[Objective]To introduce an operative treatment of complex talar body fracture and discuss the therapeutic effect in the near future.[Method]From March 1999 to January 2003,8 patients of complex talar body fracture in our department were treated.There were 5 males and 3 females with an average age of 28.9 years from 19 years to 46 years.The injuries were caused by fall in 3 cases,traffic accident in 3 cases,crash in 1 case,and on left 5 cases,right 3 cases.Two cases were combined with malleolus fracture and 1 case with open fracture and dislocation.All patients were treated with operation through approach of internal or external malleolus osteotomy and useing Absorbable screw for fixation.[Result]All the patients were followed up 1 to 3 years,average 1.3 year.By the assessment of clinical effects dependingon the complaints,functions and radiological results of the ankle and subtalar joint,4 patients were rated as being excellent,2 patients good,1 fair and 1 poor,the total rate of being excellent and good was 75%.No postoperative avascular necrosis of the talar was seen on radiographies.[Conclusion]Operation through approach of internal or external malleolus osteotomy and Absorbable scrow for fixation is a good method for treatment of complex talar body fracture.

Substance P-like immunoreactive (SP-li) cell bodies and processes and their synaptic relations with other neural elements in the nucleus raphe magnus (NRM) of rats were studied by electron microscope. The results showed that SP-li neurons are fusiform, oval and multipolar cells which distribute evenly over the nucleus. Immunostaining was present in the cytoplasmic matrix and membranes of mitochondria, endoplasmic reticulum and vesicles. Both unmyelinated and myelinated SP-li axons are found in the NRM. SP-li dendrites are numerous in the NRM. SP-li dendrites and somata are contacted by a variety of round, flat and granular vesicle-containing terminals. A central SP-li dendrite receivie convergent inputs from unlabelled axonal boutons is frequently seen in the NRM. SP-li terminals are presynaptic to the unlabelled dendrites, also some SP-li terminals are apposed or presynaptic to SP-li dendrites. Axo-axonic (SP-li) synapses were found in the NRM. The unlabelled presynaptic boutons contain clear round vesicles or mixed with granular vesicles. A central SP-li terminalis contacted by several unlabelled terminals is also found in the NRM.

ObjectiveTo evaluate the anti-glaucoma effect of 1％ D-timolol on patients with primary open-angle glaucoma （POAG） and ocular hypertension （OH）．MethodsThirty-six patients with POAG or OH were included．They were divided into two groups randomly for treating with either 1％ D-timolol or 0.5% L-timolol twice daily．The intraocular pressure（IOP） changes and side effects on eyes and cardiovascular system were noticed．Data of visual field and ocular blood flow were compared with the baseline after given the eyedrops for 3 month．ResultsAfter given one drop of the drug，intraocular pressure dropped significantly in both of the two groups．The IOP day curve at 1 month also dropped when compared with the baseline in both groups．There was no significant difference between the two drugs in magitude of hypotensive effect after 3 months．And the higher the IOP was，the more the IOP dropped when using D-timolol．There were no serious side effects noted．No significant change of ocular blood flow was found by color doppler imagine．Mean sensitivity of visual field was raised significantly in D-timolol-treated group，while in L-timolol-treated group it was not changed much．Conclusion1％ D-timolol is a favorable eyedrop. It is effective and safe for the treatment of glaucoma．

[Objective]To evaluate the inhibiting affection of Ad-BMP-7 to osteoporosis of ovariectomized rats.[Method]Mice model of osteoporosis was made by surgical ovariectomy,and divided into 4 groups:A.group of vertebral body intramedullary injection of normal saline;B.injection of Adovirus(Ad)-GFp;C.injection of Ad;D.injection of Ad+BMP(bone morphogenetic protein),the bone losing of whole body were monitored by measuring dry bone weight after 1 month,the osteoporosic condition of bone trabecular were observed by histology,and bone histomorphometry of vertebral bodies were carried to quatitatively measure the dynamic and static indexes of osteoporosic bone.[Result]The dry bone weight of AdBMP-7 rats werehigher than that of other groups.Under the microscope,the bone trabecula form of the Ad BMP-7 groups were more integrity,however,the bone trabecular of the other groups showed sharpen and ruptured.In the bone histomorphomitry,the numbers of the osteoblasts,the thickness of osteoid of group D were obviously higher than other groups.[Conclusion]Ad BMP-7 injected into the vertebral bodies of ovariectomized rats may secrete BMP-7,and inhibits the osteoporosis of ovariectomized rats in the early stage.The protective effect of this gene was not restricted to bones receiving intramedullary injection of the vector,but occurred in all bones that were evaluated.This proof of concept encourages further development of gene therapy approaches to the treatment of osteoporosis.

Today pedicle screw instrumentation system and short-segment fixation have been commonly used for treatment of thoracolumbar burst fractures because pedicle screw fixation allows 3-column fixation and facilitates simultaneous application of axial compression or distraction and rotational forces.Indirect decompression and direct decompression are the two ways to deal with canal compromise when pedicle screw instrumentation is used.Indirect decompression is achieved to correct the canal compromise due to ligamentotaxis and hyperextension.The present study reviews the current research on indirect spinal canal decompression in adult patients with thoracolumbar burst fracture.

Objective To evaluate the clinical results of one stage ante rior and posterior approach in the treatment of severe lower cervical injury. Me thod 8 cases of severe lower cervical injury underwent reduction, decompression and fixation through one stage anterior and posterior approach. 6 cases had fra cture and dislocation of cervical spine, and 2 cases cervical spine burst fractu re with cervical stenosis. Their clinical and radiographic records were reviewed retrospectively. Results Follow-ups of a mean period of 14 months showed that satisfactory recovery of neurological function was achieved. The Frankel Grade w as A in 7 cases and B in 1 case before operation, but D in 2 cases, C in 3 cases , and B in 1 case after operation except in 2 cases who had no improvement and r emained A. X-ray film demonstrated satisfactory stabilization of the fracture a nd dislocation, complete fusion of autograft, and preservation of the normal int ervertebral height and cervical lordosis. Conclusion One stage anterior and post erior approach operation is essential, safe and effective when radiographs demon strate that lower cervical canal is compressed from both anterior and posterior directions and clinical symptoms show severe neurological defects.

Objective To study the clinical results of early surgery for acute cervical spinal cord injury. Methods 24 cases of acute cervical spinal cord injury were treated with early surgery in our hospital from 1999 to 2002. The average interval from injury to surgery was 67 hours. The injured cervical segments were reduced, decompressed and fixed through anterior approach, posterior approach or anterior posterior approach. Results 22 cases got follow ups of 12 to 38 months (mean 18 months), but 2 cases were lost. 2 cases of the 11 patients of ASIA Grade A did not experience any restoration, but all the other patients got significant restoration and an average improvement of 1.8 ASIA grades. Conclusion Operation should be performed as soon as possible for acute cervical spinal cord injury, for good results can be achieved by early surgery.

10?) and delayed union of tibia in 4 sides. Conclusion Many factors can affect the prognosis of tibial Pilon fracture, but the key points for a successful operation are right procedure and timing of surgery.

Objective To investigate the clinical characteristics of postoperative spondylodiscitis after lumbar intervertebral disc herniation.Methods 9 cases with spondylodiscitis were reviewed,about their clinical symptoms,laboratory tests,bacteria culture,CT and MRI finging,etc.Results and Conclusion The clinical symptoms occurred 8~24 d after operation.Laboratory test and MRI were helpful for the early diagnosis.The outcome of both surgical and non-surgical treatment was satisfactory.