Objective To investigate the therapeutic method and effects of malignant tracheal stenosis with nitinol memory alloy stents.Methods Seventeen patients with malignant tracheal stenosis were treated by nitinol memory alloy stents.Of them,13 patients underwent chemotherapy or chemotherapy and radiotherapy after stents set.Results Eighteen tracheal stents were placed in 17 patients through interventional method,with 100% successful rate.All patients had made immediate disappearance in dyspnea.Followed-up time was taken for 1 to 11 months with no restenosis and stent migration.Conclusion Under fluoroscopic guidance,tracheal stent placement is a safe,rapid and reliable proceduce for treating malignant tracheal stenosis.

Objective To study the risk factors of nosocomial infections in patients with cerebrovascular disease and prevent and cure them.Methods A retrospective survey on the hospital infeation in patients with cerebrovascular disease in our hospital during March 2003 to March 2005 was couducted.Results The result showed that 61 of the 360 patients had hospital infection,the rate of infection was 16.94%,and the hospital average infection rate in all was 3.92%,hospital infection aging,treatment days in hospital,consciousness invasive operation Hospital infection was a retated.The main infection sites were at respirate tract,the most common bacteria were Gram-Negative bacilli.Conclusions There is higher hospital infection rate among,the acute cerebrvascular patients.Age,the critical patients,invading operations are prmincipal factors.We should prevent it in time.

The serum contents of Cu, Fe, Zn, Pb, Cr, Mn, Ca, Mg, and K in 360 adults from different work in Nanjing were determined by atomic absorption spectrophotometry. The data were analysed by grouped statistical treatment, and the relationships among sex, age and work time were discussed. The results showed that serum Cu, Fe, Zn, Cr, Mn, Pb, Ca, Mg, K differed greatly in the different workers. There was a perfect positive correlations between Cu, Zn, Cd, Mn, Pb, Mg and age, and a negetive correlations berween Cu, Fe, Zn, Cd, Cr, Pb, Mg and work time. The serum Cu, Zn, Ca, K in women were higher than that in men.

Objective To explore the relationships between the alterations of cervical sagittal parameters and clinical outcomes after anterior cervical discectomy and fusion (ACDF).Methods From January 2010 to December 2015,a total of 227 patients with cervical spondylosis who undelwent ACDF in Dongfang Hospital affiliated Tongji University were analyzed in this study.There were 109 male and 118 female,with an average age of 52.2± 10.7 years (ranged from 34 to 78 years).The average duration of follow-up after revision surgery was (21.1 ±9.0) months (12-60 months).Comparing with Japanese 0rthopaedic Association (JOA) score and its improvement rate (IR),visual analogue scale (VAS) scores and neck disability index (NDI) between preoperation and 1 year follow-up.Cervical alignment was assessed with the following 3 parameters:T1 slope (T1S),Cobb's angle of C2 to C7 and C2-7 sagittal vertical axis (SVA).And compared the changes of sagittal parameters and clinical efficacy.Results At 1 year follow-up,T1S was increased from 25.4°±8.5° to 27.9°±8.2°,Cobb's angle was increased from 12.7°±8.5° to 15.3°±9.5°,SVA was increased from (21.0± 12.3) mm to (24.30± 11.4) mm,and the differences were statistical significant (P＜ 0.001).JOA score was increased from (8.5±4.0) points to (13.0±2.4) points at 1 year follow-up,however,VAS score was decreased from 2.7± 1.8 points to 0.2±0.4 points,and NDI was decreased from 48.2％±8.2％ to 27.1％± 11.1％,and the differences were statistical significant (P ＜ 0.001).Preoperatively,T1S had positive correlations with both Cobb's angle and SVA before operation (r=0.311,0.213;P=0.000,0.001),but Cobb's angle had negative correlation with SVA (r=-0.246,P=0.000).At 1 year follow-up,T1S had positive correlations with Cobb's angle and SVA (r=0.390,0.392;P=0.000,0.000),and Cobb's angle had negative correlation with SVA (r=-0.131,P=0.048).At 1 year after operation,the change value of Cobb's angle had positive correlation with the change of JOA (r=0.294,P=0.000),but negative correlation with the change of NDI (r=-0.141,P=0.034).Conclusion ACDF is effective in the treatment of cervical spondylosis which the cervical sagittal alignment remains relatively stable,and there were significant correlation between the alteration of cervical sagittal parameters and clinical outcomes after ACDF.

