Purpose: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although interbody fusion and circumferential fusion are a relatively common surgical method for the treatment of spondylolisthesis, we retrospectively compared surgical reduction or fusion in situ with simple lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) for adult isthmic spondylolisthesis in terms of surgical invasiveness, clinical and radiographical outcomes, and complications.Methods: From January 2013 to June 2015, 84 adult patients with isthmic spondylolisthesis who underwent surgical treatment in our department were randomized to simple lumbar interbody fusion (PLIF/TLIF) group (group 1, n=45) and circumferential fusion (PLF+TLIF/PLIF) group (group 2, n=39), and followed up for average 28.6 months (range 24-54 months). All patients of both groups had low back pain as their predominant symptom, with varying degree of radicular pain and neurological symptoms. The data collected retrospectively for analysis were: duration of symptoms, levels of fusion, revision surgery, clinical and radiographic results after surgery, and complications. Results:All the 84 patients compared in two surgical approaches for IS were included in this retrospective studies. In our analysis, for the surgical management of isthmic spondylolisthesis, we indicated that both approaches lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) have equal significant, greater fusion rates with successful clinical outcomes. Conclusion:Our clinical experience along with statistic findings indicates that in conclusion, there was no significant difference was found between simple interbody fusion (PLIF/TLIF) compared to circumferential fusion (PLF+TLIF/PLIF). Moreover, both techniques led to similar surgical outcomes and complication during follow-up. Thus, these results suggest that both procedures are equally effective for the treatment of isthmic spondylolisthesis. Keywords: Introduction BackgroundSpinal fusion technique was introduced 70 years ago for the treatment of degenerative disc disease and chronic lower back pain [1]. Hibbs and Albee were two spine surgeons in 1911, who performed first spinal stabilization surgery [2,3]. Forward displacement of a vertebral bone in sequence of normal alignment of vertebra is called Isthmic Spondylolisthesis-most commonly due to progressive vertebral body malalignment in the lumbar region of spine. Even in severe case of spondylolisthesis, the slipped vertebra is comfortably reduced by the modern surgical techniques [4][5][6][7].However, these operations have high risk of neurological complications from the implant and screws, even in correct procedure, there areneurological complications [8]. There are no significant neurological complication differences found between the reduction procedure and fusion situ [5,[8][9][10]. About 90% of all vertebral body slips due to the degenerative and isthmic types of spondylolisthesis [11]. Generally in populati...

Purpose: To valuate four-quadrant location method in diagnosis and differential diagnosis of the orbital tumor by comparison study combining CT and MRI with pathology. Materials and methods:Data of 87 patients (44 female and 43 males), aged 1 to 84 years were recruited in this study, including the computed tomography(CT), Magnetic resonance imaging (MRI), and histopathology diagnosis. All orbital tumors were verified radiologically and pathologically in the Hospital of Jinggangshan University from Sep-2008 to April-2016 patients underwent CT scanning (31 Conventional CT and 18 dynamic contrast enhancements CT) and 38 patients underwent MR Imaging (35 dynamic contrast enhancement MRI and 3 conventional MRI). The clinical data were retrieved from the medical record. We classified the orbital region according to four-quadrant and eight-space (FQES) division and traditional muscleconal division with center point of optic nerve. Results:Among the 87 cases of the orbital tumors, 70 cases (80.45%) were orbital benign tumors and 17 cases (19.54%) were malignant tumors. Regarding the location of the orbit, 41 lesions (47.12%) were in superolateral, 18 lesions (20.68%) were in inferolateral, 16 lesions (18.39%) were in inferomedial, 8 lesions (9.19%) were in superomedial, 3 lesions (3.44%) were in globe, 1 lesion (1.14%) was in optic nerve. The most common tumors are hemangiomas (total 36 cases: 12 in inferolateral, 8 in inferomedial, 9 in superolateral, 7 in superomedial) and 9 cases of pleomorphic adenoma were in superolateral, 9 cases of dermoid cyst ( 7 in superolateral and in 2 inferomedial), 5 cases of inflammatory pseudotumor (4 in superolateral and 1 in inferomedial), 7 cases of lymphoma (3 in superolateral, 2 in inferolateral and 2 in inferomedial ), 3 cases of adenoid cystic carcinoma in superolateral, 3 caese solitary fibrous tumor ( 2 in suprolateral and 1 in inferomedial), 3 cases lipoma (1 in superomedial, 1 in superolateral and 1 in inferolateral), 2 cases choroidal melanoma were in globe, 1 case of metastasis in superolateral, 1 case of meningioma in optic nerve, 1 case of malignant melanoma was in superolateral. The orbital tumors appeared in orbit with mostly regular, oval and rounds shape, well defined margin. The size ranged from 0.8 mm × 4.5 cm to 4.5 cm × 2.0 cm. The CT revealed iso-density in 22, slightly high-density in 15, mixed density in 6, low density in 5 and high density in 1 lesion. Among them, 18 were contrast enhancements. On T1WI image, the MRI revealed low signal intensity in 23 cases, slightly low signal in 4 cases, iso signal intensity in 7 case, high signal intensity in 3 cases, mixed signal intensity in 1 case on T2WI, it revealed high signal intensity in 23 cases, slightly high intensity in 7 cases, low signal intensity in 4 cases, iso signal intensity in 3 cases, mixed signal intensity in 1 case. Among them, 35 contrast enhancement MRI and 3 were non contrast MRI. Benign tumor was diagnosed in 70 patients, of them 34 were male and 36 were female, and the mean age was 45.19 ...

Objective: To perform a meta-analysis of observational studies addressing whether Dispatcher Assisted Cardiopulmonary Resuscitation (DACPR), compared with independent Bystander Cardiopulmonary Resuscitation (BCPR), increases the rates of BCPR, and whether they alter survival outcomes in out-of-hospital cardiac arrests (OHCA). Methods:Relevant published articles from PubMed and Cochrane databases were studied. The baseline information and outcome data (BCPR rates, survival to hospital discharge, 1-month survival) were extracted from the out-of-hospital cardiac arrest subgroup. Meta-analyses were performed by using STATA 11.0 software. Results Conclusion:This study found that DACPR resulted in greater survival rate as compared to independent BCPR and no BCPR in OHCAs. Considering that DACPR also resulted in significantly higher rates of BCPR, DACPR should be a standard protocol for EMS systems worldwide.

Purpose: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although inter body fusion and circumferential fusion are a relatively common surgical method for the treatment of spondylolisthesis, we retrospectively compared surgical reduction or fusion in situ with simple lumbar inter body fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) for adult isthmic spondylolisthesis in terms of surgical invasiveness, clinical and radio graphical outcomes, and complications. Methods: From January 2013 to June 2015, 84 adult patients with isthmic spondylolisthesis who underwent surgical treatment in our department were randomized to simple lumbar inter body fusion (PLIF/TLIF) group (group 1, n=45) and circumferential fusion (PLF+TLIF/PLIF) group (group 2, n=39), and followed up for average 28.6 months (range 24-54 months). All patients of both groups had low back pain as their predominant symptom, with varying degree of radicular pain and neurological symptoms. The data collected retrospectively for analysis were: duration of symptoms, levels of fusion, revision surgery, clinical and radiographic results after surgery, and complications. Result: All the 84 patients compared in two surgical approaches for IS were included in this retrospective studies. In our analysis, for the surgical management of isthmic spondylolisthesis, we indicated that both approaches lumbar inter body fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) have equal significant, greater fusion rates with successful clinical outcomes