OBJECTIVETo study the risk factors of secondary kyphotic angle increment after bone cement vertebroplasty for osteoporotic vertebral compression fractures.

METHODSFrom October 2005 to May 2006, 32 (45 vertebrae) bone cement vertebroplasty procedures were performed. The operation time, injected cement volume, bone mineral density, visual analog scale (VAS) pain score, vertebral height, and kyphotic angle were recorded. The secondary increment of the kyphotic angle was calculated, and correlation analysis and linear regression analysis were performed.

RESULTSThe bone mineral density, the postoperative kyphotic angle and the vertebral midline height were significantly correlated to the secondary increment of the kyphotic angle.

CONCLUSIONLarge postoperative kyphotic angle, poor postoperative recovery of the vertebral midline height, and low bone mineral density are all risk factors of secondary increment of the kyphotic angle.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; etiology ; surgery ; Humans ; Kyphosis ; etiology ; pathology ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Osteoporosis ; complications ; surgery ; Risk Factors ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; surgery ; Treatment Outcome ; Vertebroplasty ; adverse effects

OBJECTIVETo observe the effects of lithium chloride combined with human umbilical cord blood mesenchymal stem cell (hUCB-SCs) transplantation in the treatment of spinal cord injury in rats.

METHODSEighty female SD rats with complete T9 spinal cord transaction were randomized into 4 groups (n=20), namely the control group (group A), lithium chloride group (group B), hUCB-SCs group (group C) and hUCB-SCs(+) lithium chloride group (group D). On days 1 and 3 and the last days of the following weeks postoperatively, the motor function of the hindlimb of the rats were evaluated according to the BBB scores. At 8 weeks, all the rats were sacrificed and the spinal cords were taken for morphological observation. The spinal cord tissues at the injury site were observed with Brdu nuclear labeling to identify the survival and migration of the transplanted SCs. The regeneration and distribution of the spinal nerve fibers were observed with fluorescent-gold (FG) spinal cord retrograde tracing.

RESULTSBrdu labeling showed that the transplanted hUCB-SCs survived and migrated in the spinal cord 8 weeks postoperatively in groups C and D. FG retrograde tracing identified a small amount of pyramidal cells that migrated across the injury site in groups C and D. The BBB scores of the hindlimb motor function 8 weeks postoperatively were 4.11∓0.14, 4.50∓0.15, 8.31∓0.11 and 11.15∓0.18 in groups A, B, C and D, respectively.

CONCLUSIONLithium chloride can promote the survival and differentiation of hUCB-SCs into neural cells at the injury site. Lithium chloride combined with hUCB-SCs transplantation may accelerate functional recovery of the hindlimbs in rats with complete transection of the spinal cord.

Animals ; Cord Blood Stem Cell Transplantation ; Female ; Humans ; Lithium Chloride ; therapeutic use ; Rats ; Spinal Cord Injuries ; therapy

OBJECTIVETo investigate how to select an appropriate surgical approach in the management of fracture and dislocation of lower cervical spine combined spinal cord injury.

METHODSThe clinical data of 54 patients of lower cervical spine fracture and dislocation were retrospectively analyzed. There were 29 cases with vertebral body compressive fracture and dislocation, 7 cases with vertebral body bursting fracture and dislocation, 3 cases with unilateral facet dislocation, 15 cases with bilateral facet dislocation. All cases were associated with spinal cord injury. According to American Spinal Injury Association (ASIA) grades, 21 cases were in A grade, 5 cases in B grade, 22 cases in C grade and 6 cases in D grade. All patients had surgical reduction, decompression, stabilization and fusion, 43 cases in anterior approach and 11 cases in posterior approach.

RESULTSAll patients were followed up in 12 to 36 months, the mean follow-up time was 18 months. There were no great vessels, trachea, esophagus or spinal cord iatrogenic injury. There were no pull-out and breakage of screws or plates. Fusion was achieved in all patients at an average of 12 weeks postoperatively. There were no pseudarthrosis or bone nonunion. Of all the patients, 96.3% were acquired completely reduction and the normal intervertebral height and lordosis were maintained. Patients with complete spinal cord had no neurologic recovery, but they felt relief from upper limb pain or numb. Incomplete spinal cord lesions improved on average 1-2 Frankel grade after surgery.

CONCLUSIONSFor lower cervical spine fracture and dislocation, an ideal anatomy reduction can be obtained with either anterior or posterior approach surgery. It is important to select a suitable surgical approach according to different types of cervical fracture and dislocation.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Diskectomy ; methods ; Female ; Humans ; Joint Dislocations ; complications ; surgery ; Laminectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Injuries ; complications ; Spinal Fractures ; complications ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

OBJECTIVETo investigate the effects of mechanical vibration on the morphology of the acellular scaffold for the spinal cord and establish a procedure to construct an acellular rat spinal cord allograft retaining intact matrix fibers for repairing spinal cord injuries.

