BACKGROUND: With the development of pedicle-screws,pedicle-screw internal fixation system has been widely used in the clinical treatment of thoracolumbar fractures because it can provide rigid internal fixation for injured spine to acquire more dimensional stabilization with little trauma and simple operation.OBJECTIVE: To investigate the long-term therapeutic effects of CD2 pedicle-screw intemal fixation in treatment of thoracclumbar burst fractures.METHODS: A retrospective analysis was made on 72 cases of thoracolumbar burst fractures who received treatment at the Department of Orthopedics and Traumatology of Nantong University of Traditional Chinese Medicine between January 2000 and January 2008.All these patients received CD2 pedicle-screw internal fixation treatment.All of them were checked with radiography prior to and after surgery and at the final follow-up.The anterior and posterior vertebral body height,the situation of bone graft fusion,and the change of cobb angle were observed after surgery and at final follow-up.CT examination was performed in 27 cases prior to surgery and at the final follow-up to evaluate the space occupying in the spinal canal.Frankel classification was performed to evaluate the recovery of nerve system and Oswestry Disability Questionnaire was used to score the back pain at the final follow-up.RESULTS AND CONCLUSION: 72 cases were followed up for an average of 48 months(range 0.5-8 years)after surgery.X-ray results showed that after surgery,the correction of antedor vertebral body height averaged 6.55 mm,posterior vertebral body height 2.69 mm,and cobb angle 25.7°,and at the final follow-up,correction loss averaged 2.29 mm in the anterior vertebral body height,1.74 mm in the posterior vertebral body height,and 2.6° in the cobb angle.Among 27 patients scanned by CT,the space-occupying rate of the vertebral canal was 10%-75% prior to surgery and it was declined to 5%-24% at the final follow-up.In the last survery,eggshell phenomenon was still observed in 20 cases.Neurological status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia,while no improvement was obtained in those who had preoperative complete paraplegia.Clinical curative effects were evaluated according to Oswestry Disability Questionnaire,results showed 0%in 23 cases,2% in 29 cases,3% in 5 cases,6% in 5 cases,8% in 4 cases,10% in 1 case,56% in 1 case,57% in 1 case,80% in1 case,and 87% in 2 cases.Nuts loosened in 2 cases,pedicle screws loosened in 2 cases,and sticks broken in 1 case.All these findings indicate that CD2 pedicle-screw internal fixation in treatment of thoracolumbar burst fractures can well restore vertebral heights,physiologic curves,and neurological functions.

Depression is a common mental and psychiatry disorder. Depression is easy to recur and hard to cure.These urgent problems origin from the limited understanding of this disease and the big heteroge-neity in its genology. Generalized from recent relative papers we discovered that the important onset and sus-taining basis of depression is neuroremodeling,which includes the persistent changes of histocytology,ultra-structure of synapse and abnormal expressions of gene and protein of neurons in key brain regions,and so on. These changes affect the correct dealing on the neural message which lead to depression and become the sus-taining biological basis. Therefore the key strategies to prevent and cure depression lie on preventing,individ-ual therapy and reversing neuroremodeling.

OBJECTIVE:To establish a method for simultaneous determination of 4 effective components in the couple of Coptidis Rhizoma and Evodiae Fmctus,and to investigate rational proportion of the couple.METHODS:HPLC method was adopted.The determination was performed on Welch XB C18 column with mobile phase consisted of acetonitrile-1.5 mmol/L sodium dodecyl sulfate solution (pH adjusted to 5.0 with phosphoric acid) (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 265 nm,and the column temperature was 30 ℃.The sample size was 10 μL.RESULTS:The linear ranges of berberine hydrochloride,martin hydrochloride,evodiamine and rutacarpine were 2.24-44.80 μg/mL(r=0.999 9),1.26-31.50 μg/mL(r=0.999 8),2.70-81.00 μg/mL(r=0.999 8),1.65-49.50 μg mL(r=0.999 9),respectively.RSDs of precision,stability and reproducibility tests were all lower than 3.0％.The recoveries were 98.11％-100.73％ (RSD=1.04％,n=6),96.54％-103.47％(RSD=1.86％,n=6),95.49％-102.36％ (RSD=2.05％,n=6),97.19％-103.24％ (RSD=2.19％,n=6),respectively.When the proportion of Coptidis Rhizoma-Evodiae Fructus(m/m) was 2∶ 1,the comprehensive content of each component was the highest.CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for simultaneous determination of 4 effective components in different compatibility proportions of the couple of Coptidis Rhizoma and Evodiae Fructus.The rational proportion of the couple of Coptidis Rhizoma and Evodiae Fructus is 2 ∶ 1.

Objective To observe the effect of laser irradiation on the level of histamine (Hm) , 5- hydroxytryptamine(5-HT), interleukin-1 (IL-1), tumor necrosis factor α (TNF-α) in serum and β- endorphin (β- EP) in brain tissue in rat model of rheumatoid arthritis. Methods A total of 60 Wistar rats were randomly divided into four groups:a normal group, a model group (RA without treatment), a laser + drug treatment group (RA treated by laser and drug) and a drug treatment group (RA treated by drug alone). All the groups, except the normal one, were injected with complete Freund's adjuvant to make animal model of adjuvant arthritis. All the animals were then treated accordingly. The level of Hm, 5-HT, IL-1 and TNFα in serum and β-EP in brain tissue were measured. Results Laser downregulated the content of Hm, 5-HT, IL-1 and TNFα in serum and increased the content of β-EP in brain tissue. Conclusion Laser irradiation is an effective modality for treating the animal model of rheumatoid arthritis.

