Objective To discuss the value and experience of the percutaneous vertebroplasty (PVP)in the treatment of vertebral body compression fracture(VCF)in aged osteoperosis.Methods PVP was performed in 44 cases with VCF including 28 with single vertebral compressed fracture,12 with double compressed fracture and four with triple compressed fracture,with 67 vertebrae,for clinical and radiologieal evaluation.Results The mean follow-up was 15 months(4-23 months).There could be seen immediate relief of pain in 40 cases,out-of-bed activities at operation day in 19 and out-of-bed activ- ities at second day after operation in 25.Postoperative X-ray showed uniformly distributed bone cement in the vertebral,without leakage.Conclusion PVP is a recommendable method for VCF,for it has ad- vantages of pain relief,vertebrae stabilization,minimal invasion and minor complications.

ObjectiveTo analyze the effect of temporal distance parameters on comfortable and maximal walking speed of hemiplegic stroke patients.MethodsThe comfortable and maximal walking speed of 85 hemiplegic stroke patients were tested by 10 m walking speed and temporal distance parameters of gait cycle were obtained. The effect of step length and walking rate on comfortable and maximal walking speed was analyzed.ResultsStep length and walking rate were significantly positive related to comfortable and maximal walking speed (r=0.849-0.915,P<0.001).The step regression analysis selected step length as a significant variable for comfortable and maximal walking speed (R2=0.835,R2=0.827,respectively). ConclusionThe important parameter that influences comfortable and maximal walking speed of hemiplegic stroke patients is step length.

OBJECTIVETo develop a chitosan (CH)/polyethylene glycols succinate acid (PEG-SA)-mediated mitomycin C (MMC) delivery system and investigate its drug release characteristics in vitro and its effect against scar tissue adhesion in vivo.

METHODSMitomycin C loading in the composite CH/PEG-SA/MMC films was determined using ultraviolet. The freeze-dried films were dispersed in 1 ml PBS (pH7.4) and mitomycin C release in vitro was determined according to the mitomycin C concentration-UV value standard curve. The influence of the film structure on the drug release was evaluated. The drug delivery system was then implanted in SD rats, and 4 weeks later, immunohistochemical and histological examinations were carried out to assess the therapeutic effect on epidural scar tissue.

RESULTSThe linear regression equation of the mitomycin C concentration-UV value standard curve was y=0.593x(3)-2.563x(2)+25.944x-0.236 (R(2)=1.000). The film demonstrated good drug delivery capability, and 20 mg of the samples in PBS showed a peak mitomycin C release after 12 days of 14.9616 microg/ml, which was higher than the ID(50) of mitomycin C (10.4713 microg/l) to the fibroblasts. On days 18 and 32, another two drug release peaks occurred (14.4824 microg/ml and 11.4092 microg/ml, respectively), followed by maintenance of slow release. Till day 60, the accumulative mitomycin release reached 0.1793 microg/ml, and the loaded drug was ultimately completely released. Significant differences were noted in the hydroxyproline content in the scar tissues of different groups (F=12.085, P=0.000), and the CH/PEG-SA/MMC DDS reduced the amount of scar tissue and promoted its orderly alignment to control potential scar hyperplasia that may compress the spinal cord and nerve roots.

CONCLUSIONThe composite film for drug delivery possesses good flexibility and mechanical properties and allows sustained drug release of mitomycin C to prevent epidural scar tissue adhesion following lumbar laminectomy.

Animals ; Chitosan ; chemistry ; Drug Delivery Systems ; Intervertebral Disc ; drug effects ; physiopathology ; surgery ; Mitomycin ; administration & dosage ; chemistry ; Polyethylene Glycols ; chemistry ; Polyethylenes ; chemistry ; Rats ; Rats, Sprague-Dawley ; Succinates ; chemistry ; Tissue Adhesions ; prevention & control

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 evaluate results of 1310 knees of meniscal treatments by arthroscopy and to present good method of meniscal treatment.

METHODSTheir age, traumatic mechanism and effects under arthroscopy were analysed in a series of 254 patients with meniscal injuries, there were 880 males and 374 females, the average of the patients was 25.5 years. The meniscal repair in 68 knee, partial meniscectomy in 756 knee, total meniscectomy in 480 knee and conservative treatment in 6 cases.

RESULTSThe patients were followed up 1 to 12 years with the average of 4 years and 3 months. The mean Lysholm score was 86.3 points in arthroscopic meniscal repair, 84.0 points in partial meniscectomy and 76.1 points in total meniscectomy. The mean Lysholm 98.7 points in all children patients with conservative treatment. They showed significant difference (P < 0.01) in the results of three treatments.

CONCLUSIONSMeniscal injuries should not cut off as it, should be repaired in 5 mm from meniscus to synovium and or partial meniscectomy. The general adoption is not the surgical operation on meniscal injuries of the child.

Adolescent ; Adult ; Age Factors ; Arthroscopy ; Casts, Surgical ; Child ; Female ; Follow-Up Studies ; Fracture Fixation ; methods ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; surgery ; Middle Aged ; Tibial Meniscus Injuries ; Treatment Outcome

Objective To study the application value of dynamic monitoring of blood pressure in the prevention and treatment of elderly hypertension. Methods 519 hypertensive patients from December 2017 to December 2018 were monitored with ambulatory blood pressure monitoring, and were divided into the elderly group (≥60 years old, 264 cases) and the control group (<60 years old, 255 cases). The results of ambulatory blood pressure monitoring in two groups were analyzed, which inclued the circadian rhythm of blood pressure, blood pressure, pulse pressure, coefficient of variation of blood pressure, blood pressure load value, average heart rate and morning blood pressure surge. Results The incidence of abnormal circadian rhythm of ambulatory blood pressure in the elderly group was 76.5%. Compared with the control group, there were differences in the indexes of diastolic blood pressure (DBP), diastolic blood pressure load value (DBPLV), pulse pressure (PP), 24 h average heart rate (24 hAHR), systolic blood pressure coefficient of variation (SBPCV), 24 h diastolic blood pressure coefficient of variation (24 h DBPCV) and morning diastolic blood pressure surge (MDBPS) between the two groups(all P<0.05). There were differences in 24 h systolic blood pressure (24hSBP), night systolic blood pressure (nSBP), night diastolic blood pressure (nDBP), night pulse pressure (nPP), day systolic blood pressure load value (dSBPLV), ninght systolic blood pressure load value (nSBPLV), 24 h SBPCV, 24 h dDBPCV and other indicators among different blood pressure types in the elderly group (all P<0.05). Conclusion Ambulatory blood pressure monitoring indicators have important guiding value for the prevention and treatment of elderly hypertension.

OBJECTIVETo study the in vivo stability of normal and anterior cruciate ligament (ACL)-injured knee joint before and after epidural anesthesia under 134 N pre-loading and evaluate the influence of muscular tension on the knee stability.

METHODSEight volunteers with unilateral ACL rupture and normal contralateral knee were enrolled in this study. CT (3D) images and 2 orthogonal images of the knee were captured at 0°, 30°, 60°, and 90° under 134 N pre-loading. The orthogonal images were used to recreate the in vivo knee positions at each of the targeted flexion angles by 2D/3D registration to analyze the tibial translation data.

RESULTSThe anterior tibia translation of both the intact and ACL-injured knees after anesthesia was significantly different from that before anesthesia at all the angles (P<0.05). The anterior tibial translation of the intact knee after anesthesia increased by 1.7 mm at 0°, 2.7 mm at 30°, 2.6 mm at 60°, and 2.3 mm at 90°, as compare to the increase of ACL-injured knee by 4.2 mm, 2.6 mm, 1.2 mm, and 1.6 mm, respectively.

CONCLUSIONThe muscular tension has evident influence on the knee stability in static loading.

Adult ; Female ; Humans ; Joint Instability ; Knee Joint ; physiology ; Male ; Muscle Strength ; Young Adult

Objective To observe the effect of the intensive training of core stabilization on the general function of patients with femoral neck fractures in old patients after hip arthroplasty. Methods From January, 2011 to December, 2012, 60 old patients accepted hip arthroplas-ty for femoral neck fractures were randomly divided into control group (n=30) and observation group (n=30). The control group received routine rehabilitation training 50 minutes each time, and the observation group received intensive training of core muscles 20 minutes each time based on the routine rehabilitation training 30 minutes each time, twice a day, five days a week for two weeks. Both groups were evalu-ated with Harris Hip Score (HHS), Charnley Hip Score (CHS) and modified Barthel Index (MBI) before training and one week, two weeks and three months after training. Results There was no significant difference in the scores of HHS, CHS and MBI before and one week after training (P>0.05). All the scores increased with time in both groups (F>248.165, P<0.001). The scores of HHS, CHS and MBI were signifi-cantly higher in the observation group than in the control group two weeks and three months after training (t>3.211, P<0.001). Conclusion Early intensive training of core stabilization may facilitate to recover hip function and activity of daily living in old patients after hip arthro-plasty.