[Objective]To evaluate the value of ECT in diagnosing and treatment the spinal tuberculosis.[Method]ECT by injecting 99Tcm-MDP to human body was used to know the developing of focus in spinal tuberculosis and whether other bone and joints tuberculosis were complicating simultaneously.[Result]The developing of 175 patients were positive,including multi-vertebral bodies tuberculosis 146 cases,which were composed of 2 vertebral bodies 78 case,3 vertebral bodies 26 cases,4 vertebral bodies and more 42 cases.Complicating tuberculosis of bones and joints 22 cases,articulatio sacroiliaca 29 cases.[Conclusion]ECT plays an important role in diaognosing the spinal tuberculosis and the tuberculose focus of body can be found and has the guidance for doctors to formulate the therapeutic regimem of spinal tuberculosis.

Objective To study the expression of lipopolysaccharide(LPS) receptor,CD14 in the liver tissue during acute biliary infection and its relation with production of cytokines.Methods Rat models of acute biliary infection were established by ligating the choledochus and injecting Escherichia coli O111∶B4 into the duct.The expressions of CD14 protein and mRNA in liver tissue,the plasma levels of endotoxin,TNF-? and IL-6,and phagocytosis activity of Kupffer cells(KCs) were assayed at 0,3,6,12 and 24 h after operation.Ultrastructural changes in KCs were observed by electron microscopy.Results With the course prolonging in acute biliary infection,the plasma endotoxin level was progressively increased,KCs were activated and the levels of TNF-? and IL-6 markedly were increased,while the CD14 expression obviously increased at mRNA and protein levels.Conclusion The CD14 expression is gradually increased in liver tissue during acute biliary infection.KCs are activated and releasing more and more cytokines.It might be one of the important mechanisms of that KCs improve inflammatory response during the infection.

This paper is aimed to explore the correlation of clinical outcomes with material science features of implant in the treatment of atlantoaxial instability by the Vertex technique.A total of 26 cases with atlantoaxial instability and dislocation were enrolled from the Affiliated Hospital of Luzhou Medical College between January 2004 and January 2006.They all underwent the internal fixation via posterior cervical pathway and atlantoaxial fusion in Vertex system that was produced by American Sofamor Danek Company.The intraoperative complications and postoperative neurological recovery of each case were documented.Dynamic radiograph and digital tomography were used to evaluate the extent of the atlantoaxial vertebrae stability.①The result of X-ray showed that bony fusion was successful in 22 patients during 3-month follow-ups,3 patients during 6-month follow-ups,and 1 case after implantation following bony resorption.②There was no deterioration of spinal cord injury and the JOA scores of neurofunction increased from 3-17 points(mean 6.8 points) to 5-17 points(mean 14.8 points) ,with the rate of improvement as 83%.③All 26 patients were normal in the movements of expansion and flexion,but the rotation was partly limited.There were 18 cases rotate in 120?,6 cases in 100? and 1 case in 60?.Vertex system is effective in dealing with internal fixation via posterior cervical pathway.Due to the connection with stick by multiaxial screw,Vertex system presents superiority in clinic,such as secure fixation,random length and convenient connection.Vertex system internal fixation is effective in dealing with atlantoaxial instability and dislocation.

[Objective]To discuss the causes and preventive measures of early complications after using Vertes technique in treating dens axis fracture with atlantoaxial dislocation.[Method]Eighteen cases performed Vertex technique were included in this study.The early complications(postoperative or at surgery) included vertebral artery injury(2 cases),logagnosia(1 case),anopsia(1 case),hematorrhea(1 case) and wrong instrumentation(1 case).The causes of these complications and how to prevent were analyzed.[Result]All these complications were treated in time,and no sequela was found.[Conclusion]The early complications of Vertex technique in treating dens axis fracture with atlantoaxial joint dislocation can be prevented.The timely treatment must be performed when it occurs,and the effect would be satisfactory.

