[Objective]To evaluate the outcome of thoracolumbar fracture with spinal cord injury treated with short-segment pedicle instrumentation.[Method]47 cases of thoracolumbar fracture with spinal cord injury from 1999 to 2004 in our department were collected,all of them were treated with short-segment pedicle instrumentation.The radiologic,neurologic,and functional outcome were assessed.[Result]All of the 47 cases were followed up,the mean follow-up were 51.9 months(18~ 86 months),the average of vertebral anterior and posterior height were corrected from 43.6%,71.4% to 92.2%,96.4%;and 88.3%,93.1% at the last follow-up separately.The Cobb's angle were corrected from 23.5?to 4.3?,and 8.8? at the last follow-up.62.8% of the vertebral canal was occupied pre-operation,and 11.4% post-operation,6.2% at last follow-up.There was significant deference in targets between pre-operation and post-operation(P0.05).Neurologic status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia.61.7% of patients returned to work.[Conclusion]Short-segment pedicle instrumentation can provide good reduction,strong fixation,complete decompression and fusion.The treatment outcome is good.Moreover,it is a less traumatic,simple and safe technique.

[Objective]To investigate the feasibility of the placement of pedicle screws in the thoracolumbar vertebrae under X-ray fluoroscopy step by step.[Method]Eight human cadaveric thoracolumbar spines(T9~L5) were selected and classified into group A and group B randomly,each having 4 specimens.Pedicle screws in group A were placed under X-ray fluoroscopy step by step.CT scanned the specimens of group A and measured the half pedicle length,full pedicle length and the pedicle screw passage length.The "e" angle and "f" angle of pedicle were measured on CT images.When the guide wire was pricked to the half of pedicle length,the wire tip was located at the middle line of the pedicle projection in the standard posterior-anterior image.When the wire was pricked to the full pedicle length in lumbar vertebrae,its tip was located at 3/4 line of the pedicle projection in the standard posterior-anterior image.When the wire was pricked to the full pedicle length in thoracic vertebrae,its tip was located at between 1/2 line and 3/4 line of the pedicle projection.When the wire was pricked into vertebrae,the depth of the wire and the "e" angle were noted in standard lateral image.Pedicle screws were placed by the track of the guide wire.Pedicle screws in group B were placed by traditional technique.The accuracy and feasibility of the method under X-ray fluoroscopy step by step were evaluated by observation of the position of the pedicle screws in group A and group B.[Result] Four of 72(5.56%) pedicle screws were found to have perforated the pedicle wall in group A,and 19 of 72(26.38%) pedicle screws perforated the pedicle wall in group B.The result of group A was superior to that of group B(P

Objective To discuss the individual method and its feasibility and security of balloon kyphoplasty for the treatment of osteoporotic vertebral fractures with vertebral body wall incompetence. Methods Thirty-nine vertebral bodies were performed for kyphoplasty in 35 osteoporotic patients with vertebral compression fractures with incompetence of vertebral body wall. During operation, the cement was injected twice to avoid anterior leaking in the patients with anterior wall incompetence, while in the patients with posterior or lateral wall incompetence, the cement was injected with continuously X-ray monitoring by C-arm to prevent lateral or posterior leaking. The symptoms improvement, vertebral height restoration and complications were observed. Results All patients tolerated the procedure well with immediate relief of back pain after kyphoplasty. No symptomatic complications were found in all patients. The vertebral height had a recovery rate of 68.46%, and the mean Cobb angle was improved 8.6?. There was significant difference in Cobb angles between preoperation and postoperation (P

[Objective]To explore the complications of tibial fracture treated with interlocking intramedullary nail.[Method]The full data of 785 cases of tibial fiacture treated with interlocking intramedullary nail were studied retrospectively.[Result]Mean follow-up period was 27 months (8~40months).There were some complications as follows: infection rate was 2.7% (21 cases),fracture nonunion 1.5% (12 cases),fracture delayed union 6.8% (53 cases),fracture malunion 0.9% (7 cases),knee pain 6.8% (53 cases),nail broken 1.4% (ll cases),locking screw broken or drop out 2.2% (17 cases).[Conclusion]Proper manipulations,strict indications,and postoperative treatment are vital to prevent the complications.

