OBJECTIVETo investigate the effectiveness of anterior debridement,bone graft, and posterior pedicle screw-rod internal fixation in the treatment of lumbosacral tuberculosis.

METHODSFrom January 2005 to June 2012,18 patients with lumbosacral tuberculosis undergoing the surgical treatment by anterior debridement, bone graft, and posterior pedicle screw-rod internal fixation were reviewed retrospectively. There were 12 males and 6 females with an average age of 44 years old ranging from 35 to 67. Among them, 2 cases were simple low back pain,3 cases were low back pain combined with radiating pain of lower extremity and 13 cases were muscle strength hypesthesia. According to Fankle grading,the nerve function was grade C in 3 cases,grade D in 10 cases,grade E in 5 cases. Of these cases,L4.5 was involved in 8 cases,L5 in 4 cases and L5S1 in 6 cases. The lumbosacral angle was 150 to 270 and the erythrocyte sedimentation rate (ESR) was 45 to 93 mm/h before treatment. The clinical indexes including the lumbosacral incidence, Frankel grade and ESR were reviewed at follow-up.

RESULTSAll 18 cases were followed up for 14 to 22 months. The mean operation time was 180 min. The amount of bleeding was 400 to 800 ml. Except 1 case with iliac vein injuried and 4 cases with abdominal distension,no spinal injuries and severe relative complication occurred, and neurologic function improved in various degrees. Pain in lumbosacral area and radicular pain in lower extremities disappeared. The X-ray and CT films demonstrated that bony fusion was obtained in all patients during 9 to 13 months postoperatively. The lumbosacral angle and ESR were improved significantly.

CONCLUSIONAnterior debridement, bone graft, and posterior pedicle screw-rod internal fixation is an effective method in dealing with lumbosacral spine tuberculosis.

Adult ; Aged ; Blood Loss, Surgical ; Bone Transplantation ; Debridement ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Lumbosacral Region ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Tuberculosis, Spinal ; surgery

Objective The purpose of this paper is to screen inborn errors of meta bolism (IEM) by analyzing urinary components, so as to provide laboratory guide for their diagnosis and therapy.Methods Urine samples of patients suspected to have IEM were collec- ted.Urea was de compo sed with urease and n-heptadecanoic acid was added as internal standard.Protein was denatured with ethanol and precipitate was removed by centrifugation,dried b y evaporation, the residue was trimethylsilylly derivatized with BSTFA/TMCS,and then analyzed with GC-MS for quantification of organic acids, amino acids,suga rs, polyols, purines and pyrimidines, simultaneously. This procedure is denom inated as urease pretreatment-gas chromatography-mass spectrometry (UP-GC-MS) internationally.Results Urinary samples of 327 patients from 6 provinces, cities and autonomous regions were analyzed,and 16 kinds of 27 cases of IEM were screened out with a positiv e rate of 8.26%,among which there were 3 cases of hyperphenylalaninemia,3 cases of glyceroluria,3 cases of Leigh syndrome, 2 cases of propionic acidemia, 2 case s of methylmalonic aciduria, 2 cases of von Gierke′s disease, 2 cases of fructo se-1,6-diphosphatase deficiency, 2 cases of fructosuria, 1 cases of multiple car boxylase deficiency, 1 cases of glutaric acidemia typeⅠ, 1 cases of maple sy rup urine disease, 1 cases of hyperglycinemia, 1 cases of 3-aminoisobutyric acid uria,1 cases of adult-onset typeⅡcitrullinemia,1 cases of galactosemia and 1 ca ses of Fanconi′s syndrome.Several IEM patients above had died,but satisfactory therapeutic effects had been achieved in some diseases,in cluding multiple carboxylase deficiency,methylmalonic aciduria and galactosemia. Other patients′ condition remained to be followed up.Conclusion Analysis of urinary components by UP-GC-MS provides a valuable tool for screenin g of IEM and the results will help to provide effective diagnostic and therapeut ic guide for the patients. J Appl Clin Pediatr,2005,20(2):142-144

