[Objective]To evaluate the diagnostic value of ultrasonography in patients with carpaltunnel syndrome (CTS) by measuring the thickness of transverse carpal ligament.[Method]Forty patients who had clinically and electrophysiologically confirmed as CTS underwent surgery and ultrasonographic examination by the same operator for the thickness of transverse carpal ligaments at the level of the hook of the hamate bone in transverse plane preoperatively.Twenty-four asymptomatic normal wrists served as control.Data of the ultrasonography and surgey from patients and the control groups were compared to determine the diagnostic parameters.[Result]The ultrasonographic thickness of transverse carpal ligaments in CTS patients was (0.42?0.08)cm at hamate hook leve and the data from surgey was (0.40?0.10).The data in control group was (0.29?0.07)cm.There was significant difference in the mean value of thickness of transverse carpal ligaments between the two groups at the same level.There was no significant difference between the data of CTS from surgey and ultrasonography.[Conclusion]Ultrasonography examination of the thickness of transverse carpal ligamentsis is a new and feasibile method in the diagnosis of carpal tunnel syndrome.

Objective To compare L 5 anterior roots which is mostly composed of somatic motor nerve fibers and S2 anterior roots which is mostly composed of parasympathetic nerve fibers as dynamic nerve on bladder reinnervation and functional reconstruction after spinal cord injury. Methods Randomly select one side as experimental side and the other side as control, then L 5-S2 anterior roots cross extrameningeal anastomosis in the experimental side and S2-S2 self extrameningeal anastomosis in the control side were performed in 5 dogs. The changes of bladder pressure, urethral pressure responsed to electrical stimulation of the anastomosis roots on each side were recorded in the mean time and the two groups data were compared after one year. Results There were no significant difference between the changes of bladder pressure, urethral pressure responded to the stimulation of left side and right sides anterior roots as the anastomosis operation performed. After one year, both of experimental sides L 5 and control sides S2 anterior roots established neural relationship with bladder detrusor and urethral sphincter. There were no significant difference in the change of bladder pressure responded to electrical stimulation of the anastomosis roots between experimental side (5.0?2.1) kPa and control side (4.6?1.8) kPa(P=0.17) as well. The change of urethral pressure responded to electrical stimulation of the anastomosis roots between experimental side (4.2?1.7)kPa and control side (4.4?1.6)kPa also has no significant difference(P=0.31). Conclusion In the treatment of bladder dysfunction after spinal cord injury, L 5 anterior root can serve a similar role as S2 on bladder functional reconstruction as a dynamic nerve.

To introduce a new modification to simplify the neuroprosthesis of sacral anterior root stimulated micturition for Chinese patients with spinal cord injury (SCI). Spinal cord was transected at T 10 in six dogs and they were randomly divided into 2 groups. In dogs of group I, bilateral L 7 ～S 3 posterior rhizotomy (complete de afferentation, SDAF) was performed. In animals of group II bilateral L 7 , S 2 , S 3 posterior rhizotomy plus bilateral S 1 anterior rhizotomy (partial de afferentation combined with partial de efferentation) were performed. Cystometrogram (CMG) was carried out weekly after the operations. For clinical studies, ten patients with complete SCI above cone were included. Intraoperative electrical stimulation of each individual S 2 ～S 4 roots was carried out and bladder pressure changes were recorded simultaneously. The results showed that the dogs in group II manifested a similar CMG to that of group I, indicating that a flaccid bladder with good compliance and storing function was resulted. For parasympathetic innervation to bladder detrusor in Chinese, it had been found that S 3 root was the most frequent (100%) and the most efficacious (52 2%) contributor, S 4 ranked the second frequent (90%) and a lesser but still significant efficacious (44 9%), and S 2 the least frequent (25%) and the minimal contributor (2 9%). It suggested that using one cable with two electrodes placed on the anterior roots of S 3 and S 4 bilaterally, combined with severance of S 3 and S 4 posterior roots as de afferentation, or plus division of anterior root of S 2 as de efferentation, could restore both voiding and storing function of the bladder in Chinese SCI patients. This new modification has the advantages of reducing the cost of neuroprosthesis and broadening of its indication

