From July 1998 to May 2000, 31 cases of lumbar spondylolisthesis accompanied with lumbar stenosis were treated with spinal cord decompression, autograft interbody fusion and fixed by Dyna lok system. All the patients were followed up for 6 to 28 months, averaged 12 7 months. 29 of the 31 patients were recovered completely. 2 cases of cauda equina were recovered within 2 months. Lowback pain remained in 1 case of multi segements spondylolisthesis which had been fixed for 3 vertebrae. 1 patient accompanied with cervical spinal stenosis had some residual claudication. In conclusion, spondylolisthesis fixed with the Dyna lok system can achieve a satisfactory result.

Objective To assess the clinical value of dual-energy CT (DECT) Volume software in quantitative analysis of urate crystals.Methods The DECT data of 60 gout patients based on the American College of Rheumatology diagnostic criteria were analyzed retrospectively.The volumes of urate crystals were quantitatively analyzed by using Volume software with two senior radiologists.The results were statistically analyzed.Results Seventy-two joints of 60 gout patients were scanned by DECT.40 of 43 joints had urate crystals in foot and ankle with the average volume of (0.621±0.742) cm3;18 of 19 joints had urate crystals in knee with the average volume of (0.842±1.086) cm3;10 of 10 joints had urate crystals in hand and wrist with the average volume of (0.796±0.583) cm3.There was no statistical difference for volume measurement between two doctors (P>0.05).The volumes of urate crystals in 4 patients with regular medication were reduced.Conclusion Volume software of DECT can quantitatively analyze urate crystals with a good repeatability, which has high application value in clinical diagnosis and treatment monitoring of gout.

Objective To study the significance of Titin-ab and Ryanodine receptor-ab (RyR-ab) in the myasthenia gravis (MG) patients and the expression of Titin and RyR epitopes in thymoma of myasthenia gravis.Methods Using ELISA methods,the titer of the Titin-ab,RyR-ab in the sera of 62 patients with MG,as well as 45 cases non-MG with other neurologic disorders and 50 case of normal controls were determined,and Titin and RyR were studied with immunohistochemistry stain in the 19 samples of thymic tissues from 9 cases of MG with thymoma (MGT),6 cases of MG with thymic hyperplasia (MGH), 2 cases of MG with thymic atrophy (MGA),and 2 cases of non-MG with thymic carcinoma (NMGTC). Results The positive rate of Titin-ab in MG was 35.5% (22/62),with the highest being 82.3% (14/17) in MGT group.The positive rate of RyR-ab was 24.2% (15/62),the highest being 76.5% (13/17) in MGT group.Titin receptor epitopes were expressed in the transmembrane and cytoplasm region of thymoma epithelial cells of 7 cases of MGT patients,and RyR epitopes in the transmembrane region of thymoma epithelial cells of 6 cases of MGT;but no Titin nor RyR epitopes was identified in controls and such thymic pathological patterns,as MGH,MGA,NMGTC.Conclusions Titin-ab and RyR-ab are mostly found in MGT patients;Titin and RyR epitopes are expressed in neoplasm epithelial cells of thymoma with myasthenia gravis;it's a result of autoimmunization of Titin and RyR epitopes irritated by Titin and RyR specific T cells activated by the change of pathogenic microenvionment inside the thymoma.

Objective To observe the protective effects of different doses of hydrogen-rich water on radiation injury in mice,so as to provide scientific basis for the application of hydrogen-rich water.Methods The ICR mice were randomly divided into control group,irradiation group,amifostine group and hydrogen-rich water of low,medium and high dose groups.The 30 days survival rate,body weight,hematology parameters,serum biochemical parameters,organ weight and coefficient,bone marrow micronucleus rate,bone marrow nucleated cell count were observed after total body irradiation with 9.0 Gy gamma rays.Results After 30 d of irradiation,the hydrogen-rich water showed obvious protective effect on the survival rate and body weight in a dose dependent manner so that the survival was significantly higher than that of irradiation group (t =-2.67,P ＜ 0.05).The biochemical index,such as TP,ALB and CRE in the low dose group,TP,ALB,TBIL and CRE in the medium dose group,and TP,ALB,GLU,TBIL,BUN,GRE and UA in the high dose group also indicated the protective effects of hydrogen-rich water (t =-2.04--4.11,P ＜ 0.05).But the protective effect of hydrogen-rich water was not observed in hematology,organ weight and coefficient,and bone marrow micronucleus induction.Conclusions The hydrogen-rich water has anti-radiation effect,which may depend on the dose of hydrogen.

