Humans ; Intestinal Obstruction/complications* ; Ileus/etiology* ; Abdominal Injuries/complications*

OBJECTIVETo evaluate the clinical effects of dynamic neutralization system (K-Rod) in treating multisegmental lumbar degenerative disease.

METHODSFrom October 2011 to October 2013, 20 patients with multisegmental lumbar degenerative disease were treated with dynamic neutralization system (K-Rod). There were 8 males and 12 females with an average age of 45.4 years old (ranged from 31 to 65) and an average course of 3.8 years (ranged from 9 months to 6.25 years). All patients had the history of low back and legs pain. Among them, 10 cases were far lateral lumbar disc herniation, 7 cases were lumbar spinal stenosis, 3 cases were lumbar spondylolisthesis (degree I in 2 cases and degree II in 1 case). Every patient had only one responsible segment which causing the symptom would have to be rigidly fixed during operations, and the adjacent intervertebral disc of the responsible segments at least 1 segment has already obvious degenerated. All patients underwent the operation to relieve compressed nerves and reconstruct spinal stability with K-Rod system (the responsible segments were fixed with interbody fusion, and the adjacent segments were fixed with dynamic stabilization). Visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA) and Oswestry Disability Index (ODI) were used to evaluate the clinical effects. Imaging data were used to analyze the range of motion (ROM), intervertebral disc height and intervertebral disc signal (according to modified Pfirrmann grading system) in degenerative adjacent segment.

RESULTSAll patients were followed up for more than 1 year, and preoperative symptoms obviously relieved. There were significant differences in VAS, JOA, ODI between preoperative and postoperative (postoperative at 1 week and 1 year) (P<0.05). Radiological examination showed that all responsible segments had already fused, and no looseness, displacement and breakage of internal fixations were found. Postoperative at 1 year, the ROM of adjacent segments were decreased (P<0.05). There was no significant difference in intervertebral disc height between preoperative and postoperative at 1 year (P>0.05). According to modified Pfirrmann grading system to classification for the 25 disks of adjacent segment, 8 disks (32%) got improvement, 15 disks (60%) got no change and 2 disks (8%) got aggravation at 1 year after operation.

CONCLUSIONDynamic neutralization system (K-Rod) combined with interbody fusion could obtain short-term clinical effects in the treatment of multisegmental lumbar degenerative disease.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Spondylolisthesis ; surgery

Objective To determine the conditioning regimen suitable for mice allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Twelve BALB/c mice were randomly divided into 2 equal groups to undergo X-ray irradiation by linear accelerator at the dose of 7.0 Gy (pure X-ray group) or 60Co source irradiation at the dose of 7.0 Gy (pure γ-ray group).Thirty mice were randomly divided into 2 equal groups to undergo X-ray irradiation and then infusion of bone marrow from donor mice via caudal vein (X-ray + transplantation group) or γ-ray and then infusion of bone marrow via caudal vein (γ-ray + transplahtation group).3,5,7,10,15,20,and 30 d later peripheral blood samples were collected to calculate the number of white blood cells (WBCs) and detect the chimeric rates of lymphocytes by flow cytometry.5,10,and 20 d after irradiation 15 mice were killed with their lung,liver,small intestine,spleen,and femurs taken out to undergo pathological examination.Results The survival rates during the period 5-15 days of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group.The pathological changes of organs of the X-ray +transplantation group were all more severe than those of the γ-ray + transplantation group.Since the fifth day after transplantation cells originating from the donor began to appear in the peripheral blood.The chimeric rate of the γ-ray + transplantation group 10 days after transplantation was (95.53± 2.57) %.The chimeric rates 5,10,and 20 days after transplantation of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group (t = 15.263,3.256,P < 0.05).The WBC count of both irradiation groups decreased to the lowest level 5 d later and began to increase 10 days after transplantation and the WBC counts of the γ-ray + transplantation group 10 and 20 days aftertransplantation were both significantly higher than those of the X-ray + transplantation group (t = 3.624,6.695 ,P < 0.05).The chimeric rats of the peripheral lymphocytes 10 and 20 days after transplantation of the γ-ray + transplantation group were both significantly higher than those of the X-ray + transplantation group (t = 12.317,8.295,P < 0.05).The homogeneity rate of transplantation of the γ-ray +transplantation group was better than that of the X-ray + transplantation group.Conclusions As a conditioning regimen in allogeneic hematopoietic stem cell transplantation γ-ray irradiation causes milder injury and accelerated reconstitution of hematopoiesis and immunity,in comparison with X-ray irradiation.

