Multiple functions of Maf in the regulation of cellular development and differentiation.

Cellular muscular aponeurotic fibrosarcoma (c-Maf) is a member of the large macrophage-activating factor family. C-Maf plays important roles in the morphogenetic processes and cellular differentiation of the lens, kidneys, liver, T cells and nervous system, and it is particularly important in pancreatic islet and erythroblastic island formation. However, the exact role of c-Maf remains to be elucidated. In this review, we summarize the research to clarify the functions of c-Maf in the cellular development and differentiation. The expression of c-Maf is higher in pancreatic duct cells than in pancreatic islet cells. Therefore, we suggest that pancreatic duct cells may be converted to the functional insulin-secreting cells by regulating c-Maf.

[Color-difference evaluation of denture base resin based on CIECAM02 color appearance model].

OBJECTIVE: To compare the following color-difference equations: CMC, DE2000, CAM02-LCD, CAM02-SCD, CAM020-UCS, and to search for the most appropriate one to evaluate denture base resin. METHODS: Thirty-five denture based resin pieces which were aging during different time were measured using SP62 spectrophotometer and the color-difference was calculated using the above equations. PF/3, STRESS, and F-test of every calculation result were compared. RESULTS: PF/3 of CMC, DE2000, CAM02-LCD, CAM02-SCD, CAM020-UCS were: 22.448, 22.220, 22.840, 21.760, 22.049; STRESS of those were: 0.205, 0.228, 0.260, 0.192, 0.240. CONCLUSION: By comprehensive comparison of PF/3, STRESS and F-test, CAM02-SCD is the most appropriate equation for denture base resin, which was followed by CMC. The scatter diagram of color-difference showedthat color difference measured by instrument method is more objective and accurate compared with human eyes.

[Effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeâ ¡scapular pelvis fracture].

OBJECTIVE: To analyze the effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture. METHODS: From January 2016 to June 2021, 26 patients with Ideberg typeⅡglenoid fractures were treated with trans-axillary lag screw combined with supporting plate, including 15 males and 11 females. The age ranged from 21 to 75 years, with an average of (43.12±6.56) years old. The Constant-Murley Shoulder joint Scale and University of California at Los Angeles (UCLA) score were used to evaluate the function and clinical efficacy of shoulder joint. RESULTS: All patients were followed up, and the duration ranged from 19 to 42 months, with an average of (30.6±10.5) months. One year after surgery, the Constant-Murley score increased from preoperative 34.9±2.5(ranged, from 28 to 47) to 87.2±6.8(ranged, from 70 to 95). The UCLA score improved from preoperative 17.9±1.7(9 to 25) to 33.1±2.3(29 to 35). Seventeen patients got an excellent result, with 7 good, and 2 fair. None of the patients had infection, screw, and plate loosening, fracture, and other complications after surgery. Two patients had different degrees of Chronic pain in the shoulder during the follow-up period. CONCLUSION: The treatment of Ideberg typeⅡscapular glenoid fractures through axillary approach with lag screws and supporting steel plates has the advantages of convenient exposure, direct visual restoration of the normal anatomical shape of the scapular glenoid, selection of suitable positions for screw and steel plate placement, achieving better treatment results, and fewer complications. It is an effective and reliable surgical method.

Hollow-bone-graft dynamic hip screw can fix and promote bone union after femoral neck fracture: an experimental research.

BACKGROUND: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise. OBJECTIVE: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model. DESIGN: Testing of specifically designed fixation devices in a pig animal model. INTERVENTIONS/METHODS: We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each). Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively. RESULTS: There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05). There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively. CONCLUSIONS: The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.

Anterior Approach Versus Posterior Approach With Subtotal Corpectomy, Decompression, and Reconstruction of Spine in the Treatment of Thoracolumbar Burst Fractures: A Prospective Randomized Controlled Study.

