Table of Content

24 December 2008, Volume 29 Issue 6

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Rescue Life,a Permanent Mission of Medical Science-The Nobel Prize in Physiology or Medicine for 2008

Fan Dongying;Gao Na;An Jing

2008, 29(6):  671-673. 

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In Oct 6th,2008,The Nobel Assembly at Karolinska Institute decides to award The Nobel Prize in Physiology or Medicine with one half to Harald zur Hausen for his discovery of "human papilloma viruses causing cervical cancer" and the other half jointly to Franc,oise Barré-Sinoussi and Luc Montagnier for their discovery of "human immunodeficiency virus".The three winners,their contributions and the significance of their discovery are introduced in this paper.

专题报道

Clinical Characters and Treatment Choices of Cervical Spinal Injuries in the Elderly

Jiang Shudong;Hong Yi;Zhang Junwei;Bai Jinzhu;Tang Hehu;Li Xiang

2008, 29(6):  674-676. 

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Objective To summarize clinical characters and treatment methods of cervical spinal cord injuries in the elderly.Methods Fifty-nine elderly patients(age above 60 years old) with cervical spinal injury were retrospectively reviewed from the year of 2002 to 2006.Results Incidence rate of cervical spine injuries in the elderly was 8.2 % in our study.The most common type of injury was hyperextension injuries of cervical spine and cervical central cord syndrome.Traffic accident and falling injuries were the most common reasons.Early operation and early rehabilitation could improve the ASIA 1 or 2 grade,and effectively avoid complications of cord injury.Conclusion The key point of cervical spinal cord injuries in the elderly is how to get them to leave bed in earlier stages,so that the complications of cord injury can be reduced.Early operation and rehabilitation are good methods,thus the mortality rate decreased and quality of life increased.

Surgical Treatment of Thoracolumbar Vertebral Fracture Patients with Ankylosing Spondylitis

Li Baojun;Ding Wenyuan;Shen Yong;Zhang Wei;Hai Yong

2008, 29(6):  677-680. 

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Objective To study the surgical treatment of thoracolumbar vertebral fractures in ankylosing spondylitis via anterior approach.Methods Twelve cases of thoracolumbar vertebral fractures and ankylosing spondylitis patients admitted in our hospital were studied retrospectively.There are 10 male and 2 female patients in total.We chose anterior rod system to treat these patients.According the AOclassification of the spinal fractures,there are 5 patients with type A,3 type Band 4 type C.The location of these fractures are located in T₇-L2.3 for compressive fractures,6 for burst fractures,2 for mixed fractures.Nine patients' fracture involves all three columns.There were 10 patients with spinal cord injury.Collecting data on surgical time,blood lost,neurologic recovery states,et al were collected.Results All of 12 cases were followed up for an average of 24.2 months.The surgical results were as follows:10 spinal cord injury patients got recovery.12 patients got the bone fusion.Only 1 patient received spinal cord injury in the surgery procedures.There were no complications related to the internal fixation systems.Conclusion Surgical intervention,especially anterior rod system may be the proper way to treat this injury.Fracture union and neurological improvement can be achieved in most patients.

Therapeutic Effect Analysis on Cervical Ossification in Posterior Longitudinal Ligament by Different Approaches

Wang Bing;Song Lei;Ma Song;Xing Rupeng;Cui Wei;Lin Xin;Tian Baopeng

2008, 29(6):  681-685. 

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Objective To observe and analyze the clinical results of treating ossification in posterior longitudinal ligament(OPLL) by surgery.Methods Follow-up investigation of 25 patients who received surgery for OPLL between Feb,2003 and Feb,2006.Sixteen patients with OPLLin less than three segments were given anterior cervical decompression;Six patients with more than three segments were given posterior surgery;three patients were given anterior-posterior surgery.The pre & post-operative scores of JOA 17,cervical images and the improvement ration were evaluated.Results Two patients' conditions worsened in neural symptoms after the anterior surgery,but recuperated in 4 and 12 weeks.Leakage of cerebrospinal fluid occurred with one patient during anterior surgery.According to JOA 17 Score,the preoperative mean score was 8.00±1.50(min: 5,max: 11),while the postoperative mean score was 14.24±1.42(min: 9,max: 16).The ratio of improvement was(69.80±12.28)%.MRIstudies indicated that spinal cord and nerve roots were decompressed thoroughly,and all bone graft got synostosis with in 3 months postoperatively.Conclusion The anterior operation has a significant effect on OPLL,which could resect the ossific tissue directly,decompress the spinal cord completely,and fix the vertebrae firmly.However,the dangers and complications of anterior operation are higher than those of a posterior one.Anterior-posterior-union surgery may alleviate the dangers,and microsurgery and supervision by SEPduring operation have an important effect on the safety of surgery.

Treatment of the Thoracolumbar Spine Fracture with Posterior Monosegment Pedicle Fixation at the Injured Level

Hai Yong;Lu Shibao;Wang Qingyi;Zhang Censhan;Su Qingjun;Guan Li;Kang Nan;Zhou Lijin

2008, 29(6):  686-689. 