Objective To study the relationship between graft-versus-host disease (GVHD) and endothelium injury following hematopoietic stem cells transplantation in mice. Methods C57BL/6 mice as donors and Balb/c mice as recipients were randomly divided into 4 groups: control group, bone marrow transplantation group, GVHD group, GVHD mitigation group. The clinical manifestations,circulating endothelial cells and tissue pathological changes were observed at different time points after transplantation. Results No manifestations of GVHD were found in each group at the day 5, while those were found in GVHD group at the day 9 and all died within 15 days. The counts of endothelial cells in peripheral blood showed no significant difference at the day 5 between GVHD group (7. 34 ±1.26 cells/μl) and bone marrow transplantation group (11.51 ± 7. 40 cells/μl) or GVHD mitigation group (7. 36 ± 0. 16 cells/μl), while among three groups there was statistically significant difference at the day 9 (GVHD group: 153. 64 ± 35. 35 cells/μl vs bone marrow transplantation group: 10. 49 ±5. 61 cells/μl and GVHD mitigation group: 47. 82 ± 4. 69 cells/μl). The scores of pathological aGVHD had no significant difference at the day 5 between GVHD group (4. 33± 1. 53) and bone marrow transplantation group (3. 33 ± 0. 58) or GVHD mitigation group (4. 00 ± 1.73), while among three groups there was statistically significant difference at the day 9 (GVHD group: 10. 0 vs bone marrow transplantation group: 3. 33 ± 1.15 or GVHD mitigation group: 4. 33 ± 0. 58) and at the day 14 (GVHD group: 10. 33 ± 2. 58 vs bone marrow transplantation group: 2. 33 ± 1.25 or GVHD mitigation group 3. 33 ± 1.15). Conclusion Occurrence of GVHD causes endothelial damage again and injured endothelium worsens the GVHD.

Objective To estimate the clinical value of percutaneous vertebroplasty (PVP)performed on the elderly patients aged 80 years and over with osteoporotic vertebral fractures.Methods Since January 2000, 19 patients aged 80 years and over were treated with PVP, and 17 patients from 60 to 79 years old underwent percutancous kyphoplasty (PKP). Visual analogue scale (VAS) was tested preoperatively and 1 to 7 days, 3 months, 6 months, 1 year and 2 years after operation. The time of radiation, volume of bone cement injection and hospital charges were compared betwecn two procedures. Results Over the 2-year follow-up, there were no significant differences in analgesia effects between thc two groups (P＞0.05). The radiation time of PVP and PKP was (107±37)s and (151±76)s respectively (t=2.24, P＜0.05). The hospital charges of PVP and PKP were ￥(16 124±5850) and ￥(34 265±6655) respectively (t=9.26,P＜0.01). Conclusions PVP is better than PKP for treating osteoporotic compression fractures in the elderly patients over 80 years, because of the former's simplicity and efficiency.

OBJECTIVETo analyze the neglected hidden blood loss before and after operations in the elderly patients with intertrochanteric fractures and strengthen the treatment and clinical nursing in the perioperative period in order to ensure clinical effects.

METHODSThe clinical data of 99 patients with intertrochanteric fracture treated with intramedullary nailing from January 2010 to January 2014 were retrospectively analyzed (47 males and 52 females). Forty-seven cases got blood transfusion supporting and 52 cases were not (blood transfusion group and no-blood transfusion group respectively). According to the Gross equation, the average hemoglobin (Hb) and hematocrit (HCT) were used to analyze blood loss in perioperative period and assess the patients' hidden blood loss situation.

RESULTSThere were 22 males and 30 females in blood transfusion group. The average operative time was (62.13±4.01) min; intraoperative visible blood loss and postoperative drainage were 215 ml, totally; preoperative Hb was (103.22±9.01) g/L and postoperative was (81.13±6.20) g/L; preoperative HCT was (96.93±3.38) I/L and postoperative was (308.00±11.81) I/L. There were 25 males and 22 females in no-blood transfusion group. The average operative time was (60.12±3.27) min; intraoperative visible blood loss and postoperative drainage were 196 ml, totally; the average blood transfusion were 621 ml; preoperative Hb was (92.15±5.46) g/L and preoperative was (95.20±8.93) g/L; preoperative HCT was (96.52±3.63) I/L and preoperative was (392.70±14.03) I/L. According to the Gross equation, the blood loss of no-blood transfusion group and blood transfusion group in peroperative period were (937.29±63.04) ml and (706.43±35.02) ml, respectively. The hidden blood loss was dominant. At 1, 3 months after operation, Harris score of blood transfusion group was better than that of no-blood transfusion group, and 12 months after operation, there was no significant difference between two groups.

