28 days after injury (P < 0.05). In the fracture+spinal cord injury group, the level of serum transforming growth factor beta 1 had a rapid increase on the 7th day, and reached the peak on the 14th day, and then, this level had no significant decrease until the 28th day. In the simple fracture group, the level of serum transforming growth factor beta 1 began to increase on the 2nd day, reached the peak on the 7th day, and then decreased gradualy. Remarkable changes of serum transforming growth factor beta 1 levels in patients with bone fracture combined with spinal cord injury may be associated with fracture healing in different periods.

Objective To investigate the expression of S-phase kinase associated protein 2 (Skp2) in rats with acute liver failure (ALF) and its significance. Methods There were 256 male SD rats used in this study, among which 240 were injected with D-galactosamine (D-GaIN) to set up ALF model. The rats were divided into 3 groups: ALF model group, free hepatocellular transplantation group, microencapsulated hepatocyte transplantation group, which were intraperitoneally injected with 2 mL of RPMI 1640 culture medium, free hepatocellular suspension and microencapsulated hepatocyte suspension, respectively. The other 6 rats were in control group and the rest 10 rats were used for hepatocyte isolation. Expressions of Skp2 protein in hepatocytes of rats at different time points were detected by immunohistochemical technique. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) were detected by automatic biochemistry analyzer. The survival rate in each group was observed. Comparisons among groups were done using one-factor analysis of variance. Results Levels of ALT, AST and TBil decreased more significantly by intraperitoneal transplantation of microencapsulated hepatocytes than those by intraperitoneal transplantation of free hepatocytes (P<0. 05). Skp2 labeling indices after 36 h of injection in ALF model group, free hepatocellular transplantation group and microencapsulated hepatocyte transolantation grouo were (28. 2±6.1) %, (41.4± 10. 5) % and (68. 0±10.8) %, respectively (F=29. 08 , P<0. 05). There were 4, 6 and 11 out of 15 rats survived in the 3 groups, respectively. Conclusion The dynamic observation of Skp2 expression could be used to judge the regeneration of hepatocytes.

Objective To discuss effects of Wugong Baidu Drink on expressions of Bcl-2, NF-κB mRNA genes related to the apoptosis of HaCaT in psoriasis. Methods Wistar rats were randomly divided into 6 groups:blank group, Western medicine control group, TCM control group, and Wugong Baidu Drink high, medium, and low dose groups. They were given normal saline, methotrexate suspension, compound natural indigo capsule suspension, and the different doses of Wugong Baidu Drink for gavage, respectively. Drug-containing serum of each group was prepared, and was put in the HaCaT respectively to subculture. The intervention effect of different Drug-containing serums on expressions of objective genes were detected through PR-PCR method. Results Drug-containing serum of each group could decrease the expressions of Bcl-2 mRNA and NF-κB mRNA. The most obvious effects were shown in the groups of Western medicine control group and Wugong Baidu Drink high dose group. All Wugong Baidu Drink groups showed a dose-response relationship. Conclusion Wugong Baidu Drink probably can promote the apoptosis of HaCaT by reducing the gene expressions of Bcl-2 and NF-κB. It can also decrease immune response by regulating serum factors related to T cells to play the role of anti-psoriasis.

Objective To investigate the relationship of iPTH levels, calcium and phosphorus metabolism with cardiovascular event status in the chronic renal failure (CRF) patients. Methods This article retrospectivly studied the clinical and laboratory data of 87 CRF patients. 66 patients of A group didnt occur cardiovascular events,and 21 cases of B group occurred cardiovascular and cerebrovascular events. This article analyzed iPTH levels,serum calcium, phosphorus, calcium and phosphorus product and therelationship between cardiovascular and cerebrovascular events between the two groups. Results Decreased iPTH,increased serum C reactive protein and increased lipoprotein(a) had relationship with cardiovascular and cerebrovascular events in patients with chronic renal failure,but calcium,phosphorus,calcium and phosphorus product has nothing to do with the cardiovascular and cerebrovascular events. Cardiovascular and cerebrovascular events increased significantly in dialysis patients than in non - dialysis patients. Conclusiou Chronic renal failure patients on dialysis levels of serum iPTH, CRP level, LP(a) level and dialysis could lead to cardiovascular and cerebrovascular events.

