[Objective]To study therapeutic effect of different medicines on motorneuron of spinal cord after explosive injury of spinal cord.[Method]Thirty-six rabbits were randomly divided into model group(group A,n= 12),the dexamethasone experiment group(group B,n= 12) and the methylprednisolone experiment group(group C,n=12),all rabbits were made explosive wound by 0.9 g cyclotrimethylene trinitramine,group A injection NS after blast, group B injection dexamethasone and group C injection methylprednisolone,6 and 24 hours after specimen had been taken out,then morphological change and quantity of the spinal motorneurons be observed under light microscopes.[Result]The reversible change of the neurons of rabbits happened after six hours,after 24 hours,the died motoneuron increase obviously, some rabbits remedied with dexamethasone and methylprednisolone after explosive injury in group B and C,quantity of the died motorneuron marked significant difference than that in the control group(P0.05).[Conclusion]Glycocotical stdroid can protect spinal cord motoneurons after explosive injury of spinal cord.In the experiment,there is no preponderance in early treatment of explosive injury of spinal cord between methylprednisolone and dexamethasone.

[Objective]To develop an ideal method for extracting type I collagen from cortical bone and to prepare a collagen-gelatin scaffold.[Method]The cortical bone was disintegrated into bone matrix powder in a high speed mill and was subsequently dehydrated in alcohol,decalcificated in hydrochloric acid and defatted in chloroform:methanol(1:1,v/v).The osscins were extracted using improved pepsin digestion method after the bone matrix powder was dissolved,centrifuged,dialyzed and lyophilized.Type I collagen was then characterized by SDS-PAGE and amino-acid composition analysis.The biomaterial was made of type I collagen and gelatin using freeze-drying method,and the alignment regularities of microscopic channels and their course directions were observed under the scanning electronic microscope.The size of the micropores and the factor of porosity were also measured.[Result] The collagen extracted was confirmed to be type I collagen by SDS-PAGE and amino-acid composition analysis.All the scaffolds looked like circular cylinder,the microscopic channels were arranged in parallel manners,and the pore sizes of the channels were uniform.[Conclusion]Ossein extracted from cortical bone is a real type I collagen that can be applied in the construction of collagen products.

Objective To analyze the imaging features of congenital spinal deformity (CSD) associated with split cord malformation (SCM) and other intraspinal abnormalities, and to investigate the relationship to neurological symptoms. Methods 105 cases CSD with SCM were retrospectively studied. Analysis the imaging features of SCM (including type of SCM, location of SCM, location and apical vertebrae, symmetry of divided cord) and other intraspinal abnormalities. To investigate the relationship of the factors and neurological symptoms using Chi?square test of one factor and multiple factors logistic regression analysis. Re?sults 28 cases (26.7%) were formation failure, 33 cases (31.4%) were segmentation failure, and 44 cases (41.9%) were combina?tion of 2 disorders. 41 cases had neurological symptoms, 64 cases were asymptomatic. The distribution of SCM combined with spi?nal deformities:thoracic (11 cases), thoracolumbar (18 cases) and lumbar (20 cases) in type I SCM, thoracic (31 cases), thoracolum?bar (20 cases) and lumbar (5 cases) in type II, none was in cervical. The location of SCM upper than apical vertebrae 29 cases, on apical vertebrae 25 cases, lower than apical vertebrae 51 cases. Spinal cord was splitted symmetric 27 cases and asymmetric 78 cases. 66 cases combined with other intraspinal abnormalities, lower conus 42 cases, syringomyelia 38 cases, meningocele 10 cas?es and sakrale zyste 5 cases. Associated with intraspinal abnormalities, the rate of neural symptoms was different. According to Chi?square test of one factor and multiple factors logistic regression analysis, lumbar SCM, spinal cord asymmetric and lower conus were related with neurological symptoms. Conclusion The predilection spinal deformity of type I is combination, type II SCM is segmentation failure. When SCM patients associated with other intraspinal abnormalities, the incidence of neurologic symptoms is increased. The lumbar SCM, hemicords asymmetry and lower lying conus have significant relationship with neurologic symptoms.

