Anaerolentibacter hominis gen. nov. sp. nov., Diplocloster hominis sp. nov. and Pilosibacter fragilis gen. nov. sp. nov., isolated from human faeces.

Three Gram-positive, obligately anaerobic bacterial strains, namely CSJ-1T, CSJ-3T, and CSJ-4T, were isolated from faeces of healthy persons. They were characterized through a combination of whole-genome sequencing, phenotypic traits, and metabolomic analysis. The genome sizes of CSJ-1T, CSJ-4T, and CSJ-3T were 3.3, 3.8, and 6.1 Mbp, with DNA G+C contents of 47.2, 48.3, and 48.8 mol%, respectively. Strain CSJ-3T was identified as representing a novel species, Diplocloster hominis (type strain CSJ-3T=CGMCC 1.18033T=JCM 36512T) of the genus Diplocloster. The 16S rRNA gene sequence similarity and whole genome average nucleotide identity (gANI) of CSJ-4T to its closest related species, Diplocloster modestus ASD 4241T, were 98.3 and 91.4 %, respectively. Comparative analysis of 16S rRNA gene sequences showed 91.6 % similarity between CSJ-1T and its closest phylogenetic neighbour, Catenibacillus scindens DSM 106146T, and 93.3 % similarity between CSJ-4T and its closest relative strain, Clostridium fessum SNUG30386T. Based on the polyphasic taxonomic results, we proposed two novel genera and three novel species. Strain CSJ-1T was identified as representing a novel species of novel genus, Anaerolentibacter hominis gen. nov. sp. nov. (type strain CSJ-1T=CGMCC 1.18046T=JCM 36511T) of the family Lachnospiraceae, and strain CSJ-4T was identified as representing a novel species of novel genus Pilosibacter fragilis gen. nov. sp. nov. (type strain CSJ-4T=CGMCC 1.18026T= JCM 36513T) of the family Clostridiaceae.

Evaluation of the community involvement of nursing experts in reducing unintentional injuries in children.

BACKGROUND: Nursing experts regularly visited the community to deliver safety education on the prevention of unintentional injuries in children to the parents of children aged 0-6 years and to pregnant women in a maternity school. This was undertaken to explore the effects of the measure on preventing unintentional injuries in children in Chizhou, China. METHODS: Using the convenience sampling method, the guardians(it means mother in this study)of children were investigated. The nursing experts visited communities in which the number of nursing experts is declining. Data on unintentional injuries in children in the previous year were collected retrospectively. RESULTS: After the nursing experts delivered safety education to the community, the scores of the questionnaire on unintentional injury prevention knowledge completed by children's guardians increased significantly (p < 0.01). Among the children whose guardians completed the questionnaire, there were 157 cases of unintentional injury in 2020 and 103 cases in 2021 (p < 0.05). The types of unintentional injuries included scratches, falls, sharp object injuries, swallowing of foreign bodies, burns and traffic accidents; there was no statistical difference (p > 0.05). However, there were significant differences in terms of gender ratio and location (p < 0.05). CONCLUSION: In conjunction with the maternity school for pregnant women and the vaccination programme, nursing experts delivered safety education regarding unintentional injuries in children; this may have promoted safety and protection awareness in the children's guardians and reduced unintentional injuries.

lncRNA NEAT1 aggravates sepsis-induced lung injury by regulating the miR-27a/PTEN axis.

Sepsis is an acute inflammatory reaction and a cause of acute respiratory distress syndrome (ARDS). In the present study, we explored the roles and underlying mechanism of the lncRNA Nuclear enriched abundant transcript 1 (NEAT1) in ARDS. The expression levels of genes, proteins and pro-inflammatory cytokines in patients with ARDS, LPS-stimulated cells and septic mouse models were quantified using qPCR, western blotting and ELISA assays, respectively. The molecular targeting relationship was validated by conducting a dual-luciferase reporter assay. Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8) assay. The cell cycle phase was determined by flow cytometry assay. The expression levels of NEAT1 and pro-inflammatory cytokines were higher in patients with ARDS and septic models than in controls. Knockdown of NEAT1 significantly increased cell proliferation and cycle progression and prolonged mouse survival in vitro and in vivo. Mechanistically, miR-27a was identified as a downstream target of NEAT1 and directly inhibited PTEN expression. Further rescue experiments revealed that inhibition of miR-27a impeded the promoting effects of NEAT1 silence on cell proliferation and cycle progression, whereas inhibition of PTEN markedly weakened the inhibitory effects of NEAT1 overexpression on cell proliferation and cycle progression. Altogether, our study revealed that NEAT1 plays a promoting role in the progression of ARDS via the NEAT1/miR-27a/PTEN regulatory network, providing new insight into the pathologic mechanism behind ARDS.

Psychological distress and self-management behaviours among patients with chronic hepatitis B receiving oral antiviral therapy.

AIMS: To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self-management behaviours among this population. DESIGN: A cross-sectional study. METHODS: A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March-October 2018 to complete a self-report questionnaire including the Chinese version of Depression Anxiety Stress Scale-21 and Chronic Hepatitis B Self-Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self-management behaviours respectively. RESULTS: The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31-40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self-management behaviours. CONCLUSION: Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self-management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self-management behaviours for this population. IMPACT: This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self-management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self-management behaviours for this population.

Effect of peer support intervention on diabetes distress in people with type 2 diabetes: A systematic review and meta-analysis.

AIMS: To assess the effect of peer support intervention on diabetes distress in people with type 2 diabetes. BACKGROUND: Diabetes distress may be decreased by peer support intervention, but findings about the effect of peer support on diabetes distress have been mixed. DESIGN: A systematic review and meta-analysis of randomized controlled studies. DATA SOURCES: PubMed, Embase, CENTRAL, PsycINFO, Web of Science, and CINAHL databases were searched for randomized controlled trials from inception to 30 June 2018. REVIEW METHODS: Investigators assessed eligibility, extracted data, and assessed methodological quality. Standardized mean difference and 95% confidence intervals were calculated for pooled effect size. RESULTS: A total of 13 studies included in systematic review and 10 in meta-analysis. In the random-effects model, the pooled effect size showed current peer support intervention did not significantly reduce diabetes distress in type 2 diabetes population compared with usual care. CONCLUSION: High quality and well-designed studies targeting at reducing diabetes distress are needed to further test the effect of peer support intervention on diabetes distress.

Enhancing Quality of Patients Care and Improving Patient Experience in China with Assistance of Artificial Intelligence.

Improving health of Chinese people has become national strategy according to the Healthy China 2030. Patient experience evaluation examines health care service from perspective of patients; it is important for improving health care quality. Applying artificial intelligence (AI) in patient experience is an innovative approach to assist continuous improvement of care quality of patient service. A nursing quality platform based on patient experience data which is empowered by AI technologies has been established in China for the purpose of surveillance and analysis of the quality of patient care. It contains data from nearly 1300 healthcare facilities, based on which portraits of nursing service qualities can be drawn. The patient experience big data platform has shown potentials for healthcare facilities to improve patient care quality. More efforts are needed to achieve the goal of enhancing people's sense of health gain.

Silencing long non-coding RNA MEG3 accelerates tibia fraction healing by regulating the Wnt/ß-catenin signalling pathway.

