Adult ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Skin ; blood supply ; injuries ; Surgical Flaps ; Young Adult

BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, fewer complications and higher patient satisfaction. However, for the mobile bearing and the fixed bearing, the choice of single condylar prosthesis is till controversial.OBJECTIVE: To investigate the difference of LINK fixed-bearing and Oxford mobile-bearing unicompartment arthroplasty in relieving knee joint pain, reconstruction of the knee joint function, correct the knee joint deformity for medial unicompartment knee osteoarthritis, thus providing the basis for selecting a better prosthesis.METHODS: Ninety patients with medial unicompartment knee osteoarthritis undergoing unicompartmental knee arthroplasty in the Department of Joint Surgery, Guangdong Provincial Hospital of TCM from December 2014 to June 2016 were analyzed retrospectively, followed by allotted into Oxford mobile-bearing and LINK fixed-bearing groups (n=45 per group). The preoperative and postoperative pain level, range of motion of the knee, complications, and limb alignment were assessed. The range of motion and function of the knee were evaluated by Knee Society Score system.RESULTS AND CONCLUSION: (1) The two kinds of prosthesises both could obtain good clinical effectiveness. (2)There was no significant difference in the Knee Society Score, Visual Analogue Scale scores, or the range of motion of the knee between two groups (P > 0.05). (3) No complications such as deep vein thrombosis, prosthesis loosening and joint revision were found in both groups. (4) The correction of limb alignment showed significant difference between two groups (P < 0.05). The corrective femorotibial angle in the Oxford mobile-bearing group was larger than that in the LINK fixed-bearing group. (5) These findings manifest that under the precondition of strictly mastering the indications, both fixed-bearing and Oxford mobile-bearing unicompartment arthroplasties can effectively relieve the pain and improve the function of knee joint in the treatment of unicompartmental knee osteoarthritis. Oxford mobile-bearing prosthesis exhibits advantage in restoring the limb alignment; the movable platform lower limb alignment correction angle is often bigger than fixed platform correction angle, but may accelerate the lateral cartilage wear.

OBJECTIVE: To evaluate the therapeutical effect of surgical treatment for thoracic angioma with extraosseous extension which causes spinal cord compression and neurological dysfunction. METHODS: We retrospectively analyzed 5 cases of thoracic vertebral body angioma with extraosseous extension and spinal cord compression. The operation were performed through anterior approach to resect the involved vertebral body and intracanal angioma in 5 patients. Bone graft and internal fixation were also completed in the meantime. Two patients accepted radiotherapy for 2 periods of treatment postoperatively, and the other 3 patients didn't accept the other supportive therapy. RESULTS: The blood loss during the operation was 1000 mL to 1500 mL. All the patients recovered their neurological function rapidly after the operation. The patients were followed up for 1 to 4 years, and no patient recurred. The bone graft was solidly fused in all patients. No hardware failure occurred. CONCLUSION The surgical treatment for thoracic vertebral body and extraosseous angioma with spinal cord compression is effective, reliable, and workable. Good long-term result can be obtained.
Adult ; Follow-Up Studies ; Hemangioma ; complications ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Compression ; etiology ; Spinal Neoplasms ; complications ; surgery ; Thoracic Vertebrae ; surgery

OBJECTIVETo discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis (AS) and the effect of combined anterior and posterior operation.

METHODSEighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel's score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach.

RESULTSThere were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up.

CONCLUSIONSThe study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.

Adult ; Cervical Vertebrae ; injuries ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Fractures ; surgery ; Spondylitis, Ankylosing ; complications

OBJECTIVETo study the effects of ultraviolet (UV) light-treatment on the physicochemical properties and bioactivity of micro-arc oxidation (MAO) titanium surfaces in vitro.