Objective To explore the effect of external counterpulsation on the left ventricular systolic func-tion in patients with chronic congestive heart failure.Methods 300 patients with chronic congestive heart failure were selected as the research subjects,they were randomly divided equally into observation group and control group. 150 cases in the control group were given routine drug treatment,150 cases in the observation group were treated with extracorporeal counterpulsation treatment on the basis of the control group.The brain natriuretic peptide (BNP), 6 min walking distance and left ventricular systolic function were observed before and after treatment in the two groups.The adverse reactions and clinical efficacy of the two groups were compared.Results After treatment, 6 minutes walking distance,left ventricular systolic function of the observation group were (4.712 ±35.8 )m, (48.6 ±7.6)%,which were significantly better than those of the control group [(43.16 ±3.37)m,(42.7 ± 5.2%),t =0.875,1.367,all P <0.05].The BNP level of the observation group (438.9 ±386.5)fmol/mL was sig-nificantly lower than (675.2 ±438.7)fmol/mL of the control group(t =1.256,P <0.05).The adverse reactions of the two groups had no significant difference (P >0.05).Conclusion External counterpulsation technology in the treatment of patients with chronic congestive heart failure has significant clinical effect,can improve the left ventricular systolic function in patients,it is worthy of clinical application.

Objective To analyze the curative effect of super-early keyhole surgery in treatment of hypertensive cerebral hemorrhage. Methods Clinical data of patients with hypertensive cerebral hemorrhage who received treatment in our hospital from April 2010 to October 2012 were retrospectively analyzed. Patients were divided into the observation group ( keyhole surgery group) and the control group ( routine group) by different therapeutic methods. The operation time, rate of hematoma clearance, postoperative complications, and recovery of neu-ral function of the two groups were compared. Results The observation group had a shorter operation time than the control group, and the difference was statistically significant(P<0. 001). There was no singnificant difference between the two groups in rate of hematoma clear-ance at the time of tube drawing(P>0. 05). The observation group had less postoperative complications than the control group, and the difference was statistically significant(P<0. 05). The observation group had a lower rate of metabolic disorders than the control group with a statistically significant difference(P<0. 05). Patients of the observation group had a higher scores of SSS than patients of the control group 28 days after operation, and the difference was statistically significant(P<0. 05). 6 months after operation, the observation group had a bet-ter ADL than the control group, and the difference was statistically significant(P<0. 05). Conclusion Super-early keyhole surgery which has less intraoperative injury, postoperative complication, and metabolic disorders, can achieve a better effect than routine operation. And it is of better neural functional recovery.

