Enophthalmos ; surgery ; Humans ; Orbital Fractures ; diagnosis ; surgery

Objective To assess the accuracies and feasibility of spine surgery assisted by different types of navigation system.Methods In experiment study,40 human cadaveric cervical spines were employed and 3.5 mm screws were placed into the C 3 to C 7 pedicles following five kinds of insertion techniques:blind screw placement(Group 1),assisted by X-ray fluoroscopy(Group 2),assisted by virtual fluoroscopy navigation system(Group 3),assisted by CT-based navigation system(Group 4),assisted by Iso-C 3D navigation system(Group 5).Thereafter,cortical integrity of every sample was examined by anatomic dissection.In clinical study,163 cases of spine operations assisted by different types of navigation were reviewed.The accuracies of screw placement were evaluated by postoperative CT or Iso-C 3D scan.Results In experiment study,there were 398 pedicles inserted.Group 1,the average operation time per sample was 27 minutes;36.3% of the screws were excellent,26.3% good,and 37.5% bad.Group 2,the average operation time was 112 minutes;44.9% excellent,37.2% good,and 17.9% bad.Group 3,the average operation time was 69 minutes;42.5% excellent,45.0% good,and 12.5% bad.Group 4,the average operation time was 98 minutes;87.5% excellent,12.5% good.Group 5,the average operation time was 91 minutes;90% excellent,10% good.In clinical study,272 screws inserted with virtual fluoroscopy navigation system,89.3% excellent,10.7% good.571 screws inserted with CT-based navigation system,84.9% excellent,14.4% good,0.7% bad.142 screws inserted with Iso-C 3D navigation system,95.8% excellent,4.2% good.Conclusion Computer-assisted navigation system enhances accuracies and further improves the safety of spine surgery,especially utilizing CT-based navigation system and Iso-C 3D navigation system.Iso-C 3D navigation method is better than the other two navigation methods.

Objective To investigate the features of multiple pelvic injuries (fracture combined with multiple traumas) and their effects on management and prognosis. Methods A total of 233 cases of hemodynamically unstable pelvic fractures were grouped according to the patterns of violence, fracture and associated injuries. They were assessed with measured indexes in physiological state, anatomic injury and blood requirement. Their possibilities of survival (Ps) were also predicted. All the data were statistically analyzed. Results The pelvic fractures were often combined with multiple traumas and frequently resulted from high energy traffic accidents. The correlations among sources of bleeding, amounts of blood loss and hemodynamical changes were disproportional. In unstable pelvic fractures with extra pelvic bleeding, BP and blood requirement were significantly different, and their AIS and ISS of the pelvis were higher and their Ps was lower than in the other groups. Conclusions Multiple pelvic injuries caused by high energy are often highly risky and combined with multiple traumas and several sources of bleeding. A clear and precise assessment of the total injuries and sources of bleeding will help treat the patients with different managements.

Objective To investigate the current situation of nursing research based on Omaha system in China. Methods All the nursing research based on Omaha System were retrieved and collected by using China National Knowledge Infrastructure, Wanfang database and VIP database, NoteExpress software for the management of documents was used. Based on the classification of nursing research literature, a content analysis of system analysis model analyzed the documents had been retrieved. Results Sixty-four pieces of literature were included, and thirteen categories system were formed. The transverse reliability coefficient of all kinds of system were 0.940-1.000, the longitudinal reliability coefficient were 0.658-1.000. Conclusions The study of nursing research based on Omaha system in China is booming, which is also facing challenges, and has a broad space for exploration.

Objective To evaluate the long term results of coral bone used in anterior cervical interbody fusion. Methods The 180 patients (126 males and 54 females) who had undergone anterior interbody fusion in our hospital were followed up for 6 years. Their long-term imageological data, including changes in interbody height, interbody angle and range of movement, were analyzed and compared. Results In all the cases a solid fusion was achieved between coral reef and vertebra. The fusion was evaluated as successful in all the 180 patients. Conclusion The coral bone spacer provides the same solid fusion as autografting with iliac crest does.

Objective: TO establish methods for sensitive, rapid, economical detection of Th1/Th2 Cytokine gene expression. Method: sixpairs of Primers specific for the IL-2, IL-4, IL-10, IL-13, IFNr and B-actin were designed. A Sensitive and rapid method for detection of Th1/Th2cytokine genes by RT-RCR was established. Meanwhile another method: the RNA hybridization with sir cDNA probes were established. Results:The RT-PCR reaction and RNA hybridization was used to test five kinds of Cytokine mRNAs expressed 20 tumor cell lines on mRNAs were expressed in eleven Cell lines;The mRNAs in eight cell lines. Conclusion:The preliminary results suggested that RT-PCR and RNA hybridizationnight be used to test Th1/Th2 cytokine gene expression.

