OBJECTIVETo explore the operative skills and effect of unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation in treating degenerative low lumbar disease.

METHODSFrom January 2009 to December 2011,22 patients with degenerative low lumbar disease were treated with transforaminal lumbar interbody fusion, during the operations, unilateral pedicle screw and contralateral percutaneous transfacet screw fixation were performed. There were 16 males and 6 females, aged from 32 to 71 years old with an average of (51.1 ± 10.6) years, including single segment in 20 cases and two segments in 2 cases. Clinical effects were evaluated according to visual analogue score (VAS) and Oswestry Disability Index (ODI).

RESULTSAll patients were followed up from 1 to 2.5 years with an average of 18 months. One case complicated with leakage of cerebrospinal fluid after operation and 1 case with lower limb pain of decompression-side on the 3rd day after operation. Twenty-two patients got bony fusion. There were no instability and evidence of instrument failure during follow-up. The VAS and ODI score decreased from preoperative 8.24 ± 0.72, 36.72 ± 6.84 respectively to 3.18 ± 0.66, 4.36 ± 1.12 at the final follow-up (P < 0.05).

CONCLUSIONUnilateral pedicle screw combined with contralateral percutaneous transfacet screw fixation is safe and feasible surgical technique in treating low lumbar degenerative disease. It has advantages of little trauma, rigid fixation, high fusion rate, and less complication. etc.

Adult ; Aged ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fusion ; methods

BACKGROUND:Changes of both stem cell markers and endothelial cell phenotype help understand characteristics of endothelial progenitor cells during adherent differentiation.However,there is still no specific cell marker to distinguish from mature endothelial cells.OBJECTIVE:To study the changes of stem cell markers and endothelial cell phenotype during the differentiation of rat peripheral blood rnononuclear cells into endothelial cells.DESIGN.TIME AND SETTING:Cell observation study was performed in the Laboratory of Cardiac Surgery,Qingdao Municipal Hospital between June 2004 and December 2008. MATERIALS:Peripheral blood was drawn from male SD rats to obtain mononuclear cells by Ficell density gradient centrifugation. METHODS:Mononuclear cells were in vitro cultured in fibronectin culture medium and induced by vascular endothelial growth factors(VEGF)and basic fibroblast growth factors(bFGF)in order to stimulate a differentiation into endothelial cells. MAIN OUTCOME MEASURES:Adherent cells in the culture system were identified for CD31,CD34,Rk-1 and vWF with immunochemistry within 1-7 days.RESULTS:The expressions of CD31.CD34,FIk-1.vWF on adherent cells were different in different time durations.The expressions of CD31 and CD34 started on the 2nd day of culture.reached the peak on the 4th day,gradually decreased and even disappeared on the 6thday.While.FIk-1 expressed on the 3rd day of culture,gradually increased,and reached at the peak on the 7th day.vWF expressed gradually until 100%on the 7th day. CONCLUSION:The differentiation of peripheral blood stern cells into endothelial progenitor cells is characterized by the appearance of endothelial cell phenotypes and the disappearance of stern cell markers.both in the manner of gradual progression.

Objective To investigate the synthesis of heat shock protein 70 (HSP70) induced by norepinephrine preconditioning on donor heart and its effects on myocardial cell apoptosis and apoptosis related proteins. Methods 18 Wistar rats were random divided into 2 groups, with 9 in each group. The rats in the control group were intraperitoneally injected with 0.5 ml saline. After 24 hours, hearts were isolated and stored with histidine-tryptophan-ketoglutarate (HTK) solution at 4 ℃ for 3 hours to establish Langendorff isolated heart models, and then isolated hearts were perfused by Langendorff model with Krebs-Hense leit (K-H) solution for 2 hours. The rats in the experimental group received intraperitoneally 3. 1 μmol/kg (0. 53 mg/kg) noradrenaline bitartrate that was dissolved in saline and hearts were isolated and stored after 24 hours. Followed process was the same as that in the control group. Myocardial HSP70, Bcl-2, Bax content, apoptosis index were measured, cell structures were observed under light and electron microscope.Results HSP70 in the experimental group were higher [(17.78 ± 1.82)%] than those in control group [(5.22 ± 1.05)%], and biochemical indicators in texperimental group[(41.88 ± 5.09)%, (22.61 ±3. 49 ) %] were better than those in control group [(31.36 ± 3. 27 ) %, ( 40. 52 ± 4. 1 7) %]. There were alleviated ultrastructure injures in experimental group compared with those in control group. Conclusions This study demonstrated that norepinephrine preconditioning could induce high expression of HSP70 and it could play a very important role during ischemia-reperfusion. It could protect the structure and function of myocytes in isolated rat hearts and inhibited myocardial apoptosis.

