ObjectiveTo investigate the effect of operation treating spinal multi-level tuberculosis.Methods45 patients with multi-level spine tuberculosis were treated with debridement completely and anterior or lateral-anterior intervertebrae autograft. Of them, 5 patients added to anterior instrumentation.Results45 patients had been followed up for 12 to 40 months.The back pain of 40 cases were relieved within 5 weeks after operation, erythrocyte sedimentation rate decreased 3 weeks after operation. 38 patients who involved in kyphosis decreased their kyphosis mostly and only one patient lost 3 degrees in follow-up.15 patients who involved in neurological deficits improved one or two grades (Frankel). Grafts fused in 44 patients and there were no recurrent in follow-up.Conclusions Operative treatment is efficacious to multi-level body spine tuberculosis.

OBJECTIVETo explore the clinical effects of Dynesys system for the treatment of multiple segment lumbar degenerative disease.

METHODSA total of 28 patients with lumbar degenerative disc disease treated with Dynesys system from December 2008 to May 2011 were retrospectively reviewed. There were 16 males and 12 females, aged from 27 to 75 years old with an average of 49.1 years. Thirteen patients with multiple segmental lumbar intervertebral disc protrusion, including L3-L5 in 7 cases, L2-L4 in 1 case and L4-S1 in 5 cases. Fifteen patients with multiple segmental lumbar spinal stenosis, including L3-L5 in 10 cases, L4-L5 in 4 cases and L2-S1 in 1 case. The symptoms of lumbago and (or) intermittent claudication in all patients were treated with conservative treatments for more than 6 months and these methods did not work. Visual analogue scale (VAS) was used to analyze the lumbar and leg pain, imaging data were used to measure the intervertebral space height and intervertebral motion of fixed segment and upper adjacent segment, Oswestry Disability Index (ODI) was used to evaluate the clinical effect.

RESULTSAll operations were successful and the patients were followed up from 38 to 65 months with an average 50.6 months. At final follow-up, ODI and VAS of the low back pain and leg pain were (25.10±6.52)%, (1.25±0.70) points and (1.29±0.89) points, respectively and were decreased compared with preoperative (P<0.05). Postoperative intervertebral space heights were increased and intervertebral motions were decreased in fixed segment compared with preoperative (P<0.05). There were no significant differences in intervertebral space heights and intervertebral motions of upper adjacent segment between preoperative and postoperative (P>0.05).

CONCLUSIONDynesys system may obtain long-term clinical curative effect in treating multiple lumbar degenerative disease. It can partially preserve the intervertebral motions of the fixed segments, have little effect on adjacent segments. The long-term clinical effect of Dynesys still need longer time follow-up observation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Joint Instability ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Visual Analog Scale

OBJECTIVETo analyze effects of fracture of processus styloideus ulnae on prognosis in the treatment of distal radial fracture of type C according to AO classification.

METHODSThis was a retrospective case-control study, and the information was got ten through case evaluation and follow-up, including sex, age, patient satisfaction, Gartland & Werley score and radiographic score. There were 76 patient treated with open reduction and plate fixation in People's Hospital Affiliated to Peking University from July 2006 to July 2011. All the patients were divided into two groups: no combination with fracture of processus styloideus ulnae (group A, 56 cases), combination with fracture of processus styloideus ulnae (group B, 20 cases). The patients in group A and B were treated with open reduction and internal fixation; however the fracture of processus styloideus ulnae was not fixed. The indexes such as clinical data, bone grafting, joint movement, Gartland & Werley score and radiographic score were compared between two groups.

RESULTSThe ulnaris pain of patients in group B was more obvious than that in group A. The local VAS, palmar and dorsal flexion degree of wrist joint, motion VAS, patients satisfaction score, radial and ulnar deviation degree, pronation and supination of forearm degree, Gartland & Werley score and radiographic score were separately 0.1 ± 0.1, (51.1 ± 1.9)°, (60.2 ± 1.9)°, 0.6 ± 0.1 (23.1 ± 0.9)°, (28.7 ± 1.3)° (81.5 ± 2.6)°, (68.2 ± 2.7)° 1.9 ± 0.3, 89.6 ± 12.3 in group A; and separately 0.3 ± 0.3, (51.4 ± 2.3)°, (66.6 ± 1.7)°, 0.5 ± 0.2, (24.5 ± 2.0)°, (26.9 ± 1.8)°, (80.3 ± 2.5)°, (70.3 ± 3.7)°, 1.2 ± 0.4, 92.5 ± 7.5 in group B; there were no statistical differences in above indexes between two groups.

CONCLUSIONWhether the distal radial fracture with a concomitant unrepaired ulnar styloid fracture or not exerts no influence on mainly outcomes including function, radiography and motion of the wrist.

Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Radius Fractures ; surgery ; Retrospective Studies ; Ulna Fractures ; surgery

Objective To evaluate the outcome of percutaneous K-wire leverage reduction and fixation for O'Brien Ⅱ,Ⅲ pediatric radial neck fracture.Methods From March 2010 to February 2013,16 children with O'Brien Ⅱ,Ⅲ pediatric radial neck fracture were operated in our hospital.There were 6 females and 10 males aged from 6 to 14 years old.There were 12 left arms and 4 right arms.Concomitant injuries included proximal ulna fractures in 2 cases and medial epicondyle fracture of humerus in 1 case.All children present a swollen and painful elbow with loss of rotation and pain on pronation and supination.The mean visual analogue score (VAS) was 7.9 (range,6.5-9.2).The flextion,extention,pronation and supination of elbow were 78°±3°,-54°±4°,9°±3° and 5°±3° in average.All cases were classified by the O'Brien system,including 9 cases of Ⅱ type and 7 cases of Ⅲ type.Mechanism of injury was fall from a height.The interval between injury and surgery averaged 2.8 days.Percutaneous leverage reduction and fixation were performed for 16 patients.After confirming successful reduction,the wire was advanced to the far cortex of the radius and penetrated into the far cortex to maintain the reduction status.4 weeks of long-arm cast followed by functional exercises were carried out for all patients.We analyzed radiographs and clinical results according to the criteria suggested by Metaizeau.Results 16 patients were followed up for 11.8 month in average after operation.14 patients were gained anatomical reduction.No patient had posterior interosseous nerve injury,fracture redisplacement and pin site infection.All fractures healed in a mean of 4.1 weeks.The follow-up flextion,extention,pronation and supination of elbow were 136°±4°,-2°±2°,81 °±4° and 75°±4° in average.Follow-up radiographs showed no patient had avascular necrosis of radial head.One patient had physeal arrest after 15 months of operation and outpatient follow-up observation were conducted.According to Metaizeau function scale,8 were excellent,7 good and 1 fair.The healing rate was 93.8％ (15/16).Conclusion Percutaneous joystick reduction and fixation technique have good effect for O'Brien Ⅱ,Ⅲ pediatric radial neck fracture,which is simple and easy to master.

In this paper, the process performance indexes (PPIs) P(p) and P(pk) were introduced and applied to evaluate the process capability and quality consistence of Chinese medicine products. The historical quality analysis data of Qingkailing injection were collected and taken as the research object. The confidence intervals of P(p) and P(pk) were estimated based on the Bootstrap sampling methods. Results showed that the value and width of the confidence interval P(p) of were smaller that of P(pk) suggesting that the P(pk) index was more sensitive than P(p) in process capability analysis. Within the production period concerned, the P(pk) values estimated from different quality indexes of Qingkailing injection, such as baicalin, cholic acid, geniposide and total nitrogen, were 1.122, 2.055, 1.564 and 0.891, respectively. It could be found that the cholic acid had the highest process capability, followed by the geniposide and baicalin. The total nitrogen had the lowest process capability, indicating that it is necessary to reinforce the quality management of total nitrogen related manufacturing processes. The case studies demonstrate the effectiveness and feasibility of PPIs, which are convenient to be used in production practice of Chinese medicine.
Chemistry, Pharmaceutical ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Injections ; Quality Control

OBJECTIVETo examine the effect of particulate matter (PM) less than 10 microns in diameter (PM10) and ozone (O3) on daily mortality in Shanghai, China.

METHODSA generalized additive model with penalized spline function was used to observe the acute effect of PM10 and O3 on daily mortality.

RESULTSHigher PM10 significantly increased the effect of O3 on total mortality, and O3 also increased the effect of PM10 although the estimated increment was statistically insignificant.

CONCLUSIONOur findings provide further evidence for the effect of PM10 and O3 on daily mortality.

Air Pollutants ; toxicity ; China ; epidemiology ; Humans ; Mortality ; Ozone ; toxicity ; Urban Population

OBJECTIVETo evaluate the clinical difference of locking and non-locking plates in the treatment of distal radial fractures in the elderly.

METHODSForty-nine patients with an average age of 68 years were included. The mean follow-up was 30 months. Five cases were traffic related injury, and others were simple falls. Fractures were classified according to AO classification system: 9 cases of A3, 4 cases of B, 11 cases of C1, 18 cases of C2, 7 cases of C3. Patients were grouped as locking group (29 cases) and non-locking group (20 cases).

RESULTSSignificant difference was not found between the two groups in active range of motion, Gartland and Werley score, radiological measurements and score.

CONCLUSIONLocking and non-locking plates have the same clinical outcome in the treatment of distal radial fractures in the elderly.

