Objective To investigate therapeutical methods on lumbar disc herniation with posterior edge separation of the vertebral body. Methods Different methods were applied to 31 patients, including 24 males and 7 females whose ages ranged from 18 to 61 years. Except that 2 patients with mild lumbar pain were treated with conservative therapy, the other 29 patients were treated with operation. The operations were made according to the relationship between compressive hernia and vertebral canal. For instance, for cases that the herniated mixtures were lateral, decompression with fenestration or amplified fenestration was applied to the trouble side; for cases that mixtures were central or paracentral, the same treatment was applied to both sides; and posterior lumbar interbody fusion(PLIF) or transforaminal lumbar interbody fusion (TLIF) was applied to those that the mixtures occupied most part of the front canal. Results The follow-up studies were made for all the patients for 1 to 4 years with an average period of 2.6 years. For the two patients treated with conservative therapy, one was fully recovered and the other, who took no effect from former therapy, was finally recruited after decompression with fenestration on the trouble side. Among the patients who were treated with operation, those with lateral herniated mixtures received significant effect, while only 60% of those with central or paracentral mixtures recovered (the unrecovered or even worsened patients after operation finally recruited by PLIF), and for those with mixtures occupying most part of the front canal, satisfactory effect were achieved. Conclusion Operation treatment should be applied to patients as early as possible when conservative therapy has no obvious effect. Different operation methods should be taken according to the relationship between compressive hernia and vertebral canal: 1) Decompression with fenestration or amplified fenestration on the trouble side be applied to those with lateral herniated mixtures; 2) Decompression with fenestration on both sides be applied to those with paracentral mixtures but no lateral crypt narrowness, and PLIF or TLIF to those with central mixtures or lateral crypt narrowness; 3) PLIF or TLIF be applied to those with mixtures occupying most part of the front canal.

Objective To investigate the effect of caffeine and cisplatin induced apoptosis of osteosarcoma cell line(OS-732), and to explore the potential mechanism of caffeine enhancing cytotoxic effect of cisplatin in osteosarcoma cell line. Methods The OS-732 cell line was cultured for 72 hours; treated with caffeine, cisplatin and caffeine combined with cisplatin for 72 hours respectively, the apoptosis rates of OS-732 cell line were analysed by flow cytometry. Mitochondrial transmembranous potentials were measured by cellular rhodamine 123 stain on flow cytometry. Apoptosis was assessed by electron microscope at 80 kV. Results The OS-732 cell line was cultured for 72 hours; treated with caffeine (5.0 mmol/L ), cisplatin (10.0 ?g/ml ) and caffeine (5.0 mmol/L ) combined with cisplatin (10.0 ?g/ml) for 72 hours respectively. The apoptosis rates were 2.50%, 10.62%, 31.62% and 57.44% respectively. The percentage of decline of mitochondrial transmembranous potentials were 8.12%, 26.45%, 17.82% and 38.26% respectively. Electron microscope revealed the characteristic apoptosis alterations,such as shrinking cellular chromatin condensation, crescent nucleus, cytoplasmic vacuoles and so on. Conclusion Caffeine and cisplatin can induce apoptosis of osteosarcoma cell line(OS-732), while the cell line treated with caffeine and cisplatin simultaneously, the apoptosis rate was increased obviously. The induction of apoptosis of osteosarcoma cell line by caffeine may be one of potential mechanism enhancing cytotoxic effect of cisplatin in osteosarcoma cell line.

Objective To analyze and compare clinical application of two types of clavicular hook plates. Methods From September 2000 to October 2003, 33 cases with acromioclavicular joint dislocation (Tossy Ⅲ) or distal clavicle fractures (Neer Ⅱ) were treated with insertion type (AO/ASIF) or knuckle-protruded type (WALDEMAR LINK) clavicular hook plates. The former one was used in 18 cases and the latter one in 15. Results In insertion type group, the average operation time was 28 minutes, with average incision length for 7.6 cm. All the cases got good reduction and fixation without any subluxation, except for one case suffering from impingement of the shoulder joint. In knuckle-protruded type group, the average operation time was 40 minutes, with an average incision length for 9.8 cm. After operation, one case lost hooking-up, one had born shoulder joint impingement, while another two suffered from skin pain at acromion caused by hook tip for a long time. Except for one case losing hooking-up, all cases of both groups achieved good recovery of function of shoulder joint and won satisfactory reduction without any redislocation after the implants being taken out. Conclusion Because of the advantages like convenient manipulation, short operation time, minor incisions and less potential complications, the insertion type clavicular hook plate is more suitable for cases with Tossy Ⅲ or Neer Ⅱ fractures.

Objective To investigate the causes of re-fractures of non fracture vertebral body after percutaneous kyphoplasty (PKP).Methods 512 patients (618 vertebral bodies) treated with PKP because of osteoporosis VCFs were recruited from June 2010 to June 2014.There were 107 males (121 vertebral bodies) and 405 females (497 vertebral bodies) with the mean age of 70.38±7.59 years old (51 to 91 years).There were 406 single segment fracture and 106 double segment fractures cases,and the fracture segments were T4 to L5.The T value of the patients' bone mineral density (BMD) was from-1.0 to-5.2 SD.The clinic characteristics of all the patients including age,sex,body weight,body height,body mass index (BMI),BMD score of the spine,volume of bone cement,restoration rate of anterior/middle vertebral height,postoperative complications (pulmonary embolism,bone cement leakage,nerve injury),and treated vertebral level were analyzed.Results 52 patients (10.16％,52/512) experienced refractures of non fracture vertebral body after kyphoplasty,and 4 experienced re-fracture of the fracture vertebral body after kyphoplasty.The average age of the 52 patients was 71.88±7.74 years old,meanwhile,the ratio of female was 94.23％ (49/52),the mean T value of BMD-4.03±0.60 SD,the ratio of initial double segment fractures 51.92％ (27/52).In addition,among the 456 cases with no fracture,the average age was 70.21±7.56 years,the ratio of female was 77.19％ (352/456);the mean T value of BMD was-2.89±0.55 SD;the ratio of initial double segment fractures was 17.32％(79/456).The data above (age,T value of BMD and initial double segment fractures) were all with statistical significant differences.Whereas the BMI,volume of bone cement,intervertebral disc leakage and restoration rate of anterior/middle vertebral height had no significant difference between the two groups.Furthermore,in the re-fracture of non fracture vertebral body group,32 cases (61.54％,32/52) were nonadjacent fractures,and 20 (38.46％,20/52) were adjacent fractures.Conclusion Osteoporosis degree,female and initial double segment fractures were major risk factors in the development of re-fracture of non fracture vertebral body after PKP.

Objective To describe an ideal technique to repair full-thickness lower lid marginal defects in a one-stage procedure. Methods The buccal rotation flap and the nasal septal chondromucosal flap were used in one-stage operation to repair full-thickness lower eyelid defect. Results Eleven patients including 6 male patients and 5 female patients underwent lower eyelid reconstruction since January 2000.The age ranged from 29 to 64 years with average 43. Seven patients with full-thickness lower eyelid defect were caused by basal cell carcinoma excision, while four patients were caused by trauma. All the fullthickness lower eyelid defects were reconstructed by using the buccal rotation flap and the nasal septal chondromucosal flap in one-stage operation. All the flaps survived completely after operation. There were no other complications excepting that two patients developed to mild lower eyelid retration after six months. Conclusion The technique consisting of the buccal rotation flap and the nasal septal chondromucosal flap is a simple and useful alternative procedure to close full-thickness defects in the lower eyelid.