OBJECTIVETo determine if double bundle hamstring autograft posterior cruciate ligament (PCL) reconstruction could bring better outcomes than single bundle.

METHODSFrom June 2007 to June 2009, there were 22 subjects, including 16 male and 6 female patients with an average (37 ± 13) years old (16-54 years old) were reconstructed with single bundle PCL reconstruction (single bundle group), 24 subjects, including 18 male and 6 female patients with an average (37 ± 10) years old (17 - 52 years old) were reconstructed with double bundle PCL reconstruction (double bundle group). There were no differences between the two groups on patients' demographics and the duration from the injury to the operation (P > 0.05). Clinical outcomes, KT2000 and tunnel placements of all the patients were measured and analyzed.

RESULTSThe two groups were retrospectively studied and compared with a (29 ± 9) months (24 - 55 months) follow-up. Operation duration of double bundle group was (92 ± 8) minutes which was significantly longer than the single bundle group (78 ± 13) minutes (t = 2.474, P < 0.05). IKDC, Lysholm and Tegner scores were all significantly improved at the last follow-up of both groups (single bundle group: t = 9.578, 13.115 and 8.165, P < 0.01; double bundle group: t = 4.390, 5.522 and 4.313, P < 0.05). Post operative KT2000 side-to-side difference of the double bundle group was significantly smaller than that of the single bundle group under maximum posterior force with the knee in 90° flexion ((1.5 ± 1.5) mm vs. (4.0 ± 2.9) mm, t = 2.538, P = 0.019). There were 66.7% of the patients of double bundle group were normal which was significantly higher than 31.8% of the single bundle group on the IKDC knee examination form (χ² = 5.576, P = 0.018).

CONCLUSIONSSingle or double bundle PCL reconstruction could restore the knee's stability and function satisfied. There are no differences between two groups in clinical scores, but double group manifestes a better anterior-posterior stability.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tendons ; transplantation ; Transplantation, Autologous ; Young Adult

OBJECTIVETo investigate the protective effect of soyasaponins on acute liver injury induced by D-galactosamine (GalN) and lipopolysaccharide (LPS) in mice.

METHODThe mice were randomly divided into five groups: the normal control, the model group, the silymarin (positive control) group, and soyasaponins high and low-dose groups. They were administered with drugs once every day for 7 days. At the end of the experiment, GalN and LPS were injected intraperitoneally to all of the groups except for the normal group to establish the acute liver injury model. The pathological changes were detected with hematoxylin & eosin (HE) staining, tumor necrosis factor-alpha (TNF-alpha) was detected by ELISA method, and the alanine aminotransferase (ALT), aspartate aminotransferase (AST), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST), reduced glutathione (GSH), malondialdehyde (MDA), nitric oxide (NO), and the activation of Caspase-3 and Caspase-8 were detected by the colorimetric method.

RESULTSoyasaponins could reduce the activities of serum ALT and AST, the acute hepatic injury induced by GalN/LPS, serum TNF-alpha level, hepatic NO and MDA contents, and the Caspase-3 and Caspase-8 activations of liver tissues, and increase the hepatic CAT, GPx, GST and GSH levels.

CONCLUSIONSoyasaponins shows the protective effect on acute liver injury induced by GalN and LPS in mice, which may be related to its antioxidative ability and anti-liver apoptosis.

