[Objective] To compare the efficacy of interbody fusion with cage versus corpectomy and fusion with plate in treating adjacent two-level cervical spondylosis.[Method] Sixty patients were included in this study.All patients were randomly assigned to anterior interbody fusion with cage (AIFC) group or anterior corpectomy and fusion with plate (ACFP) group. The average follow-up period was 28 months for AIFC group,and 25 months for ACFP group. [Result] The average loss of lordosis angle, the lost correction of segmental height and the scores on the criteria of 40-score method were not statistically significant between these 2 groups. The lordosis correction, operative estimated blood loss, and operative time were statistically better in the AIFC group significantly . [Conclusion] The short-term results of AIFC and ACFP in treating adjacent two-level cervical spondylosis were satisfactory. The advantages of AIFC are the elimination of donor site complications, increasing more segmental lordosis, and reducing blood loss and operative time.

Humans ; Hypertension, Pulmonary ; metabolism ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; metabolism

OBJECTIVE:To compare the effects of strontium ranelate and PTH(1-34)on bone quality of ovariectomized rats. METHODS:80 SD rats were randomly divided into sham operation group(group A,n=10)and dual ovariectomy(group B,n=70). 3 months after operation,group B were randomly divided into 7 groups,with 10 rats in each group. B0 group were given nor-mal saline [0.9 g/(kg·d)] subcutaneously;B1-B3 groups were given low-dose,medium-dose and high-dose of strontium ranelate [0.45,0.9,1.35 g/(kg·d)] intragastrically;B4-B6 groups were given low-dose,medium-dose and high-dose of PTH(1-34)[30, 60,90 μg/(kg·d),treated for 5 days,rested for 2 days] subcutaneously. Group A was same to group B0 in therapy regimen. All rats were sacrificed 8 weeks later. The contents of P1NP and CTX-1 in serum of rats were determined by ELISA assay;bone densi-ty of 4th lumbar vertebrae was detected by bone densitometer;BV/TV,Tb.Th,Tb.N and Tb.Sp were detected by CT;maximal load and elastic modulus of 5th lumbar vertebrae were measured by compression test. RESULTS:Compared with group A,the se-rum levels of P1NP and CTX-1 in B0-B6 groups increased significantly,while bone density of 4th lumbar vertebrae,maximal load and elastic modulus of 5th lumbar vertebrae decreased significantly in B0-B3 groups(P<0.05);BV/TV level of 4th lumbar verte-brae decreased significantly,while Tb.Sp level increased significantly in B0 group(P<0.05). Compared with B0 group,bone den-sity of 4th lumbar vertebrae,maximal load and elastic modulus of 5th lumbar vertebrae increased significantly in B1-B3 groups (P<0.05);P1NP content,BV/TV,Tb.N level,bone density of 4th lumbar vertebrae,maximal load and elastic modulus of 5th lumbar vertebrae increased significantly in B4-B6 groups,and were higher than in B1-B3 groups(P<0.05). Tb.Sp level of B1-B6 groups decreased significantly and were lower than those of B1-B3 groups(P<0.05). There was no statistical significance in Tb.Th level among 8 groups and CTX-1 content among B0-B6 groups (P>0.05). CONCLUSIONS:PTH(1-34) is better than strontium ranelate in inhibiting bone loss,improving vertebral bone micro-structure and biomechanical properties of ovariectomized rats.

Objective To report the treatment outcomes and repair methods for soft tissue defects at thumb using miniature flaps. Methods Six different kinds of surgical flaps were used for the repair on different thumb injuries. They were radial lateral thumb reverse island flap, dorsal ulnar thumb revers flap, first metacarpal dorsal reverse flap, first digital dorsal island flap, neurovessel pedicled V-Y advanced island flap, free nail flap first foot digital, and so on. The emergency repair using miniature flaps were studied on 132 different cases, all 137 flaps. Results The flaps survived expect 5 flaps had partial epidermis necorsis in the 137 flaps. But the 5 flaps survived too after disinfecting and changing dressing. The appearances and functions of thumbs were satisfactory for the 1 to 2 years post-operation follow-up. Conclusion It will gain better results if choosing appropriate emergency repair methods using miniature flaps on different cases.

