Objective To evaluate the clinical effect of the free-hand cervical pedicle screw fixation in treatment of the upper cervical fracture and instability.Methods A retrospective review was performed on 15 patients with upper cervical fracture and instability treated with cervical pedicle screw fixation and fusion from September 2006 to January 2009.There were 11 males and 4 females,at average age of 41.2 years(range,18-60 years).Of all,there were five patients with atlas fracture and dislocation(including three simple anterior arch fractures and two Jefferson fractures),three with axis fracture and dislocation,one with dens fractures plus nonunion,two with C2,3 fracture and dislocation and four with atlantoaxial instability without fracture.The main clinical complaints included local neck pain and/or tetraplegia.Halo traction was recommended to restore the cervical sequence preoperatively in all patients.All 15 patients were treated by cervical pedicle screw-rods internal fixation and bone graft fusion.During the operation,the point and angle of the implanted pedicle screws were determined by preoperative X-ray and CT scan and the bony channel drilled with free-hand before implantation of the Summit or Vertex pedicle screws(22-26 mm long)and posterior interlaminar autologous or allogeneic bone fusion.Patients could get out of bed with neck collar at days 1-2 after operation.Results A total of 64 cervical pedicle screws were implanted in all 15 patients,with no vertebral artery injury,spinal cord injury or cerebrospinal fluid leakage.Postoperative X-ray and CT scan confirmed satisfactory internal fixation.The clinical symptoms were improved significantly.Fourteen patients were followed up for 12-36 months,which showed bony fusion,with no looseness or breakage of the screws.Neurologic impairment was improved in all patients,with no complications associated with the cervical pedicle screw.Conclusions Cervical pedicle screw internal fixation can reestablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function and hence is a reliable method for upper cervical fracture and/or instability.

Objective To explore the relationship between peripheral Th17 cell number and chronic gastritis in Helicobacter pylori(H.pylori)-infected children.Methods Children were diagnosed as chronic gastritis by endoscopy.The degree and activity of inflammation were graded by histopathology examinations.The patients with both 13C urea breath test and urease test positive were diagnosed as H.pylori infection.The peripheral Th17 cell number was measured by flow cytometry and expressed as a ratio to total T cell.Results The Th17 cell number in HP group (chronic gastritis with H.pylori infection,n =33),non-HP group (chronic gastritis without H.pylori infection,n =24) and normal controls (n =15) were (1.55 ±0.30)％,(1.06 ±0.33)％,and (1.04 ±0.35)％,respectively.HP group included a statistically higher Th17 cell number than the other groups (all P ＜ 0.05),while no obvious difference was found between non-HP group and controls (P ＞ 0.05).According to the degree of inflammation,the chronic gastritis with H.pylori infection was categorized into non-apparent (n =10),mild (n =8),moderate (n =9) and severe (n =6) subgroups.The Th17 cell number in each subgroup was (1.64 ± 0.21)％ (non-apparent),(1.61 ± 0.23)％(mild),(1.25 ± 0.29) ％ (moderate) and (1.75 ± 0.20) ％ (severe),respectively.The moderate group had a lowest Th17 cell number among 4 groups (P ＜ 0.05).And significant differences did not exit in the other 3 groups (P ＞ 0.05).The HP group patients with different inflammatory activity had a Th17 cell number of (1.23 ±0.25)％ in nonapparent (n=15),(1.53 ±0.15)％ in mild (n=6),(1.55 ±0.32)％ in moderate (n=6) and (1.71 ±0.35)％ in severe (n =6) subgroup,respectively.However,there were no significant differences among 4 subgroups (P ＞ 0.05).Conclusions In the progress of chronic gastritis with H.pylori infection,Th17 cells may play a role as a double-edged sword by protecting and fighting against H.pylori infection and immunopathologic insults.This would provide more insights into the treatment of H.pylori infection.

