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Objective: To analyze the X-ray characteristics in youth neck type of cervical spondylosis with upper crossed syndrome(UCS)., Methods: The patients who had a neck type of cervical spondylosis with or without UCS were selected from January to October 2017, 20 cases in each group, and 10 normal volunteers were chosen in the study. X-ray examination of lateral and hyperextension-hyperflexion of cervical spine were performed to observe cervical spine angle, angular displacement and adjacent vertebral body slip., Results: The cervical spine angle was (-0.40±9.64)° in the UCS group, significantly less than (14.35±9.01)° in the normal group and (12.34±5.65)° in the non-UCS group( P <0.05). The change of angular displacement of the upper cervical vertebra in anterior flexion and posterior extension was (8.18±4.81)° in UCS group, which was also significantly less than (12.14±3.48)° in the normal group and (12.34±5.65)° in the non-UCS group( P <0.05). The slippage of the vertebral posterior margin of the lower cervical spine in the anterior flexion was 15.41±2.21 in the UCS group, which was significantly greater than 13.26±2.42 in normal group( P <0.05), and was not obviously different from 15.64±2.07 in non-UCS group( P >0.05)., Conclusions: In young patients who has a neck type of cervical spondylosis with UCS, the cervical curvature prone to straighten or reverse, the upper cervical flexion and extension are limited, while the lower cervical is in a flexion., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© 2019 by the China Journal of Orthopaedics and Traumatology Press.)

Objective: To explore the safety and effectiveness of percutaneous transforaminal endoscopic BEIS technology for lumbar lateral recess stenosis in the elderly., Methods: From February 2014 to May 2016, 21 patients with lumbar lateral recess stenosis in elderly were treated with percutaneous endoscopic BEIS. There were 13 males and 8 females, aged from 70 to 85 years old with an average of 74.3 years. Preoperative, 1 and 12 months postoperative visual analogue scale(VAS) scores and Oswestry Disability Index(ODI) were statistically analyzed. MacNab was used to assess the clinical effects., Results: All the operations were successful. The time ranged from 90 to 130 min with an average of 110 min. All the patients were followed up for 12 to 38 months with an average of 18 months. Preoperative, 1 and 12 months postoperative VAS scores were 8.47±1.23, 1.78±0.72, 0.68±0.32, and ODI scores were 32.48±10.03, 19.53±3.55, and 5.15±1.02, respectively. Postoperative scores of VAS and ODI were obviously improved( P <0.05). According to modified MacNab standard to evaluate the clinical effects, 14 cases obtained excellent results, 5 good, 2 fair. Lower limb paresthesia occurred in 1 case, and the condition was restored at 3 months postoperatively with conservative treatment. One patient was complicated with emphysema before operation secondary to pulmonary infection, and was effectively controlled with regulate antibiotic therapy. No infection of vertebral body or intervertebral space, no injuries of blood vessels or nerve root, no tear of dura, or the leakage of cerebrospinal fluid were found., Conclusions: Percutaneous transforaminal endoscopic BEIS is a safe and effective method for lumbar lateral recess stenosis in the elderly., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.)

Objective: To explore the reliability ,validity and reaction degree of patient reported outcome scale for low back and leg pain., Methods: Two hundreds inpatients were analyzed between August 2010 and January 2012, including 93 males and 107 females with an average age of 50.3 years old ranging from 22 to 65 years. There were 144 cases of lumbar disc herniation and 56 of lumber spinal stenosis. All patients were tested by the patient reported outcome scale for low back and leg pain, and then analyzed the reliability,validity and reaction degree of the scale., Results: There was no statistical significence difference (P>0.05) and significant correlation (r>0.9) in scores of two times in patients with no change in illness. Measurement result of the scale had significant correlation (r>0.9) with Oswestry disability index (ODI). The total Cronbach's Alpha of the instrument was 0.931, the total split-half reliability was 0.912. The KMO value was 0.919, Bartlett test value was 1882.975 (P<0.001), factor analysis resulted in 3 factors with eigenvalue >1 which contributed to 64.364%. Scores of two times of 43 cases who felt better were 34.80+/-9.00 and 28.77+/-8.73, respectively,with stasitical significance (P<0.01)., Conclusion: The scale has a good reliability, validity and reaction degree,which can be applied for the therapeutic evaluation of low back and leg pain.

Objective: To explore the reason,diagnose outline,therapeutic tool of the incisions deep infections at early stage after lumber internal fixation., Methods: From January 2001 to December 2011, 10 patients with incisions deep infections at the early stage after the posterior lumber internal fixation were treated with intervertebral space lavaging. There were 1 male and 9 females with an average age of 63 years, and an average infection started at the 6th day after operation. The main clinical features including backleg pain aggravating, fervescence, fresh seepage from the wound, and blood inflammatory index increased, etc. According to whether the wound could heal at the first treatment stage as a evaluation standard of curative effect., Results: Ten cases were followed up with an average period of 17 months. The wounds of 9 cases healed at the first stage and no recurrence and complications were found. One case underwent debridgement of many times with the therapic period of 7 months,at last,after taking out the vertebral pedicle bolt,the wound healed,and no recurrence after follow-up of 18 months., Conclusion: The deep wound infections after the lumber internal fixation should receive intervertebral space lavaging as soon as possible. The method can finally remain internal fixations and obtain satisfactory effects, but avoiding too much tissue cutting and tube setting in the deep intervertebral space are the keys to the successful fixation.

