Dendritic Cells ; Humans ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

Objective To evaluate the effects of different sequences of intravenous administration on sufenta-nyl-induced cough during induction of general anesthesia.Methods One hundred patients,aged 20 ~60 years,weig-hing 45 ~82 kg,ASA Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to two groups by using a random number table:sufentanyl-propofol group(group SP)and propofol-sufentanyl group(group PS).In group SP,sufentanyl 0.4μg/kg was injected intravenously over 5s,and then propofol 2mg/kg was injected intravenously.In group PS,propofol 2mg/kg was injected intravenously,and then sufentanyl 0.4μg/kg was injected intravenously over 5s.The occurrence,intensity and the time of cough were recorded within 1 min after sufentanyl injection.Results The incidence of cough was 38%(19 /50)in group SP which was significantly higher than the 12%(6 /50)in group PS(χ2 =9.013,P <0.01);The time of cough was (20.6 ±5.8)s in group SP and (18.8 ± 8.4)s in group PS,which had no statistical significance(t =1.247,P >0.05).Conclusion Administration in the propofol-sufentanyl sequence can effectively reduce the occurrence of sufentanyl-induced cough as compared with that in the sufentanyl-propofol sequence during induction of general anesthesia.

[Objective]To observe the clinical results of adjustable hollow titanium artificial vertebra in the treating of tumor,tuberculosis and severe burst fracture of the thoracic and lumber vertebra.[Method]Totally 169 cases of thoracolumbar fractures were treated,including 64 cases of tumor,66 cases of tuberculosis and 39 cases of severe burst fracture of the thoracic and lumber spine,of which 57 cases with kyphosis of those Cobb's angle was 27.1~65.4 degrees with a mean(38.5?10.7)degrees,were treated by one-stage procedure,including pathologic vertebral resection,anterior interbody reduction and implant adjustable hollow titanium artificial vertebral body,anterior internal fixation or posterior transpedicular fixation,reconstruction of spinal stability.For anterior stabilization,the Centaur plate system,Z-plate and XIAⅡrod-screw spinal system were used.Relief of the pain,the function of spinal cord or nerve,kyphosis collection and spinal stability were monitored.[Result]Postoperatively,the period of follow-up lasted 12 months to 46 months with a mean of 32 months.All these patients had their incision healed by first intention,and no recurrence was noted in those patients of tumor and tuberculosis.All patients experienced significant palliation local pain,and 73 patients showed improved neurological status(at least one grade improvement on Frankel's functional classification).The instrumentation provided immediate stability and protected against development of kyphotic deformity in all patients.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.The residual kyphotic deformity had been corrected by(31.6?8.3)degrees with a mean(6.2?8.7)degrees after operation.[Conclusion]Pathologic vertebral resection,artificial vertebral body replacement and internal fixation are ideal treatmens in thorough decompression,release of pain,reconstruction of spinal stability and resume of spinal sequence.

[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.

BACKGROUND:Creation of a precise finite element model is an important basis for the finite element mechanical analysis of the spine. The reports on the precise finite element model are less.
OBJECTIVE:To create L 3-L 5 lumbar three-dimensional finite element model and validate this model with normal CT data.
METHODS:A 39-year-old male healthy volunteer with the height of 175 cm and weighted 65 kg was selected, then the L 3-L 5 lumbar spines were scanned with 16 row spiral CT to obtain 101 CT images with the thickness of 1.25 mm. Solid geometric model was established with Geomagic9.0 software, then determined the unit type,
divided the finite element mesh, and established the finite element model for loading and calculating.
RESULTS AND CONCLUSION:A L 3-L 5 lumbar three-dimensional finite element model was established. It
included 213 736 nodes and 799 779 elements. The ranges of motion of L 3-L 4 and L 4-L 5 segments of the model were consistent with cadaveric biomechanical testing results, verified the effectiveness of the model, so the
model could be used for experimental research.

