Objective To define the indications of direct transpedicular lag screw to treat traumatic spondylolisthesis of axis (Hangmans fracure) and to evaluate the result of the technique. Methods From February 1998 to December 2000, 22 patients with acute traumatic spondylolisthesis of axis were treated. Ten of them achieved anatomic reduction by skull traction but no acceptable stability was ensured by traction alone. Among the ten patients, eight had integral and normal shaped C2 vertebral bodies (6 male, 2 female; age ranged from 18 to 42 years with an average of 28.2 years; 5, 2 and 1 patients classified as type Ⅰ, Ⅱ and Ⅱa injuries respectively according to Levine-Edwards classification and graded as D spinal injury in 2 cases and E in 6 cases according to Frankel scale) were further fixed with transpedicular lag screw. Under general anesthesia, the patients were laid in prostrate decubitus in a prepared head-neck-chest ventral plaster plate with skull traction in place to maintain reduction and lateral image intensification was applied to confirm the reduction. A posterior midline incision from C1-C3 was performed, and soft tissue was released to expose clearly the lamina, lateral mass, superior and medial aspect of the C2 pars interarticularis (isthmus plus pedicle). Points of entry for screw insertion were located at the entrance at the posterior aspect of lateral mass. The drill bit is parallel to both of the medial and superior border of C2 pars interarticularis (usually 25?-30? cephalad to the transverse plane and 30?-35? medial to the sagittal plane). The screw hole in the posterior cortex was overdrilled with a 3.5 mm drill bit for interfragmentary compression. 3.5 mm screws (25-30 mm, determined by depth gauge) were drived in after the cortex being tapped with a 3.5 mm tap. The whole procedure was done under monitoring of "C" arm fluoroscopy for safety and accuracy. Results It costs an average of 70 minutes to finish the procedure with mean blood loss of 250 ml. Hospital stay was about 18 days. A mean follow up time of 14 months (11 to 18 months) didnt confirm any early or late postoperative complications, all cases gained bony union 3 months later with complete neurological function recovery. The range of neck rotation was restored normal with no C2,3 instability or screw loosing found. Conclusion With appropriate indications, transpedicular lag screw fixation provides good reduction and stability to Hangmans fracture. This technique can only be applied to the fractures which are reductable.

Objective To study the phenolic compounds from Sagina japonica. Methods The separation and purification were carried out by silica gel Sephadex LH-20 gel and RP C-18 colomn chromatography. The structures were identified by spectra. Results Nine phenolic compounds were isolated from S. japonica. They were identified as:p-E-methoxy cinnamic acid methyl ester (Ⅰ),umbelliferone (Ⅱ),7-methoxy coumarin (Ⅲ),5,7-di-hydroxy coumarin (Ⅳ),5,7-di-methoxy coumarin (Ⅴ),cerarvensin-7-O-glucoside (Ⅵ),5,7,2'-trihydroxy-8-methoxy flavone (Ⅶ),5,7-di-hydroxy-8,2'-di-methoxy flavone (Ⅷ),5,7,3',4'-tetrahydroxy-6-methoxy flavone (Ⅸ). Conclusion All of these compounds are first isolated from S. japonica.

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.

BACKGROUND:Lumbar spinal stenosis is clinical repaired with decompression, bone fusion and internal fixation, and different internal fixation materials can be chosen during the surgery. OBJECTIVE:To explore the influence of polyetheretherketone (PEEK) pedicle screw fixation combined with interbody fusion on the bone fusion rate of patients with lumbar spinal stenosis. METHODS:A retrospective analysis was performed in 63 cases of lumbar spinal stenosis undergoing decompression and interbody fusion. These patients were divided into control group (titanium internal fixation system,n=31) and experimental group (PEEK pedicle internal fixation system,n=32) according the internal fixation materials folowed by posterior spinal decompression with interbody fusion. The Oswestry dysfunction index scores before and 4, 12, 24 weeks postoperatively and bone fusion rates at 4, 12, 24 weeks postoperatively were compared between the two groups. RESULTS AND CONCLUSION:Oswestry dysfunction index scores showed a gradual decline in both two groups before and 4, 12 and 24 weeks after treatment, but there was no difference at different time (P > 0.05). At 4 and 24 weeks after treatment, there was no difference in the bone fusion rates between the two groups (P > 0.05), but at 12 weeks after treatment, the bone fusion rate in the experimental group was better than that in the control group (P < 0.05). During the surgery, no infection and other adverse events occurred in the two groups. These results indicate that both PEEK and titanium internal fixation systems for lumbar tube stenosis have obtained good results, but PEEK material has a better role in the bone fusion at 4-12 weeks after internal fixation.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; surgery ; Nasal Septum ; pathology ; Rhinoplasty ; Tissue Transplantation ; Treatment Outcome

OBJECTIVE:To investigate the prognosis of coronary heart disease complicated with heart failure patients abandon-ing percutaneous coronary intervention (PCI) and receiving drug comprehensive therapy. METHODS:From Dec. 2010 to Jul. 2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group (105 cases) and non-operation group (112 cases). Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography re-checking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovas-cular events were recorded during follow-up period. RESULTS:7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction, heart failure and death in non-operation group was more than operation group,with statistical significance (P<0.05). 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance(P<0.05). The survival time of non-operation group was shorter than that of operation group,with statistical significance(P<0.05). CONCLUSIONS:Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.

