Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

OBJECTIVETo summarize and analyze the epidemic situation of human rabies from 1984 to 2002 in China, and to explore the possible factors causing the increase of cases so as to provide evidence for preventive and control measures.

METHODNational and some provincial data on the prevalence of rabies during 1984 to 2002 were collected and analyzed.

RESULTSFrom 1984 to 1989, the annual reported cases were between 4 000 and 6 000 but decreased after 1990. In 1996, the reported cases decreased to the lowest level from 3 520 in 1990 to 159. However, number of reported cases has been continuously increasing since 1998 which reached 1 122 in 2002, a 7.06 times increase as compared to the number in 1996. The epidemic areas were mainly located in the southeast and southwest parts of the country, such as Sichuan, Hunan, Guangxi, Guangdong, Anhui, Fujian, etc. Furthermore, there was no significant seasonal distribution as it showed before.

CONCLUSIONSuch facts as the increasing numbers of dogs, low inoculation rate to dogs, poor control on the quality of rabies vaccine, mistreatment to the wounds, and lacking good cooperation between different official departments regarding rabies control might serve as important factors responsible for the recurrence of rabies. Therefore, it is necessary to focus on the above mentioned points and to take comprehensive preventive measures to bring down the prevalence of rabies in China.

Animals ; China ; epidemiology ; Dogs ; Humans ; Rabies ; epidemiology ; prevention & control ; Rabies Vaccines ; standards ; Seasons ; Time Factors

OBJECTIVETo evaluate the effect of computer assisted navigation system in the treatment of unilateral zygomatic complex fractures.

METHODSFive patients with unilateral zygomatic complex fractures were included in this study.Preoperative design, intraoperative real-time navigation and postoperative evaluation with chromatogram were executed in the unaffected and affected side.

RESULTSUsing computer assisted navigation system, the position and direction of the affected side of the unilateral zygomatic complex fracture were confirmed and shown real-time on the screen. The global maximal deviation was less than 2 mm between the affected side and the mirror side of the healthy side with chromatogram.

CONCLUSIONSComputer assisted navigation system can instruct the treatment of unilateral zygomatic complex fractures effectively. The global comparison with chromatogram is more objective for the unilateral zygomatic complex fractures.

Adult ; Female ; Humans ; Male ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

BACKGROUND: Self-healing ability of the posterior cruciate ligament is poor, and the degradation and synthesis of extracellular matrix often follow the ligament repair. The matrix metalloproteinase family plays a critical role in the dynamic equilibrium between the matrix degradation and synthesis. OBJECTIVE: To investigate the effect of arthroscopic reconstruction of the posterior cruciate ligament, and to study its correlation with matrix metalloproteinase 2 level. METHODS: Sixty patients with posterior cruciate ligament rupture were studied, including 37 cases of autologous reconstruction and 13 cases of allogeneic reconstruction. Ligament and synovial cells from traumatic amputation patients with no ligament injury in the corresponding period were collected. Lysholm and Tegner scores were detected before and after operation. The results of postoperative drawer test were analyzed. The tibial displacement of the posterior cruciate ligament after autologous reconstruction and allogeneic reconstruction was compared. The posterior cruciate ligament cells were cultured alone or co-cultured with synovial cells, and then the level of matrix metalloproteinase 2 protein was detected. In addition, operation time, incision length, postoperative fever time and gender differences were also detected and compared.RESULTS AND CONCLUSION: Tibial displacement, irrespective of genders, was higher in the allogeneic reconstruction group than the autologous reconstruction group, while there were no significant differences in the posterior drawer test between the two reconstruction groups as well as between males and females. Postoperative Lysholm and Tegner scores were both improved significantly (P < 0.01). As time went by, the level of matrix metalloproteinase 2 had an increasing trend in the posterior cruciate ligament cells cultured alone or co-cultured with synovial cells, but the level in the co-culture group was higher than that in the single culture group. For both male and female, the autologous reconstruction group showed a longer operative time (P < 0.05 or 0.01) and a longer incision length (P < 0.01), as compared with the allogeneic reconstruction group, while the time of fever was significantly longer in the allogeneic reconstruction group (P < 0.01). Results from the last follow-up show that the autologous reconstruction is better than the allogeneic reconstruction to restore the stability of posterior cruciate ligament and shorten fever time, but longer operative time and surgical incision as well as increased level of matrix metalloproteinase 2 cannot be ignored.

OBJECTIVETo summarize and analyze the epidemic situation of hantaviruses including geographic distribution, types and prevalent intensity of epidemic areas of hantavirus for the last 30 years in China, and to discuss relative preventive measures.

METHODSCollecting and analyzing the data of hantaviruses epidemics in China.

RESULTSThe annual number of cases of hantavirus disease rapidly increased from 3295 in 1970 to 115,804 in 1986 then sustained between 40,000 and 60,000 cases annually in the 1990's, and then decreased thereafter. The epidemic areas existed in all provinces except Qinhai and Xinjiang and there were the hospitalized cases of hantavirus disease reported in other provinces. In recent years, the prevalence of hantavirus infection had increased in some cities, and the seasonal distribution of the cases changed as well.

CONCLUSIONData suggested that the new epidemic characteristics of hantaviruses had emerged in China suggesting that it was necessary to strengthen surveillance programs and to take comprehensive preventive measures for the control and prevention of hantaviruses in China.

Animals ; China ; epidemiology ; Disease Reservoirs ; Female ; Hantaan virus ; immunology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; prevention & control ; transmission ; Humans ; Male ; Mice ; Population Surveillance ; Prevalence ; Rats ; Rodent Control ; Vaccination ; Vaccines, Inactivated ; immunology

OBJECTIVETo summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia.

METHODSFrom January 2001 to January 2006, 29 patients (31 hips) of adult dysplasia of hip were included in the study. Among them, there were 22 females and 7 males, age from 38 to 65 years with average of 53 years. According to Crowe classification system, there were 22 in type III, 9 in type IV, and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach. All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length, and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function.

RESULTSAll the patients had restoration of limb length (ranged from 2.5 cm to 4.5 cm). One case of postoperative dislocation was occurred due to slight large of acetabular obtuse angle. Follow-up for 1-5 years (average 3.2 years) in 29 patients, the Harris score increased to 85.4 postoperatively. All hips had released from pain and functioned well.

CONCLUSIONSIn order to restoration anatomic structure and physiologic function of affected hip, the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastic hip.

Acetabulum ; surgery ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Connective Tissue ; surgery ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

Aim To investigate the effect of taurine-magnesium coordination compound (TMCC) on elec-trocardiogram of isolated guinea pig hearts, hoping to describe a primary research on its characteristic of anti-short QT syndrome. Methods The isolated guinea pig heart was retrograde perfused using Langendorff tech-nique. In order to determine the effects of TMCC on QT interval, transmural dispersion of repolarization, effective refractory period, instability of RR interval and instability of QT interval in the presence of potassi-um channel opener pinacidil, the electrocardiogram of isolated guinea pig hearts was recorded using Biopac physiological recorder. Results The shortened QT in-terval and the effective refractory period induced by pinacidil could be prolonged by TMCC; the increased transmural dispersion of repolarization induced by pinacidil could be decreased by TMCC; the increased instability of RR and QT interval induced by pinacidil could be decreased by TMCC. Conclusion TMCC has the effects of anti-SQT2 by prolonging the QT inter-val and the effective refractory period, reducing the transmural dispersion of repolarization and instability.

OBJECTIVESInvestigate the clinical efficacy of cryotherapy ablation treatment for advanced hepatocellular carcinoma. analyse the predictive factors of cryotherapy ablation treatment.

METHODSThere were 190 cases of hepatitis B-related HCC patients with advanced HCC from 2005 to 2008 in our hospital. By using clinical cohort method, they included cryoablation group (147 cases) and control group (43 cases), The median survival time and time to disease progression were compared. Evaluate clinical significance of age, gender, location of portal vein tumor thrombus, HBeAg, tumor histological grade, Child-Pugh classification, end-stage liver disease (MELD) score, advanced liver cancer prediction system (ALCPS) score and the Eastern Cooperative Oncology Group performance status (ECOG PS) score for predicting the efficacy of cryoablation. Group rates were compared with the x2 test, survival analysis by using Kaplan-Meier method, survival rates were compared by Log-rank analysis; multiple factor survival analysis by using Cox regression model.

RESULTSMedian survival time of cryoablation group and Control group was 7.5 (4.2 to 14.6) months and 3.2 (1.2 to 8.6) months, median TTP was 3.5 (2.5 to 4.5) months and 1.5 (1.0 to 3.5 months), the differences were statistically significant ( P less than 0.05 ). Median OS and TTP of advanced HCC patients who had Well-differentiated tumor, Child-pugh A-class and low score of MELD score, ALCPS score, ECOG PS score were significantly longer than the poorly differentiate, Child-Pugh B-class and the high those scores ( P less than 0.05). ECOG PS ( P less than 0.05, 95% CI 1.074 to 2.143) and ALCPS (P less than 0.05, 95% CI 1.005 to 2.121) were independent predictors for OS of advanced HCC.

CONCLUSIONCryoablation treatment can prolong median OS and TTP of advanced HCC; ECOG PS and ALCPS are important predictors for survival time of advanced HCC.

Carcinoma, Hepatocellular ; surgery ; Cryosurgery ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Rate ; Treatment Outcome

BACKGROUND/AIMS: The application of glycated hemoglobin (HbA1c) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA1c as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China. METHODS: In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) > or = 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA1c test. Plasma lipid, uric acid, and blood pressure were also measured. RESULTS: Using a receiver operating characteristic curve, the optimal cutoff point of HbA1c related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA1c level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA1c > or = 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA1c levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups. CONCLUSIONS: Our results suggest that HbA1c > or = 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.
Aged ; Analysis of Variance ; *Asian Continental Ancestry Group ; Biological Markers/blood ; Blood Glucose/analysis ; China/epidemiology ; *Chromatography, High Pressure Liquid/standards ; *Chromatography, Ion Exchange/standards ; Diabetes Mellitus, Type 2/blood/*diagnosis/ethnology ; Fasting/blood ; Female ; Glucose Tolerance Test/standards ; Hemoglobin A, Glycosylated/*analysis ; Humans ; Male ; Mass Screening/*methods/standards ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Reference Standards ; Reproducibility of Results ; Sensitivity and Specificity

BACKGROUND: To determine the frequency of chronic kidney disease (CKD) and its associated risk factors in Chinese type 2 diabetic patients, we conducted a cross-sectional study in Nanjing, China, in the period between January 2008 and December 2009. METHODS: Patients with type 2 diabetes under the care by Jiangsu Province Official Hospital, Nanjing, China were invited for assessment. CKD was defined as the presence of albuminuria or estimated glomerular filtration rate <60 mL/min/1.73 m2. Albuminuria was defined as urinary albumin-to-creatinine ratio > or =30 mg/g. RESULTS: We recruited 1,521 urban Chinese patients with type 2 diabetes (mean age, 63.9+/-12.0 years). The frequency of CKD and albuminuria was 31.0% and 28.9%, respectively. After adjusted by age and sex, hypertension, anemia and duration of diabetes were significantly associated with CKD with odds ratio (95% confidence interval) being 1.93 (1.28 to 2.93), 1.70 (1.09 to 2.64), and 1.03 (1.00 to 1.06), respectively. CONCLUSION: In conclusion, CKD was common in the urban Nanjing Chinese with type 2 diabetes. Strategies to prevent or delay progression of kidney disease in diabetes should be carried out at the early disease course of type 2 diabetes.
Albuminuria ; Anemia ; Asian Continental Ancestry Group ; China ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Diseases ; Odds Ratio ; Renal Insufficiency, Chronic ; Risk Factors