OBJECTIVETo explore the clinical effects of anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation in treatting multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 48 patients with multilevel cervical spondylotic myelopathy underwent surgical operation were retrospectively analyzed from October 2010 to January 2013. There were 37 males and 11 females, aged from 37 to 76 years old with an average of 54.6 years. Thirty-five cases were two-segment lesion, 7 cases were three-segment lesion, 6 cases were four-segment lesion. All the patients were treated by anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation. ROM, JOA, VAS and SF-36 scores were recorded before and after operation(including 3, 6, 12 months after operation and final follow-up). Fusion degree and spinal canal decompression condition were observed by radiographic data.

RESULTSAll patients were followed up from 14 to 48 months, with an average of 27.3 months. At 12 months after surgery, radiographic data showed that all patients obtained bony fusion, spinal canal decompression were sufficient. Preoperative vertebral canal sagittal diameter of the most serious segment were (5.13 +/- 1.32) mm, 12 months after surgery were (9.94 +/- 1.22) mm, there was statistically significance (t=2.463, P=0.014); the degree of vertebral canal decompression were (92.15 +/- 2.35)%. Postoperative ROM, JOA, VAS and SF-36 scores were obviously improved than that of preoperative (P<0.05); there was no statistically significance of ROM, JOA, VAS and SF-36 scores in each time after operation (P>0.05).

CONCLUSIONAnterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation can obtain higher fusion rate, complete thoroughly decompression, improvement of clinical symptoms and well safety in treating multilevel cervical spondylotic myelopathy.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostheses and Implants ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spondylosis ; diagnostic imaging ; surgery ; Treatment Outcome

Objective:To compare influence of valsartan (Val) combined amlodipine (Am) or hydrochlorothiazide (Hyd) on blood pressure variability and quality of life in aged patients with hypertension .Methods:A total of 127 aged patients with hypertension stage 2 and 3 were randomly divided into Val + Am group (n=64) and Val + Hyd group (n=63) .Circadian rhythm and variability of blood pressure and quality of life were observed in both groups before and after treatment .Results:(1) After treatment ,the 24hSBP ,DBP ,SBPV , DBPV and daytime SBP , DBP ,SBPV ,DBPV ,and nighttime ,morning surge of SBP and DBP all significantly reduced in both groups;(2) Compared with Val+ Hyd group ,there were significant reductions in 24hSBP [(120.6 ± 10.2) mmHg vs . (110.9 ± 11.3) mmHg] ,daytime SBP [(120.6 ± 11.3) mmHg vs .(111.6 ± 11.37) mmHg] ,nighttime SBP [(118.5 ± 11.6) mmHg vs .(108.6 ± 11.9) mmHg] ,morning surge of SBP [ (26.2 ± 13.7) mmHg vs .(23.0 ± 10.4) mmHg] (P<0.05 or <0.01);24hSBPV [ (10.7 ± 2.2) mmHg vs .(8.2 ± 2.0) mmHg] ,daytime SBPV [ (10.4 ± 1.9) mmHg vs .(8.1 ± 2.1) mmHg] (P<0.01 all);significant rise in improved percentages of physical health ,mental health and total function in quality of life (P<0.05 or <0.01) in Val + Am group .Conclusion:Valsartan combined am-lodipine or hydrochlorothiazide can both effectively improve blood pressure variability and quality of life in aged pa-tients with hypertension ,and the effect of the former is even better .

Objective To study prospectively the morphological relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy in normal-tension glaucoma (NTG). Methods Qualitative and quantitative methods were applied to evaluate the relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy by using stereo ocular fundus photography and computer analyzer systems. Results In 37 patients (42 eyes) in NTG hemorrhage group, 50 hemorrhagic spots at optic disc was found, including coloboma of retinal nerve fiber layer in 35 eyes (83.3%)(35/42). In 35 patients (40 eyes) in non-hemorrahge group, partial coloboma of retinal nerve fiber layer was found in 21 eyes (52.5%)(21/40). The difference of incidence of coloboma of retinal nerve fiber layer between the two groups was not significant (?2=1.403, P=0.236). The incidence of atrophic arc in hemorrhage group differed much from which in non-hemorrhage group (?2=7.008, P=0.008). The area of atrophic arc at ?section in hemorrhage group [(2.05?0.88)mm2] was significantly different from which in non-hemorrhage group [(1.42?0.53)mm2] (t=-2.618, P=0.012). In the follow-up period, the difference of incidence of disc-rim loss between hemorrhage and non-hemorrhage group was significant, (?2=5.802, P=0.016); while the difference of the incidence of visual field defect between the two groups was not. Conclusion In eyes with NTG, hemorrhage of optic disc, coloboma of retinal nerve fiber layer and atrophic arc are closely related. More disc-rim loss and changes of atrophic-arc area in hemorrhage group in the follow-up period suggests that hemorrhage of optic disc is the risk factor of development of NTG.

