BACKGROUND: It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy (CSM). It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra.OBJECTIVE: To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation.DESIGN: Observational study.SETTING: First Affiliated Hospital of Nanchang University.PARTICIpANTS: Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital,Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years,averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous iliac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group (n =32) and two-level segmental discectomy group (n =40) according to experimental requirement.METHODS: ①Anterior decompression plus autogenous iliac bone implant plus titanium plate internal fixation were utilized.The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous iliac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken before operation, immediately after operation, 6 and 12 months after operation. Lordosis of the fusion segment was measured with Cobb's angle, and lordosis of cervical vertebra was assessed with D value. These data were analysed by statistic software. ④Bone fusion of the patients was followed up for 12 months after operation. Vertebral fusion standards included no abnormity between two spinous processes of the fusion segment, no lucency between implant and vertebra, as well as bone trabecula across the interface between implant bone and vertebra. ⑤Biocompatibility between material and host was observed during follow-up.MAIN OUTCOME MEASURES: ①Changes of Cobb's angle and D value at different time points before and after operation,and ②Bone fusion and rejection were followed up.RESULTS: Totally 72 patients were involved in the result analysis. ①Cobb's angle was larger and D value was higher immediately after operation, 6 and 12 months after operation than those before operation in the single segmental discectomy group and the two-level segmental discectomy group (P＜0.05). ②Findings of 12-month follow-up showed that bone fusion appeared in all patients of the two groups. ③No significant rejection was found after titanium plate internal fixation implantation. It was found that material and host had a good biocompatibility.CONCLUSION: It is satisfactory to restore physiological lordosis of cervical spine by using cervical anterior plate internal fixation plus autogenous iliac bone for CSM.

