Objective To explore the technique outcome of fixing the ventral stress pedicle screws into the injured vertebrae, as a method to enhance the posterior internal fixation. Methods From March 2002 to March 2005, 33 single thoracolumbar fractures were studied retrospectively. Among which, 16 cases were treated with the above method(group A), and the other 17 were treated with traditional two-level fixation(group B). Group A involved 11 males and 5 females, aged 48 years averagely(range, 32-74 years); and group B included 12 males and 5 females, aged from 21 to 61 years(mean, 40 years). All the patients underwent the operation within up to 3 weeks after fracture. For the injured vertebral bodies, their pedicles were intact on either unilateral or bilateral side, and their lower half and endplate were free from split. In group A, the pedicle screws in the injured vertebrae were used to achieve the ventral press vertical to the distraction for the stress neutralization, and also with the routine distraction and lordosis restoration, simultaneously. The mean follow-up period was 11 months with a range from 6 to 24 months. Results After operation, the optimal Cobb angle and anterior column restoration were achieved through the ventral reduction from the injured vertebral body, which was the contribution from the vertical stress pedicle screw. The degree in anterior movement of injured vertebrae pre- and postoperatively was much more in group A than group B, and the difference was of statistical significance(P

Objective To explore major risk factors for postoperative biliary tract infection associated with endoscopic retrograde cholangiography (ERC), and to evaluate endoscopic nasobiliary drainage (ENBD) for intervening the infection.Methods A total of 512 patients who underwent ERC at the First People's Hospital of Yunnan Province from January 2010 to June 2016 were enrolled and divided into group A and B randomly.Group A underwent ENBD after ERC while group B without.The incidence rates of biliary tract infection in different causes and lesions were compared between the two groups.Results Among the 512 patients, there were 276 cases in group A and 236 cases in group B.The overall postoperative biliary infection rate was 4.30%(22/512).Patients in group A showed a smaller chance of developing postoperative biliary tract infection than that in group B [1.09%(3/276) VS 8.05%(19/236), χ2=15.00, P=0.000].Malignant biliary obstruction was the most common cause (13.46%, 14/104) and the most common site was hepatic portal (13.43%, 9/67).Conclusion ENBD can ensure smooth drainage of bile duct therefore effectively prevent biliary tract infection after ERC, especially for patients with malignant biliary obstruction and hepatic portal lesion.

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 correlation between vertebral diffusion weigllted imaging (DWI)and dual X-ray absorptiometry(DXA),quantitative computed tomography(QCT)for the evaluation of bone mineral density(BMD).Methods A total of 152 female volunteers[aged from 30 to 80 years,mean age(58.2±14.2)years 1 were recruited in this study.All subjects underwent lateral thoracicolumbar radiographs,dual X-ray absorptiometry(DXA)and quantitative computed tomography(QCT),as well as DWI examination.Lateral spine radiographs(T4-L4)were evaluated with Genant's semiquantitative assessment.BMD was obtained by both DXA and QCT at lumbar spine(L2-L4).Axial vertebral(L2-4)DWI was performed with single shot spin-echo echo-planar imaging(SS-SE-EPI)sequenee (b value=500 s/mm2)after routine MRI examination(saginal T2 WI,T1 WI and axial T2 WI).Apparent diffusion coefficient(ADC)was measured with GE-Functool DWI software.Pearson correlation analysis was used for the statistics.Results There was a decreasing tendency in ADC value with age.A positive correlation was found between ADC(0.241×10-3 mm2/s)and BMD results measured by both DXA (1.038 S/cm3)and QCT(104.2 mg/cm3)examinations(r=0.461,0.731,respectively,P＜0.01).Conclusion DWI is an useful tool for noninvasive evaluation of the pathophysiologic changes of bone marrow in volunteers with difierent bone mineral density.