CONCLUSIONThe hidden blood loss of intramedullary nailing for intertrochanteric fracture should be emphasized in perioperative period, it can avoid the perioperative complications caused by anemia and affect the prognosis of patients.

Aged ; Blood Loss, Surgical ; Blood Transfusion ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Perioperative Period ; Retrospective Studies

OBJECTIVETo evaluate the technique and therapeutic effect of sternoclavicular hook plate fixation in treating sternoclavicular joint (SCJ) dislocation.

METHODSFrom January 2010 to March 2014,6 patients with SCJ dislocation were treated with sternoclavicular hook plate fixation in our hospital. Among the 6 patients, 5 patients were male and 1 patient was female, and the average age was 34 years, ranging from 26 to 48 years. The course of the disease ranged from 3 to 20 days. All the SCJ dislocations were caused by external injury and accompanied with the symptoms of swelling pain and obvious shoulder joint activity restricted in affected side. All SCJ dislocations were anterior dislocation by the diagnosis of X-ray and CT scan. The postoperative curative effect was evaluated according to Rockwood score.

RESULTSAll the patients' operative incision were healed well and in good appearance. X-ray showed that the dislocated SCJ was well reduced and the plate was on right position. All the 6 patients were followed up for 4 to 18 months, with an average of 12 months. The results were evaluated according to Rockwood score, 4 got excellent results, 1 good and 1 fair. No fixation loosening, redislocation or side injury such as vessel, nerve or pleura injury were found.

CONCLUSIONWith sternoclavicular hook plate fixation, SCJ dislocation could be reduced while keeping its amphiarthrodial function and the completeness of the cartilage surface. Sternoclavicular hook plate fixation has advantages of safety and stabilization in fixation, and patients can begin function exercises earlier.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sternoclavicular Joint ; injuries ; surgery

Antigens, CD20 ; metabolism ; Epstein-Barr Virus Infections ; virology ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Lymphoma, Large B-Cell, Diffuse ; pathology ; virology ; Middle Aged ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; virology

Objective To understand the changes of schistosomiasis endemic situation in Sichuan Province,the upstream of Yangtze River basin,and the impact on schistosomiasis transmission in Three Gorges Reservoir area after the construction of Three Gorges Reservoir. Methods The annual reports of the schistosomiasis endemic situation in Sichuan Province from 2000-2012,the data of the schistosomiasis surveillance sites in Sichuan Province from 2001-2012,the data of the schistosomiasis sampling survey in Sichuan Province in 2001,and the relevant reference of Three Gorges Reservoir were collected. The schisto-somiasis prevalence in human and cattle,and Oncomelania hupensis snail status were investigated. The snail survey was imple-mented in Qianjin Village,Jianyang City,Sichuan Province,the nearest village to Three Gorges Reservoir Area. Results The schistosomiasis endemic situation presented a continuous declining state in Sichuan Province from 2000-2012,and reached the criteria of schistosomiasis transmission controlled in 2008. From 2012,65.07%of endemic counties reached the criteria of schis-tosomiasis transmission interrupted. From 2006,no schistosome infected snails were found. In Qianjin Village,1714 m2 environ-ments were surveyed and no snails were found. Conclusions The schistosomiasis endemic area and snail area are significantly reduced in Sichuan Province,the upstream of Yangtze River basin,after the construction of Three Gorges Reservoir. Therefore, the possibility of schistosomiasis endemic diffusing to Three Gorges Reservoir area is minimum.

Objectives To compare the efficacy and adverse effects of combining all-trans retinoic acid and arsenic triox-ide with or without anthracyclines on the treatment of childhood acute promyelocytic leukemia (APL) patients. Methods The retrospective study included 46 children as newly diagnosed APL from January 1st, 2001 to December 31st , 2012. Efficacy and adverse effects for different induction therapies and in high and low white blood cell (WBC) count subgroups were studied. Results In the non antharcycline containing group, 2 patients died during remission induction, and in the antharcycline containing group none of the patients died. No statistical difference was observed between the antharcycline containing group and the non antharcycline containing group in complete remission, the length of time to achieve molecular complete remission and minimal residual disease quantitative analysis at the end of the induction. The mean duration of high WBC count subgroup in the anthar-cycline containing group was shortened than that of the non antharcycline containing group (P<0.05). The recovery time of the abnormal coagulation was found similar between these two groups. Conclusions The use of antharcycline in induction therapy could shorten the duration of high WBC count and reduced the WBC count peak , thus reduces the risk of early death.