[Objective]To evaluate the safety and efficacy of the surgery,which was done by a video-assisted thoracoscope to release the anteriorroute part of spine and done by posterior instrumented fusion with severe Adolescent Idiopathic Scoliosis(AIS).Clinic date:There were 10 cases of AIS(King Ⅱ 6,King Ⅲ 3,King Ⅳ 1),in which there were 6 males and 4 females.The average age was 17.2 years(range 14~21).The average preoperative primary curve in the coronal plane was 91.3?(ranged 67?~125?)and the average pliability of thoracic spine was 28.3%(ranged 19.3%~36.5%).[Method]With general anesthesia(onelung ventilation or two-lung ventilation),the disc complexes and part of the anterior longitudinal ligament of 5~6 disc near apex vertebra were excised under endoscopic visualization.In the same operation,the posterior instrumented fusion was done.[Result]The anterior releases under endoscopic visualization needed 120~150 min with average bleeding 157ml(ranged 100~200 ml).The thoracic draining was 100~150 ml After the posterior route surgery,the average coronal Cobbs angle was 47?(ranged 26?~75?)and the rate of rectification was 51.5%.The patients had good fusion and outlook without other complications.[Conclusion]This way,which is done by a videoassisted thoracoscope to release the anterior part of spine and done by posterior instrumented fusion has a good result about safety and efficacy.

60?) in the Huaxi Hospital of Sichuan University. Three cases aged less than 15 years, but the patients or their relatives were informed of and consented the operation scheme. Without rectification, fusion segments were propped open about 5 mm via the upper and lower fixed vertebra, and anterior one was transplanted with fresh-frozen fibular allograft (offered by the donor corpse and excised extremities due to surgical trauma from the Department of Orthopaedics in Huaxi Hospital. The immunogenicity was greatly reduced by routine defat, acellular procedure, soaking sterilization and deep freezing), while rear one was transplanted with costal bone for supporting graft and filling the graft bone intervals with autogenous bone strips. Gypsum (brace) was used to assist external fixation for 8-10 month postoperation. The complications, graft incorporation, neurological function (Frankel grading scale A-E: complete paralysis-normal or no paralysis), back pain (0-3: none-severe), and mobility score (1-4: lying in bed-needing no assistance) before operation and at final follow-up of each patient were collected for analysis. RESULTS: All the patients were available for follow-ups and the mean period was 3.4 years (1.5-5 years).①Apparent fusion was observed in all cases with no graft fracture, only one patient reported mild graft shift and the kyphosis was unchanged.②There was no worsening of the neurological status in any patient. Frankel grades of 3 adult patients were unchanged after operation. All adolescent patients (n =3) had definite neurological improvement and could walk without assistance, while another was adult patient. Complete relief of back pain was observed in all patients. CONCLUSION: Fresh-frozen allograft fibular is a liable graft material for the treatment of severe kyphosis induced by inactive upper thoracic tuberculosis. Anterior decompression and fusion can promote the recovery of motive function and the alleviation of pain, especially is effective for neurological recovery of adolescent.

Objective To evaluate the validity of shifts management by group schedule comprising doctors,nurses and sanita-ry cleaners simultaneously on the basis of echelon allocation in Ebola Treatment Unit(ETU)of China.Methods According to the characteristics of Ebola infectious disease prevention and control,working schedule was designed basing on the medical staff compo-sition,working duration and job responsibilities.The validity of this schedule was evaluated by hospital admission time,discharge time,PPE supplies consumption,the error frequence of PPE wearing or uncoating and staff satisfaction.Results Through this mode of shift management,hospital admission time and discharge time were shortened,PPE supplies consumption and the error fre-quence of PPE wearing or uncoating were decreased,the satisfaction degree were improved among doctors,nurses and sanitary cleaners(P <0.01).Conclusion The application of this new style working schedule could ensure the nursing services to be procee-ded safely and smoothly.

