OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).

METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.

RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).

CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.

Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective To investigate the optimal technology of blind needle synovial biopsy.Methotis Blind needle synovial biopsy was performed on 81 knees with pain and swelling.Twenty patients with rheumatoid arthritis (RA) received uhrasonographic (US) examination before biopsies.Results Synovium were obtained in all patients and the successful rate was (71±21)%,while the area of synovium was (1.8±0.8)mm2.The time for accomplishing the procedure was (26±6) min and the depth of trocar insertion Was (3.1±0.7) cm.The successful rate in patients with RA (80±6)% was much higher than that in non-RA patients (54±10)%.The successful rate with US guidance (85±5)% was much higher than that without US guidance (78±6)%.The positive predictive value of synovium evaluation by naked eye Was 95.0%,while the negative predictive value was 81.1%.Conclusion Blind needle synovial biopsy should be spread because it is simple and safe to perfonn and it can obtain sufficient synovium for all purposes.

Objective:To observe the effect of different concentration of Qianggubao decoction extract on proliferation of osteoblastic cells cultured by high glucose in vitro. Methods: osteoblastic cells was isolated from the skull of 1-2 day newly born SD rats by means of Trypsin-collagenase digestion and identified by image analysis,V-G collagen staining,ALP staining, calcification nod staining etc. Different concentrations of Qianggubao decoction extract were added to the osteoblastic cells cultured by high glucose in vitro(final concentration:300mg/dl)and incubuted.The effects of Qianggubao decoction extract on the proliferation of osteoblasts was monitored by MTT analysis. Results:Qianggubao extract of 100, 50, 10?g/ml all promoted for osteoblastic cell proliferation, the 100?g/ml and 50?g/ml had the better effects (P

Objective To explore the characteristics of nosocomial infection and its related factors among those very low birth weight infant(VLBWI)for coming up with appropriate preventive measures.Methods Fifty-eight infants with birth weight of 1500 g or below in the hospital from January to June in 2012 were studied actively and retrospectively about their nosocomial infection and related risk factors.Results Thirty-five cases of nosocomial infection occurred among the 58 infants with a prevalence of 60.34%. The mainly pathogenic bacteria was Gram-positive bacteria(88.47%)and mostly,infections presented with lung infections(82.90%) within 21 days after birth.The risk factors included mechanical ventilation,PICC,Apga score<7,fluconazole administration and premature rupture of membranes of VLBWI.Conclusion VLBWI are prone to nosocomial infections,mostly lung infection on day 21 after birth.Management should be strengthened within 3 weeks after birth of VLBWI to minimize infections.Reduction of invasive procedures on children and antibiotic use is particularly important.On the other hand,strengthening the health care in the perinatal period and reducing the incidence of preterm birth cannot be ignored.

Objective To investigate the efficacy of sling-exercise therapy on cervicogenic headache. Methods 60 patients with cervicogenic headache were divided into 2 groups with 30 patients each. Group I received paravertebral block of C2 once a week for 4 weeks, and Group II received sling-exercise therapy 3 times a week in addition. The Visual Analogue Score (VAS), frequency of pain (per month) before and 1, 3, 6 months after treatment were recorded, and the incidence of improvement was observed. Results In group I, VAS significantly improved 1 and 3 months after treatment (P<0.001), while it lasted 6 months in group II (P<0.001). The VAS improved more in group II 3, 6 months after treatment (P<0.001). It was similar in pain frequency. The incidence of improvement was 33.3% (10/30) and 73.3% (22/30) in group I and group II, respectively (P<0.01). Conclusion Sling-exercise therapy may improve the efficacy of paravertebral block on cervicogenic headache, especially for the long-term.

OBJECTIVE To study the effect of epipolythiodioxopiperazine compound C87 on tumor cell proliferation and explore the potential mechanisms. METHODS Tumor cells were exposed to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h, cell viability was determined by sulforhodamine B (SRB) assay and the half growth inhibition (Gl50 ) was calculated. After treatment with C87 0.1-2.5 μmol.L-1 for 6 h, or C87 2.5 μmol.L-1 for 0-6 h, the generation of reactive oxygen species (ROS) was measured using the compound 2′,7′-dichlorofluoresceindiacetate and flow cytometry analysis. After treatment with C87 2.5 μmol.L-1 , either alone or with antioxidant N-acetylcysteine (NAC), for 6 h, the generation of ROS was measured by flow cytometry analysis. Tumor cells were exposed to C87 0.05-1 μmol.L-1 , either alone or with NAC, for 24 and 48 h, while cell viability was determined by SRB assay. RESULTS The cell viability was significantly reduced following exposure to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h in a concentration-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). At 72 h, the value of r2 was 0.946, 0.989, 0.973 and 0.984(P<0.05), respectively. The cell viability was significantly reduced following exposure to C87 1 μmol.L-1 for 24 - 72 h in a time-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). The value of r2 was 0.983, 0.956, 0.951 and 0.873(P<0.05), respectively. The generation of ROS was increased after exposure to C87 0.25-2.5 μmol.L-1 in a concentration-dependent manner in HCT116 and HeLa cells for 6 h (r2 = 0.760, P = 0.045: r2 = 0.987, P=0.001), and after exposure to C87 2.5 μmol.L-1 in a time-dependent manner in HCT116 and HeLa cells for 0.5-6 h (r2 = 0.886, P = 0.017: r2 = 0.994, P = 0.000).The C87-induced ROS generation could be blocked by NAC in HCT116 and HeLa cells(P<0.05). The C87 induced cell death could be blocked by NAC 5 and 10 mmol.L-1 , and the Gl50 value was 1.446 and 1.134 μmol.L-1 for 24 h (the Gl50 value of C87 group was 0.513 μmol.L-1 ), and 0.882 and 1.166 μmol.L-1 for 48 h (the Gl50 value of C87 group was 0.333 μmol.L-1 ). CONCLUSION The novel epipolythiodioxopiperazine derivative C87 exerts potent antitumor activity in vitro, possibly via triggering ROS production.