BACKGROUND:The type AO-C1 thoracolumbar acute spine injury is a kind of high-energy instable injury, can cause thoracolumbar fracture-dislocation, and mainly associated with spinal nerve injury. Generaly, al needs to posterior open reduction, decompression, bone graft fusion and multiple-segmental internal fixation of pedicle screw rod system, which causes excessive loss of spinal movement segment and a large number of application of internal fixators. OBJECTIVE:To evaluate the treatment effect of posterior pedicle screw mono-segmental internal fixation for treatment of the type AO-C1 thoracolumbar vertebrae fracture-dislocations. METHODS:From January 2008 to December 2013, 17 cases of type AO-C1 thoracolumbar fracture-dislocation were folowed up. Al patients were treated with one-stage posterior open reduction and pedicle screw-rod fixation. Of them, eight cases received four screws and two rods for single-segment fixation in upper and lower vertebrae adjacent to intervertebral space after dislocation (4-screw 2-rod group). Nine cases received eight screws and two rods for multiple-segment fixation in the upper and lower vertebrae adjacent to intervertebral space after dislocation (8-screw 2-rod group). Operative time and intraoperative blood loss were compared between the two groups. The Cobb’s angle was measured on lateral X-ray film of two groups preoperatively and 1 week postoperatively and during the final folow-up. The neurological function was evaluated by Frankel classification. The visual analogue scale was adopted to assess the degree of low back pain. RESULTS AND CONCLUSION:Patients were folowed up for 1 to 5 years. Significant differences were detected in the operative time between the two groups, and operative time was better in the 4-screw 2-rod group than in the 8-screw 2-rod group (P < 0.05). No significant difference was found in intraoperative blood loss between the two groups. The deformity of fracture-dislocation had been corrected, and the pain of low back had significantly relieved in al patients after fixation. According to Frankel classification, two cases at Grade A were improved to Grade E, but eight cases at Grade A got no improvement after treatment. Two cases at Grade B were also improved to Grade E at the final folow-up. Significant differences in Cobb’s angle and visual analogue scale were detectable at 1 week postoperatively and during final folow-up as compared with preoperatively (P < 0.05), but no significant difference was visible between final folow-up and 1 week postoperatively. No significant difference in Cobb’s angle and visual analogue scale was observed between the 4-screw 2-rod group and 8-screw 2-rod group. Results indicate that there was no significant difference in the clinical efficacy between 4-screw 2-rod single-segment and 8-screw 2-rod multiple-segment fixation for treating type C1 thoracolumbar vertebrae fracture-dislocation. Therefore, AO-C1 thoracolumbar vertebrae fracture-dislocation could be treated with 4-screw 2-rod single-segment reduction fixation.

Objective To explore the improving way to repair the lower one-third of leg soft tissue defect transferred the adjacent flap with non-main vessel pedicle. Methods Analyzing 42 cases.using 4 kinds flaps with nonmain vessel pedicle.If it is fine the skin around soft tissue defect of the lower one-third shank,choosing adjacent adversed sural neurotaneous vascular flap or sapheenous nerve vascular flap.If the skin damaged,chosing gastrocnemius flap.If the soft tissue defect was large,combined adversed sural neurotaneous vascular flap with gastrocnemius flap.Osteomyelitis and peroneus previs musculocutaneous flaps were choosed for small soft tissue defect. Results All case observed 6 to 12 months,37 cases were survived completely,5 cases distal part necrsis partly,among them,2 cases transferred flap repaired;1 case musculocutaneous flap transferred, 2 cases after granulation tissue grown,skin grafted. Conclusion The flap transferred adjacent non-main vessel pedicle is the best way to repaire soft tissue defect of one-third lower leg.Different flap can fit with kinds of soft tissue defect.

