Wiltse Approach Versus Conventional Transforaminal Interbody Fusion for Unstable Thoracolumbar Fracture with Intervertebral Disc Lesions

ObjectiveTo compare the clinical results of two surgical techniques, Wiltse approach and conventional transforaminal interbody fusion, for the treatment of unstable thoracolumbar fracture associated with traumatic intervertebral disc lesion (TIDL).MethodsA total of 76 patients with unstable thoracolumbar fracture associated with TIDL treated by posterior pedicle screw fixation and transforaminal thoracolumbar interbody fusion from June 2010 and July 2016 were reviewed retrospectively. These patients including 48 male and 28 female patients were divided into Wiltse approach transforaminal thoracolumbar interbody fusion (W‐TLIF) group (n = 38) and conventional transforaminal thoracolumbar interbody fusion (C‐TLIF) group (n = 38). Patients were followed up for about 33 months. Clinical and radiological records, kyphotic angle, fractured vertebral body height, visual analogue score (VAS), Oswestry Disability Index (ODI), complications, neurological improvement and fusion rate were compared between two groups.ResultsAll patients underwent posterior surgery successfully. Blood loss, operation time and hospital stay in the W‐TLIF group was 437.84 ± 143.98 ml, 118.64 ± 20.55 min and 12.32 ± 2.87 days, respectively. While those parameters in the C‐TLIF group was 862.70 ± 300.24 ml, 141.35 ± 31.72 min and 15.51 ± 2.08 days, respectively. Average operation time and hospital stay time were significantly shorter, and blood loss was significantly less in the W‐TLIF group than in the C‐TLIF group (P < 0.05). VAS and ODI in the W‐TLIF group were significantly less than those in the C‐TLIF group at 1 week after operation and final follow‐up. The kyphotic angle and vertebral body height were improved. There was 1–2 grade improvement in patients with neurological deficit. Thirty‐three patients in the W‐TLIF group and 32 patients in the C‐TLIF group had achieved fusion during follow‐up. No internal fixation failure was observed in two groups.ConclusionsThe both techniques of W‐TLIF and C‐TLIF were feasible and effective for unstable thoracolumbar fracture with TIDL. Compare to C‐TLIF, The technique of W‐TLIF was a relatively less invasive way to decompress the neural elements and an easy method to reconstruct the anterior column using the same posterior approach.     

Black Tea Reduces Diet-Induced Obesity in Mice via Modulation of Gut Microbiota and Gene Expression in Host Tissues

Black tea was reported to alter the microbiome populations and metabolites in diet-induced obese mice and displays properties that prevent obesity, but the underlying mechanism of the preventative effect of black tea on high-fat diet (HFD) induced obesity has not been elucidated. Epigenetic studies are a useful tool for determining the relationship between obesity and environment. Here, we show that the water extract of black tea (Lapsang souchong, LS) reverses HFD-induced gut dysbiosis, alters the tissue gene expression, changes the level of a major epigenetic modification (DNA methylation), and prevents obesity in HFD feeding mice. The anti-obesity properties of black tea are due to alkaloids, which are the principal active components. Our data indicate that the anti-obesity benefits of black tea are transmitted via fecal transplantation, and the change of tissue gene expression and the preventative effects on HFD-induced obesity in mice of black tea are dependent on the gut microbiota. We further show that black tea could regulate the DNA methylation of imprinted genes in the spermatozoa of high-fat diet mice. Our results show a mechanistic link between black tea, changes in the gut microbiota, epigenetic processes, and tissue gene expression in the modulation of diet-induced metabolic dysfunction.     

