Adult ; Aged ; Aged, 80 and over ; Conjunctival Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell, Marginal Zone ; diagnostic imaging ; pathology ; radiotherapy ; surgery ; Male ; Middle Aged ; Orbital Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; surgery ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

Objective: To study the biocompatibility of CFR/PEEK composite in bone tissue after implanted in lumbar intervertebral space and to evaluate its role in the interbody fusion compared to the allograft bone. Methods: Thirteen beagles were chosen among which 7 were implanted with the disk-like CFR/PEEK composite in the lumbar intervertebral space and the other 6 were implanted with allograft bone. X-ray, QCT and histological examination were employed at 6, 12 and 24 months postoperatively. Results: The X-ray results of fusion segment were in conformity with the QCT's as well as that of histological results. All animals obtained a complete fusion at 24 months. Histological examination revealed that the anterior soft tissue to the implant exhibited a nonspecific foreign body reaction with connective tissue embed the biomaterials. Carbon fragment were seen in the surrounding tissue and some of the debric were phagocytosed by foreign body giant cell. Histological examination of bone and material revealed that new bone grew along the hole of CFR/PEEK implant. Conclusion: CFR/PEEK has an excellent biocompatibility to bone tissue.

Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy.Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected.The setup errors of two anatomic sites were determined by registration of MVCT images with planning images.Bland-Altman plot analysis was used to assess the coincidence of these two methods.Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34％,46％ and 28％ in lateral (x),longitudinal (y),vertical (z) directions,respectively.The deviation values of setup errors more than 5 mm were 10％,16％ and 8％,respectively.The BlandAltman plot analysis showed that the 95％ agreement limits of agreement were (9.3,-10.6),(10.5,-11.7),(7.3,-6.9) mm in x,y,z directions,respectively,which were all out of 5 mm tolerance.The Pearson coefficient of correlation along all three directions was less than 0.05,and R2 was 0.074,0.475,and 0.178 in x,y,z directions,respectively.Conclusions To determine the setup errors for patients with multiple metastases,single-site image guidance method is not consistent,and the two site image guidance method would be recommended.

Objective To investigate the correlation of T cell subgroups and natural killer (NK) cell's activity level of peripheral blood of the patients with refractory lymphoma. Methods Flow cytometry was applied to detect T cell subgroups' level and NK cell's activity of peripheral blood in 60 early cure lymphoma patients with chemotherapy before and 20 normal controls , after chemotherapy follow-up they were divided into 30 cases of difficult cure group and 30 cases of effective group. Results Compared with the normal controls, CD+4, CD+4/CD+8 and NK cell in lymphoma patients with chemotherapy before decreased (30.17±8.63 vs 46.52±1.39, t =12.218, P ＜0.05; 0.86±0.45 vs 1.64±0.05, t =11.225, P ＜0.05; 12.39±7.08 vs 19.29±0.84,t =6.365, P＜0.05), while CD+3 and CD+8 cell increased (76.14±10.71 vs 70.48±1.44, t =-3.439, P＜0.05;40.28±14.03 vs 28.35±0.73, t =-5.625, P ＜0.05). Compared with effective group, CD+4 CD+4/CD+8 and NK cell in difficult response group with chemotherapy before decreased (27.70±7.81 vs 33.13±8.82, t =2.163, P =0.036;0.67±0.27 vs 1.10±0.52, t =3.272, P =0.003; 9.87±6.60 vs 15.40±6.58, t =2.771, P =0.008), while CD+3 and CD+8 cell increased (79.67±8.18 vs 71.91±12.00, t =-2.540, P =0.015; 44.70±13.99 vs 34.98±12.41, t =-2.416,P =0.020). Conclusion The detection of T cell subgroups' level and NK cell' s activity in early lymphoma patients before chemotherapy may play a role to diagnose and predict the outcome of refractory lymphoma patients.

Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vit- rectomy for idiopathic macular pucker.Design Retrospective case series.Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker.Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed.Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks,and anatomic outcome after surgical managements.Result A total of 88 consecutive vitrectomies were included in the study.Of the 88 eyes,8 eyes had 14 iatrogenic retinal breaks detected,with an aver- age incidence of 9.1%.Peripheral retinal breaks(8.0%)were more common than posterior retinal breaks(1.1%).All peripheral retinal breaks occurred around the selerotomy sites(100%)and the quadrant of predominant hand was involved most commonly(62%).Most of the breaks(88%)were detected during the surgery.All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment (100%).Conclusion Despite improvements in instrumentation and surgical techniques,iatrogenic retinal break continues to be an im- portant complication of pars plana vitrectomy in eyes with idiopathic macular pucker.This complication tends to occur more commonly at peripheral retina and is mainly selerotomy-related.

