OBJECTIVETo study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries.

METHODSTwelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit's nerve function and morphology.

RESULTSThe ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron.

CONCLUSIONCrossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

Adolescent ; Adult ; Anastomosis, Surgical ; methods ; Animals ; Central Nervous System ; injuries ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures ; methods ; Peripheral Nerve Injuries ; Peripheral Nerves ; surgery ; Rabbits ; Trauma, Nervous System ; surgery ; Young Adult

Animals ; Apoptosis ; drug effects ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; Pyridines ; pharmacology ; Rats ; Signal Transduction ; Spinal Cord Injuries ; enzymology ; pathology ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo investigate the clinical effects of close reduction and percutaneous minimally invasive fixation in the treatment of proximal humerus fractures.

METHODSFrom April 2008 to March 2010, 28 patients with proximal humerus fracture were treated with close reduction and percutaneous minimally invasive fixation. There were 21 males and 7 females, ranging in age from 22 to 78 years,with an average of 42.6 years. The mean time from suffering injuries to the operation was 1.7 d. Nineteen cases caused by falling down, 9 cases by traffic accident. The main clinical manifestation was swelling, pain and limited mobility of shoulders. According to Neer classification, two part fractures were in 17 cases and three part fractures in 11 cases. The locking proximal humerus plate was used to minimally fixation through deltoid muscle under acromion. The operating time,volume of blood loss, the length of incision and Constant-Murley assessment were applied to evaluate the therapeutic effects.

RESULTSThe mean operating time was 40 min, the mean blood loss was 110 ml, and the mean length of incision was about 5.6 cm. The postoperative X-ray showed excellent reduction and the plate and screws were successfully place. Twenty-eight patients were followed up for 6 to 24 months (averaged 14.2 months). The healing time ranged from 6 to 8 weeks and all incision was primarily healed. There were no cases with necrosis head humerus, 24 cases without omalgia, and 4 cases with o-malgia occasionally. All the patients can complete the daily life. The mean score of Constant-Murley assessment was 91.0 +/- 5.8, 24 cases got an excellent result, 3 good and 1 fair.

CONCLUSIONClose reduction and percutaneous minimally invasive fixation, not only can reduce surgical invasive, but also guarantee the early function activities. It has the advantages of less invasive, fixed well and less damage of blood circulation.

Adult ; Aged ; Female ; Fracture Healing ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Shoulder Fractures ; physiopathology ; surgery

OBJECTIVETo explore the methods of diagnosis and surgical treatment for patients with back pain originating from endplate.

METHODSAll patients received examinations of radiography, CT, and MR imaging. Pain level of disc was decided by discography in each patient. The principal outcome judgment were pain and disability, and the efficacy of surgical treatment was assessed by visual analog scale (VAS) for pain, and the Oswestry disability index (ODI) for functional recovery.

RESULTSAll patients with a diagnosis of back pain originating from endplate according to discography were treated with anterior or posterior fusion surgery. The mean follow-up period was three years and five months (from 2 to 6 years). Among of the 21 patients, 20 (95%) reported a disappearance or marked alleviation of low back pain, and experienced a definite improvement in physical function. A statistically significant and clinically meaningful improvement on the ODI and the VAS scores were obtained in the patients with chronic low back pain originating from endplate (P = 0.0001) after treatment.

CONCLUSIONSThe study suggests that the discography and fusion surgery may be very effective methods for the diagnosis and treatment of chronic back pain originating from endplate respectively.

Adult ; Female ; Follow-Up Studies ; Humans ; Low Back Pain ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spinal Injuries ; complications ; Treatment Outcome

Objective To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder(PTSD) in trailsferred casualty after Wenchuan Earthquake.Methods Taking PTSD symptoms self-assessment scale(PCL-C) to involve 386 wounded who sufiered 40 days after the earthquake disaster,from 11 hospitals and were transferred to Chongqing city.Multi-stage cluster sampling method was used.354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD.Results This survey contains 354 subjects,with male 154(43.6%),female 200(56.4%),age 43.76±21.22,nation alities:Han people 236(66.7%),Qiang people 114(32.2%),others4(1.1%),and marriage status as unmarried 92(26.1%),married 253(71.7%),others 9(2.2%).The wounded women PTSD have more seriotis symptoms than men,and there were differences between them in repeated and disturbing dreams of this stressful experience(t=2.46,P=0.014),a strong sense of psychological suffering annoyance (t=2.02,P=0.044),having difficulty concentrating(t=2.04,P=0.042),being"super-alert"(t=2.465,P=0.014) etc,also in the total scores(t=2.489.P=0.013)(P<0.05).The PTSD symptoms of wounded degree in who had been buried in Earthquake were more serious than those not been buried.There were significant difierences between them in the iterns as:avoid thinking about or talking about a stressful experience(t=2.661,P=0.008),avoid activities or situations that could fecall the stressful experience(t=2.705,P=0.007),trouble remembering important parts of a stressful experience (t=2.775,P=0.006),feeling emotionally numb or being unable to have loving feelings for those close to you(t=3.017,P=0.003),feeling as if your future will somehow be cut short(t=2.979,P=0.003) and total scores(t=3.175,P=0.002).The wounded that witnessed someone be buried or died in earthquake,in PTSD symptoms,were more serious than those without.In the items of feeling distant or cut off from other people,feeling emotionally numb or being unable to have loving feelings for those close to you,feeling irritable or having angry outbursts, there were significant difference(P<0.05-0.01).There were significant difrerences among the average score of the three core symptoms(F=3.350,P<0.001),among the three core symptoms as well as between the three core symptoms and total score respectively.Conclusion There were differences in the severity degrees of PTST in transferred casualty under difrerent exposed conditions.Correlations were also found between each of the symptoms.