BACKGROUND: Although the clinical effect of cervical disk replacement in short term has been ascertained, but the middle and long term result is not known, especially for the adjacent level. OBJECTIVE: To observe clinical result and effect of cervical disk replacement on adjacent level in middle and long term. DESIGN, TIME AND SETTING: Retrospective case analysis was performed at Beijing Jishuitan Hospital from December 2003 to March 2005. PARTICIPANTS: Thirty-three patients (aged 35-73 years) undergoing cervical disc replacement were followed up for 3 years. Of them, 25 patients received one-level disk replacement, and 8 received two-level disk replacement. METHODS: The clinical results and imaging before and after operation were compared. MAIN OUTCOME MEASURES: Clinical indexes including JOA grade, Odom’s grade, NDI, SF-36; X-ray: Kellgren X-ray grade, disk cervical height, disk motion, Pfirrmann disk grade, sigittal diameter of spinal cord, and compression of the spinal cord. RESULTS: The point of JOA is 13.62?2.31 before operation, 15.75?1.55 after operation; the differences were significant (P=0.000). For Kellgren X-ray, 10 levels occurred degeneration above the disk replacement level, accounted for 33% (P=0.004), and 9 levels developed degeneration below the disk replacement level, accounted for 32% (P=0.011). No obvious changes in imaging indexes were observed before and after surgery. CONCLUSION: The clinical outcome of cervical disk replacement is good in middle-term follow up. Some adjacent level degeneration may occur after cervical disk replacement, and the degeneration type is osteophyte formation in the adjacent level. This kind of adjacent level degeneration does not affect the clinical outcome in middle term follow-up.

Attention Deficit Disorder with Hyperactivity ; diagnosis ; epidemiology ; physiopathology ; Brain ; physiopathology ; Child ; Comorbidity ; Diagnosis, Differential ; Electroencephalography ; Humans ; Sleep Apnea Syndromes ; diagnosis ; epidemiology ; physiopathology

China ; Critical Care ; history ; methods ; trends ; History, 20th Century ; History, 21st Century ; Humans

Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Child ; Child, Preschool ; Female ; Humans ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Sleep Apnea, Obstructive ; genetics ; physiopathology

Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; surgery ; Tonsillectomy ; methods

Calcium Compounds ; Foreign Bodies ; complications ; etiology ; Humans ; Infant ; Male ; Oxides ; Respiratory Insufficiency ; etiology ; therapy ; Treatment Outcome

Objective To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in a hospital and compare the efficacy of different antibiotic treatments on patients with pneumonia caused by PDR-Ab.Methods Data were ret- rospectively collected from all isolated PDR-Ab strains in our hospital from February 2004 to March 2005.The clinical features and outcomes were reviewed.Results A total of 77 strains of PDR-Ab were collected, 45 of which were pathogens causing clini- cal infections (35 strains from lower respiratory tract, 6 from bloodstream, 3 from drainage fluid, and 1 from wounds).Lower respiratory tract was the most common source of PDR-Ab.More than 90% of the isolated PDR-Ab strains produced OXA-23 type?-lactamase.Cefoperazone-sulbactam plus minocyeline showed good efficacy for patients with PDR-Ab pneumonia.The total clinical cure rate was 68.4%.Bacterial eradication rate was 42.1%.The factors influencing bacterial clearance were pro- longed mechanical ventilation prior to positive culture (17.5 d vs 5.5 d).mixed infection (100% vs 12.5%) and lower GCS score (9.1?0.7 vs 13.2?2.1).Concomitant septic shock (OR=13.8) and APACHEⅡscore (OR=2.1) were independent factors of clinical outcome.Conclusions Nosocomial infections caused by PDR-Ab are not untreatable.Our analysis suggests that cefoperazone-sulbactam plus minocycline may be an effective treatment for lower respiratory tract infections caused by PDR-Ab in our hospital.

Humans ; Incidence ; Vertigo ; diagnosis ; epidemiology

Objective To evaluate the effecof bilateral ovariectomy combined with hormone injection on the bone mineral density and biomechanical property of sheep proximal femu.Method16 healthy adulsheep were divided into the sham operation group (n=8) and the experimengroup (n=8) randomly .Bilateral ovariewere only exposed in the sham operation group .The ex-perimengroup waperformed bilateral ovariectomy (OVX) and began to conducthe intramusculainjection of methylprednisolone (0 .45 mg · kg -1 · d-1 ) aftepostoperative 1 month fo10 month.The bone density (BD) of all sheep proximal femuwameas-ured before OVX and in postoperative 1 yea.The compression tesand the axial pullouteswere performed to evaluate biome-chanical property of postoperative 1 yeaproximal femu.ResultBD of proximal femubefore surgery had no statistically signifi-candifference between the two group,and which in the sham operation group had no statistically significandifference between before and aftesurgery (P＞0 .05) .BD of proximal femuin postoperative 1 yeain the experimengroup wasignificantly de-creased and significantly lowethan thain the sham operation group (P＜0 .05) .The maximal compression stresand the energy absorption value in the experimengroup were significantly lowethan those in the sham operation group with statistically signifi-candifferences(P＜0 .05);the maximal axial pulling force and the energy absorption value in the experimengroup were signifi-cantly lowethan those in the sham operation group with statistically significandifference (P>0 .05) .Conclusion The method of bilateral ovariectomy combined with hormone injection can significantly decrease BD and biomechanical intensity of sheep proximal femu.