BACKGROUND:Due to variation of spinal anatomic structure, vertebral body rotation, absence of vertebral body, and spinal canal deformation in patients with scoliosis, the deviation of pedicle screw placement can induce catastrophic results. Recently, with the wide application of pedicle screw and the continuous development of computer navigation, scoliosis surgery becomes more accurate and safe.
OBJECTIVE:To review the existing problems and advantages of Iso-C arm three-dimensional (3D) navigation system for guiding internal fixation of pedicle screw implantation in the treatment of scoliosis.
METHODS: The first author searched PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI (http://www.cnki.net/) for articles published until December 2012. The key words were “computer navigation, scoliosis, pedicle screw”. The literatures with abstracts containing above key words were retrieved. Totaly more than 50 articles were found, and 13 articles were accorded with the inclusion criteria.
RESULTS AND CONCLUSION: Iso-C arm 3D navigation system for guiding internal fixation of pedicle screw implantation in the treatment of scoliosis had obvious advantages. It fuly combined the advantages of CT 3D navigation and intraoperative X-ray navigation, and can quickly and accurately capture the image data. Real time display of images could ensure the safety of repair operation. Automatic registration function of Iso-C arm 3D navigation undoubtedly improves the efficiency and accuracy of the repair, and helps physicians with more accurate and safe ways to carry out a variety of complex scoliosis surgery.

Objective To determine the inhibitive effect of interferon-a on hepatic metastasis of colon cancer. Methods Metastatic model of human colon cancer was established by orthotopic implantation of histologically intact human tumor tissue into the colon wall of nude mice.The mice were randomly divided into 4 groups:(1)Control group(receiving saline solution only);(2)5-FU treatment group;(3) IFN-?-2b treatment group;and(4)5-FU combined with IFN-?-2b treatment group(combined group). 5-FU and IFN-?-2b were given via peritoneum injection 1 time/2 days for eight weeks.The mice were killed at nine weeks.The tumors were weighed,the microvessel density(MVD) was detected,and the liver was examined histologically in order to discover the micrometastasis. Results In control group, 5-FU group,IFN-2b group and combined group,the tumor weight was(1.53?0.78)g,(0.87?0.59)g,(0.81?0.43)g and ( 0.23?0.09)g, respectively;the tumor inhibition rate was 0,43.1%,47.1% and 84.9%, respectively;the hepatic metastasis rate was 85.7%,78.6%,21.4% and 0 respectively.MVD in IFN-? group and combined group was significant lower than that in control group and 5-FU group. Conclusions IFN-? can inhibit the growth and hepatic metastasis of orthotopic implanted human colon cancer by inhibiting the tumor angiogenesis.It may be more effective when INF-? combined with cyotoxic agents.

Objective To investigate the effects of lower limb training at different intensities on the recovery of walking function after stroke.Methods Thirty-six stroke patients were randomly divided into a 40-minutes of training group,an 80-minutes of training group and a 120-minutes of training group.Because of three missing followup cases,the final numbers of cases were 12,11 and 10 cases respectively.All of the patients received lower limb training based on regular rehabilitation therapy,but at the three different intensities:40 minutes,80 minutes or 120 minutes a day,five days per week,for 4 weeks.Walking function was assessed using the Holden functional ambulation categories (FACs) and the Fugl-Meyer assessment (FMA).These were carried out before treatment,and after two and four weeks of treatment.Results Before treatment,the average FACs of the three groups were (1.83 ±0.94),(1.73 ± 1.01) and (1.80 ± 1.03) respectively.Their average FMA scores were (19.17 ±5.52),(23.00±4.71) and (19.40 ±7.90).After two weeks of treatment,the average FAC in the 120-minutes training group was (3.30 ± 0.48),significantly higher than in the 40-minutes training group.After four weeks the average FACs in the 40-minutes,80-minutes and 120-minutes training groups were (2.67 ± 0.65),(3.18 ± 0.60) and (3.80 ±0.42) respectively.The differences between the 120-minutes group and the 80-minutes group as well as between the 80-minutes group and the 40-minutes training group were statistically significant.The average FMA scores of the three groups after four weeks were (25.08±4.46),(28.64±3.56) and (25.90±5.19) respectively.All the differences were significant compared with pre-treatment.There were no significant differences in FMA scores among the three groups after two weeks or four weeks of treatment.Before treatment,the proportion of patients able to walk independently in the 40-minutes,80-minutes and 120-minutes training groups were 16.7％,18.2％ and 20.0％.After two weeks the proportions had risen to 33.3％,36.4％ and 100％ respectively,so the results in the 120-minutes training group were significantly better.After four weeks of treatment the proportions of the three groups were 58.3％,90.9％ and 100％.All these improvements were significant compared with pre-treatment,but when compared with the 80-minutes training group,neither of the others showed a significant difference.Conclusions Intensive training can accelerate the recovery of walking function of patients after stroke and promote their ability to participate in daily activities.