As fracture healing is related to gene expression, fracture healing is prospected to be implicated in long non-coding RNAs (lncRNAs). This study focuses on the effects of epigenetic silencing of long non-coding RNA maternally expressed gene 3 (lncRNA MEG3) on fracture healing by regulating the Wnt/ß-catenin signalling pathway. Genes expressed in fracture were screened using bioinformatics and the subcellular location of MEG3 was determined using FISH. Next, we successfully established tibia fracture (TF) models of C57BL/6J and Col2a1-ICAT mice and the effect of silencing lncRNA MEG3 on fracture healing was detected after TF mice were treated with phosphate buffer saline (PBS), MEG3 siRNA and scramble siRNA. X-ray imaging, Safranin-O/fast green and haematoxylin-eosin (HE) staining and histomorphometrical and biomechanical analysis were adopted to observe and to detect the fracture healing conditions. Additionally, the positive expression of collagen II and osteocalcin was examined using immunohistochemistry. At last, in the in vitro experiment, the relationship of MEG3 and the Wnt/ß-catenin signalling pathway in fraction healing was investigated. MEG3 was located in the cell nucleus. In addition, it was found that MEG3 and the Wnt/ß-catenin signalling pathway were associated with fraction healing. Moreover, silencing MEG3 was proved to elevate callus area and maximum bending load and to furthermore enhance the recanalization of bone marrow cavity. Finally, MEG3 knockdown elevated levels of Col10a1, Runx2, Osterix, Osteocalcin, Wnt10b and ß-catenin/ß-catenin whereas it reduced p-GSK-3ß/GSK-3ß levels. Taken together, our data supported that epigenetic silencing of lncRNA MEG3 could promote the tibia fracture healing by activating the Wnt/ß-catenin signalling pathway.

Social support as a mediator between depression and quality of life in Chinese community-dwelling older adults with chronic disease.

The older adults with chronic disease usually show poor mental health and experience low quality of life (QOL). This study aimed to examine the mediating role of social support in the relationship between depression and QOL in community-dwelling older adults with chronic disease. A total of 387 Chinese older adults aged 60 or above with chronic disease were included in this cross-sectional study. Social support was negatively associated with depression and positively associated with physical component scale (PCS) and mental component scale (MCS). Depression and social support were all predictors of PCS and MCS. Mediation analysis suggested that social support partially mediated the impact of depression on PCS and MCS. Understanding the mediating role of social support might be beneficial in reducing the adverse impact of depression on QOL in community-dwelling older adults with chronic disease.

The effectiveness of exercise for fall prevention in nursing home residents: A systematic review meta-analysis.

AIM: The aim of this study was to determine the effectiveness of exercise on fall prevention in nursing home residents. BACKGROUND: Nursing home residents have a high risk of falling. No conclusive evidence exists on the effectiveness of exercise on fall prevention in nursing home residents. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA RESOURCES: Databases of PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature and China Biology Medicine were searched from inception to March 2017, with no language limitation. REVIEW METHODS: The review was conducted according to the guidelines of the Cochrane Collaboration. Studies on exercise interventions to prevent falls in nursing home residents were eligible. The primary outcome was the odds ratio with 95% confidence intervals of falls. RESULTS: Nine studies were included in the meta-analysis where exercise was compared with daily routine, social activities, and other methods in preventing falls. About falls, the pooled effect size of seven studies showed that exercise had no effect on fall prevention in nursing home residents. There was low heterogeneity. No significant publication bias was observed. CONCLUSIONS: The results of the systematic review and meta-analysis suggested that exercise did not play a role in preventing falls. Further studies with high quality and larger samples are required to support or counter the results.

Effects of intergroup exclusion on individual needs threat and behavior tendencies.

This study explores the effects of intergroup exclusion on need-threat and the behavioral tendencies of excluded individuals. Results show that those excluded by in-group members perceived more threat to relational needs, while participants excluded by out-group members perceived more threat to efficacy needs. In addition, participants excluded by out-group members displayed significantly more aggression intention and less helping intention than those who were excluded by in-group members. This study indicates that the group relationship between excluders and the excluded will directly affect threat perception and behavioral responses.

[Evaluation on dosage-based efficacy-toxicity correlation of Tripterygium wilfordii against immune inflammation in mice].

OBJECTIVE: To study the anti-immune inflammation efficacy and toxicity of Tripterygium wilfordii decoction, in order to provide experimental basis for studies on its "efficacy-toxicity" correlation. METHOD: The delayed hypersensitivity model was established by dinitrofluorobenzene in mice. Different doses of T. wilfordii decoction was administered for 5 consecutive days. The ear swelling inhibition ratio and the toxic action were observed. After the final administration, the biochemical indexes of PGE2, TNF-α, IL-2, ALT, AST, PA, TBA, TBIL in serum were detected, and the visceral indexes of heart, liver, spleen and kidney were measured. RESULT: The DNFB-induced ear swelling could be notably inhibited by multiple oral administration of T. wilfordii decoction, with the ED50 and its 95% confidence limit of 0.34 (0.21-0.42) g x kg(-1). The contents of PGE2, TNF-α, IL-2 in serum decreased in a dose-dependent manner. The activities of serum AST, ALT, TBA, TBIL and the PA content reduced. CONCLUSION: T. wilfordii decoction shows a significant anti-immune inflammation efficacy within the dosage range between 0.59 and 2.34 g x kg(-1) in a dose-dependent manner. With a certain hepatotoxicity, high dose (2.34-4.68 g x kg(-1)) of T. wilfordii decoction can cause substantial liver injury, with a dose dependence in liver function index. Therefore, the efficacy and toxicity of T. wilfordii is dose dependent, which provides reference for preventing adverse drug reactions in clinic and developing early-warning schemes and ensure the clinical medication safety of T. wilfordii.

Noble-metal-free BODIPY-cobaloxime photocatalysts for visible-light-driven hydrogen production.

In this study a series of supramolecular BODIPY-cobaloxime systems Co-Bn (n = 1-4): [{Co(dmgH)2Cl}{4,4-difluoro-8-(4-pyridyl)-1,3,5,7-tetramethyl-4-bora-3a,4a-diaza-s-indacene}] (Co-B1), [{Co(dmgH)2Cl}{4,4-difluoro-8-(4-pyridyl)-1,3,5,7-tetramethyl-2,6-diiodo-4-bora-3a,4a-diaza-s-indacene}] (Co-B2), [{Co(dmgH)2Cl}{4,4-difluoro-8-(3-pyridyl)-1,3,5,7-tetramethyl-4-bora-3a,4a-diaza-s-indacene}] (Co-B3), and [{Co(dmgH)2Cl}{4,4-difluoro-8-(3-pyridyl)-1,3,5,7-tetramethyl-2,6-diiodo-4-bora-3a,4a-diaza-s-indacene}] (Co-B4) (BODIPY = boron dipyrromethene, dmgH = dimethylglyoxime) have been synthesized by replacing one axial chlorine of cobaloxime moieties with the pyridine residues of BODIPYs, and structurally characterized. Absorption spectra show that the optical properties of the BODIPY-cobaloximes are essentially the sum of their constituent components, indicating weak interactions between the cobaloxime units and BODIPY chromophores in the ground state. If any, electronic communications may take place through the intramolecular electron transfer across their orthogonal structures. The possibility of intramolecular electron transfer is further supported by the results of the density functional theory (DFT) calculations at UB3LYP/LANL2DZ levels on Co-B2˙(-) and Co-B4˙(-), which show that the highest occupied molecular orbitals (HOMOs) possess predominantly BODIPY character, while the lowest unoccupied molecular orbitals (LUMOs) are located on the cobalt centers. The HOMO → LUMO transition is an electron-transfer process (BODIPY˙(-) radical anions → cobaloxime fragments). In view of the possible occurrence of electron transfer, these noble-metal-free BODIPY-cobaloximes are studied as single-component homogeneous photocatalysts for H2 generation in aqueous media. Under optimized conditions, the 2,6-diiodo BODIPY-sensitized cobaloxime Co-B4 that contains a meta-pyridyl at the 8-position of BODIPY presents excellent H2 photoproduction catalytic activity with a turnover number (TON) of 85, which is comparable to that of its analogue Co-B2 that has a para-pyridyl attached onto 2,6-diiodo BODIPY (TON = 82); however, both of the noniodinated BODIPY-sensitizer cobaloximes (Co-B1, Co-B3) exhibit a complete lack of activity under the same experimental conditions. These results show that the presence of heavy atoms in the core of BODIPY is essential for the catalytic process and reductive quenching pathways (namely, the intramolecular electron transfers from BODIPY˙(-) species to the cobalt centers) for these photocatalytically active systems of Co-Bn (n = 2 and 4) are thermodynamically feasible for the hydrogen-evolving reaction.