[Objective]To explore the operative method through the trans-upper-sternal approach in the treatment of the cervicothoracic spinal lesions and evaluate its clinical effects.[Method]From August 1999 to February 2006,11 cervicothoracic patients,8 males and 3 females,age ranged from 17 to 77 years with a mean of 41.5 years underwent the trans-uppersternal approach surgical treatment.There were four traumatic lesions,six tumors and one tuberculosis.The lesions were located at T3,C7~T1 and T1、2 in 1 case respectively,C7 and C6~T1 in 2 cases respectively,T1 in 4 cases.The combined cervicothoracic incision and upper sternotomy were performed for the exposure of the vertebral bodies,then tumor or vertebral body was resected,the spinal cord was decompressed,the spinal column was reconstructed and fixed.Neurologic status was assessed using the Frankel classification.[Result]The duration of follow-up ranged from 10 to 56 months with an average of 31 months.One patient developed chyle leakage of 50 ml one day after surgery and the leakage stopped 2 days after continuous drainage.One patient had transient vocal cord paresis which recovered in 3 months.All patients had their neurological improvement at different level.Nonunion or instrument-related complications were not observed,and the vertebral column had good stability.[Conclusion]The trans-upper-sternal approach gives an excellent exposure of the cervicothoracic junction.It is a technically simple,safe and effective method for anterior decompression,maintenance of anatomic alignment,fusion with bone graft and internal fixation with less complications and trauma.Attention should be paid to avoid injury of the recurrent laryngeal nerve and the thoracic duct.

Objective To observe the radiological feature of chest X ray in SARS patients. Methods The chest films of 54 cases of SARS were reviewed in the study. The chest film features and site of lung involvement were studies in early stage, most severe stage and recovery stage. The correlation between the score of lung involvement and clinical course was also studied. Results 79.63% cases had abnormal chest films in early stage. Most of them (72.22%) were found in 3～7 days after onset. The lung involvement was most common in bilateral (88.89%) and most in middle and lower field (46.30%). Exudation and consolidation lesions showed to be dominant. The lesions progressed quickly and showed to be variable. There are 17 (31.48%) cases had second peak in X ray, the mean time of onset is 14.71 days. The chest X ray is not parallel with clinical syndrome. The absorption of lung infiltrates is correlation with glucocorticosteroids treatment in 20 patients, and the correlation is not found in 26 patients.Conclusions The chest X ray of SARS has some features and its changes can reflect the clinical situation.

Objective To analysis the relationship between gestational age and perinatal outcomes in patients complicated with early onset severe preeclampsia.Methods Retrospective study was conducted on clinical documents of 221 patients with early onset severe preeclampsia( ＜ 34 weeks) who delivered after 28 gestational weeks in Peking University First Hospital from July 1999 to June 2009.Patients were divided into three groups based on gestational weeks at delivery: group Ⅰ (n = 81 ) delivered at 28 -31 weeks+6,group Ⅱ (n = 78) at 32 -33 weeks+6 and group Ⅲ (n = 62) after 34 weeks.The clinical characteristics and perinatal outcomes were compared among those three groups.Results ( 1 ) Outcome of neonates:Among 221 neonates, 13 neonates lost follow-up, including 9 in group Ⅰ , 3 in group Ⅱ, 1 in group Ⅲ.The incidence of neonatal respiratory distress syndrome ( RDS ) of 26% ( 19/72 ) in group Ⅰ were significantly higher than 7% (5/75) in group Ⅱ and 10% (6/61) in group Ⅲ (P ＜ 0.05 ).The neonatal mortality rate of (43% ,31/72) in group Ⅰ were significantly higher than 3% (2/61) in group Ⅲ and 28%(21/75) in group Ⅱ (P ＜0.05 ).The incidence of maternal complications showed no statistical difference among three groups.(2) Neonatal death analysis: all neonatal death were due to parents' give up, including 26%(8/31) in group Ⅰ, 67% (14/21)in group Ⅱ and 1/2 in group Ⅲ, which reached statistical difference(P＜0.05).Conclusions The incidence of neonatal RDS in mother with early onset severe preeclampsia was decreased if delivered after 32 weeks, and the perinatal mortality was remarkably decreased if delivered after 34 weeks.Therefore, the perinatal survival rate in women with early onset severe preeclampsia can be improved by minimizing the impact of social factors.