Objective To explore the clinical features of systemic lupus erythematosus (SLE) combined with antiphospholipid syndrome (APS) and cerebral thrombosis in a child. Method The clinical data of SLE combined with APS and cerebral thrombosis in a child was retrospectively analyzed, and the related literature was reviewed. Results This was a 12-year-old boy. The disease onset with recurrent fever, confusion and rash in cheek. He had anemia and thrombocytopenia, and positive antinuclear antibody (ANA) and anticardiolipin antibody (aCL). Magnetic resonance imaging showed multiple cerebral infarction. The diagnosis of SLE combined with APS and cerebral thrombosis was clearly made. Methylprednisolone, cyclophosphamide, warfarin, meropenem and acyclovir were used for the treatment. At the same time, the patient also received intravenous immunoglobulin. Conclusion SLE combined with APS and cerebral thrombosis in children was usually in a severe condition, the prognosis of which can be effectively improve by early diagnosis and reasonable treatment.

Objective To study the epidemiological characteristics of diarrhea-predominant irritable bowel syndrome (IBS-D) as well as the relationship between the main syndromes and different factors. Method The relevant information of patients were collected by clinical epidemiological method and the relationship between the main characteristics of the IBS-D syndromes and different factors was explored with the major syndromes as the key link. Result Most of the cases aged 30～49 years old. Special hobbies of patients followed by drinking, smoking, addicting spicy, addicting coffee and so on. Poor emotion, mental stress and diet were the main inducements. Liver stagnation and spleen deficiency has the highest percentage (44.7%). The distribution of syndromes in different ages, different genders, different occupations and different education had no significant difference. Conclusion The number of IBS-D hospital visiting-patients is lower than the actual number of illness people. Mental factors are important internal factors, and dietary factors may be an important external factor. Different factors have no effect on the distribution of syndromes.

Objective To determine operation procedure according to Oddi's sphincter functions decteted by preoperative duodenoscopy combined with intraoperative choledochoscopy (IOC). Methods The duodenal papillae and Oddi's sphincter functions of 319 cases with hepatobiliary calculus were detected by preoperative duodenoscopy, ERCP and IOC. Results As for the functions of Oddi's sphincter, 79 cases were superior, 152 cases favorable and 88 cases poor. Conclusions For patients with hepatobiliary calculus whether Oddi's sphincter is reserved according to the Oddi's sphincter function.

Objective To analyze retrospectively long term follow up of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy in prevention and treatment of pulmonary embolism (PE) in 24 patients with deep vein thrombosis (DVT) Methods This study included 13 males and 11 females with an average age of 52 4 years (14-86 years) Percutaneous implantation of inferior vena cava filters was performed via a femoral vein in 24 patients with acute or subacute DVT, of whom two were given conjunctive catheter based urokinase thrombolysis After the procedure, 20 patients underwent intravenous urokinase thrombolysis with subcutaneous low weight molecular heparin for 10 days and subsequent oral warfarin for six months Results All patients underwent a successful interventional procedure with an average 15 month (10-48 months) follow up One week after the procedure, relief of symptoms related to DVT was achieved in all the 24 patients Neither filter migration and thrombolic occlusion of filter nor PE and major hemorrhage were observed in this series Conclusion The use of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy is a safe and effective treatment modality in patients with DVT, which can be used to prevent subsequent PE

Objective To examine current use, associated complications, and short-term outcomes in patients with acute myocardial infarction (AMI) requiring intra-aortic balloon pump (IABP) counterpulsation. Methods A single-centre registry was conducted between October 2004 and July 2008. Data were collected from 121 consecutive AMI patients treated with IABP counterpulsation at the 28th Division of Beijing Anzhen Hospital. Results Among 806 patients with AMI, IABP counterpulsation was employed in 121 patients. Placement of an IABP was indicated for hemodynamic support during high-risk catheterization and/or angioplasty (66.9%) and cardiogenic shock (27.3%). Balloon insertions were successful in 98.3% of patients and duration of mean use was 34.2?16.2 hours. No major IABP complications occurred in all the patients. Diagnostic catheterization was performed in all the patients inserted with IABP, and 93.4% underwent coronary revascularization before hospital discharge. The total in-hospital mortality was 13.2% (34.4% in patients with cardiogenic shock) and varied markedly by indication and use of revascularization procedures. Conclusion IABP counterpulsation may be successfully employed for a wide variety of conditions in the AMI setting, providing significant hemodynamic support with rare major complications in a high-risk patient population. IABP counterpulsation may reduce mortality in patients with AMI undergoing reperfusion therapy.

Objective To study the relationship between arousal and sleep apnea in old people with sleep apnea syndrome(SAS). Methods Sixty-two aged patients were diagnosed of SAS after polysomnography (PSG). Records included total sleep time, apnea-hypopnea index(AHI),total arousal number(TAN), arousal index(AI), total respiratory-related arousal number(TRAN), total number of arousal lasted over 15 seconds (T15AN) and the severity of hypoxemia (desaturation). Sixty-four non-aged patients were included in control group. Ten aged patients were intervened with nasal continuous positive airway pressure (nCPAP) treatment. Data were compared with that before treatment. Results The results for the above parameters of the aged and the non-aged SAS patients were( 35.1?23.2)/h and (39.1?27.2)/h respectively for AHI, (15.8?11.4)/h and (20.4?13.0)/h for AI, 44.1% and 51.3% for the ratio of TRAN/TAN, only 6.1% and 6.7% for ratio of T15AN/TAN. 50% of 62 aged and 64 non- aged SAS patients were in severe desaturation. The AI and TRAN of the aged patients were significantly lower than that of non-aged patients (P