Objective To evaluate the reliability and the advantageof canal laminoplasty with laminoplasty over laminectomy for treatment of lumbar spinal stenosis.Methods From June 2000 to September 2004, the titanium miniplate fixation technique was applied to re-implantation of the vertebral lamina in the lumbar spine. The vertebral lamina was made with a specially made osteotome and a special technique in 18 patients with lumbar spinal stenosis. Results The patients were followed up for 1 yr and 8 mon on average (range, 3 mon4 yr and 3 mon) and were observed to have a bony fusion of the re-implanted lamina 3-9 months postoperatively. There was no nonunion, displacement of the re-implanted lamina, overgrowth of the anterior bone edge of osteotomy, recompression of the nerves or instability of the lumbar spine. Conclusion The result demonstrates that canal laminoplasty with the titanium miniplate re-implantation of the vertebral lamina in lumbar spine can restore the normal anatomy, keep stability of the spine, and avoid adhesion and scar in the canal.
ObjectiveTo explore the effect of hypertonic saline (HTS) pretreatment on levels of nitric oxide (NO) and endothelin-1(ET-1) and their correlation in hepatic ischemia reperfusion (HIR) injury in rats. MethodsThe HIR injury models were made by using Pringle, s maneuver in 45 healthy adult male Sprague-Dawley rats, which were randomly divided into three groups (n=15):sham operation (SO) group, HIR group, and HTS group. The animals were killed at 1, 6, and 24 h after reperfusion. The levels of serum NO and ET-1 were measured respectively, the correlation between NO level and ET-1 level at 6 h after reperfusion was analyzed. ResultsAt the time points of 1 h, 6 h, and 24 h after reperfusion, the serum NO levels in the HTS group and HIR group were all significantly lower than those in the SO group (P < 0.01), but the serum ET-1 levels were all significantly higher than those in the so group (P < 0.01). The serum NO levels at the time points of 1 h, 6 h, and 24 h in the HTS group were significantly higher than those at the same time in the HIR group (P < 0.01), but the serum ET-1 levels in the HTS group were significantly lower than those in the HIR group (P < 0.01). At all the time points, every detected goal had more marked level at the time point of 6 h after reperfusion. The NO level was negatively correlated with the ET-1 level. ConclusionsHTS could change levels of serum NO and ET-1 after HIR injury, and which has a negative correlation. Its mechanism might probably stimulate serum NO level and reduce the ET-1 level through some way so as to enable both dynamic balance to the benign development direction and achieve a protective effect.
目的 探讨急性胰腺炎后网膜囊早期症状性和感染性假性囊肿的手术引流治疗。 方法 对8例网膜囊早期症状性或感染性假性囊肿行内引流和外引流相结合的引流效果进行临床观察和分析。 结果 内、外引流相结合的方法治疗8例早期症状性假性囊肿或感染性假性囊肿均获得治愈，无并发症。 结论 在急性胰腺炎后早期的网膜囊症状性或感染性假性囊肿的治疗中，内、外引流相结合的治疗方法有更大的适应范围，可以取内、外引流之利，弃内、外引流之弊。
Objective Through analyzing BKCa channel expression in atrial fibroblasts in patients with sinus rhythm and atrial fibrillation (AF), to explore the mechanism of myocardial fibrosis and provide new therapeutic strategies for the treatment and reversal of AF structure reconstruction. Methods We selected 10 patients of rheumatic heart valvular disease who underwent valve replacement surgery. They were 5 patients with sinus rhythm (a sinus rhythm group, 2 males and 3 females with an average age of 49.1±8.3 years) and 5 with AF (an AF group, 3 males and 2 females with an average age of 50.3±5.8 years). About 100 mg tissue was obtained from the right auricula dextra, and the atrial fibroblasts were cultured by tissue block adherence method, and the expression of BKCa channel genes and proteins in cultured fibroblasts was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting methods. Results (1) The general data of 10 patients between the AF group and the sinus rhythm group were compared. There was no significant difference between the two groups in age (t=1.21, P=0.67) and sex (t=2.56, P=0.75). There was statistical difference in the left atrial diameter and the right atrium diameter between the two groups (t=19.45, P=0.01; t=23.52, P=0.06); (2) the mRNA expression of BKCa subunit was detected by qRT-PCR method, and there was no significant difference in the mRNA expression of BKCa α and BKCa β1 between the two groups (t=3.14, P=0.79; t=2.88, P=0.69); (3) the expression of BKCa protein was detected by western blotting method, and there was no significant difference in the protein expression of BKCa α and BKCa β1 between the two groups (t=0.55, P=0.31; t=0.73, P=0.46). Conclusion BKCa pathway may not be involved in the pathogenesis and maintenance of AF, but it may play an important role in the process of myocardial fibrosis.
ObjectiveTo investigate the effectiveness of one-stage arthroscopic reconstruction and strict immobilization for 6 weeks for treatment of knee dislocation. MethodBetween August 2010 and May 2013, 22 cases (22 knees) of knee dislocation were treated with one-stage reconstruction and strict immobilization for 6 weeks. There were 15 males and 7 females, aged 21-54 years (mean, 31.5 years). The left knee and right knee were involved in 8 cases and 14 cases respectively. The disease causes were traffic accident in 12 cases, falling from height in 6 cases, and sports injury in 4 cases. The time between injury and operation was less than 2 weeks in 6 cases, 2-3 weeks in 10 cases, and more than 3 weeks in 6 cases. The results of anterior drawer test, posterior drawer test, and Lachman test were positive in all patients. The posterior displacement of the tibia was more than 10 mm. The results of valgus stress test and varus stress test were positive in 13 cases and 11 cases respectively. The preoperative knee range of motion was (58.2±28.4) °, Lysholm score was 39.7±4.6. All patients had anterior cruciate ligament rupture and posterior cruciate ligament rupture; combined injuries included medial collateral ligament rupture in 11 cases, lateral collateral ligament rupture in 9 cases, both medial and lateral collateral ligament rupture in 2 cases, femoral condylar avulsion fracture in 2 cases, and meniscus injury in 7 cases. No nerve or blood vessel injury was observed. ResultsAll cases obtained primary healing of incision without infection. All the patients were followed up 12-48 months (mean, 27.8 months). At 12 months after operation, the results of the anterior drawer test, posterior drawer test, Lachman test, valgus stress test, and varus stress test were all negative; the knee range of motion increased was significantly to (121.3±7.9) °(t=30.061, P=0.000) ; Lysholm score was 87.2±6.1, showing significant difference when compared with preoperative score (t=24.642, P=0.000) . ConclusionsA combination of arthroscopic one-stage reconstruction and strict immobilization for treatment of knee dislocation is a safe and effective method, good stability and joint function can be achieved.