Objective To investigate the relationship between expression of active form of caspase-3 and cell cycle in Fas-mediated apoptosis of B lymphocytoma cell line MML-1. Methods MML-1 cells were incubated with agonistic anti-Fas antibody for different time,and cell apoptosis was induced.Cell apoptotic rates were analysed by flow cytometry,and sensitivity of MML-1 cells to apoptosis was determined.The expression of active form of caspase-3 was analysed by double staining with PI-Triton X and FITC-active caspase-3.Cyclin A,B_1 and E were selected as cell cycle markers for S,G_2/M and G_1 phase of MML-1 cells,and the expression of active form of caspase-3 was detected by flow cytometry. Results The cell apoptotic rate reached 56% after induction by Fas for 6 h.After induction by Fas for 4 h,the active form of caspase-3 was mainly expressed in cells of G_1 phase,while rarely in cells of S and G_2/M phase.Cells with negative cyclin A and B_1 and positive cyclin E expressed active form of caspase-3. Conclusion The expression of active form of caspase-3 in MML-1 cells mediated by Fas might be cell cycle dependent.Cells entering into late G_1 and early S phase first express active form of caspase-3,and their sensitivity to Fas-mediated apoptosis is the highest.

Objective To analyze the changes of lymphocyte subsets in peripheral blood of patients with drug eruption . Methods 18 newly diagnosed patients were served as the drug eruption group ,and were subdivided into cephalosporin group (n=9) ,penicillin group(n=5) and Chinese medicine group(n=4) according to different sensitizing drugs .20 healthy people were taken as the control group .Flow cytometry were utilized to detect the percentages and absolute counts of T lymphocytes (CD3+ ,CD3+CD4+ and CD3+CD8+ ) ,B lymphocytes ,natural killer cell(NK) and natural killer T lymphocytes(NKT) in their peripheral blood . Results Differences of percentages of T lymphocytes (CD3+ ,CD3+ CD4+ ) ,B lymphocytes ,NKT cells between the drug eruption group and the control group showed statistical significant (P<0 .05) .Difference of percentages of CD3+ CD8+ lymphocytes of pa-tients between the drug eruption group and the control group demonstrated no statistical significant (P>0 .05) ,while that of abso-lute counts of T and B lymphocytes of patients was statistical significant between the drug eruption group and the control group (P<0 .05) .Conclusion The percentages of CD3+ ,CD3+CD4+ lymphocytes of patients with drug eruption decrease ,while those of NKT cells increase ,which may be related to the patients′immune regulation .

Objective To evaluate multiple minimally invasive techniques in the treatment of severe acute pancreatitis (SAP).Methods The clinical data of 93 patients with SAP who received minimally invasive treatment at the First Affiliated Hospital of Harbin Medical University from January 2005 to July 2010 were retrospectively analyzed.Percutaneous catheter drainage (PCD),endoscopic retrograde cholangio-pancreatography (ERCP),endoscopic sphincterotomy (EST),endoscopic nasobiliary drainage (ENBD) and laparoscopy were applied according to the condition of the patients.The efficacies of different treatment methods were evaluated.Results On the basis of comprehensive treatment,32 patients received 1 kind of minimally invasive treatment,41 patients received 2 kinds of minimally invasive treatment,14 patients received 3 kinds of minimally invasive treatment and 6 patients received 4 kinds of minimally invasive treatment.Sixty-nine patients received ultrasoundguided PCD; 28 patients received ERCP,EST and (or) ENBD; 29 patients received laparoscopy; 19 patients received treatments with stepped approach; 4 patients were complicated with abdominal bleeding,and received interventional treatment.The mean time of abdominal pain relief and duration of hospital stay were (37 ± 18)hours and (31 ±21 )days,respectively.The abdominal infection rate,laparotomy transfer rate,curative rate and mortality rate were62％(58/93),4％(4/93),91％ (85/93) and 9％ (8/93),respectively.Conclusion Multiple minimally invasive techniques combined with individualized treatment may significantly improve the curative rate of SAP.

Animals ; Cell Transplantation ; Humans ; Liver Diseases ; surgery