BACKGROUND:The cervical pedicle screws mistakenly inverted the cervical pedicle could lead to the many complications such as spinal cord,vertebral arteries and nerve root damage.If the parameter of inserting pedicle screws were measured accuracy,the rate of inserting pedicle screws successfully could be improved.OBJECTIVE:To get 3D anatomic parameter of inserting pedicle screws in the cervical vertebrae with the CT three-dimensional recontruction.METHODS:The Dicom data that the cervical vertebrae had been scanned by SIEMENS EMOTION 16 CT were converted into the soft Mimics 8.1,GE workstation and three-dimensional cervical vertebrae were reconstructed.The parameters of inserting cervical pedicle screws were measured with the consideration of the diameter of pedicle screw.RESULTS AND CONCLUSION:The cervical three-dimension images were reconstructed clearly with the CT three-dimensional reconstruction techniques.The cervical pedicular width,the axial length,α and β angles were measured by the soft measure function.The average inserting angular safe range of α angle was gained with the consideration of the diameter of pedicle screw.This method can mimic the operation and it is significant way in measuring the three-dimension anatomic parameter of the cervical vertebrae.The method is a good way that how to insert the cervical pedicle screw safely.

Objective To investigate the effects of protein-enriched meal on uric acid and renal function among overweight and obese Chinese adults during weight loss. Methods People, 18-55 yearsold, with body mass index 25-35 kg/m2 and triglycerides 1.7-5.4 mmol/L were enrolled. Major exclusion criteria were: type 2 diabetes, weight reducing surgery or use of weight loss drugs, chronic kidney disease, and hepatic dysfunction. A high-protein (HP) diet (protein energy ratio was 30%) or a standard-protein (SP) diet (protein energy ratio was 15%) was provided to eligible subjects for 12 weeks (84 days). Energy intake was calculated by Katch-McArdle formula:basal metabolic rate=370+21.6 × lean body mass (kg) and coefficient of variation. All the subjects were followed up at day 0,week 4,week 8,and week12. The changes of triglyceride (TG), total cholesterin (TC), low density lipoprotein (LDL), uric acid (UA), blood urine nitrogen (BUN) and creatinine (Cre) were determined at day 0, week 4, and week 12. Results Ninety-four subjects with HP (n=49) or SP (n=45) were enrolled, and seven subjects were withdrawn for refusing the following visit. The average age was (42.68±8.98) years in HP group, and (41.09±9.67) years in SP group (P>0.05). At week 12, the BMI drop was significant in both groups from baseline, but with no significant difference between the two groups. The decreases of TG (mmol/L) at 4 weeks and 12 weeks were significant compared with the baseline (0 d, 4weeks, 12 weeks:HP:2.18±1.18, 1.77±0.82, 1.86±0.83;SP:2.60±2.67, 2.03±1.28, 1.92±0.79) (P<0.05),but with no significant difference between the two groups. Compared with the baseline, the decrease of UA (mmol/L) at 4 weeks in HP group was significant (0 d, 4 weeks, 12 weeks:HP:326.12± 88.31, 294.76 ± 106.57,307.15 ± 94.70;SP:325.62 ± 87.16,321.51 ± 101.19,315.71 ± 86.77) (P<0.05). The BUN and CRE in both groups increased slightly compared to baseline level, but remained in the normal range. Conclusion Comparison of HP and SP groups showed that renal function did not change significantly, the levels of UA in HP group decreased significantly than that in SP group.

Objective To study the application of cervical vertebral artery CT angiography(CTA) preoperatively in the screw setting of upper cervical spine.Methods The data of 170 patients who underwent upper cervical spine surgery from January 2014 to December 2015 in our hospital were retrospectively analyzed,of whom 80 cases with typeⅡodontoid fractures,90 cases with atlantoaxial dislocation;20 cases were operated with occipitocervical fusion,150 cases treated with atlantoaxial fusion.Seventy-eight cases were examinated by cervical vertebral artery CTA before sugery(observation group) but the other 92 cases(control group).The rate of the vertebral arterial lesion between the two groups were compared.Results Six cases with vertebral artery injury in control group,the incidence of arterial injury was 7％;unilateral vertebral artery was found in 3 cases,small congenital development of left cervical vertebral artery in 5 case,abnormal branch in 5 cases.The rate of dysplasia was 17％,and the rate of vertebral artery injury was 0.The rate of vertebral artery injury in control group was higher than observation group,the difference was significant(P<0.05).Conclusion Vertebral artery CTA examination preoperatively may become a routine examination,in order to make the operator carefully evaluate the relationship between the vertebral artery with atlantoaxial vertebral,choose the accurate screw-setting and avoid the vertebral artery injury in the upper cervical spine surgery.

