[Objective]To evaluate the outcome on patients with primary infection of intervertebral space of the thoracolumbar spine following combined one-stage debridement,strut grafting and internal fixation.[Method] From May 1999 to February 2006,18 patients with spontaneous infection of intervertebral space were analyzed retrospectively.These infections occurred at thoracic spine in 3 cases(16.7%),thoracolumbar junction in 2 cases(11.1%),lumbar spine in 10 cases(55.5%),and lumbosacral junction in 3 cases (16.7%).Their clinical data and outcome were studied.None of all had previous spinal surgery or spinal injection,and their diagnosis were confirmed by histopathology after surgery.All patients were treated by one-stage debridement,strut grafting and internal fixation after failure of nonsurgical treatment.Antibiotics was used following debridement in the infection sites,and was continued to be administered after surgery.Patients were evaluated before and after surgery in terms of pain,neurologic level,sagittal spinal balance,and radiologic fusion.[Result]Postoperatively,all patients experienced significant relief of symptoms,and no fever.Six patients showed improved neurological status(at least one grade improvement on Frankel's functional classification).Only 3 of 18 cases had a positive culture result that pathogen identified Staphylococcus aureus.Histological examination of the specimen after surgery revealed that inflammation occurred in all patients,but no evidence of tuberculosis.The period of follow-up ranged 13 to 45 months with a mean of 26 months.No evidence of recurrence or residual infection was observed in any patient.Postoperative radiological evaluation revealed that implants were stable,there was no phenomena of prosthesis subsidence,hook dislodgment and failure restoration of spinal segments height.Solid bony fusion was obtained in all patients.Eight patients were misdiagnosed for spinal tuberculosis.[Conclusion] One-stage eradication of the infection,strut grafting and internal fixation are effective treatments for primary infection of intervertebral space.The presence of the instrumentations at the site of infection has no negative influence on the course of infection healing.

[Objective] A retrospective study was performed to evaluate the outcome of three-dimensional correction for adolescent idiopathic scoliosis(AIS)and discuss biomechanics of posterior three-dimensional correction surgery and measures for the prevention of spinal imbalance.[Methods]Thirty-one patients with AIS were classified and treated with three-dimensional correction surgery from 2005 to 2007.There were 18 male and 13 female with the average age of 15.2 years(range,11 to 18 years).The cases were classified according to the Lenke surgical classification,including type I 8 cases,type Ⅱ 4 cases,type Ⅲ 8 cases,type Ⅳ 2 case,type Ⅴ 5 cases,type Ⅵ 4 cases.The major curve Cobb's angles,the distance of apical vertebra shift and trunk shift,were measured and analyzed in the reoperative,postoperative and final follow-up radiographies.The average preoperative coronal Cobb's angle was 54?,the distance of both apical vertebra shift and trunk shift was 5.8 cm and 2.6 cm respectively.[Results]The mean time of follow-up was 16 months(range 1 to 3 years).The average postoperative coronal Cobb's angle was 21?,as the correction was 61%,the lost angle at the last follow-up was 4.0?.The postoperative distance of apical vertebra shift was 2.5cm,as the correction was 56%,the lost distance at the last follow-up was 0.5 cm.The distance of trunk shift at the last follow-up was 1.0 cm.[Conclusion]Posterior three-dimensional correction surgery is a good corrective method in the treatment of AIS.The spinal mechanical balance should be noticed during the operaion.

0.05).One case developed hemorrhage of venous plexus in the posterior pedicle screw fixation group.And complications occurred in 6 cases(4 of superior nerve injury,1 of intra-incision hematoma and 1 of esophageal injury).There were significant differences between 2 groups(P

Objective To assess the benefit of intraoperatively placed nasointestinal feeding tubes for early postoperative enteral nutrition.Methods The retrospective study was carried out on 19 cases of in-fants with long gap esophageal atresia who underwent one-stage operation in Xinhua Hospital from January 2006 to December 2013.Patients were divided into two groups according to whether the transanastomotic na-sointestinal feeding tubes(TNFT)were placed.Demographics,associated anomalies,operative findings,com-plications,duration of enteral nutrition(EN),length of stay were analyzed.Results Thirty-seven patients had long gap esophageal atresia and nineteen underwent one-stage operation.Eight patients were identified as TNFT group while eleven patients were identified as nonfeeding tube(NFT)group.There was no significant differences between the two groups in gestational age,birth weight,associated anomalies,anastomotic leak, weight gain,ICU-free days and length of stay(P>0.05).But the ventilator-free days(23.5 d vs.19.3 d), first EN time(0.8 d vs.9.1 d)and total EN feeding time(15.9 d vs.21.4 d)between the two groups were significantly different(P<0.05 ).Conclusion Intraoperatively placed TNFT may lead to earlier EN feeding and shorter parenteral nutrition duration,but a larger prospective study would be required to prove the benefits and ensure the safety.

