ObjectiveTo summarize the applications of Schwann cells (SCs), stem cells, and genetically modified cells (GMCs) in repair of peripheral nerve defects. MethodsThe literature of original experimental study and clinical research related with SCs, stem cells, and GMCs was reviewed and analyzed. ResultsSCs play a key role in repair of peripheral nerve defects; the stem cells can be induced to differentiate into SCs, which can be implanted into nerve conduits to promote the repair of peripheral nerve defect; genetically modified technology can enhance the function of SCs and different stem cells, which has been regarded as a new option for tissue engineered nerve. ConclusionAlthough great progress has been made in tissue engineered nerve recently, mostly limited to the experimental stage. The research of seed cells in application of tissue engineered nerve need be studied deeply.
ObjectiveTo investigate the effectiveness of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) assisted with microscope in treatment of lumbar spondylolisthesis. MethodsBetween January 2011 and June 2012, 52 patients with lumbar spondylolisthesis underwent MI-TLIF assisted with microscope. There were 29 males and 23 females with an average age of 46 years (range, 32-67 years). The median disease duration was 3.2 years (range, 3 months to 6 years). There were 38 cases of lumbar isthmic spondylolisthesis and 14 cases of degenerative spondylolisthesis; 12 cases had stenosis secondary to lumbar spondylolisthesis. The affected segments were L4, 5 (29 cases) and L5, S1 (23 cases). According to the Meyerding evaluating system, 24 cases were classified as degree I and 28 cases as degree Ⅱ. The visual analogue scale (VAS) score and Oswestry disability index (ODI)were used for clinical assessment, and the clinical effects were also analyzed by Macnab criterion at last follow-up. The radiographic data were used to evaluate reduction of spondylolisthesis, including slipping degree, slipping angle, and intervertebral space height. The fusion rate was assessed by Suk criterion. ResultsThe operations were performed successfully in all patients. No dural tear or cerebrospinal fluid leakage occurred during operation. The average operation time was 105 minutes; the average intraoperative blood loss was 225 mL; the average postoperative drainage volume was 75 mL; and the average hospitalization days were 5.5 days. Superficial infection of incision occurred in 1 case and was cured after change dressing, and primary healing of incision was obtained in the others. All patients were followed up 12-26 months (mean, 18 months). No loosening, breakage, and displacement of pedicle screw and no Cage dislocation occurred by X-ray films after operation. The lumbar spondylolisthesis all got good correction. The three-dimensional CT showed continuous bone trabecula between centrums. The VAS score, ODI, and the slipping degree, slipping angle, and intervertebral space height were significantly improved at last follow-up when compared with preoperative ones (P<0.05). According to Macnab criterion at last follow-up, the results were excellent in 20 cases, good in 29 cases, and fair in 3 cases; the excellent and good rate was 94.2%. According to Suk criterion for fusion, 49 cases obtained complete fusion and 3 cases got possible fusion. ConclusionAs long as indications are seized, MI-TLIF assisted with microscope is safe and reliable for treatment of lumbar spondylolisthesis (Meyerding dergee I or Ⅱ), and it has the advantage of less injury, less blood loss, less complications, and definite short-term effectiveness.
ObjectiveTo explore the expression of Cryab in human colorectal cancer tissue and its clinical significances. MethodsTen pairs of colorectal cancer specimens of early recurrence and late recurrence in the First Hospital of Lanzhou University were collected, the Cryab mRNA expression was detected by RT-PCR. The colorectal cancer tissues and corresponding adjacent tissues of 100 patients underwent radical resection from January 2005 to December 2008 in the Donggang Branch of The First Hospital and The First Hospital of Lanzhou University were collected, the expression of Cryab protein in the colorectal cancer tissues and corresponding adjacent tissues of 100 patients with colorectal cancer were detected by immunohistochemistry SP technique. The relation between the expression of Cryab protein and the age, gender, number of tumors, tumor size, TNM stage, degree of differentiation, lymph node metastasis, or depth of invasion of the patients was analyzed. The influence of Cryab expression on prognosis of patients with colorectal cancer was evaluated by univariate and multivariate analysis. Results①The expression of Cryab mRNA in the colorectal cancer tissues with early recurrence was significantly higher than that in the colorectal cancer tissues with late recurrence (P < 0.05).②The expression of Cryab protein in the colorectal cancer tissues was significantly higher than that in the corresponding adjacent tissues (P < 0.05).③The over-expression of Cryab protein in the colorectal cancer tissues was correlated with the tumor size, degree of differentiation, lymph node metastasis, or TNM stages (P < 0.05), but not correlated with the age, sex, and number of tumors (P > 0.05).④The lymph node metastasis and expression of Cryab protein were the independent risk factors for the prognosis of patients with colorectal cancer.⑤The overall survival and disease free survival of patients with high-expression of Cryab protein were significantly lower than those in the patients with lower-expression of Cryab protein. ConclusionsThe over-expression of Cryab is closely related to the invasion and progression of colorectal cancer, they might be together involved in the progression of colorectal cancer. Cryab might be a good marker for monitoring the malignant degree and the prognosis of colorectal cancer.