Objective To discuss the value of thoracolumbar injury classification and severity score (TLICS) and load-sharing scores in guiding selection of the indications of combined anteroposterior surgery for thoracolumbar fractures. Methods A total of 216 patients with thoracolumbar fractures treated surgically from January 2006 to January 2008 were involved in the study. Combined anterior and posterior surgery was carried out in 48 patients including 32 males and 16 females (at average age of 39 years, range 18-55 years). Segments involved T11 in two patients, T12 in eight, L1 in 20 and L2 in 18. According to the classification of Magerl, there were 20 patients with type B1 fractures, 15 with type B2, four with type C1 and nine with type C2. Neurologic status based on ASIA classification was at grade A in five patients, grade B in 16, grade C in 16, grade D in nine and grade E in two. All patients were operated in lateral position at one stage within 14 days after injury, with posterior laminectomy and pedicle fixation, anterior corpectomy, reduction and strut graft. Forty-five patients were followed up for 14-38 months. Plain X-ray radiographs and reconstruction CT were taken to observe the bone healing. Local kyphosis and vertebral canal were also measured. All the patients were evaluated with TLICS and load-sharing scores. Results Lumbar physical lordosis was reconstructed, with no evident correction loss,pseudoarthrosis or implant failure noted during follow-up. The patients treated with combined surgery had TLICS score ≥5 points, load-sharing scores ≥7 points and were combined with posterior ligamentous complex injury, so the fracture could not be sufficiently decompressed and reconstructed with single anterior or posterior surgery. Of all, 45 patients were followed up for 14-38 months (mean 25 months), which showed that all the combined surgeries were performed successfully, with bone fusion and neurological status improved for at least one ASIA grade. No complications like implant breakage, loosening, titanium mesh displacement or subsidence were observed. Conclusions LICS is basically helpful for guiding selection of combined surgery, but does not well evaluate the canal compromise, to which the load-sharing scores can supplement. These two evaluation systems should be applied together. The anteroposterior surgery can be recommended when the patients are with TLICS≥5 points, load-sharing score ≥7 points and combined with ligament complex injury.

Objective To investigate the resistant patterns of Mycobacterium tuberculosis (MTB) strains against first- and second-line anti-tuberculosis drugs. Methods Drug susceptibility tests of 518 MTB strains collected from January 2008 to March 2009 were performed using BactecMGIT 960. The data were analyzed by chi square test. ResultsIn 518 strains, 168 (32.44％) were all sensitive to all seven drugs, 350 (67.56％) were resistant to at least one drug. Among all strains, 72 (13.90％) were resistant to one drug, 24 (4.63％) were resistant to two drugs, 254 (49.03％) were resistant to three or more drugs. A total of 217 strains (41.89 ％) were classified as multi-drug resistant tuberculosis (MDR-TB)strains and 65(12.55％)were extensively drug resistant tuberculosis (XDR-TB) strains which accounted for 29.95 ％ of MDR-TB strains. The drug resistant rate of isoniazid which belonged to first-line drugs was 53.67％ (278 strains) and that of ofloxacin which belonged to second-line drugs was 39.77 ％ (206 strains). In 433 retreated patients, the drug resistant rate against any drugs, MDR rate and XDR rate were 72.05％, 46.42％ and 13.86％,respectively, which were all higher than those in treatment naive patients (44.70％, 18. 82％ and 5.88％, respectively; x2 = 24. 253, x2 ＝ 22. 229 and x2 ＝ 4. 117, respectively; all P ＜ 0.01).ConclusionsThe resistant rate of MTB is high in a tuberculosis specialized hospital in Shanghai, and MDR-TB also shares a high resistant rate as well as XDR-TB. Furthermore, drug resistance is more common in retreated patients.

