Objective To evaluate effect of combined corpeetomy for multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).Methods Fifteen patients with CSM or OPLL,including 9 males and 6 females,were treated with combined corpectomy which is characterized by C4 and C6 corpectomy,excision of osteophyma,protruded disc and/or ossified posterior longitudinal ligament on basis of preservation of C5 vertebral body,structural bone grafting in C3-5 and C5-7,and anterior cervical plate fixation at C3,C5,and C7.The clinical results were evaluated with Japanese Orthopaedic Association (JOA) score.X-rays and CT scans were taken to evaluate vertebral fusion,and MRI was used to access spinal canal decompression and condition of spinal cord.Results All patients were followed up for 9 to 42 months (average,26.7 months).Bony fusion was achieved in all 15 patients.The JOA score improved from preoperative 13.44±2.81 to postoperative 16.16±2.19 (P=0.0354).The cervical lordosis improved from preoperative 1.16°±11.74° to immediately postoperative 14.36°±7.85° (P=0.00217),and 12.92°+6.17° at the final follow-up (P=0.00292).The complications included temporary hoarseness in 2 cases,dysphagia in 1 case.Conclusion The combined corpectomy for treating CSM and OPLL can obtain reliable and satisfactory results.In operation,the preservation of C5 vertebral body can provide an additional screw anchoring force and strengthen stahility.

Objective:To investigate the effect of ultrapulse fractional carbon dioxide laser (UFCL) microporous transdermal triamcinolone acetonide acetate (TAA) in the treatment of early hypertrophic scar.Methods:Ninety patients with early hypertrophic scar in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2016 to March 2019 were included and randomly divided into study group ( n=30), control group A ( n=30) and control group B ( n=30). The control group A was treated with UFCL, the control group B was treated with TAA, and the study group was treated with UFCL combined with TAA. All three groups were treated for 6 months. The effectiveness of the three groups before and 6 months after treatment was compared, the status of hypertrophic scar was evaluated by Vancouver Scar Scale (VSS), the pain degree before and after treatment was evaluated by Visual Analogue Scale (VAS), and the patients’ satisfaction with the treatment was also evaluated. Results:(1) The study group and the control group were effective in the treatment of early hypertrophic scar, and the effective rate of the study group was higher than that of the control group A and the control group B [93.3%(28/30) vs. 70.0%(21/30) and 66.7%(20/30); all P<0.05]. (2) There was no significant difference in the scores of color, thickness, softness and vascular distribution among the three groups before treatment ( P>0.05). After 6 months of treatment, the scores of the three groups were lower than those before treatment ( P<0.05). The scores of study group were lower than those of control group A and control group B respectively( P<0.05). (3) There was no significant difference in VAS scores among the three groups before treatment ( P>0.05). The VAS scores of the three groups after treatment were lower than those before treatment, and the VAS scores in study group were lower than those in control group A and control group B( P<0.05). (4) After 6 months of treatment, the satisfaction rate of study group was higher than that of control group A and control group B ( P<0.05). Conclusions:UFCL microporous transdermal TAA can effectively treat early hypertrophic scar, reduce the VSS score and VAS score of hypertrophic scar, significantly improve the state of scar hyperplasia, and improve the satisfaction rate of patients, which can be widely used in clinic.

