OBJECTIVETo investigate the clinical efficacy and safety of keyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement in cervical spine.

METHODSKeyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement, was introduced. It was performed in 40 patients. The fusion and screw position were observed in postoperative X-ray and CT, and the breach of pedicle were evaluated. Neurological improvement was followed up.

RESULTSThirty-one cases were followed up, the mean follow-up period was 35 months. 28 cases screw fixation firmly and fusion completely, 3 cases fusion partly and no screw loosening. only 6.74% had a critical breach. Neurological function were improved in 29 cases of spinal cord injuries, only critical complication in one case.

CONCLUSIONSKeyhole partial laminectomy and tapping technique. combined blind placement is one of most usefull, feasible and safe procedures in transpedicular screw placement of the cervical spine.

Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Spinal Diseases ; surgery ; Spinal Fractures ; surgery ; Treatment Outcome

OBJECTIVESTo investigate the clinical efficacy and safety of biopsy and Kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral fracture nonunion, and to explore the clinical characteristics of the disease.

METHODSFrom July 2005 to May 2010, the clinical data of 8 patients with nonunion of osteoporotic thoracolumbar vertebral fractures were studied. There were 3 males and 5 females, with the mean age of 73.5 years (range, 65 - 86 years). The fracture vertebrae were 3 cases in T(12), 4 in L(1), and 1 in L(2). All cases received radiography, CT and MRI examination. All patients were treated by using Kyphoplasty. Five patients were performed bone biopsy successfully, 3 patients were failed. The curative effect was evaluated by visual analogue scale (VAS), anterior vertebral height restoration at preoperative, postoperative and followed-up time.

RESULTSAll patients tolerated the procedure well with immediate relief of back pain after Kyphoplasty. No severe complications were found in all patients. Three cases had the pathologic appearance of sequestrum, 2 cases were sparse cancellous bone, 3 cases were abortive to biopsy. All the patients were followed up of 22.6 months (range, 3 - 37 months), the VAS was 9.5 before operation, 2.1 at the third day postoperatively, there were significant difference between the two phase (P < 0.05), and 2.3 at last follow-up, there were no difference between postoperation and follow-up phase (P > 0.05). And the height of compressed body recovered markedly. The vertebral height had a recovery rate of 67.2% postoperatively, 64.1% and at last follow-up, there were no difference between the two phase (P > 0.05).

CONCLUSIONSKyphoplasty is an effective and safe method in the treatment of osteoporotic throacolumbar vertebral fracture nonunion. Bone biopsy can play a further role of differential diagnosis.

Aged ; Aged, 80 and over ; Biopsy ; Female ; Follow-Up Studies ; Fractures, Compression ; diagnosis ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporosis ; complications ; Retrospective Studies ; Spinal Fractures ; diagnosis ; surgery ; Treatment Outcome

OBJECTIVEWe observed the therapeutic effectiveness and safety of different antidepressants as well as the correlation between symptomatic improvement of depression and improvement of chest pain in patients with susceptible "angina pectoris" and negative coronary angiogram complicating comorbid depression.

METHODSIn this double-blinded randomized study, a total of 123 eligible patients were allocated into three groups: (1) Group F: fluoxetine 20 mg QN (n = 41); (2) Group P: Placebo 1 tablet QN (n = 40); (3) Group F + O: fluoxetine 20 mg + olanzapine 2.5 mg QN for the former 2 weeks and only fluoxetine 20 mg QN for the latter 2 weeks (n = 42). The total therapy duration was 4 weeks. HAMD, HAMA and self-evaluation table of chest pain were obtained before therapy, at the end of 1 and 2 weeks after therapy.

RESULTSBaseline HAMD and HAMA scores and self-evaluation score of chest pain were similar among 3 groups and all scores were significantly improved post various therapies in the order of group F + O > group F > group P. The rate of score decrease were seen after 1 week treatment in group F + O and after 2 week treatment in group F. There was a significant positive correlation between the rates of self-evaluation chest pain score decrease and HAMD (r = 0.867, P < 0.001) and HAMA (r = 0.854, P < 0.001) score decreases after 4 weeks therapies (P < 0.05). During the whole course of treatment, no serious adverse reaction was found in all patients.

CONCLUSIONIn patients with suspected "angina pectoris" and negative coronary angiogram complicating comorbid depression, the antidepressants were safe and significantly improved the symptoms of depression and anxiety and chest pain. Low dose fluoxetine plus short term olanzapine regimen was superior to fluoxetine alone regimen in terms of stronger and quicker symptom improvement.

Aged ; Angina Pectoris ; diagnostic imaging ; drug therapy ; psychology ; Antidepressive Agents, Second-Generation ; therapeutic use ; Benzodiazepines ; therapeutic use ; Coronary Angiography ; Depressive Disorder ; drug therapy ; etiology ; Double-Blind Method ; Female ; Fluoxetine ; therapeutic use ; Humans ; Male ; Middle Aged

OBJECTIVETo determine independent factors correlated with clinical effects of DK crush and classical crush technique with drug-eluting stents on bifurcation lesions.

METHODS311 patients with bifurcation lesions were randomized to classical (C, n = 156) or double kissing (DK) crush (n = 155) stent implantation group. The primary endpoints included major adverse cardiac events (MACE).