STUDY DESIGN: A randomized, controlled follow-up study. OBJECTIVE: The objective of this study was to compare the results of anterior approach versus posterior approach with subtotal corpectomy, decompression, and reconstruction of spine in the treatment of thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Burst fractures are frequently associated with instability or neurological deficit. Anterior subtotal corpectomy, decompression, and reconstruction with instrumentation are an established method for a highly unstable burst fracture. In the past few years, subtotal corpectomy, decompression, and reconstruction of spine could be completed by posterior approach. Posterior segmental pedicle screw instrumentation, with its more rigid fixation and less technically demanding, could offer potential advantages. METHODS: A total of 64 patients with thoracolumbar burst fractures were divided into 2 groups randomly. Group A was treated by anterior approach and group B was treated by posterior approach with subtotal corpectomy, decompression, and reconstruction of spine. During the minimum 24 months (range, 24 to 72 mo) follow-up period, all patients were prospectively evaluated for clinical and radiologic outcomes. The intraoperative blood loss, operative time, complications of operation, pulmonary function, Frankel scale, and the American Spinal Injury Association (ASIA) motor score were used for clinical evaluation, whereas the heights of anterior edge of vertebral body and the Cobb angle were examined for radiologic outcome. RESULTS: All patients in this study achieved solid fusion, with significant neurological improvement. The intraoperative blood loss (P<0.05) and complications of operation were less, the operative time was shorter (P<0.05), and the pulmonary function after operation was better in the group B (P<0.05). The Frankel scale, the ASIA motor score, and the radiologic results were not significantly different (P<0.05) at all time points between the 2 groups A and B. But the 2 groups improved in their neurological function by approximately 1.3 Frankel grade and 15.6 ASIA motor scores at final follow-up. CONCLUSION: Anterior approach and posterior approach with subtotal corpectomy, decompression, and reconstruction of spine are sufficient for surgical treatment of thoracolumbar burst fractures. Less intraoperative blood loss and complications, shorter operative time, and better pulmonary function after operation are the significant advantages of posterior surgery.

Conservative versus surgical management of Pipkin type I fractures associated with posterior dislocation of the hip: a randomised controlled trial.

The aim of this study was to evaluate the long-term results of conservative and surgical fragment excision treatment in patients with Pipkin type 1 fractures of the femoral head associated with posterior dislocation of the hip by a randomised controlled trial. Sixteen patients were randomly divided into two groups: the conservative group was treated by closed reduction, and the surgical group was treated by closed reduction followed with fragment excision. Functional outcome was determined using the Thompson and Epstein score and the Merle d'Aubigne and Postel score. Outcome of the conservative group was worse than that of the surgical group (p = 0.032). The randomised controlled trial proves surgical fragment excision after closed reduction is an effective treatment for Pipkin type 1 fractures.

[Anti-HIV activities of Achyranthes bidentata polysaccharide sulfate in vitro and in vivo].

Achyranthes bidentata polysaccharide sulfate (ABPS) was a sulfated derivate derived from Achyranthes bidentata polysaccharide (ABP) which was isolated and identified from Chinese herb Achyranthes bidentata. The anti human immunodeficiency virus type 1 (HIV-1) activities were studied in vitro and in vivo. ABPS was found to inhibit HIV-1 reverse transcriptase and integrase with the 50% inhibiting concentration (IC60) of (2.948 +/- 0.556) micromol x L(-1) and (0.155 +/- 0.030) micromol x L(-1), respectively, but the parent compound ABP was not effective. ABPS inhibited HIV-1 P24 antigen with IC50 of (0.082 +/- 0.044) micromol x L(-1) and selective index (SI) of > (358 +/- 148) in MT-4 cell cultures acutely infected with HIV-1 IIIB virus, and with IC50 of (11.80 +/- 5.90) micromol x L(-1) and SI of > (24.2 +/- 12.1) in PBMC cell cultures acutely infected with clinical isolated zidovudine resistant HIV-1 virus, but there was no activity even at its concentration of 500 micromol x L(-1) in latent infection of H9/HIV-1 IIIB cell cultures. 5% sera taken from rats after intraperitoneal injection from rats with ABPS 125 mg x kg(-1) once or mice with 3 mg x kg(-1) qd for 20 days effectively inhibited HIV-1 P24 in MT-4 cell cultures, but those had no inhibitory effect when given orally. The results suggested that ABPS is a promising HIV-1 inhibitor, active on HIV-1 reverse transcriptase, integrase in vitro and HIV-1 P24 antigens in cell cultures, it was well absorbed by intraperitoneal injection but poor in oral bioavailability. It warrants further study.

