BACKGROUND:Photoelectric navigation-aided percutaneous pedicle screw placement has been developed extensively,but its accuracy,safety and effectiveness have not yet been confirmed by evidence-based medicine.OBJECTIVE:To compare the curative efficacy of photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation for thoracolumbar fractures.METHODS:Sixty patients with thoracolumbar fractures were equivalently randomized to treatment and control groups and then underwent photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation,respectively.The perioperative indexes,imaging indexes,function recovery and incidence of complications were compared between two groups.RESULTS AND CONCLUSION:(1) The Visual Analogue Scale scores,intraoperative blood loss,radiant times,and hospitalization time in the treatment group were significantly less than those in the control group (P ＜ 0.05).(2) The operation time did not differ significantly between two groups (P ＞ 0.05).(3) The postoperative sagittal Cobb angle,and percentage of anterior height in the vertebral body in the two groups were significantly improved compared with those before surgery (P ＜ 0.05),but all above imaging indexes showed no significant differences between two groups (P ＞ 0.05).The endplate-screw angle in the treatment group was significantly less than that in the control group (P ＜ 0.05).(5) The excellent and good rate of placement in the treatment group was significantly higher than that in the control group (P ＜ 0.05).(6) These results suggest that compared with the traditional open posterior pedicle screw fixation,the photoelectric navigation-aided percutaneous pedicle screw placement exhibits high placement accuracy,less radiant times,less trauma,less blood loss and rapid functional recovery.

Objective To analyze the spatial epidemiological characteristics of measles in Taizhou from 2009 to 2017, so as to provide theoretical basis for measles prevention and control. Methods The spatial autocorrelation analysis and trend surface analysis of measles epidemics data from 2009 to 2017 in Taizhou were performed using ArcGIS 10.0 software. The dynamic characteristics of measles epidemics in Taizhou were analyzed. Results Among 2009-2017 years, the incidences of measles in Taizhou ranged from 0.83/1 million to 65.43/1 million. The results of global autocorrelation analysis showed that there were spatial correlations of the incidence of measles among 2012, 2013, 2015, and 2016 in Taizhou with a high-value clustering distribution. Local autocorrelation analysis indicated that the hot spots of measles incidence in Taizhou from 2009 to 2017 were mainly concentrated in the central towns of Taizhou. Trend surface analysis suggested that the measles incidence in the south towns of Taizhou was higher than that in the north in 2010, and the incidence in the central region was higher than those in other regions in 2013 and 2015. Conclusions According to the spatial analysis, autocorrelation was observed for the spatial distribution of measles incidence in Taizhou from 2009 to 2017, and there are hot spots in the central township. Targeted preventive measures should be taken based on these characteristics.

Aged ; Femur ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps

Long-segment lichen sclerosus (LS) urethral stricture is a challenge for urologists. Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty. In this retrospective study, we investigated the outcomes of these two procedures in patients with LS urethral stricture. Between January 2015 and December 2020, 77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China). Of the 77 patients, 42 (54.5%) underwent the Asopa procedure and 35 (45.5%) underwent the Kulkarni procedure. The overall complication rate was 34.2% in the Kulkarni group and 19.0% in the Asopa group, and no difference was observed ( P = 0.105). Among the complications, no statistical difference was observed in the incidence of urethral stricture recurrence ( P = 0.724) or glans dehiscence ( P = 0.246) except for postoperative meatus stenosis ( P = 0.020). However, the recurrence-free survival rate between the two procedures was significantly different ( P = 0.016). Cox survival analysis showed that antiplatelet/anticoagulant therapy use ( P = 0.020), diabetes ( P = 0.003), current/former smoking ( P = 0.019), coronary heart disease ( P < 0.001), and stricture length ( P = 0.028) may lead to a higher hazard ratio of complications. Even so, these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures. The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences. Moreover, our results showed that antiplatelet/anticoagulant therapy use, diabetes, coronary heart disease, current/former smoking, and stricture length may be contributing factors of complications. Therefore, patients with LS are advised to undergo early interventions for better therapeutic effects.
Male ; Humans ; Urethral Stricture/etiology* ; Retrospective Studies ; Constriction, Pathologic/surgery* ; Lichen Sclerosus et Atrophicus/surgery* ; Treatment Outcome ; Urologic Surgical Procedures, Male/methods* ; China ; Urethra/surgery* ; Postoperative Complications/etiology* ; Mouth Mucosa ; Diabetes Mellitus/etiology* ; Anticoagulants ; Coronary Disease

OBJECTIVETo evaluate the effect of daily low-dose tadalafil on erectile dysfunction (ED) induced by pelvic fracture urethral disruption (PFUD).

METHODSThis study included 46 cases of PFUD-induced ED treated from Jan 2008 to Dec 2011. The patients were aged 33.9 +/- 7.2 years (range 25 -51 yr), and the interval between injury and treatment was 19.6 +/- 12.7 months (range 3 - 72 mo), all with normal erectile function before PFUD. Based on the nocturnal penile tumescence and rigidity (NPTR) recorded by erectometry without medication of phosphodiesterase type 5 inhibitor (PDE-5I), the patients were divided into an abnormal nocturnal erection group and a non-nocturnal erection group, and treated with tadalafil 10 mg once daily for 3 months. The therapeutic effect was evaluated by IIEF-5 scores and the rate of yes responses to questions 2 and 3 of the Sexual Encounter Profile (SEP).

