Objective To sum up the clinical experience of treating thoracolumbar fractures with Scofix system and transpedicular bone graft. Methods 62 consecutive patients with thoracolumbar fracture were treated operatively with reduction and stabilization by Scofix system combined with vertebral fusion via transpedicular bone grafting. Results 62 patients were followed up. Their postoperative radiographs and CT scans showed that more than 90%of the cases gained reduction, the effective diameters of vertebral canal became normal and the mean time of vertebral fusion was about 3 months. Conclusions Scofix system is effective in reduction and fixation for thoracolumbar fractures, and transpedicular bone graft is helpful in restoring the height of vertebral body and increasing vertebral fusion. The procedure also has advantages of preventing vertebral collapse, reducing nerve injury and facilitating functional recovery.

Objective To study the diagnosis and treatment in patients of esophagus carcinoma and esophagogastric junction carcinoma after operation with paralysis gastroparesis syndrome (PGS).Methods From March 1996 to December 2013 in the Affiliated Hospital of Putian University,the clinical data of PGS in 42 patients with esophagus carcinoma and esophagogastric junction carcinoma after operation were selected, and retrospectively analyzed.Results All the patients were presented with gastric retention, no obvious abdominal pain,and anal exhaust has been restored.Enteron radiography shows anastomosis and pylorus were unobstructed and gastric motility was weaken or disappear.All patients were treated with gastrointestinal decompression, nutritional support, maintaining water electrolyte metabolism balance, promoting gastrointestinal peristalsis and reducing stomach wall edema.The stomach function recovery of 40 cases was within 10-15 days, respectively.Two patients cured by pyloroplasty when they were not improved by conservative treatment for 2 months.And the stomach function recovery were within 28 days and 35 days.Conclusion Gastroparesis syndrome is a functional disease,the cure rate is high, the treatment of first choice was conservative treatment, however, for the intractable gastroparesis, pyloroplasty maybe another good choice.

Objective To study the clinical significance of the novel tumor marker Cytokerantin?19?fragment( CYFRA 21?1) of peripheral blood in patients with esophageal cancer. Methods The CYFRA 21?1 level in peripheral blood of 72 patients with benign tumor of esophagus or reflux esophagitis and 60 patients with esophageal cancer was examined before and 7 days after operation by enzyme?linked immuno sorbent assay ( ELISA) . At the same time, patients with esophageal cancer were followed up for 3 years, and the level of CYFRA21?1 was examined. Results (1)Before the operation,the level of CYFRA 21?1 was 0-3. 30 μg/L in 51. 67%( 31/60 ) of the patients with esophageal cancer, higher than that of the control group ( 16. 67%(12/72),χ2=3. 88,P<0. 05). (2)Before the operation,the level of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ were (3. 27±0. 33) μg/L and (4. 88±1. 21) μg/L,and of the control group was (2. 24±1. 17) μg/L. The levle of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ andⅢ,Ⅳ were significantly higher than that of the control group( t=2. 37,2. 00,P<0. 05) . ( 3) On the 7th day after operation,the level of CYFRA21?1 was (2. 26±1. 16) μg/L,and the difference was not significant compared with the control group(t=0. 95,P>0. 05). The level of CYFRA21?1 with the palliative resection of esophageal cancer was (3. 31±0. 66) μg/L,and the difference was significant compared with the control group(t=4. 33,P<0. 05) . ( 4 ) After 3 years of follow?up, the factors affecting the survival rate of esophageal cancer were as following:the pathologic stages of tumor(OR 4. 423,95%CI 1. 943-4. 972,P<0. 05),types of operation(OR 0. 023,95%CI 0. 012-0. 036,P<0. 05),the level of CYFRA21?1 before operation(OR 6. 798,95%CI 4. 328-8. 105,P<0. 05),and the decreased level of CYFRA21?1 after operation(OR 0. 117,95%CI 0. 074-0. 202,P<0. 05) . ( 5) During the follow?up period,the level of CYFRA21?1 in patients with local recurrence and distant metastasis of esophageal carcinoma was (7. 97±0. 44) μg/L,significantly more than that of the control group(t=5. 11,P <0. 05) . Conclusion CYFRA21?1 is a useful tumor marker in the positive rate of preoperative diagnosis of esophageal cancer, postoperative monitoring of recurrence, distant metastasis and prediction of prognosis.

