OBJECTIVETo review our experience of anterior thoracoscopic decompression and reconstruction in the treatment of thoracolumbar vertebral fractures, tuberculosis and herniated disks, and to evaluate the feasibility and effectiveness of such procedures.

METHODSTwelve patients who underwent thoracoscopic decompression and reconstruction of the spine since June 2003 have been reviewed retrospectively.

RESULTSThere were 8 male and 4 female patients, with a median age of 48.4 years (range 32 to 74 years) with thoracolumbar vertebral fractures (8 patients), tuberculosis (3 patients) and herniated disks (1 patient). The average time for the thoracoscopy was 210 minutes (range 180 to 260 minutes). Blood loss averaged 600 ml (range 300 to 800 ml), and the median length of hospital stay was 12 days (range 7 to 18 days). One patient had to give up internal fixation because of severe osteoporosis. All patients were followed up at least 3 months. No severe postoperative complications occurred. No shift of the bone graft and internal fixator. Recovery of neural function was almost the same as open procedures.

CONCLUSIONThoracoscopic anterior procedures can be used safely and effectively in the treatment of thoracolumbar spine diseases. This minimally invasive approach might decrease procedure-related trauma, operative time, blood loss, and length of hospitalization and may also alleviate postthoracotomy pain.

Adult ; Aged ; Diskectomy ; methods ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Thoracoscopy ; Tuberculosis, Spinal ; surgery

Objective To establish an acute yunaconitine poisoning rat model with a single oral administration and to determine the contents of yunaconitine in rat tissues by UPLC-MS/MS method, then investigate the distribution of yunaconitine in rats. Method The rats were randomly divided into three groups and were intragastrically administered a single dose of 2.2mg/kg,1.1mg/kg,0.7mg/kg yunaconitine, respectively.. The rats were killed 2h later, the stomach tissue, intestine tissue, liver tissue, pancreas tissue, kidney tissue, lung tissue, spleen tissue, heart tissue, bladder tissue, testis tissue, brain tissue and heart blood samples were collected. The contents of yunaconitine in the biological materials were determined by UPLC-MS/MS method after the biological samples extracted by liquid-liquid extraction. Result A rat model of the yunaconitine poisoning was made with a single dose of 1.1mg/kg, the concentrations of yunaconitine displayed in the organs with the following order:stomach, small intestine, liver, pancreas, kidney, lung, spleen, heart, bladder, testis, heart blood and brain. Conclusion Yunaconitine was widely distributed in rats, especially the levels in the stomach, small intestine and liver were the highest. The conclusion provides a basis for the selection of test materials for the poisoning of Aconitum vilmorinianum Kom.

OBJECTIVETo evaluate the effect of chemical lumbar sympathectomy (CLS) on relieving refractory pain in the lower limbs.

METHODSTwenty-four patients with refractory pain in the lower limbs underwent CLS under X-ray guidance, and 2 ml contrast agent was injected at 1/3 of the second L2 vertebrae (the L2 sympathetic ganglion). Lidocaine was then injected followed by injection of 7% phenol for performing CLS. The visual analog scale was used to assess the pain severity before and after CLS. The effect of CLS on relieving lower limb pain was compared with that of oral pain-relieving medication.

RESULTSThe lower limb pain was obviously relieved as shown by significantly decreased VAS scores in these patients after CLS. CLS exhibited a much more potent effect of pain relief in the lower limbs than the oral medication.

CONCLUSIONCLS produces significant analgesic effects to relieve refractory pain in the lower limbs.

Aged ; Aged, 80 and over ; Analgesia ; methods ; Female ; Humans ; Lidocaine ; Lower Extremity ; Male ; Middle Aged ; Pain, Intractable ; therapy ; Phenol ; Sympathectomy, Chemical ; methods

OBJECTIVE: To compare accuracy of anterior cervical pedicle screws between assist of rapid prototyping 3D guide plate and free-hand insertion, and evaluate the safety of two methods. METHODS: Eight adult cervical cadaver specimens after formaldehyde immersion, including 4 males and 4 females, aged 32 to 65(40.3±5.6) years old. After X-ray examination to exclude bone damage and deformity, 4 of them (3D guide plate group) randomly selected were for CT scan to obtain DICOM format data, and the data was imported into Mimics software for model, designed the ideal entry point and nail path for anterior cervicaltranspedicular screw (ATPS). After obtaining the personalized guide plate of the nail channel, it was exported as STL data, and the individual guide plate was printed by rapid prototyping and 3D printing technology. In turn, with the assistance of 3D guide plates, one-to-one personalized ATPS screws were placed on the four lower cervical cadaver specimens. Another 4 (free-hand group) lower cervical cadaver specimens were implanted with ATPS screws using free-hand technique. All specimens were performed CT thin-layer scanning and three-dimensional reconstruction after operation. The Tomasino method was used to evaluate the safety of the screws on the CT cross-sectional and sagittal images, to determine whether there was a cortical puncture of the lower and inner edges of the pedicle. According to the CT rating results, gradeⅠandⅡwere safe, and grade Ⅲ- Ⅴ were dangerous.And the accuracy of screws was recorded and analyzed between two groups. RESULTS: Two screws were inserted in each segment from C CONCLUSION The 3D printing rapid prototyping guide plate assisted insertion of the anterior cervical pedicle screw can significantly improve the accuracy and safety, and provide a theoretical basis for further clinical application.
Adult ; Aged ; Bone Plates ; Cervical Vertebrae/surgery* ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Pedicle Screws ; Printing, Three-Dimensional

OBJECTIVEOur previous work suggested that sensitivity of hippocampal neurons is changed in process of epileptic activities, and closely parallel to the dynamic characteristic of epileptic activity of the neurons. This study investigated the sensitivity of epileptic brain to vagal nerve stimulation (VNS) in epileptic process.

