Objective To investigate the clinical outcomes of interbody fusion with transpedicular screw fixation in the reoperation for lumbar spinal instability secondary to lumbar discectomy.Methods From May 1997 to Aug 2002, 23 patients underwent reoperation with posterior lumbar spinal decompression, removal of residual disc, transpedicular screw instrumentation and interbody fusion because of lumbar spinal instability after previous lumbar discectomy. There were 14 males and 9 females. The age of patients ranged from 28 to 64 years with an average age of 48.5 years. The time between the onset of the symptoms and the diagnosis was 18 months on average (range, 6 months to 36 years). The mean interval between the primary and revision surgery was 68 months (range, 24 months to 10 years). Lumbar discectomy had been performed in all patients as the primary surgery. All patients were evaluated by the conventional radiography, and CT or MRI if necessary. The low back pain was predominant in 8, and associated with radicular leg pain in 15. The instability of one segment was found in 17, and two segments in 6. The average follow-up was 3.6 years (range, 1 to 6.4 years). Results The lateral, AP, flexion and extension X-ray films were taken at 1, 3, 6 months and 1 year to evaluate the fusion, sliding between two vertebral bodies and internal fixation, and McGill pain questionnaire was adopted to determine the satisfaction of the patients. The intraoperative blood loss ranged from 550 to 800 ml (mean, 650 ml), and the total operative time ranged from 120 to 210 min (mean, 180 min). Based on Oswestry low back pain and disability scores, the clinical successful rate was 86.9%. The rate of patient satisfaction was 82.6%. 20 patients showed radiographic bony fusion. Pedicle screw breakage and loosening were found in 3 out of the 102 screws. 5 patients had nerve root irritation and recovered within 2 to 3 weeks. 5 patients had dural laceration. Bony nonunion was found in 3 patients. Conclusion Transpedicular screw instrumentation and interbody fusion is proved helpful in management of spinal instability secondary to decompression surgery, providing successful interbody fusion and restoration of the intervertebral stability.

Objective To observe the characterization of fat emboli in cardiac chamber in pig model and the patients undergoing total hip arthroplasty(THA) by transesophageal echocardiography(TEE). Methods Different dose of fatty liquid was injected slowly via the internal jugular vein. The changes of the image were observed by continuous TEE. The lethal dose of fat embolism was recorded. Twenty-two patients underwent TEE during THA. Gray scale and echo intensity of fat embolism in right atrium were studied quantitatively in varied periods of the operation. Results With the increase of fat liquid injected in pig model, the strong- echo particles in right atrium and ventricle became more and more, the imaging of the particles was from “moving star”, “shower-like” to “snow fluffy”, at last paradoxical fat embolism occurred when the dose of fat liquid was over 4 ml. The accumulated lethal dose of fat embolism was 15.8 ～ 27.8 ml.②Fat emboli appeared as strong- echo particles in right atrium were found in different period of THA. Average gray scale and echo intensity of emboli in right atrium were significantly higher in period B than in other periods during THA. Conclusions Fat emboli in cardiac chamber can be found sensitively by TEE. Intra-operative monitoring and quantitative analysis is helpful to identifying fat embolism syndrome.Paradoxical embolism is a reliable evidence of fat embolism syndrome.

Objective To Analyze the development tendency and major influential factors of the resource and service of traditional medicine (TM) by contrasting the statistical data between China and India.Methods The research data came from the governmental statistical date of traditional medicine.The main statistical indicators included:number of TM hospitals,number of beds in TM institutions,number of health personnel of TM,number of visits and inpatients of TM institutions.A contrastive analysis was given based on these data over the period of 2008-2012.Results In 2012,the number of traditional Chinese medicine (TCM) hospital per ten million populations was 25.1,the number of Traditional Indian Medicine (TIM) hospital per ten million populations was 25.9; the number of beds in TCM institutions per ten thousand populations was 4.5,the number of beds in TIM institutions per ten thousand populations was 0.5; the number of TCM physicians and physician assistants per ten thousand populations was 2.6,the number of TIM physicians and physician assistants per ten thousand populations was 5.9.In 2012,the numbers of visits and inpatients of governmental public TCM hospitals were 426.671 million and 16.882 million; the numbers of visits and inpatients of governmental public TIM hospitals were 73.445 million and 0.947 million.Conclusion There was no significant difference in the number of TM hospitals per ten million populations between China and India.China had obviously advantages in the number of beds in TM institutions,number of visits and inpatients of TM institution.India had obviously advantages in the number of TM health personnel.