Objective:To investigate the effect of ultrapulse fractional carbon dioxide laser (UFCL) microporous transdermal triamcinolone acetonide acetate (TAA) in the treatment of early hypertrophic scar.Methods:Ninety patients with early hypertrophic scar in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2016 to March 2019 were included and randomly divided into study group ( n=30), control group A ( n=30) and control group B ( n=30). The control group A was treated with UFCL, the control group B was treated with TAA, and the study group was treated with UFCL combined with TAA. All three groups were treated for 6 months. The effectiveness of the three groups before and 6 months after treatment was compared, the status of hypertrophic scar was evaluated by Vancouver Scar Scale (VSS), the pain degree before and after treatment was evaluated by Visual Analogue Scale (VAS), and the patients’ satisfaction with the treatment was also evaluated. Results:(1) The study group and the control group were effective in the treatment of early hypertrophic scar, and the effective rate of the study group was higher than that of the control group A and the control group B [93.3%(28/30) vs. 70.0%(21/30) and 66.7%(20/30); all P<0.05]. (2) There was no significant difference in the scores of color, thickness, softness and vascular distribution among the three groups before treatment ( P>0.05). After 6 months of treatment, the scores of the three groups were lower than those before treatment ( P<0.05). The scores of study group were lower than those of control group A and control group B respectively( P<0.05). (3) There was no significant difference in VAS scores among the three groups before treatment ( P>0.05). The VAS scores of the three groups after treatment were lower than those before treatment, and the VAS scores in study group were lower than those in control group A and control group B( P<0.05). (4) After 6 months of treatment, the satisfaction rate of study group was higher than that of control group A and control group B ( P<0.05). Conclusions:UFCL microporous transdermal TAA can effectively treat early hypertrophic scar, reduce the VSS score and VAS score of hypertrophic scar, significantly improve the state of scar hyperplasia, and improve the satisfaction rate of patients, which can be widely used in clinic.

The growth of puberty height is affected by many factors, among which the role of sex hormones is particularly important. The height increase in puberty accounts for about 20% of the final height in adulthood. It was previously believed that the final height of patients with disorders of sexual development was impaired due to the disorder of sex hormones. However, there are more classifications and subtypes of disorders of sexual development, and the growth patterns of patients with different subtypes of disorders of sexual development are also different. This article briefly reviews puberty bone growth, the effect of sex hormones on puberty bones, the sex hormone spectrum and growth pattern of patients with common disorders of sexual development, and the effect of growth hormone therapy.

The growth of puberty height is affected by many factors, among which the role of sex hormones is particularly important. The height increase in puberty accounts for about 20% of the final height in adulthood. It was previously believed that the final height of patients with disorders of sexual development was impaired due to the disorder of sex hormones. However, there are more classifications and subtypes of disorders of sexual development, and the growth patterns of patients with different subtypes of disorders of sexual development are also different. This article briefly reviews puberty bone growth, the effect of sex hormones on puberty bones, the sex hormone spectrum and growth pattern of patients with common disorders of sexual development, and the effect of growth hormone therapy.

Objective Starting from the actual numbers of health personnel of tertiary public hospitals of Traditional Chinese Medicine(TCM),to quantitatively analyze the influencing factors on the allocation of human resources and obtain a prediction model.Methods The balanced panel data from 517 Tertiary Public TCM Hospitals in the period of 2011-2020 were collected,and the two-way fixed effects model was used to empirically analyze the impact of scale,demand and other factors on the actual number of health personnel in these hospitals.Result The number of beds is a key factor affecting the human resource allocation of Public TCM Hospitals,and various factors such as de-mand,policy,price,efficiency,and administrative management also have significant impacts on the allocation.The demand for outpatient services,government financial support,and efficiency of resource utilization are all promoting factors,while the increase in human resource prices,income generation efficiency,and administrative manage-ment levels have negative effects.A prediction model is proposed.Conclusion The planning principle of matching bed numbers with human resources allocation is in line with the actual environment.When predicting the total personnel allocation or authorized strength,various factors should also be fully considered,which can provide reference for the formulation of human resource policies in Public TCM Hospitals.

OBJECTIVE: To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture. METHODS: Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically. RESULTS: All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover. CONCLUSION Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; complications ; surgery ; Fractures, Compression ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Multiple Trauma ; classification ; Spinal Fractures ; classification ; complications ; surgery ; Sternum ; injuries ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

