0.05).There was significant difference between every composite group with the positive group( P

Objective To investigate the early postoperative rehabilitation condition of patients with cervical spondylotic radiculopathy and analyze its correlation with the life style.Methods A retrospective analysis for 164 cases of cervical spondylotic radiculopathy with complete follow-up data were carried out.Using modified MacNab criteria for evaluation of postoperative recovery.The clinical efficacy was evaluated 3 months after operation,and the patients were divided into satisfactory group (excellent/good) and unsatisfactory group (fair/poor).The influencing factors included general information and the lifestyle such as smoking,drinking,sleep time,the height of the pillow,working time and frequency of physical exercise.The chi-square test and Logistic multivariate regression analysis were used to analyze the effects of lifestyle on early postoperative rehabilitation patients with cervical spondylotic radiculopathy.Results Postoperative efficacy satisfaction of patients evaluated by modified MacNab standard was 88.4％ in 3 months.There were differences in age(x2 =5.819),smoking(x2 =5.074) and frequence of physical exercise(x2 =4.430),and the differences were statistically significant (all P＜ 0.05).Logistic analysis showed that age more than 50 years old(OR=3.913,95％ CI =1.321-11.594,P=0.014),smoking(OR=3.217,95％ CI =1.126-9.195,P =0.029) and frequence of physical exercise less than or equal to 3 times a week (OR=3.906,95％ CI =1.026-14.869,P=0.046) were the risk factors affecting the satisfaction of clinical curative effect of early postoperative cervical spondylotic radiculopathy.Conclusion Age,smoking and physical exercise are related to early postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and then more than 50 years old,smoking and exercise less than 3 times a week have adverse effects on the early postoperative rehabilitation.

Objective To observe the curative effect of Weifuchun combined with Shenqifuzheng pills in the treatment of chronic atrophic gastritis.Methods 85 cases patients were divided into the control group of 42 cases and the treatment group of 43 cases.The control group were treated with omeprazole enteric -coated capsules and colloidal bismmth pectin,while the treatment group were treated with Weifuchun and Shenqifuzheng pills.The course of treatment was two months.The patients were treated by endoscopy and pathological review after the treatment,then the datas were comparedwith that before treatment.Results The total effective rate of the treatment group was 67.44%,which of the control group was 40.48%,the was statistically significant difference between the two groups (χ2 =6.22,P <0.05).The symptom scores of stomach tingling,stomach fullness,facial darkness,anorexia and melena in the two groups had statistically significant differences (t =6.14,P <0.05).Conclusion Weifuchun combined with Shenqi-fuzheng pills have good curative effect in the treatment of chronic atrophic gastritis.It should be popularized in clinic.

The learning passion,apprehension and master of probation knowledge and practice capacity of probationers have improved greatly by applying the teaching method of stage-separated to echelon teaching on the basis of the cognitive law and focusing on clinical operation practice.Meanwhile,this method has effectively improved clinical probation teaching quality of orthopedics.

BACKGROUND:The nano-hydroxyapatite has obvious advantages in bone repairing and reconstruction, but its clinical application is limited for its low osteoinductive activity and poor mechanical properties. To overcome these defects, researchers, based on the bionics principles, composite nano-hydroxyapatite with inorganic or/and organic materials to get various biomimetic composite materials.
OBJECTIVE:To review the research and application of nano-hydroxyapatite/polyamide 66 biocomposites. METHODS:A computer-based search of PubMed database was undertaken with the keywords of“nano, hydroxyapatite, polyamide 66”in English to retrieve the relevant articles published from January 1987 to
December 2012. Simultaneously, the relevant articles between January 1987 to December 2012 were searched in CNKI database with the key words of“nano, hydroxyapatite, polyamide 66”in Chinese. A total of 93 literatures were retrieved, and final y 56 standard literatures were included.
RESULTS AND CONCLUSION:The nano-hydroxyapatite/polyamide 66 biocomposites have appropriate thermostability and mechanical properties as wel as good biocompatibility. So far, the research and application of nano-hydroxyapatite/polyamide 66 biocomposites mainly focus on artificial vertebral body, lamina, and cage. The satisfactory clinical effects of the biocomposites show their broad clinical application prospects. However, there are stil many problems to be solved. For example, there are no detailed long-term fol ow-up data concerning osteogenic induction and degradation. Additional y, current studies focus on the bio-safety of materials in the aspects of cytology and histology rather than at the molecular level.

ObjectiveTo observe the spinal cord pathological change and hindlimbs motor function of rats after decompression on chronic spinal cord injury.Methods 30 Wistar rats were divided randomly into conrol group ( n =5 ),compression group ( n =5 ) and decompression group ( n =20 ),then the decompression group was subdivided into 4 parts as 1 week,2 weeks,4 weeks,6 weeks after decompression.Decompression was made after 30 days of chronic spinal cord copression injury,rats'motor function was detected by inclined plate experiment,the histopathological change,Nissl body and neural cells apoptosis in different spinal cord sections were assessed by the stainings of HE,Nissl and TUNEL.ResultsCompared with control group,the behavior testing showed all rats in compression group presented with weakness of muscle power in their hindlimbs (P ＜ 0.01 ),but the hindlimbs motor functions recovered from the first week after decompression and the difference had statistical significance compared with the compression group(P＜ 0.01 ).Then the rats hindlimbs functions recovered gradually later on.The staining of HE,Nissl and TUNEL showed that the injured spinal cord section performed no improvement at the first 2 weeks after decompression,the neural apoptosis index(24.31 ± 4.73 )％ decreased until the forth week after decompression(P＜0.05).The spinal cord segments closed to the injured part recovered in early stage.At 1 week after decompression,lots of Nissl bodys were observed in spinal anterior horn,the neural apoptosis index in the 2 sections closed to the injured part were ( 15.21 ± 4.81 ) ％ and ( 16.21 ± 3.98 ) ％,which declined observably compared with compression group(P ＜ 0.05 ).ConclusionAfter decompression on chronic spinal cord injury,the recovery of rats'hindlimbs motor function in early stage is probably benefited by the functional compensation of the spinal cord segments closed to the injured section.