Objective To investigate the correlation between vertebral diffusion weigllted imaging (DWI)and dual X-ray absorptiometry(DXA),quantitative computed tomography(QCT)for the evaluation of bone mineral density(BMD).Methods A total of 152 female volunteers[aged from 30 to 80 years,mean age(58.2±14.2)years 1 were recruited in this study.All subjects underwent lateral thoracicolumbar radiographs,dual X-ray absorptiometry(DXA)and quantitative computed tomography(QCT),as well as DWI examination.Lateral spine radiographs(T4-L4)were evaluated with Genant's semiquantitative assessment.BMD was obtained by both DXA and QCT at lumbar spine(L2-L4).Axial vertebral(L2-4)DWI was performed with single shot spin-echo echo-planar imaging(SS-SE-EPI)sequenee (b value=500 s/mm2)after routine MRI examination(saginal T2 WI,T1 WI and axial T2 WI).Apparent diffusion coefficient(ADC)was measured with GE-Functool DWI software.Pearson correlation analysis was used for the statistics.Results There was a decreasing tendency in ADC value with age.A positive correlation was found between ADC(0.241×10-3 mm2/s)and BMD results measured by both DXA (1.038 S/cm3)and QCT(104.2 mg/cm3)examinations(r=0.461,0.731,respectively,P＜0.01).Conclusion DWI is an useful tool for noninvasive evaluation of the pathophysiologic changes of bone marrow in volunteers with difierent bone mineral density.

OBJECTIVETo summarize clinical results of the microdecompression for the treatment of intraforaminal lumbar disc herniations.

METHODSFrom September 2005 to May 2013,16 patients( 12 males, 4 females)with intraforaminal lumbar disc herniations underwent microdecompression, ranging in age from 32 to 56 years old with a mean of 38.6 years old. The lumbar disc herniations were located at L(3,4). in one patient, L(4,5) in 10 cases and L5S1 in 5 cases.

RESULTSAll the patients were followed up, and the duration ranged from 20 to 48 months, with a mean period of 36 months. According to Macnab evaluation, 12 cases got an excellent result, 4 good. No apparent complications related to the technique occurred. Satisfactory clinical results were obtained in this series.

CONCLUSIONMicrodecompression may be particularly useful in the treatment of intraforaminal lumbar disc herniations. The microdecompression procedures are more likely to be well tolerated by older patients.

Adult ; Decompression ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome

Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.

