Objective To review and analyze the complications of spondylolisthesis treated wi th BAK interbody fusion cages.Methods One hundred and eighteen patients wi th spondylolisthesis were treated with BAK interbody fusion ca ges,the intraoperative and postoperative complications were reviewed,which include dural tear,nerve root injury,unsatisfactory cage position,cage retropulsion,cage subsidence and postlaminectomy adhesive arachnoiditis.Results The intraoperative complication ra te was 11%and the most commonly seen were dural tear 4c ases(3.4%),nerve root damage 3cases(2.5%)and unsatisfactory cage position 9cases(7.6%),2cases had both dural tear and unsatisfactory cage position,1patient had both nerve root injury and unsatisfactory cage position.The postoperative c omplication rate was 7.6%,which chiefly consisted of cage retropuls ion 3cases(2.5%),cage subsidence 4cases(3.4%),and postlaminec-tomy adhesive arachnoiditis 2cases(1.7%),2cases of cage retropulsion and 2ca ses of cage subsidence show partial nonunion,2cases of cage subsidence had arachnoiditis.Conclusion As a new technique,lumbar interbody fusion with BAK cages are r apidly gaining popularity,however,the complications described here suggest the importance of selection s of surgical indications and proper manipulations.[

Objective To explore the difference of myeloperoxidase(MPO)detection results among different types of samples , anticoagulant selection and comparison of detection results .Methods The plasma samples containing EDTA‐K2 or heparin and ser‐um samples of common biochemical tube without containing anticoagulant were collected from 165 persons undergoing healthy physical examination .The MPO level in 3 kinds of sample was detected .Then the detection results in each group were performed the statistical analysis .Results The MPO detection results had statistical difference between plasma samples with different antico‐agulants and between plasma samples with different anticoagulants and serum sample without anticoagulant in the same person (P<0 .05) .Conclusion Different samples types have larger difference in M PO detection results .It is suggested that each laboratory should formulate the corresponding reference intervals according to different anticoagulants ;because EDTA‐K2 anticoagulation plasma is not affected by the release of MPO from in vitro leukocytes ,it is recommended to adopt EDTA‐K2 anticoagulation blood as the first selected of M PO level detection .

Objective To evaluate the long term outcome of spondylolytic spondylolisthesis treated with Steffee system and posterolateral fusion. Methods Thirty- four patients were followed up for an average of 77.2 months. The follow- up study include slipping percentage, slipping angle, heights of intervertebral space and foramen, fusion rate, screw broken rate and clinical outcomes. Results 1) Solid fusion was obtained in 88.2％ of patients. screw broken rate was 2.9％ . 2) Comparison of pre- and post- operative slip showed correction rate of 45.1％ . The heights of intervertebral space and foramen increased, slipping angle decreased. 3) During the period of follow- up, recurrence of deformity was found. 4) The subjective outcome was better than the objective outcome. Conclusion 1) Lumbar spondylolytic spondylolisthesis with radicular symptom need complete decompression and reduction as much as possible. 2) A positive slipping angle indicates significant shearing force and the need of an interbody fusion to restore the weight- bearing capacity. 3) Objective criteria is more suitable to evaluate surgical outcome.

Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful multi-vertebral osteoporotic compression fractures. Methods From October 2002 to April 2007, 42 patients (96 vertebrae) with painful multi-vertebral osteoporotic compression fractures underwent kyphoplasty. The group included 14 men and 28 women with an average age of 72.5 years (range 56-91 years). Each pro-cedure included insertion and insertion of balloon, fracture reduction and cement filling under "C"-arm monitoring. Preoperative and postoperative pain level, SF-36 score, vertebral height restoration, local kypho-sis correction and complications were recorded and analysed. Results All 42 patients tolerated the opera-tion well and were followed up for average 31.4 months (range 12-71 months). The mean VAS pain score decreased significantly from 7.1±2.4 preoperatively to 2.7±1.3 postoperatively, the mean height of anterior and medial vertebral body were (1.8±0.5) cm, (1.6±0.6) cm preoperatively and (2.3±0.6) cm, (2.2±0.7) cm postoperatively. No significant change of posterior vertebral height was recorded postoperatively.The mean correction of local kyphosis was 9.2°at each level. 6 of 8 subscahs measured by SF-36, including physical function, role function, bodily pain, vitality, role emotion, mental health, were significantly improved by the operation. Complications were found in 7 patients including 6 cases of cement leakage with no clinical symptoms (intradiscal cement leakage in two cases, paravertebral vessel leakage in two cases, paravertebral leakage in one case and cement leakage into canal in one case), and 1 case of pulmonary embelization with symptoms relieved after conservative treatment. Conclusion Kyphoplasty is effective and relatively safe for multi-vertebral osteoporotic compression fractures.