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

Objective To compare the surgical results between anterior fixation and posterior vertebral osteotomy in patients with old thoracolumbar fracture. Methods 39 cases of old thoracolumbar fracture with posttraumatic kyphosis and neurologic compromise underwent either anterior fixation (n=19) or posterior vertebral osteotomy(n=20). In the anterior group, the average patient age was 38.3 years (range:21 to 64), the mean time from injury to operation was 5.3 months (range:2 to 16), and the mean preoperative kyphotic angle was 25.2?(range:10?to 43?). In the posterior group, the average patient age was 39.9 years (range:18 to 68), the mean time from injury to operation was 5.6 years (range: 2months to 16 years), and the mean preoperative kyphotic angle was 27.6?(range:5?to 60?). Results In the anterior group, the mean operation time was 274 minutes (range:140 to 395) with a mean blood loss of 994 mL (range: 300 to 2000), the mean postoperative kyphotic angle was 14.7?(range: 0?to 35?), and the mean angle of correction was 10.5 ?(range: 5?to 16?). In the posterior group, the mean operation time was 283 minutes (range:190 to 390) with a mean blood loss of 1654 mL (range: 800 to 3800), the mean postoperative kyphotic angle was 4.4?(range:-10?to 35?), and the mean angle of correction was 23.2?(range: 7?to 40?). All the patients with incomplete neural injury had improvement of neurologic function. Conclusion The posterior vertebral osteotomy can produce better results in kyphotic correction, while it does not increase the trauma of operation.

Objective To introduce a single level fixation and reduction for cervical dislocation. Methods 15 patients who had old cervical dislocation were treated from May 2003 to April 2004. All the patients had facet locking that could not be reduced though traction. We used posterior approach to relax facet locking and thick Ethicon wire to fix spinal process. We used anterior poach to plug coralline hydroxyapatite (CHA) as the graft. AO plates and locking screws were used to fix the vertebral body. Results All the patients got satisfactory reduction and good alignment through lysis of facet locking and CHA plug. Conclusion The posterior decompression combined with anterior stabilization can achieve satisfactory reduction and alignment for dislocation of inferior cervical vertebra.

In this study, 101 strains of bacteria were isolated from arct ic water and sediment samples. The methanol extracts of the fermented broth prod uced by these strains were screened in vitro for anti-tumor activity on mou se tsFT210 cells using the method of flow cytometry, and screened for antibacter ial activity by the method of paper disk diffusion. The result showed that one strain exhibited anti-tumor activity and eight strains had antibacterial activ ity. The stability of the antibacterial components produced by strain AR084 an d its optimum medium were also studied. The research indicated that arctic bac teria had potential application in pharmaceutics.

Proper timing of repair is one of key factors predicting long-term prognosis of iatrogenic biliary injury.Local inflammation is proved related to long-term biliary stricture.This article introduces pathological procedure of biliary injury based on pathophysiological mechanism and animal model rescarch of wound healing,and how to increase intraoperative repair rate based on the clinical evidences.The preoperative active inflammation control and systemic management could create necessary conditions for the the subsequent early repair.At the same time,authors suggest to set individual strategy regarding timing of repair.Delayed repair is recommended for combined vascular injury or severe biliary injury with terrible contamination.

Objective To investigate the related risk factors of the previous cemented vertebral body re-wedge after percutaneous kyphoplasty (PKP).Methods In this retrospective case-control study,clinical data of 617 patients treated by PKP from December 2008 to November 2014 were analyzed.According to whether the cemented vertebra wedged again,the patients were divided into cemented vertebral re-wedge group (n =12) and non-cemented vertebral re-wedge group (n =605).The data of age,preoperative bone density,preoperative vertebral osteonecrosis,intraoperative bone cement injection amount,postoperative bone cement leakage,postoperative bone cement filling,postoperative recovery rate of vertebral wedge angle,and presence or absence of adjacent old vertebral wedging were recorded in two groups.All patients were followed up for one year,and the data were summarized and statistically analyzed.Results Single factor analysis showed the factors of whether there were adjacent old vertebral wedge,preoperative vertebral osteonecrosis,cystic bone cement filling,different wedge angle recovery rate,and emergence of previous cemented vertebral body re-wedge after PKP were statistically significant between two groups (P ＜ 0.05).There was no obvious statistical difference in age,preoperative bone density,intraoperative bone cement injection amount,and intervertebral bone cement leakage between two groups (P ＞ 0.05).Multivariate Logistic stepwise regression analysis showed cystic bone cement filling,preoperative vertebral osteonecrosis,adjacent old vertebral wedging,and higher recovery rate of vertebral wedge angle were prone to appear previous cemented vertebral body rewedge (P ＜ 0.05).Conclusions Relatively higher recovery rate of vertebral wedge angle,previous adjacent old vertebral wedge,vertebral osteonecrosis,and cystic bone cement filling are risk factors closely related to cemented vertebral re-wedge after PKP,which gives a good reference to assess surgical risk,avoid risk factors and choose right surgical techniques.