Objective To study the clinical application of mediastinal elastic drainage-tube for patients with anastomotic leak after esophagus carcinoma or esophagogastric junction carcinoma surgery.Methods Two hundred and eighty-two cases esophagus carcinoma or esophagogastric junction carcinoma patients were randomly divided into 2 groups.The control group(n=140) were indwelled thoracic drainage tube after operation.However,the experimental group(n=142) were indwelled thoracic drainage tube and mediastinal elastic drainage-tube after operation.The incidence of the esophagogastrostomy fistula,diagnosis time of anastomotic leakage,maximum temperature,time of continuous ferer,total white blood cell count,cardiopulmonary complications,postoperative hospital stay,hospitalization expenses were observed and analyzed.Results (1)The incidence of the esophagogastrostomy fistula in the experimental group and the control group was 9.8%(14/142) and 12.1%(17/140),and there was no significant difference between the two groups(χ2=0.376,P>0.05).The diagnosis time of anastomotic leakage,maximum temperature,time of continuous ferer and total white blood cell count of the experimental group and the control group was (6.4±0.6) d and (10.6±0.6) d,(38.1±0.1)℃ and (39.0±0.2)℃,(72.2±2.8) h and (102.6±3.3) h,(12.6±0.7)×109/L and (19.7±0.6)×109/L after operation,there was significant difference between the two groups(t=2.708,1.662,3.164,1.837,P<0.05).The incidence of pulmonary complication,cordis complication of the experimental group and the control group was 19.7%(28/142) and 32.1%(45/140),18.3%(26/142) and 40.7%(57/140) after operation,there was significant difference between the two groups (χ2=5.077,6.606,P<0.05).The postoperative hospital stay,hospitalization expenses of the experimental group and the control group was (28.1±4.2) d and (45.6±3.9) d,￥(6 8174.7±3206.5) and￥(8 4774.8±4007.3) after operation,there was significant difference between the two groups(t=2.001,1.709,P<0.05).Conclusion The mediastinal elastic drainage-tube for patients with anastomotic leak after esophagus carcinoma or esophagogastric junction carcinoma surgery can not reduce the incidence of the esophagogastrostomy fistula,but which is conducive to the early diagnosis and timely treatment of anastomotic leakage.Meanwhile it can reduce the incidence rate of cardiac and pulmonary complications,shorten the length of stay in hospital,reduce the total cost of hospitalization.

Objective The biological half-life in vivo of local anesthesia is short, high concentration in local tissue is in-clined to cause central nerve and cardiovascular toxicity due to the drug absorption into blood by blood vessels.The research was to pre-pare the poly ( lactide-co-glycolide) nanoparticle loaded with ropivacaine ( RVC-PLGA-NPS) , optimize its process, and determine its characteristics in vitro. Methods An oil-in-water emulsion solvent evaporation technique was adopted to prepare the RVC-PLGA-NPS.The formulation was optimized by central composite design/response surface method(CCD-RSM), with the encapsulation effi-ciency( EE) , drug loading( DL) and particle size as the indexes.Research was also made on itsin vitro release by fitting different model equations. Results The acquired nanoparticals were smooth, with the mean particle size (331.21±2.11) nm, DL (13.81±1.35)%and EE (74.82±2.53)%.The accumulative release rate of the nanoparticals was about 73%in 96 h, which showed that Higuchi func-tion fitted the release curve. Conclusion The RVC-PLGA-NPS made by emulsion solvent evaporation technique have obvious drug-release behaviour in vitro.

In order to control the quality of all parts of the process for culturing,preparing and using clinically the human embryo olfactory ensheathing cells (OECs),the conduct standard of culturing human OECs from olfactory bulb is formulated. Because the strict conduct process can reduce the human factor as much as possible and ensure the stability of the cell quality. Therefore,during the culturing process of human embryo OECs, as for the embryo sample of OECs from olfactory bulb,the standard of lab condition and cell culture must be set strictly. The key steps of conduct process must be regulated,the freezing and resuscitating process of OECs must be controlled,the test method for microbial contamination during cell culture must be proposed and the risk must be reduced,then the quality of the human OECs from olfactory bulb can be guaranteed during the clinical application.

Objective To investigate the prevalence of multidrug resistant genes in Klebsiella pncumoniae.MethodsTwenty strains of multidrug resistant Klebsiella pneumoniae were isolated from burn patients.Susceptibility of these strains to 14 antibiotics was detected by KB method.PCR was used to detect oqxA,smrKpn,qacE,tehA,mdfA and qacEΔl-sul1 genes.ResultsThe antibiotic sensitivity rates of 20 multidrug resistant Klebsiella pneumoniae isolates to antibiotics tested were ＜ 30％ except that to imipenam.The positive rates of efflux pump genes mdfA,qacEΔl-sull and oqxA were 65％,100％ and 100％,respectively; while those ofsmrKpn,qacE and tehA were 0％,0％ and 15％.ConclusionoqxA gene has been detected in multidrug resistant Klebsiella pneumoniae from burn patients with high positive rate.

