Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

Objective: To explore the determinants for health-seeking behavior of the residents after cough for more than 3 weeks in Yiwu, Zhejiang Province, in order to provide reference for prevention and control of respiratory diseases. Methods: A multi-stage cluster random sampling method was used to recruit the community residents aged 5 years and above in Yiwu. A face-to-face questionnaire survey was conducted to collect demographic information, features of cough and health-seeking behaviors in the past month. The multivariate logistic regression model was employed to analyze the associated factors for health-seeking behavior after a cough for more than 3 weeks. Results: Among 6 374 residents investigated, 152 cases had a cough for more than 3 weeks in the past month, accounting for 2.48%. They were( 45.00±21.15 ) years old, including 70 ( 46.05% ) males and 82 ( 53.95% ) females. About 58.55% ( 89 ) of them sought medical treatment. The results of multivariate logistic regression analysis showed that females ( OR=2.100, 95%CI: 1.005-4.391 ), middle school education level ( OR=0.406, 95%CI: 0.168-0.983 ), family annual income of 100 000 to 199 999 yuan ( OR=2.993, 95%CI: 1.215-7.373 ) were associated factors for health-seeking behavior after a cough for more than 3 weeks. Conclusion The rate of health-seeking behavior after a cough for more than 3 weeks among the residents in Yiwu is 58.55%, which is associated with gender, education level and income.

AIMSD rats were utilized for the purpose of the exploration of effects of status epilepticus (SE) on their emotional behavior, spatial learning and memory, and explorating its molecular mechanism.

METHODSForty maturity male SD rats, weighing (200 +/- 20) g were divided randomly and equally into SE group (SG) and normal control group (NG). The SG rats were induced by Pentylenetetrazole (PTZ) and the control animals received a saline (0.9%) solution. The change of emotional behavior in two groups were tested in elevated plus maze. Furthermore, Morris water maze was applied to evaluate the effects by SE on spatial learning and memory in rats. At the same time, N-methyl-D-aspartate (NMDA) receptor NR1 subunit mRNA in the hippocampus was determined by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSIn elevated plus test, SE rats increased the times of visits as well as the time spent on the open arms of the elevated plus maze (P < 0.01). In Morris water maze, the mean escape latency for the SE rats looking for hidden platform in the place navigation test prolonged (P < 0.01). The efficiency of their search strategy was poor (P < 0.05). The swimming time in platform region and the percentage of their swimming time decreased (P < 0.01). The number of times they crossed the platform area decreased (P < 0.01). Meanwhile the expression of NR1 subunit mRNA in hippocampus was lower (P < 0.01).

CONCLUSIONThe experimental results showed that SE could result in the change of emotional behavior and damage of spatial learning and memory in rats. NR1 might be involved in the patho- and physiological process in causing these behavioral changes.

Animals ; Behavior, Animal ; drug effects ; Hippocampus ; drug effects ; metabolism ; Learning ; drug effects ; Male ; Memory ; drug effects ; Pentylenetetrazole ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Status Epilepticus ; chemically induced ; metabolism

BACKGROUND: Self-healing ability of the posterior cruciate ligament is poor, and the degradation and synthesis of extracellular matrix often follow the ligament repair. The matrix metalloproteinase family plays a critical role in the dynamic equilibrium between the matrix degradation and synthesis. OBJECTIVE: To investigate the effect of arthroscopic reconstruction of the posterior cruciate ligament, and to study its correlation with matrix metalloproteinase 2 level. METHODS: Sixty patients with posterior cruciate ligament rupture were studied, including 37 cases of autologous reconstruction and 13 cases of allogeneic reconstruction. Ligament and synovial cells from traumatic amputation patients with no ligament injury in the corresponding period were collected. Lysholm and Tegner scores were detected before and after operation. The results of postoperative drawer test were analyzed. The tibial displacement of the posterior cruciate ligament after autologous reconstruction and allogeneic reconstruction was compared. The posterior cruciate ligament cells were cultured alone or co-cultured with synovial cells, and then the level of matrix metalloproteinase 2 protein was detected. In addition, operation time, incision length, postoperative fever time and gender differences were also detected and compared.RESULTS AND CONCLUSION: Tibial displacement, irrespective of genders, was higher in the allogeneic reconstruction group than the autologous reconstruction group, while there were no significant differences in the posterior drawer test between the two reconstruction groups as well as between males and females. Postoperative Lysholm and Tegner scores were both improved significantly (P < 0.01). As time went by, the level of matrix metalloproteinase 2 had an increasing trend in the posterior cruciate ligament cells cultured alone or co-cultured with synovial cells, but the level in the co-culture group was higher than that in the single culture group. For both male and female, the autologous reconstruction group showed a longer operative time (P < 0.05 or 0.01) and a longer incision length (P < 0.01), as compared with the allogeneic reconstruction group, while the time of fever was significantly longer in the allogeneic reconstruction group (P < 0.01). Results from the last follow-up show that the autologous reconstruction is better than the allogeneic reconstruction to restore the stability of posterior cruciate ligament and shorten fever time, but longer operative time and surgical incision as well as increased level of matrix metalloproteinase 2 cannot be ignored.