Aim To study the characteristics of the binding reaction of Troxetutin with bovine serum albumin (BSA) by fluorescence and ultra violet-visible absorption spectra.Methods The quenching mechanism of the fluorescence of BSA by troxerutin was studied with fluorescence.To determine the dynamic quenching constants and static binding constants,the Stern-Volmer equation and the double reciprocal Lineweaver-Burk equation were applied. The number of binding site was calculated with double logarithmic equation and the main binding force was discussed by thermodynamic equations. The binding distance and energy transfer efficiency between donor (BSA) and acceptor (troxerutin) were obtained effectively quenched fluorescence of BSA via static quenching processes. The binding constant Ka was calculated to be in the order of 106,indicating a strong interaction between Troxerutin and BSA. The number of binding site was approximately equal to 1,the binding distance was 1.97 nm,the energy transfer efficiency was 0.529,and the binding force was mainly hydrophobic force.Conclusion Troxerutin effectively quenchs the intrinsic fluorescence of BSA via static quenching mechanism,and the binding is mainly driven by the hydrophobic interaction.

Objective: To investigate the inhibitory effect of adenovirus-mediated VEGF-siRNA on transplanted osteo- sarcoma in nude mice.Methods: VEGF-siRNA gene was cloned into the genome of replication-deficient adenovirus to construct Ad-VEGF-siRNA;the latter was then used to infect osteosarcoma MG63 cell line in vitro;and the expression of VEGF gene was detected by RT-PCR.Osteosarcoma transplantation model was established in nude mice;VEGF expression in tumor tissue was analyzed and the inhibitory effect on tumor growth and lung metastasis were also observed.Results: The recombinant adenovirus vector Ad-VEGF-siRNA was successfully constructed.In vivo and in vitro experiment both showed that Ad-VEGF-siRNA significantly downregulated VEGF expression in MG63 cells and transplanted tumor tissue. It was found that Ad-VEGF-siRNA significantly inhibited transplanted osteosarcoma growth(P

Objective To grasp the current situation and trend of health personnel development in public TCM hospitals through the analysis of health personnel statistics data of public TCM hospitals in China; To provide decision-making references for management departments. Methods Data were from the National Health and Family Planning Commission Statistical Information Center. This article analyzed staff number, the average speed of development, the average annual growth rate, health staff age, academic qualifications and job titles and other indicators of TCM public hospitals during 2010-2015. Results From 2010 to 2015, there was an annual increasing tendency of the number of TCM health personnel, and the average annual growth rate was 5.9％, but the growth of the percentage of the TCM health personnel to the total health personnel was only 0.3％. In 2015, the proportion of TCM health personnel was less than 50％; the doctor-to-nurse ratio was 1:1.18; the educational level of postgraduate and undergraduate were 14.0％ and 48.0％ respectively, less than the average level of national hospitals. Conclusion From 2010 to 2015, there is an increasing tendency of the TCM health personnel of public TCM hospitals, but the proportion of TCM health personnel is low. The doctor-to-nurse ratio is reasonable gradually, but there is still a gap compared with the average level of the national hospitals. The average age of technical health personnel tends to be younger. The proportion of high educational level health personnel is increasing, but the proportion of senior technical position is reduced. The management departments should take appropriate measures to promote the rational allocation of human resources and development of TCM hospitals.