AIM: To observe the restorative effect of compound flap transplantation on the scar of functional position after burns. METHODS: Twenty inpatients with scar of functional position after burns treated by compound flap transplantation were selected from the Department of Burns and Plastic Surgery, First Hospital Affiliated to Liuzhou Medical College between May 2002 and December 2005, and all patients knew and agreed with the items. All patients were removed of the scar of functional position under whole-anesthetization to transplant the acellular allogenic dermis (It was manufactured by Beijing Dieyalaifu Biotechnological Co., Ltd of Guangxi Beisheng Pharmaceutical Group, and it was characteristics of soft, flexible with better tenacity. Besides, it was milk white in net with two kinds of surfaces: smooth surfaces and rough surfaces). Acellular allogenic dermis of rough surface closely adhered to the wound with smooth surface up toward, and the wound was sutured. Autologous skin grafts (obtained from scalp, trunk or extremities) were transplanted into acellular allogenic dermis, and the flap gaps shall be kept as small as possible, so as to reduce the exposure of acellular allogenic dermis. Wounds were dressed at 2 weeks postoperation, and the follow-up was conducted regularly. The survival rate, contraction rate, the smooth and glossy degree, skin elasticity, joint function, and healing of donors were observed from 2 weeks to one year after the surgery. RESULTS: Twenty patients were followed after compound flap transplantation with the time ranged from one month to one year, including 4 patients within 1-3 months, 3 patients within 3-6 months, and 13 patients within 6 months to one year. Thirty functional positions out of 31 healed in the first period. While the flap in another position was influenced by exposed acellular allogenic dermis due to over large gaps among autoallergic flaps. The survival rate of transplanted flap was 93.00%, and the flaps transplanted were smooth in appearance with proper elasticity and less contraction, and the joint range of motion was better. The skin of donor site recovered better. CONCLUSION: Compound flaps can significantly ameliorate the functional disturbance and deformities caused by scar of functional position after burns with high survival rate.

Objective To expore the difference between magnetic resonance image ( MRI) expression of spinal tuberculosis and brku-cellare spondylitis. Methods Retrospectively analyzed the clinical data of 10 patients with tuberculous spondylitis and 12 patients with bru-cellar spondylitis from Jan. 2012 to Oct. 2013. All the patients were scanned by MRI, and the expression difference of MRI were compared. Results The vertebral body of spinal tuberculosis was destroyed severely, and it often accompanied by the kyphosis and multiple-level para-vertebral abscess, and even adjacent organs tuberculosis. The vertebral body of brucellar spondylitis was destroyed lightly,and the abscess is often limited. Conclusion We can distinguish spinal tuberculosis and brucellar spondylitis by the typical difference of the expression of MRI.

BACKGROUND:The method in repair of primary lumbar intervertebral infection is different in different positions, mainly containing anterior, posterior and anteroposterior pathways. In posterior pathway, muscle gap approach is recognized by many fel ows. This program has its special advantage compared with conventional posteromedial approach. OBJECTIVE:To evaluate the clinical effects of debridement, bone graft and internal fixation of pedicle screw placement in repair of primary lumbar intervertebral infection through posterior paraspinal muscle approach. METHODS:Clinical data of 13 patients with primary lumbar intervertebral infection were analyzed retrospectively. There were one case of L 2-L 3 , two cases of L 3-L 4 , four cases of L 4-L 5 and six cases of L 5-S 1 . Lumbar pain was obvious in al patients. Nine cases suffered from radioactive lower limb pain. Al patients received debridement, bone graft and internal fixation of pedicle screw placement through paraspinal muscle approach via posteromedial incision. After treatment, clinical effects were evaluated using Visual Analog Scale and lumbar Japanese Orthopaedic Association scores. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months, no recurrence. X-ray review demonstrated bony fusion, so loosening and breakage were not found in al patients. Visual Analog Scale scores revealed that Visual Analog Scale score was 8.15 preoperatively, 2.15 at 1 week postoperatively, 1 at final fol ow-up, showing significant difference (P<0.05). There was significant difference in pain between pre-treatment and post-treatment, and pain apparently relieved after treatment. Lumbar Japanese Orthopaedic Association score showed that effective outcomes were found in al patients after treatment, including nine cases of excel ent effects, three cases of good effects, one case of average effects, with the excel ent and good rate of 92%. Above findings confirmed that one-stage debridement, bone graft and internal fixation of pedicle screw placement through posterior muscle gap approach provides a good repair method for patients with primary lumbar intervertebral infection. It can achieve intervertebral space directly through intervertebral foramen, retain the central spinous process and lamina, reduce the injury to paraspinal muscle, and keep spinal ligament complex. However, strong spine fixation contributes to bone fusion, and keeps the stability of the spine after repair.