Objective To summarize the efficacy of cervical pedicle screw fixation in the treatment of cervical spinal cord injury without fracture and dislocation.Methods From September 2007 to March 2010,21 patients with cervical spinal cord injury without fracture and dislocation combined with developmental cervical stenosis were managed by pedicle screw fixation in unstable segments,and then single open-door laminoplasty in stenosis segments.The clinical outcomes were reviewed and summarized.Results All the patients received follow-up of 1-3 years.Two patients had superficial wound infection,which was cured by dressing change.One presented intra-incisional hematoma one week post-operatively and was cured by hemostasis and drainage.One had door-reclosing without symptom aggravation.There was neither perforation of pedicle screws nor breakage,loosening or displacement of internal fixation.The curvature of cervical lordosis at follow-up had significant rectification in comparison with that at preoperation,but showed unobvious change as compared with that immediately after operation.According to the modified Japanese Orthopedic Association (JOA) score,the neurological score improved from preoperative 4-15 points to 9-17 points at the final follow-up,which revealed more than 80％ of recovery in 13 patients,50％ -80％ of recovery in six and 5％ -50％ of recovery in two,with the average recovery rate of 75％.Conclusion For unstable segments in patients with cervical spinal cord injury without fracture and dislocation combined with developmental spinal stenosis,posterior pedicle screw fixation can avoid the risk of further spinal cord injury in single open-door laminoplasty and restore the physiological curvature of cervical vertebrae,which provides solid foundation for backward drift of spinal cord and creates favorable condition for recovery of spinal cord function.

Objective To explore the effect on effect of combined use of Y27632 (ROCK II inhibitor)and TDZD-8(GSK-3β inhibitor)on axonal regeneration of dorsal root ganglion (DRG) neurons in neogenetic rats. Methods All the thoracolumbar DRGs of two neogenetic Sprague-Dawley (SD)rats(<5 days)were harvested under the stereopsis raicrostat,and then the DRG neurons were cultured,purified and indentified.Fifteen adult female SD rats were randomly divided into three groups,ie,complete paraplegia group(5 rats),sham operation control group(5 rats)and normal group(5 rats)respectively.The T8-10 spinal cord extracts (SCEs) were harvested in the complete paraplegia group,sham operation control group and normal group respectively at day 7 after spinal cord injury.The experiment was divided into group A(DRG neurons + PBS),group B(DRG neurons + complete paralysis SCE),group C(DRG neurons + complete paralysis SCE + different concentration Y27632),group D(DRG neurons + complete paralysis SCE + different concentration TDZD-8)and group E(DRG neurons + complete paralysis SCE + proper concentration Y27632 and TDZD-8).The average axonal length and expression intensity of Tubulin βⅢ at distal end of neuronal axons were observed after two days of co-culture respectively in intro. Results (1)The average axonal length and expression intensity of Tubulin βⅢ at axon shaft and growth cone in the group B were significantly shorter and weaker than that in the group A,with statistical difference.(2)In the group C,the average axonal length and expression intensity of Tubulln βⅢ at axon shaft and growth cone in 5-10 μmol/L Y27632 treatment groups were more than that in the group B but lower than that in the group A.The average axonal length and expression intensity of Tubuhn βⅢ at axon shaft and growth cone in 20-50 μmol/L Y27632 treatment group were longer and stronger than that in the group A and the group B,especially the group B.Among different concentration Y27632 treatment groups,there was a longest average axonal length and strongest expression intensity of Tubulin βⅢ in 30 μmol/L treatment group.(3) In the group D,there was a longer average axonal length in 0.5-3 μmol/L TDZD-8 treatment group than that in the group A and the group B,with the longeat average axonal length in l μmool/L TDZD-8 treatment group.In 5-25 μmol/L TDZD-8 treatment groups,the average axonal length showed no difference compared with the group B but wns shorter than that in the group A.In all different concentration TDZD-8 treatment groups,the expression intensity of Tubulin βⅢ at axon shaft and growth cone was significantly stronger than that in the groups A and B.(4) In the group E,although the average axonal length was increased in the group E,there was no statisilcal difference compared with the group A,30 μmol/L Y27632 treatment group and l μmol/L TDZD-8treatment group.There was a significantly longer average axonal length in the group E than it in the group B and the expression intensity of Tubulin βⅢ at axon shaft and growth cone was stronger in the group E compared to the group A,30 μmol/L Y27632 treatment group and l μmol/L TDZD-8 treatment group.Conclusion The complete paralysis SCEs obviously inhibits DRG axonal growth,induces axonal retraction and growth cone collapse.High concentration of Y27632 can more obviously promote the axon growth compared with the low concentration,while the low concentration of TDZD-8 can obviously promote the axon growth.Combined use of appropriate concentration of TDZD-8 and Y27632 can promote the axon growth and induce the axons branching,as facilitates the formation of the axon circuit.

