For the past few years.the number of patients with thoracolumbar fractures increased year after year.With the improvement of surgical instruments and surgical techniques and the health care workers'in-depth study about thoracolumbar fractures,posterior approach treatment of patients with thoracolumbar fractures has achieved an encouraging progress.Now summarization of research progress about operation opportunity,posterior instrumentation and modified posterior surgery is made in this paper.

Objective To evaluate the value of CT scan in diagnosis of the splenic lesions.Methods A retrospective analysis was made on the CT scans of 33 patients with surgically and pathologically proven splenic lesions,which included plain CT scan(n=33),biphasic contrast-enhanced CT scan(n=28)and contrast delay scanning(n=6).Results In 33 cases,non-neoplastic lesions were 6 cases,including tuberculosis(n=2),hematomas(n=3)and inflammatory pseudotumor associated with a cavernous hemangioma(n=1).Benign tumors were 13 cases,including cysts(n=5),hemangiomas(n=4),lymphanioma(n=1)and lymph-hemangiomas(n=3).Malignant tumors were 14 cases,including malignant lymphoma(n=8),metastases(n=4),malignant myofibroblastoma and hemangioendothelial sarcoma(n=1,respectively).Conclusion CT is of significant value in diagnosis of splenic lesions.

Objective To explore the relationship between the somatosensory evoked potential (SEP) diversification during operation and the short term outcome of ossification of posterior longitudinal ligament (OPLL) of cervical spine. Methods 70 OPLL inpatients from February 2008 to February 2011were included in this study. All patients received anterior cervical operation. According to the diversification of the SEP during surgery, the patients were divided into 2 groups. The preoperative and postoperative JOA scores of the OPLL patients were collected. Results There were 35 patients in the SEP no change group and 30 in SEP improved group. There was no difference in the preoperative JOA scores between them (P>0.05), but was significantly different in the postoperative JOA scores (P>0.05). Conclusion There is some relationship between the SEP diversification during operation and the short term outcome of OPLL of cervical spine.

Objective To explore the relationship of the radiological characteristics and clinical symptoms of ossification of the posteriorlongitudinal ligament (OPLL) of cervical spine. Methods 200 OPLL patients were recruited into this study. The data of JOA scores of theOPLL patients were collected. The stenotic rate of the cervical spine canal was calculated by the sagittal plane CT. The sorts and ossificatedcervicle were also identified by the images. Results The stenotic rate of the cervical spine canal was 19.8% to 60.3% with average 42.9%,the JOA scores was 4 to 15, averaged 10. Linear regression showed the stenotic rate of the cervical spine canal was negatively correlatedwith the JOA scores (P<0.01). There were 94 cases for segmental-type, 46 for mixed-type, 23 for continuous-type and 37 for focal-type. Thethird and fourth cervical vertebrae were susceptible to ossify. Conclusion The higher the OPLL occupation ratio, the worse the clinicalOPLL symptoms. The OPLL patients following clinical symptoms with spinal cord oppression are more likely the segmental-type.

Objective To analyze CT characteristics of metastatic liver leiomyosarcoma(MLL),and to improve the diagnostic accuracy of MLL.Methods CT manifestations and clinical characteristics of 5 patients with pathological-proved MLL were retrospectively analyzed.Plain and contrast-enhanced triphase(including arterial,portal phase in all cases and delayed phase in a part of cases) scans were performed.Results On plain scan,all lesions were hypo-dense."Bull-eye-sign" was found in two cases on contrast-enhanced scan,which is the typical metastatic feature.During arterial phase,the smaller lesions showed marked peripheral enhancement and central necrosis.The larger MLL presented as solid-cystic lesions,the parenchyma of tumor was rich in blood supply.Some cases presented mild hypo-dense or iso-dense comparing with the parenchyma of the liver on delayed phase.One case was misdiagnosed as hepatic hemangioma or focal nodular hyperplasia(FNH).Metastases were found out of the liver.Tumor thrombus of portal vein was not found in all of the cases.Conclusion MLL should be considered in the patients with history of extra-hepatic leiomyosarcoma,no marker expressions,no history of hepatitis,no tumor thrombus of portal vein and the special CT findings.

Objective To explore issues of the human tissue biobank, ranging from its establishment, collection and preservation of samples, quality control, management and application. Methods Development of standardized operational procedures, collection of such samples as fresh frozen tissues from the surgery, paraffin-embedded tissues, whole blood, serum, plasma, and cerebrospinal fluid. Specimens were classified and made aliquots according to different requirements, and then stored at room temperature, -80℃ refrigerator or in liquid nitrogen. Microsoft Access database system was used in the management of these specimens. Results From September 2004 to September 2008, a total of 11 872 samples from patients with benign and malignant diseases were collected and preserved. Among them, 4360 tubes of fresh frozen tissue samples from 2500 cases were provided within and beyond the province. These samples were also applied to DNA, RNA, protein extraction and tissue microarray, and immunohistochemistry-related research. Conclusion Human tissue biobank is highly useful in sharing human tissue resources effectively, as it can provide high quality specimens from benign and malignant diseases and normal control. In addition, it plays a very important role in exploring pathogenesis, developing new technologies for early detection of disease and new therapeutic strategies.

Objective To evaluate the effect of errorless learning on memory processes.Methods Eight- y-four participants were randomly divided into three groups:a group which received computer-assisted memory train- ing (CAMG,n=30) ,a therapist-administered memory training group (TAMG,n=24) and a control group (CG,n =30).A 20-session training course with a Chinese cultural background was tailor-made for Chinese subjects with memory disorders.It was administered over the course of one month to the test groups with a similar course structure and content but different delivery modes.The control group had no training.The Rivermead Behavioral Memory Test- Chinese Version (RBMT-CV) and the Hong Kong List Learning Test (HKLLT) were used to assess memory ability and process at the start and end of the training,and one month later.A repeated measures analysis of variance was used to compare differences across the three groups.Results Comparing pre-training with post-training and follow- up,RBMT-CV and HKLLT scores improved significantly.The CAMG group demonstrated better progress encoding and storage on the HKLLT (including the random and blocked conditions) than the TAMG group.Conclusions Errorless learning is likely to be an effective technique for improving memory function in patients with traumatic brain injury.Its effects last for at least one month.Computer-administered training was more effective than therapist-admin- istered face to face training,especially in improving encoding and storage memory processes.

ObjectiveTo explore the relationship of single nucleotide polymorphism (SNPs) of the bone morphogenetic protein-4 (BMP-4) gene with the morbidity and severity of the ossification of posterior longitudinal ligament (OPLL) of the spine in Chinese patients. MethodsThe venous blood samples of 200 OPLL patients and 200 non-OPLL controls were measured with the DNA sequences in four locus of BMP-4 gene with polymerase chain reaction(PCR). ResultsThere was a significant association between the rs17563，rs2855532 polymorphism and the occurrence of OPLL （P＜0.05）. The ''T'' allele in these 2 SNPs promotes the extent of OPLL (P<0.05). However, no significant association in morbidity and severity was found between the other 2 SNPs (rs1957860, rs2071047). ConclusionSNPs in rs17563，rs2855532 associates with the morbidity and severity of the ossification of posterior longitudinal ligament of the spine in Chinese patients.

Objective To realize the current situation of prevention and control of catheter-associated urinary tract infection (CAUTI)since the development of healthcare-associated infection(HAI)management in China in the re-cent 30 years.Methods Random cluster sampling was used to select 165 secondary and tertiary hospitals in 13 provinces and cities in China,questionnaires were filled in,the content included time,scope,method,data feed-back,and incidence of CAUTI monitoring.Results Of 165 hospitals,92.12% (152/165)have implemented targe-ted monitoring,the implementation rate in tertiary hospitals was higher than secondary hospitals (98.08% [102/104]vs 81.97%[50/61],χ2 =13.748,P <0.001).Most hospitals (82.24%[125/152])only implemented monito-ring in intensive care units(ICUs)or partial ICUs.HAI management professionals,HAI control doctors and nurses in 69.08%(105/152)of hospitals jointly took responsibility for CAUTI monitoring.95.39% (145/152)of hospitals diagnosed CAUTI by combination of clinical manifestations and laboratory examination results.98.68%(150/152) of hospitals have gradually implemented intervention measures,such as strictly mastering the indications of urinary indwelling catheters,hand hygiene of health care workers,non-frequent change of urinary indwelling catheters,and necessity for daily assessment of catheterization.75.66% (115/152)of hospitals conducted feedback of monitored results to the whole hospital.Incidences of CAUTI in pre-2010,2010,and 2015 were 3.10‰,4.72‰,and 1.89‰respectively.Conclusion In the recent 30 years,monitoring on CAUTI in China has obtained achievement,CAUTI monitoring is gradually standardized and scientific,but the development at all levels of medical institutions is still imbalance,which needs to be improved further.

Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.