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Objective To evaluate the indications,clinical outcome of the treatment of thoracolumbar spine fracture with posterior transpedicular instrumentation.Methods 17 patients with thoracolumbar spine fractures underwent the surgical procedure of posterior monosegmental fixation and arthrodesis.Follow-up investigation ranged from 6～27 months(mean: 17.5),patients were assessed by clinical evaluation and radiographic study.The parameters used for clinical evaluation were the Denis pain scale and neurological evaluation by the Frankel scale.The height of the injured vertebra,kyphosis of the injured vertebral segment,and the presence of bone reabsorption around the implant were used for radiographic evaluation.Results Clinical evaluation revealed that 12 cases had no pain,5 cases with occasional pain but no medication and all patients had a high level of satisfaction with the final results.Radiographic evaluation revealed reduction rate of the injured vertebral height was 96%,and the reduction loss rate was 1.4% at final follower-up.There was no implant break,and no signs of pseudoarthrosis were observed in any patient.Conclusion The clinical and radiographic results observed show that posterior monosegmental fixation might be an adequate and effective procedure to be used in specific types of thoracolumbar spine fractures.

Effect of Mimic Posterior Asynmmetric Tether by Magnetic Force on Spinal Growth of Immature Mini-pig(Establishment of an Experimental Scoliosis Model)

Ma Xiongjun;Wei Jianjun;Wang Dong;Sun Tong

2008, 29(6):  690-695. 

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Objective To explore the etiology and pathogenesis of idiopathic scoliosis by creating experimental scoliosis as well as validate the hypothesis of spinal growth imbalance.To determine the magnitude ranges of spinal tether force and observe the changes of mini-pig's spinal deformity in three-dimensional sections by posterior transpedicle screws with Nd-Fe-B magnetic materials.Methods Sixteen mini-pigs(female,4 weeks old,(7.54±0.46)kg were randomly arranged averagely into tethering group and control group.Left-side posterior transpedicle screws(25 mm) with magnets were placed into vertebrae from T₈ to T₁₀ in tethering groups and maintained the proper magnetic polarity within distance of 5 mm;in the control group pigs underwent operation only using pedicle screws;they were all checked by A-P and lateral X-ray films every 4 weeks until 12 weeks to measure items responded to degrees of spinal deformity including weights and Cobb angles in coronal section and sagittal kyphosis and the heights of apex vertebral(T₉) between two sides as well as magnitudes of magnetic forces among the involved vertebrae.Results Mean weights of mini-pig increased about 2 times in 12 weeks(21.05±1.67)kg in tethering group and(21.75kg±1.67)kg in control group,P>0.05).The heights of T₉ vertebral increased double during 12 weeks from 6.5 mm±0.6 mm to 13.06 mm±1.37 mm in control group.The radiographic analysis demonstrated scoliosis of 11.75°±2.87° in T₈-T₁₀ tethered segments,as compared with 0.94°±0.86° in the control group(P<0.001).Similarly,thoracic lordosis developed in the tethered segments-5.25°±6.21°,as compared to 4.25°±0.71° at the control levels(P=0.003).Conclusion The asymmetrical tethering performed by transpedicle screws with Nd-Fe-Bmagnets upon the vertebral body T₈-T₁₀ of mini-pigs can modulate their spinal growth and create the mild scoliosis in coronal section and lordosis in sagittal section.the magnitude range of magnetic force upon spinal growth plates is from 1.0 Nto 2.3 N.This method validate the hypothesis of spinal growth imbalance related scoliosis pathology and abide by the Hueter-Volkmann law.The asymmetrical posterior tethering of spine have an important role in scoliotic onset and progressing,lordosis in the sagittal section may be the primary deformity of scoliosis.

Application of Percutaneous Anterior Lateral Mass Internal Fixation in C_1-2 Cervical Vertebral Fracture

Lu Shibao;Hai Yong;Kang Nan;Chi Yonglong;Xu Huazi;Huang Qishan;Mao Fangmin;Wang Shen

2008, 29(6):  696-700. 

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Objective To apply the method of percutaneous anterior lateral mass fixation for instability of C_1-2 vertebral fracture and determine the outcome of the method by radiology.Methods Thirty-eight cases of C_1-2 instability including 10 cases of Jefferson's fracture, 12 cases of anterior arch fractures of C₁, 7 cases of atlantoaxial dislocation, 5 cases of atlantoaxial subdislocation, and 4 cases of dental old fracture with dislocation were treated with percutaneous anterior lateral mass screws and bone grafting with new designed hole instrumentations. All the patients were followed-up after operation and assessed the screws position by X-ray and CT.Results All casesreached a satisfactory results of fixation without injuring the vertebral artery and spinal cord. Two screws were in poor position. One screwcame loose a year after operation, another screw went into the vertebral artery groove, but no vertebral artery injury. All the other screwswere in good position.Conclusion The operation procedure for instability of C_1-2 has the advantage of simplicity, less trauma and minimized bleeding. The operation procedure is safe with reasonable instrumentations and correct selection of the puncture point, angle and depth.

