AIM: To define the indications of C2 pedicle lag screw or C2 pedicle screw associated with C3 lateral mass screw to treat Hangman fracture, and evaluate the clinical applications. METHODS: Thirty-four patients with Hangman fracture were selected from Changzheng Hospital between February 2000 and December 2004, including 10 patients of type Ⅰ, 12 patients of type Ⅱ, and 8 patients of type Ⅱa, 4 patients of type Ⅲ. Levine-Edwards classification and graded: 2 patients of grade C spinal injury, 12 patients of grade Ds and 20 patients of grade E according to Frankel scale. Patients with typeⅠHangman's fracture were fixed by C2 pedicle lag screw, and patients with typeⅡ, Ⅱa and Ⅲ Hangman fracture were fixed by C2 pedicle screw associate C3 lateral mass screw. Postoperative neurofunctional recovery and fracture healing were studied. RESULTS: A total of 34 subjects were involved in the analysis of results. ① Frankle classification of postoperative neurofunctional recovery: There were 2 cases of grade C, 1 case recovered to grade E, and one case recovered to grade D. There were 12 cases of grade D, including 11 cases of recovered to grade E and one without change. ② In 3-6 months follow-up, X-ray of anterior-posterior and lateral position showed that all fractures healed without loose screw, vertebra artery injury or other complications. CONCLUSION: C2 pedicle lag-screw, C2 pedicle screw associated with C3 lateral mass screw are safe, effective in the treatment of Hangman fracture, which can to retain the function of upper cervical spine as great as possible.

No abstract available.
Child* ; Hand* ; Humans

No abstract available.
Fingers*

OBJECTIVETo observe the effect of activation of aldehyde dehydrogenase 2 (ALDH2) by ethanol on the expression of c-Jun N-terminal kinase (JNK) in the kidney of diabetic rats.

METHODSEightheen healthy male SD rats were randomly divided into 3 groups (n = 6): normal control group, diabetes group and ethanol + diabetes group. After 8 weeks, 24 h urine samples from rats were collected to detect urinary protein content. The kidney was isolated and the ratio of kidney weight/body weight (index of kidney weight) was detected. The levels of fasting blood glucose, glycosylated hemoglobin serum urea nitrogen and serum creatinine were measured. Morphological changes of renal tissue were observed by optical microscope. The protein expressions of ALDH2 and JNK in renal tissue were detected by Western blot.

RESULTSCompared with the normal control rats, the levels of fasting blood glucose, glycosylated hemoglobin, serum urea nitrogen, serum creatinine and the index of kidney weight were increased markedly in diabetic rats. The expression of ALDH2 protein was decreased, while p-JNK, JNK protein expressions and the ratio of p-JNK/JNK were increased. The morphological observation was shown that the amount of glomerular mesangial matrix were increased, basement membrane were thickened and capillary lumen were narrowed. However,in ethanol + diabetes group, renal function was improved and the damage of renal structure was attenuated. The expression of ALDH2 protein was increased, while p-JNK, JNK and the ratio of p-JNK/JNK were decreased.

CONCLUSIONEnhanced ALDH2 expression can protect kidney in diabetic rats, which may be relevant with inhibitting the activity of JNK pathway.

Aldehyde Dehydrogenase ; metabolism ; physiology ; Aldehyde Dehydrogenase, Mitochondrial ; Animals ; Diabetes Mellitus, Experimental ; enzymology ; Ethanol ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Kidney ; enzymology ; Male ; Mitochondrial Proteins ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley

Objective To study the effect of fluoride on bone metabolism in rats, and to understand the mechanism of pathogenesis of skeletal fluorosis. Methods A total of 80 Wistar rats were randomly divided into 4 groups that included control group (distilled water), low-dose group(NaF, 50 mg/L), medium-dose group (NaF,100 mg/L) and high-dose group(NaF, 150 mg/L), respectively. After being bred for 12 weeks, the rats were put to death (etherization). Incidence of dental fluorosis was estimated, and serum was collected. Radioimmunoassay was employed to detect the levels of osteocalcin (BGP), parathyroid hormone (PTH) and calcitonin (CT), respectively.Colorimetry method was employed to determine the levels of alkaline phosphatase (ALP) and acid phosphatase (ACP). Results Incidence of dental fluorosis between the four groups was significantly different statistically(x2 =82.81 ,P ＜ 0.01 ). The incidence was significantly different(x2 = 22.67, 40.00, 40.00, all P＜ 0.01 ) between low-dose ( 80%, 16/20), medium-dose ( 100%, 20/20), high-dose groups ( 100%, 20/20) and control group (0,0/20),respectively. Serum levels of BGP, PTH, CT were significantly different between the groups(F = 38.614, 20.778,3.023, P ＜ 0.01 or ＜ 0.05). There was no significant difference between the four.groups of ALP and ACP in serum (F = 0.609,2.895, all P ＞ 0.05 ). Serum BGP in low-dose, medium-dose and high-dose groups[ ( 19.60 ± 12.79),(33.41 ± 10.81 ), (39.46 ± 9.51 )mg/L, respectively] was significantly higher than that of the control group[ (7.35 ± 3.22)mg/L, all P ＜ 0.01 ]. Serum PTH in low-dose, medium-dose and high-dose groups[ (72.27 ± 25.38), (67.80 ± 12.01), (106.52 ± 36.37)pmol/L] was significantly higher than that of the control group[(47.08 ± 9.22)pmol/L,all P ＜ 0.01 ]. Serum PTH of the high-dose group was significantly higher than that of the low-dose and the mediumdose groups(all P ＜ 0.01 ). Serum CT in medium-dose and high-dose groups[ ( 13.39 ± 2.07), ( 15.05 ± 4.77)pmol/L ] was significantly lower than that of the control group[ (26.06 ± 28.31 ) pmol/L, all P ＜ 0.05 ] and also significantly lower than that of the low-dose group [ (24.49 ± 14. 10) pmol/L, all P ＜ 0.05 ]. Conclusions Fluoride affects bone metabolism in rats, BGP, PTH and CT play a key role in the pathogenesis of skeletal fluorosis.

Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

Objective To evaluate the effect of home-made immobilization device with KV-CBCT in lung-SBRT and investigate its clinical use value.Methods Choosing 10 lung tumor patients (half centre type tumor;half peripheral type) random analysis the interfractional and intrafractional setup errors in the SBRT process by this fixed device with KV-CBCT.The concrete method is using Varian's KV-CBCT scans the patients before and after the SBRT each time,then make the registration between the reconstructed 3 d image and the planned CT image (both based on bone landmark),we then obtain the average setup errors in LR,AP and SI directions.Simultaneously,this research make contrastive analysis of setup errors among this fixed device and other fixed devices such as vacuum pad,phantom in body IMRT.All data make one-factor analysis of variance by SSPS 17.0.Results All the setup errors data was gaussian distribution,the centre type interfraction was at (0.01 ±0.32) cm (LR),(-0.08 ±0.38) cm (AP),(0.14 ±0.36) cm (SI) of the cross section,peripheral type interfraction was at (0.01 ± 0.32) cm (LR),(-0.08 ± 0.38) cm (AP),(0.14 ± 0.36) cm (SI) of the cross section (P =0.001).We found out that the average of lung tumor's setup error at all three directions have no significant difference-the largest was the AP directions (P =0.003),the second was the SI direction (P =0.003) and the smallest was the LR direction (P =0.001).The central type has no significant difference at three directions.Compare to the other fixed device,the average setup errors of our device are (0.09 ± 0.33) cm (LR),(-0.10 ± 0.44) cm (SI),(0.17 ±0.35) cm (AP) better than the report at present paper.As the interfraction setup error was small enough by using this fixed device while it has beyond the system algorithm,the registration software of system shows (0.0 ± 0.0 cm).Conclusions The range of lung tumor motion can be cut down obviously and enhance each placement accuracy,repeatability,on SBRT with home-made immobilization device.

Objective To investigate the epidemiology of bacterial infections after liver transplantation and anaIyze the antimi- crobial susceptibility of major pathogens to provide reference for clinical therapy.Methods A retrospective survey was conduc ted in 174 patients who underwent liver transplantation during 2001 and 2004.Identification and susceptibility of pathogens were assayed by Microscan Walkaway 40 Automatic System.Results Infection was identified in 59.8% of the 174 patients after liver transplantation.A total of 218 non-duplicate strains were isolated.Most infections were caused by single pathogen.The infection was frequently identified in respiratory tract,biliary tract,blood stream or intra-abdominal cavity.The top 5 patho- gens were Acinetobacter baumannii,Staphylococcus aureus,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Escherichia coli.Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to piperacillin- tazobactam or imipenem.Most of S.aureus isolates were methicillin-resistant,which were susceptible to vancomyein.Conclu- sions Pathogens of postoperative infections in liver transplantation recipients are mostly multi-drug resistant.The microbiologi- cal surveillance is important for guiding clinical therapy.