[Expressions of G2A and OGR1 in peripheral blood cells of patients with hypoxia induced pulmonary hypertension].

OBJECTIVE: To detect the expression changes of proton-sensing receptor G2 accumulation (G2A) and ovarian cancer G protein-coupled receptor 1(OGR1) in human peripheral blood cells in hypoxic pulmonary hypertension patients(HPH). METHODS: Thirty-one patients with HPH were enrolled for HPH group(16 men and 15 women,age:(65.19±5.86) and thirty healthy persons were enrolled for the control group (NC group). The peripheral blood samples were collected and the mRNA expressions of G2A and OGR1 were determined by using real-time fluorescent quantitative PCR. The serum levels of tumor necrosis factor-α (TNF-α) were detected by using enzyme-linked immunosorbent assay (ELISA). RESULTS: PaCO2 was increased significantly in HPH group than that of the NC group (P<0.05). Forced expiratory volume in 1 sencond(FEV1)pro% and FEV1/forced vital capacity(FVC)in HPH group were significant lower than those of the NC group(P<0.05). The expressions of peripheral blood G2A mRNA and TNF-α in HPH group were increased dramatically than those of the NC group(P<0.05). The expressions of OGR1 mRNA in peripheral blood had no difference between HPH group and NC group. The expressions of G2A and TNF-α in HPH group were positively related to pulmonary artery pressure significantly. CONCLUSIONS: The expression of proton-sensing receptor G2A and the level of TNF-α are increased in peripheral blood cells of patients with pulmonary hypertension.The expressions of TNF-α,G2A and pulmonary artery pressure have positive correlation in the HPH group.

[Prevention and treatment of the related complications of tibial fractures bone defect by bone transport].

OBJECTIVE: To explore the therapeutic methods for the prevention and treatment of tibial bone defect and bone transport related complications. METHODS: From January 2012 to June 2015, 38 cases of bone defect of tibia were treated by bone transport technique treatment, including 26 males and 12 females, with an average age of 49.0 years old ranging from 36 to 66 years old. All patients were open fractures. The length of bone defect of 38 patients was 4 to 9.6 cm with an average of 5.2 cm. The force line and bone carrying rate were adjusted in time after operation. Patients insisted on loading. RESULTS: All patients were followed up for 17 to 36 months with an average of 24 months. Among them, 19 patients got natural healing in involution end;the other 18 cases respectively got healing after accordion technology in 10 cases, auxiliary internal fixation of bone graft after corresponding processing in 8 cases, 1 patient for dottiness, pneumonia, the knee joint dislocation, diabetes, cerebral palsy sequela was difficult to care, patients' families urged amputation surgery, so the amputation processing. The time of moving the bone transport was 4 to 10 months with an average of 7.1 months. Move length was 5 to 11.6 cm with an average of 8.0 cm. According to tibial stem diagnostic criteria of Johner-Wruhs score, 11 cases were excellent, 18 cases were good, 6 cases were moderate and 3 cases were poor. In addition to 1 case of amputation, the remaining cases were cured, no infection recurrence, re fracture and so on. CONCLUSIONS: Bone transport method is an effective method for the treatment of bone defect of tibia, but the existence of many complications is to limit the clinical application of the main factors, including shifting when the distance is too long the long reprojected line offset (bone exposure), nail tract infection, pin loosening, subsidence of soft tissue, loss of function of knee and ankle joint, pull a callus is not long, the contact ends were nonunion.