RESULTSTotally 38 (82.6%) of the patients accomplished the treatment and follow-up, 26 (68.4%) in the abnormal nocturnal erection group and 12 (31.6%) in the non-nocturnal erection group. After 3 months of daily tadalafil treatment at 10 mg, the IIEF-5 scores were significantly improved in the abnormal nocturnal erection group than in the non-nocturnal erection group (P < 0.05), and the rate of yes responses to SEP2 and SEP3 was remarkably higher in the former than in the latter (76.9% vs 41.7% and 65.4% vs 25.0%, P < 0.05).

CONCLUSIONSDaily low-dose tadalafil can effectively improve the erectile function of PFUD-induced ED patients, particularly in those with nocturnal erection.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Dose-Response Relationship, Drug ; Erectile Dysfunction ; drug therapy ; etiology ; physiopathology ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvis ; injuries ; Penile Erection ; Tadalafil ; Treatment Outcome ; Urethra ; injuries

OBJECTIVETo evaluate the efficacy of treating severe and chronic vertebral compressive fractures in the elderly with percutaneous vertebroplasty.

METHODSSixteen patients who suffered from severe back pain and whose daily living was badly affected were retrospectively reviewed. The average age was 72.5 years, the average disease history was 19 months, and the average compressive rate of the affected vertebral bodies was 74.1%.

RESULTSNineteen affected compressive vertebral bodies in 16 cases were treated with percutaneous vertebroplasty. All the procedures were successful without any complication. After 3.5-7 ml of cement was injected into the lesions, complete relief was achieved in 3 cases, remarkable relief was achieved in 11 cases, and improvement was observed in 2 cases. The scores of 6-point Behavioral Rating Scale and Activity of Daily Living (ADL) declined significantly after the treatment (P < 0.001).

CONCLUSIONPercutaneous vertebroplasty can significantly improve the symptoms and quality of life in the elderly patients with severe and chronic vertebral compressive fractures.

Activities of Daily Living ; Aged ; Aged, 80 and over ; Back Pain ; surgery ; Bone Cements ; therapeutic use ; Female ; Fractures, Spontaneous ; etiology ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Orthopedic Procedures ; methods ; Osteoporosis ; complications ; Quality of Life ; Retrospective Studies ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; surgery

To establish a determination method for the contents of ammonium glycyrrhetate,nardosinone,and curcumin in transdermal receptor liquid of Baimai Ointment,and investigate the percutaneous permeability of Baimai Ointment and the effects of two kinds of penetration enhancers on percutaneous absorption of three components. The contents of ammonium glycyrrhetate,nardosinone,and curcumin in transdermal receptor liquid were determined by high pressure liquid chromatography( HPLC). The vertical modified Franz diffusion cell was used to perform a transdermal experiment in vitro with the abdominal skin of mice( treated and untreated). The transdermal receptor liquid was preferably used to investigate the transdermal absorption rule of the Baimai Ointment and the effect of the penetration enhancer. The results showed that the comprehensive solubility of PEG-ET-NS( 3 ∶3 ∶4) was best among three types of receptor liquid PG-ET-NS( 3 ∶3 ∶4),PEG-ET-NS( 3 ∶3 ∶4),ET-NS( 3 ∶7). PEG-ET-NS was used as the receptor liquid for in vitro transdermal experiments. The cumulative permeation area of ammonium glycyrrhetate,nardosinone and curcumin within 24 h was 5. 73,18. 99,0. 38 μg·cm~(-2)respectively. Taking QEFand ER as comprehensive evaluation indicators of permeation performance,the comprehensive penetration-promoting performance of ammonium glycyrrhizinate: 3% PEG 400-ethanol-normal saline ≈ 1. 19 times( 3%azone) = 1. 94 times( blank); comprehensive penetration-promoting performance of nardosinone: 3% PEG 400-ethanol-normal saline≈1. 28 times( 3% azone) = 1. 37 times( blank); the comprehensive penetration performance of curcumin: 3% PEG 400-ethanol-normal saline≈1. 77 times( 3% azone) ≈3. 42 times( blank). The comprehensive penetration enhancement properties of the two penetration enhancers were as follows: 3% PEG 400-ethanol-normal saline>3%azone>blank. The transdermal absorption curve of ammonium glycyrrhetate,nardosinone and curcumin in Baimai Ointment were consistent with the zero-order equation,indicating that the transdermal absorption process was irrelevant to the concentration of three components,and its was a diffusion process. This experiment provides reference for the study of ointment transdermal preparations.
Administration, Cutaneous ; Animals ; Mice ; Ointments ; pharmacokinetics ; Permeability ; Skin ; Skin Absorption

Cholecystolithiasis ; complications ; Humans ; Hypertension, Portal ; Portal Vein ; pathology

