Objective To investigate the selection and curative effect of surgical approach for thoracolumbar fractures. Methods A retrospective analysis was conducted on 212 patients with thoracolumbar fractures treated surgically from January 1995 to January 2009 to observe the spinal column and the neurological function recovery. Results Anterior surgery was performed in 73 patients and posterior surgery in 139. The patients were followed up for average 23.7 months ( range, 12-52 months). The height of injury vertebral, the Cobb' s angle and the volume of vertebral canal were improved significantly (P <0.01 ). The patients with incomplete paralysis all got nerve function recovery at different extents ( from one grade to three grades). Conclusions Surgical treatment for thoracolumbar fractures can effectively recover the spine structure and promote the nerve function recovery. The surgical approach should be selected based on the fracture type.

Sphincter of Oddi manometry (SOM) is considered the gold standard for the diagnosis of sphincter of Oddi dysfunction (SOD),especially the type Ⅰ SOD.The dysfunction of sphincter of Oddi can lead to other comorbidity.Therefore,SOM is of special importance for such patients.When performing SOM,we need to intubate into the papilla,so it requires high technique and is associated with a relatively higher risk of post-ERCP pancreatitis.Recently,the equipment of SOM is being updated constantly.The use of modified catheter and high resolution gastrointestinal dynamic system for recording and analyzing has made the technology more accurate and safe than ever before.Due to the widespread use of ERCP,SOM is expected to be one of the routine examinations in clinical practice and its application has a promising prospect.This article reviews the latest research progress on SOM in recent years.

[Objective]To evaluate the results of arthroscopic capsular release for the treatment of idiopathic frozen shoulder.[Method]From January 2004 to April 2005,7 patients with diagnosis of idiopathic frozea shoulder,who had symptoms for an average of 8.0 months(5 to 13months)with failed conservative treatment for at least 4 months,were treated with arthroscopic capsular release combined with rehabilitaticon exercises after operation.Under general anesthesia,all the patients underwent arthroscopic capsular release and manipulation.All patients were strictly evaluated by Constant score,normalized Constant score and the Visual Analog Scale(VAS 1 to 15 points,1 = no pain),before operation,at 3 weeks after operation,3 months after operation and 17.2 months after operation respectively.[Result]All patients were followed up with a mean of 17.2 months(8 to 23 months).The average in-hospital day was 8.1 days(7 to 10 days).All patients had significant improvement in terms of functional gain and pain relief after operntion.The preoperative pain score improved from(5.2?2.4)points to(11.2?2.0),(14.6?0.4)and(14.7?0.4)points at 3 weeks after operation,3 months after operation end 17.2 months after operation respectively.The Constant score improved from(24.5?14.2)to(47.0?18.8),(68.9?9.4)and(70.1?7.9),and the normalized Constant score improvad from(31.0%?17.3%)to(60.1%?24.9%),(87.1%?14.5%)and(89.7%?12.1%).There was no complication in the treatment procedures.[Conclusion]Arthrosenpic capsular release is a safe and effective surgical procedure in the management of idiopathic frozen shoulder unresponsive to conservative treatment.It has advantages of little invasive,better recovery,less operation time and less complications.

Objective·Giving the ovariectomized (OVX) mice exogenous estrogen replace therapy (ERT) so as to explore the inflammatory mechanism of estrogen in the pain modulation of OVX mice.Methods·Twenty-four 12-week-old female C57BL/6J mice were randomized into three groups:sham group (S),ovariectomy+placebo group (P),ovariectomy+estrogen group (E).The ERT began from one week after OVX and last for four weeks.Paw withdraw threshold (PWT) and paw withdraw latency (PWL) were measured at one day before OVX,and three days,one week,two weeks,three weeks,four weeks and five weeks after OVX.Concentrations of inflammatory cytokines in serum were measured at three days and five weeks postoperatively.Five weeks after operation,the lumbar intumescentia of spinal cord was taken and the expression of p38 was analyzed by Western blotting.Results·All the OVX mice's PWTs or PWLs were decreased after operation compared with non-operation mice;PWTs and PWLs were significantly different from group S separately from one week and three days after OVX (P＜0.01).The inflammatory cytokines of OVX mice were significantly higher than group S (both P＜0.01) at three days after OVX.Western blotting results showed that the p38 of group P was significantly higher than that of group S after five weeks postoperatively (P＜0.01).By receiving ERT,both PWTs and PWLs of group E increased slightly and were significantly different from group S (P＜0.01) at four and five weeks after OVX.At five weeks after OVX,inflammatory cytokines of group E were significantly lower than group P (P＜0.01) but still much higher than group S (P＜0.01).Meanwhile the content of p38 in group E was less than that in group P (P＜0.01).The p38 in group E was still more than group S,however it was no longer significantly different from group S (P＞0.05).Conclusion·Estrogen may reduce concentrations of inflammatory cytokines through the p38 MAPK pathway and plays an important role in the pain modulation of OVX mice.