Objective To investigate the clinical results of minimal invasion spinal surgery (MISS) in treating tibial plateau fractures to provide best procedure for such treatment.Methods The study involved 36 cases with tibial plateau fractures resulted from traffic injury,fall-from-height injury and strain injury including 24 males and 12 females at age of 19-65 years (average 42.6 years).According to Schatzker classification,there were seven cases of typeⅠ,five typeⅡ,five typeⅢ,five type IV,sev- en typeⅤand seven typeⅥ.All cases were treated by different methods of MISS.Results Follow up for 8-24 months in 35 cases showed fracture healing within 3-4 months,without severe complications such as poor wound healing,infection or osteofascial compartment syndrome.Meanwhile,no traumatic knee osteoarthritis,inversion or eversion of the knee were found.The mean range of knee motion was 94?,with fine knee function in 32 cases (91.4%) according to Merchant score.Conclusions Treatment of tibi- al plateau fractures should adopt limit incision,indirect reduction and biofixation to take place widespread exposure and rigid plate fixation.MISS is safe and effective for tibial plateau fractures.

OBJECTIVETo investigate of the value of monitoring of saturation of blood oxygen of the injured extremity on prevention of osteofascial compartmental syndrome.

METHODSTwenty patients of osteofascial compartmental syndrome included 13 male and 7 female with an average age of 32 years ranging from 13 to 60. There were 13 cases of tibial and fibual fractures, 3 cases of tibial plateau fractures, 4 cases of femoral shaft fractures. SpO2 on the end of injured extremities were dynamic monitored and osteofascial compartmental pressure was measured by modified Whiteside method. The data of two group were compared.

RESULTSAmong 20 cases, it's negative correlation between the data of pulse blood oxygen saturation and osteofascial compartmental pressure.

CONCLUSIONThe method of dynamic monitor extremity SpO2 can reflect indirectly the ischemia in muscle and nerve and report the early diagnosis and management of osteofascial compartmental syndrome.

Adolescent ; Adult ; Compartment Syndromes ; blood ; diagnosis ; metabolism ; physiopathology ; Female ; Heart Rate ; physiology ; Humans ; Ischemia ; metabolism ; physiopathology ; Male ; Middle Aged ; Muscles ; metabolism ; Nerve Tissue ; metabolism ; Oximetry ; methods ; Oxygen ; blood ; Regional Blood Flow ; physiology ; Young Adult

OBJECTIVETo introduce the operation indication, operation fashion, operation time, mainipulation point, and treatment effect of pelvic ring disruptions with percutaneous fixation.

METHODSFifty-eight patients with pelvic ring disruptions were treated with sacroiliac screws, pubic ramus screws or pubic tubercle screws and iliac wing screws, and the effects was evaluated.

RESULTSAmong the 58 patients, the result of reductions in 52 cases was satisfied, 6 cases was dissatisfied; fracture point in 57 cases was healed up, 1 case disconnect; vessel and nerve was not injured in 56 cases, S(1) nerve root was injured in 2 case, bequeathing anaesthesia of lower limbs and saddle area.

CONCLUSIONSThe technique with percutaneous fixations is minitraumatic and reliable to fix the pelvic ring disruptions with little bleeding. These percutaneous techniques have a good outlook. Bone tractions with big weight before operation make for reductions in operation.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Pubic Bone ; surgery ; Retrospective Studies ; Sacroiliac Joint ; surgery ; Treatment Outcome

OBJECTIVETo present the technique for percutaneous placement of cannulated screws in the iliac wing, and to describe the surgical technique and the methods, the indication, the time, the key of operation and the clinic outcomes of the technique.

METHODSThrough the anatomy study of ilium, a wider columns structure at the posterior ilium was found, which was named "the posterior columns of pelvis", and then measure the parameter of the structure. Twelve patients with the injuries in the iliac wing and the anterior ring of pelvis were treated with percutaneous cannulated screws internal fixation.