Objective To evaluate the reliability and validity of Morisky questionnaire in measurement of the compliance with hypertensive medications. Methods Seventy-four eligible subjects were selected and asked to fill a Morisky questionnaire about their adherence in taking antihypertensive drugs during the past 1 month; nineteen of them received two surveys at 3～7 day intervals. The internal consistency (Cronbach ? coefficients),test-retest reliability (interclass correlation coefficients),construct validity and convergent validity were calculated. Results The Cronbach ? coefficient of the questionnaire was 0.749 and the interclass correlation coefficients between the items and the total scores of the questionnaires ranged from 0.71 to 1.00. Factor analysis yielded one factor with an accumulated contribution rate of 57.3%,and the loading values of all items on this factor were above 0.6. The Spearman correlation coefficients between the Morisky scores and the adherence assessment by the subjects themselves were over 0.3 (P

OBJECTIVE: To observe the effects of Xuebijing injection on serum level of C reactive protein(CRP) and the incidence of sepsis in patients with severe burn.METHODS: Eighty cases with severe burn injury were randomly assigned to receive routine therapy alone(control group,n=40) routine therapy in combination with Xuebijing injection 100 mL q.d(treatment group,n=40) for 14 days.The level of CRP at 0,3,7,and 14 days were recorded and the incidences of sepsis in the two groups were analyzed statistically.RESULTS: At 7 days,the level of CRP in the treatment group was significantly lower than in the control group(P

Objective: To investigate the rate of post-stroke depression and psychosocial factors related to it, and to provide the direction and the basis for clinical nursing. Methods: 69 patients with stroke were assessed by Zung Self-rating Depression Scale and Type A Behavior Pattern Scale. Their sex, age, behavior type, marital condition, level of education, supportor of medical expenses were collected and analysed statistically. Results: The rate of post-stroke depression was 59.42%, and the rate in type A behavior group was higher than that in the other behavior groups(P

The information system of 301 Hospital One-Card service, was designed to enable outpatients to register online via mobile ends, pay in real-time, and hierarchical examination-diagnosis among other services. As the hospital HIS system cannot link to the Internet directly, the system could make use of the Internet application front end of China′s financial platform, and such means of 2D-barcodes and APP. This innovation could improve outpatient experience, keep confidential of medical information and patients′privacy, and change on-site registration to appointment in advance.

BACKGROUND:Mesenchymal stem cells have a extreme prospect in orthopedics, which show great potential especially in the treatment of articular cartilage defect disease. Bone marrow is the main source of mesenchymal stem cells, and the iliac puncture is a conventional way to obtain bone marrow, but is restricted by the limited resources and strict technical requirements. Therefore, it is of great significance to explore new effective and convenient sources of mesenchymal stem cells. OBJECTIVE:To explore the feasibility of autologous mesenchymal stem cells derived from the joint drainage fluid after knee arthroscopy.METHODS: We selected eight patients who underwent arthroscopic surgery to collect joint drainage fluid by pre-made sterile blood bag before the wound closure. Precipitation with hydroxyethyl starch and density gradient centrifugation method were performed to isolate and culture mesenchymal stem cells from the joint drainage fluid. Cell morphology, growth curve, surface marker identification were observed and detected using flow cytometry. Then, adipogenic, chondrogenic and osteogenic differentiation of cells were induced and identified by oil red O, toluidine blue staining, and alizarin red staining, respectively. RESULTS AND CONCLUSION:The cultured cells were spindle-shaped, adherently grew and had good proliferation ability, which were positive for CD44, CD90, CD105 and CD73, but not for CD45. Under standard inductions, the cultured cells were induced to differentiate into osteoblasts, adipocytes and chondrocytes. Therefore, these cells were confirmed as mesenchymal stem cells. Mesenchymal stem cells were successfully isolated from the joint drainage fluid of eight patients and had no difference in cell morphology, proliferation and phenotypes. To conclude, the joint drainage fluid is an ideal source of mesenchymal stem cells with the guaranteed quality and quantity.

Objective To discuss the efficacy of photoselective vaporization of the prostate(PVP) for patients with benign prostatic hyperplasia(BPH).Methods From July 2006 to August 2007,110 patients with BPH received PVP in our hospital.The safety of the procedure,Pre- and postoperative Qmax,and IPSS of the cases were recorded and analyzed.Results The mean operation time was(51.2?36.3) minutes(ranged from 15 to 180).In the patients,23 cases had a prostate weighed ≥100 g,9 of them received TURP during the procedure.89 patients underwent bladder irrigation for 15 to 48 hours(mean,36 hours).After the operation,urinary catheter was left indwelling in all the patients except for 6(

Objective To study the clinical application of laparoscopic operation and the morbidity and their prevention. Methods 21069 cases of laparoscopic surgery were reviewed retrospectively. Results Laparoscopic operation was used in 19 conditions including cholecystectomy (21002),hepatic operation (21), common bile duct calculi (3), spleen trauma (1),kidney cyst (3),gynoplasty (16),chest surgery (2), intestinal adhesion (14),assistant Miles (3),appendectomy (2),mesentery teratoma (1).Major complications (60) (0.29%) included injury of choleduct (18), bile leakage (18),hemorrhage (17),the injury of gastrointestinal tract (7). Conclusions Laparoscopic operation may be in a more extensive seope. The major complications can be reduced by strict procedures of laparoscopic operation.