METHODSEpileptic model was evoked by penicillin. Left vagal nerves were stimulated to inhibit the seizures induced by penicillin. The electrocorticography (ECoG) and electromyography (EMG) were recorded to analyze inhibiting effect of VNS in epileptic process.

RESULTSIt was found that VNS could inhibit the seizures caused by penicillin, and the inhibiting effect of VNS to seizures increased as the vagal nerve stimulating time prolonged. It was also found that the inhibiting effect of VNS to seizures decreased in epileptic process.

CONCLUSIONThe results suggested that the sensitivity of epileptic brain to VNS was different in epileptic process. The inhibiting effect of VNS to seizure decreased as the development of seizures.

Action Potentials ; physiology ; Animals ; Electric Stimulation ; Electroencephalography ; Electromyography ; Epilepsy ; chemically induced ; prevention & control ; Frontal Lobe ; physiopathology ; Male ; Motor Cortex ; drug effects ; physiopathology ; Neural Inhibition ; physiology ; Nonlinear Dynamics ; Parietal Lobe ; physiopathology ; Penicillins ; Rats ; Rats, Sprague-Dawley ; Seizures ; chemically induced ; prevention & control ; Vagus Nerve ; physiology

OBJECTIVETo study the effect of botulinum toxin type A (BTXA) on spontaneous discharge and sympathetic- sensory coupling in chronically compressed dorsal root ganglion (DRG) neurons in rats.

METHODSIn chronically compressed rat DRG, spontaneous activities of the single fibers from DRG neurons were recorded and their changes observed after BTAX application on the damaged DGR. Sympathetic modulation of the spontaneous discharge from the compressed DRG neurons was observed by electric stimulation of the lumbar sympathetic trunk, and the changes in this effect were evaluated after intravenous BTXA injection in the rats.

RESULTSActive spontaneous discharges were recorded in the injured DRG neurons, and 47 injured DRG neurons responded to Ca2+-free artificial cerebrospinal fluid but not to BTXA treatment. Sixty-four percent of the neurons in the injured DRG responded to sympathetic stimulation, and this response was blocked by intravenously injection of BTXA.

CONCLUSIONBTXA does not affect spontaneous activities of injured DRG neurons, but blocks sympathetic-sensory coupling in these neurons.

Action Potentials ; drug effects ; Animals ; Botulinum Toxins, Type A ; pharmacology ; Ganglia, Spinal ; cytology ; drug effects ; physiopathology ; Nerve Compression Syndromes ; physiopathology ; Neurons ; drug effects ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo assess the safety and feasibility of laparoscopic and open repair of perforated peptic ulcer.

METHODSStudies on comparison between laparoscopic repair(LR) and open repair(OR) of perforated peptic ulcer were collected. Data of operating time, blood loss, time to first flatus, postoperative hospital stay, postoperative complications and mortality between LR group and OR group were meta-analyzed using fixed effect model and random effect model.

RESULTSNineteen studies including 1507 patients were selected for this study,including laparoscopic surgery(n=673) and open surgery(n=834). There were significant differences in blood loss, time to first flatus, postoperative hospital stay, wound infection rate and mortality between LR group and OR group. However, no significant differences existed in operative time, postoperative sepsis, pulmonary infection, abdominal abscess, and suture leakage between the two groups.

CONCLUSIONSLaparoscopic repair of perforated peptic ulcer is associated with improved outcomes in terms of less blood loss, quicker recovery, and lower rates of wound infection and mortality. Laparoscopic repair of perforated peptic ulcer is safe and feasible.

Humans ; Laparoscopy ; Laparotomy ; Peptic Ulcer Perforation ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the effect of radiofrequency of different temperatures and durations on sciatic nerve motor conduction velocity (MCV).

METHODSThe bilateral sciatic nerve of 70 adult SD rats was dissected and exposed to radiofrequency ablation of different temperatures (30, 50, 55, 60, and 70 degrees C) and durations. The nerves were also exposed to increasing ablation temperatures from 30 degrees C to 50 degrees C with an increment of 5 degrees C (60 s at each temperature), and the changes in the MCV parameters were observed.