Objective To investigate the morphological changes, apoptosis and brain-derived neurotrophic factor mRNA(BDNF mRNA)expression in rat conus medullaris induced by cauda equine compression, and to discuss the possible mechanisms. Methods Ninety male SD rats were divided into 3 groups: normal control, sham operation,and cauda equine compressed. The animals were sacrificed and took samples in 30 min, 2 hours,4 hours,8 hours,1 day,3 days,1 week,2 weeks,3 weeks after cauda equine compression model were created. The morphological study concerned with cauda equina and conus medullaris was done under light microscope and transmission electron microscope. TUNEL staining and in situ hybridization staining were used to investigate apoptosis and BDNF mRNA expression changes. The positive cells in 1mm2 were calculated,and the data were disposed through one way analysis of variance. Results Histological observation showed notable alteration of cauda equina and neurons in conus medullaris. The positive cells of TUNEL and BDNF mRNA in situ hybridization staining increased in 8 hours and 4 hours after cauda equina compressed,and both reached the climax in 3days after cauda equina compressed. At the time 3weeks after cauda equine compressed, the positive cells were still much higher than that of the control groups. Conclusion The compression of cauda equina will result in neurons morphological changes and apoptosis in medullary cone,and cause central neuron un-reversible injury. It might be one of the reasons why the prognosis is poor in cauda equina syndrome. Neurons and glial cells may produce BDNF by themselves to survival from cauda equina compression.

OBJECTIVETo investigate the epidemic status of brucellosis in the occupational population in Yuxi, China, and to develop effective prevention and control strategies.

METHODSSerological test was performed for 2320 employees involved in breeding, slaughtering, meat and dairy product processing, veterinary medicine, and sales in counties and districts where brucellosis was detected from 2008 to 2014 in Yuxi; pathogenic detection was performed for those in the occupational population who were suspected of brucellosis.

RESULTSThe results of serological test showed that the infection rate of brucellosis reached 3.32% , and 15 cases of brucellosis had clinical symptoms. The employees involved in breeding had the highest infection rate (4.89%) (χ2=25.75, P<0.05). From 2008 to 2014, the infection rate of brucellosis was 0.37%~4.93% and tended to increase; 67.85% of the occupational population did not take personal protective measures and had a significantly higher infection rate than those who took personal protective measures (4.45% vs 0.94%; χ2=19.42, P<0.05). Among the 161 patients suspected of brucellosis, 42 cases were diagnosed as current brucellosis confirmed by laboratory pathogenic detection.

CONCLUSIONThe infection rate of brucellosis and the number of newly diagnosed cases tend to increase in the occupational population in Yuxi, and the employees involved in breeding are the major infected population.

Animal Husbandry ; Brucellosis ; epidemiology ; China ; epidemiology ; Dairying ; Humans ; Meat ; Occupational Diseases ; epidemiology ; microbiology ; Veterinary Medicine

Objective To investigate characteristics of cage migration after transforaminal lumbar interbody fusion (TLIF) and related risk factors.Methods A retrospective study was conducted to review cage migration in 512 patients who had undergone TLIF procedure from January 2010 to June 2011 in 5 spinal research centers.There were 255 males and 257 females,aged from 37 to 77 years (average,54.7 years).All patients were followed up at 3,6,12 months after operation.The clinical outcomes were evaluated using the visual analogue scores (VAS) and Oswestry disability index (ODI).X-rays and 3D CT scans were used to analyze the incidence and related risks factors of cage migration in these patients.Results Cage migration was found in 6 of 512 patients,the total incidence was 1.17％.Significant difference was found between each center.Cages with different shapes had different incidence.The analysis showed that the incidence of migration of rectangular-shaped cage (3.11％,5/161) was significantly higher than that of kidney-shaped cage (0.28％,1/351).The cage in double-segment TLIF (5.75％,5/87) was easier to migrate than that in monosegment TLIF (0.24％,1/425); furthermore,linear type endplate(3.50％,5/143) was remarkably easier to migrate than concave-concave one (0.27％,1/369).Conclusion Difference in operative skills,cage shape,number of fused segments,adjacent endplate shape,and lumbar spondylolisthesis might be risk factors for cage migration after TLIF.