RESULTSAll of the fractures healed in the followed up period. Vertical replacement were all completely corrected. Two of the cases left behind slight rotary replacement, and no complication were found.

CONCLUSIONSThe technique of percutaneous cannulated screws internal fixation for treating the posterior portion of the iliac wing fractures has the advantages of small trauma, less bleeding stiff fixation, which is an ideal and minimally invasive technique.

Adolescent ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Ilium ; injuries ; surgery ; Male ; Middle Aged ; Treatment Outcome

BACKGROUND: How to successfully obtain compact endothelium layers on smooth muscle cells is the most crucial part for the tissue-engineered vessels. OBJECTIVE: To explore the effects of different cell implantation concentrations on the construction of the complete biological tissue-engineered blood vessels.METHODS: Different concentrations of porcine vascular smooth muscle cells (5×105, 5×107 cells/L) were implanted on the porcine acellular vascular matrix to culture for 3 days. Then different concentrations of endothelial progenitor cells (5×105, 5×107 cells/L) were implanted on the smooth muscle cell-vascular matrix composite to construct lamellar complete biological tissue-engineered blood vessels.RESULTS AND CONCLUSION: The growth curves of high concentrations of smooth muscle cells on the acellular vascular matrix were similar to that of low concentrations. Moreover, the growth curves of cells implanted in the culture plates were similar to that implanted on the acellular matrix. However, cells in the low concentration groups have relatively low proliferation activity and low coverage rate. The cell coverage rate decreased as follows: high concentrations of endothelial progenitor cells+acellular matrix containing high concentrations of smooth muscle cells > high concentrations of endothelial progenitor cells+acellular matrix containing low concentrations of smooth muscle cells > low concentrations of endothelial progenitor cells+acellular matrix containing high concentrations of smooth muscle cells > low concentrations of endothelial progenitor cells+acellular matrix containing low concentrations of smooth muscle cells. Moreover, high concentrations of endothelial progenitor cells form relatively compact layers on the acellular matrix and show cobble-like growth. These findings indicate that an increase in the cell implantation concentrations is beneficial to the rapid formation of compact cell layers on the material surface.

Objective To study the curative effect of continuous veno-venous hemodiafiltration(CVVH)in patients with acute renal failure(ARF)after aortic dissection surgery. Methods Fifteen patients with renal dysfunction following aortic dissection surgery underwent CVVH from Feb. 2002 to Dec. 2009 in this study.The clinical data of these patients were collected,such as heart rate(HR),central vein pressure(CVP),mean artery blood pressure(MAP),PaO2,renal function,perioperative manifestations and outcomes. Results Eleven patients survived but 4 died during the course of treatment. There were significant decreases of BUN,Creatinin after CVVH (P ＜ 0. 05)treatment,and the urine volume returned to nomal after CVVH in 6 -40 days. Conclusions CVVH is an effective,convenient and safe treatment for patients with severely ARF following aortic dissection surgery.

OBJECTIVEThere are small smount of literatures on the study of the anterior surgical approaches to the upper thoracic spine (UTS). Moreover, there are many differences among the results of these studies. This study is to investigate the exposure ranges of different anterior surgical approaches to the UTS for making the preoperative plan by means of CT images analysis.

METHODSFrom October to December in 2008, 120 CT images of normal chests were chosen. These subjects (58 males, 62 females) ranged in age from 16 to 75 years (mean 40.3 +/- 12.3 years). By using the X-ray positioning images of these CT images,following indexes were studied: the location of the superior margin of the left brachiocephalic vein on the sagittal plane, the confluence of the bilateral brachiocephalic veins, and the vertebrae level of the tracheal bifurcation. The caudal access of E1 (the interval between the tracheo esophageal sheath and the bilateral carotid sheath), E2 (the interval between the right brachiocephalic vein and the brachiocephalic artery), and E3 (the interval between the ascending aorta and superior caval vein) were respectively defined as the above mentioned three points.

RESULTSAmong the 120 studies, 105 T2 vertebral bodies could be exposed through E1 (87.5%), 82 T3 vertebral bodies could be exposed through E2 (68.3%), and 89 T4 vertebral bodies could be exposed through E3 (74.2%).

CONCLUSIONThe exposure ranges of three different anterior surgical approaches to the upper thoracic spine are different. Proper surgical approaches could be selected according to the chest CT images of the patients.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Surgical Procedures, Operative ; methods ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods ; Young Adult