA copies,so as to assess the clinical value of Pre-S1 in detection of HBV replication.Methods:A total of 363 HBsAg-positive samples were col- lected.The levels of Pre-S1 antigen,HBeAg and HBV DNA copies were determined by ELISA,time-resolved immuno-fluores- cent method and real-time fluorescent quantitative PCR(FQ-PCR),respectively.The correlation between the determination re- sults was analyzed.Results:Pre-S1 antigen level was correlated with the level of HBeAg(X~2=94.4,P

OBJECTIVETo investigate the anti hepatitis E virus (HEV) and HEV RNA in acute and convalescent sera of patients with NonA-E acute hepatitis.

METHODSThe serum samples were taken from 95 patients who were diagnosed as acute NonA-E hepatitis. Enzyme immunoassay (EIA) was used for detecting anti-HEV Immunoglobulin G (IgG, Genolable and Wantai EIA anti-HEV kits). RT-PCR amplification of HEV RNA was based on the open reading frame 2 region of HEV and the PCR products were sequenced.

RESULTSSera from 95 patients who were negative for anti-HEV in acute phase were followed up for 11-35 days to detect the anti-HEV antibody in recovery phase, 16/95 (16.84%) were positive for anti-HEV (wantai EIA anti-HEV kits). Ten (62.50%) were positive for HEV RNA in acute phase. Sequence analysis showed that 4 were HEV genotype. 6 were HEV genotype; 12/95 (12.50%) were positive for anti-HEV (Genolable EIA anti-HEV kits). Seven were positive for HEV RNA; 4 belonged to HEV genotype, 3 were HEV genotype.

CONCLUSIONIt is significant and necessary to detect anti HEV antibody and HEV RNA in patients with HEV infection during acute phase and convalesent phase.

Acute Disease ; Amino Acid Sequence ; Base Sequence ; Convalescence ; Genotype ; Hepatitis Antibodies ; blood ; Hepatitis E ; genetics ; immunology ; virology ; Hepatitis E virus ; genetics ; immunology ; Humans ; Immunoglobulin G ; blood ; RNA, Viral ; blood ; genetics ; Sequence Homology ; Viral Proteins ; genetics

OBJECTIVETo understand the pollution rates of vibrio cholera (V. cholera) in different seafood, aquatic products and their circulatory processes, so as to help making measures for cholera control and prevention.

METHODSDifferent seafood, aquatic products and breed water specimen collected from 12 provinces of China were tested from July to September in 2005.

RESULTA total of 12 104 samples of seafood and aquatic products were tested and the average pollution rate of vibrio cholera was 0.52%. The positive isolate rate of turtle sample (1.72%) was the highest among all samples. The second higher isolated rate was 1.14% in water specimen of turtle breed pool. The positive rate of bullfrog was 0.50%. The percentage of toxin strains was 47.54% and 79.31% of them were isolated from turtle and water samples of turtle breed pool. The important sector of the pollution of vibrio cholera was in turtle breed pool (2.38%).

CONCLUSIONThe average pollution rate of vibrio cholera in seafood and aquatic products in 12 provinces of China was low. It should be very necessary to supervise the sanitation in turtle breed for controlling and preventing the vibrio cholera.

Animals ; China ; Female ; Fishes ; microbiology ; Food Contamination ; analysis ; prevention & control ; statistics & numerical data ; Male ; Seafood ; microbiology ; Seawater ; analysis ; Turtles ; microbiology ; Vibrio cholerae ; isolation & purification

Objective To observe the effects of genistein and 17?-estradiol on microstructure of cancellous bone in ovariectomized (OVX) rats.Methods Ninty 7-month-old SD rats were randomly divided into baseline group,ovariectomized (OVX),sham-operated (SHAM),17?-estradiol treated (10?g?kg~(-1).day~(-1),EST) and genistein treated (5 mg?kg~(-1)?day~(-1),GEN) groups,and were killed at the beginning of the experiment,the 3rd and 15th week after operation.MicroCT scanning was performed on the left tibia in vitro.The regions involving 0.5 mm slice thickness and 1.6 mm distal to the tibial growth plate were selected as the regions of interest.Results At the 3rd week after operation,the tissue bone mineral density (tBMD) and trabecular thickness (sTh.Th) in group GEN were significantly higher than those in OVX and EST groups (all P