Humans ; Spinal Fusion ; Spine ; surgery

Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; surgery ; Osteotomy ; adverse effects ; methods ; Thoracic Vertebrae ; surgery

Objective To study effects and other related problems of surgery for patients with cervical spine fracture and ankylosing spondylitis.Methods Twelve patients with cervical spine fracture and ankylosing spondylitis were treated with surgery from April 1986 to April 2004.All eases were studied retrospectively.They were followed up for an average of 67.5 months and their complete clinical data were kept.The neurological function was evaluated by ASIA (American Spinal Injury Association) impairment scale,and the image analyzing software (Image-Pro Plus 5.1) was used to measure the angles of superior and inferior vertebral bodies of the fusion segment at flexion and extension positions.The difference between flexion and extension angles,?,served as the parameter of interspinal movement.According to the definition of spinal fusion by FDA (Food and Drug Administration),the?≥4?was considered as nonfusion.Other related problems were discussed by descriptive study.Results The average improvement in the nine patients with neurological injury was 1.3 ASIA grades.The injured segments in 10 cases were treated with fusion,of whom nine were fused by internal fixation.The fusion rate was 100%.Three cases were scheduled to have laminoplasty,but two had to receive laminectomy instead because of intraoperative complete fracture at the hinged side.Ten patients were complicated by insufficient function of major organs preop- eratively,and endotracheal intubation was difficult to perform in eight cases.Postoperative complications occurred in three cases,but fortunately healed completely.There were no deaths or fatal complications.Conclusions The neurological function can be improved by surgery for patients with cervical spine fracture and ankylosing spondylitis. Although the cervical spine is instable for most of the patients,fusion with internal fixation is indicated and can be successful.Those who had preoperative systemic diseases are likely to suffer from postoperative complications.The difficult endotracheal intubation is a common intraoperative problem.

Objective To explore the effect of long-term chronic mild stress on depression-like behaviors and the expression of heat shock protein 70(HSP70) in rats.Methods The standard SD rats were divided into two groups as following:one group (n =6) was treated with chronic mild stress for 3 weeks,and another group (n =5) was treated with chronic mild stress for 6 weeks.Depression-like behaviors of rats was observed by sucrose consumption test and open field test before and after chronic mild stress.And Western Blot,RT-PCR and immunohistochemistry were utilized to detect the HSP70 expression in the hippocampus and frontal lobes of rats after chronic mild stress.Results The sucrose favoritism in sucrose consumption test,the scores of crossing and the time for rats' retention in the center grid of open field test in long-term group were higher than those in short term group(P＜ 0.05).HSP70 expression in the hippocampus and frontal lobes of long-term group (0.81 ± 0.08,0.85 ± 0.08)detected by Western Blot and immunohistochemistry was higher that of short-term group (0.60 ± 0.06,0.85 ±0.07).HSP70 expression in the hippocampus of long-term group (0.90 ± 0.05,1.37 ± 0.38)detected by RT-PCR was higher that of short-term group(0.78 ± 0.04,1.08 ± 0.14) (P ＜ 0.05).Conclusion After long-term chronic mild stress,the depression-like behaviors decrease,and at the same time HSP70 mRNA and protein increase.

Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.

Objective:To evaluate the effects of perioperative glutamine-supplemented total parenteral nutrition support on nutritional status of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer were randomized into three groups.The group of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric(104.6 kJ/(kg?d) and isonitrogenous(0.20 g/kg?d~(-1)) total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting for 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.Nutritional status was determined by body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of albumin,prealbumin transferin,glutamine,muscle concentration of glutamine and nitrogen balance.Results:No serious complications occurred in any groups during the trial.Body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of prealbumin,transferin and nitrogen balance were not significantly different among groups.On postoperative day 6,the concentration of glutamine in blood and muscle in Gln-TPN group was higher than that in other two groups.Conclusions:Glutamine-supplemented TPN is beneficial to alleviating the state of catabolism caused by chemotherapy and operation.It can raise the concentrations of glutamine in blood and muscle,decrease the loss of muscle and fat tissue and promote synthesis of protein.

To explore the protective effect of sodium tanshinone IIA sulfonate (STS) on microcirculatory disturbance of small intestine in rats with sepsis, and the possible mechanism, a rat model of sepsis was induced by cecal ligation and puncture (CLP). Rats were randomly divided into 3 groups: sham operated group (S), sepsis group (CLP) and STS treatment group (STS). STS (1 mg/kg) was slowly injected through the right external jugular vein after CLP. The histopathologic changes in the intestinal tissue and changes of mesenteric microcirculation were observed. The levels of tumor necrosis factor-α (TNF-α) in the intestinal tissue were determined by using enzyme-linked immunoabsorbent assay (ELISA). The expression of intercellular adhesion molecule-1 (ICAM-1) in the intestinal tissue was detected by using immunohistochemisty and Western blot, that of nuclear factor κB (NF-κB) and tissue factor (TF) by using Western blot, and the levels of NF-κB mRNA expression by using RT-PCR respectively. The microcirculatory disturbance of the intestine was aggravated after CLP. The injury of the intestinal tissues was obviously aggravated in CLP group as compared with S group. The expression levels of NF-κB p65, ICAM-1, TF and TNF-α were upregulaed after CLP (P<0.01). STS post-treatment could ameliorate the microcirculatory disturbance, attenuate the injury of the intestinal tissues induced by CLP, and decrease the levels of NF-κB, ICAM-1, TF and TNF-α (P<0.01). It is suggested that STS can ameliorate the microcirculatory disturbance of the small intestine in rats with sepsis, and the mechanism may be associated with the inhibition of inflammatory responses and amelioration of coagulation abnormality.

Calculi ; Humans ; Lung Diseases ; Male ; Middle Aged ; Pulmonary Alveoli ; pathology

Carcinoma, Squamous Cell ; radiotherapy ; Head and Neck Neoplasms ; radiotherapy ; Humans

ObjectiveTo evaluate a second endoscopy for prevention of delayed bleeding after ESD.MethodsData of 67 patients with gastric epithelial neoplasms undergoing ESD from May to November 2011 were reviewed.The median age was 63 ( 31 ～ 84) years.All patients were followed up by endoscopy on the first and the third day after ESD.ResultsOf 67 lesions,5 were located at cardia,6 at gastric body,3 at fundus,35 at antrum,16 at gastric angle,and 2 at residual stomach.The mean maximum diameter of the lesions was 3.73±4 1.24 (2.0 ～ 7.0) cm.There were no intraoperative complications.Post-ESD delayed bleeding was detected by endoscopy in 6 (9.0％ ) patients,with 5 on the third day and 1 on the fourth day.Forrest grading showed 2 cases of Ⅰ b,and 4 of Ⅱ b.All 6 cases were cured by endoscopy.The incidence of postoperative bleeding was far more than that evaluated based on the patients' clinical manifestations only.But therapeutic effect and saffety were the same according to the follow-up results.ConclusionIncidence of post-ESD bleeding is high,but there are no symptoms or severe consequences,so a second endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding.