Objective To study the change of glycogen phosphorylase isoenzyme BB(GPBB)in neonates with asphyxia complicated with myocardial injury and its correlation with various perinatal factors. Methods Sixty-four neonates with asphyxia(including 39 mild asphyxia and 25 severe asphyxiated neonates,30 neonates with and 34 without myocardial injures)were enrolled and 25 healthy neonates were studied as control. The plasma levels of GPBB were measured by enzyme-linked immunosorbent assay(ELISA). Myocardial enzymes,cardiac troponin I,electrocardiogram,chest X-ray were performed simultaneously. Results The plasma GPBB levels were significantly higher in neonates with myocardial injury(13.84,7.57 ng/ml)than those without myocardial injury(4.97,3.24 ng/ml)and control group(4.95,1.99 ng/ml)( P ＜ 0.01). The sensitivities of GPBB,cTnI and CK-MB in diagnosing myocardial injury were 90%,66.7% and 83.3%,respectively. The sensitivity of GPBB was significantly higher than that of cTnI(χ~2 ＝ 4.812,P ＜ 0.05),with no statistical difference between GPBB and CK-MB(χ~2 ＝ 0.577,P ＞ 0.05). The specificities of GPBB,cTnI and CK-MB in diagnosing myocardial injury were 88.2%,91.2% and 67.6%,respectively. The specificity of GPBB was significantly higher than that of CK-MB(χ~2 ＝ 4.191,P ＜ 0.05),with no statistical difference between GPBB and cTnI(χ~2 ＝ 0.159,P ＞ 0.05). Plasma GPBB levels were significantly higher in neonates with severe asphyxia(14.67,6.09 ng/ml)than those with mild asphyxia(5.61,3.56 ng/ml)and control group(P ＜ 0.01). GPBB levels were higher in mildly asphyxiated neonates than those in control neonates,but with no statistical significance(P ＞ 0.05). Spearman rank correlation analysis showed that plasma GPBB levels positively correlated with the cloudiness of the amniotic fluid(r ＝ 0.500,P ＜ 0.001)and negatively correlated with Apgar score(r ＝ -0.520,P ＜ 0.001). Conclusions This study indicated that GPBB can be used as an ideal biomarker of myocardial ischemia injury in neonates with asphyxia. The determination of GPBB in early neonatal period is useful in detecting and assessing the severity of myocardial injury.

OBJECTIVETo evaluate the clinical results and the value of the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation for the treatment of ossifying thoracic disc herniation.

METHODSThirty nine cases of ossifying thoracic disc herniation who accepted the posterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation were included in this study. There were 21 male and 18 female patients. The age ranged from 33 to 69 years, with an average of 53 years. The course of disease ranged from 1 month to 18 months, with an average of 6.5 months. The lesion locations were T7-8 for 1 case, T8-9 for 4 cases, T9-10 for 9 cases, T10-11 for 7 cases, T11-12 for 10 cases, T12-L1 for 6 cases, and both T11-12 and T12-L1 for 2 cases. The clinical results were evaluated by Otani scored system.

RESULTSThe operative time was from 2.5 to 5.0 hours, with average of 3.3 hours. The blood loss was from 400 to 2 000 ml, with average of 850 ml. All patients were successfully operated without neurological symptoms aggravation and accidents. The followed-up period was 24 to 60 months, mean 40.5 months. According to Otani scored system, there were excellent results in 16 cases and good results in 18 cases. The clinical satisfaction rate was 87.2%. All obtained bony fusion without instrument failure.

CONCLUSIONPosterior approach 360° vertebral canal decompression and transfacet discectomy combined with interbody fusion and pedicle screw internal fixation is a safe and effective surgical procedure for the treatment of ossifying thoracic disc herniation.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; Treatment Outcome