参麦注射液合血府逐瘀汤治疗缺血性ST-T改变疗效观察

[目的]观察参麦注射液联合血府逐瘀汤治疗缺血性ST-T改变的临床疗效。[方法]将75例有心肌缺血型心电图改变的患者随机分成治疗组40例(以参麦注射液联合血府逐瘀汤治疗)与对照组35例(单纯西药治疗),疗程为14天,比较两组疗效。[结果]治疗组疗效优于对照组。[结论]参麦注射液联合血府逐瘀汤治疗缺血性ST-T改变有较好的疗效。     

中医学:一种基于隐喻认知的语言

目的:从认知语言学的角度明确中医语言性质。方法:应用隐喻认知语言学方位隐喻、实体隐喻、结构隐喻等相关概念对中医语言进行分析。结果:隐喻于中医药语言中可谓无处不在。结论:研究评判中医学的前提是必须清楚中医学的语言。     

血小板对单核细胞促凝活性的影响

目的 研究血小板对单核细胞促凝活性的影响。方法 采用一期法血浆凝固时间测定单核细胞促凝活性;单抗中和法确定组织因子（TF）活性及P－选择素的作用。结果 ①内毒素激活的单核细胞促凝活性显著增高,TF单抗能明显阻断该效应;②胶原激活的血小板对单核细胞及内毒素激活的单核细胞的促凝活性均有明显的增强作用;③抗血小板P－选择素单抗能阻断活化的血小板对单核细胞促凝活性的增强效应。结论 ①单核细胞促凝活性是由于TF的表达;②血小板对单核细胞促凝活性的增强效应是通过P－选择素实现的。     

儿童急性ITP与EB病毒感染的相关性研究

目的探讨EB病毒感染与ITP的相互关系。方法回顾性研究2010-11—2012-12内蒙古自治区人民医院小儿血液科收治的163名ITP患儿,针对EB病毒感染情况分EB-VCA-Ig M(+)/Ig G(+)、EB-VCA-Ig M(-)/Ig G(+)、EB-VCA-Ig M(-)/Ig G(-)3组,对各组血小板计数上升至正常水平的平均住院天数进行统计学分析。结果EB-VCA-Ig M(+)/Ig G(+)组血小板上升至正常的平均住院天数明显高于其他组,另两组间差异无统计学意义;EB-VCA-Ig M(+)/Ig G(+)和EB-VCA-Ig M(-)/Ig G(+)两组ITP转慢率均高于非EB病毒感染者,而两组间转慢率差异无统计学意义。结论 EB病毒感染的ITP患儿血小板上升至正常的平均住院天数明显比非感染EB病毒患儿的血小板上升至正常的平均住院天数延长。     

宫颈癌根治术对育龄女性性功能及生活质量的影响

目的:研究宫颈癌根治术对育龄女性性功能、生活质量的影响。方法:选取我院2011年1月至2015年12月期间实施宫颈癌根治术的318例宫颈癌患者作为研究对象,对比患者治疗前后的性功能评分,QLQ-C30生活质量评分,不同治疗方式对患者性功能评分总分值及QLQ-C30总分值的影响,分析患者性功能评分总分与QLQ-C30总分的相关性。结果:治疗后患者性功能评分的各项分值均明显低于治疗前的水平,差异均有统计学意义(P0.05)。治疗后QLQ-C30生活质量评分的各项分值均明显高于治疗前的水平,差异均有统计学意义(P0.05);治疗后单纯手术组的性功能评分总分值及QLQ-C30总分值仍明显高于手术综合放化疗组,差异均有统计学意义(P0.05);治疗后保留盆腔神经组的性功能评分总分值及QLQ-C30总分值仍明显高于未保留盆腔神经组,差异均有统计学意义(P0.05)。根据Spearman法分析相关性可知,患者性功能评分总分与QLQ-C30总分呈负相关(r=-0.789,P=0.000)。结论:宫颈癌根治术对于育龄女性的性功能及生活质量均具有一定的影响,临床治疗时应综合考虑患者的实际情况,尽可能地选择科学合理的治疗方案。     

医院船执行海外人道主义救援任务数据统计规范研究

目的提高医院船海外人道主义救援任务过程中数据信息统计科学性。方法采取Delphi法确定数据统计框架,通过文献回顾荟萃和专家访谈法确定数据统计口径,建立相应制度规范,并联合浙江大学对信息系统平台实施数字化改进。结果任务数据信息逐步完善,历次任务救治数据完整率不断提高。