Objective To investigate the changes of cellular configuration and polarized characteristic of visual pigment during the development of rod cells of neonatal calf in vitro. Methods Retinal cells of neonatal calf were dissociated and cultivated for 10, 20, 30 and 40 days in vitro were used for immunocytochemical analysis. Retinal rod cells were identified by rho4D2 antibody. The configuration of positive cells and rhodopsin molecular distribution were analysed at different cultivated time. The immuno-reactivity of positive cells was measured by image analysis system. Results The rho4D2 immuno-reactive cells included small round cells without protuberance and the cells with protuberance at the peak. At the 10th day after cultivation, the visual pigment immunoreaction was suffusive in the whole cell membrane and apical process; while at the 30th and 40th day, it gathered at the membrane of apical process or one pole of the cells. The results of quantitative analysis showed that the immunoreactive intensity of positive cells at the 20th day after cultivation was stronger than that at the 10th day; while there was no significant difference among the immunoreactive intensity at the 20th, 30th, and 40th day. Conclusions Rod cells at the 30th and 40th day after cultivation have the polarized characterization and visual pigment molecular distribution with high level of expressive ability of protein, which are mature neurons.

Objective To describe CT and MRI imaging findings of retinal hamartomas with tuberous sclerosis and evaluate their clinical value.Design Retrospective case series.Participants 7 patients of tuberous sclerosis complex(TSC) who have ocular lesions found with CT and MRI examination.Methods 7 patients with tuberous sclerosis were diagnosed by clinical data and head CT.The size,morphology,density and enhancing situation of the retinal lesions were observed with CT and MRI,as while as with direct or indirect fundoscopy.Main Outcome Measures CT and MRI features of ocular lesions.Results 7 cases displayed intracranial calcification and/or non-calcified tubercles,situating in subendyma(7 cases,accounting for 100%) by head CT.Orbital CT and MRI showed 4 cases (57.1%) of flat retinal hamartomas 3 cases(42.9%) of retinal lobular and nodular hamartomas,2 cases(28.6%) scattered calcification patches in hamartoma,and 2 cases(28.6%) of nanophthalmos.The lesions displayed unenhancement on contrast-enhanced MR images in 7 cases(100%).There was 1 case(14.3%) of progressive retinal astrocytic hamartoma.Conclusion The examination of CT and MRI may find the bigger retinal hamartomas,which can play a very important role at the diagnosis with the help of whole brain examination. For progressive retinal astrocytic hamartoma,systemic evaluation with CT and MRI can provide evidence for choosing appropriate thera- pies.

AIM:To investigate the effect of hydrogen sulfide (H2S) on the expression of MAPKs and ileal epithelial cell apoptosis in the rats with intestinal ischemia-reperfusion ( I/R) injury.METHODS:Healthy female Wistar rats were randomly divided into sham operation group, I/R group, I/R+sodium hydrosulfide ( NaHS) group .The animal model of intestinal ischemia reperfusion was established.Apoptosis index ( AI) of ileal epithelial cell was measured by TUNEL assay.H2 S was detected by sensitive sulfide electrode.The mRNA expression of ERK, JNK and p38MAPK was detected by RT-PCR.The protein levels of phosphorylation( p)-ERK, p-JNK, p-NF-κB P65 and p38MAPK were deter-mined by Western blot.RESULTS:H2 S, ERK mRNA and p-ERK in I/R group were significantly higher than those in I/R+NaHS group and sham group while JNK mRNA, p38MAPK mRNA, p-JNK, p-p38MAPK, p-NF-κB P65 and AI were predominantly higher than those in I/R+NaHS group and sham group (P<0.01).CONCLUSION:H2S attenuates ileal epithelial cell apoptosis in the rats with intestinal I/R injury by down-regulating ERK mRNA p-ERk and up-regulating JNK mRNA, p38MAPK mRNA and phosphorylation of JNK, p38MAPK and NF-κB P65.