[Treatment of degenerative lumbar scoliosis with selective segmental transforaminal lumbar interbody fusion].

OBJECTIVE: To explore the treatment outcomes of degenerative lumbar scoliosis (DLS) with selective segmental transforaminal lumbar interbody fusion (TLIF). METHODS: The clinical data were analyzed for a total of 42 cases with degenerative scoliosis from November 2008 to March 2011.There were 14 males and 28 females with a mean age of 62.4 years (range, 41-76).The indications for TLIF of motion segment included segmental instability and significant upper endplate obliquities of L3 or L4.Interbody spinal fusion was performed for 3 segments in 3 cases; 2 in 17; 1 in 22.All patients were followed postoperatively with a mean duration of 1.6 years (range, 0.5-3).The imaging examinations included Cobb angle of scoliosis and lumbar lordosis angle.The clinical symptoms were evaluated with Oswestry disability index (ODI) score. RESULTS: The mean preoperative Cobb angle of 32.7° ± 12.4° was significantly corrected to 9.2° ± 5.5° at the final follow-up (t = 14.86, P < 0.05) with a correction rate of 71.8%. The mean preoperative lumbar lordosis angle of 25.5° ± 12.6° was also significantly corrected to 39.3° ± 8.5° (t = 12.11, P < 0.05) with a correction rate of 46.4%.There was significant difference (P < 0.05) in ODI between preoperation (43.8 ± 5.6) and postoperation (18.7 ± 1.8).But no significant difference (P > 0.05) existed in ODI between postoperation (18.7 ± 1.8) and the final follow-up (23.6 ± 2.3). And 86% of the patients showed considerable symptomatic improvement of neurogenic intermittent claudication. And clinical symptoms and functional tolerance for daily activities improved postoperatively in 92%. At the follow-up after 6 months postoperatively, all operated segments achieved fusion standard and no pseudoarthrosis formed. CONCLUSION: Selective segmental TLIF is helpful in correcting lumbar lordosis, segmental deformity and translation. And it offers better outcomes of posterior spinal fusion for the treatment of DLS.

[Histone deacetylase inhibits the growth and migration of human osteosarcoma cells].

OBJECTIVE: To explore the effects of histone deacetylase inhibitors (HDACIs) on human osteosarcoma in vitro and in vivo. METHODS: HDACI suberoylanilide hydroxamic acid (SAHA) and sodium butyrate (SB) were employed to examine the effects on human osteosarcoma in vitro and in vivo. The in vitro effects of HDACI SAHA and SB were evaluated in SaOS2 and U2OS human osteosarcoma cell lines. Cell growth, cell cycle progression and histone acetylation were examined by methyl tolyl sulfide (MTS), flow cytometry and Western blot respectively.In addition, SAHA or SB was administered for 4 weeks in a murine xenograph model for assessing the in vitro effects. RESULTS: MTS assay revealed that SAHA and SB significantly suppressed the growth of SaOS2 and U2OS cells in a concentration-dependent manner.Western blot analysis indicated that the levels of acetylated H3 increased after HDACI treatment.Flow cytometry showed that SAHA arrested the cell cycle in G1 and G2/M phase, while SB arrested the cell cycle in G2/M phase. The tumor growth of murine xenograph model with SaOS2 was inhibited by SAHA and SB compared with vehicle control. CONCLUSION: HDACI SAHA and SB significantly inhibit the growth of human osteosarcoma cells and induce cell cycle arrest. Meanwhile, the tumor inhibitory effects were also validated in a murine xenograft model.