AIM: To explore the effect of atorvastatin on cardiac remodeling in spontaneous hypertension rats(SHR).METHODS: Twelve spontaneous hypertension rats were divided randomly into two groups: group of atorvastatin(atorvastatin 50 mg?kg~(-1)?d~(-1)) and group of SHR(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)).Additionally,six male Wistar-Kyoto rats(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)) were selected as control group.Systolic blood pressure was assessed with the tail-cuff method.After six weeks,entire heart,and left ventricle were weighed.The left ventricular weight index was calculated and myocardial hydroxyproline and collagen protein concentration were measured.The serum high sensitivity CRP(hs-CRP) was measured by nephelometry.The localization of vascular cell adhesion molecule(VCAM) in myocardium was investigated by immunohistochemistry assays.The level of NF-?B mRNA expression was detected with in situ hybridization.Ultrastructure in cardiac muscle was also observed under transmission electron microscope.RESULTS: The expression of myocardial VCAM and NF-?B in SHR group was stronger than that in WHY group.Compared with SHR group,entire heart weight,left ventricular weight,left ventricular weight index,serum hs-CRP,myocardial hydroxyproline and collagen protein concentration was decreased,the expression of myocardial VCAM and NF-?B in SHR group was weaker than that in atorvastatin treatment group.The myocardial pathological change such as incomplete karyotheca in cardiac muscle cells,no clear of transverse striation and the mess in myofibril alignment,and hyperplasy in interstitial collagen fibre were observed in SHR group and these changes were improved in atorvastatin treatment group.CONCLUSION: The cardiac remodeling in SHR is improved by atorvastatin.The molecular mechanism may be related to its down-regulating the expression of VCAM protein and NF-?B and inhibiting myocardial chronic inflammation.

AIM:To investigate morphologic and functional changes of small intestinal mucosa and proliferating cell nuclear antigen in postoperative portal hypertension patients with single or combined administration of Gln and rhGH.METHODS:Twenty-nine portal hypertension patients with surgical treatment were prospectively randomized to four groups as follows:① Gln group(n=6);② rhGH group(n=8);③ Gln+rhGH group(n=7)and ④ control group(n=8).A standard solution for TPN was given three days after operation for a week.The concentration ratio of urinary lactulose and mannitol(L/M),the villus height and crypt depth and PCNA index of small intestinal mucosa were compared.RESULTS:A week after TPN postoperation,the increased ratios of L/M in Gln+rhGH group were less than those in control group(P0.05).CONCLUSION:This study suggest that Gln together with rhGH reduce the intestinal permeability and protect the mucosa integrality in postoperative portal hypertension patients,but not in single treatment.

Objective To compare the clinical outcomes of long and short InterTan intramedullary nailing of senior intertrochanteric hip fracture in conjunction with early total care (ETC).Methods In this prospective study, records of 30 elder patients with intertrochanteric fracture hospitalized between January 2011 and September 2013 were included.Using the concept of ETC, the patients were treated with long (long-nail group, n =15) and short InterTan intramedullary nails (shortnail group, n =15) within 72 hours postinjury.The two groups were compared for operation time, intraoperative blood loss, fracture healing time, Harris hip score, time to pre-injury mobilization and hardware failure rate.Results Operation time was (77.25 ± 7.38) minutes in long-nail group versus (72.10 ± 6.90) minutes in short-nail group (P ＜ 0.01).Time to pre-injury mobilization was (7.45 ± 1.61) months in long-nail group versus (8.57 ± 2.18) months in short-nail group (P ＜ 0.05).There were no significant differences between long-and short-nail groups regarding the blood loss [(180.75 ± 38.26)ml vs (178.62 ± 34.79)ml], fracture healing time [(4.82 ± 1.12)months vs (4.76 ± 1.04) months], and Harris hip score [(83.75 ± 1.71) points vs (82.57 ± 2.18) points] (P ＞ 0.05).Conclusions Either long or short InterTan intramedullary nailing combined with ETC is effective in treatment of intertrochanteric hip fracture in the elderly.However patients treated with long nails return to pre-injury mobilization relatively earlier.Long InterTan intramedullary nail system is better for the patients combined with serious osteoporosis.