Objective To explore the correlation between spinal sagittal balance and quality of life after the treatment of percutaneous kyphoplasty in osteoporotic vertebral compressive fractures. Methods We retrospec-tively enrolled and screened 85 patients with osteoporotic vertebral compression fractures(OVCF),treated by per-cutaneous kyphoplasty(PKP)in spinal surgery department of Shanghai East Hospital from January 2012 to Decem-ber 2016. The full length of the spine X-ray examinations had been taken preoperatively,pre-discharge and during the follow-up and spine-pelvis sagittal parameters included C7 sagittal vertical axis(C7SVA),thoracic kyphosis (TK),lumber lordosis(LL),pelvic incidence(PT)and sacral slope(SS). Shot Form 36 Health Survey Question-naire(SF-36)was used for the scoring. Results In the last follow-up,C7SVA decreased from(35.9 ± 17.1)mm to(30.8 ± 12.8)mm(P=0.002)and SF-36 scores varied significantly(P<0.01). Before the surgery,follow-up 3 days,6 months and 12 months after the surgery,C7SVA was negatively correlated with the general health status in each period of SF-36(r=-0.343,-0.264,-0.272,-0.258;P=0.001,0.015,0.012,0.017). Conclusions PKP has a significant effect on OVCFs and changes the spine-pelvic sagittal balance in patients with OVCF. Spinal-pel-vic sagittal balance is closely related to the quality of life of these patients.

Objective:To summary the mixed infection as well as clinical characteristics and analyze the risk factors for mixed infection of severe adenovirus pneumonia(SAP) in children.Methods:The clinical data of 114 children with SAP were retrospectively analyzed.Multivariate Logistic regression analysis was performed to assess the risk factors for mixed infection.Results:The incidence age was from 6 months to 2 years(62.5%). High fever(94.7%), cough(98.2%), dyspnea(86.8%) and lethargy(95.6%) were the main symptoms.Laboratory examination showed that children with SAP were prone to increased white blood cell count, C-reactive protein, procalcitonin, aspartate aminotransferase, alanine aminotransferase and CK-MB, as well as decreased proportion of CD3 + , CD4 + , CD8 + , CD4 + /CD8 + and NK cells.The main complications intrapulmonary organ were respiratory failure(80.7%). The main complications extrapulmonary organ were circulatory complications (55.3%). SAP was easily combined with other pathogenic infections.Streptococcus pneumoniae(22.9%)was the most common bacterial pathogen.Respiratory syncytial virus(10.0%)were the most common virus, in addition, mycoplasma pneumoniae(17.1%) was also common.Multivariable Logistic regression analysis showed that the decreasing ratio of CD4 + /CD8 + and NK cells, congenital heart disease and congenital airway dysplasia were the independent risk factors for mixed infection of SAP in children( P<0.05). Conclusion:The SAP patients could easily suffer from mixed infection and high fatality rate.Immune dysregulation is the important risk factors for mixed infection of SAP in children.So immunoregulatory treatment is very important.

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Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objectives: To propose a novel clinical classification system of gallbladder cancer, and to investigate the differences of clinicopathological characteristics and prognosis based on patients who underwent radical resection with different types of gallbladder cancer. Methods: The clinical data of 1 059 patients with gallbladder cancer underwent radical resection in 12 institutions in China from January 2013 to December 2017 were retrospectively collected and analyzed.There were 389 males and 670 females, aged (62.0±10.5)years(range:22-88 years).According to the location of tumor and the mode of invasion,the tumors were divided into peritoneal type, hepatic type, hepatic hilum type and mixed type, the surgical procedures were divided into regional radical resection and extended radical resection.The correlation between different types and T stage, N stage, vascular invasion, neural invasion, median survival time and surgical procedures were analyzed.Rates were compared by χ² test, survival analysis was carried by Kaplan-Meier and Log-rank test. Results: Regional radical resection was performed in 940 cases,including 81 cases in T1 stage,859 cases in T2-T4 stage,119 cases underwent extended radical resection;R0 resection was achieved in 990 cases(93.5%).The overall median survival time was 28 months.There were 81 patients in Tis-T1 stage and 978 patients in T2-T4 stage.The classification of gallbladder cancer in patients with T2-T4 stage: 345 cases(35.3%)of peritoneal type, 331 cases(33.8%) of hepatic type, 122 cases(12.5%) of hepatic hilum type and 180 cases(18.4%) of mixed type.T stage(χ²=288.60,P<0.01),N stage(χ²=68.10, P<0.01), vascular invasion(χ²=128.70, P<0.01)and neural invasion(χ²=54.30, P<0.01)were significantly correlated with the classification.The median survival time of peritoneal type,hepatic type,hepatic hilum type and mixed type was 48 months,21 months,16 months and 11 months,respectively(χ²=80.60,P<0.01).There was no significant difference in median survival time between regional radical resection and extended radical resection in the peritoneal type,hepatic type,hepatic hilum type and mixed type(all P>0.05). Conclusion With application of new clinical classification, different types of gallbladder cancer are proved to be correlated with TNM stage, malignant biological behavior and prognosis, which will facilitate us in preoperative evaluation,surgical planning and prognosis evaluation.