OBJECTIVE: To investigate the utilization status of antibiotics in rural area of Ningbo and to put forward improvement measures.METHODS: The data regarding the utilization of antibiotics were obtained by questionnaire survey and the on-the-spot investigation among the randomly selected 52 township hospitals,451 village clinics,and 117 drugstores in Ningbo.RESULTS: The irrational drug utilization phenomena were widespread in township hospitals,village clinics,and drugstores in Ningbo,which involved technical problems as well as administrative loophole,and manifested as insufficient etiology evidence,nonstandard dosage regimen,unclear indications for preventive medication or combined uses of antibiotics,and lack of effective drug control measures etc.CONCLUSION: The irrational drug utilization phenomena are widespread in rural area of Ningbo,which should be given proper intervention.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:In retrospective study, the distribution,composition and drug resistance of pathogens in our hospital during Jan.-Dec. in 2015 were analyzed statistically. RESULTS:In 2015,a total of 9401 specimens were collected in microbiology laboratory of our hospital;pathogens were detect-ed in 1743 specimens with positive rate of 18.54%;1591 strains of pathogens were isolated,mainly from sputum (59.77%), urine (14.775) and blood sample (8.93%). Totally 347 strains of Gram-positive bacteria(21.81%),991 strains of Gram-negative bacteria (62.29%),253 strains of fungus (15.90%)were detected. Top 4 pathogens in the list of amount were Escherichia coli, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus. S. aureus,Streptococcus pneumoniae and Staphylo-coccus haemolyticus were sensitive to vancomycin,linezolid and sodium fusidate,with resistance rate of 0;resistance rates of them to erythromycin were more than 65%. The resistance rate of S. aureus to penicillin was more than 95%,and S. haemolyticus showed high resistance rate to common antibiotics. Drug resistances of E. coli,K. pneumoniae and P. aeruginosa to carbapenems were all lower than 15%,and they were sensitive to polymyxin with resistance rate of 0. Resistance rate of E. coli to quinolones was more than 50%. CONCLUSIONS:The main pathogens are Gram-negative bacteria in our hospital,drug resistance of them are not satisfactory. Drugs most sensitive to main pathogens include vancomycin,linezolid,carbapenems,etc. The inspection of patho-gen drug resistance characteristics should be strengthened,and antibiotics should be selected rationally and normatively according to the results of drug sensitivity test.

Objective To explore the indications,feasibility and clinical outcome of minimally invasive laminoplasty for cervical spondylotic myelopathy (CSM) using microendoscopic technique.Methods From January 2011 to December 2013,51 patients with CSM treated by this technique in our hospital were reviewed in this study.All these patients were followed up at least 9 months.There were 28 males and 23 females with a mean age of 58 years (range 41-76 years).All patients were found to have cervical disc herniation with spinal cord compression.Among these patients,2 segments (C5-6),3 segments (C3-5/C4-6),4 segments (C3 -6) and 5 segments (C3-7) laminoplasty performed in 5,7,22 and 17 cases respectively.Therapy effect and axial symptom were evaluated according to Japanese Orthopedic Association (JOA) scores and visual analogue scales (VAS) respectively.Cervical curvature index (CCI) and range of motion (ROM) were judged by X-ray.The sagittal diameter of cervical spine,canal enlargement and bony healing were judged by CT scans.Spinal cord signal intensity changes and spinal cord decompression status judged by MRI.Statistical analysis of JOA score,VAS score,CCI and ROM were performed by paired design t test.Results The mean operative time was (1 15±21.9) min,ranging 58-139 min.The mean blood loss was (227.8±73.2) ml,ranging 110-380 ml.The followe-up time ranged 9-36 months with an average of (20±5.9) months..The mean JOA scores had improved from 8.02± 1.69 pre-operatively to 13.02± 1.48 post-operatively.The results were excellent in 17 cases,good in 28 and fair in 4.The VAS scores of axial pain significantly improved to 2.22±0.90 at the final follow-up compared with 4.96± 1.39 preoperatively.Axial symptom were excellent in 18 cases,good in 21 and fair in 12.Pre-operative was 15.40％±4.50％ and postoperative was 15.09％±4.87％,there was no significant difference.ROM of pre-operative was 40.98°±8.27° and postoperative was 38.88°±9.53°,and there was no significant difference.The sagittal diameter of the spinal canal increased 1.3-3.2 mm postoperatively with an average of (2.32±0.42) mm.A total of 204 vertebral lamina were bilaterally slotted and fixed.146 lamina were observed bone healing at the last follow-up.The bone healing rate was 71.6％.Complications such as upper limb motion dysfunction occurred in 1 case muscle strength restored after treatment of methylprednisolone sodium succinate,and little screw looseness in occurred 1 case,and non special treatment was given..Conclusion CMEL is a newsurgical approache which causes less damage to the spinous process-ligament complex and the deep extensor muscles,and the procedure can be used for CSM effectively and safely.

