OBJECTIVETo compare the biomechanical performances of different wires and cable fixation devices in posterior instrumentation for atlantoaxial instability, and test the effect of different fixation strengths and fixation approaches on the surgical outcomes.

METHODSSix specimens of the atlantoaxial complex (C0-C3) were used to establish models of the normal complex, unstable complex (type II odontoid fracture) and fixed complex. On the wd-5 mechanical testing machine, the parameters including the strength and rigidity of anti-rotation, change and strength of stress, and stability were measured for the normal complex, atlantoaxial instability complex, the new type titanium cable fixation system, Atlas titanium cable, Songer titanium cable, and stainless wire.

RESULTSThe strength and rigidity of anti-rotation, change and strength of stress, stability of flexion, extension and lateral bending of the unstable atlantoaxial complex fixed by the new double locking titanium cable fixation system were superior to those of the Songer or Atlas titanium cable (P<0.05) and medical stainless wire (P<0.05). Simultaneous cable fastening on both sides resulted in better fixation effect than successive cable fastening (P<0.05). Better fixation effect was achieved by fastening the specimen following a rest (P<0.05).

CONCLUSIONSThe fixation effects can be enhanced by increased fastening strengths. The new type double locking titanium cable fixation system has better biomechanical performance than the conventional Songer and Atlas titanium cables. Fastening the unstable specimens after a rest following simultaneous fastening of the specimen on both sides produces better fixation effect.

Atlanto-Axial Joint ; physiopathology ; surgery ; Biomechanical Phenomena ; Bone Wires ; Cadaver ; Humans ; Internal Fixators ; Joint Instability ; physiopathology ; surgery ; Orthopedic Fixation Devices

Objective To study the characteristics of the transcranial electric stimulation(TES)-elicited motor evoked potentials(MEP)recorded from different points of the diaphragm,and to determine the optimal record- ing site in the diaphragm.Methods One EEG electrode was placed subcutaneously in the midline of the skull as stimulation electrode and another EEG electrode was inserted into hard palate submucously as cathode in 30 male rats.And single square wave electrical pulse was used for stimulation.The stimulation intensity was 15 mA,the du- ration of the pulse was 0.2 ms,and the stimulating interval was 200 ms.The concentric needle electrode were insert- ed into the following eight sites:the medial,intermediate,lateral crura of the diaphragm,the junction of the posterior axilla line and the inferior border of the eleventh rib,the junction of the anterior axilla line and the inferior border of the ninth rib,the junction of the intermediate line of the clavicle and the inferior border of the eighth rib,the junction of the para-sternal line and the inferior border of the seventh rib,the pars sternalis.The MEP was recorded from each point,respectively.The optimal sites of the diaphragm MEP were found and recorded.Results The MEPs were re- corded from each of the 8 sites of the diaphragm in all the rats after TES.There was no statistically significant differ- ence among the latencies of every site.But the amplitude varied from 6.08?0.46 mV in maximum along the inferior border of the ninth rib at the anterior line of the axilla to the minimum of O.91?0.03 mV at the pars sternalis. Conclusion It is safer to insert the needle along the inferior border of the ninth rib at the anterior line of the axilla, because there was certain distant from the folding part of the pleura and the amplitude of the recorded wave at this point is maximal.

OBJECTIVETo compare the anti-rotation biomechanical performances of wire and various cable fixation devices currently used in the posterior Brooks instrumentation for atlantoaxial instability.

METHODSIn this experiment,six specimens of the atlantoaxial complex (Occipital-C3) were used. The models of the normal complex,unstable complex (type II odontoid fracture) and fixed complex were established. On the WD-5 mechanics experimental machine,the parameters including the strength and rigidity of anti-rotation were quantified for the normal complex (group N),the atlantoaxial instability complex (group M), the new type Titanium cable (group A), Atlas titanium cable (group B), Songer Titanium cable (group C), stainless wire(group D).