Objective To explore the expression of CD133 and nestin in human glioma cell of patients with neuroglioeytoma and to see whether CD133 and nestin expression associate with the differentiation and pathologic grading.Methods The expression of CD133 and nesfin was detected by immunohistochemistry staining in 65 cases of human glioma and 19 specimens of normal brain tissues.Results The rate of the CD133 positive ceUs was 18.46%in human glioma and 0 in the control group(P＜0.01),and that of nesfin was 23.79%and 5.16%respectively.The positive cell rates of CD133 or nestin varied accordingly to different pathological grades.There were significant difference between grade Ⅰ and grade Ⅲ or grade Ⅳ (P＜0.01).There were difference between grade Ⅱ and grade Ⅲor grade Ⅳ (P＜0.01).The same significance were also found between grade Ⅲ and grade Ⅳ(P＜0.01).The higher pathological grades had higher positive cell rates.There was a significant corl~lation between the rate of CD133 positive cells and that of nestin in experimental group (r=0.408,P＜0.01).Conclusion Detecting CD133 and nestin in the human glioma can be used in diagnosing,judging the malignancy degree and the prognosis.

Gastroesophageal reflux(GER) has a close association with asthma through vagal nerve.Cholinergic nerve and cholinergic receptors might play an important role in the development of GER-induced asthma,indicating that anti-cholinergic drugs may have therapatic potential in the treatment of asthma induced by gastroesophageal reflux.

Objective To evaluate the short term clinical effect in treating hepatocelluler carcinoma combined transcatheter arterial chemoembolization(TACE) with huachan-shu injection.Methods Forty-three patients suffered with hepatocelluler carcinoma(HCC) were randomly divided into two groups.In the treatment groups,21 patients received Huaichan-shu injection after TACE,and 22 patients in the control group were treated with TACE simply,the serum a-fetal protein(AFP) was detected by raido-immunologieal technology.At the sam time,the observed indexes including the changes of symptoms and signs,side effects,ultra-sound,CT and liver or kidney fuctions were considered.Results In the treatment group.Six cases were evaluated as CR,9 PR and 3 NC.Compard with the control group CR,PR and NC were 3,5 and 11 cases respectively.The effective rate was 77% in the treatment group,which was superion to the control group(51.37%,P

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.

Objective To discuss the surgical effect of adult lipomatous tethered cord syndrome (TCS). Methods The clinical data of 29 patients with adult lipomatous TCS were systematically analyzed. Eleven of male and 18 of female,who ranged from 20 to 59 years. All patients were performed filum terminale release and lipoma excision, the clinical outcome after operation was analyzed according to Hoffman grading criteria and visual analog scale (VAS). Results According to Hoffman grading criteria, 9 cases were obviously improved in leg muscle weakness, including 1 case with urination disturbance improved significantly. Also the lower back pain of patients were improved obviously: (2.63 ± 1.30) scores vs. (8.67±0.30) scores, there was significant difference (P<0.05). Conclusions Filum terminale release and lipoma excision can effectively improve the symptom of lower back pain of adult lipomatous TCS patients, meanwhile the symptom of paraparesis can improve appropriate postoperatively. But urinary deficits do not show a significant change.

Objective To determine the relation between the graduation and type of Modic change and low back pain. Methods Ninety-seven patients with low back pain associated with Modic change were enrolled, and the data of clinical were analyzed. The degree of back pain was evaluated by visual analog score (VAS) and Oswestry disability index (ODI). The relation between Modic change and the degree of low back pain was evaluated. Results In 97 patients, the type of Modic change:28 cases (28.9%) were type Ⅰ, 37 cases (38.1%) were type Ⅱ, 11 cases (11.3%) were Ⅱ/Ⅲ, and 21 cases (21.6%) were type Ⅲ. The graduation of Modic change:39 cases (40.2%) were minimal, 34 cases (35.1%) were moderate, and 24 cases (24.7%) were severe. The VAS of type Ⅰ, type Ⅱ, typeⅡ/Ⅲand typeⅢin patients with Modic change were (3.8 ± 0.4), (2.6 ± 0.2), (1.7 ± 0.5) and (1.0 ± 0.6) scores, and there were statistical differences (P<0.05). The ODI scores of type Ⅰ, type Ⅱ, type Ⅱ/Ⅲ and type Ⅲ in patients with Modic change were (11.8 ± 0.7), (8.4 ± 1.1), (5.7 ± 1.3) and (2.0 ± 1.0) scores, and there were statistical differences (P<0.05). Spearman correlation analysis result showed that the type of Modic change was negatively correlated with the intensity of low back pain (r=-0.342, P<0.01). There were no statistical difference in VAS and ODI score among the patients with minimal, moderate and severe of Modic change (P>0.05). Spearman correlation analysis result showed that the graduation of Modic change had no correlation with the intensity of low back pain (r = 0.351, P>0.05). Conclusions The graduation of Modic change does not directly correlate with the low back pain, but the type of Modic lesion is more important.