Operative Treatment of Comminuted Calcaneal Fracture Involved Posterior Sub-talar Joint by Titanic Anatomy Plate

Wang Qiang;Shen Huiliang

2008, 29(6):  701-704. 

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Objective To analyze the operative treatment results and complications of the involved articulation calcaneal fracture.Methods From April of 2003 to April of 2007,titanic calcaneal anatomy plate was applied to treat 23 cases of comminuted calcaneal fracture involved posterior sub-talar joint with a lateral approach for the reduction.Results All patients were followed up for an average of 23 months.The data were evaluated with Mayland foot score,the excellent or good rates were 83.3% in Sanders Ⅱ type,88.9% in type Ⅲ,and 50% in type Ⅳ.The primary operative complications derived from the wound were skin necrosis rate at 8.7% and infection rate at 4.3%.Conclusion For the SandersⅡ or Ⅲ calcaneal fracture,treatment with a titanic anatomy plate can receive perfect results.The operative timing should depend on the situation of the soft tissue to avoid post-operative complications.

Studies on Changes in the Distal Position of First Metatarsal after the Ludloff Osteotomy

Zhang Jianzhong;Mao Wei

2008, 29(6):  705-708. 

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Objective To study the changes in distal position of first metatarsal in correcting varus after the Ludloff osteotomy.Methods Ludloff Osteotomy was simulated on a wooden cylinder 86.56 mm in length and 30.65 mm in diameter and the experimental date were recorded.Results As the angle between the distal and proximal fragments increased,the length of the cylinder became shorter,and the distal cross section of the cylinder showed an internal rotation.When cutting it more plantar,the distal lowest point of the cylinder lowered first,then rose.However,if the cutting was more dorsal or horizontal,the distal lowest point rose constantly.Conclusion The distal cross section of the first metatarsal showed an internal rotation after Ludloff Osteotomy,which affects the positioning of the metatarsal-sesamoid joint.Across section of 15～20°angle plantar is suggested for patients with serious lateral metatarsalgia.

Studies on Surgical Decompression,Posterior Lumbar Interbody Fusion and Pedicle Screw Fixation for the Treatment of Lumbar Degenerative Diseases

Li Jinjun;Li Dong;Yang Yong;Yang Jinjiang;Wang Bingqiang

2008, 29(6):  709-711. 

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Objective To study the effects of surgical decompression,posterior lumbar interbody fusion and pedicle screw fixation for the treatment of lumbar degenerative diseases.Methods There were 44 patients who were treated with laminectomy,discectomy,nerve root loosening,posterior lumbar interbody fusion and pedicle screw fixation between the years 2000 and 2005.Of these were 18 males and 26 females,aging from 33 to 72(with a mean age of 49.2).The patients included 36 disk hernation,8 spondylolisthesis and 17 combined lumbar stenosis.For the treatment,35 patients were carried on operation of single interbody fusion and 9 with two interbody fusion and the follow-up investigation lasted for 1～5 years.Clinical status was evaluated by the Japanese Orthopaedic Association(JOA) score preoperation and at 3,6,12,24,36,48,60 months postoperation.The fusion rate was evaluated by lumbar X-ray.Results Fusion rate was 95.5% on the first year postoperatively.JOAscore of follow-up investigations increased significantly than that of preoperation,the average space between disks postoperation decreased significantly than that of preoperation,but it has lost when compared the height of disk postoperation with follow-up after surgery.Conclusion Surgical decompression,postural lumbar interbody fusion and pedicle screw fixation is an effective method for the treatment of lumbar degenerative diseases.

Studies on Treatment to InfrapateIlar Fat Pad Syndrome in 22 Patients

Liu Deyun;Li Liping

2008, 29(6):  712-713. 

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Objective To provide an effective the treatment method for hyperplasia and hypertrophy with clinical symptoms induced by injury of infrapatellar fat pad.Methods Atotal of 22 patients with infrapatellar fat pad syndrome were received in our hospital between the years 1996 and 2007,12 of them underwent surgery,10 of them underwent outpatient treatment.Results All patients received follow up 2～8 years after surgery.It disappeared that the symptoms and signs caused by hypertrophy of fat pad disappeared in the postoperative patients,while they aggravated in un-operative patients.Conclusion Once the hypertrophy and hyperplasia of the infrapatellar fat pad occurs,surgery is the best way to resect the whole fat pad,and it is hard to cure by the use of drugs.

Clinical Experience on Replantation of Complex Disjunct Fingers in 94 Cases

Shi Liqiang;Liu Suanghui;Zhang Wenyuan;An Zhijun;Hu xiangjun

2008, 29(6):  714-716. 

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Objective To study how to raise success rate of replantation of complex disjunct fingers and how to improve post-operative function of fingers.Methods The replantation used regressive method by replanting blood-vessels,nerves,tendons and some cases used repair mode of diversify composed blood-vessel anastomose.Results One hundred and twenty one fingers in 94 cases were followed up for 6 to 12 months.The shape and function of replanted fingers were in good conditions.Conclusion Though the replantation of complex disjunct fingers were in good shape and function can be obtained by pertinent operative treatment.