Objective To investigate the causes and clinical significance of cement leakage into disc space during kyphoplasty. Methods Since 2002, 178 patients with osteoporotic vertebral compression fractures underwent kypboplasty and 15 of them were detected intradiscal cement leakage and followed up more than 2 years (mean 2 years and 8 months). The mean injection of cement in these patients was 4.2ml.The series comprised 10 females and 5 males, with an average of 71.2 years old ( range, 54～84 years old).Visual analog scale was used to score back pain pre- and postoperatively. The height and MRI index of the involved disc were recorded and compared. Results The discs involved were as following: T10-11 for 4 cases,T11-12 for 1, T12L1for 4, L1-2 for 2, L2-3 for 3, L3-4 for 1. Cement leakage was detected in the disc above the fractured vertebrae in 10 cases, and in the disc below the fractured vertebrae in 5 patients. The back pain significantly alleviated and the average visual analog scale (VAS) score was decreased from 8.5±2.1 preoper-atively to 3.3±1.4 postoperatively (P< 0.05). The anterior disc height was (5.1±2.1)mm preoperatively and (4.8±1.9) mm at the final follow-up, the middle disc height was (7.4±3.2) mm preoperatively and (7.3±2.9) mm at the final follow-up, the posterior disc height was (4.9±2.5) mm preoperatively and (5.0±1.8) mm at fi-nal follow-up, the heights of intervertebral space were well maintained. The signal intensity decreased and became inconsistent in some discs, and the preoperative MRI index significantly decreased from 25482.4± 3467.5 to 18927.6±2519.4 at the final follow-up (t=1.967,P< 0.05). Conclusion Pain relief is impressive in patients with intradiseal cement leakage during kyphoplasty. However, cement leakage into disc space may accellerate the process of disc degeneration.

Objective: To compare the quality of life of schizophrenics treated with risperidone and clozapine Method: We followed 24 schizophrenics treated with risperidone and 26 with clozapine for 6 months All subjects were assessed with PANSS, TESS and WHO QOL-100 before treatment and 1, 2, 3, 6 months after Results: After 6 month, risperidone and clozapine had similar effects on positive and negative symptoms of schizophrenia Risperidone group had greater improvement in total score of PANSS Risperidone could significantly improve all aspects of quality of life of patients, except Domination While clozapine just improved some parts of that, it had no help to Physics, Psychology and Independence Conclusion:Risperidone is more favorable than clozapine for schizophrenics to return to society

Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful osteoporotic vertebral compressive fractures. Methods From May 2000 to June 2002, 56 consecutive procedures were performed in 30 patients of painful osteoporotic vertebral compressive fractures with intact posterior vertebral body wall. Each procedure includes bilateral insertion of inflatable balloon, fracture reduction and fulfilled with bone cement. Preoperative and postoperative symptom levels, complications and radiographic findings were recorded and analyzed. Results All 30 patients tolerated the procedure well with immediate relief of their back pain in 48 hours. The mean loss of the anterior and mid vertebral body heights were (13.6?2.3) mm, (9.2?1.4) mm preoperatively and (4.7?1.5) mm, (3.4?1.1) mm postoperatively. The mean kyphosis was improved from 23.4??5.2? to 9.2??4.7?. Cement leakage and cerebrospinal fluid leakage occurred at one level respectively and resulted in no clinical symptoms, no other complication was found. Conclusion As a promising minimally invasive surgery, balloon kyphoplasty can provide early improvement of pain and function as well as spinal alignment in treatment of painful osteoporotic compressive fractures.

