OBJECTIVETo evaluate the clinical and radiographic results of total lumbar disc replacement with SB Charité III prosthesis.

METHODSFrom Dec 1999 to Dec 2006, total lumbar disc replacement with SB Charité III prosthesis was performed in 65 patients affected with degenerative lumbar disc disorders. Among these patients, 48 (52 prosthesis) were followed up for more than two years (from 2.0 to 7.5 years). There were 22 males and 26 females with an average age of 43 years old (from 36 to 58 years). The diagnosis was lumbar disc herniation with low back pain in 34 patients, discogenic low back pain in 9 patients and failed lumbar disc surgery in 5 patients. All patients underwent standard anterior procedure under general anesthesia. One level replacement was done in 44 patients (L3,4 in 3, L4,5 in 23 and L5-S1 in 18), and two level procedures in 4 patients (L3,4/L4,5 in 1 and L4,5/L5-S1 in 3). Clinical and radiographic results of these patients were evaluated at each follow-up time (1, 3, 6, 12, 24 months after operation and the latest).

RESULTSThe average visual analogue scales score for pain was 9.3 before operation, changed to 4.3 one month after operation, further declined to 2.6 two years after operation and finally to 1.8 at the latest follow-up evaluation. Meanwhile, the average Oswestry Disability Index was 45.8 before operation, 28.6 one month after operation, 12.5 two years after operation and 8.2 at the latest followup evaluation. All operated levels but one maintained mobile and there was no significant loss of range of motion observed. Complications such as implant dislocation or significant subsidence of the prosthesis occurred in none case of this group. All patients but one (98%) were satisfied with the surgery at the latest follow-up evaluation.

CONCLUSIONSTotal lumbar disc replacement is an effective method for the treatment of degenerative disc disorders. Its long-term outcome remains to be verified.

Adult ; Arthroplasty, Replacement ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; surgery ; Joint Prosthesis ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate device implanted complications and corresponding therapeutic strategies of Coflex interspinous dynamic stabilization system for lumbar spine intraoperatively and postoperatively.

METHODSFrom September 2008 to August 2010, 133 cases of degenerative disease of lumbar spine including 62 males and 71 females, ranging from 35 to 81 years of age (mean 60.8 years), underwent or planed to be underwent decompression with Coflex interspinous dynamic stabilization system were reviewed retrospectively, and 13 cases including 6 males and 7 females, ranging from 41 to 71 years of age (mean 58.6 years), occurred device implanted complications. The Coflex implanted complications were analyzed, and therapeutic strategies according to different character were carried out, scores of visual analogue scale (VAS), Oswestry disability index(ODI) and effect-related data preoperatively, postoperatively, after conservative treatment and in final follow-up were evaluated with paired-samples t test.

RESULTSThirteen cases of Coflex implanted complications and treatment applied included: 3 cases occurred fracture of spinous processes intraoperatively were treated by pedicle screws instead; 2 cases occurred fracture of spinous processes postoperatively or during follow-up, including 1 case underwent revision with pedicle screws, another 1 case treated with conservative treatment; 4 cases with degenerative coronal spondylolysis in surgical segments, 1 case with sagittal instability preoperatively, and 1 case with device dislodgment in follow-up all suffered aggravated pain and received conservative treatment; 1 case suffered implanted malposition intraoperatively was underwent internal fixation with pedicle screws instead; at length, 1 case with aggravated pain postoperatively and without definite reason received revision with internal fixation of pedicle screws demolishing the Coflex. The follow-up time of 13 cases ranged from 20 to 38 months (mean 27.6 months); and 7 cases implanted Coflex with aggravated pain of lumbar and lower limb, but the position of device can still maintained, were received conservative treatment, and whose score of VAS and ODI in the final follow-up were 1.9 ± 0.7 and 23.2 ± 3.4, and comparing to 6.1 ± 1.1 and 58.1 ± 3.0 preoperatively, evident improvement was got finally (t = 8.2 and 18.2, P < 0.01). Scores of VAS and ODI of 2 cases with Coflex implanted complications underwent revision with pedicle screws were also improved correspondingly.

