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Thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is usually progressive and responds poorly to conservative therapy, making surgery the only effective treatment option. A variety of surgical procedures have been developed to treat thoracic OPLL. However, the optimal surgical approach for removal of thoracic OPLL remains unclear. In the present study, we described a newly modified posterior approach for the removal of OPLL: circular decompression via dural approach, and complete removal of OPLL can be achieved under direct vision and without neurological deficit. Three patients with beak-type thoracic OPLL presented with progressive thoracic myelopathy and leg weakness. Magnetic resonance imaging showed the spinal cord severely compressed. The surgical management of the three patients involved the 'cave-in' circular decompression and transdural resection of OPLL. Transdural circumferential decompression was successfully performed in all three patients. Clinical outcome measures, including pre- and postoperative radiographic parameters, were assessed. All of the patients were followed up for an average of 12 months (ranging from 10 to 15 months), and no surgery-related complications occurred. Weakness relief and neural function recovery were satisfactorily achieved in all patients by the final follow-up. Transdural circumferential decompression was an effective method for thoracic spinal stenosis caused by concurrent beak-type OPLL, by which OPLL could be safely removed. It is especially useful when there is a severe adhesion between the dura OPLL. [ABSTRACT FROM AUTHOR]

Objective: To study the prevalent characteristics and risk factors of viral hepatitis E in Yantai and the relative for strategy on viral hepatitis E control in the area., Methods: Data on viral hepatitis E incidence reported by the Notifiable Infectious Disease Reporting System in 2005-2009 was analyzed. 2028 persons were chosen for hepatitis E virus (HEV) antibody detection by enzyme linked immunosorbent assay method. RT-nPCR method was applied to obtain the sequence of HEV in HEV cases. A case-control study was used to identify the risk factors of HEV infection., Results: The distribution of HEV cases was sporadic in Yantai, and the annual incidence rate was 5.70/100 000, with spring as the prevalent season. Farmers were the main population involved and with those over the age of 40. Regional distribution was mainly along the coastline. Data from the sequential analysis showed that gene type of local patients was type 4 and healthy person whose HEV-IgM was positive was type l. Finding from the case-control study suggested that eating seafoods, living condition in the households and unhealthy habits played important roles in the infection of HEV. Results from multiple logistic regression showed that eating seafood, with eat-out history, drinking alcohol and un-boiled water were the main risk factors in the infection of HEV., Conclusion: The level of HE in Yantai will maintain in a high level, but there is no chance of epidemic outbreak of HE in large range. Population of incidence mainly concentrates on farmers.