Surgical Treatment of Tibial Plateau Fractures under Arthroscopic Guide

Zhang Xinghuo;Yu Zhenshan;Zhang Yakui;Gao Jiayi;Zeng Jizhou;Wang Xuefei;Cui Libin;Liu Liang;Lü Zhengang;Ge Shuanglei;Zhu Xu;Zhao Feng

2008, 29(6):  717-721. 

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Objective To explore the feasibility and evaluate the outcome of surgical treatment of tibial plateau fractures under arthroscopic guide.Methods From May of 2006 to Feb of 2007,eighteen cases of tibia plateau fractures underwent the procedures of surgical treatment under arthroscopic guide and help reduction.The patients were 32.5(20～54) years old at average,male in 8 cases,female in 10 cases.Six cases combined with meniscus lesion and 3 cases with medial collateral ligament injury.For Schatzker classification,the 18 cases were divided into type Ⅰ in 7 cases,type Ⅱ in 5 cases,type Ⅲ in 4 cases and type Ⅳ in 2 cases.Results Healed fractures were found at 3～8 months after operation in all 18 cases,and there were no infections,compartment syndromes or other complications.The average follow-up period was 12 months(9～18 months).According to the Sanders evaluation criterion,17 cases were in excellent and good conditions,and there were no traumatic arthritis,varus and valgus deformity in all cases.Conclusion Treatment of tibial plateau fractures under arthroscopic guide can avoid opening up the knee joint,it's less invasive and safe procedures make it possible to treat the combined injuries in the knee at the same time with rehabilitation easier.This treatment is especially effective to type Ⅰ～Ⅲ and some Ⅳ of Schatzker classification.

Evaluation on Therapeutic Effects of Total Knee Replacement with Domestic TC-Dynamic

Liu Ruibo;Sun Zhenjie;Kong Lingying;Yan Qingming;Gao Liying;Zhou Huaidong;Yuan Yi

2008, 29(6):  722-723. 

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Objective To explore short term therapeutic effects of total knee replacement with domestic TC-Dynamic.Methods Eighty one knees from 78 cases were treated with total knee replacement using domestic TC-Dynamic.Results According to the criteria of American's Surgical Association of knee,pest-operative knees averaged at a score of 83(it was 39 in average prior to the operation) and the functional score for post-operative knees was 85 in average(it was 36 in average before operation).Conclusion The domestic TC-Dynamic system is reasonable in design and convenient in operation,beneficial to patients' recovery and valuable to wide application clinically.

基础研究

Effects of β-sitosterol on Spatial Learning and Memory of Mice with Hypercholesterolemic Diet

Yu Huanling;Bi Yanxia;Xiao Rong;Ma Weiwei;Xiang Li;Ding Bingjie;He Lingling

2008, 29(6):  724-727. 

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Objective To investigate the effects of β-sitosterol on serum lipids,spatial learning and memory.Methods Sixty male C57BL/6J mice were divided into chow diet(control),hypercholesterolemic diet(HF),and 4.0 mg/kg(LβSITO),16.0 mg/kg(MβSITO),32.0 mg/kg(HβSITO),β-sitosterol treated groups(n=12 for each group).Results Serum cholesterol and low density lipoprotein cholesterol level in 32.0mg/kg β-sitosterol group were significantly decreased,and their escape latency in morris water maze task was significantly shortened compared to that in hypercholesterolemic diet feed group.Conclusion These results indicated that β-sitosterol lowered serum cholesterol and improved spatial and learning and memory of mice with HF.

Changes in Expression of α₁-adrenergic Receptor and Angiotensin ⅡReceptor Subtypes in Kidney of Rats with Aging

Cao Xiaojing;Li Yanfang

2008, 29(6):  728-731. 

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Objective The changes in α₁-adrenergic receptor(α₁-AR) and angiotensinⅡ receptor(ATR) expressions were considered to be associated with functional decline of renal vasoconstriction,renal structure and function.This study was designed to examine the expressions of α₁-AR and ATRsubtypes in renal tissue from young adult,middle age,presenium to senium of rats.Methods Western blotting was used to quantitate the protein levels of α₁-AR and ATR subtypes in renal tissue of 3-(young adult),12-(middle age),18-(presenium) and 24-(senium) month-old Wistar rats.Results α_1A-AR expression decreased gradually with aging: α_1A-AR protein levels decreased in middle age,presenium and senium when compared with young adult rats,respectively(P<0.01).However,the expressions of α_1B-AR and α_1D-AR remained unchanged during senescence.AT₁R expressions were unaffected by aging from young adult to middle age,but exhibited a remarkable downregulation in presenim and senium(P<0.01).In addition,AT₂R expression increased significantly in senium(P<0.01).Conclusion There are considerable changes in expression levels of renal α₁-AR and ATR subtypes during aging.The downregulation of α_1A-AR expression may account for the reduced reactivity of renal α₁-AR to vasoconstrictors and the decline of renal function in senium.Both the downregulation of AT₁R and the upregulation of AT₂R can be beneficial to maintain the normal physiological function of kidney during aging.

Enhanced Expression of Aquaporin-4 Aggravates Brain Edema after Traumatic Brain Injury in Rat

Zhang LinYuan Fang

2008, 29(6):  732-736. 

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Objective To investigate the expression changes in aquaporin-4(AQP4) during brain traumatic edema in rat,and evaluate its relationship with the disruption of blood-brain barrier(BBB) permeability.Methods Ninety-four SDrats were randomly allocated into control group,sham operation group and brain injury group,with the last group further divided into groups of 1,6,24,48 and 168 h after rat brain injury.In a rat impact-acceleration head injury model,brain water contents were measured by wet-dry weight method,BBB permeability was evaluated by immunohistochemical staining of IgG,and the expressions of AQP4 and GFAP in brain were determined by immunohistochemical stain and Western blotting.Results After rat brain trauma,cerebral water content of injured brain increased significantly at 6 h,and reached maximum at 24 h.The extravasation of IgG in injured brain occurred at 1 h,and peaked at 6h.Western blotting study detected enhancement AQP4 expression adjacent to injury site after brain trauma,and immunostaining revealed the changes in AQP4 polar distribution in the reactive astrocyte,with increased AQP4 expressions both in the peri-vascular astrocyte end-feet and cell body.The time course of enhanced AQP4 expressions was accompanied with the increase of brain water content and delayed after the maximum extravasation of IgG.Conclusion Enhanced expressions of AQP4 followed the disruption of BBBpermeability,which means it may contribute to the development of brain edema after rat traumatic brain injury.

Expression of Human Vascular Endothelial Growth Factor in Cultured NIH3T3 Cells

Wang Yamei;Li Shentao;Weng Mingjie;Sun Licui;Si Yang;Yan Yudong;Qi Yahui

2008, 29(6):  737-740. 

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Objective To study human vascular endothelial growth factor(hVEGF) gene transfer and expression in NIH3T3 fibroblast cell line,and establish the experimental foundation of angiogenesis tissue engineering organization and the treatment of ischemic disorders.Methods pcDNA/V eukaryotic expression vector and pcDNA3.1(+) were transfected into NIH3T3 cells mediated by liposome.The transfected cells were grown in DMEM medium containing G418 for 72 hours,and the clones of cells were selected and continued to grow in G418 medium.The cells stably expressing hVEGFwere selected under the pressure of G418.The selected cells were grown in DMEMmedium containing G418 for 72 hours,and then the supernatant was collected.The expressed hVEGFprotein was analysed by using Western blot and immunohistochemical methods.Results Western blotting showed that hVEGFof 22000 was detected in culture medium of NIH3T3 cells transfected with pcDNA/V.Immunohistochemistry demonstrated that the NIH3T3 cells transfected with pcDNA/V showed positive reaction to VEGFin cytoplasm,whereas faint reaction was observed in non-transfected cells and pcDNA3.1(+)-transfected cells.Conclusion Human VEGFgene was successfully transfected and its protein could be expressed in NIH3T3 cells.

Changes in Expression of UⅡ and Its Receptor in 2DM Mouse Liver

Wang Hongxia;Zeng Xiangjun;Wang Jue;Lu Lingqiao;Mu Jing;Chang Jing;Zhang Like

2008, 29(6):  741-744. 

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Objective To study the expression changes of UⅡ and its receptor in 2DMmouse liver.Methods Blood glucose monitoring device was used to examine the concentration of fast blood glucose.Radioimmunity assay method was used to examine the concentration of plasma UⅡ and insulin.RT-PCR method was used to assay the expression of GPR14 mRNA in mouse liver.Immunohistochemistry method was used to assay UⅡ immunological activity expression in mouse liver.Results Compared with control group,the concentration of fasting blood glucose,plasma insulin and plasma UⅡ increased in 2DM group,immunological activity of UⅡ was strong positive expression in 2DM mouse liver,the expression of GPR14 mRNA was up-regulated in 2DM mouse liver.Conclusion It is possible that the increasing expression of UⅡ derived from liver is a source of plasma UⅡ.But it is unclear what relevance the up-regulated expression of GPR14 mRNA has with 2DM and deserves further study.

临床研究

Study on the Effects of Platelet-derived Growth Factor(PDGF)and Vascular Endothelial Growth Factor(VEGF)

Chen Weihui;Wang Daye;Ma Song;Wang Jue;Tian Baopeng;Pan Haitao

2008, 29(6):  745-753. 

