Objective To investigate the stability and the stress distributions of L3-5 fused with three different approaches (interbody, posterolateral and circumferential fusions) and to investigate degeneration of thesegment adjacent to the fused functional spinal unit. Methods A detailed L3-5 three-dimensional nonlinear finite element model of a normal man aged 32 was established and validated. Based on the model, the destabilized model, the interbody, posterolateral and circumferential fusions models of L4-5 were established. After the loadings were placed on all the models, we recorded the angular motions of the fused segment and the Von Mises stress of the adjacent intervertebral disc. Results The circumferential fusion was most stable than the others, and the interbody fusion was more stable than the posterolateral fusion. The maximal Von Mises stress of the adjacent L3,4 intervertebral disc in all the models was ranked descendingly as flexion,lateral bending,torsion and extension. For the three kinds of fusions, the stress increment of the L3,4 intervertebral disc was ranked ascendingly as interbody fusion,posterolateral fusion and circumferential fusion. Conclusion After destabilization of the L4,5 segment, the stability of the circumferential fusionis better than that of the others, particularly under the flexional or extensional loading. The stability of the interbody fusion is better than that of the posterolateral fusion, except for under the flexional loading. The feasibility of adjacent segment degeneration can be ranked descendingly as: circumferential fusion,posterolateral fusion and interbody fusion.
【Abstract】 Objective To investigate the effectiveness of all-trans-retinoic acid (ATRA) at different concentrationson prol iferation and differentiation of the rat embryonic neural stem cells (NSCs), and to find the optimal concentration of ATRA that promoting the differentiation of NSCs into neurons. Methods NSCs were isolated from cerebral cortex of rat embryos (embryonic day 12-16, average 15 days), and were cultured in serum-free medium (DMEM/F12 medium containing 20 ng/mL bFGF and 20 ng/mL EGF) at the concentration of 1×106 cells/mL. Subcultures were performed 7 days after the primary culture. The cell clusters of the 3rd passage were centrifuged and divided into 5 groups. In the experimental groups (groups A, B, C, D), the ATRA concentration was 0.5, 1.0, 5.0, 10.0 μmol/L in DMEM/F12 complete medium respectively, while in control group (group E), the ATRA concentration was 0 in DMEM/F12 complete medium. The prol iferation rate of each group was analyzedby cell counting day by day till 7th day, and BrdU positive cell counting 1, 3, 5, 7, 9 days after culture. In addition, collecting the 3rd passage NSCs and divided into 5 groups. In the experimental groups (groups A, B, C, D), the ATRA concentration was 0.5, 1.0, 5.0, 10.0 μmol/L in DMEM/F12 medium containing 5% FBS respectively, while in control group (group E), the ATRA concentration was 0 in DMEM/F12 medium containing 5% FBS. The capacity of NSCs differentiation toward neurons was determined by immunofluorescence double-labell ing and flow cytometry. Results Cell counting 1-7 days after culture in each experimental group (groups A, B, C, D) showed no significant differences (P gt; 0.05). Cell counting at each time point of all the experimental groups were less than those of control group (P lt; 0.05). BrdU positive cells were increased 1, 3, 5, 7, 9 days after culture in each experimental group (groups A, B, C, D), but there was no significant difference between each experimental group(P gt; 0.05). BrdU positive cells at each time point of control groups were more than those of all the experimental groups (P lt;0.05). The differentiation ratio of neurons was enhanced in experimental groups and the optimal ATRA treatment concentration was 1.0 μmol/ L (experimental group B). The differentiation ratio of neurons induced by ATRA in group B was 29.46% ± 0.47%, 47.25% ± 0.46% and 66.81% ± 0.57% respectively after cultured 3, 5 and 7 days, whereas the differentiation ratio of neurons was 11.11% ± 0.59%, 14.10% ± 0.32% and 15.92% ± 0.70% respectively in control group. The majority of NSCs differentiated into astrogl ial phenotypes in control group. By flow cytometry detection, the differentiation ratio of neurons after cultured 3 days and 7 days in experimental groups were more than those in control group (P lt; 0.05). Conclusion ATRA treatment remarkably promoted the differentiation of NSCs into neurons and the optimal concentration was 1.0 μmol/L.
