ObjectiveTo observe the morphological features of the basivertebral foramen (BF) in thoracolumbar (T12,L1,L2 and L3).MethodsA total of 36 health adults were underwent multi-slice CT thin slice scans and three-dimensional reconstruction.In the horizontal and sagittal CT reconstruction images,BF weight (BFW),BF depth (BFD),BF high (BFH),BF relative to the body weight (BFWr),BF relative to the body depth (BFDr),and BF relative to the body high (BFHr),were measured.The distance between the BF and each side in the horizontal and sagittal CT images were also measured.The correlation between the measured parameters of BF and the gender,age,body mass index(BMI) were analyzed statistically.Results 81％ BF was triangular or trapezoid.There was a bone interval within 6％ BF.In the same level in 36 cases,the maximum of BFW,BFD and BFH were approximately 1/3 vertebral body in the same plane.The average BFW,BFD and BFH were approximately 25％ vertebral body in the same plane.In all four levels,the distance from the BF to the cranial endplate was shorter than to the caudal endplate (P＜O.05).The mean BFW,BFH,BFWr,BFHr in different levels were no significant difference(P＞0.05).The mean BFD and BFDr in L3,however,were greater than other levels.There were no significant correlations among gender and BFW,BFWr,BFD,BFDr,BFH,BFHr.There was a correlation between the age and L1BFHr and L2BFHr,and a correlation between BMI and L1BFH,L2BFW,L3BFH and L3BFHr.ConclusionThere was a BF in all specimens.The most common appearance of BF was triangular or trapezoid.BF was closer to the cranial endplate in all four levels in the sagittal CT images.Variations of BF were significantly different in individuals.

Objective To ev aluate clinical results of selective anterior corpectomy combined with segmental discectomv and fusion for multilevel cervical myelopathv andits related factors.Methods Twenty-five patients of multilevel cervical myelopathv with 3 or 4 consecutive segments were treated with selective anterior corpectomy combinedwith segmental discectomy and fusion.The clinical results were evaluated by the parameters including improvement of Japanese Orthopaedic Association (JOA)score postoperatively,fusion rate,and the degree of spinal canal decompression and range of motion of the cervical spine.Results JOA score were improved from 9.5±1.3 pre-operatively to 13.8±0.8(P＜0.01)6 months post operation and 1 3.6±0.9(P＜0.05)atthe final follow-up.Bony fusion was verified by X-ray and 3D-CT scan 1 2 months post operation and final follow-up.Moreover,the degree of decompression of the spinal canal was also remarkable.The range of motion of the cervical spine after operation decreased significantly(P＜0.05).Conclusion Selective anterior corpectomy combined with segmental discectomy and fusion was an alternative choice for the surgical treatment of multilevel cervical myelopathy.

ObjectiveTo compare the clinical results of small surgical incision of bilateral spinous process and traditional open surgical incision in posterior single level lumbar interbody fusion,and assess the application value of the small surgical incision of bilateral spinous process in posterior single level lumbar interbody fusion.MethodsFrom December 2006 to June 2008,70 patients with lower lumbar vertebral diseases underwent single segment posterior lumbar interbody fusion.Patients were randomly divided into small surgical incision of bilateral spinous process group(Hereinafter referred to as small incision group) of 36 cases and 34 cases of conventional open group.Small incision group included 20 males and 16 females with an average age of 52.0 years.Traditional open group included 16 males and 18 females with an average age of 53.2 years.Two groups of operative time,blood loss,postoperative drainage,X-ray projection operation frequency,hospital stay,complication rate,creatine phosphokinase (CPK) level,multifidus cross-sectional area,postoperative low back pain visual analogue scale(VAS),Oswestry disability index(ODI),interbody fusion rate were compared,respectively.ResultsAll of 70 cases were followed up for 12-24 months (average,16).There were no statistically differences in the operation time,the number of X-ray projection,complication rate,and fusion rate between the two groups (P＞0.05),but there were significant differences in blood loss,postoperative drainage,the first day and the third day of postoperative the level of CPK,postoperative multifidus muscle cross-sectional area,postoperative low back pain VAS,hospital stay,and postoperative ODI between the two groups(P＜0.05).ConclusionSmall surgical incision of bilateral spinous process and traditional open surgical posterior lumbar interbody fusion were satisfied with the efficacy,but small surgical incision of bilateral spinous process with less trauma,shorter hospital stay,and rapid postoperative recovery.