Objective To study the effect and prognosis of percutaneous coronary intervention(PCI) for pa- tients with coronary artery disease(CAD).Methods Selected coronary angiography was performed in 31 patients with CAD.PTCA and stent implantation were performed in the patients of coronary stenosis(≥75 % in diameter). The effect and prngnosis of coronary interventionary therapy in patients were observed.Results The results of coro- nary angiongraphy suggested there were 18 patiens of coronary stenosis(≥75 % in diameter),PTCA and stent im- plantation were performed in 13 patients.Symptom was relieved greatly after the operation.There were 2 patients of coronary stenosis again,and 5 patients died.Conclusion Selected coronary angiography was an effective way to di- agnose CHD.The coronery interventioned therapy was not only effective in relieving symptom,but also in improving the quality of life of patients with CAD.

Objective To observe p53 expression in liver tissue of patients with chronic hepatitis B and its influencing factors.Methods 17 cases HBeAg-negative chronic hepatitis B patients and 31 cases HBeAg-positive chronic hepatitis B patients were divided into 2 groups.Results (1) HBeAg-negative chronic hepatitis B patients were older,mostly male and HBV DNA lower.These three indicators between two groups patients appeared statistical difference.Serum markers were no statistical difference between two groups patients except Glo.(2) Pathological inflammation and fibrosis Staging were no statistical difference between two groups patients.p53 expression positive rate and p53 expression semi-quantitative scoring in liver tissue were no statistical difference between the two groups.( 3 ) Logistic regression analysis showed that only liver fibrosis staging (S) is a risk factor for p53 expression.Compared with the S0-1,p53expression increased by 3.9 times the rate of positive in S ≥ 2.Conclusion Liver fibrosis staging in patients with chronic hepatitis B is a risk factor for p53 positive expression in liver.

Objective To investigate the effect of extract of ginkgo biloba leaf(EGb) during the formation of HBV-related hepatocellular carcinoma ( HCC ).Methods 99 HBV transgenic mice were randomly divided into control group,high-dose group,low-dose group.High-dose group and low-dose group were intraperitoneal injected 35mg/(kg · d) and 17.5 mg/( kg · d) of the shuxuening injection.Control group without special treatment.The serological markers and immunohistochemical markers in liver tissue will be done at the first 12 months and 18 months.Results ( 1 ) HBV transgenic mice can be found HCC at the 18 months.The incidence of HCC was lower in high-dose group and low-dose group,there was statistically different among the three groups.(2) The semi-quantitative scoring of liver HBx expression was highest in the control group at the 12 months.The semi-quantitative scoring of liver HBx,p53 and Bcl-2 expression was highest in the control group at the 18 months.They all appeared statistically different among the three groups.(3) Spearman correlation analysis showed that HCC incidence and liver tissue HBx,p53,Bcl-2 expression was a certain degree of positive correlation.r was 0.536,0.487 and 0.403,P ＜ 0.05.Conclusion EGb can reduced the incidence of the HCC with HBV transgenic mice.The reason may be that the EGb can reduce liver HBx,p53,Bcl-2 protein expression in the HBV transgenic mice.

