Objective:To observe the effectiveness of photon therapeutic instrument combined with magnesium sulfate on puerperants with hemorrhoids.Methods: Sixty eight puerperants cases with hemorrhoids were chosen and randomly divided into an observation group and a control group, each with 34 cases. In the control group, Mayinglong hemorrhoids suppository was used on the hemorrhoids. While in the observation group patients were given photon therapeutic instrument combined with magnesium sulfate on the hemorrhoids. The curative effectiveness, the scores of pain, breastfeeding rates were compared between the two groups.Results: After one course of treatment, the treatment effect of observation group was 91.18%, which was higer than control group that was 82.35%, the difference was statistically significant(x2=4.086,P<0.05). After one course of treatment, the scores of pain in observation group was lower than that in control group, the difference was statistically significant(t=2.773,P<0.05). During the four months of postpartum, the breastfeeding rates in observation group was higher than that in control group, the difference was statistically significant(x2=4.403,P<0.05).Conclusion: Treating by photon therapeutic instrument combined with magnesium sulfate on puerperants with hemorrhoids, can increase treatment effect, reduce the severity of pain, and enhance breastfeeding rates, is worthy of clinic application.

10.3969/j.issn.2095-4344.2013.23.015

Objective To analyze the therapy and prognosis of palindromic ovarian carcinoma. Methods The clinical data of 40 cases of palindromic ovarian carcinoma were reviewed retrospectively. Results After the first surgery, the mean recurrent time of the patients with remained tumors smaller than 2 0 cm was (37 26?11 79) months, and that of the patients with remained tumors larger than 2 0 cm was (7 88?1 49) months. There was a significnat difference in the mean recurrent time between the two groups of the patients with different size of remained tumors(P0 05). Conclusion The recurrence of ovarian cancer was related to the size of remained tumor. Secondary operation plus chemotherapy could improve the short-term survival rate of the patients with palindromic ovarian carcinoma.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P

Objective To assess the clinical application of microendoscopic discectomy (MED) system in the treatment of 36 cases of special lumbar disc herniation (LDH). Methods Laminectomy and decompression, and removal of fractured end plate or calcified herniated discs were performed by MED using self-made bone chisel, osteotome and L-shaped osteotome. Results Intraoperative dural laceration occurred in 2 cases, and no conversions to open surgery were required. Follow-up observation ranged (3～12) months (mean, 9.5 months). According to Macnab criteria, 28 patients had excellent, 5 had good, 2 had fair, and 1 had poor outcomes, with good or excellent results in 91.7% (33/36) of the patients. Conclusions MED may be carried out in patients in side position. Calcified herniated discs and fractured end plate can be excised by MED with self-made tools.

Objective To explore the application of integrating 64-slice CT image with three-dimensional electroanatomic mapping(Carto-Merge) in guiding catheter ablation of atrial fibrillation(AF).Methods Fifteen patients with drug-refractory AF received catheter ablation of AF.64-slice CT scan was performee 1-3 days prior to the ablation procedures.Using a novel software package,the left atrium(LA)with PVs was segmented and extracted for image registration with a combination of landmark registration and surface registration.Results The integration of the CT image into the electroanatomic mapping system was performed successfully in all patients with an error of 2.11?0.82 mm.Thirty pairs of PVs were electrically isolated after circumferential rediogrequency pulmorary rein ablation.The mean procedure time was 170.51?38.47 minutes.Cardiac tamponade occurred in one patient.All the fifteen patients were free of AF recurrence after 3 months of follow up including the 2 cases of persistent AF who required antiarrhythmic drugs.No thromboembolic events or stenosis were observed.Conclusion Integration of 64-slice CT image into the CARTO system successfully performed in patients undergoing catheter ablation of AF and enhance the ablation success rate.