Objective To compare the therapeutic effects in respect of ventilatory response and the change of hemodynamics of two modes of mechanical ventilation [ proportional assist ventilation (PAV) vs.Bi-level positive airway pressure ventilation (BiPAP) ] on patients with acute cardiogenic pulmonary edema (ACPE).Methods Thirty-two patients diagnosed as ACPE were recruited from May 2008 to April 2009.After conventional therapy ( cardiotonic,diuretic,vasodilators,oxygen) were ineffective for half an hour,32 patients were randomly divided into three groups:control group ( 12 cases kept conventional treatment without mechanical ventilation),BiPAP group ( 12 cases were treated with BiPAP mode of non-invasive mechanical ventilation plus conventional treatment) and PAV group (8 cases were treated with PAV mode of non-invasive mechanical ventilation along with conventional treatment ).Results PaO2,RR and oxygenation index were improved significantly in three groups after 1 hour treatment ( P ＜ 0.05 ).While PaO2 and oxygenation index in noninvasive ventilation groups were higher than those in control group ( P ＜0.05 ).The time required for amelioration of dyspnea in noninvsaive ventilation groups was shorter than that in control group ( P ＜ 0.05 ).The peak airway pressure and the index of degree of comfort ( VAS score,auxiliary respiratory muscles score) in PAV group were lower than those in BiPAP group (P ＜ 0.05 ).Conclusions Both modes of noninvasive mechanical ventilations could improve the oxygenation and relief of dyspnea in patients with ACPE.PAV and BiPAP had the similar effect in patients with ACPE.The synchronization and comfort in PAV group were better than those in BiPAP group.The PAV mode of noninvasive mechanical ventilation was well accepted by patients with ACPE.

Objective To observe the influence of bone marrow mesenchymal stem cells (BMSCs) transplantation on the expression of alpha-amino hydroxymethyl-oxazole propionic acid (AMPA) receptors GluR1 and GluR2 in rats with spinal cord injury (SCI) so as to investigate the potential anti- chronic stress mechanism of BMSCs transplantation in treatment of rats with spinal cord injury.Methods A total of 48 adult male SD rats were equally divided into three groups:control group,treatment group and model group.The rats in the model and treatment group underwent lower thoracic SCI with the modified Allen' s method,and the rats in control group received only laminectomy.At day 7 after thoracic SCI,100 μl of Hank's buffered saline solution containing 1.0 × 106 BMSCs was injected into the subarachnoid space from L4-L5 intervertebral space in the treatment group and control group,and the same amount of Hank' s buffered saline solution was injected in the model group.The motor function of the rat posterior limbs was assessed by Basso-Beattie-Bresnahan (BBB) scale before and after operation.Half of the rats were anesthetized at days 14 and 28 postoperatively to harvest brains which were frozen and cut in a cryostat to detect the expressions of GluR1 and GluR2 proteins by immunohistochemistry.Results After BMSCs transplantation,the motor function of the posterior limbs in the treatment group was improved progressively.At day 14 after transplantation,the number of GluR1-positive cells of the model and treatment group was higher than that of the control group in the hippocampus CA1 region (P ＜0.05,P ＜0.01 respectively) ; GluR2-positive cells had the similar tendency,without significant difference(P ＞ 0.05 ).At the 28th day after transplantation,GluR1 positive cells of the model group were higher than those of the control group in CA1,CA3,DG regions and those of the treatment group in CA1,CA3 regions (P ＜0.05,P ＜0.01,respectively) ; GluR1 positive cells of the model and treatment group were higher than their counterpart at day 14 after grafting procedure,with significant difference (P ＜0.05,P ＜0.01,respectively).GluR2 positive cells of the treatment group were higher than those of the control group in the basolateral amygdale (BLA) (P ＜0.05 ) and had similar tendency with GluR1 expression in other regions ( P ＞ 0.05 ).Conclusion BMSCs transplantation implies a potential antichronic stress mechanism of SCI rats,since it can improve the motor function of posterior limbs in rats with lower thoracic SCI and regulate the expressions of AMPA receptor GluR1 and GluR2.

ObjectiveTo investigate the degree of acceptance of Emergency Medicine and the abilities of first aid in senior medical students, and study the methods of how to improve their abilities and skills.MethodsA random sample survey methodology.ResultsA total of 146 medical students of clinical medicine were surveyed.99.32％ of student believed that emergency medicine was essential and necessary in their learning process.The knowledge of first aid would play important role for their future work.55.48％ of students considered that there were partial overlaps in teaching content in emergency medicine and internal medical and surgery.Senior medical students accessed to knowledge mainly through books,followed by the Internet,television and newspapers and their first aid knowledge and skills were poor.ConclusionEmergency medical teaching should be focused on highlighting its characteristics.The visualization of the operation and standardized assessment will help to strengthen students' mastery of first-aid knowledge and skills.