Aged ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Retrospective Studies ; Treatment Outcome

AIM: To study the chemical constituents of the roots of Achyranthes bidentata Bl. METHODS: The chemical constituents were isolated and purified by macroporous adsorptive resin D101, silica gel, and ODS column chromatographies and preparetive HPLC. Their structures were elucidated on the basis of 1D and 2D NMR analyses. RESULTS: Two feruloyl tyramine glycosides and seven triterpenoid saponins were obtained and identified as N-trans-feruloyl-3-methoxytyramine-4'-O-β-D-glucopyranoside (1), N-trans-feruloyl-3-methoxytyra mine-4-O-β-D-glucopyranoside (2), PJS-1 (3), chikusetsusaponin IVa (4), oleanolic acid 3-O-[β-D-glucuronopy ranoside-6-O-methyl ester]-28-O-β-D-glucopyranoside (5), oleanolic acid 3-O-[β-D-glucuronopyran-oside-6-O-ethylester]-28-O-β-D-glucopyranoside (6), oleanolic acid 3-O-[β-D-glucuronopyranoside-6-O-butyl ester]-28-O-β-D-glucopyranoside (7), ginsenoside R(0) (8) and hederagenin-28-O-β-D-glucopyranosyl ester (9). CONCLUSION Compound 1 is a new feruloyl tyramine glycoside, while compounds 2 and 9 are reported from A. bidentata for the first time.
Achyranthes ; chemistry ; Glucosides ; chemistry ; isolation & purification ; Molecular Structure ; Plant Extracts ; chemistry ; Plant Roots ; chemistry ; Saponins ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification ; Tyramine ; analogs & derivatives ; chemistry ; isolation & purification

OBJECTIVETo investigate the characteristics of work needed to release adhesion in the early stage of flexor tendon healing.

METHODSEighty-four profoundus flexor tendons of the 3rd toe of Sanhuang chicken were severed and repaired by either Modified Kessler technique or Tsuge technique randomly. At 0, 1, 4, 7, 10, 14, 21 d after the operation, 6 tendons from each repair technique group were harvested and tested by biomechanical test machine. An elongation force-elongation distance curve was obtained and work of adhesion release was calculated in this curve. Whether adhesion band had been released or not was confirmed by gross inspection immediately after the test.

RESULTSWork of adhesion release: this work significantly increased at the 7th day in Modified Kessler group and at the 10th day in Tsuge group. Modified Kessler group was significantly higher than Tsuge group at the 7th day. At the 21st day after operation, adhesion could not be effectively released by full range excursion of flexor tendon profoundus.

CONCLUSIONWork of adhesion release begins to increase significantly since the 7th approximately 10th day postoperatively. At the 21st day after the operation, adhesion could not be fully released by full range of flexor tendon profoundus flexion.

Animals ; Chickens ; Male ; Stress, Mechanical ; Suture Techniques ; Tendon Injuries ; physiopathology ; surgery ; Tendons ; pathology ; physiopathology ; Tensile Strength ; Time Factors ; Tissue Adhesions ; physiopathology ; Wound Healing

OBJECTIVETo compare the biomechanical characteristics of 2 different repair methods:Modified Kessler and Tsuge.

METHODSEighty-four profound flexor tendons of 3(rd) toe of Sanhuang chicken were severed and repaired by either Modified Kessler or Tsuge method randomly. Six repaired tendons for each repair method were harvested at 0, 1, 4, 7, 10, 14, 21 days after operation and tested in an Instron 1185 biomechanical testing machine. An elongation force-elongation distance curve was obtained, and biomechanical meters (including rupture force and rupture work) were calculated from this curve.

RESULTSRupture force: rupture force significantly decreased at 10(th) and 14(th) day in both repair groups, and returned to immediate level at 21(st) day in Modified Kessler group but not in Tsuge group; Tsuge method was significantly higher than Modified Kessler group at time-points immediately and 7 days after operation. Rupture work: this work significantly decreased at 10(th) (65.17 mJ) and 14(th) (40.0 mJ) day and resumed to immediate level at 21(st) day in Modified Kessler group; While in Tsuge group, it decreased significantly at 14(th) and 21(st) day. Tsuge method was significantly higher than Modified Kessler group only at time 0.

CONCLUSIONThe biomechanical properties decrease significantly after 10(th) day at both repair method groups. It resumes to immediate level at 21(st) day in Modified Kessler group. There is no significant difference after 10(th) day between both repair methods.

Animals ; Biomechanical Phenomena ; Chickens ; Disease Models, Animal ; Orthopedic Procedures ; methods ; Reconstructive Surgical Procedures ; Suture Techniques ; Tendon Injuries ; surgery ; Tendons ; surgery