OBJECTIVETo analyze the reason and strategy for failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures.

METHODSFrom March 2008 to December 2010,the clinical data of 18 patients with thoracolumbar fracture failed in posterior pedicle screw short-segment internal fixation were retrospectively analyzed. There were 11 males and 7 females with an average age of 37.2 years (ranged, 19 to 63). The time from the first operation to complication occurrence was from 6 to 44 months with an average of 14.3 months. Of them,fusion failure was in 7 cases (combined with screw breakage in 4 cases), the progressive neuro-dysfunction was in 5 cases,the progressive lumbodorsal pain was in 6 cases. All 18 patients with kyphosis were treated with anterior internal fixation remaining posterior fixation (9 cases) and anterior internal fixation after posterior fixation removal (9 cases).

RESULTSAll the patients were followed up from 18 to 50 months with an average of 30.5 months. No intetnal fixation loosening and breakage were found, moreover, X-ray and lamellar CT showed bone healing well. Preoperative, postoperative at 3 months and at final follow-up, ODI score was respectively 31.6+/-5.1, 8.6+/-5.7, 8.3+/-3.2; VAS score was respectively 7.2+/-2.3, 2.3+/-0.7, 2.1+/-1.1; kyphosis angle was respectively (-21.2/-+7.8 degreeso, (-5.3+/-6.8 degrees ), (-5.8+/-7.8 )degrees. Compared with preoperative data ,above-listed items had obviously ameliorated(P<0.05).

CONCLUSIONTreatment of thoracolumbar fracture with posterior pedicle screw short-segment internal fixation may result in the complications such as bone nonunion ,internal fixation breakage and progressive kyphosis. Anterior reconstruction may be a good strategy for the failure of posterior operation.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

Aimed at feasibility of microbiological control of Chironomidae larvae in sourcewater, Shenzhen, China, the functional characters of Bacillus thuringiensis subsp. Iaraelensis to Chironomus kiiensis tokunaga were studied for the first time. In this study, bioassays were carried out with third-instar larvae, results showed that the LC 50 s(24h) were 24.2 and 32.6 mg/L for Bacillus thuringiensis subsp. Iaraelensis IPS82 and 187 respectively. Tests in fermentation of IPS82 show good correlations between toxicity, cell density, dissolved oxygen and spore-forming phase. The tests on environmental factors influencing toxicity to Chironomus kiiensis tokunaga showed that sunlight is the most important factor, shortening the half life of Bti from 21 days in dark to 10 days; temperature variations(15～30℃) caused no impact on toxicity, but 35℃ increases 16% of larvae mortality. The toxicity of IPS82 is relatively insensitive to change pH deviated from 7 to 11, due to drop of larvae mortality from 66.7 to 40%, at pH of 3, to 16%; its toxicity is stable in low larva density (

Metabolic abnormalities were identified and carotid intima-media-thickness(IMT)was measured in 221 individuals at risk for metabolic syndrome(MS).The results indicated that IMT was significantly thicker in MS individuals than that in non-MS individuals(P＜0.01).And there was a tendency of progressive increase in IMT with increasing components of metabolic syndrome.

Objective To observe the effect of atorvastatin on mixed dyslipidemia in type 2 diabetic patients. Methods 39 patients of type 2 diabetic with mixed dyslipidemia were taken with atorvastatin for 6 months,and the change of total cholesterel(TC),triglyceride(TG),low-debsity-lipoprotein-cholesteral(LDL-C),high-debsity-lipopro- tein-cholesteral(HDL-C)were observed.The incidence of side-effect was recorded.Results TC,TG,LDL-C were obviously reduced and their extent of reduction were 26.17 %,54.97 %,38.92 %.HDL-C was obviously increased and it's extent of increase was 14.81%(P