Objective To investigate the efficacy of Kurokawa s open door expansive laminoplasty for the treatment of cervical spinal stenotic myelopathy. Methods Sixty seven patients admitted to Zhongshan hospital with cervical spinal stenotic myelopathy undergone Kurokawa s procedure in the last 6 years were included in this study. All of the patients were followed up after operation. The follow up period ranged from 10 months to more than 6 years. The average age at operation was 55.2 years. Japanese Orthopedic Association (JOA)score were used to measure the severity of cervical spinal stenotic myelopathy and recovery rates. Results JOA scores increased from 7.1 to 12.5, 12.9 and 12.8 at the first, third, and fifth postoperative year respectively(P

Objective To evaluate the effectiveness of laparoscopy in anterio r lumbar interbody fusion. Methods Twenty-three laparoscopic anterior lumbar int erbody fusions were performed in the period between December 2000 and December 2 002. There were 9 males and 14 females with a mean age of 52 years (range, 46 to 66 years). In this group, there were 18 of spondylolisthesis, 3 of lumbar spina l instability and 2 of degenerative disc treated with anterior lumbar interbody fusion using Syncage and autograft with balloon-assisted endoscopic extraperiton eal gasless exposure. The main complaints were low back pain radiating to leg. 1 3 cases were fused at L4,5 and 10 at L5S1. The Oswestry Disability Index (ODI) w as recorded to evaluate the function preoperatively, and in the 2nd week, 3rd, 6 th and 12th month postoperatively. X-ray was taken to observe the fusion and the subsided cage. Results The operative time ranged from 50 to 180 min with a mean of 120 min, and the bleeding volume ranged from 50 to 300 ml with a mean of 80 ml. There were complications in 2 cases, one which was caused by laparoscopic mi sguidance, and the other was bleeding due to a small vessel injury. All the case s were followed-up from 12 to 24 months, with a mean of 16.6 months. The ODI was found with significant difference comparing preoperatively to at 2nd week, 3rd, 6th and 12th month postoperatively (P

AIM: To compare pharmacokinetics and relative bioavailability of telmisartan capsule (T) and telmisartan tablet(R). METHODS: 20 male healthy Chinese volunteers were enrolled in a randomized two-way crossover designs with a single-oral dose study(80 mg once per day for each preparation). The plasma telmisatan concentration was determined by HPLC- fluorescence detector. Plasma levels of telmisatan were followed up to 96 h. Area under the telmisartan concentration time curve was calculated by variance analysis and the bioequivalent was determined by two one-side t-test. RESULTS: A two-compartment model was adopted in telmisartan plasma concentration-time data analysis. The pharmacokinetic parameters of T and R in single-dose study including Cmax (μg·L-1), Tmax (h), T1/2β (h), MRT(h), AUC0-92(μg·h·L-1) were as following: 456±253 and 760±314, 1.61±0.71 and 1.08±0.36, 22.39±6.29 and 21.08±5.24, 27.02±6.23 and 24.27±5.79, 3454±1050 and 3635±1300, respectively. Statistically significant differences were observed between the parameter values of the two products in Cmax and Tmax; whereas there was no statistically significant difference between AUC0-∞μg·h·L-1 (3601±1095 and 3767±1399). The relative bioavailability for T was 97.28%±12.74%. CONCLUSION: The test telmisartan capsule is bioequivalent to the reference tablet.

Objective To investigate the clinical effect of the bone graft fusion of the posterior lumbar interbody fusion (PLIF) combined with posterolateral fusion(PLF) in treating lumbar spondylolisthesis .Methods 63 cases of lumbar spondylolisthesis were performed the posterior unilateral or bilateral vertebral plate resection ,nerve root canal decompression ,clearing the slippage space , reduction ,fixation short-segment vertebral pedicle nail-stick system for reduction and fixation ,bone graft fusion with the interverte-bral space Cage and posterior-lateral bone graft fusion ,vertebral pedicle isthmus cracking was performed the clearance and bone graft fusion(PLIF combined with PLF ) .The JOA scores ,lumbar lordosis ,segment lordosis ,intervertebral space height ,slippage rate and complications were recorded before operation ,in postoperative 1 week ,6 ,12 months .Results All cases had no serious complications .The JOA scores were increased to some different degrees from the beginning of postoperative 1 week ,with the reha-bilitation time extension ,the JOA scores were gradually increased ,the improvement rate of the postoperative JOA score averaged 85 .00% .The lumbar lordosis ,segment lordosis ,intervertebral space height and slippage rate after operation were significantly im-proved compared with before operation ,the fusion failure rate was 4 .76% .Conclusion The bone graft fusion of PLIF combined with PLF is one of ideal methods to treat lumbar spondylolisthesis .

Objective To investigate the influence of gene therapy using survivin as a gene target on biological behavior of pancreatic carcinoma cell line. Methods Chemically synthesized siRNA and shRNA in pGCSi vector were used to silence survivin expression of pancreatic carcinoma cell line PaTu8988. The therapeutical effects of survivin as a gene target were evaluated through determination of the down-regulation of survivin gene expression, cellular shape, cell apoptosis, cell viability and apoptosis signal pathway changes. Results After transfection of different arrays of siRNA and shRNA vectors to silence the survivin expression, survivin mRNA and protein levels were significantly decreased (P < 0.05) ; PI staining revealed the presence of karyopyknosis, the cell apoptosis index was more than 20%; hypodiploid DNA content before G0/G1 detected by flow cytometry ; cell viability measured by MTT assay was significantly decreased (P <0.05) ; the activity of caspase-3 remarkably increased (P < 0. 05). Conclusions The pancreatic carcinoma cell line PaTu8988 be induced to promote spontaneous apoptosis procedure through silencing survivin expression by RNAi, which could accelerate carcinoma cell apoptosis and improve therapeutic effect on pancreatic carcinoma.

Acute Disease ; Animals ; Charcoal ; therapeutic use ; Enema ; Milk ; Paraquat ; toxicity