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Objective To explore the mechanism of platelet-derived growth factor(PDGF) and vascular endothelial growth factor(VEGF) enhanced osteogenesis on SDrats fracture healing after cerebral trauma by investigating the distinct expressions of PDGFand VEGFin fracture only and in fracture with brain injury.Theory basis was afforded for the treatment of refractoriness fracture for clinical selectivity.Methods Two hundred and four rats were divided into four groups randomly: group A,negative control(n=12);group B,cerebral trauma group(n=56);group C,fracture group(n=68);and group Dfracture with cerebral trauma group(n=68).The rat models of fracture and cerebral trauma were established.8 rats in each of group B,Cand Dwere put to death in the first day,fourth day,first week,second week,third week,fourth week and fifth week after the operation.Osteotylus samples were obtained about one centimeter away from broken ends of fractured bone for immunohistochemistry staining.The rats which were put to death in the fourth and fifth week were examined with X-rays to observe the reparative process.And then,12 rats of group Cand Dwere put to death at the sixth week.They were examined with X-rays and taken the whole left radial bone for biomechanical experiment.Results ① X-rays: group C: In the fourth and fifth week,there were some existing callus and fracture lines were clear.In the sixth week,the fracture lines were not clear but still can be seen.group D: In the fourth week,fracture lines were clear.In the fifth week,the fracture lines were not clear.And in the sixth week,the fracture lines were disappeared.② Biomechanical experiment: In the sixth week,the maximum load that radial bones in group Aand Dcan be accepted were nearly the same.When comparing to group C,there was statistical significance(P﹤0.01).③ Immunohistochemistry staining image analysis: PDGF: the expression in group Cstarted to appear in the first day and rose to the peak about in the second week.The expression of PDGFin group Dstarted to appear in the first day,but the first week it was close to the peak,reaching it by the second week in the first day,fourth day and the first week,there was statistical significance between group Cand group D(P<0.01).VEGF: the expressions of group Cappeared in the first week and rose to the peak by about the third week.The expression of VEGFin group Dstarted to appear in the fourth day,reached the peak about the third week.In the fourth day,the first week and the second week,there was statistical significance between group Cand D(P<0.01).Conclusions ① According to the results of the X-ray and biomechanics experiment,the fracture healing speed in group Dis faster than group C.② According to the results of immunohistochemistry staining image analysis,the persistence time of the expression of PDGFand VEGFof group Dis longer than group C.And the crest-time of group Dcomes earlier than group C.③ The acceleration of fracture healing after cerebral trauma may be relevant to longer persistence time and ahead of schedule in expression crest-time of PDGF and VEGF.

Relationship of Serum Ferritin,Oxidized Low Density Lipoprotein and Total Bilirubin in Patients with Coronary Heart Disease

Wang Yanling;Cui Wei;Hua Qi;Xu Dong

2008, 29(6):  754-757. 

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Objective To investigate the relationship of serum ferritin(SF),oxidized low density lipoprotein(Ox-LDL),total bilirubin(TBIL),the ratio of serum ferritin and total bilirubin(SF/TBIL) and Gensini scores in patients with coronary heart disease(CHD) and to appraise the diagnosis of CHDby measuring SF/TBIL.Methods Gensini scores,SF,TBIL,Ox-LDL,SF/TBIL,total cholesterol(TC),triglycerides(TG),high density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) were calculated and measured in 70 CHD and 62 NCHD diagnosed by coronary arterography.Results CHDgroup showed significant high levels of SF,Ox-LDL,SF/TBIL,LDL-C(P<0.01),and low levels of TBILand HDL-C(P<0.05) when compared with NCHDgroup.In CHDgroup,Ox-LDLand Gensini scores were positively correlated with SF(r=0.423,P<0.01;r=0.534,P<0.01) and SF/TBIL(r=0.481,P<0.01;r=0.604,P<0.01) while negatively correlated with TBIL(r=-0.346,P<0.01;r=-0.484,P<0.01).To analyze SF/TBILby ROC,the area under the ROCcurve was 0.895(P<0.01) and the sensitivity and specificity of diagnosing CHDwere 85.7% and 82.3% when SF/TBILwas 16.5559.TC,HDL-C,TBIL and SF/TBIL entered Logistic equation.Conclusion SF/TBIL,a risk factor of CHD,reflects the influential factors of coronary atherosclerosis more comprehensively and objectively than SFor TBIL.To CHD,SF/TBILhas certain diagnostic value.Both lower bilirubin and higher serum ferritin promote coronary heart disease.

Application of Lodixanol on Patients with Chronic Renal Failure

Gao Kang;Yang Ming;Wang Qing;Han Ling;Yin Zhaoxia;Zhao Yan;Chen Xin;Chen Liwei;Cen Qiang;Hu Wenze;Sun Yiguang

2008, 29(6):  758-761. 

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Objective To discuss the effects of lodixanol on patients with moderate to severe renal failure.Methods One hundred and twenty-six patients who had undergone coronary angiography and intervention were retrospectively analyzed.These 126 cases were divided into group A(72 cases,using lodixanol) and group B(54 cases,using iohexol).Between group A and B,the clinical features,serum creatinine(Scr),creatinine clearance rates(Ccr),and mobidity rates and prognosis of radiocontrast induced nephropathy(CIN) were compared.Results There was no difference in pre-procedure risk factors of CINbetween group A and B.In both groups there were Scr increasing and Ccr decreasing which caused CIN.However,the CIN rates were lower in group Athan in group B(4.2% vs 29.6%,P<0.05).There were 6 cases of adverse effects,5 of them were in group B.Conclusion Comparing with hypotonic contrast agents,the isotonic contrast agents could lower Scr baseline level and CINoccurrence rates,at the same time adverse effects can be reduced especially in patients with chronic renal failure or diabetes.