Objective To investigate the effect of galectin-3 (Gal-3) on the pathogenesis of primary biliary cirrhosis (PBC).Methods The clinic data of 72 PBC patients at different stages were analyzed and the serum levels of Gal-3 were detected in 72 PBC patients and 20 controls by enzyme linked immunosorbent assay (ELISA).Independent t-test,variance analysis,LSD-t and Pearson correlation analysis were adopted for data analysis.Results The serum Gal-3 levels were significantly higher in PBC patients than those of healthy controls [(855±634) pg/ml,(463±446) pg/ml,P＜0.05].With the progression of disease,the levels of Gal-3,platelets,hemoglobin,albumin,IgM and complement C3 gradually declined,but the level of total bilirubin gradually elevated(P＜0.05).There was positive correlation between Gal-3 and immunoglobin IgM,complement C3 levels (r=0.330,P=0.005; r=0.357,P=0.002).There was negative correlation between Gal-3 and total bilirubin levels (r=0.350,P=0.003).Conclusion The Gal-3 can participate in the immune-mediated inflammation of PBC and the formation of liver fibrosis.The levels of Gal-3,platelet count,hemoglobin,albumin,IgM,complement C3 and total bilirubin could be regarded as laboratory parameters for the evaluation of the disease severity and prognosis.

After the present situation and characteristics of literature novelty assessment of traditional Chinese medicine were described, the importance of characteristic traditional Chinese medicine literacy of literature novelty assessors of traditional Chinese medicine was elaborated, the effect of literature novelty assessors on the literature novelty assessment of traditional Chinese medicine and the training of literature novelty assessors were studied in order to provide reference for other colleges and universities or scientific research institutions.

This study was aimed to compare the mechanical characteristics under different physiological load conditions with three-dimensional finite element model of rigid fixation and elastic fixation in the lumbar. We observed the stress distribution characteristics of a sample of healthy male volunteer modeling under vertical, flexion and extension torque situation. The outcomes showed that there existed 4-6 times pressure on the connecting rod of rigid fixation compared with the elastic fixations under different loads, and the stress peak and area of force on elastic fixation were much higher than that of the rigid fixations. The elastic fixation has more biomechanical advantages than rigid fixation in promoting interbody lumbar fusion after surgery.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Models, Theoretical ; Pressure ; Range of Motion, Articular ; Spinal Fusion

Objective To study the prevalence of metabolic syndrome (MS) within the Uyghur people with abnormal glucose metabolism in Xinjiang province according to three different diagnostic criteria and effects of accumulation of MS components on blood lipid profile.Methods Components of MS and blood lipid profile were observed with 666 Uyghur people with abnormal glucose metabolism after cluster randomized sampling method for selecting in Xinjiang province,and analyzed with the recommended diagnostic criteria by the National Cholesterol Education Program-Adult treatment Panel Ⅲ(NCEP-ATP Ⅲ,2001),the Chinese Diabetes Society under Chinese Medical Association (CDS,2004) and the International Diabetes Federation (IDF,2005).Results Prevalence of MS was 21.92％ (14.67％),23.72％ (15.88％),57.51％ (38.48％) with the criteria by NCEP-ATPⅢ,CDS,and IDF,respectively.IDF was the best among three criteria.The most combination was the abnormal glucose metabolism,dyslipidemia and obesity.In the ATPⅢ (2001),with the increase of number of components of metabolic syndrome,highdensity lipoprotein cholesterol (HDL-C) drop,low density lipoprotein cholesterol (LDL-C) increased; there was not significant difference in the CDS.Conclusions The incidence of MS was high in the Uyghur people with abnormal glucose metabolism in Xinjiang province.Most of them complicated with dyslipidemia.One of common components of MS included the elevated triglycerides,decreased HDL-C,and increased size of LDL-C particles,which could easily cause cardiovascular disease.