Subscapularis Transthoracic Versus Posterolateral Approaches in the Surgical Management of Upper Thoracic Tuberculosis: A Prospective, Randomized Controlled Study.

The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20-52 years) was followed up for a minimum of 12 months (range: 12-60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb's angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb's angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction.

Solvent-controlled three families of Zn(II) coordination compounds: synthesis, crystal structure, solvent-induced structural transformation, supramolecular isomerism and photoluminescence.

This work reports the assembly, topological structure, supramolecular isomerism and luminescence of three solvent-controlled families of coordination compounds, [Zn(bpz)2(H2O)3·2Hpta] (1), [Zn(bpz)(pta)]n (2), [Zn(bpz)(tpa)(H2O)]n (3), [Zn(bpz)(tpa)·4H2O]n (4), and [Zn(bpz)(npa)·H2O]n (5 and 6) (bpz = 3,3',5,5'-tetramethyl-4,4'-bipyrazole, H2pta = phthalic acid, H2tpa = terephthalic acid, H2npa = 4-nitrophthalic acid). The six transition metal compounds reported in this study were definitely characterized by X-ray crystallography to reveal how networks with different topologies are constructed around the same four-connected metal centers. Compound 1 is a 0D discrete molecule, in which Zn(II) is in a trigonal bipyramidal coordination geometry, whereas the guest Hpta(-) as counteranion is hydrogen-bonded with the [Zn(bpz)2(H2O)3]. In compound 2, the Zn(II) center is linked by two bpz and two pta; thus, a 4-connected dia network with the point symbol {6(6)} is formed. In 3, the Zn(II) center is six-coordinated, but in fact it is also a 4-connected node in the whole network due to the terminal aqua ligand and bidentate chelating carboxylate group thus, the resultant network has a 4-connected cds topology with the point symbol {6(5)·8}. Compound 4 exhibits a chiral two-fold interpenetrated 4-connected qtz network with the point symbol {6(4)·8(2)}. Compounds 5 and 6 are a pair of genuine supramolecular isomers with identical 4-connected dia topology. The three families of compounds, namely, 1/2, 3/4, and 5/6, are structurally controlled by the solvent systems H2O/CH3OH-H2O, H2O/DMF-CH3OH, and CH3OH-H2O/CH3CN-H2O, respectively. Except for the discrete molecule 1, the other five compounds have the same 4-connected coordination networks, but with different topologies ranging from dia (2, 5, 6), cds (3) to qtz (4), suggesting the important influences that the linkage orientations of the ligand and different geometries of the 4-connected node exert in self-assembly. Interestingly, discrete 1 can be irreversibly transformed from a 0D discrete molecule to an infinite 3D structure (2) by heating it in CH3OH-H2O solvent, indicating a solvent-induced structural transformation. In addition, results about thermal stabilities and photoluminescence spectra are also discussed in detail.

Comparative study on treating complete dislocation of acromioclavicular joint with three different methods.

OBJECTIVE: To comparatively study complete dislocation of acromioclavicular joint treated with three different methods. METHODS: A total of 96 patients (81 males and 15 females, aged 16-59 years, mean=45 years) with complete dislocation of acromioclavicular joint were treated with Dewar's operation (Group A, n=32), internal fixation with Kirschner tension band wires (Group B, n=44), or internal fixation with Wolter plates (Group C, n=20), respectively, in this study. Eighty-five patients suffered from acute dislocations and eleven from chronic dislocations. RESULTS: The patients were followed up for 50 months on an average. According to Karlsson's standard, in Group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In Group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In Group C, 15 patients were assessed as good, 4 as fair and 1 as poor. The good and fair rates were significantly different between Group A and Group B, and between Group C and Group B, but no statistical difference was found between Group A and Group C. The operating time was (52.36+/-7.24) minutes, (67.43+/-8.11) minutes and (69.73+/-8.04) minutes in Groups A, B and C, respectively. And the hospitalizing fees were (2400+/-270) yuan, (2100+/-190) yuan and (8450+/-360) yuan in Groups A, B and C, respectively. CONCLUSIONS: Dewar's operation is a good and safe method with shorter operating time and lower hospitalizing fee for treating complete dislocation of acromioclavicular joint. The method is simple without the need of a second operation to remove the implants and with few complications.