Objective To examine the effects and mechanisms of siRNA targeting aquaporin 4 (AQP 4) in combination with hyperbaric oxygen therapy(HBO) on cerebral edema and apoptosis in the brain tissue of rats after hemorrhage.Methods Rats were randomly divided into four groups,the control group,the hyperbaric oxygen group,the AQP-4 siRNA group and the combination therapy group (24 rats).Thrombin Ⅶ was injected into the caudate nucleus to establish the hemorrhage model.Construction of siRNA targeting aquaporin 4 was conducted.The mRNA expression of AQP-4 was detected by RT-PCR at day 3.Changes in brain moisture and blood-brain barrier perme ability were measured by a wet/dry weight method and Evans blue fluorometry.The nerve cell apoptosis rate was analyzed by Annexin V andTdT-mediated dUTP-biotin nick end labeling (TUNEL).The expression of proteins including AQP-4,MMP-2,MMP-9,Bcl-2 and caspase-3 was detected by Western Blotting.All the animals were given a score for their nerve function at day 3.Results AQP-4 siRNA treatment obtained better effects than HBO in decreasing the brain edema leveland silencing AQP-4 mRNA(P＜0.05)while,the combination therapy group achieved the best results(P＜ 0.05).Compared with the control group,the percentage of apoptotic cells decreased in all the three treatment groups,with the most marked decrease observed in the combination treatment group(4.24± 0.04)％(F=13.76,P=0.001).The expression of AQP-4,MMP-2,MMP-9 and caspase-3 was lower (P＜0.05) and the expression of Bcl-2 was higher(P＜0.01)in the combination treatment group than in the other three groups.Compared with the control group,all the other three groups received better scores on nerve function defect evaluation at day 3 after hemorrhage(P＜0.05),with the combination treatment group again achieving the most favorable score (4.7 ± 1.1) (F=7.21,P =0.013).Conclusions Targeted siRNA interference combined with hyperbaric oxygen can effectively reduce cerebral edema after cerebral hemorrhage,inhibit neuronal apoptosis and promote neuron function recovery.The underlying mechanisms may be related to down-regulation of AQP-4,MMP 2,MMP-9 and caspase-3 expression and up-regulation of Bcl-2 expression.

OBJECTIVETo investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures.

METHODSBetween June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function.

RESULTSAll patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor.

CONCLUSIONAsian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

Adult ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Femur ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To compare complications of ureteroneocystostomy and end-to-end ureteroureterostomy after kidney transplantation. Methods Eighty allograft renal transplantation patients between January 2005 and October 2008 were divided into two groups according to urinary tract reconstruction approach: ureteroneocystostomy group (40 cases) and ureteroureterostomy group (40 cases). Complications including leakage of urine,vesicoureteral reflux,obstruction of ureter and urinary tract infection were recorded.Results In ureteroneocystostomy group and ureteroureterostomy group,the patients were followed up for 13 - 46 (24.5 ± 8.9), 13 - 46 (26.0 ± 7.2) months postoperatively, urinary complications were recorded for 10 eases (25.0%, 10/40) and 4 cases (10.0%, 4/40)(P > 0.05), incidence of leakage of urine were 2.5%(1/40)and 5.0%(2/40) (P > 0.05), vesicoureteral reflux were 10.0% (4/40) and 0 (P ＜ 0.05), obstruction of ureter were 0 and 5.0% (2/40) (P > 0.05), and urinary tract infection were 12.5% (5/40) and 0 (P < 0.05).Conclusions Compared with ureteroneoc ystostomy, ureteroureterostomy can reduce the incidence of vesicoureteral reflux and urinary tract infection,it can be regarded as the first choice for urinary tract reconstruction after kidney transplant recipients.

Based on reservoir condition and fluid characteristics, the oil-degrading bacterial strain NX-2 was screened from Ma-2 fault block of Huabei oil field. Bacterial metabolism and the capability of improving oil property were evaluated on oxygen-deficient condition. At 87℃ which reservoir temperature is, artificial homogeneous core displacement experiment indicated the enhanced oil recovery of microbe was 7.1% higher than that of waterflooding. In experiment on individual well Ma-410, additional oil production of 669 tons was gained, and decreased water production of this trial well reached more than 3000 tons. These results demonstrated NX-2 could adapt to stratum conditions, enhance oil recovery and improve oil property as well.