Objective To investigate the MR imaging technique and features of acute radiation- induced hepatic injury with superparamagnetic iron oxide(SPIO)enhancement in a rabbit model.Methods On the 10th day after half-liver single 40 Gy X-ray irradiation,MR imaging before and after SPIO administration and pathologic study of 12 adult rabbits were performed.Results On the 10th post-irradiation day,TSE T_2 WI before SPIO enhancement,the irradiated liver of two rabbits showed relatively higher signal, and 1 showed slightly lower signal.With SPIO enhancement,the irradiated livers of 9 rabbits were found to be abnormal,manifesting as higher or slightly higher areas on multiple MR imaging sequences,especially the TFE T_1 WI sequence.Histological specimen with HE stain under light microscopy revealed occlusive injury of central veins(veno-occlusive disease,VOD)in each irradiated liver to some extent.Electron microscopy investigation of the irradiated liver disclosed intracellular edema,fibrin deposition,and widening of the Disse-space.Conclusion The early pathologic feature of the irradiated liver is occlusive injury of the central vein.MR imaging with SPIO enhancement is effective to valuate the early irradiation-induced liver injury.

OBJECTIVE: To discuss the efficacy and safety of simultaneous bilateral endoscopic surgery (SBES) for bilateral upper urinary tract calculi, and to summarize the initial experience. METHODS: Patients diagnosed with bilateral upper urinary tract calculi who underwent SBES in the Department of Urology, Beijing Chao-Yang Hospital from January 2019 to January 2020 were enrolled retrospectively. The demographic and clinical data of the patients were recorded, and the operation status, stone free rate (SFR) and peri-operative complications were analyzed. The primary end point was SFR, and second end point was peri-operative complications. RESULTS: A total of 23 patients underwent SBES, of which SBES was completed in 19 patients (12 males, and 7 females). The mean age was (41.3±12.0) years. Fourteen patients underwent modified supine position surgery and 4 patients in prone split-leg position. There was no statistical difference in the demographic and baseline clinical data of the patients in different positions. One patient underwent right percutaneous nephrolithotomy (PCNL) and left endoscopic combined intra-renal surgery (ECIRS) in the prone split-leg position, while 18 patients received simul-taneous surgery with PCNL and contralateral retrograde intra-renal surgery (RIRS). The mean anesthesia and operation time was (128.7±26.5) min and (70.7±20.3) min, respectively, which was significantly longer in the patients with prone split-leg position than in the patients with modified supine position, anesthesia time in the patients with prone split-leg position and modified supine position: (148.4±20.4) min vs. (121.6±25.3) min, respectively, t=－2.121, P=0.049, while the operation time in the patients with prone split-leg position and modified supine position: (86.4±21.1) min vs. (65.1±17.4) min, respectively, t=－2.222, P=0.040. There was no significant difference between the two groups in indwelling of nephrostomy [prone split-leg position and modified supine position: (2.6±0.9) d vs. (2.1±1.0) d, respectively; t=－0.880, P=0.391] and the length of hospital stay [prone split-leg position and modified supine position: (6.0±2.7) d vs. (5.2±1.8) d, respectively; t=－0.731, P=0.475]. One month after the operation, the SFR was 78.9%, and 3 patients had minor peri-operative complications (Clavien-Dindo grades Ⅰ/Ⅱ) without any serious complications (Clavien-Dindo grades Ⅲ/Ⅳ/Ⅴ). CONCLUSION The simultaneous bilateral endoscopic surgery would decrease the operation time and anesthesia exposure under the premise of ensuring the SFR, which is helpful to reduce the risk of peri-operative complications, especially to the patients who can not tolerate the second-stage or long-time operation.
Adult ; Calcinosis/surgery* ; Endoscopy ; Female ; Humans ; Kidney Calculi ; Male ; Middle Aged ; Nephrolithotomy, Percutaneous ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Urologic Diseases/surgery*