To explore the expression of Wnt-1 during the process of inducing neural stem cells (NSCs) into neurons by using all-trans-retinoic acid (ATRA) in vitro and the effect of Wnt-1 on NSCs differentiation. Methods NSCs isolated from cerebral cortex of SD rat embryo (12-16 days’ gestation) were cultured. The concentration of cells at passage 3 were adjusted to 1 × 106 cells /mL and treated with ATRA at 0.5, 1.0, 5.0 and 10.0 μmol/L, respectively. Differentiation ratio of NSCsinto neurons in each group was detected by double-labelling immunofluorescence technique and flow cytometry, and 1.0 μmol/ L was selected as the best concentration for ATRA to promote NSCs differentiation. In experimental group, NSCs at passage 3 were cultured with ATRA at 1.0 μmol/L in vitro, and expression of Wnt-1 was detected by immunocytochemistry staining, realtime flurescent quantitive PCR and Western blot at 3, 5, 7 and 9 days after culture, respectively. The cells at passage 3 receiving no ATRA served as control group. Results Immunocytochemistry staining: in the control group, there was l ittle Wnt-1 protein expression; in the experimental group, peak expression of Wnt-1 and numerous positive cells occurred at 3 days after culture, the positive expression of Wnt-1 was still evident at 5 days after culture, and there was significant difference between two groups in integrated absorbance (IA) value at 3 and 5 days after culture(P lt; 0.05), obvious decrease of positive expression of Wnt-1 was evident, and no significant difference was evident between two groups in IA value at 7 and 9 days (P gt; 0.05). Real-time fluorescence quantitative PCR: the relative expression of Wnt-1 mRNA in the control group was 0.021 7 ± 0.072 1; the relative expression of Wnt-1 mRNA in the experimental group at 3, 5, 7 and 9 days was 0.512 2 ± 0.280 0, 0.216 4 ± 0.887 0, 0.038 5 ± 0.299 4 and 0.035 5 ± 0.309 5, respectively, indicating the value decreased over time, and there were significant difference between two groups at 3 and 5 days (P lt; 0.05), and no significant difference at 7 and 9 days (P gt; 0.05) . Western blot detection: specific and visible staining band was noted; in the control group, Wnt-1 protein expression was 0.005 1 ± 0.558 3; in the experimental group, Wnt-1 protein expression at 3, 5, 7 and 9 days was 0.451 7 ± 0.071 3, 0.311 7 ± 0.080 5, 0.007 3 ± 0.052 7 and 0.004 7 ± 0.931 4, respectively, suggesting the value decreased over time; there were significant differences between two groups at 3 and 5 days (P lt; 0.05), and no significant differences at 7 and 9 days (P gt; 0.05). Conclusion With the induction of ATRA at 1.0 μmol/L, Wnt-1 and NSCs differentiation in early stage are positively correlated. Its possible mechanism may rely on the activation of such signals as classic Wnt-1 signal pathway, indicating Wnt-1 relates to the differentation of NSCs into neurons.
目的 探讨德阳市道路交通伤中人员分布的流行病学特点。 方法 回顾性统计分析德阳市2003年－2005年发生的5 300例道路交通伤资料，总结其中的规律和特点。 结果 在5 300例交通伤中，伤亡人员以男性居多（男︰女= 2.58︰1），其中16～55岁的青壮年占了全部伤亡人员的75.72%；工人、农林牧渔业人员和学生占交通伤的比例最高，达52.73%。步行、二轮摩托车和自行车是造成人员伤亡的最主要三个原因，三者比例达到了59.34%。 结论 加强交通安全意识的教育，加大交通法规的宣传和贯彻力度，加强部门间协作是减少交通伤发生的有效措施。Objective To investigate the epidemiological characteristics of the distrubution of people with trauma due to traffic accidents in Deyang City. Methods The data of 5 300 road traffic accidents from 2003 to 2005 in Deyang were retrospectively analyzed. The rules and characters were summarized. Results More males were injured or dead than females in the 5 300 road traffic accidents (male : female = 2.58︰1 ). The young adults aged from 16 to 55 accounted for 75.72% of all the casualties. The workers, agriculture employees and students had the largest percentage (52.73%) of the injuries. Walking and riding motorcycles and bicycles were the main causes leading to the injury, which occupied 59.34%. Conclusion The effective measures to reduce trauma due to traffic accidents will attribute to enhance the personnel awareness of road safety education, improve the publicity work and enforcement of traffic laws, and strengthen collaboration of different epartments.