[Studies on the inhibition of polyhydroxylated aromatic compounds against HIV-1 integrase].

AIM: Three major enzymes of HIV-1, reverse transcriptase (RT), protease (PR), and integrase (IN), are important targets for anti-HIV drugs. Nine RT and five PR inhibitors have been effectively used in treatment of AIDS patients. In order to find active integrase inhibitors, twenty polyhydroxylated aromatic compounds were tested. METHODS: ELISA method was used to test the integrase activity. The synthesized donor substrate oligonucleotide representing the HIV-1 U5LTR was immobilized onto Covalink polystyrene microtiter plates, and a synthesized biotinlated 20 bp oligonucleotide was used as the target substrate. The products were detected and quantified by a colorimetric avidin-linked alkaline phosphatase reporter system. RESULTS: Compound NQ-2 was found to inhibit HIV-1 integrase with the IC50 of 78.5 mumol.L-1 by ELISA method. Its novel analogue NQ-3 was found to be 2 fold more potent on HIV intrgrase than NQ-2, IC50 was 37.2 mumol.L-1. The IC50s of NQ-2 and NQ-3 to inhibit the 3'-pro + assembly activity of integrase were 96.94 mumol.L-1 and 8.48 mumol.L-1; to inhibit assembly activity were 168 and 6.9 mumol.L-1 and to inhibit strand-transfer activity were 49.8 and 1.1 mumol.L-1, respectively. Compound NQ-2 mostly inhibited the strand transfer activity of HIV-1 integrase. Compound NQ-3 inhibited both the assembly and strand-transfer with high activities. CONCLUSION: Naphthoquinone compound NQ-3 was found to be a novel HIV integrase inhibitor which warrants further study. Uncoupled ELISA HIV integrase assay is shown to be useful to screen HIV-1 integrase inhibitors.

Effect of pore size of D, L-polylactic acid as bone repair material on bone regeneration.

OBJECTIVE: To study the bone regeneration behavior in porous D,L-polylactic acid (D,L-PLA) with different pore sizes. METHOD: A particulate-leaching method was employed to prepare porous biodegradable D,L-PLA with different pore sizes (75, 250, 400, 750 micrometer) and with porosity of 75% as the materials to repair bone defects in rabbits. The materials were then implanted at random into 40 rabbits with bilateral radius bone defect, leaving another 10 rabbits without implantation as blank control. Gross observation and X-ray and histomorphological examination as well as assessment of the biomechanics of the implants were performed in 2, 4, 8 and 12 weeks respectively after the operation. RESULTS: New bone tissue occurred around the implanted materials with pore sizes of 250, 400 or 750 micrometer 12 weeks after the operation. In the control group and in the rabbits with implants with pore size of 75 micrometer, the bone defect was filled with connective tissues. The implants with 250-micrometer pores had the strongest biomechanical strengths of all the materials (P<0.01) at 8 weeks and 12 weeks after the operation. CONCLUSION: The pore size of the porous implants decides the behavior of bone regeneration, and D, L-PLA polymer with 250-micrometer pores produces the most desired effects.

Feasibility of atlantoaxial pedicle screws' placement in children 6-8 years of age: a cadaveric and tomographic study.

The aims of this study were to evaluate the linear and angular dimensions of children's atlantoaxial pedicle using cadavers combined with axial computed tomography (CT) and to examine the feasibility of placing atlantoaxial pedicle screws (3.5 mm diameter) on the vertebrae of children 6-8 years of age. Fourteen cadaveric specimens, ranging in age from 6 to 8 years, were dissected to obtain their atlantoaxial vertebrae. We manually measured 12 linear anatomic parameters related to the atlantoaxial pedicle, its lateral mass, and the posterior arch under the vertebral artery groove. CT axial scanning of the atlantoaxial region was performed on 32 healthy children ranging in age from 6 to 8 years. The length of the atlantoaxial pedicles and the angle between the pedicle axis and the midline of the vertebral body were measured on the atlantoaxial transverse CT imaging. It is feasible to place a 3.5 mm screw in the atlantoaxial pedicle of children ranging in age from 6 to 8 years when the appropriate entry point and trajectory of the screw are chosen.

[Micromovement characteristic of distal tibiofibular joints in normal Chinese].

OBJECTIVE: To analyze micromovement of distal tihiofihular joints in different motion range of ankle joint ,and define the micromovement characteristic and range of distal tibiofihular joints. METHODS: Twelve normal Chinese were chosen. There were 9 males and 3 females, aged from 19 to 37 years old with an average (26.5 +/- 0.5) years. Detection terminals of laser photographic scanner were installed near the highest point between medial malleolus and lateral malleolos, the change of detection terminals on the position of dorsiflex, extension, introversion and eversion of ankle joint were scanned by 3D-laser scanner. The displacement of two detection terminals on the X ,Y and Z-axis (X-axis stands for the vertical-axis between coronal plane and Z-axis Y-axis stands for the vertical-axis between sagittal plane and Z-axis Z-axis stands for macroaxis of tibia). RESULTS: Along with increased range of motion on the position of dorsiflex ,extension, introversion and eversion of ankle joint, the range of micromovement of distal tibiofibolar joints increased too. The max-displacement of X, Y and Z were respectively (1.04 +/- 0.12) mm, (1.70 +/- 0.16) mm and--(0.87 +/- 0.10) mm. CONCLUSION: 3D-laser scanner can be used to determine the detailed displacement of distal tibiofibolar joint on the X , Y and Z, and measure the motion of distal tibiofibular joint. The method can be used to study the pathologic change of distal tibiofibular joint ,and provide basic biomechnics data for internal fixtor fitting for the characteristic of distal tibiofibular joint.

Total en bloc spondylectomy of L3 vertebra for histiocytic sarcoma.

This article describes a rare malignant spinal tumor successfully treated with total en bloc spondylectomy via a posterior approach. The purpose of this study was to emphasize the occurrence of primary histiocytic sarcoma in the lumbar spine. Histiocytic sarcomas are rare, malignant neoplasms of the lymphohematopoietic system that usually occur in the skin, lymph nodes, and intestinal tracts. Primary spinal column histiocytic sarcoma is rare. To the authors' knowledge, no reports have been published of treating this tumor with total en bloc spondylectomy.A 27-year-old woman presented with a 2-month history of intermittent low back pain and right lower extremity pain. Magnetic resonance imaging and computed tomography (CT) revealed a lumbar vertebra tumor. Positron emission tomography/CT showed focal accumulation in the tumor site. The patient was diagnosed with a histiocytic sarcoma based on biopsy findings and underwent total en bloc spondylectomy of L3 and reconstruction via a posterior approach. The patient maintained normal neurologic function, and the pain was lessened. No major complications occurred. No radiotherapy or chemotherapy was administered postoperatively, and no local tumor recurrence or distant metastases existed at 2-year follow-up.The diagnosis of histiocytic sarcoma relies predominantly on the verification of histiocytic lineage and the exclusion of other, poorly differentiated, large-cell malignancies by immunohistochemical stain. Total en bloc spondylectomy at L3 via a posterior approach can be performed safely and is an important approach in the treatment of selected spinal tumors.

