OBJECTIVE: To investigate the clinical efficacy of percutaneous screw fixation combined with minimally invasive transpedicular bone grafting and non-bone grafting in the treatment of thoracolumbar fractures. METHODS: From Janury 2021 to June 2022, 40 patients with thoracolumbar fracture were divided into the experimental group and the control group. There were 26 patients in the experimental group, including 21 males and 5 females with an aberage age of (47.3±12.3) years old, who underwent percutaneous pedicle screw fixation combined with transpedicular autogenous bone grafting. In the control group, 14 patients received percutaneous pedicle screw fixation only. including 7 makes and 7 females with an average age of (50.2±11.2) years old. The operative time, intraoperative blood loss, anterior height ratio of injured vertebrae, Cobb angle, visual analogue score (VAS), MacNab scores, loosening or broken of the implants. were compared and analyzed. RESULTS: There was no significant difference in operation time, intraoperative blood loss, VAS and anterior height ratio of injured vertebrae between the two groups. Compared with the preoperative results, VAS and anterior height ratio of injured vertebrae were improved statistically(P<0.05). For Cobb angle of injured vertebra, there was no significant difference between the two groups before surgery (P=0.766). While at 1 week, 3 months and 12 months after surgery, there were statistically differences between the two groups (P values were 0.042, 0.007 and 0.039, respectively). The Cobb angle of injured vertebrae one year after operation was statistically decreased in both groups compared with that before surgery (P<0.001). One year after surgery, the excellent and good rate of Macnab scores was 96.15% in the experimental group and 92.86% in the control group, and there was no statistical differences between the two groups (P=0.648). There was one patient in the control group suffering superficial wound infection on the third day, which was cured by dressing change and anti-infection treatment. There were no postoperative screw loosening and broken in both groups. CONCLUSION The two surgical methods have the advantages of less trauma, less pain and quicker recovery, which can restore the height of the injured vertebra, reconstruct the spinal sequence and reduce the fracture of the vertebral body. Transpedicular autogenous bone grafting can increase the stability of the fractured vertebra and maintain the height of the vertebra better after surgery, thus reducing the possibility of complications such as kyphosis, screw loosening and broken.
Male ; Female ; Humans ; Adult ; Middle Aged ; Pedicle Screws ; Bone Transplantation ; Blood Loss, Surgical ; Lumbar Vertebrae/injuries* ; Thoracic Vertebrae/injuries* ; Fracture Fixation, Internal/methods* ; Spinal Fractures/surgery* ; Treatment Outcome ; Retrospective Studies

OBJECTIVETo investigate the feasibility and therapeutic effect of subcutaneous pedicle screw-rod system with modified placement in treatment of Tile B pelvic fractures.

METHODSFrom June 2014 to August 2015, 14 patients with Tile B pelvic fractures were treated by subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle. There were 8 males and 6 females, aged from 23 to 65 years with an average of 42 years. Operative time, intraoperative blood loss, fracture healing and postoperative complication were observed and clinical effects were evaluated by Matta reduction standard and Majeed score.

RESULTSAll patients were followed up from 8 to 15 months with an average of 10.5 months. Operative time was 25 to 45 min with an average of 32 min;intraoperative blood loss was 10 to 35 ml with an average of 18 ml. All fractures got primary healing and healed time was 9 to 14 weeks with an average of 12.5 weeks. No postoperative incision infection, internal fixation failure and ectopic ossification were found, 4 cases occurred unilateral lateral femoral cutaneous nerve injury and 1 case occurred unilateral femoral nerve paralysis, but all restored finally. According to Matta criteria, reduction was excellent in 7 cases, good in 5 cases, fair in 2 case. According to Majeed score system, the functional evaluation at last follow-up was excellent in 5 cases, good in 7 cases, fair in 2 cases with the average score of 81.50±8.05.

CONCLUSIONSSubcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle have advantages of strong reduction, less trauma and complications, and is a promising surgical method in the treatment of Tile B pelvic fractures.

Objective To analyze the impact of feedforward control nursing intervention on e-mergence agitation and recovery quality in general anesthesia surgery patients.Methods A total of 118 patients undergoing general anesthesia surgery were selected by convenient sampling,and ran-domly divided into control group and observation group,with 59 patients in each group.The control group received routine nursing intervention during emergence anesthesia,while the observation group received feedforward control nursing intervention.The incidence of emergence agitation,recovery quality,pain condition,and nursing quality were compared between the two groups.Results The incidence of emergence agitation during emergence in the observation group was significantly lower than that in the control group(42.37％versus 69.49％,P＜0.05).The Richmond Agitation-Seda-tion Scale(RASS)scores,duration and frequency of agitation were lower or shorter in the observation group than those in the control group(P＜0.05).The observation group exhibited shorter time for spontaneous respiration recovery,eye opening,extubation,full consciousness,and stay in the postan-esthesia care unit compared to the control group(P＜0.05).The Steward emergence score was higher in the observation group(P＜0.05).The postoperative pain score was lower,while nursing quality score was higher in the observation group than those in the control group(P＜0.05).Conclusion Feed-forward control nursing intervention can reduce the incidence of emergence agitation in general anesthesia surgery patients,improve recovery quality,alleviate postoperative pain,and enhance nursing quality.

Objective To analyze the impact of feedforward control nursing intervention on e-mergence agitation and recovery quality in general anesthesia surgery patients.Methods A total of 118 patients undergoing general anesthesia surgery were selected by convenient sampling,and ran-domly divided into control group and observation group,with 59 patients in each group.The control group received routine nursing intervention during emergence anesthesia,while the observation group received feedforward control nursing intervention.The incidence of emergence agitation,recovery quality,pain condition,and nursing quality were compared between the two groups.Results The incidence of emergence agitation during emergence in the observation group was significantly lower than that in the control group(42.37％versus 69.49％,P＜0.05).The Richmond Agitation-Seda-tion Scale(RASS)scores,duration and frequency of agitation were lower or shorter in the observation group than those in the control group(P＜0.05).The observation group exhibited shorter time for spontaneous respiration recovery,eye opening,extubation,full consciousness,and stay in the postan-esthesia care unit compared to the control group(P＜0.05).The Steward emergence score was higher in the observation group(P＜0.05).The postoperative pain score was lower,while nursing quality score was higher in the observation group than those in the control group(P＜0.05).Conclusion Feed-forward control nursing intervention can reduce the incidence of emergence agitation in general anesthesia surgery patients,improve recovery quality,alleviate postoperative pain,and enhance nursing quality.

Taxol is a secondary metabolite with prominent anti-tumor activity, but the yield cannot meet the growing clinical demand due to lower content in yew. Now, most enzyme genes involved in taxol biosynthesis have been cloned and identified, so that obtaining this drug by using synthetic biology method has become a hotspot in recent years. However, most hydroxylases involved in taxol biosynthetic pathway have not been explored. Here, we reviewed the progress on the biosynthesis pathway of taxol, especially concerning hydroxylase. The future research areas of taxol biosynthesis through synthetic biology were also discussed to provide basis for the discovery of uncharacterized hydroxylase genes and the mass taxol production by synthetic biology technology.
Biosynthetic Pathways ; Mixed Function Oxygenases ; metabolism ; Paclitaxel ; biosynthesis ; Synthetic Biology ; Taxus ; enzymology