BACKGROUND:Titanium mesh is a new type of bone graft supports used for the treatment of spine, especial y the cervical spine disorders at home and abroad in recent years. But, at present, how to improve the cervical lordosis curvature during anterior surgery is the difficulty for the treatment of cervical spondylotic myelopathy.
OBJECTIVE:To observe the effect of straight titanium mesh and individual designed titanium mesh used in the bone graft fusion and internal fixation on the recovery of cervical curvature and Japanese Orthopaedic Association score during anterior cervical subtotal vertebrectomy in the patients with cervical spondylotic myelopathy.
METHODS:Forty-three patients with cervical spondylotic myelopathy treated with surgical indications of subtotal vertebrectomy and decompression internal fixation were included, and the patients were divided into two groups according to different internal fixation methods. There were 15 cases in the individual designed titanium mesh group and 28 cases in the straight titanium mesh group. The preoperative anteroposterior X-ray films of the cervical spine of al the patients were as the blank control group. The clinical data of the patients in two groups were retrospectively analyzed, and the postoperative Japanese Orthopaedic Association score, cervical curvature, intervertebral angles and intervertebral height were compared.
RESULTS AND CONCLUSION:The cervical lordosis angle and the intervertebral angle of surgery segment in the individual designed titanium mesh group were improved when compared with those in the straight titanium mesh group and the blank control group (P<0.01), and the straight titanium mesh group was better than the blank control group (P<0.05). The intervertebral height of surgery segment in the individual designed titanium mesh group and the straight titanium mesh group was increased for 3.69 mm and 3.22 mm respectively when compared with that in the blank control group, and there was significant difference between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). There was no significant difference in Japanese Orthopaedic Association score between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). During subtotal vertebrectomy for the treatment of cervical spondylotic myelopathy, cutting titanium mesh into trapezoidal shape to simulate the normal disc shape of former high to low can effectively restore the physiological curvature of cervical spine and the intervertebral height of surgery segment.

Objective To analyze the influences of lacrimal secretion and tear film after interferon-alpha therapy in patients with chronic viral hepatitis.Methods Sixty patients with chronic viral hepatitis who would accept the interferon-alpha therapy,including 30 cases of hepatitis B and 30 chronic viral hepatitis C,visited our department of ophthalmology and were enrolled in this study.All cases received eye examination,including medical history,slit lamp examination,corneal fluorescein staining ( FL) ,tear film break-up time ( BUT) and schirmer test before inter-feron-alpha therapy and two months after the therapy.Results In the 60 cases of chronic viral hepatitis,there were 19 dry eye cases (31.67%) and 41 non-dry eye cases (68.33%).In dry eyes group,9 of them (47.37%) were hepatitis B patients and 10 of them were hepatitis C patients (52.63%) .There was significant difference in FL grade (t=-5.288,P<0.05),BUT (t=5.799,P<0.05),Schirmer Ⅰ(t=5.319,P<0.05) test in hepatitis B before and two months after interferon-alpha therapy.Statistical significance had been found before and two months after therapy in FL grade (t=-9.103,P<0.05),BUT (t=5.682,P<0.05),SchirmerⅠtest (t=4.592,P<0.05). The incidence of dry eye syndrome in hepatitis B patients increased from 26.70%to 53.30%two months after treated with interferon-alpha,while the incidence of dry eye syndrome in hepatitis C patients increased from 33.30% to 60.00% two months after treated with interferon-alpha.Conclusion Dry eye syndrome is one of common complica-tions in patients with chronic viral hepatitis.Interferon-alpha therapy would influence the lacrimal secretion and dam-age tear film,which increased the dry symptoms in patients.We should pay attention to the side effects of interferon-alpha therapy.

Objective:To explore the effect of puerarin on uterine estrogen receptor(ER)? expression in ovariectomized rats.Methods:Ovariectomized rats were given with puerarin in different doses and premarin for 30 days,and then the expression of E2 was observe by ELISA and the expressions of uterine ER? were observed by using immunohistochemical methods.Results:The expressions of serum E2 in ovariectomized rats were decreased(P