CONCLUSIONSCoflex interspinous dynamic stabilization system implanted should be avoided to cases who suffered with osteoporosis, too narrow interspinous space and intervertebral coronal spondylolysis or sagittal instability; and choice of device, depth of implantation and intensity of clumping should be appropriate. For patients with symptom but device still in right position, conservative treatment can be carried out; but for patients subjected to malposition of device, failure of implantation intraoperatively or intolerance to device, revisions and salvages should be underwent with internal fixation of pedicle screws.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; adverse effects ; Intervertebral Disc Degeneration ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; adverse effects ; instrumentation ; methods ; Treatment Outcome

OBJECTIVETo investigate the applications of fluoroscopy-based navigation in pelvic fractures and related surgical considerations.

METHODSFrom May 2010 to December, 16 patients with pelvic fractures were treated with computerized navigation. There were 12 males and 4 females with an average age of 37 years (ranged from 20 to 54 years). Fractures were caused by traffic accident in 5 cases, crush injury in 5 cases and falling from height in 6 cases. Based on the Tile classification, there were 15 cases of Tile C type and 1 case of Tile B type. In these patients, 4 patients were treated with sacroiliac screw fixation; 2 patients were treated with sacroiliac screw fixation, screw fixation for pubic symphysis diastasis and pubic fractures; 8 patients were treated with sacroiliac screw fixation and screw fixation for pubic fractures; 2 patients were treated with screw fixation for pubic fractures. The index such as screw inserting time, accurance of inserting screws, intra-operative blood losing, injuries of nerve, vascular and other organs, reduction conditions were observed.

RESULTSA total of 36 screws were inserted. The average time was 20 min for each screw placement. The blood loss ranged from 10 to 20 ml. There were no wound infections, neurovascualr injuries and other organ injuries. The postoperative pelvic X-ray and three-dimensional CT showed that the fractures had good reduction and all the screws had good position.

CONCLUSIONPercutaneous screw fixation of pelvic fractures with fluoroscopy-based navigation have advantages such as little trauma, less blood loss, little complication, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but need adequate preoperative reperation and high requirements for the surgeon.

Adult ; Bone Screws ; Female ; Fluoroscopy ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pelvic Bones ; injuries ; Preoperative Care ; Surgery, Computer-Assisted

OBJECTIVETo investigate the expression of AML1/ETO9a isoform in the acute myeloid leukemia (AML)-M2 patients.

METHODSExpressions of AML1/ETO fusion gene and AML1/ETO9a isoform were detected by using reverse transcriptase-polymerase chain reaction (RT-PCR) in leukemia patients, MDS patients, leukemia cell lines and healthy subjects. Karyotype was studied by R-banding technique.

RESULTIn 30 newly diagnosed AML-M2 patients 15 were found to express AML1/ETO9a isoform, while the rest including 20 AML-M2CR, 18 other subtypes of AML, 5 chronic myelogenous leukemia (CML), 3 myelodysplastic syndromes (MDS), 3 leukemia cell lines (NB4, KG-1, K562) and 5 healthy subjects were AML1/ETO9a negative. Among the 15 AML/ETO9a isoform expressing cases, 13 were demonstrated t(8;21) translocation and AML1/ETO expression.

CONCLUSIONIsoform AML1/ETO9a was correlated to AML/M2, and it may promote the development of leukemia in combination with the AML1/ETO fusion gene.

