后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的效果观察

目的探讨后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的效果。方法选取本院2014年1月~2016年1月收治的40例胸腰椎骨折患者作为研究对象,根据治疗方法的不同分为A组和B组,各20例。A组予以常规内固定后外侧植骨,B组予以经椎弓根椎体植骨疗法。比较两组术前、术后3个月及术后12个月的伤椎Cobb角、椎体前和椎体后缘高度压缩率以及术后3个月骨折预后情况及并发症发生率。结果 B组术后3、12个月的伤椎Cobb角、椎体前缘高度压缩率、椎体后缘高度压缩率均优于A组,差异有统计学意义(P<0.05)。B组术后3个月的VAS评分低于A组,差异有统计学意义(P<0.05)。B组术后3个月的愈合率高于A组,并发症发生率低于A组,差异有统计学意义(P<0.05)。结论予以胸腰椎骨折患者后路内固定及经椎弓根椎体植骨疗法可改善患者术后的Cobb角,降低椎体前后缘高度压缩率,提高术后愈合率,降低术后并发症,其效果显著,值得临床推广应用。

后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的疗效分析

目的：分析后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗当中的临床效果。方法：选我院在2016年7月～2017年8月收治的胸腰椎骨折患者80例为研究对象,分为对照组与观察组，每组40例患者。对照组采用常规治疗方式进行治疗，观察组采用后路径经椎弓根椎体植骨疗法进行治疗，观察2组患者的治疗效果。结果：2组患者在术后12-24个月之间复查入院，将椎弓根钉取出体内，2组患者均没有出现断钉。2组患者在1期术后Cobb角度与手术前相比明显缩小，手术后3天与取出内固定,2组患者椎体丧失的高度和Cobb角度并没有明显差异（P〉0.05）。2组患者将内固定物取出之后，伤椎的高度与后凸Cobb角度变化有统计学意义（P〈0.05）。结论：后路内固定与经椎弓根椎体植骨疗法在胸腰椎骨折治疗当中的临床效果显著，可以有效的对椎体的高度进行纠正、对脊柱生理弯曲的恢复有明显作用故果，值得临床推广与应用。

短节段椎弓根钉内固定术联合经椎弓根植骨治疗胸腰椎骨折疗效观察

目的观察短节段椎弓根钉内固定术联合经椎弓根植骨治疗胸腰椎骨折的疗效。方法胸腰椎骨折患者103例,对照组47例予以短节段椎弓根钉内固定术治疗,观察组56例在对照组术式基础上采用经椎弓根椎体内植骨。记录两组手术时间、术中出血量、术后引流量、住院时间和脊髓功能优良率。末次随访时进行视觉模拟评分（VAS）评价腰背部疼痛情况。比较两组术前及末次随访时椎管侵占率、Cobb角、伤椎前缘高度比值。结果术后随访24~48个月,观察组脊髓功能优良率（67.86%）高于对照组（42.22%）,P〈0.05。两组手术时间、术中出血量、术后引流量、住院时间及术后VAS差异无统计学意义（P均〉0.05）。两组术后椎管侵占率和Cobb角均低于术前,伤椎前缘高度比值高于术前（P均〈0.01）;观察组术后椎管侵占率和Cobb角低于对照组,伤椎前缘高度比值高于对照组（P均〈0.01）。结论短节段椎弓根钉内固定术联合经椎弓根椎体内植骨治疗胸腰椎骨折疗效较好。

L型锁定钢板加植骨微创疗法用于Ⅱ型及Ⅲ型胫骨Pilon骨折治疗临床疗效评价

目的探讨L型锁定钢板加植骨微创疗法用于Ⅱ型及Ⅲ型胫骨Pilon骨折治疗的临床疗效。方法 110例Rüedi-Allgwer分型Ⅱ型及Ⅲ型胫骨Pilon骨折患者,随机分为对照组和试验组,各55例。对照组使用传统切开复位胫骨远端普通解剖钢板内固定进行治疗,试验组使用L型锁定钢板加植骨微创疗法进行治疗。比较两组的疗效和并发症情况。结果治疗后,试验组优30例、良15例、中7例、差3例,对照组优15例、良18例、中15例、差7例,试验组疗效优于对照组,差异具有统计学意义(P<0.05)。试验组手术切口感染、局部皮瓣缺血坏死、钢板外露少于对照组,差异具有统计学意义(P<0.05)。结论 L型锁定钢板加植骨微创疗法治疗Ⅱ型及Ⅲ型胫骨Pilon骨折疗效好,并发症少,值得推广使用。

“L”型锁定钢板加植骨微创疗法用于胫骨Pilon骨折治疗临床疗效评价

目的：探究对胫骨Pilon骨折患者采用“L”型锁定钢板加植骨微创疗法的临床治疗效果。方法：随机选取24例2014年3月～2015年3月期间在我院因胫骨Pilon骨折而入院治疗的患者，对所有患者采用“L”型锁定钢板加植骨微创疗法进行治疗，并根据Burwell－charnley的Pilon骨折的放射学评价标准以及Mazur等制定的踝关节症状与功能评分标准对治疗效果进行评价。结果：根据Burwell－charnley的Pilon骨折的放射学评价标准可知，24例患者中术后有20例患者达到解剖复位的标准，4例患者复位一般，0例患者复位差。另外，根据Mazur等制定的踝关节症状与功能评分标准可知，术后24例患者中12例患者治疗效果优秀，8例良好，3例一般，1例较差，综合治疗优良率为83．3％。结论：临床治疗胫骨Pilon骨折采用“L”型锁定钢板加植骨微创疗法临床效果十分显著，值得在临床广泛推广。