Objective:To investigate the clinical effect of Dynamic neutralization system applied to the treatment of lumbar degenerative diseases with fatty infiltration of multifidus muscle.Methods:From Jan 2015 to Dec 2017, a total of 53 patients of lumbar degenerative diseases with multifidus fatty infiltration treated by Dynesys in our hospital were analyzed, included 21 males and 32 females, aged 66.2±7.4 (range 48-81) years. There were lumbar spinal stenosis in 37 casesand lumbar disc herniationin 16 cases; the index level included L 2-S 1 in 3 cases, L 3-S 1 in 13 cases, L 2-L 5 in 5 cases, L 4-S 1 in 17 cases, and L 3-L 5 in 15 cases. The pedicle screws were inserted at the point of intersection of the outer edge of superior articular process and the midline of transverse process. After discectomy of herniated disc and hyperplastic ligamentum flavum, the distance between the upper and lower pedicle screws was measured and then the spacer of the corresponding length was cut out. Finally, the spacer was placed and fixed between the upper and lower pedicle screws by the elastic rope. The degree of multifidus fat infiltration, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slop (SS), range of motion (ROM), intervertebral height (IH), Japanese Orthopaedic Association (JOA) score, Oswestry disability index (ODI), the MOS 36-item short-form health survey (SF-36) and visual analog scale (VAS) were evaluated postoperatively. Results:The operation was performed successfully in all the patients. The operation duration was 173.5±64.7 (range 125-240) min. Intraoperative blood loss was 469.5±118.2 (range 380-620) ml. The patients were followed up for 47.9±6.7 (range 38-62) months averagely. At the last follow-up, the degree of fatty infiltration of the multifidus muscle showed no further progress by MR scan. There was no significant difference in ROM and IH at different time points preoperativelyand postoperatively. The LL recovered from 37.6°±8.8° to 43.2°±9.1°, the PT decreased from 24.7°±9.3° to 20.5°±5.1°, and the SS increased from 22.1°±7.7°to 26.3°±8.0°. The JOA score increased from preoperative 6.4±1.2 to 20.6±2.8, ODI decreased from preoperative 50.6%±11.3% to 13.0%±3.4%, SF-36 increased from preoperative 81.5±3.6 to 95.5±4.2, and the VAS decreased from preoperative 4.2±1.0 to 1.1±0.6. One patient experienced loosening and displacement on the left side pedicle screw of the L2 vertebral body 3.5 years after operation, and herclinical symptom improved significantly after conservative treatment.Conclusion:Dynesysis is safe and effective for the treatment of lumbar degenerative diseases with fatty infiltration of multifidus muscle, and it can restore the complete structure and function of tension band at lower back and prevent the progress of multifidus muscle fat infiltration combined with postoperative rehabilitation training.

Objective To invesigate the feasibility of low radiation dose and low contrast dosage in triple-rule-out computed tomo-graphy angiography(TRO-CTA)on the 320-row detector CT.Methods A total of 120 patients who underwent CTA were prospec-tively selected.All patients were divided into control group(n=90)and experimental group(n=30).The control group employed standard-doses protocol of pulmonary CTA(120 kV tube voltage,45 mL contrast dosage),coronary CTA(120 kV,50-60 mL),and aortic CTA(120 kV,75 mL),while the experimental group received TRO-CTA with 100 kV and 70-80 mL.The peak time of contrast dosage at the pulmonary artery and aorta was measured by low-dose detection method in the experimental group,and the contrast examination was performed sequentially in the control group.Subjective scores and objective image quality of the pulmonary artery,coronary artery,and aorta in the experimental group and the control group were measured and compared,respectively.The effective dose(ED)between the two groups were recorded and compared.Independent samples t-test and Fisher exact probability were used to analyze the statistical differences between the above measures.Results There were no significant differences in CT values,con-trast-to-noise ratio(CNR),signal-to-noise ratio(SNR)of pulmonary artery,coronary artery and aorta between the two groups(P＞0.05).The mean subjective scores of pulmonary artery,coronary artery and aorta segments in the two groups were not less than 3 points,meeting the requirement of clinical diagnosis.There was no statistical difference in subjective scores between the two groups(P＞0.05).There was statistically significant difference in ED between the two groups(P＜0.05).The ED of pulmonary artery,coronary artery,and aorta in the experimental group were 11.49％,13.33％,and 11.46％significantly lower than those in the control group,respec-tively.Conclusion It is feasible to obtain TRO-CTA images used by the low radiation dose and low contrast dosage on the 320-row detector CT,and radiation dose and contrast dosage can be reduced reasonably without alterations of TRO-CTA images quality in clinical practice.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

OBJECTIVE: To investigate the prevalence and influencing factors of low back pain in workers in automobile manufacturing plants. METHODS: A judgment sampling method was used to select 394 workers with working length ≥1 year in an automobile manufacturing plant as study subjects. A questionnaire survey was conducted to investigate the prevalence of low back pain in these workers using the Nordic Musculoskeletal Disorders Questionnaire. RESULTS: The prevalence of low back pain in these study subjects was 28. 9%( 114/394). The multivariate logistic regression analysis results showed that the relative risk ranked from high to low is as follow: uncomfortable working posture [Odds ratio( OR) =7. 31,95% confidence interval( 95% CI) = 2. 92-18. 28],feeling tired after work( OR = 5. 34,95% CI = 1. 22-23. 32],the commu time more than 30 minutes( OR = 2. 76,95% CI = 1. 38-5. 52),insufficient operating space( OR = 2. 22,95% CI = 1. 28-3. 83),hand or arm frequently used at work( OR = 2. 08,95% CI = 1. 14-3. 78) and age( OR = 2. 00,95% CI = 1. 19-3. 35),that were all risk factors of low back pain( P < 0. 05). CONCLUSION: The frequent use of hand or arm at work,insufficient operating space,uncomfortable working posture,feeling tired after work,and long commute time are the main influencing factors affecting the low back pain of automobile manufacturing workers.