Adolescent ; Adult ; Aged ; Core Binding Factor Alpha 2 Subunit ; genetics ; metabolism ; Female ; Gene Expression ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Male ; Middle Aged ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Protein Isoforms ; genetics ; metabolism ; RUNX1 Translocation Partner 1 Protein

[Objective]To investigate the therapeutic influencing factors for surgical treatment of deep comatose patients after spontaneous cerebellar hemorrhage.[Methods]The clinical data of 23 patients in deep coma due to spontaneous cerebellar hemorrhage,admitted to our hospital fiom March 2003 to January 2012,were studied retrospectively.Eighteen patients received surgical treatment were divided into 2 groups depending on their different prognoses;the therapeutical effect and their prognostic factors were analyzed.[Results] The interval between onset of symptom and operation in patients having favorable outcome was significantly shorter than that in patients with unfavorable outcome (P=0.023).No significant differences on age,hospitalization time,hematoma size,presence of obstructive bydrocephalus,obliteration of perimesencephalic cistern and presence of cycle respiration were noted between the 2 groups.[Conclusion] Deep coma is not a contraindication for surgery in very recent onset patients after spontaneous cerebellar hemorrhage and immediate surgical relief of brain stem compression is the most important factor for reduction mortality in patients with spontaneous cerebellar hemorrhage.

Objective To investigate the expression of Aurora-A in gliomas and its relationship with clinical significance of gliomas.Methods Forty glioma specimens kept with paraffin,including 8 with WHO grade Ⅰ,8 with WHO grade Ⅱ,10 with grade Ⅲ and 14 with grade Ⅳ,collected in our hospital from June 2010 to August 2012 during the surgery,were chosen in our study.The expression of Aurora-A was detected by immunohistochemistry in these 40 glioma specimens.The relationships between Aurora-A expression and clinical factors were analyzed.Results The Aurora-A protein expression mainly located in the cytoplasm and (or) nucleus; positive expression rate of Aurora-A was 72.5％ (29/40); the Aurora-A protein expression was significantly different in the glioma specimens of different pathological grades and different survival times of the patients:Aurora-A protein expression was positively related with pathological grades,and the Aurora-A protein expression in patients having survival time shorter than or equal to 3 years was significantly higher than that in patients having survival time longer than 3 years (P＜0.05).Conclusion Over-expression of Aurora-A in gliomas is correlated with prognosis of patients; Aurora-A maybe a potential marker for gliomas and a new therapy target.

Objective To investigate the Effects of conventional open craniotomy and key-hole approach on neurosurgical management of hypertensive intracerebral hemorrhage (HICH) and on cellular immunal function of these patients.Methods Eighty-three patients with HICH,admitted to and performed operation in our hospital from September 2008 to May 2011 (53 underwent conventional open craniotomy and 30 underwent surgery via key hole approach) were chosen in our study.Their CD3,CD4 and CD8 positive cell percentage and ratio of CD4/CD8 in serum before operation and 1 and 7 d after operation were detected.The infectious complications were analyzed and prognoses were evaluated by activities of daily living (ADL) grading.Results The CD3 and CD8 positive cell percentage,and ratio of CD4/CD8 in serum 1 and 7 d after the operation were significantly decreased as compared with those before operation (P＜0.05),and those 7 d after operation were significantly increased as compared with those 1 d after operation (P＜0.05).One and 7 d after operation,the CD3 and CD8 positive cell percentage,and ratio of CD4/CD8 in the key hole approach group were significantly higher than those in the conventional open craniotomy group (P＜0.05).The postoperative pulmonary infection rate in the conventional open craniotomy group was significantly higher than that in the key hole approach group (P＜0.05).Conclusion As compared with conventional open craniotomy,surgery via key-hole approach has the same prognosis in treatment of HICH which has not yet occurred herniation,while the influence of cellular immunal function and the incidence of lung infection is relatively lower.

OBJECTIVETo investigate the comparability of bcr-abl (P210) transcript levels detected in different hospitals.