Objective To compare biological properties of ehitosan composite artificial neural type Ⅰ collagen scaffold material cross-linked with ultraviolet rays (UV), genipin (GP) and glutaraldehyde (GTA) in aspects of uhrastrueture, porosity, swelling rate, degradation rate, crosslinking degree and cytotoxicity. Methods (1) According to different cross-linking methods, biomaterials were divided into three groups, ie, UV group, GP group and GTA group. (2)The mierostrueture of three groups was observed under scanning electron microscope (SEM) to measure pore size, porosity rate and pore-size distribution. (3)Swelling rate and in vitro degradation rate:the biomaterials were weighed (W_0) after crosslinking and then immersed in culture medium containing 10 ml aseptic phosphate buffer solution (PBS). The samples were drawn from the culture medium after 24 hours, wiped with filter paper to remove excess liquid and weighed (W_1). Swelling rate(%) = W_1-W_0/W_0×100%. The remaining sampies from each group were weighed (W_2) at 4, 8, 12 weeks with the same procedure. Degradation rate (%) = W_1-W_2/W_1×100%. (4)Determination of cross-linking index: 10 samples were prepared from each group, five samples from which were reacted with trinitro-benzen-sulfonic acid(TNBS)and sodium bicarbonate and then were hydrolyzed with hydrochloric acid. The absorbance of the diluted solution was measured at 346 nm. The other five samples were prepared by the same procedure, except for hydrochloric acid was added before addition of TNBS, when the absorbance was measured as control (A_(control)). The absorbance after crosslinking:A_(after)=ATNBS-A_(control). Another 10 samples without any crosslinking were detected with the same procedure to measure the absorbance before crosslinking (A_(before)). Crosslinkiag index = (A_(before)-A_(after))/A_(before)×100%. (5) Determination of cytotoxicity : two international standard experimental methods were adopted in the study according to experimental principle of GB/T 16886-ISO 10993 on medical apparatus. L929 fibroblasts of mouse were used for in vitro experimental study of cytotoxicity of modified scaffold. Results The biomaterials without any cross-linking were circular cylinder, with parallel arranged microscopic channel and uniform pore size of 30-120 μm. The pore size of UV group remained basically unchanged, while the pore size in GP group and GTA group was smaller than that in UV group. (2) The porosity rate in GP group and GTA group was higher than that in UV group, but there was no statistical difference between GP group and GTA group. The swelling rate of GP group was higher than that GTA group, which was higher than UV group. (3)The crosslinking index of GP group and GTA group were 55.3% and 82.5%. (4) No statistical difference was found in regard of in vitro degradation rate after GP group and GTA group were put in PBS for4, 8 and 12 weeks, respectively. But in vitro degradation rate in UV group was significantly higher than that in GP group and GTA group. (5) Cell culture in GTA group presented partial necrosis, while cells cultured in GP group and UV group grew well. Conclusion Collagen/chitosan scaffolds cross-linked with GP have sound biostability and good biocompatibility and hence are potential alternatives for nerve tissue engineering.

Objective: To investigate the molecular transmission network characteristics of HIV-1 among men who have sex with men (MSM) in Shaoxing City, Zhejiang Province, so as to provide insights into AIDS prevention and control among MSM. Methods: Newly reported HIV/AIDS cases among MSM in Shaoxing City were selected from January 2021 to September 2023. Plasma samples before the antiviral treatment were collected. The HIV-1 pol gene was amplified using reverse transcription PCR and nested PCR to construct phylogenetic trees for gene subtype analysis. The HIV-TRACE method was used to construct a molecular transmission network with a genetic distance of 1.5% to analyze clustering and the characteristics of cases within molecular clusters. Results: A total of 216 HIV/AIDS cases among MSM were included, and 179 qualified sequences were obtained. The predominant HIV-1 subtypes were CRF07_BC and CRF01_AE, with 95 and 66 cases, respectively. At 1.5% genetic distance, 20 molecular clusters were formed, with 61 nodes and 58 edges. A total of 61 sequences were connected to the transmission network (34.08%). HIV/AIDS cases among MSM from all the counties (cities, districts) in Shaoxing City were included in the network. There was the largest molecular cluster with ≥10 nodes, involving 12 cases from five counties (cities, districts), 3 medium-sized molecular clusters with 4 to 5 nodes, and the 16 small-sized molecular clusters with 2 or 3 nodes. Seven cases with high risk of transmission, each with ≥4 edges, were all CRF07_BC subtypes. Among them, two cases were from the large molecular cluster, and five cases were from the same molecular cluster composed of cases from Shengzhou City and Xinchang County. Conclusions The predominant HIV-1 subtypes among MSM in Shaoxing City were CRF07_BC and CRF01_AE. There was cross-regional HIV transmission, and potential transmission risk might exist in Shengzhou City and Xinchang County.

Objective:By analyzing the current status of hospital scientific research contract management, identifying common problems in contract review and proposing suggestions to improve the efficiency of hospital scientific research contract management.Methods:Taking a large comprehensive tertiary hospital as an example, through interviews with professional lawyers, and analysis of problems identified in the preliminary review of a total number of 419 scientific research contracts from 2018 to 2020, further solutions are proposed.Results:Identified problems include no breach protocol of the contract, more attention should be paid to intellectual property protection clauses, supplementary signing of contracts, not include the ethics consideration and protection of genetics resources, low efficiency, time costing, and lack of information sharing among multiple departments.Conclusions:By improving the level of scientific research services, strengthening the Principle Investigator’s awareness of the significance of contract management, enhancing the legal and regulatory training, pay more attention to the protection of intellectual property rights, develop contract templates and establishing an information system to improve the management level of scientific research contracts.