Objective To investigate and analyze the clinical and imageological features of skull base erosion in nasopharyngeal carcinoma( NPC). Methods 67 NPC patients proved by pathology were retrospectively reviewed. All patients underwent both CT and MRI plain plus enhancement scan. Scan slices were performed from oral pharynx (lower border of second cervical vertebra) to suprasellar cistern by axial CT scans and axial, sagittal and coronal MRI scans. Results (1) 52 patients with skull base erosion were found with MRI, and only 35 patients with CT. The following structures and figures were difined with CT and MRI respectively: pterygoid plates 8,14; clivus 22,25 ; petrous apex 25 ,28 ; sphenoid body or sinus 19,25; sphenoid wing 9, 12; cavernous sinus 14,17. The display difference between CT and MRI had statistical significance ( x2= 9. 47 , P = 0. 02). (2) CT- defined skull base erosion was most bone destruction , however, not only bone destruction but also tumor crossing skull base structure could be defined by MRI. (3) The incidence of headache was 82.7% (43/52) , cranial nerve palsy was 67. 3% (35/52) , both headache and cranial nerve palsy was 57. 7% (30/52). Conclusion Headache and cranial nerve palsy are primary characteristics of the skull base erosion in NPC. MRI is superior to CT in defining both bone erosion and brain tissue abnormality.

Objective: To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. Methods : The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model. Results: Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. Conclusions The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.

Objective To determine the status of false-positive report of congenital syphilis (CS),to analyze the possible causes of mis-diagnosis.Methods Basic information on CS in Shanghai in the past five years was collected.We identified infants diagnosed with CS and followed up the sero- logical reactivity of those patients and their mothers.The serological reactivity[rapid plasmin reagin (RPR)and treponema palidum hemagglutination assay(TPPA)]of infants was followed-up for up to 24 months,or until both antibodies turned to negative.The medical history of the mothers was col- lected,and their sera were examined for syphilitic antibodies.Results Total 99 infants diagnosed with CS were recruited. The major diagnostic method was treponemal antibody detection.Only 31.3% of the 99 infants exhibited clinical symptoms or syphilis-like symptoms at delivery.The cumu- lative RPR loss rates of the infants were 44.2%,64.0%,72.7%,83.9% and 87.1% at 1-3,3-6,6- 12,12-18 and 18-24 months after birth,respectively.The cumulative TPPA loss rates were 1.1%, 18.6%,44.6%,66.7% and 74.4% for 1-3,3-6,6-12,12-18 and 18-24 months after birth,respec- tively.TPPA remained positive in all mothers with syphilis.Conclusion The diagnosis of congenital syphilis determined solely by the positive tests of RPR and TPPA is unreliable and can be misdiagno- sis.The diagnosis and management of congenital syphilis should be urgently improved,and that the profes- sional health institutions should perform and closely monitor the quality controls in the diagnosis of CS and standardize the intervention strategy of maternal syphilis.

OBJECTIVETo investigate the relationship between the blood flow of the exceedingly expanded skin and the viability of the flap.

METHODSThe piglets were set up as the animal model. They were divided into 7 groups according to different injection volume of the tissue expander, i. e. injection to 1/2 content, 3/4 content, full content, 50% over content, 100% over content, sham-operation control and normal control. At different stages of expansion, the blood flow and the amplitude of the expanded skin were examined by laser Doppler. The survival length of the expanded flap was measured. Furthermore, statistical analysis was performed.

RESULTSAs the expansion volume increasing, the blood flow and the amplitude of the expanded skin increased, the survival length of the expanded flap increased also. In the meantime, the amplitude instability and vessel permeability increased. When the injection volume exceeded to 100%, the blood flow and the survival length of the expanded flap decreased.

CONCLUSIONSIn soft tissue and skin expansion, increasing injection volume could increase the survival length of the expanded flap, while over-expansion to 100% content may cause blood flow disturbance.

Animals ; Graft Survival ; Models, Animal ; Skin ; blood supply ; Skin Transplantation ; Surgical Flaps ; blood supply ; Swine ; Swine, Miniature ; Tissue Expansion Devices