RESULTSThe max strength of A, B, C, D groups was 12.5, 11.3, 11.52, 11.55 N x m respectively, the max rigidity was 58.81, 53.17, 54.11, 54.35 N x cm/deg respectively. The strength and rigidity of anti-rotation, compare to the unstable atlantoaxial complex which were fixed by the new double locking Titanium cable fixation system were superior to those of normal complex, instability complex, Songer or Atlas Titanium cable (P < 0.05).

CONCLUSIONHaving been changed the locking method, the anti-rotation biomechanical characteristics of the new type double locking Titanium cable fixation system are superior or similar to the traditional Songer or Atlas Titanium cable.

Atlanto-Axial Joint ; physiopathology ; surgery ; Biomechanical Phenomena ; Bone Wires ; Humans ; Joint Instability ; physiopathology ; surgery ; Orthopedic Fixation Devices ; Rotation

Objective: To observe the efficacy of electroacupuncture (EA) plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis (KOA). Methods: A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Patients in the observation group received the treatment of EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises), while patients in the control group only received EA treatment. Both groups were treated for 5 weeks. The changes of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores in the two groups were observed after treatment. Results: After treatment, the total effective rate in the observation group (92.3％) was significantly higher than that in the control group (70.0％), (P<0.05); the WOMAC and VAS scores in both groups were significantly lower than those before treatment, showing statistical significance (all P<0.01); there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups (P<0.05, P<0.01). Conclusion: EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises) is clinically effective for KOA. This combined treatment can alleviate clinical symptoms.

To effectively guarantee quality of randomized controlld trial (RCT) of acupuncture and develop reasonable content and checklist of on-site quality control, influencing factors on quality of acupuncture RCT are analyzed and scientificity of quality control content and feasibility of on-site manipulation are put into overall consideration. Based on content and checklist of on-site quality control in National 11th Five-Year Plan Project Optimization of Comprehensive Treatment Plan for TCM in Prevention and Treatment of Serious Disease and Clinical Assessment on Generic Technology and Quality Control Research, it is proposed that on-site quality control of acupuncture RCT should be conducted with PICOST (patient, intervention, comparison, out come, site and time) as core, especially on quality control of interveners' skills and outcome assessment of blinding, and checklist of on-site quality control is developed to provide references for undertaking groups of the project.
Acupuncture Therapy ; standards ; China ; Humans ; Quality Control ; Randomized Controlled Trials as Topic ; standards ; Research Design ; standards

OBJECTIVETo summarize the clinical characteristics of severe adolescent idiopathic cervical kyphosis and the operation method.

METHODSA retrospective study was performed in 12 adolescent patients with severe cervical kyphosis treated from July 2003 to January 2007. Preoperative the Cobb angle of kyphosis range from 55 degrees to 73 degrees (average 61 degrees ). According to the angles between the posterior vertebral body tangents at every involved level on lateral cervical radiograph in extension, the osteotomy angles and range of lamina and facet were decided. The anterior release and posterior osteotomy were performed firstly. Then skull traction was maintained in order to correct the deformity as long as possible, fusion and internal fixation was completed after 7-10 days. The cervical coronal and sagittal planes X-rays and the MR were hold after operation 3 days, 3 months, 6 months, 1 year and 2 years. At the same time the treatment result, bone fusion and the instrumentation were followed up, and the symptoms were compared between pre-operation and post-operation.

RESULTSThe defect appearance of the patients was improved significantly, with the total disappearance of neck pain and improvement of nerve function. Post-operational cervical spine MR showed that the physiological curve of cervical spine was restored, cerebral spinal fluid line was clear in the kyphosis area and no spinal cord compression was found. X-ray imaging of post-operation 3 d showed that Cobb angle ranged from -12.3 degrees to 11.2 degrees with an average of -2.0 degrees . Beside one patient's AISA score was D, other patient's AISA score was E.

CONCLUSIONSThe severe adolescent idiopathic cervical kyphosis has its own clinical manifestation. It is an ideal treatment to completely assess the deformity, have staging operation and skull traction between two operations.