Objective To study the change in endogenous hydrogen sulfide (H2S) in patients with acute pancreatitis and its relationship to coagulation function. Methods A prospective case control study was conducted. Forty patients with mild acute pancreatitis (MAP group) and 40 with severe acute pancreatitis (SAP group) admitted to Yiwu Central Hospital in Zhejiang Province from December 2002 to March 2015 were enrolled. Forty healthy persons served as control (healthy control group). Blood was collected to determine the levels of H2S, blood coagulation factor Ⅷ (FⅧ), von Willebrand factor (vWF), plasminogen (PLG), antithrombin (AT), platelet count (PLT), tissue factor (TF), tumor necrosis factor-α (TNF-α), and protease activated receptor-1 (PAR-1). The correlations among the above parameters were analyzed. Results There was no statistical significance in sex, age, body weight and time of disease among three groups, indicating it was comparable among the groups. Compared with healthy control group, the levels of H2S, FⅧ, vWF, TF, TNF-α, and PAR-1 in MAP and SAP groups were significantly elevated [H2S (μmol/L): 67.42±6.34, 112.47±12.69 vs. 42.57±4.18, FⅧ: (67.5±5.8)%, (82.3±4.7)% vs. (57.2±6.4)%, vWF: (112.6±9.7)%, (142.5±12.5)% vs. (76.4±8.2)%, TF (ng/L): 45.27±4.34, 64.76±6.25 vs. 18.15±1.89, TNF-α (ng/L): 197.67±13.62, 324.72±25.54 vs. 20.08±2.57, PAR-1 (fluorescence intensity): 32.16±4.43, 56.12±7.07 vs. 12.27±2.12, all P < 0.01], and PLG and AT activity were significantly decreased [PLG: (52.4±4.7)%, (36.7±3.2)% vs. (62.1±5.6)%, AT: (43.2±6.9)%, (35.5±5.4)% vs. (53.6±6.1)%, all P < 0.01]. The changes in the parameters in SAP group were more remarkable than those in MAP group (all P < 0.01). PLT in SAP group was significantly lower than that in healthy control and MAP groups (×109/L: 8.5±1.1 vs. 15.7±2.8, 12.4±1.9, both P < 0.01). H2S was positively correlated with FⅧ, vWF, TF, TNF-α, and PAR-1 (r value was 0.56, 0.61, 0.72, 0.66, 0.64, respectively, all P < 0.01), and it was negatively correlated with PLG and AT (r value was -0.64, -0.57, both P < 0.01). Conclusion As an inflammatory factor, endogenous H2S deteriorates coagulation function in patients with acute pancreatitis by up-regulating TF, TNF-α, and PAR-1.

Objective To study on the ultrastructural characteristic of segments of photoreceptors from neonatal retinas for supporting donor retina choice of retinal transplantation. Methods Photoreceptors from neonatal calf and adult calf were analysed by scanning electron microscopy and transmission electron microscopy. Results Segments of photoreceptors from neonatal calf appeared the mushroom pattern, in which, distal end of outer segment which was ball shaped formed the head with mushrooms appea rance, and the inner segments along with some of outer segments formed the body with mushrooms appea rance. Within the outer segment, plasma membranes of adjacent evaginations form a disk subsequently. The array of most disks were vertical to the entire length of segments, but some were parallel and slope to. Owing to the incomplete formation, some rim of disk near distal end of outer segment revealed step shaped appearance. The distal end of outer segment displays some processes consisted of membranous discs, much vesicular material and mitochondria, much rough endoplasmic reticulum (RER) and numerous polysomes. Segments of photoreceptor connected with outer nuclear layer via the external limiting membrane. Conclusion The typical morphological structures of outer segments suggest the immature and strong gowth ability of photoreceptors of the retina of neonatal calf, and therefore the competence for donor material of retinal transplantation.

Objective To explore the effects of drugs on functions of mitochondria in retinal nerve cells, and to lay a foundation of the investigation of drug protection for retinal nerve cells. Methods Cultivation of the retinal nerve cells of 8 eyes of neonatal calves was performed. The changes of fluorescent density of the mitochondria of cultured cells labeled by dye rhodamine 123 (Rh123) before and after the activation of the medicines, including ferulic acid (FA), arginine, glycine, taurine, vitamine E and brain-derived neurotrophic factor (BDNF) respectively, were detected by laser-scanning confocal microscopy. Results FA with the concentration of 500 ?g/ml led the diphasic variation of the fluorescent intensity of mitochondria. After scanning for 60.772 seconds when treated with FA firstly, the fluorescent intensity decreased rapidly (from 45.425?4.153 to 22.135?5.293); while after 112.774 seconds when treated secondly, the intensity increased obviously (from 19.655?4.383 to 28.247?4.764), and after 168.773 seconds when treated thirdly the intensity still increased. After scanning for 56.457 seconds when treated with vitamin E (12.5 mg/ml), the fluorescent intensity increased obviously (from 88.255?5.039 to 111.273?4.529), which suggested that vitamin E with the concentration of 12.5 mg/ml strengthen the fluorescent intensity. After scanning for 58.147 and 134.148 seconds when treated with BDNF (50 ng/ml) respectively, the fluorescent intensity increased obviously (from 69.115?5.038 to 77.225?5.131) which suggested that BDNF with the concentration of 50 ng/ml led the increase of the fluorescent intensity. Glycine (2.5 mg/ml) and arginine(30 mg/ml) didn't affect the fluorescent intensity of mitochondria, and taurine (6.25 mg/ml) caused the appreciable decrease of the fluorescent intensity. Conclusion FA, BDNF and vitamin E may promote the metabolism of retinal nerve cells via the path of mitochondria, while amino acids may adjust the activation of retinal nerve cells through other ways.