ObjectiveTo explore the effectiveness percutaneous monoaxial screw combined with polyaxial pedical screw for treating thoracolumbar fracture by comparing with simple polyaxial pedicle screw fixation. MethodsBetween January 2012 and June 2014, 56 cases of thoracolumbar fractures were treated by percutaneous pedicle screw fixation, the clinical data were retrospectively analyzed. Of 56 cases, 30 were treated with percutaneous monoaxial screw combined with percutaneous polyaxial pedical screw fixation (group A), 26 patients with only percutaneous polyaxial pedicle screw fixation (group B). There was no significant difference in gender, age, body mass index, injury causes, time from injury to admission, involved segments, fracture type, and preoperative American Spinal Injury Association (ASIA) stage, visual analogue scale (VAS), the anterior height of the injured vertebrae, Cobb angle, and sagittal index between 2 groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded and compared between the 2 groups. The VAS score was used to evaluate the improvement of the pain. The sagittal kyphosis Cobb angle, the anterior height of the injured vertebrae, sagittal index, and the average correction (difference between 3 days after oeration and preoperation) and loss degrees (difference between last follow-up and 3 days after operation) were measured on the X-ray films at preoperation, 3 days after operation, and last follow-up. ResultsIncision healing at stage I was obtained, no related complications occurred. The operation time and intraoperative blood loss showed no significant difference between 2 groups (P>0.05). The patients were followed up 20-42 months (mean, 32 months) in group A and 21-44 months (mean, 30 months) in group B. VAS score of group A was significantly lower than that of group B at 3 days after operation (t=-2.277, P=0.027), but no significant difference was found at last follow-up (t=-0.289, P=0.774). X-ray examination showed good position of internal fixation, with no broken nails or exit of nail. There were significant differences in the anterior height of the injured vertebrae, Cobb angle, and sagittal index between at preoperation and at 3 days and last follow-up, and between at 3 days and last follow-up in 2 groups (P<0.05). The anterior height of the injured vertebrae, Cobb angle, and sagittal index of group A were significantly better than those of group B at 3 days and last follow-up (P<0.05), and correction degree were significantly higher than those of group B (P<0.05), but loss degree was not significant between 2 groups (P>0.05). ConclusionPercutaneous monoaxial screw combined with polyaxial pedicle screw fixation is better than simply polyaxial pedicle screw in effects of treating thoracolumbar fracture under the premise of strictly holding indications.
ObjectiveTo survey and analyze the trend of congenital heart disease (CHD) of regions distribution and medical payment model in Children's Hospital of Gansu Province over the past 11 years, and to provide evidence for diagnosis and treatment strategies for CHD children. MethodsMedical records of the CHD children hospitalized in the Children's Hospital of Gansu Province from 2001 to 2011 were completely collected. Regional distribution, year and other basic information of them were extracted. Data was then analyzed using the SPSS 16.0 software. ResultsA total of 591 CHD children were included. Most of them came from Middle-Long, accounting for 68.87%; while the number of CHD children in the region of East-Long and He-xi had a tendency of growth by year, with average growth speed of 189.42% and 27.62%, respectively. Most of them came from the region which is economic class Ⅲ, accounting for 35.64% (highest) with average growth speed (203.45%). Most of the treatment costs were self-supported before 2005, and health insurance and other social aids were consistently increasing after 2005. Most of the institutions for initial visit were town-level hospitals, accounting for 55.50%, and with average growth speed of 170.18%. ConclusionThe medical demand of CHD children in less-developed regions in Gansu province increases year by year. Government-guided healthcare system should be established and improved so as to basically guarantee the prevention and treatment of CHD in less-developed regions.