Adolescent ; Cervical Vertebrae ; surgery ; Female ; Humans ; Kyphosis ; surgery ; Male ; Retrospective Studies ; Spinal Fusion ; methods

Objective To evaluate the solute clearance characteristics of REXEEDTM series dialyzers during high-flux dialysis, and explore the care characteristics. Methods A randomized crossover study of 3×3 Latin square was designed based on different dialyzers. Eighteen patients with regular hemodialysis underwent dialysis with REXEEDTM-15AC dialyzer, REXEEDTM-15UC dialyzer and controlled APS-15U dialyzer, respectively. Blood samples were obtained from the blood flow entrance and exit of dialyzers, levels of urea nitrogen, creatinine, phosphate and β2-microglobulin were detected, and solute clearance rates were calculated. Before and after the third dialysis with each dialyzer, blood samples were obtained to measure the levels of urea nitrogen and creatinine, and the rates of decrease were calculated. The vital signs of each patient were intensively observed, and the venous pressure and transmembrane pressure were monitored from the dialyzers. Results The urea nitrogen clearance rates of REXEEDTM-15AC dialyzer and REXEEDTM-15UC dialyzer were significantly higher than that of APS-15U dialyzer (P<0.05). The creatinine clearance rate of REXEEDTM-15AC dialyzer was significantly higher than that of APS-15U dialyzer(P<0.05). There was no significant difference in the rate of decrease in blood urea nitrogen among different dialyzers of the same patient(>65 % for all patients). The vital signs were stable with no adverse events during dialysis, and there was no abnormal findings in laboratory security parameters. Conclusion REXEEDTM series dialyzers are effective and safe for clinical application. Great importance should be attached to the complaints from patients during dialysis. For those with less ultrafiltration, fluid as well as uhrafiltration should be supplemented to increase the transmembrane pressure.

Neurodegenerative disease is common and frequently occurs in elderly patients. Previous studies have shown that ginsenoside Rg1 was able to inhibit senescent of brain, but the mechanism on the brain during the treatment remains elucidated. To study the mechanism of ginsenoside Rg1 in the process of anti-aging of brain, forty male SD rats were randomly divided into normal group, Rg1 normal group, brain aging model group and Rg1 brain aging model group, each group with 10 rats (brain aging model group: subcutaneous injection of D-galactose (120 mg kg(-1)), qd for 42 consecutive days; Rg1 brain aging model group: while copying the same test as that of brain aging model group, begin intraperitoneal injection of ginsenosides Rg1 (20 mg x kg(-1)) qd for 27 d from 16 d. Rg1 normal group: subcutaneous injection of the same amount of saline; begin intraperitoneal injection of ginsenosides Rg1 (20 mg x kg(-1)) qd for 27 d from 16 d. Normal: injected with an equal volume of saline within the same time. Perform the related experiment on the second day after finishing copying the model or the completion of the first two days of drug injections). Learning and memory abilities were measured by Morris water maze. The number of senescent cells was detected by SA-beta-Gal staining while the level of IL-1 and IL-6 proinflammatory cytokines in hippocampus were detected by ELISA. The activities of SOD, contents of GSH in hippo- campus were quantified by chromatometry. The change of telomerase activities and telomerase length were performed by TRAP-PCR and southern blotting assay, respectively. It is pointed that, in brain aging model group, the spatial learning and memory capacities were weaken, SA-beta-Gal positive granules increased in section of brain tissue, the activity of antioxidant enzyme SOD and the contents of GSH decreased in hippocampus, the level of IL-1 and IL-6 increased in hippocampus, while the length of telomere and the activity of telomerase decreased in hippocampus. Rats of Rg1 brain aging group had their spatial learning and memory capacities enhanced, SA-beta-Gal positive granules in section of brain tissue decreased, the activity of antioxidant enzyme SOD and the contents of GSH increased in hippocampus, the level of IL-1 and IL-6 in hippocampus decreased, the length contraction of telomere suppressed while the change of telomerase activity increased in hippocampus. Compared with that of normal group, the spatial learning and memory capacities were enhanced in Rg1 normal group, SA-beta-Gal positive granules in section of brain tissue decreased in Rg1 normal group, the level of IL-1 and IL-6 in hippocampus decreased in Rg1 normal group. The results indicated that improvement of antioxidant ability, regulating the level of proinflammatory cytokines and regulation of telomerase system may be the underlying anti-aging mechanism of Ginsenoside Rg1.
Aging ; drug effects ; Animals ; Brain ; drug effects ; Ginsenosides ; pharmacology ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the effect of rosiglitazone on the activity of signal transducer and activator of transcription 1 in rats with severe acute pancreatitis.