Objective To establish a rat model of coal-burning-borne fluorosis,and to observe the expression changes of bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-3 (BMP-3) in the serum of rat treated with different dose of fluoride and different treatment duration.Methods A total of 120 clean grade SD rats(body mass between 80 to 120 g) weaned for 4 weeks were randomly assigned into four groups,which were control,low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,respectively,and 30 rats in each group (female 15,male 15).All of the rats were fed with coal drying corn from fluorosis area.Ten rats were killed by femoral artery bleeding 30 d,90 d and 180 d after exposed to fluoride,respectively.Serum BMP-2 and BMP-3 level was tested by enzyme-linked immunosorbent assay (ELISA).Results ①Results of BMP-2:after exposed to fluoride for 90 d and 180 d,the differences of serum BMP-2 level between groups were statistically significant(F=385.08,173.98,all P ＜ 0.01).In low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,the expression of serum BMP-2 at 90 d[(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] and 180 d[(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89)μg/L] was higher than that of control group[(12.54 ± 1.29),(7.53 ± 0.97)μg/L,all P ＜ 0.05],and the level of BMP-2 increased with increasing dose of fluoride (all P ＜ 0.05).Within each group,the difference of serum BMP-2 was statistically significant(F =55.42,511.58,686.35,671.64,all P ＜ 0.01).The expression of BMP-2 in each group at 90 d [(12.54 ± 1.29),(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] was higher than that at 30 d[(11.75 ± 1.15),(11.42 ± 1.07),(11.38 ± 0.92),(11.15 ±1.03)μg/L,all P ＜ 0.05].The expression of BMP-2 in each group at 180 d[(7.53 ± 0.97),(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89) μg/L] was lower than that at 90 d.②Results of BMP-3:the difference between groups was not statistically significant at every experimental stage(F =0.7215,1.2951,0.0964,all P ＞ 0.05).Conclusions Longer excessive fluoride intake stimulates the expression of BMP-2 in rats,but with prolonged fluoride intake,the stimulation becomes weak.The effect of fluoride on BMP-3 is not as sensitive as that on BMP-2.

Objective To study the microbiology of root surface caries in elderly patients. Methods Seventy-five elderly people (aged 60～77 years) were divided into 2 groups:Control group of patients without root caries (n=30) and root caries group of patients with root caries without apicitis and pulpitis (n=45).Plaque samples were collected,cultured in selective and non-selective media.After the bacteria were isolated,the total count and the detection rates and bacterium numbers of porphyromonas,pervotella,streptococcus mutants group,actiomyces and lactobacillus were compared between the groups of control and root caries.Results The count of total bacteria, streptococcus mutants group,actinomyces,lactobacillus and of root caries group were significantly higher that those of the control group(4.73?0.75)lg(CFU/ml+1)vs(4.17?0.47)lg(CFU/ml+1), (3.89?0.89)lg(CFU/ml+1) vs (2.84?1.14) lg (CFU/ml+1),(3.24?1.89) lg (CFU/ml+1) vs (2.19?0.11)lg(CFU/ml+1),(3.24?1.11)lg(CFU/ml+1)vs(2.43?0.95)lg(CFU/ml+1), (2.67?0.70)lg(CFU/ml+1)vs (3.24?0.21)lg(CFU/ml+1),(P

The aim of the present study was to investigate the effects of tumor conditioned medium (TCM) on the proliferation, adhesion and migration of human umbilical vein endothelial cell (HUVEC). Cells were divided into control group, TCM stock solution group, TCM monodilution group and TCM didilution group (n = 6), and MTT assay was used to determine endothelial cells proliferation level after being stimulated with TCM for 24 h. Coating culture dishes with Fn was used to detect the adhesion ability of endothelial cells to basement membrane in control group and TCM stock solution group (n = 6). Wound closure model was used to test the migration ability of endothelial cells in control group and TCM stock solution group at 12 h and 24 h (n = 6). The results showed that TCM at different concentrations influenced proliferation of endothelial cells in distinct degree. Compared to the control group (absorbance value: 0.58 ± 0.04), the stock solution had no effect on proliferation of endothelial cells (absorbance value: 0.55 ± 0.01). However, the TCM monodilution and TCM didilution enhanced the proliferation of endothelial cells significantly (absorbance value: 0.66 ± 0.03, P < 0.01 and 0.70 ± 0.02, P < 0.001 separately). TCM downregulated the adhesion of endothelial cells to basement membrane. Moreover, compared to the migration distance of control group at 12 h and 24 h [(14.05 ± 6.25) µm and (48.75 ± 16.37) µm separately], TCM upregulated the basement membrane migration [(68.25 ± 26.20) µm and (119.70 ± 34.90) µm at 12 h and 24 h, both P < 0.05 separately]. These results suggest that TCM downregulates the adhesion ability of endothelial cells and upregulates their migration ability, and thus facilitates tumor metastasis.
Cell Adhesion ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media, Conditioned ; pharmacology ; HT29 Cells ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; Humans ; Tumor Cells, Cultured

