BACKGROUND:With the development of fixation materials and technology, scholars began to use artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. OBJECTIVE: To summarize the characteristics of artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. METHODS:The literatures about artificial bone graft materials in repair of spinal tuberculosis were retrieved from CNKI and PubMed database during 1985 to 2014 by computer. The keywords were “spinal tuberculosis, bone transplantation, internal fixation” in Chinese and English, respectively. RESULTS AND CONCLUSION:In the repair of spinal tuberculosis using artificial bone materials combined with pedicle screw fixation, autologous bone is the gold standard for bone grafting, presenting with no immune rejection. To avoid the occurrence of limited bone mass, pain and other complications, however, artificial bone materials have been extensively studied. Currently used artificial materials mainly include titanium and its aloys, hydroxyapatite composites and medical calcium sulfate, which al have good biocompatibility. But there are stil certain limitations and shortcomings.

ObjectiveTo explore the effect of age on clinical outcomes of patients with massive infarction after decompressive craniectomy.MethodsClinical data of 103-sufferers,who have been operated by decompressive craniectomy in our hospital from January 1999 to January 2010 were summarized.Based on age,these data are divided into the research group( ≥60 years old,number =48) and the control group( ＜ 60 years old,number =55 ).Then two groups were studied and discussed by mortality,the ratio of postoperative complications and cases of preoperative comorbidities.ResultsComparing with the control group,it was evident that patients of the research group had higher mortality and ratio of postoperative complications,and moat of them suffered from preoperative manifold comorbidities ( x2 =11.097,24.915,14.404,all P ＜ 0.01 ).Besides,the percentage of patients with good prognosis was significantly lower( x2 =9.821,P ＜ 0.01 ).ConclusionPostoperative clinical outcomes of aged patients with the massive infarction were affected by preoperative manifold comorbidities and postoperative complications.However,younger patients could correspondingly achieve the preferable treatment effect after surgery.Hence,age should possess an imporrant impact for clinical outcomes of patients with massive cerebral infarction after decompressive craniectomy.

Objective To investigate the effects of butylphthalide injection on serum levels of inflammatory factors and oxidative stress products in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction were selected in our hospital from March 2014 to September 2016. Patients were divided into conventional treatment group (n=56) and butylphthalide group (n=64) according the therapeutic methods. The conventional treatment group was treated with improving microcirculation and resisting blood platelet aggregation, while the butylphthalide group was injected with butylphthalide (100 mL intravenous drip, twice a day) on the basis of conventional treatment. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-17, IL-23 and methane dicarboxylic aldehyde (MDA) were detected before the treatment and 7 days,14 days after the treatment. The clinical efficacy was also accessed. Results The TNF-α, IL-6, IL-17, IL-23 and MDA levels were significantly decreased 7 days and 14 days after the treatment than those before the treatment in two groups of patients (P<0.05). And the above indexes were also decreased in butylphthalide group than those of conventional treatment group (P < 0.05). No obvious adverse reactions were observed in two groups. Conclusion Butylphthalide can improve the clinical symptoms through the inhibition of inflammation and oxidative stress in patients with acute cerebral infarction.