METHODSThe pure titanium were prepared using MAO. MAO titanium samples were treated with 15 W bactericidal lamp UVC [λ = (250 ± 20) nm] or 15 W mercury lamp [λ = (360 ± 20) nm] for 24 h under ambient conditions. Three sample groups were prepared: MAO, UVA treated after MAO (MAO + UVA), UVC treated after MAO (MAO + UVC). The surface physicochemical properties were evaluated using scanning electron microscopy (SEM), contact angle measuring device, energy dispersive X-ray spectrometer (EDX), and X-ray diffraction (XRD). Bicinchoninic acid (BCA) based colorimetric detection was used to quantify the percentage of albumin adsorption after 2 h, 6 h, and 24 h incubation on the titanium surfaces. The rates of MG-63 cells attached to each group titanium surfaces were calculated by nucleus immunofluorescence using Hoechst 33342 after 1 h, 2 h, and 4 h incubation. SEM was used to observe cell morphology on titanium surfaces in each group.

RESULTSNo obvious differences in surface topography, TiO(2) crystal and elemental composition were detected on titanium surfaces with or without UV treatment. Statistically significant difference in contact angles among MAO + UVC group (65.34 ± 1.16)°, MAO + UVA group (44.64 ± 1.28)°, and MAO group (3.41 ± 0.48)° were found (P < 0.001). The percentage of albumin adsorption reached the plateau after 2 h incubation on MAO + UVC titanium surfaces (48.16 ± 1.24)%, which was higher than those in MAO [(8.22 ± 2.99)%] and MAO + UVA groups [(5.29 ± 2.27)%, P < 0.001]. The rates of cells attached to the surfaces of MAO + UVC titanium was greater than that on MAO surfaces and MAO + UVA surfaces after 1 h [(40.71 ± 4.08)%], 2 h [(53.72 ± 2.38)%], 4 h [(70.32 ± 2.85)%] incubation (P < 0.05). The MAO + UVC surfaces remarkably enhanced the spread of MG-63 cells, however, there was no significant difference between the group of MAO and MAO + UVA.

CONCLUSIONSPretreatment of micro-arc oxidation titanium with UVC light considerably improved the surface bioactivity to MG-63 cells, which showed an increase in cellular attachment and spread.

Absorption ; Albumins ; metabolism ; Cell Adhesion ; Cell Line, Tumor ; Humans ; Microscopy, Electron, Scanning ; Osteosarcoma ; pathology ; Oxidation-Reduction ; Spectrometry, X-Ray Emission ; Surface Properties ; Titanium ; chemistry ; radiation effects ; Ultraviolet Rays ; X-Ray Diffraction

OBJECTIVETo discuss the pathological characteristics of cervical spinal fracture of ankylosing spondylitis (AS), and surgical effect by combined anterior and posterior operation.

METHODSEighteen AS patients with traumatic cervical fracture-dislocation were treated from January 2000 to January 2006. The symptom duration of AS was 14.5 years in average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D in Frankel's score. All patients underwent surgical procedures by combined anterior and posterior approach.

RESULTSThere were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage. There were some extent neurological improvement in 14 incompletely paraplegic patients, no improvement in 4 complete paraplegia patients. The follow-up period was 21.2 months in average and the bone fusion was 3.6 months. There were 4 complications during perioperative period and 1 in long term follow-up.

CONCLUSIONSThe study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is the reasonable surgical strategy in the treatment of cervical spinal fracture-dislocation with AS.

Adult ; Cervical Vertebrae ; injuries ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Compression ; complications ; surgery ; Spinal Fractures ; complications ; surgery ; Spinal Fusion ; methods ; Spondylitis, Ankylosing ; complications ; pathology ; Treatment Outcome

OBJECTIVETo prepare pneumolysin as a new protein carrier of vaccine against otitis media with genetic engineering technology and establish the base of the study on pneumococcal conjugative vaccines.

METHODSGenomic DNA was isolated from streptococcus pneumoniae. A pair of primers which included two restriction sites was designed based on the published pneumolysin gene sequence. The pneumolysin gene was amplified from pneumococcal DNA with PCR technology. The restriction enzyme digested fragment was linked into the cloning vector PET-28a and the recombinant plasmid DNA containing pneumolysin was then transfected into host cell E. coli JM109 (DE3).