Effects of Anisometropia and Its Correction to Binocular Vision

Qi Ying;Zhou Yuehua

2008, 29(6):  762-765. 

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Objective To discuss the factors affecting binocular vision by observing the effects of anisometropia and its correction vis LASIKand glasses.Methods LASIK were performed in patients with anisometropia during June 2003 and March 2005 in our hospital.In this program,43 cases were followed-up,of them 13 persons are males and 30 are females.The middle number of refractive difference wa 4.866±2.059(2.50 D～10.75 D);average refractive diopter was-7.55±3.33 D(-2.44～-16.00 D);average visual acuity of the naked eye was 0.08±0.07;the stereovision was examined before LASIKand 3 or 6 monthes after operation respectively.The standard was ≤60 s,central stereovision;80～800 s,lateral stereovision;0,stereo blind.The patients were divided into two groups by 4 Daccording to the refractive difference,to study the correction of anisometropia and the recovery of binocular vision.The data were analyzed by SAS.Results Two cases had normal stereovision,7 had peripheral stereovision and 34 were stereovision blind before LASIK.Three months after operation,15 had normal stereovision,23 had peripheral stereovision and 5 was stereovision blind.The 6 months result wa 23,16 and 4 respectively.Compare the stereopsis results of 3 and 6 months after operation with the results before operation(P<0.001),but the data collected between 3 and 6 months after operation had no statistical meaning.Three months after operation,4 patients got normal stereovision,18 patients got peripheral stereovision,4 patients had no stereovision in the group of >4 D.In the group of ≤4 D,the number was 11,5 and 1 respectively(P=0.0023),4 patients got normal stereovision,19 patients got peripheral stereovision,3 patients had no stereovision in the group of >4 D 6 months after operation while in the group of ≤4 D,the number was 12,4 and 1 respectively(P=0.0014).The stereovision results between with glasses and after operation was plus correlate,the stereovision outcome after operation was better than with glasses.Conclusion Adults with anisometropia could acquire not only normal fusion,but also got normal or partial stereopsis after LASIK,it is up to the corrected visual acuity,the degree of anisometropia and the results of binocular vision with glasses.

Analysis on Five Pediatric Patients with Myositis Ossificans Progressiva

Hu Bing;Li Caifeng;Kuang Weiying;Wang Jiang;Han Tongxin;He Xiaohu

2008, 29(6):  766-769. 

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Objective To investigate the clinical characteristic,image manifestation,diagnosis and the therapeutic methods of the myositis ossificans progressiva(MOP).Methods Five pediatric patients with MOPwere reported.The clinical manifestation,changes in imageology,diagnosis,and the motivation of aggravation were analyzed by using retrospective analysis.The literatures relevant to MOPwere reviewed.Results The average age of onset ranges from 7 to 11 years old in all 5 cases(4 boys and 1 girl).MOP in all the patients were represented as recurrence of local tissue swelling,bone calcification accompanied by disturbance in adjacent joint motion,distinctive malformation of digiti,and corresponding changes in imageology.As the MOPaggravated progressively,trauma and local stimulation could exacerbate the pathogenetic progress.Conclusion MOPis a rare autosomal dominant inherited disease and could be early diagnosed by clinical manifestation and the distinctive malformation of digiti.Misdiagnosis is common and will impact the development of the disease.There has been no special treatment at present and the focus of management should base on early diagnosis as well as avoiding the motivation which might aggravate the disease.

Clinical Experience on Local Nerve Blockade Anaesthesia for Tension-free Inguinal Hernia Repairing in the Senile Patients

Wang Minggang;Chen Jie;Liu Sujun;Shen Yingmo;Bao Shaoyu;Zhu Dawei

2008, 29(6):  770-772. 

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Objective To evaluate the curative effect of local nerve blockade anaesthesia for tension-free inguinal hernia repairing in senile patients.Methods 3257 senile patients with tension-free hernioplasty under local nerve blockade anaesthesia from Feb₂₀₀₂ to Jun₂₀₀₈ in our center were analyzed.Results The operative time was 18 to 50 minutes at average time 28 minutes.All patients had good anaesthetic condition and no urinary retention,except one case with infective wound,36 cases with scrotal hydrocles and 5 cases with chronic pain.The average stay in hospital was 2.9 days,and the average cost was 4267 yuan(RMB).4 cases had recurrence and no one had the feeling of foreign body follow-up in an average of 48 months.Conclusion The open groin tension-free hernioplasty under local nerve blockade anaesthesia is a safe and credible operation procedure.

Effect of Subclinical Hypothyroidism on Glucose Metabolism of Type 2 Diabetic Patients

Liu Wei;Hua Lin;Yu Mei;Pan Sufang;Xie Rongrong;Yang Jinkui

2008, 29(6):  773-777. 