BACKGROUND:In recent years, the researchers have studied the adjacent segment degeneration after cervical fusion. Several studies concerned the adjacent segment degeneration after anterior cervical corpectomy and fusion.
OBJECTIVE:To evaluate the correlative factors of adjacent segment degeneration after anterior cervical corpectomy and fusion.
METHODS:122 patients were included in the study from 126 patients who underwent anterior cervical corpectomy and fusion that operated by the same treatment team and involved a single vertebral body and the two plates between February 2009 and February 2012. The final fol ow-up period was 3 years. According to the degeneration progress of adjacent segment degeneration, these patients were divided into non-progression group and progression group. The gender, age, preoperative adjacent segment degeneration, cervical range of motion, upper and lower vertebral range of motion, surgical segment, titanium mesh subsidence, plate-to-disc distance, and cervical curvature index were compared between two groups. Logistic regression analysis was applied to analyze the correlative factors of adjacent segment degeneration.
RESULTS AND CONCLUSION:(1) There were significant differences in preoperative adjacent segment degeneration, postoperative cervical range of motion, postoperative upper and lower vertebral range of motion, and postoperative cervical curvature index (P<0.05), which were included in logistic regression analysis. (2) Logistic regression analysis regression model:adjacent segment degeneration=0.317× postoperative cervical range of motion+3.374×preoperative adjacent segment degeneration+1.862 × postoperative lower vertebral range of motion-0.795×postoperative cervical curvature index-16.481. Logistic regression analysis demonstrated that preoperative range of motion, postoperative cervical range of motion, postoperative lower vertebral range of motion and postoperative cervical curvature index were correlative factors of range of motion after adjacent segment degeneration (P<0.05). (3) These results indicated that preoperative adjacent segment degeneration, postoperative cervical range of motion, postoperative lower vertebral range of motion and postoperative cervical curvature index were correlative factors of adjacent segment degeneration. We should actively carry out effective measures to prevent the progress of the adjacent segment degeneration before, during and after anterior cervical corpectomy and fusion.

Objective:To evaluate the efficacy and safety of sodium hyaluronate gel in preventing adhesion after prophylactic enterostomy.Methods:One hundred and twenty four patients from 6 hospitals were enrolled in this prospective multi-center randomized controlled trial. Patients were randomized into the study group ( n=59) or the control group ( n=65).All patients underwent prophylactic enterostomy. Patients of study group received odium hyaluronate gel for adhesion-prevention,while those in control group did not receive any adhesion-prevention treatment. The incidence of moderate to severe adhesion around the incision in the stoma area were evalutated during stoma reduction surgery. Results:The incidence of moderate to severe adhesion around the incision in the stoma area was 6.3% in the study group, the difference was statistically significant ( P<0.05) compared to that of the control group (32.6%). Conclusion:Sodium hyaluronate gel can safely and effectively reduce the incidence of moderate and severe adhesions after abdominal surgery.

Objective To compare the dose distribution between volumetric-modulated arc therapy ( VMAT ) and intensity-modulated radiotherapy ( IMRT ) in patients with brain metastases receiving hippocampus-sparing whole brain radiotherapy. Methods Forty-six patients with brain metastases admitted to our hospital from 2013 to 2016 were recruited in this study. After fusing the CT and MRI images, the hippocampus was delineated on the fusion images. The three-grade hippocampal avoidance regions were created by using a volumetric expansion of 3,5 and 10 mm surrounding the hippocampus. The planning target volume ( PTV) was calculated by subtracting the 5-mm expansion surrounding the hippocampus from the whole brain. The prescription dose was 30 Gy/10 fractions. The 7-field IMRT and single arc VMAT were designed for each case. The dose distribution of PTV,hippocampus and other organs at risk ( OARs) were evaluated in both plans. Results The PTV was statistically compared between VMAT and IMRT:V95:95. 90％ and 94. 97％( P=0. 000 );V90:98. 17％ and 97. 48％( P=0. 000 );CI:0. 825 and 0. 813 ( P=0. 013);HI:0. 277 and 0. 289(P=0. 025).The hippocampal dose was also compared between VMAT and IMRT:the Dmax of hippocampus was 1698. 9 cGy for VMAT and 1784. 9 cGy for IMRT (P=0. 002).TheDmean of hippocampus was 1183. 8 cGy for VMAT and 1112. 7 cGy for IMRT (P=0. 000).No statistical significance was observed between IMRT and VMAT in protecting the OARs except the chiasma opticum ( 3262. 6 cGy and 3529. 3 cGy,P=0. 000).The MU and treatment time of VMAT and IMRT were 651 and 2768( P=0. 000) ,and 188 s and 504 s ( P=0. 000) . Conclusions The dose distribution of PTV in VMAT is significantly better than that in IMRT. VMAT is advantageous in protecting the hippocampus than IMRT. VMAT can significantly shorten treatment time and MU and enhance the equipment utilization. Besides, VMAT can achieve the goal of protecting the hippocampus and meet the prescription dose requirement of PTV.