[Combination of bone marrow concentrate and PGA scaffolds enhancing bone marrow stimulation in the repair of rabbit articular cartilage].

OBJECTIVE: To observe the effects of bone marrow concentrate (BMC)-PGA scaffolds for bone marrow stimulation enhancement and repairing rabbit articular cartilage. METHODS: A rabbit model of articular cartilage defect was established for BMC-PGA stent implantation. After 8 weeks, the experimental animals were sacrificed. And the methods of hematoxylin and eosin stain, toluidine blue stain and immunohistochemistry were used to evaluate the effects of bone marrow stimulation enhancement and rabbit cartilage defect repairing. RESULTS: Visible new cartilage formation was evident after implantation. As compared with other groups, the repairing effect was better. CONCLUSION: The implantation of BMC-PGA scaffolds is both simple and effective in the repair of articular cartilage.

[RNAi-mediated knockdown of cyclooxygenase 2 inhibits the growth and migration of SaOS2 human osteosarcoma cells].

OBJECTIVE: To explore the effects of a knockdown of cyclooxygenase 2 upon the growth and migration of SaOS2 cells. METHODS: We employed lentivirus mediated-RNA interference technology to knockdown the endogenous expression of gene COX-2 in human osteosarcoma cells (SaOS2) and analyzed their phenotypical changes. The effects of COX-2 silencing on the proliferation, cell cycle and migration of SaOS2 cells were assessed by thiazolyl blue tetrazolium bromide, flow cytometry and migration assays respectively. COX-2, vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) mRNA and protein expression were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. RESULTS: A decreased expression of COX-2 in human osteosarcoma cells significantly inhibited the growth and decreased the migration ability of SaOS2 cells. Furthermore, it also reduced VEGF, EGF and bFGF mRNA and protein expression. CONCLUSION: The COX-2 signaling pathway may provide a novel therapeutic target for the treatment of human osteosarcoma.

[Selection of suitable procedure in the treatment of degenerative lumbar scoliosis based upon imaging studies].

OBJECTIVE: To compare the clinical efficacies of two different procedures in the treatment of degenerative lumbar scoliosis. METHODS: From August 2008 to August 2011, 28 patients of lumbar degenerative scoliosis were divided into one group (n = 14) undergoing modified transforaminal lumbar interbody fusion (TLIF) instrumented surgery and another group (n = 14) undergoing posterolateral fusion (PLF) instrumented surgery. There were 12 males and 16 females with a mean age of 66.2 years (range: 54-79). The operative durations and bleeding volumes of two groups were recorded. The post-operative efficacy was evaluated with VAS (visual analogue scale) for low back pain, ODI (Oswestry disability index), Cobb' angle and lumbar lordosis angle on plain film. RESULTS: The mean follow-up period was 25.9 months. The operative duration was 192.0 ± 44.7 min in modified TLIF group versus 163.0 ± 39.0 min in PLF group. The bleeding volume was 718.0 ± 197.2 ml in modified TLIF group versus 546.0 ± 226.6 ml in PLF group. All operated lumbar intervertebral achieved bony fusion in modified TLIF group by the last follow-up. Two cases had no bony fusion and there was one case of pseudarthrosis in PLF group. Significant differences existed between two groups in pre-operative and post-operative values of VAS, ODI, Cobb' s angle and lumbar lordosis angle (P < 0.05). There were significant differences between two groups in the values of pre-operative and post-operative VAS and lumbar lordosis angle (P < 0.05) but not in the values of pre-operative and post-operative ODI and Cobb' s angle (P > 0.05). CONCLUSION: As an alternative, safe and effective procedure, modified TLIF instrumented is superior to PLF instrumented in the treatment of lumbar degenerative scoliosis.

[Short fusion and long fusion for degenerative lumbar scoliosis with lumbar stenosis].