METHODSFifteen segments of rat spinal cord were divided randomly into 3 groups and subjected to mechanical vibration at the frequency 80 r/min (group A, n=5), 120 r/min (group B, n=5), and 160 r/min (group C, n=5) respectively. The spinal cord was treated with Triton X-100 and sodium deoxycholate at room temperature and washed with distilled water. The specimens were observed microscopically with HE staining, and the ultrastructure was observed using scanning electron microscope.

RESULTSIn group A, the spinal cord specimens contained numerous cells and neural sheaths. Vibration at 120 and 160 r/min (in groups B and C) resulted in depletion of all the cells, axons and neural sheaths from the spinal cord after treatment with Triton X-100 and sodium deoxycholate. The acellular spinal cord consisted of a meshwork of the matrix fibers in longitudinal arrangement. In group C, however, obvious disruption of both the spinal dura mater and the matrix fiber occurred in the acellular spinal cord.

CONCLUSIONAll the cells, axons and neural sheaths in the spinal cord can be removed by chemical extraction with Triton X-100 and sodium deoxycholate. Mechanical vibration at suitable frequency may cell preserve the 3-dimensional structure of the matrix fibers. The acellular spinal cord scaffold may serve as an ideal material for constructing tissue-engineered spinal cord.

Animals ; Cell Separation ; methods ; Female ; Male ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; anatomy & histology ; cytology ; Spinal Cord Injuries ; therapy ; Tissue Engineering ; methods ; Vibration

OBJECTIVETo research the repair effect of transplantation of glial cell line-derived neurotrophic factor (GDNF) modified olfactory ensheathing cells (OECs) combination with injecting axonal growth inhibiting protein antibody (IN-1) in vivo.

METHODSTo construct lentivirus vector with GDNF gene and infect OECs in vitro, use the immunoblotting (Western Blot) to observe the expression of GDNF was detected through Western Blot. Fifty adult female SD rats which to establish thoracic spinal cord transection injury model were randomly divided into A (control group), B (IN-1 antibody group), C (OECs group), D (GDNF-OECs group), and E (GDNF-OECs+IN-1 group) 5 groups of each 10 rats. To observe regeneration of the impaired nerve axon by NF200 immunohistochemistry, Biotinylated dextran amine (BDA) anterograde tracing corticospinal tract. Basso, Beattie and Bresnahan (BBB) score was used to evaluating hindlimb motor function recovery.

RESULTSAdd up to 13 rats died post operation. OECs labeled by hoechst still survived and migrated in spinal cord 8 weeks post operation. Lots of confused and disorderly regenerated axons which crossing the injured region of spinal cord were displayed between spinal cord stumps in GDNF-OECs+IN-1 group and GDNF-OECs group; some of axons existed in OECs group, but there is no obviously continue nerve fibers crossing the injured region of spinal cord;in contrast to IN-1 and control groups, few of regenerated axons and atrophy of spinal cord stumps were observed. The results of BBB hindlimb motor rating scale were 7.70+/-0.24, 7.89+/-0.15, 10.50+/-0.25, 11.43+/-0.23 and 12.81+/-0.40 for the control group, IN-1 group, OECs group, GDNF-OECs group and the allied treatment group respectively.

CONCLUSIONSThe transplantation of GDNF-OECs combination with IN-1 antibody may benefit the survival and regeneration of the injured axons, and accelerate the repair of the injured spinal cord and functional recover of hindlimb locomotor in rats in a more efficient way than that with OECs or IN-1 alone.

Acute Disease ; Animals ; Antibodies, Monoclonal ; pharmacology ; Cell Transplantation ; Cells, Cultured ; Disease Models, Animal ; Female ; Genetic Vectors ; Glial Cell Line-Derived Neurotrophic Factor ; genetics ; pharmacology ; Olfactory Bulb ; cytology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; therapy ; Transfection

Objective To provide a solution to improve the radiation shielding for medical accelerator room with clay bricks.Methods According to the basic shielding equations provided by the relevant national standards and international reports,equations for shielding reconstruction calculation were derived to calculate the required thickness of clay bricks wall,which reached the reference dose rate control level.The dose rates at reference points after reconstruction were also estimated based on the measured dose rates at reference points before reconstruction of accelerator room,calculated distance correction factors and transmission factors of added clay bricks wall.Results The measured dose rates satisfied the requirement of reference dose rate control level.The estimated dose rates were slightly higher than the measured values.Conclusion The radiation shielding requirement of medical accelerator room is fulfilled with the presented shielding reconstruction method by building clay bricks wall,measured dose rates could be conservatively predicted with the dose rates calculated by derived equations.