Objective:To determine the concentration of meropenem in human serum and investigate its pharmacokinetics in Chi-nese elderly patients. Methods:Meropenem with single dose of 0. 5-1. 0 g was given to 25 elder patients by infusion administration. The concentration of meropenem was detected by an HPLC method. The pharmacokinetic parameters were calculated according to the pharmacokinetic model for adults and T>MIC was calculated by simple mathematical simulation. Results: The major pharmacokinetics parameters were as follows:Cmax of (46. 2 ± 24. 4) μg·ml-1;t1/2 of (3. 3 ± 1. 8) h,CL of (8. 7 ± 5. 0) L·h-1 ,V of (9. 8 ± 1. 3) L and AUC of (148. 2 ± 75. 4)μg·h·ml-1 . Compared with that of the healthy subjects reported in the literatures, t1/2 significantly pro-longed, V significantly decreased and AUC significantly increased (P<0. 01). Conclusion: The pharmacokinetics of meropenem in elder patients is significantly different from the healthy subjects. The clinical application should pay attention to monitoring the blood concentration of meropenem.

Background Whether ocular anterior and posterior chamber exist a blood-aqueous barrier is in controversy.Conventional method can not offer a good evidence because it is unable to detect the aqueous component in the posterior chamber.Objective This study was to investigate the distribution of Gadolinium-diethylene triamine pentaacetic acids(Gd-DTPA)after peripheral iridectomy with magnetic resonance imaging(MRI)in rabbit.Methods Monocular peripheral iridectomy was performed on the right eyes in 8 clean New Zealand white rabbits and the fellow eyes were as controls.0.2 ml/kg(0.5 mol/L)Gd-DTPA,a tracer of MRI,was injected into ear vein in vivo to scan the eyes with MRI for the observation of the permeability and distribution.The signal enhanced ratio of interest region associated with time were analyzed.Results The signal in ciliary body of both eyes showed an immediately sharp enhancement within 10 minutes following the injection of Gd-DTPA with a peak intensity at 30-40 minutes,and then the intensity was gradually weaken over time.The signal was stronger in the operative eyes than that in the fellow eyes.The signal in the posterior chamber was gradually increased after operation,however,that in posterior chamber of the control eyes was lower.The interest regions of Gd-DTPA were ciliary,anterior chamber and posterior chamber,and the enhanced signal intensities were consisted in the posterior chamber after operation.However,the increase of the signal was not seen in the posterior chamber in the control eyes.Conclusions The pathway of plasma protein entering into the anterior chamber is very different from that of aqueous secretion.There exists a barrier between the anterior and posterior chamber which might be an integral part of the blood-ocular barrier.

Objective In order to improve the understanding of Kimura's disease,the clinical features and the pathological changes of 12 patients were analyzed.Methods Twelve cases with Kimura's disease ad- mitted to Qilu Hospital of Shandong University were retrospectively reviewed.Results All 12 patients were in relatively good condition and presented as subcutaneous nodules or swelling lymph nodes.Peripheral blood eosinophilia did not occur in 5 cases,4 out of 6 patients had high-level serum IgE.Biopsies were taken in all cases and the characteristic histological presentations were discovered.Only one patient developed pulmonary inflammation and acute myocardial infarction which were rare in Kimura's disease.Conclusions Definite di- agnosis of Kimura's disease mainly relies on biopsy.A patient with Kimura's disease can suffer from severe pulmonary and cardiac diseases,but the relationship between them should be studied further.