Objective To observe the clinical value of indocyanine green retention rate at 15 minutes (ICGR15) in the evaluation of hepatic functional reserve. Methods A total of 185 patients with liver disease, including 45 cases of liver failure, 90 cases of cirrhosis (child A, B and C, respectively), 20 cases of acute hepatitis, 30 cases of chronic hepatitis (mild, moderate). Expression levels of ICGR15 were compared between groups. Values of ICGR15, total bilirubin (TBIL), albumin (ALB), blood coagulation time (PT) were compared before treatment and one month after treatment in hepatic failure group. Levels of alanine aminotransferase (ALT), aspertate aminotransferase (AST), TBIL and ICGR15 were compared before treatment and 1 month after treatment in acute hepatitis group. Results Levels of ICGR15 (%) were 56.3±14.7, 28.9±9.6, 22.4±6.8 and 13.7±2.3 in liver failure group, liver cirrhosis group, acute hepatitis group and chronic hepatitis group, which showed a gradual downward trend (F=125.317, P<0.05). Among them, the levels of ICGR15 (%) were 17.3±5.4, 25.7±7.5 and 34.5±7.3 in Child A, B and C groups of liver cirrhosis group, which showed a gradual upward trend (P<0.05). After one month treatment, levels of TBIL, PT and ICGR15 were significantly lower than T helper 17 cells; intima-media thickness before the treatment in liver failure group. The levels of ALT, AST, TBIL and ICGR15 were significantly lower after treatment than those before treatment in acute hepatitis group (P<0.05). Conclusion ICGR15 can reflect hepatic reserved function, which is not affected by the application of albumin and fresh plasma, and makes up the deficiency of PT and ALB detection.

Intravenous thrombolysis is the only treatment that has the evidence of evidence-based medicine in acute ischemic stroke. However, the narrow time window has limited the treatment opportunities of many patients. Transcranial ultrasound thrombolysis is a very promising thrombolysis-assisted method, and transcranial ultrasound plus microbubble-assisted thrombolysis is the research hotspot in recent years. At present, more suitable ultrasonic instruments for thrombolysis and a number of ways of ultrasound-assisted thrombolysis are being developed.

Objective To evaluate two kinds of anterior screw fixations in the treatment of odontoid fractures. Methods A total of 36 patients with D' Alonzo type Ⅱ odontoid process fractures were treated with anterior screw fixation in our department from 1999 to July 2009. There were 28 males and 8 females at mean age of 42.3 years (rang 17-59 years). According to time and surgery procedures, the patients were divided into Group A ( from 1999 to June 2005, n = 11 ) and Group B ( from June 2005 to July 2009, n = 25 ). Patients in Group A received anterior hollow screw fixation of the odontoid process monitored under G-arm or C-arm, while those in Group B received anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system. The operation time and blood loss in two groups were compared by Student' s t test and analyzed with SPSS 13.0 statistical software. X-ray examination was performed in all patients 3, 6 and 12 months after operation to observe fracture union and stability of the upper cervical spine. Results The operation time was ( 102 ± 12) min ( range, 77-148 min) in Group A and ( 104 ± 14) min ( range, 71-150 min) in Group B, with no statistical difference ( P =0.21 ). The blood loss was (465 ± 5) ml (range, 20-130 ml) in Group A and (42 ± 6) ml (range, 26-150 ml) inGroup B, with no statistical difference (P = 0.16). All patients received reexamination three months after operation, which showed no bony union or dislocation but average 40% restriction of neck rotation. One year after operation, 30 patients (83%) got fracture union and six ( 17% ) got fiber healing, with average 24% restriction of neck rotation. Conclusions There is no statistical significant differences between two groups in aspects of operation time, blood loss and fracture healing. But anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system can reduce exposure to radiation of both patients and surgeons. Furthermore, solid screws can be applied to augment the fixation intensity and thereby reduce the complications caused by non - union.

Objective To investigate the prevalence of low back pain among adults in Beijing.Methods The study design was a cross-sectional study,and the multi-stage sampling was used.A questionnaire survey was conducted in December 2010 to investigate prevalence of low back pain in adults who had lived in Beijing for over 6 months.Total prevalence and prevalence by region,gender and age were calculated.The chi-square test was used to compare results.Results A total of 3860 people were enrolled in this study.The one-year prevalence of low back pain was 26.09％ (1007/3860),and the point prevalence was 6.11％ (236/3860).The prevalence of different duration of low back pain (3 months,3-6 months,≥6 months) was 16.76％ (647/3860),4.12％ (159/3860) and 5.21％ (201/3860),respectively.The prevalence of females (28.83％) was higher than that of males (23.03％).The prevalence among different regions was significantly different.Prevalence in suburb and rural area (29.88％ and 27.54％,respectively) was higher than that in urban area (20.88％).No matter males or females,the prevalence in urban area was the lowest (17.48％ and 24.00％,respectively).With the increasing of age,the prevalence of low back pain became higher.In males,the prevalence of 55 to 59 years group was highest,while 60 to 64 years group was highest in females.In urban area and rural area,the prevalence of 60 to 64 years group was highest (34.43％ and 48.68％,respectively),while 55 to 59 years group was highest in suburb (47.26％).Conclusion The oneyear and point prevalence of low back pain among adults in Beijing are higher,with wide distribution.The chronic low back pain is more common.The prevalence of low back pain is higher in suburb and rural area.Females have a higher prevalence than males.Moreover,the prevalence of low back pain increases with age.