Objective To improve the permeation of nasal mucosa by preparing the cholic acid-hydroxypropyl-?-cyclodextrin(HP-?-CD) and characterize the inclusion complex.Methods The inclusion complex was characterized by using phase solubility,scanning electron microscope(SEM),Fourier transform-infrared(FT-IR),differential scanning calorimetry(DSC),and superconducting NMR;In an effort to investigate the effect of HP?-CD on cholic acid,the studies of in vitro permeation of nasal mucosa was performed.Results Phase solubility curve was AL type,K=564.30 L/mol,and the characterization de-monstrates the formation of inclusion complex;The permeability coefficients and steady state fluxes through ovine and porcine nasal mucosa were enhanced by the formation of inclusion complex with HP-?-CD about 1.46 and 1.44 times of the uncomplexed cholic acid,respectively.Conclusion The inclusion complex is formed and it could increase the permeability of nasal mucosa by preparing the cholic acid-HP-?-CD.

Objective To observe the effects of asthmatic children treated by inhaled salmeterol xinafoate and fluticasone propi-onate powder. Methods One hundred and fourty cases of moderate and severe asthmatic children were treated in non- acute period aged from 4 to 14 years by inhaling salmeterol xinafoate and fluticasone propionate powder, compared with control group treated by flu-ticasone propionate in 106 cases, and the pulmonary function was monitored simultaneously. Results The total effective rate of the treatment group and control group were 99. 3 % , 99. 1 % , respectively.The pulmonary function indexes such as the first one second expiration volume(FEV1), flow velocity of 50 % expiration vital capacity(FEF50%), peak expiration velocity(PEF1) after being treated 4 months was improved significantly compared with those before treatment.The difference between them was statistically significant (P

Objective To investigate the correlation between apparent diffusion coefficient (ADC)of diffusion weighted imaging (DWI)and prognostic factors in rectal cancer.Methods 5 5 patients with rectal cancer were confirmed pathologically.Conventional pelvic MRI and DWI examination were performed,and the mean ADC values of tumor were measured preoperatively.The patients were divided into two groups with or without lymph node metastasis,and were also divided into four groups with negative,weakly positive,positive or strongly positive expression of EGFR in rectal cancer.The ADC values were calculated in each group,and the correlation of ADC values with the lymph node status and EGFR expression classification were analyzed.Results In 5 5 patients with colorectal cancer,there were 13 lesions with lymph node metastasis and the positive expression rate of EGFR was 67.2%.There were no significant difference in mean ADC value between the groups with and without lymph node metastasis (P=0.342).The number of lesions with negative,weakly positive,positive and strongly positive EGFR expression were 18,15,12 and 10.The difference in the mean ADC values among negative,weakly positive,positive and strongly positive expression groups of prognostic factor EGFR was not significantly different (P=0.412).There were also no correlations in the prognostic factors mentioned above (r=0.183 and -0.324,all P>0.05).Conclusion The ADC value can not be used to predict the prognosis and to provide more valu-able information for individualized therapy in patients with rectal carcinoma,which needs further studiy in the future.

Objective To investigate the correlation between apparent diffusion coefficient (ADC)value of MR diffusion weighted imaging (DWI)and Ki-67 expression in rectal cancer.Methods The data of 47 patients with rectal cancer confirmed by pathology were retrospectively analyzed.Pelvic MRI,rectum DWI and enhanced examination were performed preoperatively.According to the Ki-67 index,the patients were divided into A-D four Groups:Group A with Ki-67 <10% (-),Group B with Ki-67 10%-25%(+),Group C with Ki-67 26%-50%(++);and Group D Ki-67 > 50%(+++).ADC values were calculated in each group to analyze the correlation with the Ki-67 expression levels.Results The mean ADC value were (1.280 ± 0.200 )× 10 -3 mm2/s in Group A (13 cases),(1.044±0.046)×10 -3 mm2/s in Group B (14 cases),(0.987 ±0.256)×10 -3 mm2/s in Group C (9 cases), and (0.85 1±0.099)×10 -3 mm2/s in Group D (1 1 cases).The mean ADC values were significantly different in the different groups with different levels of Ki-67 expression (P =0.001).ADC value and Ki-67 expression were moderate negatively correlated (r = -0.577, P=0.000).Conclusion DWI and ADC measurement can evaluate indirectly the cell proliferation and prognosis of rectal tumor to some extent.