RESULTSThe MCV parameters of rat sciatic nerve underwent significant changes following the radiofrequency exposures (P<0.05) except for the exposure at 55 degrees celsius; for 10 s. Below the temperature of 55 degrees celsius;, the MCV showed no obvious correlation to the exposure time for the group. For the nerves exposed to radiofrequency of 55 degrees celsius;, the latency was not correlated to the exposure time within 30 s, and data could be obtained from 55 s group; with these exceptions, the latency was found to positively while the negative phase wave inversely correlated to the exposure time. With fixed exposure time of 60 s, the MCV parameters were positively correlated to the ablation temperature (below 50 degrees C). Failure of MCV measurement occurred following exposures to 55 degrees celsius; for 50 s (or longer) or to 60 degrees C (or higher) for 10 s.

CONCLUSIONLow-temperature radiofrequency (below 50 degrees C) produces definite effects on the MCV of rat sciatic nerve, and the effects are not associated with the exposure time, the mechanism of which remains unclear. At a given temperature, the ablation for sufficiently long durations can result in complete block of the MCV. At higher temperatures, radiofrequency exposure cause obvious nerve conduction block.

Animals ; Electric Stimulation Therapy ; methods ; Female ; Male ; Motor Neurons ; physiology ; Neural Conduction ; Pain ; etiology ; Pain Management ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; physiopathology ; Temperature ; Time Factors

Objective To investigate the regulatory actions of Intestines-unblocking, Turbid-purging Recipe (ITR) on colonic 5-hydroxytryptamine (5-HT) and its receptor 5-hydroxytryptamine 3 (5-HT3) in rats with constipation-dominant irritable bowel syndrome (IBS-C), and to explore the therapeutic mechanism of ITR in treating IBS-C. Methods Forty-two male SD rats were randomly divided into 6 groups, namely normal group, model group, western medicine group, high-, middle- and low-dose Chinese medicine groups, 7 rats in each group. IBS-C rat model was established by intragastric administration of ice water. After establishment of the model, western medicine group was given intragastric administration of Cisapride Tablets (at the dosage of 3.6 mg·kg-1·d-1), Chinese medicine groups were given intragastric administration of various dosages of ITR granules (18.5, 9.25, 4.625 g·kg-1·d-1 respectively) , and the model group was given intragastric administration of normal saline, the treatment lasting 14 d. The rats in various groups were given normal feeding and drinking. After treatment, HE staining method was used to observe pathological changes in the intestinal tissue, immunohistochemistry method was used to observe the expression levels of intestinal 5-HT and 5-HT3 receptor. Results Compared with the normal group, the expression level of rat intestinal 5-HT was increased (P < 0.05) and that of 5-HT3 receptor was decreased (P < 0.05) in the model group and the medication groups. Compared with the model group, 5-HT expression level was decreased significantly (P<0.05) and 5-HT3 receptor expression level was increased (P < 0.05) in the medication groups, and the improvement of the middle-dose Chinese medicine group was more obvious (P < 0.05). Conclusion ITR has therapeutic efficacy for IBS-C rats through lowering 5-HT expression and increasing 5-HT3 receptor expression, which results into the improvement of intestinal sensitivity and abnormal dynamic of the rats.

BACKGROUNDThe gender difference on long-term outcome in unselected patients after percutaneous coronary intervention (PCI) has not yet been fully investigated. This study aimed to evaluate the gender difference on five-year outcomes following EXCEL biodegradable polymer-coated sirolimus-eluting stenting in patients with coronary disease.

METHODSA total of 2077 "all comers", consisting of 1528 (73.6%) men and 549 (26.4%) women, who were exclusively treated with EXCEL coronary stents were enrolled in the prospective CREATE study at 59 centers from four countries. After propensity score matching, the baseline characteristics of the two groups were well matched. Recommended antiplatelet regimen was clopidogrel and aspirin for six months followed by chronic aspirin therapy. The primary outcome that was the rate of major adverse cardiac events (MACE), defined as a composite of cardiac mortality, non-fatal myocardial infarction (MI) and target lesion revascularization (TLR), and stent thrombosis (ST) at five years were compared between the two gender groups.

RESULTSIn the two groups, women had higher proportions of clinical risk factors, such as being elderly, diabetes mellitus, hypertension and hyperlipidemia, compared to men. Besides, the mean target vessel number per patient was higher and the mean reference vessel diameter smaller for women. Men had higher risks of cardiac death (3.7% vs. 1.6%, P = 0.021) and MACE (8.4% vs. 4.7%, P = 0.004) at five years compared with women. However, the cumulative hazards of non-fatal MI and TLR were similar between men and women. The incidence of Academic Research Consortium (ARC) definite or probable stent thrombosis was similar between the two groups (1.3% vs. 1.0%, P = 0.639). Prolonged clopidogrel therapy (>6 months) did not reduce the cumulative hazards of ST from six months to five years in both men (χ(2) = 0.098, log rank P = 0.754) and women (χ(2) = 2.043, log rank P = 0.153) patients.

CONCLUSIONSWomen had a lower MACE and cardiac death rate than men after biodegradable polymer-coated sirolimus-eluting stenting in long term follow-up. Effects of prolonged dual antiplatelet therapy (DAPT) in preventing stent thrombosis was similar with six-month DAPT after EXCEL stent implantation in both men and women groups.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Polymers ; chemistry ; Prospective Studies ; Sex Factors ; Sirolimus ; therapeutic use ; Treatment Outcome