Objective To systematically evaluate the efficacy and safety of posterior short segment and long segment pedicle screw internal fixation in the treatment of thoracolumbar burst fracture. Methods By searching the database, including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, a comprehensive study was carried out to make a comparison between the posterior short segment and the long segment pedicle screws internal fixation in treatment of thoracolumbar burst fracture, and Meta analysis was performed. Results A total of 14 related studies and 658 patients were enrolled in the study, including 320 patients in short segment group and 338 cases in long segment group, and Meta analysis was performed. The results suggested that there was no significant difference between the short segment group and the long segment group in terms of the deformity angle of the injured vertebra measured after operation and at the last follow?up, and sagittal index at the last follow?up ( MD=-0. 22,95%CI -2. 73,2. 28,P=0. 86;MD=-0. 28,95%CI -2. 23,1. 67, P=0. 78;MD=0. 47, 95%CI -3. 45, 4. 39, P=0. 81 ) . Besides, both groups had no statistical difference in post?operative COBB angle,anterior vertebral height and compression rate of injured vertebrae ( MD=0. 21,95%CI -0. 65,1. 06,P=0. 64; MD=-0. 46,95%CI -1. 40,0. 49,P=0. 34; MD=0. 47,95%CI -2. 28, 3. 21, P= 0. 74 ) , while the differences in COBB angle, anterior vertebral height, compression rate, correction loss were statistically significant at the last follow?up (MD=5. 11,95%CI 2. 81,7. 40,P<0. 0001;MD=-11. 89,95%CI-15. 28,-8. 50,P<0. 00001;MD=6. 46,95%CI 3. 85,9. 07,P<0. 00001) . There was no significant difference in VAS scores and the ODI scores between the two groups at the last follow?up ( MD =0. 01,95%CI -0. 15,0. 17,P=0. 9; MD=-0. 47,95%CI -2. 68,1. 74,P=0. 86),while the two groups showed statistically significant difference in fixation failure ( RR = 0. 08, 95%CI 0. 01, 0. 15, P = 0. 02 ) . Conclusion Posterior long segment pedicle screw internal fixation is more effective in treating thoracolumbar burst fracture than short segment surgery. It can reduce the COBB angle,restore the anterior height of the injured vertebra,and decrease the anterior vertebral pressure.

Objective To investigate the biocompatibility and safety of nanoscale brain-targeting-carrier micelles [poly (ethylene)-b-poly (lactic acid)/OX26 conjugate micells (copolymer/OX26)],and to explore its possibility as brain-targeted-drug carrier for brain glioma.Methods The C6 glioma cells were cultured in vitro and divided into experimental groups with different concentrations (10, 20, 40, 80 mg · L-1 )of nano micelle, and the medium without micelle was used as control group.The inhibitory effect of nano-micelles on the rat brain glioma C6 cells was examined by Trypan blue cell counting assay.Flow cytometry (FCM)was used to detect the changes of apoptosis and cell cycle of C6 cells,and confocal laser scanning microscope (CLSM)was performed to analyze the distribution of copolymer/OX26 into C6 cells. Results The results of Trypan blue cell counting assay showed copolymer/OX26 didn’t affect the growth of C6 cells,and there were no significant differences in the number of C6 cells between control group and expreimental groups (P >0.05).The results of FCM showed that the cell cycle and and the apoptotic rates of C6 cells had no changes compared with control group (P > 0.05).The results of CLSM showed that the fluorescence intensities in experimental groups were higher than those in blank micelles group and blank control group (P < 0.05 ), and they were increased in dose- and time-dependent manner (P <0.05).Conclusion Copolymer/OX26 has no effect on the growth and apoptosis of glioma cells.By bonding OX26,copolymer/OX26 can significantly increase the intake of C6 cells on the nano micelles.

AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent - function magnetic resonance imaging techniques ( BOLD-fMRI) .
METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7. 12. 0. 635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.
RESULTS: The functional area that was left occipital lobe (BA18), middle occipital gyrus (BA19), limbic lobe (BA19), lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe ( BA7 ) expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1. 5762, 1. 6856 respectively (P<0. 001). However, the difference of activated intensity was lower after 18mo, mean t value was 1. 1473 (0. 001 CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.

This study aims to assess the expression of Klotho and insulin-like growth factor-1 (IGF-1) and the association between Klotho and IGF-1 in rats with dementia model. Thirty rats were randomly divided into three groups. Morris water maze was used to investigate the learning and memory functions, and enzyme linked immunosorbent assay was used to analyze the levels of Klotho and IGF-1. Klotho and IGF-1 levels in the model group were lower than those in other 2 groups. Morris water maze test showed that the model group had longer escape latency times and shorter step platform times compared to other groups. Line correlation model demonstrated that Klotho level was positively correlated with IGF-1 level in rats with dementia (P= 0. 029). The levels of Klotho and IGF-1 both reduced at hippocampus in rats with dementia model, suggesting that it may be a close relationship between Klotho and IGF-1 in the pathogenesis of dementia.
Animals ; Dementia ; metabolism ; Female ; Glucuronidase ; genetics ; metabolism ; Hippocampus ; metabolism ; Insulin-Like Growth Factor I ; genetics ; metabolism ; Male ; Maze Learning ; Memory ; physiology ; Rats ; Rats, Wistar