Objective To explore the application of robot-assisted pedicle screw fixation combined with total endoscopic decompression and interbody fusion in single segment lumbar decompression and fusion. Methods A total of 27 cases undergoing single segment lumbar decompression and fusion between August 2020 and May 2021 in the People’s Hospital of Deyang City were retrospectively collected. They were divided into group A and B according to their surgery method. The patients in group A underwent robot-assisted pedicle screw fixation combined with total endoscopic decompression and interbody fusion surgery, while the ones in group B underwent traditional posterior decompression and fusion. The operation time, amount of bleeding, Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) score before operation and one month and three months after operation, and success rate of screw placement were compared. Results There were 12 patients in group A, 5 males and 7 females, aged (59.83±6.79) years, and 15 patients in group B, 6 males and 9 females, aged (53.73±14.87) years. The amount of intraoperative bleeding [(195.00±45.23) vs. (240.00±47.06) mL] and postoperative hospital stay [(5.92±1.56) vs. (8.33±3.62) d] in group A were less than those in group B (P<0.05), while the operation time [(185.80±52.13) vs. (160.70±21.37) min] and the success rate of screw placement [100.0% (48/48) vs. 96.7% (58/60)] had no statistical difference between the two groups (P>0.05). The VAS score and ODI score of the two groups decreased significantly over time (P<0.05), but there was no significant difference in VAS score between the two groups at the same time point before operation, one month after operation, or three months after operation (P>0.05). The ODI score of group A was better than that of group B one month after operation (P=0.010), but there was no significant difference between the two groups before operation or three months after operation (P>0.05). Conclusion Compared with traditional open surgery, the application of robot-assisted total endoscopic lumbar decompression and fusion technology in single segment lumbar fusion has good early clinical outcome, high success rate of screw placement, and small trauma, which is beneficial to early functional recovery and has the significance of further exploring its application prospect.
Objective To explore the effectiveness of Colorado 2TM system in the stabil ity reconstruction of sacroil iac joint fracture and dislocation in Tile C pelvic fracture. Methods Between February 2009 and January 2011，8 cases of Tile C pelvic fracture were treated with Colorado 2TM system. There were 3 males and 5 females with an average age of 34.4years (range，22-52 years). Fractures were caused by traffic accident in 3 cases, by fall ing from height in 3 cases，and by crash of heavy object in 2 cases. According to Tile classification, 5 cases were classified as C1-2, 2 cases as C1-3，and 1 case as C2. The time between injury and operation was 5-10 days (mean, 7 days). After skeletal traction reduction, Colorado 2TM system was used to fix sacroil iac joint, and reconstruction plate or external fixation was selectively adopted. Results The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory, posterior pelvic ring achieved effective stabil ity. All the incisions healed by first intention, and no blood vessel or nerve injury occurred. Eight patients were followed up 6-24 months (mean, 12 months). No loosening or breakage of internal fixation was observed and no re-dislocation of sacroil iac joint occurred. The bone heal ing time was 6-12 months (mean, 9 months). According to Majeed’s functional criterion, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case at last follow-up. Conclusion Colorado 2TM system could provide immediate stabil ity of pelvic posterior ring and good maintenance of reduction effect, which is an effective method in the therapy of sacroil iac joint fracture and dislocation in Tile C pelvic fracture.
Objective To retrospectively analyze the 420 fractured inpatients in the People’s Hospital of Deyang city seven days after the Wenchuan earthquake, so as to provide reference for the improvement of emergency plans earthquakes and the subsequent treatment of fracture patients. Methods The analysis was based on the data provided by the Department of Orthopedics of the Hospital up until July 18,2008. The software Microsoft EXCEL was used for data input, and SPSS 13.0 was used for statistical analysis. Results Up to July 18 420 cases from the disaster area have been treated in the department of orthopedics, including 176 men (41.9%) and 244 women (58.1%), the age was from 1 to 102 years and a median age of 43 years (2 761) among the inpatients. Most patients(328 cases) were sent to the hospital within the first three days after the quake (78.1%), and the number of inpatients were 92 4-7 days after the quake. The wounded were mainly from Mianzhu,Shifang , and Guanghan. The admission fracture diagnoses were tibial fractures (18.8%), fibular fractures (16.6%), and femoral fractures (14.9%). The major treatments were splinting, plaster fixation, or traction for closed fractures (301 cases), internal fixation or external fixation for malreduction (85 cases), and debridement suture and plaster fixation for open fractures (78 cases). Conclusion It is a vital to develop an emergent plan for fracture patients after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, and individual therapy.