Objective: To observe and compare the therapeutic effects of two methods to lumbar disc herniation treated by manipulation combined with Chinese herbs and traction with Western medicine., Methods: A multi-center with a central district unit was used to study the patients with lumbar disc herniation from November 28th, 2008 to May 7th, 2010. All the patients were divided into treatment group and control group. The treatment group had 100 cases, including 45 males and 55 females, averaged (43.43 +/- 9.18) years. The treatment group was treated by manipulation combined with Chinese herbs; Control group had 100 cases (5 cases were fall off), including 38 males and 57 females, averaged (42.29 +/- 9.78) years. The control group was treated by traction with Western medicine. The course of treatment was 3 weeks. VAS, M-JOA, LMS (lower limb muscle strength) and classification efficacy was used to evaluate outcome and therapeutic effects before and after treatment., Results: VAS and M-JOA were improved after the treatment both in treatment group and control group; there was no significant difference in LMS before and after treatment in both groups. VAS and M-JOA in treatment group was superior to those of control group after treatment. There was no significant difference in LMS. According to classification efficacy, 41 cases got excellent result, 34 good, 13 fair and 12 poor in treatment group; in control group, 35 cases obtained excellent results, 16 good, 19 fair and 25 poor. The effect of treatment group was better than that of control group., Conclusion: Both of two methods can improve the score of VAS, M-JOA, and treatment group is better than that of control group. While for the improvement of LMS, both of two methods have no obvious effects.

Objectives: To study the effects of Sanqi qisodium hyaluronate gel on collagen-I and collagen-III expression in the process of rabbits' epidural scar formation after operation., Methods: Ninety-six white rabbits with 6-month-old, half males and half females, weighted from 2 to 2.5 kg, which were randomly divided into normal saline group (A), Sanqi group (B), qisodium hyaluronate group (C) and Sanqi qisodium hyaluronate gel group (D). The laminectomy of rabbits were performed in group A, B, C, D, the duras were surrounded with normal saline, Sanqi liquid, qisodium hyaluronate and Sanqi qisodium hyaluronate gel respectively. Animals of each group were killed at 1, 2, 4, 8 weeks after operation. Use Masson staining for histological observation of collagen, and in situ hybridization staining for the analysis of collagen-I and collagen-III expression., Results: In the Masson staining, Sanqi qisodium hyaluronate gel group was more regular than the control group in the shape of collagen texture. As to the expression of collagen-I, and Sanqi qisodium hyaluronate gel group was lower than normal saline group, the Sanqi group and qisodium hyaluronate group at 4 weeks after using medicine (P < 0.01); while the Sanqi qisodium hyaluronate gel group was higher than normal saline group, Sanqi group and qisodium hyaluronate group in the collagen-III expression (P < 0.01)., Conclusions: Sanqi qisodium hyaluronate gel could improve collagen's arrangement of the rabbit's epidural scar after operation, reduce its rigidity and increase flexibility.

Objective: To provide a quantitative base for diagnosing cervical vertigo by establishing a biomechanics method., Methods: From July 2004 to Nov 2005, the static posturography (SPG) of normal 86 health individuals and 75 patients with cervical vertigo were quantitatively measured and qualitative diagnosis respectively in closed and open eyes. There were 40 male and 46 female in health adults, ranging from 20 to 74 years old (mean 30 years). There were 16 male and 59 female in vertigo patients, ranging from 20 to 74 years old (mean 44.5 years). In contrast to current diagnosis method of patients with cervical vertigo, the clinical value was evaluated., Results: Under the state of closed eyes, the sensitivity of SPG diagnosing cervical vertigo was 76%; the specificity was 93%; the Youden index was 69%; the coincidence was 85.1%; the positive predictive value was 90.5%; the negative predictive value was 93%; the positive and negative likelihood ratio were 10.893 and 0.258 respectively. Under the state of open eyes, the sensitivity was 49.3%; the specificity was 87.2%; the Youden index was 38.6%; the coincidence was 69.6%; the positive predictive value was 77.1%; the negative predictive value was 87.2%; the positive likelihood ratio was 3.857; the negative one was 0.581. Regardless of closed or open eyes, foreword-backward type shift orbit was the with cervical vertigo., Conclusion: The patients with cervical vertigo and normal individuals can be diagnosed objectively and quantitatively with SPG under the state of closed eyes, which can achieve the basic requirements of diagnosing cervical vertigo with validity, reliability and good clinical application. However, the rate of missed diagnosis with SPG under the state of open eyes is too high to meet the diagnostic needs.

Calcium phosphate cement (CPC) is considered as an important bone repairing materials due to its excellent biocompatibility, osteoconductivity and remodellability, the study about its performance is still a hot topic in the field of bone tissue engineering. Premixed calcium phosphate cements (PCPC) has advantages that can save operatiion time,be convenient to the operation and preservation compared with the traditional way of immediately mixing calcium phosphate cement. PCCP has overcome the shortcomings of uneven and inadequate mixing, and can be arbitrarily remodeled according to the shape of defect, thus researches on PCCP has also become more and more interested

Transforming growth factor (TGF-beta) plays a central role in wound healing and scarring. TGF-beta is a member of cytokine family, involving cell proliferation, migration, differentiation and apoptosis, which subsequently trigger extracellular matrix (ECM) deposite and collagen overproduction. A number of regulators of TGF-beta expression bave been identified, including Decorin CTGF, etc. TCM can reduced later scarring, and it accelerates wound healing. TCM can reduce the expression of TGF-beta, resistance of fibrosis, so that lighten the development of scar. This article reviewed the mechanism of TGF-beta in the scarring and TCM can decrease the development of scar effected by TGF-beta.