Objective To investigate the feasibility of thoracoscopic minimal access anterior surgery for thoracic spine. Methods Minimal access anterior thoracic surgery was conducted under thoracoscope in 14 patients in this hospital from October 2001 to October 2002.Six patients with thoracic vertebral metastasis underwent vertebral body excision, reconstruction by cement and steel plate, and anterior internal fixation with screw-rod system;4 patients with thoracic vertebral tuberculosis received focus resection,bone graft and anterior internal fixation with screw-rod system; 2 patients with of thoracic disc herniation received discectomy and fusion;2 patients with thoracic vertebral facture and dislocation received reduction, decompression, bone graft and anterior screw-rod internal fixation. Results Postoperative imageological analysis revealed that the focus had been cleaned completely and the internal fixation was excellent. Follow-up for 4～12 months in 14 patients showed that the pain on chest and back disappeared in all the patients. Of the 13 patients with spinal compression, muscle strength recovered from grade A～D preoperatively to grade C～E postoperatively. Conclusions Thoracoscopic minimal access anterior thoracic surgery is feasible. It offers satisfactory short-term effects.

Objective: To explore influence of p38 mitogen-activated protein kinase (p38MAPK) inhibitor on myocardial cell apoptosis and expression of tumor necrosis factor (TNF)-α in rats with ischemia/reperfusion (I/R) injury. Methods: According to number table method, a total of 30 SD rats were randomly and equally divided into blank control group, I/R group and inhibitor group. p38MAPK mRNA expression, TNF-α level and myocardial cell apoptotic rate were measured, compared and analyzed among three groups. Results: Compared with blank control group, there were significant increase in TNF-α level [(3.68±0.16) μg/L vs. (5.02±0.09) μg/L], p38MAPK mRNA expression [(1.76±0.46) vs. (2.35±0.02)] and myocardial cell apoptotic rate [-(3.51±0.40) % vs. - (1.8±0.23) %] in I/R group, P=0.001 all. Compared with I/R group, there were significant decrease in p38MAPK mRNA expression (2.09±0.16), TNF-α level [(4.15±0.11) μg/L] and myocardial cell apoptotic rate [-(2.9±0.50) %] in inhibitor group, P=0.001 all. Conclusion: Inhibition of p38 mitogen-activated protein kinase expression in myocardium of rats can decrease production of tumor necrosis factor-α and myocardial cell apoptosis, then relieve ischemia/ reperfusion injury of myocardial cells.

Objective To investigate the effect of rocuronium 0.3 mg/kg(ED95)for anesthesia induclion on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods Seventy-five patients,ASA Ⅰ or Ⅱ,aged 20-70 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into two groups:rocuronium group(groupⅠ,n=38)and sevoflurane group(group Ⅱ,n =37).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 ug/kg.After loss of eyelash reflex,group Ⅰ received rocuronium 0.3 mg/kg(ED95)and was intubated with the electromyographic(EMG)endotracheal tube under glidescope al 2 min after rocuronium administration.Group Ⅱ received sevoflurane inhalation and was endotracheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4％.Anesthesia was maintained with inhalation of sevoflurane in both groups.SP,DP,and HR were monitored continuously through the surgery.Cooper's score and the success of attempt at endotracheal intubation were recorded.Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 min intervals from 30 min to 70 min of surgery duration.Results SP,DP and HR remained within normal range in both groups.The success rates of endotracheal intubation were 100％ in both groups,but the Cooper' s score of group Ⅰ was significantly higher than that of group Ⅱ(P ＜ 0.05).Compared with group Ⅱ,the amplitude of EMG respouses was significantly decreased in group Ⅰ(P ＜ 0.05).However,the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve.Conclusion Rocuronium 0.3 mg/kg(ED95)for anesthesia induction can not only provide satisfied endotracheal intubation conditions,but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.

Objective To observe the effect of H shaped decalcified bone grafting on spinal fusion and anti conglutination by posterior approach and to evaluate its values in the application in spinal posterior approach surgery. Methods Total laminectomy was performed on 23 cases of severe spinal stenosis and 31 cases of intraspinal tumor for decompression. Thorough decompression of the nerve roots was performed on the former following total laminectomy while exploration and excision of the neoplasm were done on the latter. Then, H shaped decalcified bone grafts were inlaid between spinous processes and transverse processes to cover the lamina defection and overlap the adjacent segments in all cases. At last, the spinal internal fixation or plaster external fixation were used to stabilize vertebral segments according to the economic status of patients. The average time of follow up was 21 months (18～31 months). Results All patients got successful segmental spinal fusion within 8 months. Clinical symptoms were obviously alleviated in 43 cases at the end of follow up but symptoms recurred 12 months after operation in other 11 cases(all were tumor patients). Conclusion H shaped decalcified bone graft is valuable in spinal fusion and anti conglutination in spinal posterior approach surgery.