OBJECTIVETo provide anatomical data for transoral atlantoaxial reduction plate internal fixation.

METHODMicrosurgical dissecting was performed on 10 fresh craniocervical specimens layer by layer according to transoral approach. Stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationships of atlas and axis and correlative anatomical parameters of internal fixation to atlantoaxial joint were observed.

RESULT(1) Posterior pharyngeal wall consisted of 2 layers and 2 interspace: mucosa, anterior fascia of vertebrae, posterior interspace of pharynx and anterior interspace of vertebrae. (2) The range from anterior rim of foramen magnum to C3 could be exposed by this approach. (3) The distance between the vertebral artery at atlas and midline was (25.2 +/- 2.3) mm and that between the vertebral artery at axis and midline was (18.4 +/- 2.6) mm. (4) The width of atlas and that of axis could be exposed respectively to (39.4 +/- 2.2) mm and (39.0 +/- 2.1) mm. The distance (a) between 2 atlas screw inserting points (center of anterior aspect of C-1 lateral mass) was (31.4 +/- 3.3) mm. The vertical distance (b) between the connecting line of 2 atlas screw inserting points and that of 2 axis screw inserting points (at the central part of the vertebrae which was 3 - 4 mm lateral to the midline of C-2 vertebrae) was (18.7 +/- 2.7) mm. The odds of a/b was 1.5 approximately 1.7.

CONCLUSIONSAnterior atlantoaxial plate internal fixation through transoral approach is suitable and feasible. The design of the plate should be based on the above data.

Atlanto-Occipital Joint ; anatomy & histology ; surgery ; Bone Plates ; Cervical Vertebrae ; anatomy & histology ; surgery ; Equipment Design ; Humans ; Microsurgery ; Oropharynx ; anatomy & histology ; Spinal Fusion ; instrumentation ; methods

OBJECTIVETo determine the amount of silver in silver-loaded coral hydroxyapatite (Ag(+)-CHA) bone substitute and its impact on the biocompatibility of this material with mouse embryonic osteoblast cells.

METHODSAg(+)-CHA was prepared by immersing coral hydroxyapatite in a serial concentration of silver nitrate solutions. The amount of silver in the prepared Ag(+)-CHA was measured by inductively coupled plasma atomic emission spectrometry (ICP-AES). The viability of MC3T3-E1 cells incubated with Ag(+)-CHA was measured by MTT colorimetric assay, and the cell growth and morphological changes were observed by inverted phase-contrast microscope and confocal laser scanning microscope.

RESULTSThe amount of silver loading in the bone substitutes prepared by immersion in 1×10(-2), 1×10(-3), 5×10(-4), 10(-4), 8×10(-5), and 5×10(-5) mol/L silver nitrate solutions were 4127.67∓47.35, 167.90∓11.00, 83.42∓4.51, 30.20∓2.32, 22.39∓4.09, and 15.11∓0.55 µg/g, respectively. A low silver content in the material (prepared with silver nitrate solution of less than 8×10(-5) mol/L) showed no significant inhibitory effect on the growth of MC3T3-E1 cells or produced noticeable cytotoxic effect. On the materials prepared with 8×10(-5) and 10(-5) mol/L silver nitrate solution, the osteoblasts displayed active proliferation similar to those incubated on materials without silver loading. The confluent cells showed a normal fusiform morphology with tight arrangement.

CONCLUSIONAg(+)-CHA with low silver content has a good biocompability and can promote the proliferation and growth of MC3T3-E1 cells in vitro, suggesting the clinical potential of this material as a anti-infection bone substitute.

3T3 Cells ; Animals ; Anthozoa ; chemistry ; Anti-Bacterial Agents ; analysis ; pharmacology ; Biocompatible Materials ; chemistry ; pharmacology ; Bone Substitutes ; chemistry ; pharmacology ; Cells, Cultured ; Durapatite ; chemistry ; pharmacology ; Materials Testing ; Mice ; Silver ; analysis ; chemistry ; pharmacology

OBJECTIVETo investigate the treatment for traumatic intervertebrae disk herniation in cervical thoracic junction.

METHODSFrom 2003 to 2008, there were 10 patients with trautimatic intervertebral disk herniation in cervical thoracic junction, which included 6 males and 4 females, aged from 23 to 66 years (means 41.5 years). All of them were performed through the transforminal approach combined with internal fixation. After operation all patient underwent hyperbaric oxygen treatment. The function of spine was evaluated by JOA score system.