Objective: To investigate the antimicrobial susceptibility of Brucella and to provide a scientific basis for rational drug use and effective treatment of patients with brucellosis. Methods: A total of 41 Brucella strains were isolated from the blood of patients with brucellosis in 5 counties and 2 districts in Yuxi City, China from 2014 to 2016. The susceptibility to 23 antimicrobial drugs was tested using Kirby-Bauer (K-B) disk diffusion method and the sizes of antimicrobial rings were recorded. The susceptibility testing results were interpreted according to the Drug Susceptibility Testing Guideline (2009 version) . Results: The susceptibility rate of Brucella was 100.00% to ofloxacin, ciprofloxacin, levofloxacin, and amikacin and >90% to cefotaxime, cefepime, imipenem, doxycycline, cefoperazone, minocycline, tobramycin, rifampicin, cefoperazone/sulbactam, and chloramphenicol. The high resistance to aztreonam and ampicillin was observed (87.80% and 41.46%). Doxycycline-intermediate strains, rifampicin-intermediate strains, and rifampicin-resistant strains were identified. Conclusion Doxycycline and rifampicin are commonly used in the treatment of brucellosis, but doxycycline/rifampicin-intermediate and-resistant strains have been identified. The susceptibility of Brucella to fluoroquinolones and cephalosporins was high, so the two drugs can be considered in the treatment of brucellosis.

Objective:To compare the clinical efficacy between puncture assisted by a "TINAVI" orthopaedic robot versus freehand puncture in vertebroplaty for osteoporotic vertebral compression fracture(OVCF) of the upper thoracic vertebra.Methods:A retrospective study was conducted of the 19 patients (20 vertebral bodies) with OVCF of the upper thoracic vertebra who had been treated at Department of Spine Surgery, Honghui Hospital from January 2018 to March 2019 by robotic vertebroplasty (robot group) and of another 21 counterpart patients (21 vertebral bodies) who had been treated by conventional vertebroplasty from January 2016 to December 2017 (freehand group). Puncture was conducted by a "TINAVI" orthopaedic robot in the robotic vertebroplasty but freehand in the conventional vertebroplasty. The robot group had 5 males and 14 females, aged from 62 to 88 years; the freehand group had 6 males and 15 females, aged from 64 to 83 years. The 2 groups were compared in terms of operation time, bone cement volume, postoperative complications (cement leakage, infection and embolism), visual analogue scale (VAS), Oswestry disability index (ODI), anterior height (AH) and kyphosis angulation (KA) of the injured vertebra at day 1 and last follow-up after surgery.Results:The 2 groups were comparable because there were no significant differences between them in the preoperative general data ( P>0.05). Vertebroplasty via unilateral puncture approach was completed uneventfully in the 19 patients (20 vertebral bodies) in the robot group and in the 21 patients (21 vertebral bodies) in the freehand group. The 40 patients were followed up for 6 to 12 months (mean, 8.3 month). The operation time [(37.9±8.2) min], bone cement volume [(2.3±0.9) mL] and rate of cement leakage (10.0%, 2/20) in the robot group were all significantly less or lower than those in the freehand group [(46.2±9.4) min, (4.2±1.3) mL and 42.9% (9/21)] ( P<0.05). No infection or embolism was observed in either group. There were no significant differences between the 2 groups in VAS, ODI, AH or KA of the injured vertebra at day 1 or last follow-up after surgery ( P>0.05). Conclusion:In vertebroplaty for OVCF of the upper thoracic vertebra, compared with conventional freehand puncture, puncture assisted by a "TINAVI" orthopaedic robot can lead to satisfactory clinical efficacy because it reduces operation time, volume of bone cement injection, and thus incidence of bone cement leakage.