[Clinical study on unilateral pedicle screw fixation and interbody fusion for the treatment of lumbar degenerative diseases under Quadrant system].

OBJECTIVE: To compare the clinical effects of unilateral pedicle screw fixation (uni-PS) assisted by Quadrant system and bilateral pedicle screw fixation (bi-PS) for the treatment of lumbar degenerative diseases. METHODS: From October 2008 to October 2010,102 patients with lower back pain, unilateral lower limb radiating pain or paraesthesia were treated with pedicle screw fixation and lumbar interbody fusion. There were 67 males and 35 females with an average age of 51.5 years ranging from 34 to 69 years. The patients were randomly divided into two groups (group A and group B) according to the internal fixation type. The patients of group A (n=50) underwent with minimally transforaminal lumbar interbody fusion (TLIF) and unilateral pedicle screw fixation with one single cage placement assisted by Quadrant system;and the patients of group B (n = 52) underwent with posterior lumbar interbody fusion (PLIF) and bilateral pedicle screw fixation with one single cage placement. There were no significant differences between two groups in general information (P > 0.05). VAS score and ODI score system were used to evaluate the preoperative and postoperative pain and function recovery. Operative time, volume of blood loss, fusion rate and complication rate were compared and analyzed by statistical test. RESULTS: All the patients were followed up from 12 to 21 months with an average of 18.2 months. In the group A,operative time and volume of blood loss were (87.6 +/- 25.5) min and (105.7 +/- 27.2) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.2 +/- 1.4, 7.9 +/- 1.1, 42.2 +/- 11.8 to 3.2 +/- 0.6, 3.0 +/- 0.7,15.6 +/- 2.3 at one month after operation; the fusion rate was 96.0% (48/50) and the complication rate was 4.00% (2/50). In the group B,operative time and volume of blood loss were (160.3 +/- 20.5) min and (220.6 +/- 25.5) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.3 +/- 1.1, 8.1 +/- 0.9, 43.1 +/- 12.0 to 3.3 +/- 0.4, 3.2 +/- 0.3, 14.9 +/- 2.6; the fusion rate was 96.2% (50/52) and the compli- cation rate was 5.77% (3/52). There were no statistically significant differences between the two groups in fusion rate, complication rate, VAS pain and ODI score. Whereas the operative time and blood loss in group A were significantly lower than that of group B. CONCLUSION: Minimally invasive unilateral pedicle screw fixation is a safe and feasible method for the treatment of lumbar degenerative diseases. It is as effective as the bilateral fixation in lumbar spinal fusion. In addition, it has the advantages of short operative time, less volume of blood loss, high fusion rate, etc.

[Application of absorbable screw in treatment of scaphoid fracture by retrograde internal fixation].

OBJECTIVE: To evaluate the surgical effects of treatment of scaphoid fracture with retrograde internal fixation using absorbable screw. METHODS: From December 2001 to December 2007, 18 cases of scaphoid fracture were treated with absorbable screw by retrograde internal fixation. There were 12 males and 6 females with an average age of 26 years ranging from 17 to 40 years. Ten cases were medium fractures of scaphoid and 8 cases were proximal fraxtures. RESULTS: All patients were followed-up for from 12 to 36 months (means 25 months). Among them, 17 cases were union and 1 case was nonunion. The mean time of union was 13 weeks. The mean range of motion of wrist was about 90% and mean scratch strength of wrist was about 95% to fine lateral. There were no pain in 14 cases, and slight pain in 3, medial pain in 1 casea of ununion. According to Cooney's clinical evaluation system, the score was increased from (68.2 +/- 1.5) before operation to (88.7 +/- 1.2) after operation, the postoperative score was higher than preoperative remarkable; 9 patients were fine, 8 were good and 1 was bad. CONCLUSION: This technology had some advantage such as simple surgery, decreasing demonstrate rest blood circulation, stable fixation, reducing bone healing time and increasing healing time. It is an effective way to treat scaphoid fracture.