METHODSFifty-four male Wistar rats were randomly allocated into three groups (n = 18). SO group: sham-operated animals served as control, operation was executed and sodium chloride but not sodium taurocholate was injected. SAP group: SAP was induced by the retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. ROSI group: same as SAP group, but rosiglitazone (6 mg/kg) was administered intravenously 30 min before operation. Rats in each group were sacrificed at 3,6 and 12 h after operation. The levels of serum amylase and histologic scores of pancreatic tissue were measured. The expression of TNF-alpha mRNA in pancreatic tissue were determined by reverse transcription-polymerase chain reaction (RT-PCR). The expression of phosphorylated STAT1 in pancreatic tissue was assayed by immunohistochemistry.

RESULTSCompared to SO group, the levels of serum amylase and phosphorylated STAT1, TNF-alpha mRNA and histologic scores of pancreatic tissue were significantly elevated at the same time points after SAP (P < 0.01). The levels of these detection in ROSI group were lower than those of the SAP group at the same time points (P < 0.05), but higher than SO group (P < 0.05).

CONCLUSIONSSTAT1 was activated in severe acute pancreatitis. Rosiglitazone has a protective effects in rats with severe acute pancreatitis. The mechanism of its protective effects maybe that it inhibits the activation of JAK/STAT pathway, which can down-regulate the expression of TNF-alpha mRNA and block the the inflammatory cascade partially.

Acute Disease ; Animals ; Disease Models, Animal ; Male ; Pancreas ; metabolism ; pathology ; Pancreatitis ; drug therapy ; metabolism ; pathology ; Random Allocation ; Rats ; Rats, Wistar ; STAT1 Transcription Factor ; metabolism ; Thiazolidinediones ; pharmacology

Objective To observe the clinical efficacy of electroacupuncture (EA) in treating knee osteoarthritis (KOA).Method Sixty KOA patients were randomized into a treatment group and a control group by using random number table, 30 cases each. The control group was intervened by oral administration of Celecoxib capsules, while the treatment group was given EA, 14 d as a treatment course. The changes of relevant cytokines [apelin, tumor necrosis factor (TNF)-α, TNF soluble receptor (TNFsR)-Ⅰ, TNFsR-Ⅱ, interleukin (IL)-1β, and IL-6] in serum of the two groups were observed.Result The intra-group comparisons of the total score, and the scores of pain, stiffness and dysfunction of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index showed significant differences in both groups (P<0.05); there were significant between-group differences in comparing the total score, and the scores of pain, stiffness and dysfunction of the WOMAC index after the treatment (P<0.05). The Visual Analogue Scale (VAS) scores were changed significantly after the intervention in both groups (P<0.05); there was nosignificant difference in comparing the VAS score between the two groups after the treatment (P>0.05). The levels of IL-6, TNF-α and TNFsR-Ⅰ were significantly changed after the treatment in both groups (P<0.05); the level of IL-1β was markedly changed after the intervention in the control group (P<0.05); there was a significant change in the level of apelin after the intervention in the treatment group (P<0.05), and there was a significant difference in comparing the level of apelin between the two groups after the treatment (P<0.05).Conclusion EA can produce a satisfactory efficacy in treating KOA; it can significantly improve the symptoms and signs, and mitigate pain and symptoms through regulating the expressions of cytokines.