Objective To explore the clinical effect of the percutaneous vertebroplasty(PVP) and filling auto-solidification calcium phosphate cement(CPC) in treatment of osteoporotic thoracolumbar vertebral fractures. Methods From January, 2004, 26 patients with osteoporotic thoracolumbar vertebral compression fracture (29 vertebral bodies) were treated with intraoperative manipulative reduction, PVP and filling auto-solidification CPC. Results PVP were successfully performed with unilateral or bilateral vertebral pedicles for the 29 vertebrae. The average injection dose of CPC was 4.6 mL. CPC leakage occurred during the procedure in 5 vertebrae of 5 cases. All the patients were followed up for 3 to 8 months (averaging 4.6 months) and experienced complete pain relief. There was no severe complication related to the treatment. Except in 3 patients who lost 15%of the vertebral body height, the anterior height of the injured vertebral body in the other 23 patients recovered averagely to 80%of the normal one. Conclusion PVP with filling auto-solidification CPC is safe and effective in the treatment of osteoporotic thoracolumbar vertebral compression fractures.

[Objective]To improve the diagnosis and treatment of acute fatal pulmonary thromboembolism(PTE)in orthopedic perioperation.[Method]Clinical manifestations,radiological features,laboratory examination data,treatment and prognosis of 12 patients diagnosed as acute fatal PTE in orthopedic perioperation from February,2002 to July,2005 were retrospectively analyzed.[Result]Nine patients received emergent thrombolytic and anticoagulant therapy,7 were alleviated and 2 died;3 patients with sudden cardiac arrest died after failed cardiopulmonary resuscitation.[Conclusion]Acute fatal PTE is a severe disease of orthopaedics.The realization and alert of the existence of acute fatal PTE must be increased.Early diagnosis and efficient treatment is the key to preventing from death.

0.05). However,the accuracy in placement pedicle screws and derotation rate of apical vertebrae were much higher in the individually treated group than those in the standard group (P=0.001,0.02).[Conclusion]The accuracy in placement pedicle screws and correction effects on transverse plane of patients with Lenke Ⅰ AIS can be improved significantly by individual selection of entrance point.

Objective To study the distribution and molecular characteristics of Vibrio parahaemolyticus(VP) in patients with a‐cute diarrhea ,and provide a scientific basis for the prevention and control of VP infection .Methods From 2010 to 2014 ,62 VP iso‐lates were collected from patients with acute diarrhea ,for serotyping and virulence gene (tdh and tdh) detection of VP .Molecular characteristics analysis was carried out by using multi‐locus sequence typing (MLST) .Results 7 different serotypes were found from the 62 isolates .O3∶K6 was the most common serotype of VP ,accounting for 74 .19% (46 isolates) ,followed by O4∶K68 (6 isolates) .Tdh gene was the mainly virulence gene ,with a percentage of 95 .16% (59 isolates) ,only three isolates were trh positive . 7 STs were found through MLST analysis of 62 VP isolates ,among which ,ST3 was the most important type ,accounted for 85 .50%(53 isolates) .Conclusion O3∶ K6 serotype VP was the most prevalent type .Tdh gene is the most important virulence gene of WP .ST3 was the the dominant epidemic type .

Objective To investigate the surgical reparation of large coloboma raw surface after facial tumour resection in elderly patients.Methods According to the position and characteristics of tumor as well as the age and tolerance of the patients, full thick skin graft, the skin flaps with subcutaneous pedicle and free skin flap were designed and used in the reparation.Results 24 cases with large coloboma raw surface (5 cm×7 cm-12 cm× 16 cm)were treated by the utilization of three approaches after tumor resection.The large coloboma raw surface in all patients achieved the healing with satisfactory appearance.Conclusions After facial tumour resection, the large coloboma raw surface can be repaired by using the skin graft, skin flaps after tumor resection or free skin flap if designed reasonably.The procedure of operation is simple and the therapeutic effect is satisfactory.

Objective To evaluate the feasibility and outcome of transpedicular screw fixation in fracture reduction and maintenance of reduction for thoracolumbar fractures.Methods The clinical data of 43 patients with thoracolumbar fractures admitted to Orthopedic Trauma Hospital of Qingdao from January 2003 to December 2006 were retrospectively analyzed.The inclusion criteria were as follow;sin-gle vertebral fracture involving T_(12)-L_2, integrated pedicle and no inferior endplate fracture.All patients received operation within 10 days after injury.Three-level fixation at fractured vertebra plus pedicle screw fixation was performed in 23 patients (Group A) including 15 males and 8 females, at mean age of 45 years (19-77 years).Traditional two-level fixation was done on the other 20 patients (Group B) inclu-ding 11 males and 9 females, at mean age of 42 years (22-67 years).In Group A, the transpedicular screws fixing the fractured vertebra and cephal vertebra were distracted after locking the transpedicular screw of the fracture vertebra and caudal vertebra.Results The height of the anterior edge of the cau-dal disc in Group B was 0.035 ±0.042, greater than 0.061 ±.036 in Group A, with statistical differ-ence (P < 0.05).There was no statistical difference in the changes of Cobb angle after the operation be-tween (915.8 ±7.8)°in Group A and (13.1±5.2)°in Group B.34 patients were followed up for an average period of 15 months (11-24 months) , which showed smaller Cobb angle in Group A (5.4°compared with Group B (8.9°)(P <0.05).There was one patient with screw breakage in Group A and two in Group B.Conclusion Transpedicular screws can enhance the stability of the posterior short-segment instrumentation, avoid over-distraction of the caudal discs, improve stress distribution and lessen loss of correction for some thoracolumbar fractures.

