Graft vs Host Disease ; drug therapy ; Humans ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; therapeutic use

Objective To discuss the short-term clinical effect of K-Rod pedicle dynamic fixation system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,28 patients with multiple segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system were retrospectively reviewed. The short-term clinical effect were based on Oswestry disability index score,visual analogous scale ( VAS) ,improvement rate of low back pain,postoperative lumbar hyperextension, hyperbend X-ray film lumbar ROM value ( lumbar flexion mobility) ,average operation time, intraoperative blood loss. Results All of 28 cases were achieved 12 ~24 months follow-up,the difference of Oswestry disability index score and visual analogous scale ( VAS) between 12 months postoperatively and preoperatively were statistically significant,the improvement rate of low back pain was (87. 0 ± 2. 0)%,the average operation time was (99. 6 ± 16. 2) minutes,the average blood loss was (70. 5 ± 31. 5)mL,the average length of stay(ALOS) was (11. 2 ± 2. 6) days after sur-gery. Conclusion K-Rod pedicle dynamic fixation system in the treatment of multiple segmental lumbar degeneration can obtain satisfactory short-term clinical effect.

Objective To discuss the clinical effect and the notes of atlas lateral mass screws combined with posterior epistropheus ped-icle screws for the treatment of atlantoaxial joint instability. Methods In our hospital from January 2006 to January 2011,48 cases of atlan-toaxial joint instability accepted operation of the atlas lateral mass screws combined with epistropheus pedicle screws were analyzed. Results All patients with follow-up time 12~24 months,an average of 17 months,were achieved primary healing and atlanto-axial intervertebral osse-ous healing. Besides postoperative neck pillow area pain improved and nerve function get a degree of recovery,there was no inner fixed damage cases. Complications of operation include venous plexus hemorrhage was in 2 cases,cervical occipital pain and numbness increase in 3 cases,cere-brospinal fluid leak in 2 cases,vertebral artery extrusion occlusion after cerebral ischemic symptoms in 1 case. Conclusion Combination of atlas lateral mass screws and posterior epistropheus pedicle screws technique is one of the effective means of treatment of atlantoaxial joint instabili-ty and can obtain satisfactory clinical effect. Standard operation performance is the key to reduce or even eliminate surgical complications.

Objective Currently there is little study on the K-Rod pedicle fixation system in the treatment of far lateral lum-ber disc hernaition with multiple segment degeneration.The study was to compare the short-term efficay of K-Rod pedicle dynamic fixa-tion system and lumbar fusion for far lateral lumber disc herniation with multiple segment degeneration. Methods Retrospective a-nalysis were made on 56 patients with lumbar intervertebral disc herniation with multiple segment degeneration who received operation in General Hospital of Shenyang Military Region from January 2010 to October 2012.They were divided into K-Rod group (combined treatment of lumbar fusion and adjacent degenerative segment unfusion) and traditional fusion group according to different treatments. 28 patients in K-Rod group were treated with K-Rod pedicle dynamic fixation system and 28 cases in traditional fusion group were trea-ted with traditional lumbar fusion and internal fixation.Comparative analysis were made on the indexes before and after operation be-tween two groups, including Oswestry disability index, visual analogous scale (VAS) ,improvement rate of low back pain, postopera-tive lumbar spine X-ray, operation time, intraoperative blood loss and postoperative average length of stay. Results 12 to 24 months follow-up were achieved on 56 cases.The Oswestry function score and visual analog scale for both groups were improved significantly at 12 months after operation, and the difference was of statistical significance (P<0.05).Oswestry function scores and vis-ual analog scales between two groups were of no significant difference either before operation or after operation (P>0.05), while the average operation time ([119.6 ±14.2] min vs [155.5 ±17.5]min), the average blood loss ([235.5 ±32.5] mL vs [367.5 ±29. 5] mL), the average length of stay (ALOS) ([10.5 ±2.2] vs [14.2 ±2.6]d) between K-Rod group and traditional fusion group were of significant difference(P<0.05). Conclusion In the treatment of far lateral lumber disc hernaition with multiple segment degeneration, the K-Rod pedicle dynamic fixation system atrributes to less intraoperative blood loss, shorter operation time and little postoperative effect on lumbar spine mobility.

Objective The purpose was to compare the biomechanical characteristics of new percutaneous guide wire and conventional wire in cadaveric spines,and to evaluate the new percutaneous guide wire's efficacy and safety in a clinical trial.Methods Compared the push-out and penetration forces of the new percutaneous guide wire and conventional wire in fresh cadaveric lumbar spines from L1 to L5.And analyzed the related complications of new percutaneous guide wire by clinical experiment.Results Push-out forces caused the spiral part of the new percutaneous guide wire to bend or spread,so as to resist the anterior migration of the guide wire.The mean push-out forces of the new percutaneous guide wire and conventional wire were (15.5-+ 1.9) N and (5.7 ± 0.8) N respectively (P ＜ 0.01),and the mean penetration forces were (69.1 ±4.2) N and (37.1 ±4.8) N respectively (P ＜0.01).There was no wire breakage or anterior-wall penetration in the clinical trial of 222 new percutaneous guide wire.Conclusion The mean push-out and penetration forces of the new percutaneous guide wire were approximately 2 to 3 times greater than those of conventional wire.The new percutaneous guide wire effectively prevented guide-wire anterior migration and penetration of the anterior vertebral-body wall.The new percutaneous guide wire device could effectively improve the safety of percutaneous pedicle screw insertion procedures for patient with osteoporosis.

Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury

China ; Haplopappus ; Humans ; Phytotherapy ; Sesquiterpenes

Chromatography, Gas ; methods ; Chromatography, High Pressure Liquid ; methods ; Humans ; Hypnotics and Sedatives ; blood ; Pentobarbital ; blood ; Pharmaceutical Preparations ; blood ; Sensitivity and Specificity

Calcitonin ; blood ; Fluorine ; adverse effects ; Humans ; Occupational Exposure ; adverse effects ; Osteocalcin ; blood

ObjectiveTo assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD).Methods320-de-tector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD.ResultsIn 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21.9%) were involved by 320-detector row CTA. The distribution was consistent with that of TTE. Mean-while, there were one case of left circumlfex artery, one case of GCAA at distal of the right coronary artery, 2 cases of thrombus, 1 case of coronary stenosis and 2 cases of calciifcation.ConclusionsCAA caused by KD may be persistent for a long time. The thrombus, stenosis, and calciifcation of coronary can occurr at late phase in GCAA. TTE is sensitive and reliable to detect proxi-mal and middle segment of coronary lesions, but has limitations in detection of distal segment of coronary arteries. 320-detector row CTA has more comprehensively view of each coronary artery lesions and is especially sensitive and reliable to detect coro-nary thrombosis, calciifcation and narrowing in proximal and distal coronary arteries after acute phase.