Objective To obtain the normal values of four-phase rhinomanometry specific parameters of normal adult Chinese and analyze the correlation between four-phase rhinomanometry and acoustic rhinometry measurement results. Methods Eighty-five normal adults were recruited. The HRR2 four-phase rhinomanometer was used to acquire the effective resistances in inspiration, expiration and total breathing process (Reffin, Reffex, Refft) and vertex resistance in the process of inspiration and expiration (Vrin and Vrex). The Eecovisian acoustic rhinometry was used to measure the minimum cross-sectional area (MCA) and the nasal volume of 0-5 cm nasal cavity (V5). Results Reffin (x-±s) was (1.28±1.02) Pa/(cm3·s) for male, (1.55±1.03) Pa/(cm3·s) for female;Reflex (x-±s) was (1.43±1.07) Pa/(cm3·s) for male, (1.75±1.14) Pa/(cm3·s) for female;Refft (x-±s) was (1.34±0.99) Pa/(cm3·s) for male, (1.62±1.03) Pa/(cm3·s) for female;Vrin (x-±s) was (1.31±1.03) Pa/(cm3·s) for male;(1.60±1.03) Pa/(cm3·s) for female, Vrex (x-±s) was (1.46±1.04) Pa/(cm3·s) for male, (1.82·1.17) Pa/(cm3·s) for female. No statistically significant difference was found between men and women(r=0.661、-0.397、0.127、0.649、-0.684, P>0.05, respectively). There was no significant correlation between Reffin, Reffex, Refft, Vrin, Vrex and age, height, weight, head circumference, body surface area, body mass index (P>0.05, respectively). However, there was significant correlation between Reffin, Reffex, Refft, Vrin, Vrex and MCA, V5 (P<0.05, respectively). Conclusions The results of four-phase rhinomanometry show significant correlation to acoustic rhinometry.

OBJECTIVETo explore the clinical effects of total vertebral column resection combined with anterior mesh cage support in treating severe congenital kyphoscoliosis.

METHODSFrom April 2008 to April 2012,21 patients with severe congenital kyphoscoliosis were treated with total vertebral column resection and internal fixation through posterior approach combined with anterior mesh cage support. There were 8 males and 13 females with an average age of 19.4 years old (ranged from 10 to 35). And 6 cases were thoracic segments deformity,13 cases were thoracolumbar segments and 2 cases were lumbar segments, of them, 2 cases were accompanied with Chairs deformity, 6 cases with diastematomyelia, 4 cases with syringomyelia,and 1 case with neurofibromatosis. According to the Frankel grade system, 3 cases were grade C, 5 cases grade D and 13 cases grade E. Blood loss, operative time, and perioperative complications were recorded. Coronal and sagittal Cobb angle, apical vertebral offset distance, sagittal offset, the relative height of shoulders, razor back deformities were measured and analyzed before and after operation.

RESULTSThe average operative time was 5.2 h (3.5 to 6.5 h) and blood loss was 2,500 ml (1,400 to 4,900 ml). The 2nd day after operation, apical vertebral offset distance, sagittal offset, the relative height of shoulders, razor back deformities had obviously improved than preoperative (P < 0.05). There was no significant difference in above items between postoperative on the 2nd day and final follow-up (P > 0.05). The corrective rate of kyphosis and scoliosis were (60.97 +/- 6.30)% and (62.24 +/- 5.82)%, respectively. On the first day after surgery,2 cases of Frankel grade E aggravated to grade D, and obtained recovery at 2 week after conservative treatment. And 1 case palinesthesia later,grade D aggravated to grade C and obtained recovery after revision surgery in time. One case complicated with permanent blindness of left eye, 1 case occurred injury of pleura and 2 cases had cerebrospinal fluid leak during operation. All patients were followed up from 9 to 31 months with an av- erage of 18.6 months. At final follow-up,all patients obtained bone union, Frankel grade D in 4 cases and grade E in 17 cases, no correction loss and internal fixation loosening was found.

CONCLUSIONTotal vertebral column resection combined with anterior mesh cage support can effectively correct kyphosis and scoliosis in severe congenital kyphoscoliosis and can avoid injury of spine cord by spinal crispation, but intraoperative position and neurologic complications should still be considered.

Adolescent ; Adult ; Child ; Female ; Humans ; Kyphosis ; complications ; congenital ; diagnostic imaging ; surgery ; Male ; Retrospective Studies ; Scoliosis ; complications ; congenital ; diagnostic imaging ; surgery ; Spine ; surgery ; Tomography, X-Ray Computed ; Young Adult