Alanine Transaminase ; blood ; Animals ; Antioxidants ; metabolism ; Apoptosis ; drug effects ; Aspartate Aminotransferases ; blood ; Caspases ; metabolism ; Chemical and Drug Induced Liver Injury ; metabolism ; pathology ; prevention & control ; Galactosamine ; toxicity ; Lipopolysaccharides ; toxicity ; Liver ; pathology ; Male ; Mice ; Saponins ; pharmacology ; Soybeans ; chemistry

Objective To explore the cause,urgent management,further treatment,outcome and prevention of internal carotid artery (ICA) injury during transnasal endoscopic surgery.Methods Five ICA injury happened during transnasal endoscopic surgery of sphenoidal sinus and (or) sellar region,involving 1 case of traumatic optic neuropathy,1 case of sphenoidal cyst,1 case of fungal sphenoid sinusitis,1 case of sellar adenoid cystic carcinoma and 1 case of pituitary tumor.These five cases were from three different hospitals in 1990 -2009,and the clinical data were collected and retrospectively reviewed.Results Injury of ICA was related with improper anatomic localization and operative procedures.The locations of injury were in cavenous segement in 3 cases,lacerum segment in 1 case,and clinic segment in 1 case,respectively.The types of injury included 3 cases of bleeding of laceration,1 case of carotid cavernous fistula and 1 case of pseudoaneurysme.Salvage sphenoid sinus packing with vaseline strip and subsequent intravascular stent graft implantation (2 cases) and endovascular embolization (2 cases) effectively controlled bleeding.Four cases were successfully treated without craniocerebral or ocular complications,only 1 case died of massive blood loss.Among 4 survival cases,1 patient abandoned further therapy,the other 3 patients were curcd of primary disease by reoperation or subsequent treatment.Conclusion Preoperatively,reading carefully the imaging data,intraoperatively,identifying anatomical positions accurately,performing proper operation,and stopping bleeding decidedly, postoperatively, seeking interdisciplinary cooperation to repair vascular damages,all these procedures can effectively reduce the surgical risk of ICA injury.

Objective To explore the clinical value of the combined dual-source CT venography(CTV)for the diagnosis of iliac vein compression syndrome(IVCS).Methods 43 patients with clinically suspected IVCS underwent CTV examination.Among them,22 cases were assessed with combined CTV while 21 cases were given conventionally indirect CTV.The lower extremity deep vein was scanned from foot to head.The dual-energy technology was applied for data acquisition.Results Two kinds of CTV methods could be used directly for diagnosing IVCS and checking the asymptomatic mild iliac vein compression.32 IVCS patients were diagnosed by CTV.In 27 cases with deep venous thrombosis(DVT),the average diameter of the left iliac vein was(3.23 ± 1.45)mm and the average compression rate was 67%.The differences were statistically significant in comparisons of the average diameter of left iliac vein between IVCS patients with or without DVT and patients without IVCS.The image quality scores of bidirectional CTV were higher than indirect CTV with statistically significant difference.Conclusion Combined CTV is a feasible technique for lower extremity venography.The image quality of combined CTV is better than conventional indirect CTV with greater clinical value.

Anaphylaxis is increasingly in children, which is currently undernotified, underdiagnosed, and undertreated in China.In order to further improved the understanding and management of anaphylaxis, this issue reviews the pathogenesis, triggers and risk factors, clinical diagnosis and management of anaphylaxis, thus offers the recommedations of anaphylaxis in Chinese children based on previous published evidence-based guidelines and practice parameters.Recommendation aims to develop guiding principles for the diagnosis and management of anaphylaxis in children, and provide a framework for the development of new guidelines.

Objective To discuss the treatment of ureteropelvic junction obstruction by laparoscopic pyeloplasty. Methods A retrospective review of consecutive laparoscopic pyeloplasty in 102 patients between September 2001 and December 2007 was performed. The ureterpelvic junction was dissected and the obstruction portion was excised. Anastomosis was then performed through the ureter and the renal pelvis walls with a stent. Results The mean operating time was 120 min and the average blood loss was 80ml. No major complication occurred intraoperative. The drainage was removed in 3-10 days. The average hospital stay was 8.5 days. The stent was kept for 30-60 days. IVU and B ultrasound examination revealed that the hydronephrosis alleviated during the follow-up and no anastomosis stricture occurred. Conclusions Laparoscopic dismembered pyeloplasty could provide lower morbidity, shorter hospital stay, and faster convalescence. It could be an effective treatment for ureteropelvic junction obstruction.