Objective:To explore the clinical effect of modified urethral anastomosis in penile reconstruction for female-to-male(FTM) transsexuals.Methods:A retrospective analysis was performed on the FTM transsexuals undergoing penile and urethral reconstruction in Second Affiliated Hospital of Naval Medical University from December 2016 to December 2020. In this method, lower abdominal flap and anterolateral thigh (ALT) flap were used to reconstruct the neophallus, and vaginal mucosa was used to reconstruct the urethra step by step. The 2 stage procedure was divided into 3 stage. During the second stage operation, a 2 cm wide flap bridge was reserved near the perineal end of the prefabricated urethral opening, which separated the prefabricated urethral from the urethra reserved at the pubic area. And the third stage urethral anastomosis was performed 6 months later. The urethral function after penile reconstruction was followed up to observe whether the patients had urinary fistula, standing urination and urethral patency.Results:A total of 6 FTM transsexuals, aged 29-40 years, were enrolled in the study. The operation was successful. Among them, the right ALT flap was used in 4 cases, and the left lower abdominal flap was used in 2 cases. In one case, partial flap necrosis was found in the distal part of the penis one week after the second stage surgery, which healed with free skin grafting after 2 weeks. During postoperative follow-up of 10-30 months, no urinary fistula occurred and all patients were able to urinate standing up, with no urethral stricture.Conclusions:The urethra was prefabricated with a lower abdominal flap or ALT flap, and then the procedure of phalloplasty and modified urethral anastomosis was performed in stages, which could reduce the incidence of urinary fistula and urethral stricture in FTM transsexuals.

Objective:To explore the effect of oxidative stress on cognitive function following chest blast injury in mice.Methods:Sixty male C57BL/6 mice were divided into control group ( n=15) and chest blast group ( n=45) according to a random number table. The chest blast group was subgrouped at 1, 3, 7 days after injury for subsequent experiments. A self-developed blast injury device was used to prepare the mouse model of chest blast injury. Toklu score was used to evaluate the behavior changes in mice. Morris water maze test was used to evaluate the changes in spatial memory. HE staining was used to observe the pathological changes in the frontal cortex and hippocampus. Tissue reactive oxygen species (ROS) assay kit was used to detect ROS expression in the frontal cortex and hippocampus. Western blotting was used to assess changes of malondialdehyde (MDA) and cyclooxygenase-2 (COX2) in the frontal cortex and hippocampus. Results:The Toklu score of the chest blast group at 1 day after injury was (6.7±2.1)points, significantly higher than that of the control group [(2.0±0.0)points], as well as those of the chest blast group at 3 and 7 days after injury [(2.7±1.2)points and (2.0±0.0)points] (all P<0.01). There was no significant difference in the Toklu score between the control group and the chest blast group at 3 and 7 days after injury (all P>0.05). The Morris water maze test showed that the latency periods at 1 and 3 days after injury were 60.1(60.1, 60.1)seconds and 60.1(56.3, 60.1)seconds, significantly longer than that of the control group [10.1(3.9, 18.3)seconds] (all P<0.01). The latency period of the chest blast group at 7 days after injury was 60.1(30.5, 60.1)seconds, with no difference from the control group ( P>0.05). No significant differences were found in the latency periods of the chest blast group at 1, 3 and 7 days after injury (all P>0.05). In the control group, the pyramidal cells in the frontal cortex and hippocampus were regular in shape, with intensely-stained and clearly visible nuclei as well as uniform cytoplasm. In the chest blast group, diflerent degree of necrosis of pyramidal cells in the frontal cortex and strong cytoplasmic eosinophilia in the hippocampus were observed at different time points after injury. The levels of ROS in the frontal cortex of the chest blast group were (10.43±0.36)RFU/mg and (2.91±0.35)RFU/mg at 3 and 7 days after injury, which were significantly higher than that of the control group [(0.70±0.01)RFU/mg] ( P<0.05 or 0.01). The level of ROS in the frontal cortex of the chest blast group at 3 days after injury was significantly higher than that at 1 day [(2.13±0.65)RFU/mg] and that at 7 days after injury (all P<0.01). There were no statistical differences in the levels of ROS in the frontal cortex of the chest blast group at 1 and 7 days after injury ( P>0.05). The levels of ROS in the hippocampus of the chest blast group were (5.39±0.79)RFU/mg and (5.65±1.17)RFU/mg at 3 and 7 days after injury, which were significantly higher than those of the control group and of the chest blast group at 1 day after injury [ (0.73±0.06)RFU/mg and (2.33±0.02)RFU/mg] (all P<0.01). No significant differences were found between the levels of ROS in the hippocampus of the chest blast group at 3 and 7 days after injury and between the ROS levels of the control group and of the chest blast group at 1 day after injury (all P>0.05). The levels of ROS in the frontal cortex and hippocampus showed significant differences between the chest blast group at 3 and 7 days after injury (all P<0.01) but no significant differences between the control group and the chest blast group at 1 day after injury (all P>0.05). Western blotting showed that the levels of MDA in the frontal cortex of the chest blast group were 0.73±0.04, 0.83±0.04 and 0.99±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.56±0.04) ( P<0.05 or 0.01). The level of MDA in the frontal cortex of the chest blast group was significantly higher at 7 days after injury compared with that at 1 and 3 days after injury ( P<0.05 or 0.01), but there was no statistical difference between 1 day and 3 days after injury ( P>0.05). The levels of COX2 in the frontal cortex of the chest blast group were 2.93±0.02, 4.82±0.15 and 4.76±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (1.93±0.06) (all P<0.01). There were statistical differences in the levels of COX2 in the frontal cortex of the chest blast group at 3 and 7 days after injury compared with that at 1 day after injury (all P<0.01), but no statistical significance was found between 3 and 7 days after injury ( P>0.05). The levels of MDA in the hippocampus of the chest blast group were 0.92±0.11, 0.83±0.03 and 0.68±0.03 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.49±0.03) (all P<0.01). There was a significant difference in the level of MDA in the hippocampus of the chest blast group at 7 days after injury compared with those at 1 and 3 days after injury ( P<0.05 or 0.01), but the difference was not statistically significant among other groups (all P>0.05). The levels of COX2 in the hippocampus of the chest blast group were 0.88±0.06, 0.87±0.06 and 0.80±0.06 at 1, 3 and 7 days after injury, which were significantly higher than that of the control group (0.37±0.04) (all P<0.01). There were significant differences in the levels of COX2 of the chest blast group among 1, 3 and 7 days after injury (all P>0.05). Statistically significant differences were found between the levels of MDA in the frontal cortex and hippocampus of the chest blast group at 1 and 7 days after injury (all P<0.01), but no statistical significant difference between the control group and the chest blast group at 1 day after injury ( P>0.05). The levels of COX2 in the frontal cortex and hippocampus were significantly different among all groups (all P<0.01). Conclusions:In the short term after chest blast injury, there will be cognitive dysfunction in mice. Oxidative stress is one of the important contributing factors, and the cognitive damage in the frontal cortex is more serious than that in the hippocampus.

Objective:To explore the clinical effect of modified urethral anastomosis in penile reconstruction for female-to-male(FTM) transsexuals.Methods:A retrospective analysis was performed on the FTM transsexuals undergoing penile and urethral reconstruction in Second Affiliated Hospital of Naval Medical University from December 2016 to December 2020. In this method, lower abdominal flap and anterolateral thigh (ALT) flap were used to reconstruct the neophallus, and vaginal mucosa was used to reconstruct the urethra step by step. The 2 stage procedure was divided into 3 stage. During the second stage operation, a 2 cm wide flap bridge was reserved near the perineal end of the prefabricated urethral opening, which separated the prefabricated urethral from the urethra reserved at the pubic area. And the third stage urethral anastomosis was performed 6 months later. The urethral function after penile reconstruction was followed up to observe whether the patients had urinary fistula, standing urination and urethral patency.Results:A total of 6 FTM transsexuals, aged 29-40 years, were enrolled in the study. The operation was successful. Among them, the right ALT flap was used in 4 cases, and the left lower abdominal flap was used in 2 cases. In one case, partial flap necrosis was found in the distal part of the penis one week after the second stage surgery, which healed with free skin grafting after 2 weeks. During postoperative follow-up of 10-30 months, no urinary fistula occurred and all patients were able to urinate standing up, with no urethral stricture.Conclusions:The urethra was prefabricated with a lower abdominal flap or ALT flap, and then the procedure of phalloplasty and modified urethral anastomosis was performed in stages, which could reduce the incidence of urinary fistula and urethral stricture in FTM transsexuals.