[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 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 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

The origin and the course of the thoracic duct and its opening into the vein were studied in 150 cadavers including 15 fetuses and 138 infants. They are classfied into 5 types.1. The normol type of the thoracic duct begins in the abdominal cavity as a single trunk, It ascends along the right side of the aorta and empties into the venous system on the left side at the root of the neck. This type of the duct which is described in the general text book, occurred in 84.67 per cent.2. The two-trunk type of the thoracic duct begins in the abdominal cavity as two trunks and ascends along the each side of the aorta. The two trunks join together at different levels in the thorax forming a single trunk which empties into the venous system on the left side at the root of the neck. This type of the duct occurred in 10.66 per cent.3. The bifurcated-type of the thoracic duct starts in the abdominal cavity as a single trunk and passing cephalad on the right side of the aorta and divides into two branches at the level of the 6th～4th thoracic vertebra, The right branch opens into the venous svstem on the right side and the left branch opens into the venous system on the left side. This type of the duct occurred in 3.33 per cent. The type which ascends along the left side of the aorta was found.4. The right thoracic duct begins in the abdominal cavity as a single trunk and runs its entire course along the left side of the aorta. The termination opens into the right jugular venous angle. This type of the duct occurred in 0.67 per cent.5. The left thoracic duct begins in the abdominal cavity as a single trunk and ascends along the left side of the aorta. It empties into the left jugular venous angle. This type of the duct occurred in 0.67 per cent.

Objective To investigate the feasibility, safety and impact on performance indicators of coronary angio graphy, percutaneous coronary intervention and coronary artery bypass grafting (CABG) in day care ward of heart center. Methods 128 patients performing coronary angiography and receiving stent implantation or coronary artery bypass surgery when necessary from October 2014 to December 2016 were retrospectively analyzed. The success rate of procedure, intraoperative and postoperative adverse cardiac events (death, myocardial infarction and interventional complications: coronary artery spasm, dissection, perforation and occlusion, contrast agent allergy, upper extremity edema, patients with osteofascial compartment syndrome and radial artery occlusion), average hospitalization days and medical expenses were compared with patients at the same period in general ward. Results Seventy-six cases underwent coronary angiography, among whom 35 cases received stent implantation and 17 cases received coronary artery bypass grafting. The success rate was 100%. Adverse events were radial artery spasm in 5 cases, puncture site hematoma in 3 cases and contrast agent allergy in 1 case. Day care ward significantly shortened the average hospitalization days (P<0.05); there was a downward trend, although there was no statistical difference in hospitalization expenses (P>0.05). Conclusions Coronary angiography and revascularization at the day care ward model is safe and feasible in the heart center if diagnostic and therapeutic techniques are mature.

ObjectiveTo investigate the effects of chitosan/PVA nerve conduits which used for repairing sciatics nerve defect in rats.MethodsTwenty-seven rats were divided into 3 groups randomly,with 9 rats in each group. Firstly, the 15mm defects in the left sciatic nerves were made in the rats and were respectively repaired with chitosan/PVA conduits graft (group A), the silicon conduits graft (group B),and autografts (group C). At 12 weeks after the operations, the left sciatic nerves were taken out, and the comparative evaluation was made on the repairing effects by wet weight of gastrocnemius and soleus muscles, histological examination,computerized imaging analysis and True Blue retrograde tracing. ResultsThe wet weight of gastrocnemius and soleus muscles showed no significant difference between the chitosan/PVA graft and autograft groups (P ＞ 0.05). The wet weight of gastrocnemius and soleus muscles in significant difference between the chitosan/PVA graft and the silicon group at 12 weeks after the operation(P ＜ 0.05). The nerve fiber density showed no statistically significant differences between the chitosan/PVA and autograft groups(P＞ 0.05).The regenerative nerve fiber in group B had normal morphological and structural characters under transmission electron microscope.True Blue-labeled neuron cell bodies were found within both anterior horn of gray matter in the spinal cord and dorsal root ganglions (DRGs) ipsilateral to the operated side of the tested rats on illumination with ultra-violet light 1 week after the injection of True Blue.Conclusion Chitosan/PVA nerve conduit can effectively promote the nerve regeneration and myelinization of rat sciatic nerve, which is expected to substitute for autograft to repair nerve defects succesfully.

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 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.