0.05).In 25.28% of the population in the Second Songhua River region,the hair Hg content exceeded 1 mg/kg.In 21.85% and 16.67% of the population of Wujiazhan town and Songyuan city,the hair Hg content exceeded 1 mg/kg.Conclusion In the investigated area,the level of hair mercury shows a downtrend,but there still is health risk from mercury exposure.

OBJECTIVETo evaluate the efficacy and safety of percutaneous pedicle screw fixation (PPSF) and open pedicle screw fixation (OPSF) in the treatment of single level of thoracolumbar fracture.

METHODSDatabases including Pubmed, Embasem, CNKI were searched to collect clinical trials of the clinical safety and efficiency of PPSF and OPSF for single level of thoracolumbar unstable fracture, relevant proceedings and references were also retrieved manually. Studies from 1990 to 2014 that met the inclusion and exclusion standards were researched. The data were extracted and the methods from the studies were also evaluated. Data analysis was conducted with the Review Manager 5.3 software. Observation targets included operation time, intraoperative bleeding, postoperative bleeding, hospitalization time, the bed time, postoperative vertebral Cobb angle, vertebral body height, pain score and the length of incision operation.

RESULTSFifteen papers were finally studied, including 2 randomized controlled trials (RCT) and 13 case-control studies, involving 789 patients. Compared with OPSF, the PPSF in treating thoracolumbar fracture had shorter operation time, smaller operation incision, less intraoperative and postoperation bleeding, shorter hospitalization days, fewer pain (P<0.00001), the less improvement in the change of Cobb angle (P=0.0006). There was no significant difference in the improvement of vertebral body height (P=0.36), the bed time from operation to exercise (P=0.38) between OPSF and PPSF.

CONCLUSIONCompared with OPSF, PPSF is better, safer, and has fewer pain. But there is no evidence that the PPSF is better in the recovery of the spinal height, and they have the same effect in the long-term follow-up for thoracolumbar fractures. PPSF brines minimally invasive to patients with better effect. It is worth further study and clinical research.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Pedicle Screws ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; surgery ; Treatment Outcome

Objective To evaluate the clinical outcome of lumbopelvic reconstruction in treatment of unstable sacral fractures.Methods A retrospective study was performed on 17 cases (12 males and 5 females； at 23-55 years of age,mean 35.5 years) of unstable sacral fractures treated from January 2007 to June 2012.There were 11 cases of zone Ⅱ fracture and six zone Ⅲ fracture according to Denis classification and nine cases of type B fracture and eight type C fracture according to Tile classification.Sacral nerve injury assessed by Gibbons criteria was 3 points in seven cases and 4 points in 10 cases.Lumbar-pelvic ring stability of the patients was restored by posterior decompression and lumbar pedicle screw fixation combined with sacral pedicle screw or iliac screw fixation.Fracture reduction and healing were measured by X-ray film or CT scan； functional outcomes by Majeed scale； neurological outcome by Gibbons criteria.Results All the cases were followed up for mean 16 months (range,8-24 months).X-ray and CT follow-up revealed all fractures had bone union at average 6 months in the absence of remnant sacrum malformation,pseudarthrosis and fracture redisplacement.Iliac screw loosening not yet breakage happened to one case.In total,12 cases had full recovery of neurological function； four significant improvement,but experienced different degree of footdrop and hypoesthesia of lower extremities； one poor improvement and experienced not only lower extremity dysfunction but also bladder and bowel dysfunction.According to Majeed scale in the final follow-up,clinical functional outcome was excellent in 12 cases,good in three,fair in one and poor in one,with excellent-good rate of 88％.Gibbons score improved from preoperative (3.29 ±0.47) points to postoperative (1.53±0.94) points (t=12.94,P＜0.01).Conclusion Posterior decompression plus lumbar pedicle screw fixation combined with sacral pedicle screw and/or iliac screw fixation is an effective method for treatment of unstable sacral fracture,for it can restore general stability of spine-pelvis,facilitate neurological function recovery and allow early weight-bearing.

BACKGROUND:Intertrochanteric femoral fractures are one of the most common fractures in old patients. How to effectively fix has a great chalenge for orthopedic surgeons. No consensus on which fixation method is optimal has been obtained in the academia. OBJECTIVE: To evaluate the clinical therapeutic effects and complications of minimaly invasive percutaneous proximal femur locking compression plate for senile stable intertrochanteric fractures. METHODS:From May 2010 to May 2012, 98 patients (34 males and 64 females) with stable intertrochanteric fractures were treated with minimaly invasive percutaneous proximal femur locking compression plate fixation. The mean age was 76 years (range, 59-93 years). The mean time between fractures and operation was 3 days (range, 1-5 days). Patients were folowed up regularly after treatment. Healing time, Harris score of hip function recovery and the occurrence of complications were evaluated. RESULTS AND CONCLUSION: Al patients were folowed up for 12-24 months. Al incisions obtained healing by first intention. Al fractures reached clinical healing, and the healing time was 12-20 weeks (16 weeks on average). There was no fixation failure and loosing, rotation, crispatura deformity or screw cutting the femoral head. The function of the hip joint was assessed according to the Harris scoring: excelent in 75 cases and good in 18 cases, with the excelent and good rate of 95%. These data verify that proximal femur locking compression plate can be a feasible alternative to the treatment of stable intertrochanteric fractures. The patients obtained satisfactory outcomes, with less complication, indicating that there is a good biocompatibility between the implant and elderly host.