RESULTSDNA fragments were subcloned to construct the complete pneumolysin gene by a conventional coning and PCR. The inserted pneumolysin gene sequence was confirmed by DNA sequencing and the pneumolysin protein was successfully expressed. The relative molecular mass of the expressed product was 52 000. The expressed product amounted to 8% of the total host cell protein.

CONCLUSIONSThe pneumolysin gene was successfully cloned into host cell using genetic engineering technology. The recombinant pneumolysin was expressed and purified for preparation. This work laid a foundation of the preparation of pneumococcal conjugative vaccines.

Bacterial Proteins ; biosynthesis ; genetics ; Cloning, Molecular ; Genetic Engineering ; Genetic Vectors ; Plasmids ; Pneumococcal Vaccines ; genetics ; Streptococcus pneumoniae ; genetics ; Streptolysins ; biosynthesis ; genetics

OBJECTIVETo compare the efficacy and toxicity of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of stage III non-small cell lung cancer.

METHODSFrom February, 2007 to June, 2010, 93 patients with unresectable stage III non-small cell lung cancer were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of cisplatin plus gemcitabine, docetaxel or vinorelbine. Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy).

RESULTSThe response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant metastasis than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis, radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT-CT group had a significantly higher rate of III-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group.

CONCLUSIONCompared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant metastasis, but is associated with a higher toxicity.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; radiotherapy ; therapy ; Chemoradiotherapy ; methods ; Combined Modality Therapy ; Consolidation Chemotherapy ; methods ; Female ; Humans ; Lung Neoplasms ; radiotherapy ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Survival Analysis

OBJECTIVE: To evaluate the efficacy of screw-rod technique in treating cervical spinal cord injury without fracture and dislocation. METHODS: The screw-rod technique was used to treat 38 patients with cervical spinal cord injury without fracture and dislocation. The JOA scores before and after the surgery were evaluated. RESULTS: No severe complication occurred. The JOA scores were increased by 4.1, 6.7, 7.8, and 8.1 respectively at 0 th, 4 th, 12 th and 24 th weeks after the operation. Neurological deficits were improved one year after the operation in 1 patient. CONCLUSION Treating cervical spinal cord injury without fracture and dislocation with screw-rod technique can achive an efficient and safe clinical outcome.
Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Spinal Cord Injuries ; surgery ; Spinal Injuries ; surgery

OBJECTIVE: To evaluate the clinical outcome of one stage posterior vertebral column resection in patients with spinal tuberculosis combined with kyphotic deformity. METHODS: Thirty-six patients with spinal tuberculosis combined with kyphotic deformity underwent posterior one-stage vertebral column resection reducing tension on the spinal cord from 1998 to 2006. The patients were mobilized with a thoracolumbar orthosis for 3 months. All patients had a minimum of a 2-year follow-up, and clinical examinations and radiographs were obtained at 6-month intervals. RESULTS: No perioperative mortality occurred. The average duration of surgery was 208 (145 approximately 385) min. The kyphotic Cobb angle improved from the preoperative average of 57.2 degree(17 degree approximately 86 degree) to a postoperative average of 8.9 degree(-6 degree approximately 27 degree). The average horizontal distance between C(7) and S(1) was 13.6 (8 approximately 19) mm preoperatively and 3.6 (-11 approximately 9) mm postoperatively. Nineteen patients had preoperative neurological deficits. Of them, 89.5% (17/19) showed a postoperative neurologic improvement. Perioperative complications occurred in 3(8.5%) of the 36 patients with pneumonias and superficial infections. Twenty-five patients (69.4%) showed radiographic evidence of solid fusion in the follow-up examinations. In the follow-up, 25% (9/36) patients rated their results as excellent, 66.7% (24/36) as good, 2 as fair, and 1 as poor. CONCLUSION One stage posterior vertebral column resection for the treatment of spinal tuberculosis with kyphotic deformity is safe and effective. Because this procedure is highly technical, the surgeon must be familiar with the pathoanatomy and the operation must be carefully done.
Adolescent ; Adult ; Female ; Humans ; Kyphosis ; etiology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Osteotomy ; methods ; Spine ; surgery ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; complications ; surgery