Objective To evaluate the clinical effect of limited open reduction, poking reduction and QWIX cannulated screw internal fixation in treatment of posterior malleolar fracture. Methods A total of 14 patients with posterior malleolar fracture were treated by limited open reduction, poking reduction and QWIX cannulated screw internal fixation. Injury causes included traffic accidents in five patients, fall from height injury in four and inversion sprain in five. According to fracture type classification methods of Weber and Danis, there were two patients with type A3, seven with type B3 and five with type C3. Func-tional exercise was carried out based on postoperative exercise plan. Regular follow-up was performed to e-valuate the functional recovery of the ankle joint. Results All patients were followed up for 6-18 months (average 9.5 months). One patient with sural nerve injury returned to normal after six months. Twelve pa-tients showed excellent range of motion of the ankle joint and normal gait three months after operation. In 12 patients, dorsiflexion of the ankle joint was > 20° and plantar flexion > 40° six months after operation, which was approximately similar to contralateral normal ankle joint. The ankle joint function of all patients returned to normal six months after operation. According to Baird-Jackson ankle joint function evaluation, the result was excellent in 12 patients, good in one and fair in one, with excellence rate of 93%. Con-clusion The limited open reduction, poking reduction and internal fixation of QWIX caunulated screw are effective method for treatment of posterior malleolar fractures.

BACKGROUND:Compared with conservative treatment, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can rapidly relieve the pain caused by the compression of osteoporotic vertebral body. However, the perfusion of bone cement can not only restore the rigidity of fractured vertebrae, but also theoretical y alter the stress distribution of fractured vertebrae and increase the stress load of adjacent vertebrae, thus causing adjacent intervertebral disc degeneration. ＜br> OBJECTIVE:To observe the effects of PVP and PKP on the adjacent intervertebral disc degeneration and explore the possible mechanism. ＜br> METHODS:A total of 85 patients with osteoporotic vertebral compression fracture were divided into three groups:conservative treatment group (n=23), PVP group (n=42) and PKP group (n=23). ODI scores, DHI, MRII, and peripheral interleukin-1β, interleukin-6, tumor necrosis factor-αlevels were col ected and analyzed at different time points. ＜br> RESULTS AND CONCLUSION:The results showed that, PVP group and PKP group relieved pain effectively, reduced the time in bed, and had a better treatment satisfaction, but there were no significant differences in the scores of ODI scores between PVP group and PKP group at 24 months after discharge (P>0.05). At 24 months after discharge, MRII in the PVP group and PKP group were lower than that in conservative treatment group and before treatment (P＜0.05), while peripheral interleukin-1, interleukin-6, tumor necrosis factor-αlevels were higher (P＜0.05), there were significant differences between PVP group and PKP group (P＜0.05). The disc degeneration adjacent to the fractured vertebral body can be accelerated by PVP and PKP procedures, and the latter is more serious. Interleukin-1, interleukin-6, tumor necrosis factor-αlevels are closely related to the degree of intervertebral disc degeneration.

BACKGROUND:Matrix metaloproteinases are now generaly considered to be able to degrade al extracelular matrices. Hypersecretion of matrix metaloproteinases or reduction in tissue inhibitors of matrix metaloproteinases leads to destruction of the dynamic balance of extracelular matrix. OBJECTIVE: To elucidate the role of matrix metaloproteinase-1 and tissue inhibitor of matrix metaloproteinase-1 in the pathogenesis and progression of intervertebral disc degeneration. METHODS:A total of 60 patients with intervertebral disc degeneration were included. Mild, moderate, and severe degeneration signals appeared on MRI imaging of the patients. Meanwhile, 20 patients with vertebral fracture, mainly cervical spine fracture, were selected as the control group. Venous blood samples were colected before the surgery; the intervertebral disc specimens were sequentialy colected. RESULTS AND CONCLUSION: Serum and tissue levels of matrix metaloproteinase-1 in patients with intervertebral disc degeneration were significantly increased compared with the control group (P < 0.05), and furthermore those were significantly increased in patients with severe disc degeneration compared with patients with mild and moderate disc degeneration (P < 0.05). However, serum and tissue levels of tissue inhibitors of matrix metaloproteinases did not differ significantly between the disc degeneration and control groups (P > 0.05). These results indicate that hypersecretion of matrix metaloproteinase-1 occurs in patients with intervertebral disc degeneration; however, the expression of tissue inhibitor of matrix metaloproteinase-1 is not correlated with intervertebral disc degeneration.

[Objective]To investigate the feasibility and efficacy of percutaneous kyphoplasty in treating severe vertebral body compression fractures in patients with osteoporosis.[Method]Data from 15 patient who suffered from severe vertebral compression fractures was retrospectively reviewed.Seventeen percutaneous kyphoplasty were performed under C arm X-ray machine guidance.The clinical effects were evaluated by observing the charges of visual analog scale,locomotor activity scale,height of vertebral bodies and the Cobb's angle.[Result]All patients were successfully treated.Visual analog scale decreased from 7.9?1.3 preoperatively to 2.5?0.8 postoperatively(P