Objective To study the clinical feature, diagnossis and therapy of open spinal cord injury. Methods A retrospective study was performed in 15 patients with open spinal cord injury including 14 males and one female, at age range of 15-46 years (mean 23 years). There were two patients with open cervical spinal cord injury, 11 with open thoracic spinal cord injury and two with open lumbar spinal cord injury. Injury causes included sharp knife injury in 12 patients, firearm injury in two and stick stabbing in one. According to ASIA scale, there was one patient at Grade A, two at Grade B, seven at Grade C, four at Grade D and one at Grade E preoperatively. Foreign bodies were found in the wound in four patients. There were three patients combined with spinous process fracture, eight with vertebral plate fracture and five with vertebral body fractures. All 15 patients were treated by emergency management including vertical canal exploration, hematoma debridement or foreign body removal. Results Postoperative complications included cerebrospinal fluid leakage in two patients and wound infection ( without spinal cord infection) in one. There were different degrees of neural functional recovery in five patients. The post-operation ASIA scale: one patient at Grade A, three at Grade C, 10 at Grade D and one at Grade E,with no patient at Grade B. Conclusions For open spinal cord injury, emergency operation is necessary under adequate preoperative preparation. Preoperative identification of foreign bodies, exploration and decompression are beneficial to spinal cord function recovery and reduction of the incidence rate of postoperative complications like infection or hemorrhage.

BACKGROUND:Adipose-derived stem cel s have a wide variety of sources and strong proliferation ability, which are easy to access and simple to culture. Therefore, adipose-derived stem cel s that are secondary to bone marrow mesenchymal stem cel s are expected to become the most promising seed cel s for bone tissue engineering.
OBJECTIVE:To explore the feasibility of rabbit adipose-derived stem cel s with demineralized bone matrix to repair ulna defects.
METHODS:Ulna defect model was made in rabbits. Demineralized bone matrix was implanted into the right defect region as control group. After osteogenic induction, rabbit adipose-derived stem cel s/demineralized bone matrix composite was implanted into the left defect region as experimental group. At 12 weeks after implantation, defect tissues were taken for CT scanning and histological detection.
RESULTS AND CONCLUSION:CT results showed that there was unclear boundary between the broken ends of fractured bone and the composite material in the experimental group, and paral el cal uses out of the broken end could be seen. In the control group, the broken end was clearly seen and no cal us occurred continuously. Fibers were connected at the defect site, and no new bone occurred. Histological findings showed that typical regenerated bone tissues were seen in the experimental group with osteocytes, bone lacunae and bone trabeculae;there were more osteocytes and bone lacunae, but bone trabecula was only seen in a part of bone defects;a few of col agens interlarded the regenerated bone tissues. In the control group, the residual of demineralized bone matrix was seen as wel as some col agenous fibers, and periosteal bone formed a little, but no large amount of regenerated osteoid tissues were found. These findings indicate that under osteogenic induction, rabbit adipose-derived stem cel s combined with demineralized bone matrix are feasible to repair ulna defects.

Objective To investigated the expression of scavenger receptor A(SR-A) and lipopolysaccharide(LPS) receptor CD14 in endotoxin-induced acute liver injury.Methods Ninety Wistar rats were randomly divided into endotoxaemia group(LPS group) and normal saline group(NS group).The model of endotoxaemia and acute endotoxin-induced liver injury was established by injection of endotoxin(5mg/kg) via tail veins in LPS group,while the rats in NS group received injection of 0.2ml normal saline as control.At 0,1.5,3,6,12h after injection,the levels of endotoxin,TNF-?,IL-1,alanine transaminase(ALT) and total bilirubin(TB) in plasma,SR-A and CD14 expressions in liver tissues were determined,pathological changes of liver tissues and ultrastructural changes of Kupffer cells(KCs) were observed by light and electron microscopy respectively,while the phagocytosis of KCs was determined too.Results Compared with NS group,KCs were activated on morphology and functions(proliferated diffusely,enlarged in size and increased in phagocytosis function),levels of TNF-? and IL-1 increased markedly,the pathological changes of cell degeneration and necrosis and the liver function were gradually aggravated,while SR-A expression decreased and CD14 expression increased obviously(P

Objective To investigate the expression of scavenger receptor A(SR-A) in rat liver tissues during acute obstructive suppurative cholangitis(AOSC) and its relations with inflammatory mediators and hepatic injury.Methods Wistar rat models of AOSC were reproduced by ligating choledochus and inside injecting Escherichia coli O111∶B4.The plasma endotoxin concentrations,TNF-? levels and expressions of SR-A protein and mRNA in liver tissues were assayed by limulus test,ELISA,immunohistochemistry and RT-PCR,respectively.Pathological changes of liver tissues were observed under light microscope.Results With the time prolonged,the plasma endotoxin concentrations and the TNF-? levels gradually increased,but the SR-A protein and mRNA expressions decreased in the rats of experimental group,significantly different with those in sham operation group and normal saline group(P