Objective To study the effect of glutamine (Gln) on the intestinal mucosa inflammatory reaction and permeability after intestine ischemia-reperfusion injury in rats.Methods The rat model of intestinal ischemia-reperfusion injury was established by clamping the mesenteric superior artery and then restoring blood flow.Forty-eight model rats were divided into control group (n =24) and model + Gln group (n =24)according to the stochastic indicator method.Both groups were given enteral nutrition with equal energy and nitrogen [energy 125.4 kJ/ (kg · d) and nitrogen 0.2 g/ (kg · d)].The model +Gln group was fed with enteral nutrition plus 3％ Gln,while the control group was fed with enteral nutrition plus 3％ soybean protein.The experiment lasted 8 days after modeling.The intestinal mucosa and the plasma levels of nuclear factor-κB (NF-κB),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),Gln,D-LACtic acid and diamine oxidase (DAO) were observed in rats before and after modeling and on the 3rb and 8rd day of the experiment.Changes in the morphology of intestinal mucosa were observed by electron microscopy.Results After modeling in control and model + Gln group,the level of NF-κB in intestinal mucosa [18 cases (75.0％) and 17 cases (70.8％)] were significantly higher than those before modeling [0 case (0.0％),P =0.013,P =0.019],the level of IL-6 in intestinal mucosa [(313.27±75.28) pg/g and (321.75±76.46) pg/g] were significantly higher than those before modeling [(227.52 ±58.13) pg/g,P =0.023,P =0.043],and the level of TNF-α in intestinal mucosa [(241.28 ±65.29) pg/g and (240.35 ±64.86) pg/g] were significantly higher than those before modeling [(172.45 ±33.76) pg/g,P=0.036,P=0.011].The plasma level of IL-6 [(150.32 ± 18.74) ng/L and (148.21 ±20.19) ng/L] were significantly higher than those before modeling [(116.37 ± 14.59) ng/L,P =0.032,P =0.025],the plasma level of TNF-α [(127.62 ± 14.24) ng/Land (123.86 ± 13.75) ng/L] were significantly higher than those before modeling [(85.18 ± 8.84) ng/L,P =0.018,P =0.035],and the plasma level of D-LAC [(0.46 ±0.03) mmol/L and (0.51 ±0.04) mmol/L]were significantly higher than those before modeling [(0.27 ±0.02) mmol/L,P =0.041,P =0.018],and the plasma level ofDAO [(2.76±0.57) U/ml and (2.58 ±0.51) U/ml] were significantly higher than those before modeling [(1.52±0.24) U/ml,P=0.015,P=0.037],while the plasma level of Gln [(0.18 ±0.01) g/L and (0.21 ± 0.01) g/L] were significantly lower than those before modeling [(0.39 ± 0.03) g/L,P =0.026,P =0.031].On the 3rd and 8th days of the experiment in the control group,the level of NF-κB in intestinal mucosa [16 cases (66.7％),15 cases (62.5％)] were significantly higher than those before modeling (P =0.027,P =0.002),the level of TNF-α in intestinal mucosa [(226.23 ±55.35) pg/g and (214.76 ±54.82) pg/g] were significantly higher than those before modeling (P=0.042,P =0.038)],the level of IL-6in intestinal mucosa [(297.56 ± 71.39) pg/g and (291.49 ± 68.46) pg/g] were significantly higher than those before modeling (P =0.031,P =0.012).On the 3rd and 8th days in the control group,the plasma level of IL-6[(147.38 ± 17.25) ng/L and (144.65 ± 15.32) ng/L] were significantly higher than those before modeling (P =0.016,P =0.034),the plasma level of TNF-α [(121.75 ± 13.72) ng/L and (113.83 ± 11.69) ng/L] were significantly higher than those before modeling (P =0.025,P =0.041),the plasma level of D-LAC [(0.41 ±0.03) mmol/L and (0.53 ±0.05) mmol/L)] were significantly higher than those before modeling (P =0.029,P =0.030),the plasma level of DAO [(2.51 ± 0.52) U/ml and (1.76 ± 0.34) U/ml] were significantly higher than those before modeling (P =0.034,P =0.016).The plasma level of Gln [(0.22 ±0.01) g/L and (0.21 ±0.03) g/L] were significantly lower than those before modeling (P =0.042,P =0.035).On the 3rd day of the experiment in the model + Gln group,the levels of NF-κB,TNF-α,and IL-6 in intestinal mucosa [14 cases (58.3％),(213.78 ±43.76) pg/g,(293.72 ±69.86) pg/g] were significantly higher than those before modeling (P =0.038,P =0.026,P =0.013) ; the plasma level of IL-6,TNF-α,D-LAC,and DAO [(135.61 ±14.25) ng/L,(117.35 ±11.29) ng/L,(0.45 ±0.03) mmol/L,and (2.26 ± 0.43) U/ml] were significantly higher than those before modeling (P =0.021,P =0.032,P =0.032,P =0.025).On the 8th day of the experiment in the model + Gln group,the levels of NF-κB,TNF-α,and IL-6 in intestinal mucosa [9 cases (37.5％),(184.53 ± 42.16) pg/g,and (236.83 ±66.52) pg/g] were significantly lower than those after modeling and those in the control group (P =0.024,P=0.027; P=0.026,P=0.039; P=0.013,P=0.028) ; the plasma levels of IL-6,TNF-α,D-LAC,and DAO [(126.35±12.74) ng/L,(92.76±9.42) ng/L,(0.31 ±0.02) mmol/L,and (1.76±0.34) U/ml]were significantly lower than those after modeling and those in the control group (P =0.021,P =0.030; P =0.032,P =0.025 ; P =0.024,P =0.037 ; P =0.022,P =0.036) ; the plasma level of Gln [(0.40 ±0.03) g/L] was significantly higher than those after modeling and in the control group (P =0.028,P =0.032).Under the electron microscope,the structure of villus and recess was damaged after modeling,villi were sparse and short,with a lot of inflammatory cell infiltration in the lamina propria.Lymphangiectasia and edema occured after modeling.On the 8th day,compared with after modeling and the control group,intestinal villi and recess structure were significantly restored in the model + Gln group; compared with the after-modeling status,the recovery of intestinal mucosa villi and recess structure was not obvious,and the inflammatory cell infiltration in the lamina propria persisted in the control group.Conclusion Gln repairs ischemia-reperfusion injury in the intestinal mucosa by regulating intestinal mucosa inflammatory cytokine release,inhibitng inflammatory response,and reducing the permeability of the intestinal mucosa.

Objective To investigate the clinical value of combined detection of the serum levels of CA125,CA72-4 and tumor specific growth factor(TSGF)in the diagnosis of ovary cancer and the curative effect.Methods Serum levels of CA125,CA72-4 and TSGF in 68 patients with ovary cancer,53 patients with benign ovary rumor and 50 normal controls were measured by chemiluminescent immunoassay(CLIA)and chemical colorimetry.Results and clinical data were statisticaly analyzed.Results The levels of CA125,CA72-4 and TSGF in ovary cancer group were higher than that in the benign ovarian tumor group and healthy controls(all P ＜0.01).When use three tumor markers united detection,sensitivity,specificity and accuracy were 91.2％,83.0％ and 87.4％ respectively.The sensitivity and accuracy was higher than any single detection.The specificity with single CA125 testing was consistently.The levels of CA125,CA72-4 and TSGF in patients with ovary cancer were significantly different after surgical treatment for five days(all P ＜0.05).Conclusion The combined detection of the three markers may increase the positive rate in the early diagnosis of ovarian cancer,and help to differentiate the benign and malignant ovarian tumor,but also is valuable to observe the curative rate and postoperative monitor of the ovary cancer.

Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy(3DCRT)combined with chemotherapy(CT)for locally advance non-small cell lung cancer(NSCLC).Methods from May.2002 tO Dec 2004,36 patients with NSCLC were treated with three dimensional-conformal radiotherapy combined with chemotherapy navelbine+cisplafin(NP)Results The overall response rate(CR+PR)was 91.7% for the primary tumor,and 100%for metastases mediastinal lymph mode.The leucopenia mte was 94.4%(55.6%Grade 3.4)Acute radiation esophagitis occurred in 52.8%of patients(Grade 1.2)Acute radiation pneumonitis was observed in 11.1%of patients(Grade 1.2)Conclusion 3DCRT combined with CT is well tolerated in most patients with NSCLC.Its early responses are milder than the conventional radiotherapy combined with chemotherapy.Remote results awmt further follow-up

Objective To investigate postoperative complications and proper treatment of craniopharyngioma after microsurgical resection. Methods The postoperative complications and treatments of 58 patients with craniopharyngioma who underwent microneurosurgical resection in our department were analyzed retrospectively. Results In the 58 cases ,45 cases received total resection, 11 cases received subtotal resection, and 2 cases received partial resection. Different levels of postoperative complications occurred in all of the cases, with diabetes insipidus in 55 cases , hypematremia and hyperchloraemia in 32 cases, hyponatremia in 25 cases, hyperpyrexia in 24 cases and hyperglycosemia acidosis in 2 cases. Forty-seven cases recovered clinically,9 cases improved,and 2 cases died. Conclusions Postoperative intensive monitor of water intake,and discharge,fluctuation of electrolyte, and actively correction of diabetes insipidus and electrolyte disturbances and maintaince of fluid balance may play an important role in postoperation treatment of craniopharyngiomas.

BACKGROUND:The bony crista has been found in the distal humeral medullary cavity,but its specific morphological characteristics and clinical significance are not clear.OBJECTIVE:To study the morphology of bony crista inside the distal intramedullary of the human humerus and its potential clinical relevance.DESIGN,TIME AND SETTING:CT scanning and measurement as well as visualized observation to the specimen for the dry adult humeri was performed at CT Room and Department of Orthopaedics,First Affiliated Hospital,Nanchang University from June to December 2007.MATERIALS:A total of 80 dry adult humeri (left:49;right:31) were purchased from the Department of Anatomy,Medical College of Nanchang University,excluding the fractured and lesion humerus.METHODS:The low 1/3 of eighty human humeri were scanned by 16 layer spiral CT.The morphological features of the intramedullary bony prominence above the olecranon fossa was described in terms of coronal plane,sagittal plane and transverse section after three-dimensional reconstruction.The low 1/3 of twenty humeri were then split vertically in the middle line in coronal plane,to view the intramedullary bony crista directly.MAIN OUTCOME MEASURES:The bony crista mainly located on the medial or lateral side,the range of the bas'dar part of the bony crista,alinement characteristic of the bony crista.RESULTS:The extent of intramedullary bony crista ranged from 1.9 to 3.2 cm (mean 2.6 cm) above the olecranon fossa,the density similar to cortical bone,with an basement posterior,and medial part and lateral side intero-inferiody incline.59 out of the 80 humeri,medial side dorminated;on the rest humeri the lateral side dorminated.2 or 3 parallel lines on the dorminate side,irregular alignment on the other side.CONCLUSION:The study described the morphology of the distal intramedullary bony crista of the humerus,which has never been reported so far.In addition,its clinical relevance in terms of the internal fixation of fracture on the distal humerus and elbow arthroplasty was also demonstrated.

Child ; Dinitrobenzenes ; poisoning ; Humans

1-Alkyl-2-acetylglycerophosphocholine Esterase ; blood ; genetics ; Adolescent ; Asthma ; blood ; enzymology ; genetics ; Child ; Child, Preschool ; Female ; Gene Expression Regulation, Enzymologic ; Genotype ; Humans ; Infant ; Male ; Mutation ; Polymerase Chain Reaction

Acquired Immunodeficiency Syndrome ; microbiology ; Female ; Humans ; Mycoses ; diagnosis ; Young Adult

Acupuncture Therapy ; Adolescent ; Adult ; Diarrhea ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; therapy ; Male ; Middle Aged ; Mouth ; Young Adult