Objective To study the relationship between inflammation and malnutrition in patients with stable chronic obstructive pulmonary disease (COPD).Methods A total of 85 patients with stable COPD and 30 healthy subjects were recruited .All patients were divided into the lower body mass index (BMI,BMI<18.5 kg/m~2) group and normal BMI (BMI=18.5-23.9 kg/m~2) group.Lung function,arterial blood gall,cell differenti-als in induced sputum,and the levels of serum C-reactive protein (CRP),interleukin-8(IL-8),interleukin-6 (IL-6),interleukin-10 (IL-10),and tumor necrosis factor-α(TNF-α) were determined.Results The levels of total cell count and neutrophils in induced sputum were significantly higher in lower BMI group than in normal BMI group and healthy subjects (P<0.05).The forced expiratory volume in 1 second percentage,forced expiratory volume in 1 second/forced vital capacity,and arterial oxygen tension were significantly lower in lower BMI group than in normal BMI group,and the arterial carbon dioxide tension was significantly higher in lower BMI group than in normal BMI group (P<0.05).The levels of serum CRP,IL-8,IL-6,and TNF-α were significantly higher in lower BMI group than those in normal BMI group and healthy subjects (P<0.05).In lower BMI group,BMI was negatively correlated with total cell count (r=-0.492,P=0.0038) and neutrophils (r=-0.501,P=0.0032) in induced sputum and the levels of serum CRP (r=-0.473,P=0.0083),IL-8(r=-0.382,P=0.0421),IL-6(r=-0.422,P=0.0147),and TNF-α(r=-0.416,P=0.0156),respectively.Conclu-sion Local and systemic inflammatory reaction is responsible for malnutrition associated with COPD.

Objective To investigate the effects of ischemic postconditioning (IPOC) on myocardial perfusion and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) who were treated with emergency percutaneous coronary intervention (PCI). Methods A total of 203 patients with STEMI who received emergency PCI were randomly divided into IPOC group (n=103) and control group (n=100). For the patients of IPOC group the angioplasty balloon was re-inflated within one minute after the beginning of reperfusion, the procedure was repeated three times, each time the inflation of balloon lasted for 1 minute using low-pressure (4-6 atm), and the interval between the inflation procedures was one minute. For the patients of the control group , no additional intervention was employed during the first 6 minutes of reperfusion. Cardiac troponin I(cTnI) peaks, creatine kinase-MB (CK-MB) peaks, left ventricular ejection fraction (LVEF), wall motion score index (WMSI), corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC), and major adverse cardiac events (MACE) occurred during hospitalization time in both groups were recorded and the results were compared between the two groups. Results No significant differences in age, sex, risk factors, infarction-related artery, ischemia time, etc. existed between the two groups (P>0.05). The CTFC values of IPOC group were significantly faster than those of the control group, that was (25.3±7.9) vs.(29.4±8.4),(P<0.05). The CK-MB peak and cTnI peak values of IPOC group were remarkably lower than those of the control group, those were (157.3 ±83.6) U/L vs. (201.5 ±77.3) U/L and (2.5 ±1.3) ng/mL vs. (3.1 ±1.0) ng/mL respectively (P<0.05). At the time of admission, there were no significantly differences in the LVEF and WMSI values between the two groups, and three months after PCI the LVEF and WMSI values of IPOC group were significantly better than those of the control group, those were (57.4 ±8.7)% vs. (53.6 ±9.3)% and (1.19 ±0.4) vs. (1.27 ±0.3) respectively, the differences were statistically significant (P<0.05). Three months after PCI, the occurrence of MACE in IPOC group was obviously lower than that in the control group (P<0.05). Conclusion Ischemic postconditioning can improve the infarction-related artery blood flow in patients with STEMI who receive emergency PCI treatment, it can also reduce ischemia-reperfusion injury and improve the cardiac function as well as patient’s prognosis after AMI.

Objective To investigate the prevalence of mobile genetic elements in Acinetobacter baumannii strains isolated from burn patients. Methods Polymerase chain reaction (PCR) was used to detect the genes encoding the integron, transposon, conjugative plasmid and insertion sequence in 20 strains of Acinetobacter baumannii isolated from burn patients. Results tnpU and ISaba1 genes were detected in all 20 strains, and int Ⅰ gene was detected in 19 strains (95.0%). Other genes were all negative. Conclusion Mobile genetic elements carrying multi-drug resistant genes are found in Acinctobacter baumannii strains isolated from bum patients.