Child ; Enterovirus A, Human ; Enterovirus Infections ; Humans

Adult ; Benzene ; Biomarkers, Tumor ; blood ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Serum ; chemistry

There is no radical cure for essential thrombocythemia currently. Professor SUN Xue-mei has extensive clinical experience in treating it by combined therapy of Chinese and Western medicine. In this paper, authors tried to summarize her experience from guiding ideology and therapeutic points. Authors insisted on the direction of integrative medicine on the basis of syndrome differentiation, paying attention to psychological counseling,and applied individual treatment in clinics.
Acupuncture Therapy ; Female ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective To study the anatomy of the innervation of hallucis longus muscle,and discuss the clinical value of the innervation.Methods Nineteen limbs of 10 cadavers were studied.There were 4 female cadavers and 6 male cadavers.Nine were left legs and 10 were right legs.The specimens were anatomied to confirm the tibialis anterior,extensor digitorum longus and hallucis longus muscle.The innervation of hallucis longus muscle was been observed along the deep peroneal nerve.Measuring the muscular branches length (nerve length,NL),the distance from the tip of the fibular head to the muscular brance (nerve-fibula head length,NFL),and fibular length (fibula length,FL).The hematoxylin and eosin stain was used to observe the numbers of nerve fascicle for each branch of EHL.Results Twenty-three muscle branches of hallucis longus muscle were found in 19 limbs,15 limbs had a single branch,4 limbs had the double branches.All branches were originated in the deep peroneal nerve.Fourteen branches were into hallucis longus muscle from the fibular side,3 from anterior side,6 from the tibial side.The fibula length was 37.0±1.9 cm (range,34.5-40.6 cm); the nerve-fibula head length was 89.0±5.2 mm (range,75.4-97.2 mm);nerve length was 48.5±5.0 mm (range,33.6-57.4 mm); the nerve-fibula head length/fibula length was 0.245±0.020 (range,0.211-0.280).Among 15 specimens with single branch,3 branches had a unique nerve fascicle and 12 had two fascicles.Among 4 specimens with doulbe branches,only 1 branch had two fascicles,7 branches had a unique fascicle.Conclusion Special anatomical features of muscular branches might be the reason of isolated extensor hallucis longus dysfunction.

Background The alteration of dominance eye is associated with visual quality in patients with age-related cataract or after cataract-surgery.However,the study on the relationship of dominance eye shift with vision following cataract-surgery is lack.Objective This study was to observe the influence of age-related cataract and cataract surgery on ocular dominance in the elderly.Methods A serial cases-observational study was designed.Eighty-seven patients with age-related cataract were collected from December 2011 to April 2012 in Affiliated Eye Hospital of Wenzhou Medical University,and phacoemulsification combined with intraocular lens (IOL) implantation was performed in all the patients.The patients were grouped into binocular vision difference (best corrected distance vision) ≥2 lines group (42 patients) and ≤ 1 line group (45 patients) on the standard logarithmic visual acuity chart.The frequency and shift of dominant eye were determined by card-hole method or thumb method before operation and 1 day,1 week,1 month and 3 months after operation.The difference in the frequencies of dominant eye between before and after operation was analyzed with MecNmar test.Results The median of best corrected distance vision (LogMAR) was 0.40 (0.00-1.40) in preoperation and 0.00 (-0.08-0.30) in postoperation,with significant difference between them (Z=-9.481,P =0.000).In the binocular vision difference ≥ 2 lines group,the dominant eyes were 24 in the right eyes and 18 in the left eyes.The milder cataractous eyes were identified as dominant eyes in 33 (78.57％) patients and heavier cataractous eyes were determined as dominant eyes in 9 (21.43％) patients before operation.However,the right eye was evidenced as dominant eye in 31 patients and the left eye was in 11 patients after operation.In the 42 patients,dominant eye shifted from the left eyes to the right eyes in 10 patients and from the right eyes to the left eyes in 3 patients,and 4 patients presented an unstable change binocularly.In 45 patients of the binocular vision difference ≤ 1 line group,the dominant eyes were the right eyes in 27 patients and the left eyes in 18 eyes in preoperation ; while after operation,dominant eye altered form the left eyes to the right eyes in 3 patients and form the right eyes to the left eyes in 1 patient,and unstable change occurred in 5 patients.There were no significant differences in the frequency of dominant eyes between before and after operation both the two groups (group A:P =0.092 ; group B:P =0.727).Conclusions Age-related cataract impact on eye dominance.Dominance eye may occur alteration binocularly following cataract surgery,which is one of causes of visual discomfort.

