Objective To evaluate the value of CT guided percutaneous lumbar diskectomy (CT PLD) at plateau area. Methods Sixty eight cases of lumbar disc herniation was reated with CT PLD. (1)Before operation, diseased intervertebral disc was scanned, cases were selected, and operation plan was plotted . (2)The best puncture arrangement was chosen on the current video CT picture by designing the puncture path, noting down the puncture parameter, and marking the puncture spot on patient′s body surface. (3)Puncture was performed according to fixed parameter. (4)Operation was performed after the puncture needle was put into the disc ascertained by scan.(5)CT scan was done again after operation to observe if the puncture path had bleeding and intervertebral disc recovery. Results After 3 to 18 months′ follow up, 28 cases were prominent effective and 36 cases effective. The lumbar disc backed 1 to 4 mm. The total effective rate was 94.12%. Conclusion CT PLD is an ideal therapeutic method for lumbar disc herniation at plateau area because it is safe and effective and with less complications.

ObjectiveTo study the application of three-dimensional simulated surgical technique in precise hepatectomy. MethodsFrom July 2009 to February 2010, 16 patients with primary liver cancer underwent preoperative simulated imaging and three-dimensional simulation of liver resection.The 3D extent of simulated hepatectomy and actual hepatectomy was compared and analyzed. ResultsThe shape and the extent of the liver resected were very similar in the simulated and the actual hepatectomies. The mean differences in the length, breadth and depth of the remnant livers were 0. 6118 cm,0. 4490 cm and 0. 3199 cm, respectively. ConclusionsSimulation hepatectomy could predict the extent of the actual liver resection, and provided accurate guidance and preoperative planning for precise hepatectomy.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Objective : To explore the effects of the nerve growth factor neutralizing antibody ( anti⁃NGF) and γ⁃secretase inhibitor 3,5⁃difluorophenylacetyl⁃L⁃alanyl⁃S⁃ph ⁃enylglycine⁃t⁃butyl ester (DAPT) on the nuclear expression of p75 neurotrophin receptor (p75NTR ) in esophageal cancer Eca109 cells and on cell proliferation and invasion. Methods : Immunofluorescence cytochemistry was used to detect the expression changes of p75NTR and Ki6 in Eca109 cells before and after treatment with the anti⁃NGF and γ⁃secretase inhibitor DAPT; CCK⁃8 kit and Transwell cell invasion experiment were used to detect the changes of cell proliferation and invasion ability before and after treatment of Eca109 cells with the anti⁃NGF and γ⁃secretase inhibitor DAPT alone or in combination. Results: Immunofluorescence cytochemistry showed that after treatment of cells with the anti⁃NGF and γ⁃secretase inhibitor DAPT, the number of cells expressing p75NTR in the nucleus decreased, and after the combined treatment of cells with the anti⁃NGF and γ⁃secretase inhibitor DAPT, the number of cells expressing p75NTR in the nucleus was the least, and the difference was statistically significant (P < 0. 05); CCK⁃8 method and Transwell cell invasion experiment showed that after treatment of cells with the anti⁃NGF and γ⁃secretase inhibitor DAPT, cell proliferation and invasion ability were correspondingly weaker than those before treatment, and the difference was statistically significant (P < 0. 05) . Conclusion The anti⁃NGF and γ⁃secretase inhibitor DAPT not only inhibit the nuclear transfer of p75NTR , but also reduce the nuclear expression rate of p75NTR and weaken the cell proliferation and invasion ability accordingly.

OBJECTIVE: To investigate the effectiveness of sagittal top compression reduction technique in the treatment of thoracolumbar vertebral fractures. METHODS: A retrospective analysis was conducted on the clinical data of 59 patients with thoracolumbar vertebral fractures who met the selection criteria and were admitted between November 2018 and January 2022. Among them, 34 patients were treated with sagittal top compression reduction technique (top pressure group), and 25 patients were treated with traditional reduction technique (traditional group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, fracture segment, cause of injury, AO classification of thoracolumbar vertebral fractures, thoracolumbar injury classification and severity (TLICS) score, American Spinal Injury Association (ASIA) grading, surgical approach, preoperative vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, segmental kyphosis angle, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and incidence of complications between the two groups were recorded and compared. After operation, VAS score and ODI were used to evaluate effectiveness, and X-ray and CT examinations were performed to measure imaging indicators such as vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, and segmental kyphosis angle. RESULTS: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. Patients in both groups were followed up 6-48 months, with an average of 20.6 months. No loosening, breakage, or failure of internal fixation occurred during follow-up. The imaging indicators, VAS score, and ODI of the two groups significantly improved at 1 week and last follow-up when compared to preoperative ones ( P<0.05). At last follow-up, the VAS score and ODI further significantly improved when compared to 1 week after operation ( P<0.05). At 1 week after operation and last follow-up, the vertebral body index, segmental kyphosis angle, injured vertebra angle, and ODI in the top pressure group were significantly better than those in the traditional group ( P<0.05). There was no significant difference in VAS score and height ratio of the anterior margin of injured vertebra between the two groups at 1 week after operation ( P>0.05), but the two indicators in the top pressure group were significantly better than those in the traditional group at last follow-up ( P<0.05). CONCLUSION The treatment of thoracolumbar vertebral fractures with sagittal top compression reduction technique can significantly improve the quality of vertebral reduction, and is superior to traditional reduction techniques in relieving pain and improving spinal function.
Humans ; Thoracic Vertebrae/injuries* ; Lumbar Vertebrae/injuries* ; Retrospective Studies ; Blood Loss, Surgical ; Treatment Outcome ; Pedicle Screws ; Spinal Fractures/surgery* ; Kyphosis ; Fracture Fixation, Internal ; Fractures, Compression/surgery*