Objective:To study the relationship between dynamic Hoffmann's sign(DHS) and the early diagnosis of cervical spondylotic myelopathy. Methods:Patients with neck, shoulder and back pain (218 cases) were employed in this investigation. Among them, 96 cases had positive reaction to DHS test and they received 3 7 years follow up as study group. The other 122 cases negative to DHS test were taken as control group. The clinical data included the patient's symptoms and signs, sagittal diameter of cervical spinal canal, Pavlov rate, angular displacement and horizontal displacement between cervical vertebral, etc . Results:There were 72 cases in study group developed cervical spondylotic myelopathy and needed operation during follow up. Meanwhile, 11 cases in control group received surgical treatment. The incidence of stenosis of cervical spinal canal, herniation of cervical intervertebral disc and instability of cervical spine in DHS group were significantly higher than that of the control group. Conclusion:DHS is closely related to the onset of cervical spondylotic myelopathy. The patients should be followed up closely if they present positive reaction to DHS, and should be operated on early when their neurological symptom is progressing.

0.05). X ray film revealed that there was no loosening and displacement of internal fixation device in the test group 3 days after operation. In control group, there were 2 cases of slight graft bone displacement. Both groups exhibited a stiff bone fusion at operative level 3 months later. The intervertebral disc height of fusion level increased by (1.2?0.7) mm in the test group while decreased by (1.5?0.8) mm in the control group. CT scan revealed that there was tight contact between the internal fixation device and bone 3 days after operation. Both groups had obtained bone fusion in CT image 3 months later. Conclusion:Threaded cervical interbody fusion device made from carbon fiber reinforced PEEK has an excellent biocompatibility and can restore the intervertebral disc hight effectively with satisfactory fusion rate.

Objective: To study the biocompatibility of CFR/PEEK composite in bone tissue after implanted in lumbar intervertebral space and to evaluate its role in the interbody fusion compared to the allograft bone. Methods: Thirteen beagles were chosen among which 7 were implanted with the disk-like CFR/PEEK composite in the lumbar intervertebral space and the other 6 were implanted with allograft bone. X-ray, QCT and histological examination were employed at 6, 12 and 24 months postoperatively. Results: The X-ray results of fusion segment were in conformity with the QCT's as well as that of histological results. All animals obtained a complete fusion at 24 months. Histological examination revealed that the anterior soft tissue to the implant exhibited a nonspecific foreign body reaction with connective tissue embed the biomaterials. Carbon fragment were seen in the surrounding tissue and some of the debric were phagocytosed by foreign body giant cell. Histological examination of bone and material revealed that new bone grew along the hole of CFR/PEEK implant. Conclusion: CFR/PEEK has an excellent biocompatibility to bone tissue.

OBJECTIVESTo determine the effect of destroying capsaicin-sensitive primary afferents (CSPA) fibers on paw withdrawal mechanical threshold (PWMT) induced by the direct compression of L5 nerve root with autologous disc.

METHODSThe procedure used autologous disc of the rats from the coccygeal intervertebral discs to apply direct pressure to the L5 dorsal root. PWMT was measured at the different time points post-surgery and pre-surgery. The changes in spatial expression pattern of c-fos protein in the spinal cord were also determined at 3 weeks when PWMT decreased to the peak.

RESULTSThe pretreatment with capsaicin produced a complete prevention of mechanical hyperalgesia induced by disc compression. The direct compression of L5 nerve root produced an obvious expression of fos-like immunoreactivity neurons in the dorsal horn of the spinal cord, which was significantly decreased by pretreatment with capsaicin.

CONCLUSIONSThe study shows that CSPA fibers, which mainly terminated in superficial layers of dorsal horn, may play a key role in mechanical hyperalgesia in the new sciatica model.

Afferent Pathways ; physiopathology ; Animals ; Capsaicin ; pharmacology ; Disease Models, Animal ; Hyperalgesia ; physiopathology ; Intervertebral Disc Displacement ; complications ; Male ; Pain Threshold ; drug effects ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sciatica ; etiology ; metabolism ; physiopathology ; Spinal Nerve Roots ; metabolism

OBJECTIVETo retrospectively analyses the results of dynamic axial external fixator with modified technique in the treatment of severely Pilon fractures.

METHODSFrom July 2000 to February 2003, 14 patients with severely Pilon fractures were treated with dynamic axial external fixator inserted with modified technique combined with limited open reduction and internal fixation with screws and Kirschner wires, with two distal external pins inserted into talus and calcaneus respectively so that the rotation axis of distal clamp was coincided with that of ankle joint. All patients were young or middle-aged people from 20 y to 52 y (average 38 y). All fractures were Rüedi-Allg were type II or type III. External fixators were removed after bone healing. Duration of follow-up was 5 - 36 m (average 18 m).

RESULTSThe time of bone healing was 12 - 24 weeks (average 14 weeks). At the latest follow-up, results include 5 excellent, 6 good and 3 fair according to ankle scoring system (ASS). There was only one case of superficial pin site infection settled with oral antibiotics and pin site care with mild disinfectants. There was no wound breakdown, superficial and deep infection, osteomyelitis, fracture fragments redisplacement and collapse.

CONCLUSIONDynamic axial external fixator with modified technique combined with limited internal fixation is an effective method for the treatment of severely Pilon fractures.

Adult ; Ankle Injuries ; surgery ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery