Objective To assess the adequacy of decompression immediately in anterior cervical surgical procedures with epidurography, and to prevent from leaving compressive materials. Methods After completing primary decompression of anterior cervical intervertebral space by discectomy or corpectomy, posterior longitudinal ligaments were incised or resected, 5-10 ml Omnipaque 300 contrast medium was injected into upper and lower segments of decompressed area through a soft 18# injection needle. Distribution of the contrast medium in front of dura mater was observed by fluoroscopy so as to identify whether the spinal cords were decompressed completely. 64 patients suffered from cervical spondylotic myelopathy, and spinal cords were compressed respectively by giant intervertebral disc prolapse, osteophyte or short segmental OPLL. Intraoperative epidurography was performed after primary anterior decompression. If contrast medium in front of dura mater was discontinued by fluoroscopy, incomplete decompression was judged. 39 of 64 patients were followed up after operation, and in 18 patients of them MRI were taken within 1-12 weeks after operation. Neurological function was compared between preoperation, immediate postoperation and final follow-up by means of JOA scores. Results After completing primary decompression, epidurographs showed that the contrast medium were continuous in front of dura mater in 49 cases(77%), 11 patients of them were examined by MRI during follow-up and the images indicated that cervical cords were free of compression. In 15 cases (23%), the contrast medium was not continuous in front of dura mater, then decompression was performed further until the contrast medium no any interruption. 7 patients of them were confirmed by MRI that cervical cords were no more compressed. 39 patients were followed up postoperatively with a mean follow-up of 13 months. Neurological function was recovered immediately after operation by 52% and 61% at final follow-up. No neurological deficit progressed in all of them. Conclusion Intraoperative epidurography is effective and safe for assessment of decompression during anterior cervical surgical procedures.

Objective To observe the effect of unilateral ureter obstruction(UUO) on the expression of complement 5a receptor(C5aR) in rat renal tissue,and to investigate the roles played by C5aR in the development of renal intersititial fibrosis.Methods Thirty six male Sprague Dawley rats were randomly assigned into two groups(18 each): sham-operated group and UUO group.The left ureter of the rats in UUO group was obstructed,while in sham-operated group the left ureter was not.Six rats in each group were executed respectively on the 5th,10th and 15th day after surgery.Histological changes in renal tubular interstitium were observed with H.E.and Masson staining,and the expression of C5aR in renal tissues was detected by iminunohistochemical ELiVisionTM plus at each time point.Results Renal tubular dilatation and partial interstitial cells degeneration were found in UUO group on the 5th day after surgery.Necrosis of the interstitial cells was found in renal tubule,and the interstitial fibrosis was found on the 10th day.On the 15th day after surgery diffuse thickening and shrinkage of renal tubular basement membrane and obvious fibrosis were found(P0.05).Conclusion The C5aR expression in renal tissue increases significantly at the early stage of UUO,while the process is slowed down in the later stage.C5aR may take part in the process of renal intersititial fibrosis at the early stage.

ObjectiveTo investigate the correlation of radiographic parameters and health-related quality of life(HRQOL) instruments before and after thoracolumbar kyphosis correction in ankylosing spondylitis (AS) kyphosis.MethodsThirty-eight AS patients with fixed thoracolumbar kyphosis were treated with pedicle subtraction osteotomies(PSO) in our hospital from January 2004 to March 2010.Pre- and post-operative radiological parameters,Cobb T1-S1,pelvic incidence(PI),pelvic tilt (PT),sacral slope (SS),and sagittal vertical axis(SVA) were measured.The Oswestry disability index(ODI) and scoliosis research society-22(SRS-22) questionnaire were used to evaluate the clinical results.Statistical correlation analysis was made to determine correlation between radiographic parameters and overall or partial specific scores of HRQOL instruments.ResultsThe life quality and related radiological spino-pelvic parameters were improved significantly after operation.Preoperatively,Cobb T1-S1,PT,SS,and SVA had partial correlation with ODI walking score and ODI standing score; postoperatively,only PT and SS had partial correlation with ODI.ConclusionPelvic positional parameters are the key parameters for upright activities,and making pelvis in a neutral position is the ultimate goal of surgery.

[Objective]To explore the efficacy and results of tibial tubercle osteotomy used in exposure in complicated total knee arthroplasty.[Methods]During the period from Apr.2005 to Apr.2007,the tibial tubercle osteotomy were used in 16 cases of complicated total knee arthroplasty.The mean follow-up time were 20 months(6～26 months).Knee society score(KSS) and radiography were used to evaluate the clinical results.[Results]The mean KSS improved from 46 points preoperatively to 91 points postoperatively.The mean ROM improved to from 53?preoperatively 105?postoperatively.At 3 months after surgery the radiography examines showed all 16 cases had achieved satisfactory healing.The tubercle fragment slided toward proximal 0.7 cm occurred in one case,and finally healed at that position.[Conclusion]Exposure of the knee may be difficult in the total knee arthroplasty,but tibial tubercle osteotomy is a safe and reliable procedure which affords excellent exposure.

OBJECTIVE To describe the surgical experience in the repair of cerebrospinal fluid (CSF)rhinorrhea treated by endoscopic transnasal approaches. METHODS From Oct. 2003 to Dec. 2008, 38 patients with CSF rhinorrhea were treated. Endoscopic endonasal approaches and surgical techniques in repair of CSF leaks were reviewed in a series of 38 patients included 21 patients with traumatic CSF leakage, 10 patients with spontaneous CSF leakage, and 7 patients with other reasons. RESULTS Followup of 6 months to 3 years after operation, successful rate at first attempt was 92.1%. Two patients needed a second surgical repair and one patient a third surgical repair. The complications included meningitis and acute obstructive hydrocephalus in two patients respectively. CONCLUSION The endoscopic endonasal approaches is the first choice for repair of CSF leakage for its minimal invasive injury and high successful rate. Leakage site identification, site preparation, accurate graft placement and postoperative management are critical to the success of operation.

