Objective To study the risk factors of recurrence after debridement bone graft fusion in elderly patients with spi‐nal tuberculosis(TB) .Methods The data of 415 elderly patients with spinal tuberculosis in our hospital from January 2003 to De‐cember 2013 were retrospectively analyzed .Among them ,46 cases (observation group) recurred and 369 cases(control group) had no postoperative recurrence .The preoperative anti‐TB treatment duration ,surgical removal degree of lesions ,postoperative stand‐ardized therapy ,extra‐skeletal TB ,drug resistance ,postoperative braking duration ,complicating systemic disease ,anemia or malnu‐trition ,etc .were statistically analyzed .Results Preoperative anti‐TB treatment duration ,surgical removal degree of lesions ,postop‐erative standardized therapy ,extra‐skeletal TB ,drug resistance ,postoperative braking duration ,complicating systemic disease ,ane‐mia or malnutrition were the major risk factors for postoperative recurrence of senile spinal TB ;preoperative anti‐TB treatment du‐ration ,surgical removal degree of lesions ,postoperative standardized therapy ,extra‐skeletal TB ,drug resistance ,postoperative bra‐king duration ,complicating systemic disease and anemia or malnutrition were closely related with postoperative recurrence of senile spinal TB ,which were their independent risk factors .Conclusion The recurrence of senile spinal tuberculosis and bone graft fusion and is closely related to various factors .

Objective To assess the clinical outcomes of posterior decompression and lumbar interbody fusion with internal fixation treatment for degenerative lumbar scoliosis (DLS). Methods Ninety-eight patients underwent surgery for DLS were retrospectively reviewed in this study. The mean age of the patients(male 35 and femail 63) was (56±9) years. The mean Cobb angle of curves was (26±9)° and the mean scoliosis Cobb angle of lumbar was (19±11)° in patients before surgery. A posterior medial incision was made for spinal exposure. According to the preoperative plan, patients were operated with posterior de-compression and lumbar interbody fusion with internal fixation. The clinical outcomes were assessed by the JOA scores.The preoperative and postoperative Cobb angle was recorded. Results The mean follow-up time was (3.7±2.4) years. The mean JOA scores were improved from (10±2) points preoperatively to (26±3) points at the last follow-up. The excellent or good outcome rates were 89.7%for patients with surgery. The average interbody fusion time was (5.7±1.4) months. The mean postoperative Cobb angle was (6±2)° at the last follow-up, and the mean Cobb angle correction was (17±4)°, with the correction rate of 59.2%. The mean lumbar lordosis angle was (12±3)°. There was no failure in internal fixation. Conclusion The posterior decompression and lumbar interbody fusion with internal fixation appears to be a reasonable option for degenerative lumbar scoliosis.

BACKGROUND: In vitro construction of tissue engineered cardiac muscle becomes a hot spot in recent years, and the selection and design of scaffold is the key link. However, there is lack of ideal cardiac tissue engineering scaffold material. OBJECTIVE: To evaluate the novel biodegradable polyurethane in vitro, and to discuss the feasibility of polyurethane as cardiac tissue engineeru scaffold. METHODS: A new type polyurethane (PV-Lys) was synthesized using diphenylmethane-4,4'-diisocyanate as hard segment and lysine as expand chain. The tensile and suture strength were tested in vitro respectively, hydrolytic degradation was carded out in phosphate buffer saline of pH 7.4 at 37 ℃, and cytotoxicity was evaluated by MTT measurement and morphological observation. RESULTS AND CONCLUSION: The tensile strength of the polyurethane was up to (8.1±0.1) MPa, and the suture strength was (12.2+0.8) N. The average value of the mass loss of PV-Lys was (13.1+0.3)% at 8 weeks of in vitro hydrolytic degradation. MTT assay results showed that the cytotoxic grade of the novel PV-Lys was 0-1. Cell morphology observation showed that the L929 cells were spindle-shaped or tdangular with good stretch. This PV-Lys scaffold is with favorable mechanical property, cytocompatibility, biodegradable property, which meets the requirements of tissue engineering application.

Objective: To investigate the technical method for harvesting and application of the descending branch of the lateral circumflex femoral artery (DBLCFA) in the coronary artery bypass grafting (CABG) operation. Methods: Between December 2016 and April 2017, 19 patients were arranged to use DBLCFA and got CT angiography (CTA) of pelvic and femoral arteries pre-operative at Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Finally, DBLCFA was harvested in 16 patients (including 2 female patients, with a mean age of (47.4±8.5) years) through the anterior thigh incision (13 cases on the left side, 3 cases on the right side). The CABG operations were performed under the cardiopulmonary bypass support (in 10 cases) or under the beating heart condition (in 6 cases), and the DBLCFA conduit was used combining with bilateral internal thoracic artery (in 12 cases), radial artery (in 7 cases) and saphenpous vein (in 3 cases). Results: Due to anatomical variations such as short length and anomalous branch, or due to silent atherosclerosis stenosis of femoral artery, DBLCFA in 3 patients was considered inappropriate for use and was not harvested after CTA examination. In another 16 patients, DBLCFA was safely and quickly harvested and successfully used. On average, 3.4±0.6 anastomosis was built up in CBAG, no adverse effects were exhibited. The length of the harvested DBLCFA was (10.3±1.8) cm, with average lumen diameter of (1.9±0.5) mm. DBLCFA was used as free graft in 15 patients (7 to the first diagonal branch, 6 to the ramus intermedius branch, 1 to the left anterior descending branch and 1 to the second obtuse marginal branch). In 1 patient, the DBLCFA was firstly implanted end-to-side to the internal thoracic artery as a "Y" type composite graft, and then anastomosed to the third obtuse marginal branch. Conclusions The descending branch of the lateral circumflex femoral artery is an option conduit in CABG. It can be harvested easily and safely. However, pre-operative CTA examination is necessary to exclude the variation and appropriate strategy for graft establishment should be considered during the operation.