OBJECTIVE: To explore the indications, surgical techniques and prognostic factors of short fusion versus long fusion for elder patients with degenerative lumbar scoliosis. METHODS: Thirty-eight patients undergoing different kinds of surgical procedures for lumbar spinal scoliosis between June 2005 and October 2010 were recruited for this retrospective study. The mean patient age at surgery was 64.2 years (range: 61 - 75). The short fusion group included 13 patients and the long fusion group 25 patients. RESULTS: There were a variety of treatment methods of degenerative scoliosis based on the symptomatology and radiological measurements of scoliosis and stenosis. Thirty-eight patients were followed up for an average of 37 months. The number of fused levels was 2.8 ± 0.7 segments in the short fusion group versus 5.1 ± 1.4 in the long fusion group. The average preoperative Cobb angle was 18.6° (range: 12 - 27) in the short fusion group versus 33.5° (range: 3 - 42) in the long fusion group. The correction of Cobb angle averaged 40% in the short fusion group versus 67% in the long fusion group. Clinical symptoms and functional tolerance for daily activities improved postoperatively. Radiographic evaluations showed reduced deformity on the frontal and sagittal planes. There were no infections, pseudoarthrosis, instrument-related failures or reoperations. CONCLUSIONS: Long segment fusion is superior to its short segment counterpart in correcting scoliotic curvature and coronal imbalance and improving rotational subluxation of apical vertebra. Careful perioperative preparation is essential in the treatment of elder patients with lumbar spinal scoliosis.

[Application of C1-C2 pedicle screw fixation in atlantoaxial complex fracture].

OBJECTIVE: To explore the therapeutic effects of posterior transpedicular screw internal fixation in atlantoaxial complex fracture patients. METHODS: Among 17 patients, there were Anderson II type of odontoid plus atlas fracture (n = 10) and Hangman plus atlas fracture (n = 7). They were categorized by their preoperative spinal cord scores according to the Frankel classification: C-class (n = 2), D-class (n = 6) and E-class (n = 5). Transpedicular screw internal fixation was performed to stabilize atlas and axis in 8 cases. Granular allograft bone was planted onto the surface of posterior arches in both atlas and axis. And the other 5 cases underwent no bony fusion. RESULTS: All patients were followed up for an average of 24 months. All screws were successfully placed in atlas and axis. And the cases of atlantoaxial dislocation were reduced. Bony fusion was observed at Months 3 - 6 post-operation. Atlantoaxial rotational function restored satisfactorily in all patients. But axial rotation was partially lost. CONCLUSION: Posterior transpedicular screw internal fixation can regain atlantoaxial joint stability immediately and promote bony fusion. And it is an effective therapy for atlantoaxial complex fracture.

[Biomechanical study of atlantoaxial fixation for transverse ligament injury leading to atlantoaxial instability].

OBJECTIVE: To explore the three-dimensional movement of atlantoaxial joint, complete transverse ligament and cracked transverse ligament after posterior atlantoaxial fixation. METHODS: The fresh upper cervical cadaveric specimens were collected from 6 males dead from active craniocerebral injury. The average age was 39.7 years old (range: 26 - 57). The specimens were divided into 3 groups of intact (Group I), transverse ligament cracked (Group D) and posterior atlantoaxial fixation (Group F). They were tested consecutively. RESULTS: The range of sagittal movement increased when the transverse ligament became cracked. And it had significant difference compared with the Group I (P < 0.05). But the ranges of lateral flexion and rotation showed no significant difference. When posterior atlantoaxial fixation was performed, all three-dimensional movements decreased. And significant differences existed as compared with Group I (P < 0.05). CONCLUSION: Under normal conditions, the main movement of atlantoaxial joint is rotation with lesser sagittal movement and lest lateral flexion. The range of sagittal movement increases significantly when transverse ligament is cracked (P < 0.05), especially so for anteflexion movement. The increase of lateral flexion and rotation has no significant difference compared with Group I. When posterior atlantoaxial Fixation is performed, all three-dimensional movements decrease significantly as compared with Group I (P < 0.05), especially loss of rotation function.