RESULTSAll patients were followed up for 8 to 16 months(means 13 months). All patients got recovery of spine function to some extent except one case with complete spine damaged. The JOA scores was improved from (8 +/- 3) before operation to (15 +/- 2) after operation.

CONCLUSIONEarly and effective treatment by transforminal operation could be helpful for the recovery of spine function.

Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo improve the recognition and treatment of Chinese cutis verticis gyrata.

METHODSBased on the review of the etiopathology, clinical features, diagnosis, classification and treatment of the disease in the literatures, six patients with the cutis verticis gyrata were treated with the skin graft or the expanded scalp flap.

RESULTSThe operative effects were satisfactory during 6 months to 5 years of the follow-ups. No recurrence was found in all cases. Two patients treated with skin graft had lead to baldness, four patients treated with the expanded scalp flap had been good appearance.

CONCLUSIONSThe method of the expanded scalp flap is good and effective treatment for the cutis verticis gyrate.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Scalp ; abnormalities ; Scalp Dermatoses ; pathology ; surgery ; Tissue Expansion ; methods ; Young Adult

Objective To evaluate the value of positron emission tomography(PET)-CT imaging combined with continual detection of CA_(125)in serum for diagnosis of early recurrent ovarian epithelial carcinoma.Methods Twenty six patients received PET-CT imaging,who were all diagnosed as primary epithelial ovarian cancer of stage Ⅱ-Ⅳ and had complete remission after cytoreductive surgery and multiple courses of chemotherapy in Shandong Provincial Cancer Hospital.After a steady period,all patients experienced progressive rising of CA_(125)values 3 times in 2 months.But no positive lesion was found by CT, or although suspicious positive focus was found,the recurrent and(or)metastatic extent was not definite. Out of 26 patients,16 were delivered rechemotherapy and(or)radiotherapy,and 10 received re- cytoreductive surgery.Results(1)Of 26 patients,the value of CA_(125)was more than 35 kU/L in 17,and in 14 of 17,pelvic or abdominal cavity recurrence was diagnosed by CT and PET-CT,and 4 showed simuhaneously distant metastasis on PET-CT.In the remaining 3 patients of which CT findings were negative,2 had pelvic and abdominal cavity recurrence,and one had bone metastasis on PET-CT.Of 9 patients with progressive rising CA_(125)levels but the value was less than cut-off(

OBJECTIVETo elucidate the characteristics of variation and the genetic evolution of non-structural protein (NS1, NS2) genes related to avian influenza subtype H5N1 viruses isolated from the boundary region of Yunnan province.

METHODSSwab samples were collected from foreign poultry and wild birds in the boundary regions of Yunnan province and screened by H5/N1 subtype-specific multiplex RT-PCR. The NS segment of H5N1 virus from the positive samples were amplified by RT-PCR and cloned into pMD18-T vectors for sequencing. The alignment and phylogenetic analysis on those available NS1, NS2 genes were performed with sequences of the known reference strains.

RESULTS71 positive samples were identified from 1240 samples, with the positive rate as 5.72%. Fourteen different NS segment sequences were obtained from 30 representative positive samples and could be divided into 3 distinct clades or sub-clades (I-1, I-2 and II), by phylogenetic analysis. The NS1/NS2 genes and Hemagglutinin (HA) genes of H5N1 viruses from the boundary regions of Yunnan province showed different relationships regarding the characteristics on genetic evolution. The substitution or mutation of key amino acids sites had been noticed in the nuclear location signal domains, effect domain, and other pathogenicity markers.

CONCLUSIONNS genes of H5N1 subtype viruses in boundary region of Yunnan province showed genetic divergence and the virus of clade I-2 and II had become dominant epidemic strains in this region since 2010.

Amino Acid Sequence ; Animals ; Animals, Wild ; Birds ; virology ; China ; epidemiology ; Evolution, Molecular ; Genome, Viral ; Influenza A Virus, H5N1 Subtype ; genetics ; isolation & purification ; Influenza in Birds ; epidemiology ; virology ; Phylogeny

AIMTo investigate the protective effect of monosialoganglioside (GM1) on injury induced by oxygen glucose deprivation/reperfusion (OGD/Rep) in rat hippocampal slices.

METHODSThe protective effects of GM1 on hippocampal slices after OGD/Rep were observed by detecting the light transmittance (LT) changes of rat hippocampal slices and 2, 3, 5-triphenyltetrazolium chloride (TTC) staining of rat hippocampal slices.