Objective To investigate the expression of Th1/Th2 cytoki nes in early symptomatic syphilitic lesions and its relationship with the sero-c onversion of RPR test in patients with syphilis. Methods The expression of Th1/Th2 cytokines in lesions from 30 patients with early symptomatic syphilis was i mmunohistochemically detected with ABC method. The serum titers of RPR test in t hese patients were measured in 1, 3, 6, 9 and 12 months after routine benzathine penicillin treatment. Results Among 10 cases of primary syphilis, the express ion of both Th1 and Th2 cytokines in the lesions was found in 9 cases, while onl y Th1 cytokine expression was observed in the remainder case; and the sero-conve rsion of RPR test occurred in all 10 cases during the follow-up period. Among 20 cases of secondary syphilis, Th1/Th2 cytokines expressed in the lesions in 16 c ases, and only Th2 cytokines expressed in 4 cases; and the sero-conversion of RP R test was found in 12 cases during the follow-up period. The expression of Th1 cytokines in early syphilitic lesions was positively correlated with the sero-co nversion of RPR test. The higher the expression of IFN- the more likely the s ero-conversion of RPR test. Conclusion The early activation and persistence of the expression of Th1 cytokines may play an important role in the clearance of pathogens.

ObjectiveTo explore the effects of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/nuclear factor-kappa B (NF-κB) signal pathway on the process of follicle-stimulating hormone (FSH) facilitating cell proliferation and invasion in human epithelial ovarian cancer. Methods Ovarian cancer cell lines SKOV3 and 3AO were cultured to exponential phase,then assigned to control group,FSH group,LY294002 group and FSH + LY294002 group,respectively.Cells were treated with different concentration of FSH and LY294002,respectively.The effects of FSH on cell proliferation were observed by methylthiazolyl tetrazolium (MTT).Morphological changes were observed by phase contrast microscope.The ability of cell invasion was investigated by transwell invasion assay.The expression of FSH receptor (FSHR),Akt1/2,phosphorylated-Akt (p-Akt) and NF-κB p65 protein were detected by western blot.Results( 1 ) FSH could promote the proliferation of SKOV3 and 3AO cells.When the cells were treated with 40 U/L FSH for 48 hours (SKOV3) and 24 hours (3AO),compared with those in control groups,they reached the highest proliferation rate (P ＜ 0.05 ),respectively.(2) The morphology of SKOV3 and 3AO cells in four groups:in control group,SKOV3 cells were short spindle and 3AO cells were long spindle,the nuclei of them were both roundness or oval,the cytoplasm were bright.In FSH group,the cells changed to slightly longer or polygonal,they were full in shape,meanwhile,the cell intensity were higher than control group.In LY294002 group,some cells changed from spindle to round,and began to shrink.The cell intensity diminished.The morphology of FSH + LY294002 group was similar with control group,but the cell intensity was lower than that in FSH group.(3)The number of SKOV3 cell that passed through the membrane in control group,FSH group,LY294002 group and FSH + LY294002 group was (26 ± 6),( 118 ± 19),( 18 ± 5) and ( 38 ± 7 ),respectively.The number of 3AO cell was ( 19 ± 4 ),( 134 ± 20),(12 ±3) and (58 ± 11 ),respectively.The results showed that the number of cells in FSH group was significantly higher than that in control group ( P ＜ 0.05 ),while the number of cell in FSH + LY294002 group was significantly fewer than that in FSH group (P ＜ 0.05 ).(4) There was no significant difference in the expression of FSHR and Akt1/2 between FSH group and control group (P ＞ 0.05 ),but FSH increased the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm in SKOV3 and 3AO cells,there were significant differences compared with control group ( P ＜ 0.05 ).LY294002 reversed the effects of FSH on increasing the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm,there were significant differences among LY294002 group,FSH + LY294002 group and FSH group (P ＜ 0.05 ).ConclusionThe effects of FSH on proliferation and invasion of ovarian cancer cell lines SKOV3 and 3AO may be realized by regulating the activity of NF-κB in PI3K/Akt signal pathway.