Objective To investigate the serum adiponectin levels and TNF-? levels in women with gestational diabetes and to study their clinical significance.Methods Plasma concentration of adiponectin,tumor necrosis factor alpha and correlate parameters were measured in 50 patients with gestational diabetes(GDM)and 36 pregnant women with normal glucose tolerance(NGT).Radio immunoassay was used to measure the adiponectin,TNF-? level was measured by ELISA.Serum insulin level was measured by Electrochemiluminescent immunoassays fasting glucose levels by glucose oxidase method.Results GDM patients had significantly lower concentrations of adiponectin(10.3?(2.4) mg/L) and elevated levels of TNF-?(4.6?(1.5)?g/L) in comparison to NGT women.In GDM group TNF-? level was correlated positively with serum insulin level,glucose level.Concentration of adiponectin was negatively correlated with corresponding parameters.Conclusion Elevated level of TNF-? and decreased adiponectin concentration may not simply reflect maternal adiposity and insulin resistant state,but may contribute to the impaired glucose metabolism during pregnancy and forecast the risk of metabolism syndrome.

Object To study the chemical constituents from the roots of Stellera chamaejasme L. Methods Chemical constituents were isolated by chromatographic methods and identified by physiochemical and spectral analysis. Results One lignan and three biflavonoids were purified and determined as bursehernin (Ⅰ), chamaejasmenin B (Ⅱ), isoneochamaejasmin A (Ⅲ),and (+)-chamaejasmin (Ⅳ). Conclusion Compound Ⅲ and Ⅳ are determined as new optical compounds. Compound I is first isolated from Stellera L. species.

BACKGROUND: Donor complications have been detected following autologous tendon transplantation for posterior cruciate ligament reconstruction. Although artificial tendon development and tissue-engineered tendon have achieved great progresses, there are some issues in clinical application. Since 1980's, allogenic tendon transplantation has aroused increasing attention. OBJECTIVE: To explore the selection of allogenic tendon materials and the effect of their application on reconstructing posterior cruciate ligament. METHODS: A total of 17 patients with posterior cruciate ligament injury of knee joint were treated with cryopreserved allogenic tendon by Tibial-inlay technique. During the operation, two tracts of tendons soaked in gentamicin saline for 15 minutes were conduplicated, and one end of the tendon was cancellous bone screw and fixed to the tibia attachment point of posterior cruciate ligament, and the other end was introduced into the joint through retention suture. The posterior joint capsule was repaired. The patient was placed at supine position, and the knee was flexed for 90°. The other end of the graft was introduced to femoral tunnel, and anterior drawer was tensed, and fixed by screw. RESULTS AND CONCLUSlN: The preoperative posterior drawer test of patients was >2+, including 7 cases of 3+ and 6 of 4+. The postoperative posterior drawer test was 0 in 4 cases, 1+ in 8 cases, 2+ in 4 cases and 3+ in 1 case, suggesting the posterior movement of the knee joint was significantly improved. Lysholm scores of patients were (48.5±4.3) points before operation and (88.3±5.4) points after operation. Results show that cryopreserved allogenic tendon by Tibial-inlay technique could restored function of posterior cruciate ligament with a favorable effect.

Altitude ; Altitude Sickness ; prevention & control ; Health Services Administration ; Humans

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.

AIM: To observe the changes in subfoveal choroidal thickness ( SFCT ) after intravitreal injections of ranibizumab ( IVR ) for macular edema secondary to retinal vein occlusion ( RVO) .
METHODS:Thirty-six eyes of 36 patients with macular edema secondary to RVO) were treated with 0. 5mg IVR monthly for 3mo and received additional IVR as needed over the following 1a period. SFCT of the all eyes ( the affected eyes with RVO and unaffected fellow eyes ) was measured by enhanced depth imaging optical coherence tomography images before and after the IVR.
RESULTS: The mean SFCT of the affected eyes with RVO decreased from 246. 7±115. 0μm at baseline to 220. 5±102.0μm at 1mo (P<0.05), 198.3± 114.0μm at 6mo (P<0.01), 212. 6± 96. 0μm at 12mo (P<0. 01). Whereas the fellow eyes changed from 229. 4±108. 0μm at baseline to 226. 3±107. 0μm at 1mo (P>0. 05), 228. 6±127. 0μm at 6mo (P>0.05), 223.6±101.0μm at 12mo(P>0.05). There were statistically significant difference between affected eyes with RVO and unaffected fellow eyes.
CONCLUSION: The SFCT is decreased after IVR for macular edema secondary to RVO. IVR seems to affect the hemorheology of the choroid.