Community rehabilitation of cardiovascular disease is of great significance. Exercise therapy of cardiovascular disease in communities is necessary and feasible. At present, the main problems China faced to carry out community exercise therapy of cardiovascular disease include: cardiovascular patients with a weak sense of community exercise therapy, lack of professional rehabilitation personnel, inadequate community-based exercise therapy practice and lack of community rehabilitation funding. To solve above problems, we should strengthen the community exercise therapy practice of cardiovascular disease, and promote the cooperation between community rehabilitation and hospital rehabilitation. In all, comprehensive efforts should be made in order to solve the problems.

Aggregatibacter actinomycetemcomitans ; physiology ; Bacterial Adhesion ; Biofilms ; Periodontal Diseases ; microbiology ; Porphyromonas endodontalis ; physiology

Adolescent ; Female ; Humans ; Hypothyroidism ; etiology ; Lupus Erythematosus, Systemic ; complications

BACKGROUND: Excellent Iow-antigenicity xenogeneic biological valve scaffold is the premise of constructing tissue-engineered valve by using which kind of acellular methods.OBJECTIVE: To explore the optimal preparation method of making tissue engineered heart valves by meesuring efficiency of different acellular methods and ability to preserve the matrix.DESIGN, TIME AND SETTING: The prospective randomly controlled study was performed at the Central Laboratory of Taian Central Hospital from January 2007 to June 2008.MATERIALS: Sixteen specimens of porcine aortic valves were randomly divided into control, NaCI-sodium-dodecyl-sulfate (SDS),trypsin and triton-X100 groups.METHODS: Specimens in the control group were left intact. Three test groups were decelluladzed with NaCI, trypsin andTriton-X100 respectively.MAIN OUTCOME MEASURES: The gross structure, optical and electron microscope ultrastructure of the decelluarated porcineheart valve matrix was compared. The expression of vascular endothelial cell major histocompatibility complex (MHC)- Ⅰ antigenwas detected by immunohistochemical method.RESULTS: Treatment with NaCL-SDS achieved only incomplete decellularization. The main components of extracellular matdxwere reserved completely, but the fibrous components became unclear and swelling. Treatment with trypsin removed cellscompletely, but caused serious structural alterations, with the presence of swollen collagen fiber, crude edge, widen and irregularfiber interspace. Treatment with Triton-X100 achieved both complete decelluarization and preservation of the matrix structure.Valves following treatment of NaCI-SDS, trypsin and Triton-X100 had certain immunogenicity. However, the immunogenicity ofvalves following treatment of trypsin and Triton-X100 was significantly lower compared with the treatment of NaCL-SDS.CONCLUSION: The decellularization method by Triton-X100 is effective and complete. The Triton-X100 method does not changematrix structure and has low immunogenicity.

Objective To discuss the clinical characteristics,injury mechanisms,and treatment options of atlantoaxial complex fractures.Methods Twenty-three patients with atlantoaxial complex fractures were enrolled in the study,including 13 men and 10 women with age ranging from 23 to 63 years (average 42.6 years).Treatment options were determined on the basis of injury patterns of the patients,including nonoperative treatments for 11 patients and operative treatments for 12 patients.Complications and prognosis were evaluated for all patients in follow-up.Results All patients were followed up for average 32 months (range,6-58 months),which showed the recovery of atlantoaxial stability and the bony union or fusion.At postoperative six months,Japanese Orthopedics Association (JOA) score of all patients averaged 14.1 points (range,11.5-15.8 points) with the improvement rate of 82.7％.No complications like spinal cord injury,vertebral artery injury or cerebrospinal fluid leakage occurred in operative treatment group.Conclusions Mechanisms of atlantoaxial complex fractures are largely overextension/compression and lateral bending/compression.Furthermore,treatment plans should be determined in the light of fracture types.

Objective To evaluate the efficacy of decortication by video-assisted thoracic surgery (VATS) in pa﹣tients with tuberculous empyema, and discuss its indications. Methods 60 patients with tuberculous empyema who underwent decortication by VATS for surgical management from December 2010 to December 2015 were included. Under a thoracoscope, we cleaned up the pus, separated adhesions, scraped granulation tissues and caseous necrosis on the inner wall of the abscess cavity, and stripped the thickened fiberboard of the parietal and visceral pleurae. Af﹣ter the procedure, sufficient drainage and antituberculosis therapy were carried out. Results All the patients in this group were operated successfully. All the patients were cured without perioperative death and complications. No re﹣currence of empyema was observed at the follow-up examination from 2 months to 5 years, and suffered pulmonary reexpansions were better. Conclusions The decortication by VATS for tuberculous empyema is safe, effective, mini﹣mally invasive. The imaging manifestations of pleural thickening in 1 cm, no obvious calcification, no serious lesions in the lungs are the indications for the operation.