Objective:To construct a scientific and technological evaluation system based on the needs of the pilot program for building a national high-quality hospital and establishing a national medical center.Methods:Xiangya Hospital of Central South University gradually improved its academic evaluation system by following the guidelines outlined in national authorities′ documents regarding "abolishing the five only" and "setting new standards", adhering to the guiding principles of "quality, contribution, efficiency, and impact" and employing the principles of "high-standard evaluation, quantitative evaluation, representative work evaluation, and third-party evaluation" .Results:The hospital established a comprehensive, scientific, and quantifiable indicator pool. These indicators were applied to various aspects of medical innovation evaluation, including awarding incentives, discipline assessment, professional promotion, personnel assessment, mentor selection for graduates, and excellence evaluation. Simultaneously, the hospital developed an intelligent platform for medical innovation evaluation and assessment in university-affiliated hospitals based on performance management theory.Conclusions:Through the construction and practice of the Xiangya technology evaluation system, the hospital further improved and optimized its academic evaluation work, guiding researchers to high-quality innovation and efficient translational research, ultimately promoting the high-quality development of the hospital.

Objective To compare differences of SRS-22 scores between male and female AIS patients.Methods From October 2007 to April 2009,298 AIS patients from 7 spine centers completed simplified Chinese edition of SRS-22 questionnaire,including 62 males and 236 females with an average age of 15.7 years old,and the average Cobb angle was 52.8°.Of 62 male patients,34 were from urban areas and 28 rural areas.Among 236 female patients,132 were from urban areas and 104 rural areas.A comparison was conducted in terms of age,Cobb angle,the ratio of urban population to rural population,and the scores of all domains and the subtotal scores of SRS-22 questionnaire between male and female patients.Results There was no difference of age,Cobb angle and the ratio of urban population to rural population between male and female patients(P＞0.05).The scores of four domains and subtotal scores of SRS-22 questionnaire were significantly higher in male patients when compared with female patients(P＜0.05).Conclusion Gender difference should be taken into the consideration when estimating the quality of life in AIS patients by SRS-22 questionnaire.The quality of life in male patients with AIS was better than that of female patients.

OBJECTIVETo analyze the risk factors of neurological complications of posterior vertebral column resection in the treatment of severe rigid congenital spinal deformities.

METHODSThe clinical data of 88 patients with severe rigid congenital spinal deformities who underwent PVCR in Department Of Orthopaedics, Xijing Hospital, Fourth Military Medical University from June 2007 to November 2012 were collected. There were 39 males and 49 females at the average age of 16.9 years (range 6-46 years). To measure the Cobb angle and balance at preoperative, postoperative and follow up, and to record the operation report, neurological complications and at follow up. The relevant factors of neurological complications were analyzed by one-way analysis, including: age, Cobb angle, operation time, body mass index, pulmonary function, blood volume loss, resection level, number of vertebrae fixed, number of vertebrae resected, usage of cage or titanium mesh, preoperative neurologic function, the type of deformity and combination of spinal canal deformity, and further analyzed by multiariable Logistic regression analysis.

RESULTSThe average follow up was 42 months (range 19 to 83 months). The number of resected vertebrae average 1.3 (range 1 to 3), operative time average 502.4 min (range 165.0 to 880.0 min), estimate blood loss average 2,238 ml (range 100 to 11,500 ml) for an average 69.3% blood volume loss (range 9% to 299%). The average preoperative major coronal curve of 93.6° corrected to 22.2°, at the final follow-up, the coronal curve was 22.2° with a correction of 76.8%. The average preoperative coronal imbalance (absolute value) was 2.5 cm decreasing to 1.3 cm at the final follow-up. The average preoperative major sagittal curve of 88.2° corrected to 28.7°, at the final follow-up, the sagittal curve was 29.2°, average decrease in kyphosis of 59.0°. The average preoperative sagittal imbalance (absolute value) was 3.1 cm decreasing to 1.2 cm at the final follow-up. There were 12 patients (13.6%) developed a neurological complications. High rate of neurological complications was occurred in patients with operative time greater than 480 min, pulmonary dysfunction, blood volume loss greater than 50%, T7-T99 osteotomy and preoperative neurologic compromise (P=0.046, 0.000, 0.000, 0.033, 0.043).

CONCLUSIONSPosterior vertebral column resection can achieve satisfactory efficacy in treatment of severe spinal deformities. Pulmonary dysfunction and blood volume loss greater than 50% were significant risk factors of neurological complications.

Adolescent ; Adult ; Child ; Female ; Humans ; Kyphosis ; Male ; Middle Aged ; Neurosurgical Procedures ; Orthopedic Procedures ; Osteotomy ; Retrospective Studies ; Risk Factors ; Scoliosis ; Spinal Canal ; Spinal Diseases ; surgery ; Spine ; abnormalities ; surgery ; Treatment Outcome ; Young Adult