BACKGROUND:Deep vein thrombosis is a common complication following bone surgeries,so its prevention and treatment become critical.However,there are few studies on the incidence of deep vein thrombosis after spine surgery in the elderly.OBJECTIVE:To explore the diagnosis of deep vein thrombosis after spine surgery in the elderly and its incidence after intervention with low-molecular-weight heparin.METHODS:All patients undergoing spine surgery were randomly divided into experimental and control groups.Patients in the experimental group were subjected to the subcutaneous injection of 0.4 mL of low-molecular-weight heparin (4 100 IU) at 12 hours postoperatively,once daily for 7-14 days from the next day.Those received no intervention served as controls.The thromboplastin time,thrombin time,activated partial thromboplastin time,and level of plasma fibrinogen were detected before and after treatment.Color Doppler ultrasound results of the lower extremity vessel before and after treatment and postoperative drainage volume were recorded.RESULTS AND CONCLUSION:(1) In the experimental group,the lower level of plasma fibrinogen and slightly prolonged thromboplastin time,thrombin time and activated partial thromboplastin time were observed,but all were within the normal range.(2) The incidence of deep vein thrombosis in the experimental group (0％) was significantly lower than that in the control group (5％,P ＜ 0.05).(3) To conclude,low-molecular-weight heparin therapy significantly reduced the incidence of deep vein thrombosis after spine surgery.

Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.

Objective To investigate the application value of interleukin-27 (IL-27) in the patients with acute coronary syndrome (ACS).Methods A total of 208 ACS patients were enrolled in the study,including 76 acute myocardial infarction (AMI) patients with ST elevation (STEMI),58 AMI patients with non-ST elevation (NSTEMI) and 74 unstable angina pectoris (UAP) patients.These patients were divided into single-vessel lesions,double-vessel lesions and three-vessel lesions groups,and 62 patients with chest pain syndrome (CPS) were selected as a control group.The plasma IL-27 levels of all patients were determined by enzyme linked immunosorbent assay (ELISA) and analyzed.Results The levels of plasma IL-27 (median[P25,P75]) in STEMI (308.64 [245.17,359.26] pg/mL),NSTEMI (256.88 [181.52,332.51] pg/mL) and UAP (218.12 [165.33,312.46] pg/mL) patients were significantly higher than that in CPS patients (100.66[68.98,228.86] pg/mL,P ＜ 0.01).The levels of plasma IL-27 in STEMI patients were significantly higher than that in NSTEMI and UAP patients (P ＜ 0.05).The positive rate of IL-27 in ACS patients with negative TnI was 54.24％ (32/59).The sensitivity and specificity of IL-27 in predicting ACS from chest pain patients were 80.29％and 58.06％,respectively.The levels of plasma IL-27 in the patients with three-vessel lesions were significantly higher than that with single-vessel lesions (P ＜ 0.05).Conclusion Plasma IL-27 levels in ACS patients increase obviously,which may be involved in the pathogenesis of ACS.IL-27 may be helpful for the diagnosis of ACS patients with negative TnI and the prediction of ACS state.