后路减压植骨AF螺钉内固定治疗胸腰段椎体骨折并脊髓损伤的疗效

目的探讨利用后路减压植骨AF螺钉内固定的方法治疗胸腰段椎体骨折并脊髓损伤的疗效。方法分析60例经影像学确诊的胸腰段椎体骨折并脊髓损伤患者的资料,采用神经恢复疗效以及骨折复位效果来分析和评价临床效果,其中,神经恢复疗效主要标准是Frankel分级评分,骨折复位效果指标主要是Cobb’s角和椎体高度测量。结果 60例患者治疗前后两项指标比较,差异有统计意义,P<0.05。结论对于治疗胸腰段椎体骨折并脊髓损伤,后路减压植骨AF螺钉内固定的方法十分有效。

Strong prognostic value of nodal and bone marrow micro-involvement in patients with pancreatic ductal carcinoma receiving no adjuvant chemotherapy

AIM： To study the prognostic value of adjuvant chemotherapy in patients with pancreatic, ductal adenocarcinoma. METHODS： Lymph nodes from 106 patients with resectable pancreatic ductal adenocarcinoma were systematically sampled. A total of 318 lymph nodes classified histopathologically as tumor-free were examined using sensitive immunohistochemical assays. Forty-three （41%） of the 106 patients were staged as pT1/2, 63 （59%） as pT3/4, 51 （48%） as pNo, and 55 （52%） as pN1. The study population included 59 （56%） patients exhibiting G1/2, and 47 （44%） patients with G3 tumors. Patients received no adjuvant chemoor radiation therapy and were followed up for a median of 12 （range： 3.5 to 139） mo.RESULTS： Immunostaining with Ber-EP4 revealed nodal microinvolvement in lymph nodes classified as ＂tumor free＂ by conventional histopathology in 73 （69%） out of the 106 patients. Twenty-nine （57%） of 51 patients staged histopathologically as pNo had nodal microinvolvement. The five-year survival probability for pN0-patients was 54% for those without nodal microinvolvement and 0% for those with nodal microinvolvement. Cox-regression modeling revealed the independent prognostic effect of nodal microinvolvement on recurrence-free （relative risk 2.92, P = 0.005） and overall （relative risk 2.49, P = 0.009） survival. CONCLUSION： The study reveals strong and independent prognostic significance of nodal microinvolvement in patients with pancreatic ductal adenocarcinoma who have received no adjuvant therapy. The addition of immunohistochemical findings to histopathology reports stratification of patients with may help to improve risk pancreatic cancer.

A SIMPLIFIED IN VIVO DOSIMETRY FOR TOTAL BODY IRRADIATION PRIOR TO BONE MARROW TRANSPLANTATION

For TBI (total body irradiation) prior to BMT(bone marrow transplantation )and in order to guarantee exact treatment,it is necessary to perfect in vivo dosimetry to detect any deviation of the treatment and to verify the dose dis-tribution. A simplified and convenient transmission type in vivo dosimetry and problems are introduced and discussed.

Acceleration of Immune Reconstitution after Bone Marrow Transplantation in Mice by Bone Marrow Stromal Cell Line Transfected with IL-6 Gene

To observe potential effect of the engineered bone marrow stromal cell line QXMSC1 secreting IL-6 (QXMSCIL-6) on accelerating immune reconstitution in syngeneic bone marrow transplantation in mice, QXMSC1 was transfected with the eukaryocytic expression vector pcDNAIL-6, which contained hIL-6 cDNA by liposome-mediated gene transfecting technique. G418-resistance clone was selected by limiting dilution. The highest secreting clone was selected by ELISA assay and used in animal experiments. The recipient mice (BALB/c) were lethally irradiated and cotransplanted syngeneic bone marrow (10 7/mice) and the QXMSC1IL-6 (5×10 5/mice). Lymphocyte proliferation induced by ConA and LPS, helper T lymphocyte precursor (HTLp), cytotoxic T lymphocyte precursor (CTLp), plaque-forming cell (PFC), delayed type hypersensitivity (DTH) were examined 30, 60 days in post transplantation respectively. The results showed that lymphocytes proliferation to ConA and LPS, HTLp, CTLp increased, DTH and PFC were improved by cografted stromal cells QXMSC1IL-6 on 30, 60 days after BMT. These results demonstrated that the bone marrow stromal cell line QXMSC1IL-6 transfected with IL-6 (QXMSC1IL-6) accelerated immune reconstitution in syngeneic bone marrow transplantation.

External fixation and bone grafting for collapsed and comminuted distal radius fracture

Objective: To study the therapeutic effect of collapsed and comminuted distal radius fracture. Methods: Twenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius. Results: All 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient’s radius. The average volar tilt was 6° to 15° and the average ulnar tilt was 18° to 25°. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good. Conclusions: The method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.