Objective To investigate the efficacy and safety of anterior approach using an expandable artificial vertebral body for the correction of post-traumatic kyphosis (PTK) in the thoracolumbar spine.Methods From August 2009 to August 2011,13 patients with PTK in the thoracolumbar spine were treated through an anterior approach using an expandable artificial vertebral body.There were 4 males and 9 females,aged from 38 to 62 years (average,53.3±7.6 years).The injury levels consisted of T12 in 5 cases,L1 in 6 cases and L2 in 2 cases.All the operations were done by a single surgeon group.In the procedure,symptomatic vertebra and its two discs were excised,and the bony endplates were reserved.After putting an expandable artificial vertebral body into the space,the kyphosis was corrected by extending the artificial vertebral body.The operative duration,blood loss,Cobb angle,visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded.Results All patients were successfully followed up for an average time of (18±5.5) months (range,12 to 28 months).The average Cobb angle was 33.9°±7.2°(range,22°to 53°)before operation and 7.3°±4.8°(range,2°to 16°)at final follow-up.The average VAS score was 6.4±0.9 (range,5 to 8)before operation and 1.5±0.8(range,0 to 3)at final follow-up.The average ODI was 50.5％±10.8％(range,38％ to 78％)before operation and 10.9％±4.9％(range,4％ to 22％) at final follow-up.All patients achieved bony fusion 12 months after operation.Conclusion Application of expandable artificial vertebral body through an anterior approach for PTK in the thoracolumbar spine has several advantages: large angle correction,less interruption of nerve,mini-invasion and less levels fixation.Satisfactory clinical outcome can be achieved.

Objective To compare the difference of adjacent segment degeneration (ASD) following one-level mini-open or conventional open posterior lumbar interbody fusion (PLIF).Methods From October 2005 to September 2008,108 patients underwent one-level instrumented PLIF using two different approaches: mini-open approach in 56 patients including 32 males and 23 females,aged from 32 to 68 years (average,53.8 years) and conventional open approach in 52 patients including 24 males and 28 females,aged from 27 to 69 years (average,52.6 years).The follow-up rates of the mini-open and conventional open groups were 91.1％ and 88.5％,respectively.The visual analog scale (VAS),Oswestry disability index (ODI),multifidus muscle injury and ASD were evaluated.Results There were no significant differences in VAS and ODI scores between two groups preoperatively,but the two scores in the mini-open group were significantly lower than those in conventional open group after surgery.Compared with the conventional open approach,less decrease of cross sectional area and less severe fatty degeneration of the multifidus muscle were observed in mini-open group.There were 4 cases of radiographic ASD in the mini-open group including two symptomatic cases,and 11 cases in the conventional open group including 4 symptomatic cases among them 2 required surgical intervention.Both radiographic and symptomatic ASD were correlated with the decrease of cross sectional area and degree of fatty degeneration of the multifidus muscle,but only symptomatic ASD was associated with the clinical results.Conclusion Compared with the conventional open approach,the mini-open PLIF has many advantages,such as better clinical outcomes,lower incidence of multifidus muscle atrophy,and lower incidence of radiographic ASD.