Objective To evaluate the clinical result of modified anterior decompression for the treatment of cervical myelopathy due to ossification of posterior longitudinal ligament(OPLL). Methods From April 1994 to October 2002, 42 cases of OPLL involving 134 cervical segments were operated using modified anterior decompression, among them there were 35 cases, 122 segments of the continuous type; 4 cases, 9 segments of the mixed type; 3 cases, 3 segments of the solitary type. The preoperative index of thickness (O-Index) ranged from 12.4%-78.8%, with an average of 43.2%. A slot was made in the vertebral body through anterior approach and bilateral border of the ossification was dissected from the posterior wall of vertebral body with burr-drill. Results The average follow-up was 3 years and 8 months ranging from 1 year and 6 months to 8 years. The recovery of neurologic function was evaluated according to JOA score: 28 cases with mild neurologic deficit (13-16 points) improved on average 74% postoperatively; 11 cases of the moderately damaged group (8-12 points) improved on 75%; 3 cases of the severely damaged group (

The concept of EMR is described and the problems of EMR application are analyzed including restrictions on change permissions and writing time of EMR, and sounds in medical record management mechanism to ensure legality and effectiveness of record. Based on improvement of national policy, third-party management services institutions are estab- lished and related suggestions on technical and environmental support of EMR development are provided, and the future of its development in our country are expected.

Objective To dump and recover the expired data in No.1 Military Medical Project, avoiding the waste of large amount of storage space and improving the operation performance of hospital information system. Methods After clearing the backup table, the data from the original table backup was put into the backup table. The data was unloaded from the backup table to a file, and then the file was saved. The data in the original table was deleted, but it could be restored to the table when needed, and the corresponding data could be obtained through the application program. Results The storage space was enlarged after data dump. Conclusion The dump of the expired data can make data management more scientific and hospital information system run more smoothly.

Objective To explore the technique and clinical outcome of the atlantoaxial pedicle screw system in the treatment of the unstable atlantoaxial dislocation post traction.Methods The study involved 32 patients with atlantoaxial dislocation(type T2 of TOI classification)admitted from March 2005 to September 2009.There were 17 patients with fresh odontoid fracture and two with old odontoid fracture,five with traumatic disruption of the transverse atlantal ligament and eight with congenital odontoid dysplasia.JOA scores of neurological function before operation was at a range of 5-13(average 8.38).The average of space available for the cord(SAC)was 9.15 mm.Before the atlantoaxial pedicle screw system was carried out,the skull traction was performed in all the patients preoperatively.Results A total of 128 pedicle screws were inserted safely,with mean operation time and perioperative blood loss for 1.5 hours and 300 ml,respectively.No injury to the vertebral artery or spinal cord was observed.All the patients were followed up for 12-24 months,which showed that JOA scores one year after operation was increased to 10-17(average 14.56),with the improvement rate of 71.70%,and that the SAC was average 14.86 mm.The X-ray and SCT scans verified the proper position of the screws,with no internal fixation failure or atlantoaxial redislocation.After 3-6 months,all the patients except for one patient achieved a solid bone fusion.One year after operation,the one patient with no bone graft fusion was removed of the internal fixation system and obtained satisfactory restoration of the rotational function.Conclusions Atlantoaxial pedicle screw system is an effective method for the treatment of the unstable atlantoaxial dislocation post traction,for it has the advantages of stable three-dimension fixation,direct screw placement,intraoperative reduction and high fusion rate.

To investigate the assessed value of serum lactate dehydrogenase (LDH) and vascular endothelial growth factor (VEGF) for short-term efficacy of transcatheter arterial chemoembolization (TACE). Methods: Serum concentrations of LDH and VEGF from 70 patients with primary liver cancer on the 1st day before therapy and the 3rd, 7th, 14th, and 21st day after TACE ther-apy was determined. The benefit group includes complete remission, partial remission, and stable disease, while the invalid group in-cludes only disease progression. Results:The serum levels of LDH and VEGF in the invalid group were significantly higher than those in the benefit group on the 14th and 21st days after TACE (P<0.05). The percentage changes of the serum concentrations of LDH and VEGF in the invalid group were higher than those in the benefit group on the 21st day after TACE. Percentage changes on the 21st day after TACE were drawn into the ROC curve;the areas under the curve were 65.9%and 85.5%. The optimal cutoff points of LDH and VEGF, which correspond to the Youden index, were 0.272 and 0.745, respectively. Conclusion:The expression levels of VEGF and LDH can be used to assess the short-term efficacy of TACE. A lower expression level corresponds to short-term efficacy.

Objective:To investigate the volatile constituents in Folium isatidis. Methods:The volatile constituents from Folium isatidis were analyzed by head-space solid micro-extraction coupled with GC-MS for the first time. Results: Thirty-five compounds (89. 95%) were identified from the volatile constituents in Folium isatidis. The main volatile constituents of Folium isatidis were 6, 10, 14-trimethyl-2-pentadecanone (6. 32%), nonanal (5. 99%), phenethyl isothiocyanate (5. 79%) and palmitic acid (5. 62%). Conclusion:Palmitic acid and benzyl alcohol may be the main effective constituents in Folium isatidis.

Objective Diabetic infrapopliteal artery occlusive disease Deep balloon angioplasty ( percutaneoustransluminal an-gioplasty, PTA) near the middle of the treatment effect and the Department of internal medicine ,conservative treatment .Methods Sixty patients with type II diabetes mellitus complicated with severe infrapopliteal arterial occlusive patients , divided into treatment group (41 cases) and Department of internal medicine treatment group (19 cases),all patients had CTA or MRA or DSA imaging;in-terventional treatment group using Deep balloonPTA ,3 days before operation and postoperative long-term Plavix and culture as anti platelet , blood glucose controltherapy;Department of internal medicine treatment group with control of blood glucose ,precedent in im-proving microcirculation ,debridement dressing and anti infection;observed in 2 week,1 month,3 months,6 months ,1 year,2 years,3 years, two groups were compared after treatment of clinical symptoms and changes signs ,ankle brachial index (ABI),the dorsal artery of foot diameter and blood flow velocity ,evaluation and the total efficiency of 6 months,1 year,2 years,3 years and cut rate .Results Interventional arterial blood flow improved significantly after operation in treatment group ,the clinical symptoms,signs were improved obviously, ankle brachial index improved significantly ,compared with the Department of internal medicine treatment group statistical significance ( P <0.05 ) ,and the total efficiency of 3 years the rate of limb salvage and Department of internal medicine therapy group with significant difference ( P <0.05).Conclusions Deep balloon PTA treating diabetic infrapopliteal artery occlusive disease cura-tive effect,can significantly improve the rate of limb salvage;Department of internal medicine treatment forelderly ,important organ dys-function patients .

Objective To evaluate the mid-term and long-term effects of early endovascular emboli-zation in treating ruptured posterior communicating artery aneurysm. Methods Early endovascular embolization therapy was carried out in 36 patients with ruptured posterior communicating artery aneurysm (36 aneurysms in total), and the effects of embolization therapy were evaluated by using Raymond grading method. The unified imaging review program was formulated, and the mid-term and long-term effects were evaluated at half, 1, 2, 3 and 5 years after the treatment. Results The technical success rate was 100% in 36 patients (36 aneurysms in total). Raymond grading evaluation showed that gradeⅠwas seen in 32 patients, gradeⅡ in 2 patients, and grade Ⅲ in 2 patients. Recurrence of aneurysm was found in 5 patients (13.89%) at half (n=1), 2 (n=1), 3 (n=1) and 5 years (n=2) after the treatment. Re-rupture of the recurrent aneurysm was seen in one patient (2.78%). No death occurred during the following-up period. Conclusion Early endovascular embolization for ruptured posterior communicating artery aneurysm can effectively improve the prognosis of subarachnoid hemorrhage, and regular imaging examination can promptly detect the recurrence of aneurysm. Effective interventions are helpful for preventing deterioration and rupture of aneurysm.

Objective:To screen the differentially expressed miRNAs in umbilical cord tissue of children with nonsyndromic cleft lip and/or cleft palate( NSCL/P) using miRNA microarray and comprehensive bioinformatics analysis for the prediction of related the bio-logical process and signaling pathways. Methods:Umbilical cord tissues of 4 cases of healthy newborns' and 4 lip or palate tissues of 4 cases with NSCL/P without other disease aged younger than 2 years were collected. The differentially expressed miRNAs were screened by miRNA microarray. Targets of dysrugulated miRNAs were predicted by TARGETSCAN-VERT, MIRDB and RNA22-HSA. All the gene sets were analyzed by gene ontology and pathway enrichment. Results: MiRNA microarray demonstrated that 254 miRNAs were dysregulated(181 miRNAs were up-regulated and 73 downregulated,P <0. 05). The dysregulated miRNAs targets contained 5029 genes. The dysregulated miRNAs targets were enriched in anatomical structure development,cell adhesion,cell proliferation,cell motili-ty and other biological processes. The dysregulated miRNAs targets were enriched in Wnt, mTOR, cGMP-PKG, TGFβ, PI3K-Akt and other signaling pathways. Conclusion:The target genes set of miRNAs are enriched in multiple biological processes and signaling path-ways related to NSCL/P, which indicate that genetic and environmental factors may influence the development process of NSCL/P.

Objective To compare the clinical effect of hepatic artery perfusion of antibiotics with that of intravenous administration of antibiotics in treating pyogenic liver abscess which is unsuitable for puncture drainage management. Methods Between October 2010 and October 2013, a total of 32 cases with bacterial liver abscesses which were unsuitable for puncture drainage management were encountered at the Third Affiliated Hospital of Wenzhou Medical University. The patients were divided into group A (n = 15) and group B (n = 17). Hepatic arterial perfusion of antibiotics was carried out in the patients of group A, while intravenous administration of antibiotics was employed in the patients of group B. Percutaneous puncture drainage was adopted in the patients when their imaging examination showed liquefaction within the lesion. Results The hospitalization time, recovery time of body temperature, hemogram recovery time and liquefaction extent of the lesion in group A were much better than those in group B , and the differences were statistically significant (P < 0.05). Conclusion Hepatic arterial perfusion of antibiotics is an important and effective treatment for bacterial liver abscesses.