Objective To detect the level of Serum and liver tissue TGF-β1 in patients with chronic hepatitis B, to study their relation to liver fibrosis and gain the evidence for diagnosis of liver fibrosis. Methods The liver fibrosis grades(S0-S4) of 131 cases with chronic HBV infection were diagnosed after liver biopsy. Serum TGF-β1 was detected by enzyme-linked immunosorbent assay, and the semiquantitative analysis was applied after detecting the expression of TGF-β1 in liver tissue with immunohistochemistry. Their relations to liver fibrosis were analyzed. Results Serum and tissue level of TGF-β1 increased significantly with the development of fibrosis, and the same result was obtained between themselves(P＜0.01). There was very significant difference for Serum level of TGF-β1 among the groups with different fibrosis grades (P＜0.01). Serum levels of TGF-β1 were decreased significantly comparing the Group S0 or S1 to S4(P＜0.005). There were significant difference for Serum level of TGF-β1 among S0 and the others(P＜0.005). And there was significant difference between S1 and S3(P＜0.005) .The expression level of TGF-β1 in liver tissue has no significant difference between group S3 and S4 (P＞0.05). However, the differences were significantly among the others comparisons(P＜0.01). Conclusion There is close relation between the level of TGF-β1 and the different liver fibrosis grades due to chronic hepatitis B. The serum level of TGF-β1 is a potential noninvasive maker for diagnosis of liver fibrosis.

OBJECTIVETo summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia.

METHODSFrom January 2001 to January 2006, 29 patients (31 hips) of adult dysplasia of hip were included in the study. Among them, there were 22 females and 7 males, age from 38 to 65 years with average of 53 years. According to Crowe classification system, there were 22 in type III, 9 in type IV, and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach. All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length, and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function.

RESULTSAll the patients had restoration of limb length (ranged from 2.5 cm to 4.5 cm). One case of postoperative dislocation was occurred due to slight large of acetabular obtuse angle. Follow-up for 1-5 years (average 3.2 years) in 29 patients, the Harris score increased to 85.4 postoperatively. All hips had released from pain and functioned well.

CONCLUSIONSIn order to restoration anatomic structure and physiologic function of affected hip, the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastic hip.

Acetabulum ; surgery ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Connective Tissue ; surgery ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the correlations of microvessel density (MVD), vascular endothelial growth factor (VEGF), thrombospodin1 (TSP1) and p53 protein with prognosis in epithelial ovarian cancer.

METHODSSamples from 57 patients with primary epithelial ovarian cancer were examined by immunohistochemical staining using anti-VEGF, anti-TSP1, anti-p53 and anti-CD34 antibodies. The correlation of MVD, expression of VEGF, TSP1 and p53 protein with postoperative recurrence and overall survival were analyzed retrospectively.

RESULTSVEGF, TSP1 and p53 protein was positively detected in 40 (70.2%), 27 (47.4%) and 35 (61.4%) of those patients, respectively. The mean MVD in this series was 30.3 +/- 8.5. High MVD, positive VEGF expression and negative TSP1 expression were positively correlated with postoperative recurrence. Univariate analysis showed that patients with high MVD, positive expression of VEGF and p53 had shorter median overall survival time than those with lower MVD, negative expression of VEGF and p53 (P = 0.0187, P = 0.010 and P = 0.005, respectively), while TSP1 expression was revealed as a protective factor for prognosis. Patients with positive expression of TSP1 had longer median overall survival time than those with negative TSP1 expression (P = 0.042). Multivariate analysis showed that MVD and p53 expression were two independent prognostic factors in epithelial ovarian cancer (P = 0.018 and P = 0.009, respectively).

CONCLUSIONVEGF, TSP1 and p53 protein may play an important role in the angiogenesis of epithelial ovarian cancer. High MVD level and p53 protein expression are two independent poor prognostic factors.

Adenocarcinoma, Clear Cell ; blood supply ; metabolism ; pathology ; Adult ; Aged ; Aged, 80 and over ; Cystadenocarcinoma, Serous ; blood supply ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Microvessels ; pathology ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Ovarian Neoplasms ; blood supply ; metabolism ; pathology ; Retrospective Studies ; Survival Rate ; Thrombospondin 1 ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism