BACKGROUND: Current commonly used bone graft materials include cancellous bone or bone blocks from ilium, tibia, fibula and others. There is no report of bone graft and fusion in cervical spine from manubrium sterni. OBJECTIVE: To measure lateral X-ray of cervical vertebrae with no degeneration and manubrium sterni samples to explore feasibility of autologous cancellous bone graft of manubrium sterni with pyramesh in anterior cervical spinal fusion surgery, so as to develop a new source of autogenous bone graft.METHODS: A total of 40 manubrium sterni specimens were selected and the length, maximum width and minimum width, thickness, anterior and posterior cortex thickness of manubrium sterni were measured. Manubrium sterni area was calculated: the length, maximum width and minimum width were 4 mm reduced from those of manubrium sterni, its thickness was 2 mm reduced from that of manubrium sterni. The formula of measuring the manubrium sterni volume is (maximum width of manubrium sterni + the minimum width of manubrium sterni)×length of manubrium sterni × thickness of manubrium sterni×1/2. Intervertebral height and vertebral height from C2 to C7 were measured from lateral cervical radiograph of 106 patients with cervical radiolopathy, and the length of pyramesh needed in anterior cervical spinal surgery for one, two, three discs resection, one vertebra plus two discs resection and two vertebrae plus three discs resection was calculated. RESULTS AND CONCLUSION: The manubrium sterni volume was (17 735.51±5 234.92) mm3 and the volume of bone-grafting area was (8 982.83±2 427.76) mm3. The length of pyramesh and volume of bone used in operation were minimal for one disc resection, and maximal for two vertebrae plus three discs resection. The volume of bone graft in the pyramesh was significantly less than the donor area in any anterior cervical spinal fusion operation. Results show that autologous cancellous graft of manubrium sterni combined with pyramesh supporting can be used in anterior cervical spinal fusion surgery. Compared with autologous iliac graft, this method is simpler and does not influence early functional exercise or walking bearing weight.

BACKGROUND: During thoracolumbar anterior operation, implant collapse is an important factor for affecting outcome in patients with thoracolumbar fracture. In particular, osteoporotic patients commonly developed implant collapse, nail channel loose, bone disunion, kyphosis deformation. Bioactive artificial vertebrae of nano-hydroxyapatite and polyamide 66 (n-HA/PA66) has good biocompatibility and biological safety and is an ideal substitute for vertebral body bone graft. OBJECTIVE: To investigate the efficacy of the bioactive artificial verteificial vertebrae of nano-hydroxyapatite and polyamide 66 (n-HA/PA66) for osteoporotic thoracolumbar burst fracture. DESIGN, TIME AND SETTING: A retrospective case analysis was conducted at the Department of Spinal Surgery, Affiliated Hospital of Luzhou Medical College from January 2004 to January 2008. PARTICIPANTS: A total of 20 patients with moderate and severe osteoporotic thoracolumbar fracture (6 males and 14 females) aged 51 -82 years, with an average of 69 years were enrolled in this study. There were 17 cases of fresh fracture and 3 cases of old fracture. n-HAyPA66 was produced by the Sichuan Guona Science and Technology Co., Ltd. This artificial vertebral body was in 10-35 mm diameter, 30-100 mm length, circular cylinder shape, 3-12 mm midheaven diameter, 2.5-6.5 mm tubal wall thickness, with the presence of 2 mm holes surrounding the vertebral body. The contact area of the vertebral body was 78.5-176.7 mm2. Fixity was anterior nail plate system (titanium alloy material) produced by Foshan Shitaibao Company. METHODS: Following conventional tracheal intubation and general anesthesia, at right arm recumbent, according to various fracture-involved segments, different regions were incised and treated with anterior decompression, implanted with artificial vertebrae with the bioactive artificial verteificial vertebrae n-HA/PA66 and fixed with steel plate. MAIN OUTCOME MEASURES: Fracture healing and implant loose were observed by radiograph. Cobb angle, the height of damaged vertebral body and spinal cord function score were compared prior to surgery, 3 months following surgery and the last follow-up. RESULTS: All the patients were successfully operated. Bleeding 200-800 mL during surgery and operation time ranged from 2.0 to 3.0 hours. There were 1 case of pulmonary infection and 1 case of delayed wound healing. A total of 20 patients were followed up for 6-42 months (averagely 18 months). Postoperative radiograph review demonstrated that closed vertebral body was healed three to four months. No significant displacement of implant was found. There was less loss of reestablished vertebral body height. Internal fixation position was good, without nail breakdown or internal fixation loose/displacement. At 3 months following surgery, significant differences in Cobb angle, the height of damaged vertebral body and spinal cord function score were detected compared with that before surgery (P < 0.05). No significant difference in postoperative two follow-up was detected (P > 0.05). CONCLUSION: The bioactive artificial vertebrae of n-HA/PA66 can increase the fusion area, reduce local pressure and prevent loosening of implants and sinking into the vertebrae, finally resulting in restoration of vertebral body height.

Objective To measure the morphological parameters of cervical endplate of Chinese by using computed tomography (CT)scans,and to provide an accurate morphometric basis for designing and developing the cervical disc prostheses.Methods 80 healthy subjects were scanned by CT.The parameters of each cervical vertebra from C3 to C7 were measured by CT scans including upper anteroposterior length (APLu),upper center mediolateral length (CMLu),lower anteroposterior length (APLl) and lower center mediolateral length (CMLl).These parameters were compared between genders and among different vertebral levels.Results The values of APLu, CMLu,APLl and CMLl were increased with the decreasing of cervical segment (P APLu = 0.023,P CMLu = 0.007, P APLl =0.035,P CMLl < 0.001).There was statistically significant difference in morphological parameters between genders (P < 0.05).Compared with the reported data of other different populations,the statistically significant difference in morphological parameters also existed in the study.Conclusion The study provides an accurate morphological basis for designing the suitable artificial cervical disc for Chinese population.

lacZα-mini-attTn7 was inserted into the intergenic region between the gG and gD genes in a PRV bacterial artificial chromosome (BAC) by homologous recombination in E. coli. The resulting recombinant BAC (pBeckerZF1) was confirmed by PCR and sequencing. Green fluorescent protein (GFP) gene was then transposed into pBeckerZF1 by transposon Tn7 to generate pBeckerZF2. Recombinant viruses vBeckerZF1 and vBeckerZF2 were generated by transfection with the corresponding BAC pBeckerZF1 or pBeckerZF2. The titers and cytopathic effect (CPE) observed for by vBeckerZF1 and vBeckerZF2 was comparable to that of the parental virus vBecker3. vBeckerZF2 was serial passaged for five rounds in cell culture, and the mini-Tn7 insertion was stably maintained in viral genome. These results show that recombinant viruses can be rapidly and reliably created by Tn7-mediated transposition. This technology should accelerate greatly the pace at which recombinant PRV can be generated and, thus, facilitate the use of recombinant viruses for detailed mutagenic studies.

Objective To analyze the efficacy of the combination of MALDI-TOF and immunoadsorption to detect new biomarkers for lupus. Methods Twenty lupus patients at active stage (SLE group), 10 SLE patients in remission (SLE control group), 10 RA patients and 10 PSS patients (other rheumatic disease control group) and 20 healthy volunteers (healthy control group) were enrolled. The serum samples before and after immunoadsorption from SLE group and those from the control groups were co-incubated with activated chitosan copper derivative nano material. The adsorbed nano material was spotted onto the matrix used in MALDI-TOF for analysis by the Axima-CFR plus MALDI-TOF mass spectrometer. T-test was used for statistical analysis. Results MALDI-TOF MS screening showed that three potential protein biomarkers of mass-to-charge (m/z) ratio 3136, 3264, 3326 were found to be very specific for lupus patients: All of them were expressed before immunoadsorption in high quantity and none of them could be detected both after immunoadsorption and in all the three control groups. None of them (<10 000) were in the molecular weight range of the biomarkers used nowadays such as auto antibodies and complement (>50 000). Conclusion The combination of MALDI-TOF and immunoadsorption is effective in the detection of new serum protein biomarkers for lupus and it may be helpful in the screening of SLE patients at active stage from healthy people.

Ascites ; Bacterial Infections ; Humans ; Liver Cirrhosis ; Peritonitis ; microbiology ; Risk Factors

OBJECTIVETo analyze the incidence, clinical features and the predisposing factors of fungal septicemia, and investigate the risk factors for death due to fungal septicemia and the prognosis of the patients.

METHODSWe retrospectively analyzed the clinical data of 91 patients with fungal septicemia diagnosed in the last 17 years, including 60 patients with clinical cure or improvement, and 31 who die of the disease. Based on the results by univariate analysis, the data were analyzed using logistic multiple regression and Fisher's discriminant analysis.

RESULTSFungal septicemia had many predisposing factors with high mortality rate. Univariate analysis revealed significant differences between the cured/improved cases and the fatal cases for 12 variables, including advanced age, complication by bacterial infection, septic shock, multiple organ dysfunction syndrome (MODS), ICU patients, cortical hormone therapy, surgery, chemotherapy, use of immunopotentiating agents, length of hospital stay before antifungal therapy, time of anti-fungus therapy and types of invasive procedures. Logistic multiple regression analysis showed that the types of invasive procedures, MODS, surgery and prolonged hospital stay before antifungal therapy were the independent risk factors for fungal septicemia-related death. Fisher's linear discriminant equation was established for predicting the prognosis of the disease.

CONCLUSIONThe types of invasive procedure, MODS, surgery and prolonged hospital stay before antifungal therapy are the independent risk factors for fungal septicemia-related death, and the patients' prognosis can be predicted using Fisher's linear discriminant equation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antifungal Agents ; therapeutic use ; Cause of Death ; Child ; Child, Preschool ; Female ; Fungemia ; diagnosis ; etiology ; mortality ; therapy ; Humans ; Infant ; Male ; Middle Aged ; Models, Theoretical ; Prognosis ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo develop a public health index related to the comprehensive assessment on the impact caused by floods.

METHODSA Analytic hierarchy process (AHP) theory was used to establish the initial evaluation system on the impact of floods. Modified-Delphi process was used to screen and determine the indicators and their weights while synthetical scored method was used to establish the comprehensive assessment model. Percentile was used to differentiate the degree of floods. Finally, analysis of variance (ANOVA) and correlation analysis were used to test the differentiability of the model for different degree of floods and the independence of these indicators.

RESULTSThe model of comprehensive assessment on the impact of floods was set up, including six first-ranking indicators and twenty-four sub-indicators. The values of comprehensive assessment were divided into five grades by the percentiles. Verified results indicated that there were significant difference among the five grades (F = 76.11, P < 0.01) and all indicators were independent.

CONCLUSIONAn index of comprehensive assessment on the impact of floods was established, which could be used to evaluate the impact of floods and to differentiate the degree of flood, which seemed to have the characteristic of reliability, comprehensiveness and practicability.

Analysis of Variance ; China ; Delphi Technique ; Disasters ; Health Status Indicators ; Humans ; Models, Theoretical ; Public Health ; standards ; statistics & numerical data ; Research ; statistics & numerical data ; Research Design

In this study, immunohistochemistry and Western blot were used to determine whether the expression of NF-kappaB in the hippocampus of prenatally stressed offspring rats is gender-dependent. The results were as follows: In the female offspring rats, the expressions of p65 in the hippocampal dentate gyrus in mid-term stress (MS) and late-term stress (LS) groups were significantly less than that in the control group (P<0.01). There was a significant difference between MS and LS groups (P<0.01). The expressions of p50 in all regions of hippocampus in MS and LS groups were significantly more than that in the control group (P<0.01). A significant difference was also present between MS and LS groups (P<0.01). In the male offspring rats, the expressions of p65 in the hippocampal dentate gyrus in MS and LS groups were evidently more than that in the control group (P<0.01). There was a significant difference between MS and LS groups (P<0.01). The expressions of p50 in all regions of hippocampus in MS and LS groups were significantly less than that in the control group (P<0.05, P<0.01). There was also a significant difference in p65 expression between MS and LS groups (P<0.01). In addition, in the control group the expressions of p65 in the hippocampal dentate gyrus of female offspring rats were significantly more than that of male ones (P<0.01). However, in LS group the expressions of p65 in the hippocampal dentate gyrus of female offspring rats were significantly less than that of male ones (P<0.01). Moreover, there was no significant difference in p65 expression between female and male offspring rats in MS group. In the control group the gender difference in the expression of p50 was only observed in hippocampal CA1 (P<0.01). The expressions of p50 in all regions of hippocampus of female offspring rats were significantly more than that of male ones in LS group (P<0.01). There was no significant difference in p50 expression between female and male offspring rats in MS group. The results of Western blot were similar to those of immunohistochemical study. These results indicate that prenatal stress in different gestational periods significantly affects the expressions of p65 and p50 in hippocampus, and this effect is gender-dependent. This may be one of the mechanisms underlying the gender difference in the ability of learning and memory of the prenatally stressed offspring rats.
Animals ; Female ; Hippocampus ; metabolism ; Male ; NF-kappa B p50 Subunit ; metabolism ; Pregnancy ; Prenatal Exposure Delayed Effects ; Rats ; Sex Factors ; Stress, Physiological ; Transcription Factor RelA ; metabolism

BACKGROUND: This study aimed to investigate whether fatty infiltration (FI) measured on a single sagittal magnetic resonance imaging (MRI) slice can represent FI of the whole supraspinatus muscle. METHODS: This study retrospectively reviewed the MRIs of 106 patients (age 50–79 years) divided into three rotator cuff tear-size groups: medium, large, and massive. Fat mass and muscle mass on all T1-weighted sagittal MRI scans (FA and MA) were measured. Of the total MRI scans, the Y-view was defined as the most lateral image of the junction of the scapular spine with the scapular body on the oblique sagittal T1-weighted image. Fat mass and muscle mass seen on this Y-view single slice were recorded as F1 and M1, respectively. Fat mass and muscle mass were also assessed on MRI scans lateral and medial to the Y-view. The means of fat mass and muscle mass on these three slices were recorded as F3 and M3, respectively. Average FI ratios (fat mass/muscle mass) of the three assessment methods (F1/M1, FA/MA, and F3/M3) were compared. Intraclass correlation coefficients (ICCs) were calculated for inter- and intraobserver reliability. RESULTS: ICCs showed higher reliability (> 0.8) for all measurements. F1/M1 values were not statistically different from FA/MA and F3/M3 values (p > 0.05), except in males with medium and large tears. F3/M3 and FA/MA were not statistically different. The difference between F1/M1 and FA/MA did not exceed 2%. CONCLUSIONS: A single sagittal MRI slice can represent the whole FI in chronic rotator cuff tears, except in some patient groups. We recommend measurement of FI using a single sagittal MRI slice, given the effort required for repeated measurements.
Humans ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Rotator Cuff* ; Spine ; Tears*