OBJECTIVETo analyze the clinical effects of short-segment posterior pedicle screw combined with transpedicle vertebral bone grafting in treating thoracolumbar burst fractures.

METHODSFrom March 2008 to March 2013, 62 patients with thoracolumbar burst fractures were treated with short-segment posterior pedicle screw combined with transpedicle vertebral bone grafting. Including 40 males and 22 females, the age from 17 to 65 years old with an average of 38 years. According to AO classification, 34 cases were type A3.1, 7 cases were type A3.2 and 21 cases were type A3.3. Load-sharing scores were from 4 to 6 points with an average of 5.4 points. According to ASIA grade, 2 cases were grade C, 5 cases were grade D and 55 cases were grade E. Preoperative, postoperative at 3 d and final follow-up, the Cobb angle, the relative height of anterior vertebral body and the encroachment rate of spinal canal were measured by X-ray films and computed tomography (CT) scan, meanwhile, the information of bone healing and spinal nerves recovery were observed.

RESULTSAll patients were followed up from 11 to 14 months with an average of 12.2 months. The duration of removing internal fixation were from 9 to 13 months (averaged, 11.5 months). One suffered from infection and was cured by debridement. Two cases had mild pain of back. At 6 months after operation, according to ASIA grade to evaluate never function, 1 case was grade C, 3 cases were grade D and 58 cases were grade E. X-ray and CT showed the fractures obtained good union at final follow-up. The Cobb angle, the relative height of anterior vertebral body and the encroachment rate of spinal canal had obviously improved at 3 days after operation (P<0.05); but there was no significant differences between postoperative at 3 d and final follow-up (P>0.05).

CONCLUSIONShort-segment posterior pedicle screw combined with transpedicle vertebral bone grafting is an effective method to treat thoracolumbar burst fractures. It can reduce the loss of postoperative correction and prevent the internal fixation failure.

Adolescent ; Adult ; Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fractures ; surgery ; Spinal Fusion ; Thoracic Vertebrae ; injuries ; surgery

Humans ; Traumatology

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction clinical disease. Surgery is the main therapeutic tool for CSM. However, there are obvious differences in clinical functional recovery after operation. For the past few years, the influence factors of prognosis in cervical spondylosis myelopathic has been widely concerned. Age, nerve function, course of desease, imaging findings,surgical method and related factors became the investigative point for prognosis of cervical spondylotic myelopathy. Present viewpoint showed that the older patient, preoperative worse nerve function, longer the course of disease would result in worse outcomes. Imaging examination maybe can indicate the prognosis, but the correlation is unclear. Selection of surgical method and approach should be based on the principles of sufficient decompression, stabilize the alignment of the cervical spine, keeping backward extension of cervical spine, maintain effective decompression, preventing complications. Therefore, the treatment of cervical spondylotic myelopathy should be on the basis of pathogenic condition and imaging examination at early stage and a suitable usrgical procedure should be performed to obtain a better prognosis.
Cervical Vertebrae ; surgery ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiography ; Spinal Cord Diseases ; diagnosis ; diagnostic imaging ; surgery ; Spondylosis ; diagnosis ; diagnostic imaging ; surgery

Blue light has been widely used for the treatment of neonatal hyperbilirubinemia since the 1950s. Neonatal phototherapy can decrease plasma unconjugated bilirubin level, thus preventing bilirubin encephalopathy, and greatly reduces the exchange transfusion rate. Generally, it is accepted that the side effects of neonatal phototherapy are not serious and seem to be well controlled, however recent research has provided new evidence. The short-term side effects of phototherapy include interference with maternal-infant interaction, imbalance of thermal environment and water loss, electrolyte disturbance, bronze baby syndrome and circadian rhythm disorder. In addition, phototherapy may be associated with some long-term side effects such as melanocytic nevi and skin cancer, allergic diseases, patent ductus arteriosus and retinal damage. Therefore, it is necessary to develop evidence-based guidelines, new light devices and alternative agents, as well as individualized treatments, to minimize the side effects of phototherapy.
Evidence-Based Practice ; Humans ; Hyperbilirubinemia, Neonatal ; therapy ; Phototherapy ; adverse effects

BACKGROUNDRecent studies have indicated that many mutations in mitochondrial (mt) DNA NDI gene region are related to diabetes mellitus. In this study we explored the relationship between various mtDNA ND1 gene mutations and type 2 diabetes mellitus (DM) among Chinese.

METHODSUsing PCR restriction fragment length polymorphism (PCR-RFLP) analysis and gene sequencing, 4 spots of mtDNA (nt3243, nt3316, nt3394, nt3426) were screened in 478 diabetics and 430 non-diabetic subjects.

RESULTSIn diabetic group, there were 13 carriers (2.72%) of 3316 G-->A mutation,12 (2.51%) of 3394 T-->C mutation and 2 (0.42%) of 3426A-->G mutation. In controls, only 3394 T-->C mutation was observed in 2 subjects (0.47%). There was significant difference in the frequency of 3316 and 3394 mutation between two groups (P < 0.05, respectively). More subjects with mitochondrial DNA ND1 gene mutations had DM family history and greater tendency of maternal inheritance when compared to those patients without mutation in diabetic group (P < 0.01). A 3426 mutation diabetic pedigree was studied, and we found 12 maternal members in the family had the same mutation.

CONCLUSIONmtDNA ND1 gene mutations at nt3316 (G-->A), nt3394 (T-->C) and 3426 (A-->G) might contribute to the pathogenesis of DM with other genetic factors and environment factors.

Base Sequence ; DNA, Mitochondrial ; genetics ; Diabetes Mellitus, Type 2 ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; NADH Dehydrogenase ; genetics ; Pedigree ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sequence Analysis, DNA

OBJECTIVETo identify the risk factors for patent ductus arteriosus (PDA) in neonates.

METHODSFifty infants with PDA and 100 infants without PDA were enrolled. Chi-square test, Student's t test and the linear correlation analysis were used to study the clinical data. Logistic regression analysis was used to investigate the independent risk factors for PDA.

RESULTSThe prevalence of PDA was negatively correlated with the gestation age (r=-0.03, P<0.05) and birth weight (r=-0.04, P<0.05). Oxygen inhalation was a protective factor for the development of PDA. Fetal distress, meconium-stained amniotic fluid, oligohydramnios, cord entanglement, 1 minute Apgar score <8, maternal infection and hypoxic-ischemic encephalopathy were the independent risk factors for the development of PDA.

CONCLUSIONSThe incidence of PDA can be reduced by preventing maternal infection, premature birth, low birth weight and hypoxia.

Apgar Score ; Birth Weight ; Ductus Arteriosus, Patent ; etiology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Risk Factors

OBJECTIVETo investigate the research on neonatal jaundice in recent years by co-word analysis and to summarize the hot spots and trend of research in this field in China.

METHODSThe CNKI was searched with "neonate" and "jaundice" as the key words to identify the papers published from January 2009 to July 2013 that were in accordance with strict inclusion and exclusion criteria. To reveal the relationship between different high-frequency key words, Microsoft Office Excel 2013 was used for statistical analysis of key words, and Ucinet 6.0 and Netdraw were used for co-occurrence analysis.

RESULTSA total of 2 054 papers were included, and 44 high-frequency key words were extracted. The current hotspots of research on neonatal jaundice in China were displayed, and the relationship between different high-frequency key words was presented.

CONCLUSIONSThere has been in-depth research on clinical manifestations and diagnosis of neonatal jaundice in China, but further research is needed to investigate the etiology, mechanism, and treatment of neonatal jaundice.

Biomedical Research ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; complications ; diagnosis ; therapy

OBJECTIVETo evaluate the effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria among preterm infants in the neonatal intensive care unit (NICU).

METHODSA double-blind, randomized, placebo-controlled trial was carried out in the preterm infants who were transferred to the NICU immediately after birth. These infants were stratified by whether they were breastfed and then randomized into test group and control group. The test group was given probiotics from the day when enteral feeding began, while the control group was treated conventionally without probiotics. The two groups were compared in terms of the colonization with extended-spectrum beta-lactamase-producing bacteria, as assessed by rectal swabs on days 1, 3, 7, and 14 after birth, and the incidence of diseases.

RESULTSRectal colonization with drug-resistant bacteria was found in the test group (n=119) and control group (n=138) on days 1, 3, 7, and 14 after birth. There were no significant differences in the incidence of late-onset sepsis and necrotizing enterocolitis between the two groups (P>0.05). Among non-breastfed infants, the test group had significantly decreased rectal colonization with drug-resistant bacteria compared with the control group on day 14 after birth (71.1% vs 88.9%; P=0.04). No probiotic-related adverse events were observed in the study.

CONCLUSIONSOral administration of probiotics may reduce rectal colonization with drug-resistant bacteria in preterm infants under certain conditions and shows good safety.

Administration, Oral ; Bacteria ; isolation & purification ; Breast Feeding ; Double-Blind Method ; Drug Resistance, Bacterial ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Probiotics ; administration & dosage ; Rectum ; microbiology

OBJECTIVEThe advantage of perforator flaps versus musculocutaneous flaps is the reduced morbidity of the donor site with preservation of the nerves, muscles and deep fascia. We evaluate the reconstruction result of perforator flaps in head and neck region.

METHODSA retrospective review was performed of perforator flap reconstructions for head and neck tumor ablation defects since December of 2003 to May of 2005. There were 14 flaps including 8 anterolateral thigh (ALT) flaps and 6 deep inferior epigastric artery perforator (DIEAP) flaps. Recipient sites were subdivide into oral tongue (n=3), buccal mucosa (n=3), pharyngeal wall (n=3), base of tongue (n=2), skull base (n=1), scalp (n=1) and midface (n=1).

RESULTSThe overall free flap success rate was 93% (13/14). One DIEAP flap lost because the draining jugular vein was thrombosed. No complications were observed in the donor site, including wound dehiscence, weakness and hernia.

CONCLUSIONPerforator flaps are the new and reliable technique for head and neck surgical defects. Because of the minimum donor site morbidity, the perforator flap may be one of the primary choice in the near future.

Adult ; Aged ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo study the bacterial culture results of expressed breast milk.

METHODSA total of 1178 expressed breast milk samples were collected for bacterial culture. The breast milk sampled from the mothers of preterm neonates (n=615) and term neonates (n=563) who were hospitalized between May 2014 and April 2015.

RESULTSThere was no significant difference in bacterial counts between the preterm and term sample groups (P>0.05). Potential intestinal pathogens were found in 55 samples (4.63%) of the 1178 samples, with no significant difference between the preterm and term sample groups (P>0.05). The second expressed milk samples from 33 mothers were cultured. Only 10 samples (30%) were found to have the same bacteria as the first time. The detection rate of bacterial load of ≥ 10⁵ CFU/mL was higher in those samples with potential intestinal pathogens, as compared with those samples without potential intestinal pathogens (43.64% vs 14.87%; P<0.05). There was no correlation between the incidence of neonatal infections and potential intestinal pathogens in breast milk.

CONCLUSIONSBreast milk is not sterile. Bacterial loads and phylotypes are variable. Random breast milk cultures can neither describe bacterial colonies in breast milk, nor be a predictor of neonatal infection.

Bacterial Load ; Female ; Humans ; Male ; Milk, Human ; microbiology ; Pilot Projects