RESULTS(1) In four groups treated with 0 (control), 0.1, 1.0, 10 micromol/L GM1, the peak of light transmittance (LT) in the slices treated with 1.0 micromol/L GM1 was significantly lower than that of the control and the group treated with 0.10 micromol/L GM1 (P < 0.01, ANOVA), while the peak of LT in the slices treated with 10.0 micromol/L GM1 was significantly lower than that of the other groups (P < 0.01, ANOVA). The time to reach the peak of LT in four groups was significantly different from each other (P < 0.05, Kruskal-Wallis test). The time to reach the peak of LT in the group treated with 1 micromol/L GM1 was the significantly longer than that in the control (P < 0.01, Mann-Whitney U test). (2) There was characteristic dose-response relationship between GM1 and TTC staining of rat hippocampal slices. In the five groups, treated with 0 (control), 0.01, 0.1, 1.0, 10 micromol/L GM1 respectively, TTC staining in the group treated with 1 micromol/L GM1 was the deepest (P < 0.05 vs. control, 0.01 and 0.1 micromol/L GM1 group, ANOVA), and the next was in the group treated with 10 micromol/L GM1 (P < 0.05 vs. control and 0.01 micromol/L GM1 group, ANOVA).

CONCLUSIONGM1 could protect injury induced by OGD/Rep in rat hippocampal slices effectively in vitro.

Animals ; G(M1) Ganglioside ; pharmacology ; Glucose ; deficiency ; Hippocampus ; metabolism ; Hypoxia ; metabolism ; In Vitro Techniques ; Male ; Oxygen ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury

OBJECTIVETo elucidate the variation in characterizations and genetic evolution of the matrix protein 2 or ion channel protein(M2) genes of avian influenza subtype H5N1 viruses in the boundary region of Yunnan province from 2008 to 2012.

METHODSA total of swab samples were collected from foreign poultry such as the junction between Yunnan and Vietnam, Laos,myanmar and wild birds in boundary region of Yunnan province from 2008 to 2012 and screened by H5N1 subtype-specific multiplex RT-PCR. The M genes of H5N1 virus from the positive samples were amplified by RT-PCR and cloned into pMD18-T vectors for sequencing. The alignment and phylogenetic analysis of M2 genes were performed with sequences of the known reference strains.

RESULTSA total of 71 positive samples were found out of 1240 samples and the positive rate was 5.72%. A total of 14 different M2 sequences were obtained from 30 positive samples and were divided into 3 distinct clades or sub-clades(1.2.1, 1.2.2 and 2) by phylogenetic analysis, 5, 7 and 2, respectively. The M2 genes and Hemagglutinin(HA) genes of H5N1 viruses from the boundary region of Yunnan province had showed different relationship of genetic evolution. The substitution or mutation of key amino acids sites had been found among the domains of epitope, adamantane-resistance, and poultry or human original viral strains.

CONCLUSIONThe M2 genes of H5N1 subtype viruses in boundary region of Yunnan province from 2008 to 2012 showed genetic divergence and the virus of clade 1.2.2 had become dominant epidemic strain in this region.

Animals ; Birds ; virology ; Chickens ; virology ; China ; Evolution, Molecular ; Influenza A Virus, H5N1 Subtype ; classification ; genetics ; Influenza in Birds ; virology ; Phylogeny ; Poultry ; virology ; Viral Matrix Proteins ; genetics

Adult ; Female ; Hepatitis B, Chronic ; complications ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Function Tests ; Male ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; complications ; physiopathology

OBJECTIVETo design a clinically applicable transoralpharyngeal atlantoaxial reduction plate (TARP), introduce the operation procedure, and evaluate its preliminary clinical effects.

METHODSA novel TARP system, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operational instruments was developed. This system was applied clinically on five patients with irreducible atlantoaxial dislocation of congenital or traumatic origin. During operation, the reduction was completed by the combined action of the plate and the atlantoaxial reductor after transoral joint release and cord decompression. Bone graft granules were implanted between the bilateral atlantoaxial joints and TARP was used to immobilize subsequently the atlas and axis.

RESULTSClinical application demonstrated that TARP could induce instant reduction and that the method was operationally feasible and its postoperational effect was satisfactory.

CONCLUSIONSThe design of TARP is novel. The operational procedure is simple and easy to use. Furthermore, instant reduction can be completed during the operation and the fixation is relatively stable. TARP is an ideal alternative for irreducible atlantoaxial dislocation and may have excellent prospects for further clinical applications.

Adolescent ; Adult ; Atlanto-Axial Joint ; surgery ; Bone Plates ; Bone Screws ; Decompression, Surgical ; methods ; Equipment Design ; Female ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Male ; Mouth ; surgery ; Spinal Fusion ; methods