Objective:To observe the effect of tetrahydroxy stilbene glycoside （TSG） on the expression of glycogen synthase kinase 3β （GSK3β）， cyclic adenosine monophosphate-dependent protein kinase （PKA） and Serine/threonine phosphatase 2A（PP2A） in the brain of amyloid precursor protein/presenilin-1/Tau （APP/PS1/Tau） triple-transgenic mice dementia model. Method:A total of forty-five 8-month-old APP/PS1/Tau transgenic mice were randomly divided into model group， positive control group （Huperzine-A， 0.15 mg·kg^-1）， low， medium and high dose TSG groups （TSG， 0.033，0.1，0.3 g·kg^-1）， with 9 mice in each group， and another nine C5B7L/6J mice of the same age were selected as normal control group. After 60 days of intragastric administration， the general structure of hippocampal neurons was observed by hematoxylin-eosin （HE） staining， immunohistochemical （IHC） was used to detect the expression of PKA protein in the brain of mice in each group， the mRNA expression levels of GSK3β， PKA and PP2A were detected by real time quantitative reverse transcription polymerase chain reaction （Real-time PCR）， and protein expression levels of GSK3β and PP2A were detected by Western blot. Result:Compared with the normal control group， the apoptosis level of neurons in the model group was significantly increased， the protein and mRNA expression levels of GSK3β and PKA were significantly increased （P<0.05， P<0.01）， and the protein and mRNA expression levels of PP2A were significantly decreased （P<0.05， P<0.01）. Compared with the model group， the apoptosis level of neurons in each treatment group was significantly down-regulated， the protein and mRNA expression levels of GSK3β and PKA were significantly down-regulated （P<0.05， P<0.01）， and the protein and mRNA expression levels of PP2A were significantly increased （P<0.05， P<0.01）. Conclusion:The mechanism of TSG in the treatment of Alzheimer's disease （AD） may be related to lowering the transcription and expression of GSK3β and PKA， increasing the transcription and expression of PP2A.

Objective To discuss the possibility for regeneration of knee joint with normal function under bionics biomechanical environment. Methods Seven normal rabbits with two metal frames respectively mounted on their femur and tibia of single (right) side leg by two threading pins of 1.5 mm diameter were used. Then the external artificial joints, containing two four-bar-linkage inside and outside of the knee to simulate motion trajectory of the joint in sagital plane were connected with the two preset fixed frames before osteotomy. The arthro-cartilage of the knee joint, crucial ligaments, semi-lunar fibro-cartilages, and partial under-cartilage-osseous intra articular capsule were cut off during osteotomy, with the patella, sesamoid bones remained intact. Insertion sites of muscle tendons were not invaded as far as possible, and capsules with ligaments outside were kept complete when the incision wound was closed by suture. The rabbits could move freely after osteotomy. The range of motion (ROM) of the knees in sagital plane and bony gap between the femur and tibia were measured by X-Ray films during the fracture healing after osteotomy. Results External artificial knee joints were successfully installed on right legs of 6 rabbits among the seven. The rabbits moved freely after osteotomy under the control of minimal invasive external artificial joint in bionics trajectory. The average angles between femoral shaft and tibial shaft at the 1st week after osteotomy were from (144.7±15.62)° in extremely flexed position to (44.2±25.77)° in extremely extended position, with ROM of (100.5±29.03)°. At the 12th week, the average angles were from (139.4 ± 12.92)° in extremely flexed position to (40.4±22.04)° in extremely extended position, with ROM of (99.0±23.39)°. No significant differences were displayed in flexed/extended position and ROM between the 1st and 12th week, with the bony gaps of the knees still existed but decreased significantly from (4.03±1.84) mm at the 1st week to (2.32±1.05) mm at the 12th week. In contrast, bony gaps of the opposite knees were not changed significantly, which were (1.27±0.22) mm on average. At the end of 16th week after osteotomy, the external artificial joints were removed. Newly born cartilage, with white color and smooth surface, were covered at lower end of the femur and upper end of the tibia. Typical trochlear surface appeared at the front side of regenerated cartilage corresponding to the posterior surface of the patella. And the regenerated fibro-bundle linkage similar with ligament, which started from bony structure of regenerated lower end of the femur and inserted into regenerated upper end of the tibia, was observed in each rabbit. At the 25th week, the average angles between femoral shaft and tibial shaft were from (148.3 ± 4.75)° in extremely flexed position to (48.30±17.57)° in extremely extended position, with ROM of (100.0±20.80)°. In the opposite (left) leg, the average angles between femoral shaft and tibial shaft were from (148.3±7.5)° in extremely flexed position to (21.6±9.09)° in extremely extended position, with ROM of (126.7±6.88)°, and the average bony gap of the knees after osteotomy was (1.4±0.59) mm, while that of the opposite (left) knees was (0.92±0.35) mm. Conclusions The external artificial joint with bionics trajectory could reserve the space for regeneration of rabbit knee joint by providing motion modeling environment, and proved the stress adaption during fracture healing. The present results indicated that regeneration of the knee joint after intra-capsular osteotomy in bionics biomechanical environment was possible.