Objective To summarize the perioperative experience of nursing the middle-aged and elderly patients of lumbar spinal stenosis and degenerative lumbar scoliosis treated with posterior or transforaminal lumbar interbody fusion. Methods Posterior or transforaminal lumbar interbody fusion was performed in 69 middle-aged and elderly patients with lumbar spinal stenosis and degenerative lumbar scoliosis. Nursing measures included evaluation and treatment of complications, preoperative guidance for surgical body position, and postoperative close monitoring, treatment of complications and functional exercises. Results The operation on all the 69 patients was smooth, with surgical time ranged from 3 to 7 hours and bleeding volume between 300~750 mL. Postoperatively, 9 patients suffered from CSF leaks, 3 ones had a screw loose by imageology, 2 did from pneumonia, 2 did from DVT, and 3 did from depression. After clinical management and nursing, all the patients were cured and discharged. Conclusions Meticulous clinical treatment and nursing of preoperative complications and instructions on body position are the foundation for successful surgeries. Postoperatively, close monitoring, management of the complications and the instruction on functional exercises are guarantees for the successful surgeries.

Objective To investigate the distribution regularity of TCM science basic syndrome for multilple sclerosis (MS}. Methods Through retrospective analysis for general data of case 223 patients and the information of TCM diagnosis with the method of case analysis and modem mathematical statistic, the syndrome types of the case collected were established. Results General fatigue, weariness and no desire to speak, quadriplegia, megrim, acroanesthesia and so on, which reflect the main symptoms of MS, with occurrence frequency of above 60 percent. Five basic symptoms: Syndrome of haemostasis blocking collaterals (18.0%), dark purple tongue is the most important factor; Syndrome of dampness-heat blocking collaterals (17.2%), yellow greasy furred tongue is the important factor; Syndrome of yin-asthenia and obstruction of collateral (14.8%), rapid and thining pulse is the important factor; Syndrome of endogenous wind of liver and obstruction of collateral due to wind-phlegm (14.1%), physical convulsion is the important factor; Syndrome of asthenia of both qi and blood, and channel qi unfavorable (35.9%), feeble pulse is the important factor. Conclusion The location of MS is channels and collaterals. The characteristic of MS is haemostasis, moist heat, deficiency of yin and wind-sputum, deficiency of qi and blood. General fatigue, weariness and no desire to speak, quadriplegia, megrim, acroanesthesia and so on are the main characteristics of MS.

Objective To analyse the CT features of pulmonary echinococcosis and to assess CT value in diagnosing this disease.Methods CT fingings of pulmonary echinococcosis in 35 cases proved pathologically were analyzed retrospectively.Results Pulmonary granulosus echinococcosis was 33 cases including simple hydatid cyst (11 lesions),datugter cyst hydatid (3 lesions),with calcification (1 lesion) ,rupture (11 lesions),merging infection (4 lesions) and rupture into thorax (3 lesions).Pulmonary alveolar echinococcosis was 2 lesions,CT findings apperared as irregular,peripherally scattered more nodules with small vacuoles or calcification and in combination with hepatic alveolar echinococcosis.Conclusion Pulmonary echinococcosis had characteristic features on CT,CT examination can provide more imaging informations for the treatment of pulmonary echinococcosis

Objective To assessed the distribution of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in Xinjiang Uygur and Han nationality populations,and to investigate correlation and the incidence of all cases of macrovascular disease (coronary artery disease,carotid atherosclerosis and peripheral arterial disease)and analysis of risk factors.To further study the correlation between the incidence of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in type 2 diabetes melli-tus(T2DM)of Han and Uygur ethnic and the incidence of all cases vascular disease,then to analysis the risk factors. Methods 497 adults with T2DM who were treated in the Endocrinology department in hospital from May 2012 to April 2014 were involved in this study,including 298 Uygur patients and 199 Han patients.215 non -T2DMpatients who were treated in the Cardiology department in hospital were also involved in the study,including 93 Uighur patients and 122 Han patients.Then the total 712 patients were detectedby using PCR -SNP Stream technology to analyse rs2383206.rs10757278 loci SNP genotyping.The relevant results were compared with t test,two different genotype distribution and allele frequency were compared with χ2 test,multiple factors analysis were calculated by Logisitic regression.Results The distribution of genotype with two SNP loci had no significant difference between the patients in Uygur group and Han group (rs2383206χ2 =5.570,P =0.062;rs10757278 χ2 =2.721,P =0.257 ),and there's no significant difference between the patients with macrovascular disease and non -macrovascular disease in all patients(rs2383206χ2 =0.120,P =0.950;rs10757278 χ2 =1.027,P =0.598).Logisitic regression analysis showed that the incidence of macrovascular was significantly associated with increasing age(χ2 =28.820,P =0.000)and fatty liver(χ2 =5.210,P =0.020)in Uighur group with type 2 DM.In Han group with type 2 DM,the macrovascular was significantly associated with the increase of age (χ2 =19.980,P =0.000),elevated fasting blood glucose (FPG)(χ2 =4.070,P =0.044)and poor controlled with glycosylated hemoglobin (χ2 =4.280,P =0.040). Conclusion This study found that there's no correlation between two single nucleotide polymorphisms (SNPS)loci (rs2383206.rs10757278)on chromosome 9 p21 large with macrovascular in Uygur group and Han group.Increasing age,higher FPG and poor controlled with glycosylated hemoglobin combined with fatty liver were the risk factors for macrovascular.

Objective To compare the efficacy and complications of Chinese Shang Ring circumcision with conventional circumcisiom Methods Clinical data of 479 cases of Chinese Shang Ring circumcision and 354 cases of conventional circumcision with complete follow-up were analyzed.Comparisons were made between the two groups on operation time,pain score,blood loss,postoperative complications,postoperative satisfaction with penile appearance,wound healing time and treatment costs. Results There was no statistical difference in age and foreskin status between the two groups (P＞0.05).For the Shang Ring group,the operation time was(5±1)rain,blood loss was (0.98±1.14)ml,pain score during operation was 0.25±0.54,24-hour pain score after operation was 1.63±0.87,the postoperative complication rate was 6.89% (33/479),wound healing time was (20±5)d,the satisfaction rate of appearance was 99.79% (478/479),and treatment cost was (871±52) yuan.For the conventional group,the operation time was (27±5) min,blood loss was (8.30±3.60)ml,pain score during operation was 3.29±1.57,24-hour pain score after operation was 5.56±1.42,the postoperative complication rate was 13.28%(47/354),wound healing time was (13±2)d,satisfaction rate of appearance was 92.37% (327/354),and treatment cost was (554±46) yuan.Compared with the conventional group,the Shang Ring group had a shorter operation time,less blood loss,less pain score,higher appearance satisfaction rate and a lower complication rate (P＜0.05).But wound healing time was longer and treatment cost was higher in the Shang Ring group (P＜0.05). Conclusions Chinese Shang Ring circumcision is simpler and an improved approach over conventional circumeision with shorter operative time,less blood loss,less pain,relatively lower complication rate and higher satisfaction and acceptability.

Objective To analyze the cause of acute brain swelling,brain encephalocele in brain traumatic injury craniotomy,and the reason,diagnosis and treatment methods of progressive epidural hematoma.Methods The clinical data of 381 patients with brain traumatic injury craniotomy were retrospetively analyzed.Of 318 patients,27cases had progressive epidural hematoma during operation.Results 9 cases died because of functional failure of brain stem,the other 18 cases were all clinically cured.Conclusion If acute brain swelling and encephalocele occured during operation,the cause should be found quickly,especially when there was skull fracture or epidural hematoma on the contralateral brain,the head CT and operation should be taken immediately,and the bulging brain tissue should not be removed blindly,and the skull should not be forced to close,otherwise the prognosis maybe poor.

Objective To investigate the expression and clinical significance of intergrin linked kinase (ILK) in pancreatic carcinoma.Methods ILK protein was detected by immunohistochemistry and Western blotting in 60 cases of pancreatic carcinoma and 32 cases of normal pancreatic tissue,and the relationship with the clinicopathological characteristics were analyzed.Results Immunohistochemistry showed ILK was expressed in cytoplasm and membrane of pancreatic carcinoma cells and the positive rate was 65% (39/60),which was significantly higher than 18.75% (6/32) of normal pancreatic tissue(P ＜0.05 ).Western blotting showed the expression of ILK in pancreatic carcinoma tissue was 303933±195116,which was significantly higher than 144613±30074 of normal pancreatic tissue(P＜0.05 ).In pancreatic carcinoma,the expression of ILK was correlated with clinical stage and lymph metastasis(P＜0.05 ),but not correlated with tumor cell differentiation(P＞0.05 ).Conclusions ILK protein was highly expressed in pancreatic carcinoma tissue and it was correlated with the degree of malignancy.

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.

OBJECTIVETo observe the effect of needling at Weizhong (BL 40) acupoint in inducing metabolic changes in brain with positron emission tomography and dynamic contrast (PET/CT) imaging for exploring the mechanism of central regulation of acupuncture.

METHODSPET/CT was performed before and during needling Weizhong acupoint of right leg by electro-acupuncture in 8 healthy volunteers, and also in other 8 subjects without any acupoint stimulation for control. Difference of brain functional images between the two groups before and during needling was analyzed by pairing t-test with statistical parametric mapping.

RESULTSThe needling evoked mean activated cerebral functional regions were: left Broadmann area (BA) 10, 11, 22, 38, 39, 40, 44-46, right BA10, bilateral BA18, 19, and left cerebellar cortex, claustrum and insula (t > 3.36, P < 0.01, k >30 voxels); its mean inhibited brain functional regions were: bilateral BA24, left BA7, 8, 19, 40, right BA 1, 3, 6, 20, 44, and left substantia nigra.

CONCLUSIONThere is a certain connection between Weizhong acupoint and the brain. Needling this acupoint could exert effects through activating or inhibiting brain function in specific regions and neurohumoral regulation. One of the central regulation mechanisms of acupuncture was functional activation in superior, middle, and inferior frontal gyrus, insula and cerebellum and functional inhibition in callosal gyrus, lobi parietalis and substantia nigra. This study further demonstrated PET/CT is useful in revealing TCM meridian theory and could provide objective proof of central regulation for acupuncture treatment.

Acupuncture ; Acupuncture Points ; Adult ; Brain ; physiology ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; methods

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.