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Objective To investigate glucose metabolism in type 2 diabetics with subclinical hypothyroidism(SCH).Methods The study population consisted of 1170 cases of type 2 diabetics registered in Beijing Tongren Hospital,and the clinical biochemistry indexes,the functions of thyroid and pancreas islets were examined in the SCH patients and non-SCH type 2 diabetic patients.Results In SCH group,the levels of FBG,PBG,HbA1c and FT₄ were significantly lower,and the levels of TSH,TGA,TPoAb were significantly higher than non-SCH group.In SCH group which TSH>10 mIU/L,the levels of BMI were significantly higher than that of 10≥TSH>4 mIU/L.The C-peptide released test showed that the C-peptide levels of underlying and 3 h after intake 100 g carbohydrate were significantly higher in SCHgroup.But there were no difference in the two SCHsubgroups based on different TSHlevel.The results of correlation analysis showed that in all objects there were significant positive correlation between Cp₀,Cp₁,Cp₂,Cp₃ and TSH,and there were negative correlation between FBG,PBG,HbA1c and TSH.In SCHgroup,there were no significant positive correlation between FBG,PBG,HbA1c,Cp₀,Cp₁,Cp₂,Cp₃ and TSH.Conclusion SCH can affect glucose metabolism,and became notable with the aggravation of SCH.

Coronary Angiography with 64-slice Spiral CT:Influence of Reconstruction Interval and Heart Rate on Image Quality

Hu Bin;Xu Wenjian;Zhang Tong;Chen Haisong

2008, 29(6):  778-783. 

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Objective The reconstructive intervals providing best image quality for non-invasive coronary angiography with 64-slice computed tomography(CT) were evaluated.Methods Contrast enhanced,retrospectively electrocardiography(ECG)-gated 64-slice CTcoronary angiography was performed in 64 patients.Depending on the average heart rate during scanning,patients were grouped as <65 bpm(n=36),65～79 bpm(n=18) and ≥80 bpm(n=10).Two blinded and independent readers assessed the image quality of each coronary segment with a diameter ≥1.5 mm using the following scores: 5,no motion artifacts;4,minor artifacts;3,moderate artifacts;2,severe artifacts;and 1,not evaluative.Results Best image quality was obtained in all coronary segments at 60% or 65% for groupⅠandⅡ.In group Ⅲ.The left main artery,the left anterior descending artery and the left circumflex artery were clearly visualized at 60% of R-Rphases,while the right coronary artery was seen at 40% of R-Rphases.Conclusion When heart rate is <80bpm,64-slice CTcoronary angiography provides best image quality in mid-diastole,diagnostic image quality of all coronary segments can be obtained at reconstruction interval of 60% or 65%.When heart rate is ≥80 bpm,the right and left coronary artery should be reconstructed respectively to improve the image quality of coronary.

Analysis on Premenstrual Tension of 455 College Female Students

Zhu Xian;Zhou Jiun;Li Xiuhua

2008, 29(6):  784-787. 

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Objective To learn about the causes of premenstrual tension in college female students and set the focus on health education.Methods To survey by questionnaire 460 female students who have had physical examination and who are in different specialties from first-year to third-year girl students in a certain university.The general symptoms of premenstrual and menstrual periods were collected.Results Four hundred and fifty-five questionnaires were valid among the 460,the validity rate was 98.9%.The findings showed that over 61% college girls have suffered from premenstrual tension in a certain extent.The major causes of the change of menstrual period and premenstrual tension were mainly associated with emotional instability,environmental change,the change of living habit,the physical activities during menstrual period,stresses and strains from studies,and so on.52% students are worried about the change of menstrual period and the worsening premenstrual tension.Conclusion The education of healthy sexual psychology of college girls is the most effective way to prevent and treat menstrual disorder and premenstrual tension.The incidence of menalgia and premenstrual syndrome are quite high.The orders of factors that influence the normal menstrual adjustment are environment,biology,the temperament features and negative life events.Different specialties,psychological stress from examinations and sports also influence the normal menses to a certain extent.

综述

Current Situation and Prospect of Tropical Medicine

Gu Junchao;Gan Shaobo

2008, 29(6):  793-795. 

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The rapid development of technology provided the direction and momentum for the development of tropical medicine.At the same time,economic,environmental and social factors made the pathogen species variation,and infectious diseases became more complicated,prevention and treatment of tropical diseases have faced with new challenges.To strong the concerns and input into tropical medicine research,improve gene technology,biochip technology and global monitoring systems and other advanced technology,pay attention to disease prevention and control decision-making research and universal health education,will be a new strategy for tropical medicine development in the future.

Discussion on Few Issues of Acupuncture Rehabilitation

Zhao Ziqiang;Xie Xincai

2008, 29(6):  796-797. 

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Most of the patients in China who have come to seek help from acupuncture rehabilitation are satisfied with the curative effects,which shows its noticeable predominance.This paper studies and analyzes the mechanism,the adaptable diseases and the main points of the clinical medicine of acupuncture rehabilitation in order to improve the cause of rehabilitation with Chinese characteristics.