Objective To study the transcriptional regulation of vp1667 by H-NS in Vibrio parahaemolyticus.Methods Total RNAs were extracted from Δhns and WT strains.Quantitative RT-PCR was carried out to calculate the transcriptional variation of vp1667 between Δhns and WT.Primer extension assay was also employed to detect the transcription start site and the promoter activity (i.e.the amount of primer extension products) of vp1667 in Δhns and that in WT.The promoter DNA region of vp1667 was amplified, purified, and cloned into the corresponding restriction endonuclease sites of pHRP309 that harbors a gentamicin resistance gene and a promoterless lacZ reporter gene.The recombinant pHRP309 plasmid was transformed into Δhns and WT, respectively, while β-galactosidase activity in cellular extracts was measured using a β-galactosidase enzyme assay system.The over-expressed His-H-NS was purified under native conditions with nickel loaded HiTrap Chelating Sepharose columns.The electrophoretic mobility shift assay (EMSA) and DNaseⅠ footprinting were then applied to analyze the DNA-binding activity of His-H-NS to vp1667 promoter region in vitro.Results and Conclusion The primer extension assay detected one transcription start site for vp1667, which was located at 28 bp upstream of vp1667, and its transcribed activity was under the negative control of the H-NS.The EMSA and DNaseⅠ footprinting assay results showed that His-H-NS was unable to bind to the promoter-proximal DNA region of vp1667, suggesting that H-NS indirectly inhibits the transcription of vp1667.

Objective To investigate the regulation of swimming motility by H-NS in Vibrio parahaemolyticus(VP). Methods VP was inoculated into the semi-solid swimming agar plate containing 1% Oxoid tryptone, 2% NaCl, 0.5%Difco Noble Agar, and 0.1% arabinose followed by incubation at 37℃ for 4.5 h before the diameters of bacterial lawns were measured.Total RNAs were extracted from the wild-type (WT) strains and the hns null mutant (Δhns), and the quantitative real-time( RT)-PCR( qRT-PCR) was carried out to calculate the transcriptional variation of flaA between WT andΔhns strains.The entire promoter DNA region of flaA was amplified and cloned into the lacZ fusion vector pHRP309 containing a promoterless lacZ gene. The recombinant lacZ reporter plasmid was transformed into WT and Δhns, respectively, to measure the β-galactosidase activities in cellular extracts using the β-galactosidase enzyme assay system. Results and Conclusion The phenotype results showed that swimming motility of VP was enhanced by H-NS.The qRT-PCR and LacZ fusion results indicated that the transcription of flaA was positively regulated by H-NS.Collectively, H-NS promotes the swimming motility of VP, at least partly, by activating the transcription of flaA.

Objective To compare the clinical outcome between vertebra fracture fixation plus injectable calcium sulfate vertebroplasty and simple vertebra fracture fixation in the treatment of thoracolumbar burst fracture.Methods A total of 61 patients with thoracolumbar burst fracture treated from January 2005 to December 2008 were involved and divided into two groups,ie,Group A ( treated with three-level fixation at fractured vertebra and injectable calcium sulfate vertebroplasty) and Group B ( treated with three-level fixation at fractured vertebra alone).Group A had 22 males and 10 females,at mean age of 36.8 years (21-65 years).The mean follow-up period was 15.6 months (13-27 months).Group B had 18 males and 11 females,at mean age of 38.3 years (19-70 years).The mean follow-up period was 14.7 months (12-28 months).The ratio of anterior vertebral height,Cobb angle,VAS score were compared between the two groups.Results There were no statistical differences in the aspects of age,sex,fracture segments and preoperative neurological status distribution in the two groups( P ＞0.05 ).All patients with partial neurologic deficits initially improved for 1-2 grade at the final follow-up.Blood loss and operation time in Group A were less than that in Group B (P ＜0.05 ).The ratio of anterior vertebral height and the Cobb angle showed no statistical significance (P ＞ 0.05 ),but the ratio of anterior vertebral height and the Cobb angle in Group A was less than those in Group B at the latest follow-up (P ＜0.05 ).The VAS score showed no statistical significance between the two groups at the latest followup (P ＞ 0.05 ).There was one patient with screw breakage in Group B,while there was no implant failure in Group A.Conclusion The vertebra fracture fixation plus calcium sulfate cement vertebroplasty is a safe and effective method for the treatment of thoracolumbar burst fracture as it can restore the vertebral mechanical strength,achieve and maintain kyphosis correction,decrease the instrument failure rate and loss of vertebral height.

BACKGROUND: Vertebrae axial rotation is a basic deformity of scoliosis, the rotational degree of which is hard to measure due to the field limitation of posterior spinal instrumentation. Currently, vertebrae rotational degree is measured according to preoperative X-ray film or CT, while no reports concerning measuring vertebrae rotational degree during operation. OBJECTIVE: To explore the feasibility of measurement of vertebrae rotational degree with the entry point of pedicle screws.METHODS: Design of the path of pedicle screws on CT scans before surgery, a line bisection and perpendicular to another connecting bilateral entry point of pedicle screws, and the angle of vertebral rotation (EPPsag) was taken as the angle between this line and the saggital plane. The difference among vertebrae rotational degrees measured by conimeter, Ho's method and EPPsag was compared by Wilcoxon signed rank test. The intra-observer and inter-observer difference was analyzed with One-WayANOVA. Conimeter was used to measure vertebrae rotational degree of each vertebra in 9 lumbar specimens, and the results was compared to EPPsag.RESULTS AND CONCLUSION: There was no significant difference among EPPsag, actual rotational degree and measuring results of Ho's method (P>0.05). The One-Way ANOVA showed that the differences between intra-observer analysis and inter-observer analysis (P>0.05). The results demonstrated that EPPsag can exhibit vertebrae rotational degree accurately and repeatability. This anger can be obtained accurately with the instrument if the vertebrae rotational degree not exceeding 30°.