METHODSTen hospitals in China took part in the four times of sample exchange and comparisons from April, 2010 to August, 2011. The exchange samples were prepared by Peking University People's Hospital. Firstly, the BCR-ABL (P210)(+) cells from a newly diagnosed chronic myeloid leukemia patient were 10-fold serially diluted by BCR-ABL (P210)(-) cells and they covered 4 magnitudes. Then, TRIzol reagents were thoroughly mixed with cells in each tube. Every 12 samples (three samples per magnitude) were sent to the other 9 hospitals. The cell number of each sample was 8×10(6). The detection of bcr-abl transcript levels by real-time quantitative PCR were performed in every hospital according to their own protocols. Conversion factors (CF) were calculated using regression equation.

RESULTSDifferences in bcr-abl transcript levels did exist among results of 10 hospitals in each comparison. In general, the results of the most of hospitals were in line with the dilutions of cells. CF of every hospital fluctuated. Three hospitals had relatively stable CF, and their ranges were 2.8 - 5.2, 1.2 - 2.8 and 2.2 - 6.8, respectively; two hospitals had unstable CF with ranges 0.76 - 7.0 and 2.1 - 18.7; three hospitals couldn't be calculated CF one or two times because of the significant deviation of the results from the actually bcr-abl transcript levels, and their ranges of CF which could be calculated were 1.9 - 19.2, 3.6 - 7.6 and 0.18 - 14.7; One hospital only had two CF (3.3 and 5.0) because of the replacement of an important reagent during the period of comparisons.

CONCLUSIONSComparability of bcr-abl (P210) transcript levels between different hospitals could be achieved through CF which acquired by sample exchange and comparison. The stable and reliable detection system is the premise to acquire correct CF.

Bone Marrow Cells ; China ; Fusion Proteins, bcr-abl ; genetics ; isolation & purification ; Hospitals ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo clarify whether A1166C polymorphism of the angiotensin II type 1 receptor (AT(1)R) gene is associated with susceptibility to essential hypertension in Han, Tibetan and Yi populations in China.

METHODSThis study involved 302 normotensive and 446 hypertensive subjects. The polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in genomic DNA. The data were analyzed by ANCOVA, chi-square test, and multiple logistic regression.

RESULTSIn normotensive controls, the A1166 allele frequencies were 0.979, 0.939 and 0.965 in Han, Tibetan and Yi participants, respectively. There was no significant intergroup variation in frequency of the allele in normotensives (chi-square=4.166, P=0.125). The frequency of the A1166 allele in Tibetan male hypertensives was significantly higher than that in normotensives (chi-square=11.46, P=0.001). There was no significant difference in A1166C genotype distribution and allele frequency between normotensives and hypertensives either in the Han (P=0.465) or Yi (P=0.357) populations. Body mass index in the Han and Yi populations (P=0.0001), age in the Tibetan and Yi populations (P=0.0001), and AA genotype in the Tibetan male population (P=0.0034) all were independent risk factors for hypertension. Diastolic blood pressure levels were significantly higher in Tibetan male subjects with the AA genotype than in those with the AC+CC genotype (P=0.0040).

CONCLUSIONThe A1166 allele is very common in Han, Tibetan and Yi populations, approximately 1.35-fold more common than in Caucasians. The A1166 allele of the AT(1)R gene may be a predisposing factor for essential hypertension in Tibetan males. A1166C polymorphism of the AT(1)R gene is probably not involved in the pathogenesis of essential hypertension in Han and Yi populations.

Alleles ; Asian Continental Ancestry Group ; genetics ; Blood Pressure ; genetics ; China ; ethnology ; DNA ; analysis ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genetics, Population ; Genotype ; Humans ; Hypertension ; genetics ; Male ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Receptor, Angiotensin, Type 1 ; genetics ; Tibet

The present study investigated the chemical constituents of the roots and rhizomes of Panax notoginseng. Compounds were isolated by various column chromatographic methods, and their structures were elucidated by the extensive analysis of spectroscopic data and chemical evidences. A novel 12, 23-epoxy dammarane-type saponin, named epoxynotoginsenoside A (1), together with four known compounds (2-5), was isolated and characterized.
Panax notoginseng ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry ; Saponins ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification