[Objective]To evaluate the outcomes of treating thoracolumbar burst fractures in young adults with posterior short-segment pedicle screw fixation without fusion by analyzing the clinical and radiographic parameters.[Method]Fifty-four patients with thoracolumbar burst fractures from June 2002 to April 2006 were investigated retrospectively.Thirty-one patients were male and 23 were female.The mean age was 31 years.All patients underwent open reduction and posterior short-segment pedicle screw fixation without bone graft fusion,and had their implants removed at 12 to 20 months post-operatively.Pain status was evaluated using the visual analog scale(VAS).Changes in the anterior vertebral height ratio,Cobb′s angle,and vertebral wedge angle were measured preoperatively,postoperatively,before implant removal,and at 2 years after implant removal.[Result]Thirty-two patients were available to follow-up,with an average period of 43 months(range,36-56 months).A good correction was gained and pain was released significantly after surgery.The loss of correction was statistically significant and there were 4 patients suffering from screw broken before the instrumentation removal,however.A progressive kyphotic deformity (Cobb′s angle increased while vertebral wedge angle unchanged) was caused by the collapse of the intervertebral disc space while the reduced vertebral height was stable after the implant removal.No significant correlation was found between the final kyphosis and pain scale.[Conclusion]Short-segment pedicle screw fixation without fusion can provide good reduction and sustained corrective height if adequat indication of thoracolumbar burst fractures has been choosen.Earlier implant removal can regain local segmental motion.

Objective To investigate the influence of tiotropium bromide on lung function index,quality of life and re-hospitalization risk of patients with bronchial dilation and pulmonary infection.Methods 100 patients with bronchiectasis and lung infection were chosen,and they were randomly divided into control group (50 patients) with BAL used alone and observation group(50 patients) with tiotropium bromide on the basis of control group.The short-term clinical effects,the levels of FVC,FEV1 and FEV1 ％,BODE index scores and QLI scores before and after treatment,and re-hospitalization rate of the two groups were compared.Results The short-term effective rate of the observation group was significantly higher than that of the control group(94.00％ vs.76.00％,x2 =7.81,P ＜ 0.05).The levels of FVC,FEV1 and FEV1％ after treatment of both two groups were significantly higherthan before treatment[(2.78 ±0.57)L vs.(2.15 ± 0.33) L,(3.60 ± 0.71) L vs.(2.20 ± 0.36) L;(2.15 ± 0.42)L vs.(1.23 ±0.32)L,(2.77±0.59)L vs.(1.17 ±0.29)L;(65.25 ±11.45)％ vs.(51.79 ±9.23)％,(77.46 ±15.80) ％ vs.(52.02 ± 9.36) ％,t =2.34,2.97;2.52,3.07;2.47,3.12,all P ＜ 0.05].After treatment,the levels of FVC,FEV1 and FEV1 ％ of the observation group were significantly higher than control group [(3.60 ± 0.71) L vs.(2.78 ±0.57)L;(2.77 ±0.59)L vs.(2.15 ±0.42)L;(77.46±15.80)％ vs.(65.25 ± 11.45)％,t =2.26,2.44,2.30,all P ＜0.05].The QLI score and BODE index scores after treatment of both two groups were significantly better than before treatment[(3.37 ± 0.54) points vs.(3.95 ± 0.65) points,(2.11 ± 0.40) points vs.(3.87 ±0.61)points,(7.28 ±1.18)points vs.(5.04 ± 0.95) points,(8.69 ± 1.54) points vs.(5.13 ±0.98) points,t =2.29,2.81;2.50,2.96,all P ＜ 0.05].After treatment,the QLI score and BODE index scores of the observation group were significantly better than the control group[(2.11 ±0.40) points vs.(3.37 ±0.54) points,(8.69 ± 1.54) points vs.(7.28 ± 1.18)points,t =2.21,2.44,all P ＜ 0.05].The re-hospitalization rate of the observation group was significantly lower than that of the control group (16.00％ vs.2.00％;28.00％ vs.6.00％;x2 =8.02,9.74,all P ＜ 0.05).Conclusion Selective cholinergic receptor blocker combined with BAL in the treatment of patients with bronchial dilation and pulmonary infection can efficiently relieve the respiratory symptoms,improve lung function,improve the quality of life and is helpful to avoid re-hospitalization occurrence.

Objective To assess the clinical results of crossing cannulated screw fixation for intra-articulsr calcaneal fractures.Methods A total of 65 patients (72 sides) were retrospectively studied from July 2012 to June 2015 by case-control study,including 63 males and two females at age range of 18-70 years [(45.7 ± 12.2) years].According to the Sanders classification,there were 49 fractures of type Ⅱ (25 type Ⅱa,17 type Ⅱb,7 type Ⅱc) and 23 fractures of type Ⅲ (12 type Ⅲab,6 type Ⅲac,5 type Ⅲ bc).The cases had been divided into two groups,namely,the crossing caunulated screw fixation group (CCSFG group,30 cases) and plate fixation group (PFG group,42 cases).The results were compared with regard of the hospitalization time,fracture reduction and union,AOFAS score system,and complications.The calcaneal shape was assessed by the length,width,height,Bhler angle and Gissane angle.The foot function was assessed by the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score system.Results All were followed up for 6-24 months [(15.2 ± 4.7)months],and presented fracture healing.The time of hospitalization was (10.2 ± 2.3)days (7-14 days) and (18.6 ±3.3)days (13-28 days) in CCSFG and PFG groups,respectively(P ＜0.05).At the first and final visits during follow-up,the changes in calcaneal width and B(o)hler angle of CCSFG group were smaller than that of PFG group (P ＜ 0.05).For Sanders Ⅱ type cases,the average AOFAS function scores in CCSFG and PFG groups were (89.3 ± 6.8) points and (90.1 ± 8.1) points,respectively (P ＞ 0.05).For Sanders type Ⅲ cases,the corresponding scores in CCSFG and PFG groups were (83.5 ± 10.8) points and (82.5 ±7.3)points,respectively (P ＞0.05).The complication rate in the CSFG and PFG groups was 20％ and 19％,respectively (P ＞ 0.05).Conclusions Compared with the plate fixation,the crossing cannulated screw fixation has advantages of less invasion,better stability,shorter hospitalization time,faster functional recovery and can be recommended as the first choice for mild to moderate comminuted calcaneal fractures.

Criteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15％.The sensitivity and specificity of screening memory impairment increased by 18.1％ and 11.6％,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5％ and missed diagnosis was decreased by 34.5％.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.