RESULTSFinal kissing balloon inflation (FKBI) success rate was 76% in C and 100% in DK groups (P < 0.001). DK crush procedure was characterized by lower unsatisfactory FKBI rate (27.6% vs.6.3%, P < 0.01). Clinical follow-up was available in 100% and angiographic follow-up in 82% patients. The overall restenosis rate was 32.3% in C and 20.3% in DK groups (P = 0.01), respectively. Cumulative 8-month MACE was 35.9% in without-FKBI and 19.7% in with-FKBI sub-groups, and 11.4% in DK group (P = 0.02). The incidence of stent thrombosis was 3.2% in C group (5.1% without vs. 1.7% with FKBI) and 1.3% in DK group (P > 0.05). The predictive factors of MACE included minimal side branch stent lumen diameter and lack of DK crush technique.

CONCLUSIONDK crush technique is an alternative of double stenting techniques in terms of improvement of restenosis and clinical outcomes.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Artery Disease ; therapy ; Coronary Stenosis ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stents

OBJECTIVE: To explore the clinical effect in the near future between Zero-profile intervertebral fusion system (Zero-P) and conventional cage-plate intervertebral fusion system (CCP) for the multi-segment(>=2 segments) cervical spondylosis. METHODS: Forty-two patients with cervical spondylosis who underwent multi-segment decompression of the cervical spine from October 2012 to October 2017 were selected as subjects. Zero-P was applied in 21 patients (Zero-P group) and CCP was applied in 21 patients(CCP group). The general condition and perioperative parameters of all the patients were recorded. VAS, JOA scores and incidence of dysphagia were observed before and after operation. The prevertebral soft tissue thickness was measured at 1 week, 1 month after operation and at the last follow-up. At the same time, the Cobb angle of the functional unit of the fusion segments was measured, and the overall curvature change of the cervical vertebra was observed. The clinical efficacy was reviewed at 1 week, 1, 3, 12 months after surgery, and the AP and lateral cervical X-rays were reviewed to evaluate the internal fixation effect. RESULTS: There were no significant differences in age, gender, duration of disease, surgical segment, follow-up time and hospitalization time between two groups(>0.05). The length of the surgical incision, intraoperative blood loss, operation time, postoperative drainage volume in the Zero-P group were(4.37±0.72) cm, (50.9±7.98)ml, (84.4±8.18) min, (76.2±10.13) ml, respectively, and those in CCP group were (6.50±0.71) cm, (108.6±9.25) ml, (118.6±8.55) min, (130.1±9.42) ml, respectively. There were signigicant differences in above items between two groups(<0.05). There were no significant difference in the VAS and JOA improvement rate between two groups at the last follow-up (>0.05). There was no significant difference in the overall physiological curvature of the cervical vertebra between two groups (>0.05). The prevertebral soft tissue thickness at 1 week, 1 month after operation, final follow-up respectively was(11.6±1.9), (9.8±1.4), (9.5±1.6) mm in Zero-P group, and in CCP group those were(12.5±2.6), (11.1±2.4), (11.0±1.9) mm, respectively. There were significant differences in each time point between two groups(<0.05). At the last follow-up, no complication of dysphagia was found in Zero-P group, and three patients had dysphagia in CCP group, with a statistically significant difference between two groups (<0.05). CONCLUSIONS Multiple segmental decompression fusion to treat cervical spondylosis, regardless of the traditional CCP system or new Zero-P system are effective methods, but the Zero-P system has advantages of small surgical incision, short operation time, less intraoperative bleeding, convenient operation, better recovery of prevertebral soft tissue swelling, and lower possibility of postoperative dysphagia.
Bone Plates ; Case-Control Studies ; Cervical Vertebrae ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylosis ; Treatment Outcome

The Cd stress of Chrysanthemum indicum was treated by different concentrations of Cd Cl2 solution in the culture substrate. The content of Cd in different parts of Ch. indicum and the content of buddleoside and the total flavonoids in Ch. indicum were determined. The absorption characteristics of Cd elements in Ch. indicum were analyzed. And the influence of Cd elements on the quality of the herbs. The results showed that the application of soil Cd in the range of 0-100 mg·kg~(-1) had no significant effect on the biomass of Ch. indicum,and the root-shoot ratio showed a decreasing-increasing-decreasing trend. The content of Cd in different parts of Ch. indicum was significantly different,and the content of aboveground part was higher than that of underground part. The enrichment factors of Cd elements in different parts of Ch. indicum are different. The enrichment coefficient of aboveground parts is larger than that of underground parts. The whole parts and plants show an increase first and then decrease,and the overall enrichment factor is greater than1. The transfer coefficient of the aerial part/underground part of Ch. indicum showed a decreasing-increasing-decreasing-increasing trend with the increase of the amount of Cd applied in the soil,and the transfer coefficient was higher than 1. The contents of buddleoside and total flavonoids in Ch. indicum after Cd stress treatment were lower than the control,and the overall performance was lower and then increased,but it was still significantly lower than the control,indicating that Cd pollution directly led to the decrease of chemical quality of Ch. indicum.
Cadmium ; Chrysanthemum ; Flavonoids ; Soil ; Soil Pollutants