Up to now,studies among the world have put forward various hypotheses about the pathophysiology and future research direction of Takotsubo cardiomyopathy (TTC).Large amounts of diagnosis and differential diagnosis have been done on TTC,and consensuses have been reached on it's definition,epidemiology,clinical manifestations and prognosis.In this review,we will summarize the recent progress in the study of TTC,and make a comprehensive analysis and perspective on it's clinical research and forensic value.

OBJECTIVETo compare the diagnostic value between digital photography (DR) and multi-slice spiral CT (MSCT) in fracture and dislocation of foot and ankle.

METHODSFrom August 2010 to August 2012, the DR and MSCT data of 52 patients with fracture and dislocation of foot and ankle were compared according to results of surgery or discharge diagnosis. There were 37 males and 15 females, aged from 15 to 49 years old. Wilcoxon signed rank test was used for statistical analysis.

RESULTSThe results of 52 cases of MSCT were matched with the postoperative or discharge diagnosis. A total of 172 fractures were found on MSCT and 98 fractures were found on DR, the results had significant difference in detecting fracture (V=1 081, P<0.05); A total of 24 dislocations were found on MSCT and 16 dislocations were found on DR,the results also had significant difference in detecting dislocation (V=21, P<0.05). Fractures of 6 cases with DR diagnosis were corrected and located by MSCT.

CONCLUSIONMSCT is significantly better than DR in diagnosis of fracture and dislocation of foot and ankle. The examination of two parts should be performed in DR. MSCT and multi-planar reconstruction (MPR) examination should be further performed if DR results are unclear or do not match with clinical symptoms, missed diagnosis and misdiagnosis can be avoided.

Adolescent ; Adult ; Ankle Injuries ; diagnostic imaging ; Female ; Foot Injuries ; diagnostic imaging ; Fractures, Bone ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Joint Dislocations ; diagnostic imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Photography

OBJECTIVETo investigate the long-term efficacy of anterior approach surgery on cervical spondylotic myelopathy and factors affecting prognosis.

METHODSThe data in 116 patients suffered from cervical spondylosis from January 1992 to December 2000 were reviewed, including 80 male cases and 36 female cases, whose age ranged from 36 to 76 years (mean, 51 years). The preoperative course of disease was 2 months to 20 years (mean, 19 months). There were 65 cases (56.0%) with single segments involved, 44 cases (37.9%) with two segments, 7 cases (6.0%) with three segments. Ninety-eight cases were onset slowly, 18 cases with no remote cause and aggravating quickly. Three kinds of surgeries were performed: anterior cervical decompression and autoiliac bone interbody fusion, anterior cervical decompression and fusion with threaded fusion cage, anterior cervical decompression and autoiliac bone interbody fusion with anterior screw-plate system. Improvement in spinal cord function was assessed using the Japanese Orthopaedic Association (JOA) scoring system, the long-term efficacy and influential factors were also analyzed.

RESULTSThe mean follow-up time was 7 years and three months (5 - 12 years). The mean preoperative JOA score was 9.34 +/- 1.81. The mean postoperative JOA score was 10.35 +/- 1.85. At the final follow-up, the JOA score was 14.09 +/- 1.90 and the recovery rate was 63.2%. Among the total patients, 27 cases were excellent, 47 cases were fine, 23 cases were good, 19 cases were poor, the fineness rate was 63.8%. The long-term efficacy of anterior approach surgery has close correlations with time of course, age of onset, preoperative spinal cord function and the number of affected segments, but has no correlations with modes of fusion and internal fixation.

CONCLUSIONSThe patients will be attentively observed while having a definite diagnosis of cervical spondylotic myelopathy. The good long-term results will be obtained after early anterior cervical decompression and fusion.

Adult ; Aged ; Cervical Vertebrae ; pathology ; surgery ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Osteophytosis ; surgery ; Time Factors ; Treatment Outcome

Circular RNA(circRNA)is a type of noncoding RNA with tissue specificity and high stabil-ity, which forms a closed continuous loop and is abundantly expressed in tissue cells. According to re-cent research, the regulatory function of circRNA elucidating in the occurrence and development of dis-ease shows a potential for diagnosing clinical disease and revealing disease mechanism. This paper re-views the biological characteristics, analysis methods of circRNA and its research progress in clinical ap-plication as biomarker, and outlooks its application in the field of forensic medicine.