A total of 13 mumps virus strains were isolated using Vero/Slam cell line from the patients' throat swabs and urines during mumps outbreaks and sporadics in liaoning Province from 2008 to 2011. Fragments of 316 nucleotides containing SH genes from 13 mumps virus isolates were amplified by RT-PCR, the PCR products were sequenced and analyzed. Based on the 316 nucleotides of SH gene, the phylogenetic trees were constructed with WHO mumps reference strains downloaded from GenBank and 13 mumps virus strains. It showed that the 12 mumps virus strains in 2008-2011 belonged to F genotype, nucleotide acids and amino acids similarities were 94.9%-100.0% and 83.3%-100.0%. Compared to the F reference strains, nucleotide acids and amino acids similarities were 92.4%-97.2% and 96.5% 84.2%, indicating that liaoning mumps strains had large genotype variation. Furthermore, compared to other genotype mumps strains, 6 nucleotides mutations (C(Nt65), C(Nt105), G(Nt137), C(Nt192), C(Nt239), G(NT262)) in SH gene were shared in all of liaoning F genotype mumps viruses. However these mutations were not found in other genotypes of mumps viruses. Conserved amino acids in SH protein of some liaoning mumps strains had changed (S to P at position 2 P to L at position 6 T to N at positon 23 L to P/R at position 48). The genotype specific triplet IML (at position 28-30) was changed to TMP in strain 2008-001-007 2011-015 s, nucleotide acids and amino acids similarities of strain 2008-001-07 were 87.5% and 79.8%, compared to F reference strains respectively, and 96.8% and 97.4% respectively compared to the G reference strains, in dicating strain 2008-001-07 belonged to G genotype,which was first found in mainland China.
Amino Acid Sequence ; China ; Genetic Variation ; Genotype ; Humans ; Molecular Sequence Data ; Mumps ; epidemiology ; virology ; Mumps virus ; chemistry ; classification ; genetics ; isolation & purification ; Mutation ; Phylogeny ; Sequence Homology, Amino Acid ; Viral Proteins ; chemistry ; genetics ; metabolism

OBJECTIVETo investigate the influence of therapeutic bloodletting at Jing-well points and hypothermia on acute cerebral edema after traumatic brain injury (TBI) in rats.

METHODSSeventy-five SD rats were randomly divided into sham-operation group (Sham), TBI group (TBI), bloodletting group (BL), mild-induced hypothermia group (MIH), and bloodletting plus MIH group (BL + MIH) (n = 15). The model of TBI was established by electric controlled cortical impactor (eCCI). The rats of BL group were bloodletting at Jing-well points immediately after injury, twice daily. While the MIH group was settled on a hypothermia blanket promptly after TBI for 6 hours, so that the temperature dropped to 32 degrees. Each of measurement was performed after 48 hours. Magnetic resonance imaging (MRI) was used to evaluate the dynamic impairment of cerebral edema after TBI (n = 3). In addition, mNSS score, measurements of wet and dry brain weight, and Evans Blue assay were performed to investigate the neurologic deficit, cerebral water content (n = 8), and blood-brain barrier permeability (BBB), (n = 4), respectively.

RESULTSMRI analysis showed that the cerebral edema, hematoma and midline shifting of rats in TBI group was more serious than other treatment group. Meanwhile compared with TBI group, the mNSS scores of every treatment group were meaningfully lower (all P < 0.05). Furthermore, treatment with BL+ MIH group was superior to the separated BL and MIH group (all P < 0.01). In addition, brain water content of each intervention group reduced to varying degrees (all P < 0.05), especially that of MIH group and BL + MIH group (P <0.01). BBB permeability of each treatment group was also significantly improved (all P < 0.01), and the improvement in MIH group and BL + MIH group was much better than the BL alone group (P < 0.05, P < 0.01).

CONCLUSIONOur major finding is that bloodletting at Jing-well points and MIH can reduce cerebral edema and BBB dysfunction and exert neuroprotective effects after TBI. The results suggest that the combination of BL and MIH is more effective than other treatment being used alone.

Animals ; Blood-Brain Barrier ; Bloodletting ; Brain ; pathology ; Brain Edema ; prevention & control ; Brain Injuries ; therapy ; Hypothermia, Induced ; Rats ; Rats, Sprague-Dawley