AIM: To investigate the mechanism of inhibiting the neointimal formation through blocking osteopontin (OPN) by using anti-OPN antibody. METHODS: The anti-OPN antibody was injected via tail vein after the left carotid artery of rats was de-endothelialized by balloon catheter. The expression of matrix metalloproteinase-2 (MMP-2), tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) and OPN were detected by gelatin zymogram, Western blotting, immunohistochemistry and flow cytometry. RESULTS: The neointima in rats treated with anti-OPN antibody was significantly thinner than that in untreated rats (P

Objective To analyze the effect of X-irradiation on the proteins expression of p57kip2 and TGF-β1 in lung cancer cell stain A549 and its clinical significance.Methods Lung cancer cell stain A549 was cultivated and cell,protein was extracted at 6,12,24,36 and 48 hours after X-irradiation by differenl doses(2,4, 8 and 12 Gy).The expression of p57kip2 and TGF-β1 proteins were examined by Western blot.Results The expression of p57kip2 in lung cancer cell stain A549 was very low before X-irradiation.and increased significantly after irradiation with difierent doses and reached the peak level at 12 hours after irradiation(P<0.05).TGF-β1 reached its peak 1evel at 6 hours after irradiation(P<0.05).Conclusions X-irradiation can up-regulate the expression of p57kip2 and TGF-β1 proteins which increased with certain doses.p57kip2 and TGF-β1 could be usedto predict the damage degree of cancer cells by X-ray.

A method for the analysis of five types of triphenylmethane dye residues in water was developed by using solid phase extraction ( SPE) combined with ultra performance liquid chromatography coupled to triple quadrupole linear ion trap mass spectrometry ( UPLC-MS/MS/MS ) . The water samples were extracted and cleaned with mixed-mode cation exchange solid-phase extraction cartridges ( MCX) . The UPLC separation was performed on a C18 column with a linear gradient elution program of acetonitrile and 5 mmol/L aqueous ammonium acetate ( containing 0. 02% formic acid) as mobile phase. Triphenylmethane dye residues were analyzed by mass spectrometry under an electrospray ionization interface ( ESI ) in positive ion mode with MRM-IDA-EPI mode. The calibration curves of five types of triphenylmethane dyes were linear in the range of 0. 02-20 μg/L, and the correlation coefficients were not less than 0. 998. The recoveries at spiked levels of 5 , 10 and 20 μg/L were in the range of 70 . 9%-101%, and the RSDs were 3 . 4%-11 . 9% ( n=6 ) . The limit of detection and quantification were 0. 42-2. 18 ng/L and 1. 68-8. 73 ng/L, respectively. The method was performed as sensitive and accurate, and also suitable for simultaneous determination of five types of triphenylmethane dye residues in water.

Objective To investigate the clinical outcomes of different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture.Methods From January 2010 to June 2014,33 cases of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture were treated with open reduction and internal fixation.According to the different managements of the complete rupture of the deltoid ligament,the patients were divided into 4 groups:9 cases in the non-repair group,7 cases in the superficial layer repair group,9 cases in the deep layer repair group,and 8 cases in the complete repair group.All the patients took anteroposterior,lateral and gravity stress radiographs preoperatively and postoperatively.The 4 groups were compatible in preoperative general data (P ＞ 0.05).The 4 groups were compared in terms of operation time,medial clear space and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.Results All the patients were followed up for 6 to 18 months (average,13.7 months).All wounds healed at the first stage without any infection.All fractures united primarily after 3 to 9 months (average,4.7 months).The operation time for the superficial layer repair group was significantly longer than for the non-repair group,but significantly shorter than for the deep layer repair and the complete repair groups (P ＜ 0.05).In gravity stress radiographs,there was no significant difference in medial clear space among the 4 groups (P ＞ 0.05),but there were significant differences before and after operation in the 4 groups (P ＜ 0.05).The postoperative AOFAS ankle-hindfoot score in the repair groups was significantly higher than in the non-repair group and the superficial layer repair group(P ＜ 0.05).Conclusion To achieve satisfactory outcomes for patients with complete rupture of the deltoid ligament associated with supination-external rotation ankle fractures,anatomic open reduction and rigid internal fixation is necessary,and repair of the deltoid ligament,especially its superficial layer,is a valuable contribution.

Objective To investigate the influence of pullulan molecular weight and spacer length on the properties of modified pullulan carriers including morphologies,sizes and in vitro release behaviours of drug-loading carriers.Methods Using cholesterol as hydrophobic ligand,succinic anhydride and 1,6-hexyldiisocyanate as spacers,hydrophobic modified pullulans with different molecular weights were prepared.Self-assembled nanoparticles were then formed in the aqueous solution,and drug-loaded nanoparticles were prepared by dialysis method.The influence of pullulan molecular weight and spacer length on the loading-content,morphologies and in vitro release behaviours of drug-loading nanoparticles were then investigated in detail.Results Self-assembled nanoparticles could be formed by the cholesterol-modified pullulan,and doxorubicin and mitoxantrone could be loaded into cholesterol-modified pullulan to form nanoparticles.Pullulan molecular weight and spacer length show influences on sizes,morphologies and stabilities of pullulan nanoparticles and drug-loaded nanocarriers.Conclusions Before drug loading,nanoparticles with larger moleculare weight and shorter spacer length are more stable in solution,while after drug loading,the influences of these two factors on the nanoparticles are drug-type depended.