Objective To detect the differentially expressed microRNAs (miRNAs) in bladder cancer tissue and normal bladder tissue. Methods Total RNA was extracted from bladder cancer tissue and normal bladder tissue by Trizol, and then miRNAs were isolated and enriched from the total RNA. Mammalian miRNA microarrays were used to analyze the differentially expressed miRNAs between the bladder cancer tissue and normal tissue. Data analysis was performed by software of LuxS-can3. 0 and SAM version 2. 1. Choose let-7 gene which was interesting to us, and validation of mi-croarray results was carried out by northern blotting. Results Compared with normal bladder tissues, there were 71 differentially expressed miRNAs in bladder cancer tissue, of which there were 38 down-regulated ones and 33 up-regulated ones. Among these miRNAs, 26 miRNAs were the most significant with 12 up-regulated and 14 down-regulated. The expression of let-7 gene in bladder cancer was down-regulated to normal bladder tissue by northern blotting, which was in agreement with the results of the miRNA microarrays. Conclusion There are differentially expressed miRNAs between bladder cancer tissue and normal bladder tissue, and let-7 gene is probably as a tumor suppressor in bladder cancer.

3 month),fluid sign was observed in 2(3 vertebrae,3/26,11.5%). Conclusion Fluid sign is characteristic in acute,subacute and early chronic trauma vertebral compression fracture for bone marrow edema,while it is rare in metastatic tumor vertebral compression fracture.It may paly a role in the differentiation of benign and malignant vertebral compression fracture.

To investigate the influence of Anxin granules combined with tirofiban on acute myocardial infarction (AMI) Patients after elective percutaneous coronary intervention (PCI). One hundred and twenty AMI patients were randomly divided into treatment group and control group. The patients in the two groups were all given Tirofiban 30mins before PCI . The treatment group was added Anxin granules 30 mins before and after PCI. Tissue factor (TF) and von willebrand factor (vWF) were tested at 6 hours after operation. Syndromatology alteration of traditional Chinese medicine (TCM) and bleeding complications were observed at 4 weeks after operation. Both TF and vWF at 6 hours after operation of the treatment group was lower than the control group significantly (P < 0.01), while the condition of myocardial ischemia at 90 mins after operation of the treatment group was better than control group with significance. The syndromatology alteration of TCM especially spontaneous perspiration and hypodynamia of the treatment group were improved significantly compared to control group 4 weeks after operation. All patients in both groups had no bleeding complications and thrombopenia. The study suggests that Anxin granules combined with tirofiba can improve the clinical efficacy and the endothelial function of AMI patients after PCI with no increase in bleeding events.
Aged ; Angioplasty, Balloon, Coronary ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; complications ; metabolism ; surgery ; Postoperative Hemorrhage ; drug therapy ; etiology ; metabolism ; prevention & control ; Thromboplastin ; metabolism ; von Willebrand Factor ; metabolism

BACKGROUNDSubclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma.

METHODSSix patients with spontaneous remission of acromegaly or gigantism were enrolled. The clinical characteristics, endocrinological evaluation and imageological characteristics were retrospectively analyzed.

RESULTSIn these cases, the initial clinical presences were diabetes mellitus or hypogonadism. No abrupt headache, vomiting, visual function impairment, or conscious disturbance had ever been complained of. The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher, but nadir GH levels were all still > 1 µg/L in 75 g oral glucose tolerance test. Magnetic resonance imaging detected enlarged sella, partial empty sella and compressed pituitary. The transsphenoidal surgery was performed in 2 cases, and the other patients were conservatively managed. All the patients were in clinical remission.

CONCLUSIONSWhen the clinical presences, endocrine evaluation, biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly, the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed. To these patients, conservative therapy may be appropriate.

Acromegaly ; diagnosis ; etiology ; Adolescent ; Adult ; Aged ; Female ; Gigantism ; diagnosis ; etiology ; Growth Hormone-Secreting Pituitary Adenoma ; complications ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Neoplasms ; complications ; Young Adult

OBJECTIVESTo investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins.

METHODSA retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis.

RESULTSThe median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor.

CONCLUSIONSRe-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Female ; Follow-Up Studies ; Frozen Sections ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; surgery