Objective:To study the relations between the length and costs of hospitalization and the severe ad- verse drug events which took place in the gastroenterologic and pulmonary wards.Method:Pharmacists surveyed ADEs in- cluding their existence and preventability in the wards,and found out the quantity of excessive length and extra costs of hos- pitalization.Result:There were totally 20 identified severe ADEs in which 11 were preventable in the pulmonary wards during 8 months and in the gastroenterologic wards during 5 months.The mean attribute length of stay was 17.8 days and mean attribute extra cost of hospitalization was 16,869 yuan for each ADE.The mean attribute length of stay was 19.3 days and mean attribute extra cost of hospitalization was 12,578 yuan for each preventable ADE.Conclusion:The attribute length of stay and extra costs of hospitalization were substantial.Since many severe ADEs were preventable,the effective measure must be taken to decrease their incidence.

Objective To develop an all-in-one multifunctional thoracolumbar fixation rescue vest for land and water rescue of thoracolumbar injury and investigate its application effect.Methods According to the thoracolumbar physiological curve,type Ⅰ thoracolumbar fixation rescue vest with keel and inflatable airbag and type Ⅱ thoracolumbar fixation rescue vest with additional lifesaving balloon and inflatable cylinder were developed using thermoplastic polyurethane (TPU)-nylon composites and polycarbonate (PC) as the main materials.Clinical application of type Ⅰ thoracolumbar fixation rescue vest in 532 cases of thoracolumbar injury was discussed.Type Ⅱ thoracolumbar fixation rescue vest were tested at marine rescue and related parameters measured were automatic inflation time,buoyancy force,floating time,floating condition and victims' face orientation.Clinical outcome was quantified by the MacNab standard,and VAS for pain was recorded.Results According to the MacNab standard,excellent outcome was achieved for all cases.VAS improved from 8.2 points to 2 points after the bracing was applied,showing 100％ improvements.The brace into the water showed automatic inflation time of 3-5 seconds and maximum buoyancy force of 100 kg,and ensured a 90 kg dummy of floating over 96 hours.At marine rescue,the wounded in braced condition showed face upward with 24-hour buoyancy loss ≤5％ and freedom of movement.Conclusions The multifunctional thoracolumbar fixation rescue vest provides dual immobilization and ensures marine rescue for its automatic inflation device.This invention provides the feasibility to remove,transport and evacuate the thoracolumbar fracture patients in cabin.

Objective To quantify the expressions of tumor necrosis factor-α (TNF-α),caspase-8 and caspase-3 in lichen planus (LP) lesions,and to investigate their significance.Methods Skin samples were collected from the lesions of 20 patients with LP and normal skin of 20 healthy human controls.Immunohistochemistry was used to determine the expressions of TNF-αt,caspase-8 and caspase-3,and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) technique to evaluate the apoptosis in keratinocytes,in these samples.Results The expression levels (expressed in integrated optical density,IOD)of TNF-α,caspase-8 and caspase-3 were (12.58 ± 2.33) × 103,(11.69 ± 3.52) × 103 and (11.45 ± 2.82) × 103 respectively in LP lesions,significantly higher than those in the normal skin ((5.12 ± 1.78) × 103,(3.87 ± 3.36)× 103,(4.76 ± 1.93) × 103,t =11.38,7.19,8.76,respectively,all P ＜ 0.01).Elevated apoptosis index was noted in keratinocytes from LP lesions compared with those from normal skin (71.35 ± 7.93 vs.33.62 ± 8.75,t =14.29,P ＜ 0.01).In LP lesions,the expressions of both TNF-α and caspase-8 were positively correlated with the apoptosis index of keratinocytes (r =0.72,0.75,respectively,both P ＜ 0.01) and the expression of caspase-3 (r =0.68,0.73,respectively,both P ＜ 0.01).Conclusion The up-regulated expressions of TNF-α,caspase-8 and caspase-3 may participate in the apoptosis in keratinocytes in LP.

ABSTRACT:Objective To compare the clinical effects of Zero-P and traditional titanium plate with cage in treating single level cervical spondylosis.Methods We retrospectively analyzed the clinical data of 28 patients with single level cervical spondylosis who underwent anterior cervical discectomy and fusion (ACDF)by traditional titanium plate with cage (group A,n=16)or Zero-P implant (group B,n=16)in our department between January 2012 and January 2014.The intraoperative blood loss,operation time,postoperative JOA scores,JOA recovery rate,NDI scores,and dysphagia incidence in both groups were measured and compared.The changes of the midpoint interbody height (IBH),the cervical Cobb angle of the surgical segment and the cervical Cobb angle of C2 and C7 vertebral body were measured on the standing lateral cervical spine X-ray.Results The operation time was significantly longer in group A than in group B (P < 0 .0 1 ), but there were no significant differences in intraoperative blood loss between the two groups (P>0 .0 5 ).The incidence of dysphagia was lower in group B than in group A.The two groups did not significantly differ in JOA score or JOA improvement rate during the same period after operation (P>0.05).The NDI score in group B was significantly lower than that in group A (P<0 .0 5 )at 1 month and 6 months after operation,but showed no significant difference in preoperative and 1 2 months after operation (P>0 .0 5 ).The midpoint interbody height in group B was significantly greater than that in group A (P<0 .0 5 )1 2 months after operation,but showed no significant difference one month after operation.The cervical Cobb angle of the surgical segment was significantly greater in group B than in group A (P<0 .0 5 )after operation, but there was no significant difference in cervical Cobb angle of C2 and C7 vertebral body between the two groups at various time points (P>0.05).Conclusion Zero-p and traditional titanium plate with cage have similar effects in treating single level cervical spondylotic myelopathy,and Zero-P system has the advantages of lower incidence of dysphagia after operation,shorter operation time and better recovery of postoperative cervical physiological structure.

Objective To study the association between the cerebral infarction and the angiotensin converting enzyme (ACE) gene rs4646994 and rs35397082 polymorphisms in Binhai area ,Tianjin .Methods Gene sequencing and DNA electrophoresis were used for the detection of the ACE gene single nucleotide polymorphisms (SNPs)(rs4646994 and rs35397082) .53 samples from pa‐tients with acute cerebral infarction and 53 samples from healthy volunteers were used in our study .Serum sample were collected from each group and tested by ACE ELISA .Results There were only deletion type of rs35397082 SNP in both of the control and cerebral infarction group .In the control group ,the number of insertion type of rs4646994 was 45(84 .91% ) ,deletion type was 8(15 . 09% ) and in the patients group ,the number of insertion was 47(88 .68% ) and the deletion was 6(11 .32% ) .There was no signifi‐cant difference between the patients group and the healthy donors (P>0 .05) .The concentration of ACE in control group was high‐er than the patients with acute cerebral infraction (P<0 .05) .Conclusion There is no significant association between the ACE gene polymorphisms(rs35397082 and rs4646994) and cerebral infarction in Binhai area ,Tianjin .The different concentration of ACE is not caused by these two SNPs .In this study ,these two SNPs are not the are not the risk factors of the cerebral infarction in Tianjin based on our study .

Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.

Objective To compare the modified expanding suspended laminoplasty and posterior pedicle screw fixation applied in lumbar intraspinal tumors and evaluate operation,complications,postoperative neurofunctional improvement and lumbar lumbar stability in the two groups.Methods We made a retrospective analysis of the clinical data of 1 14 cases of lumbar intraspinal tumors, including 66 cases of modified expanding suspended laminoplasty and 48 cases of posterior pedicle screw fixation.We compared the operation time,operation bleeding volume,and incidence of postoperative cerebrospinal fluid leakage in the two groups.We also analyzed the lumbar instability and spinal cord injury score standard by the Japanese Orthopedic Association (JOA)between the two groups at 3,6, 12,and 24 months after operation.Results The results of modified expanding suspended laminoplasty group were significantly better than those of posterior pedicle screw fixation group in operation time, operation bleeding volume and incidence of postoperative cerebrospinal fluid leakage (P < 0.01 ).The lumbar instability did not significantly differ between the two groups (P >0.05).At 3,6 or 12 months after the operation, changes in the increase of JOA score of the two groups had no significant difference (P > 0.05 ).However,24 mouths after the operation,the group of posterior pedicle screw fixation had significantly improved JOA score compared with that in the modified expanding suspended laminoplasty group.Conclusion Both the modified expanding suspended laminoplasty and posterior pedicle screw fixation have a favorable outcome of postoperative lumbar instability and neurofunction.And posterior pedicle screw fixation is superior to modified expanding suspended laminoplasty in improving neurofunction.

Objective To investigate the indications,surgical principles and advantages and disadvantages of microsurgery of intra-spinal tumor via the quadrant pathway.Methods We made a retrospective analysis of the clinical data of patients with spinal canal tumors treated via the quadrant pathway from October 2014 to July 201 5. Results Totally 1 6 patients were included.Their tumors were fully removed by microscopic resection,in which there were three epidural cases,twelve subdural extra-medullar cases,and one intra-medullar case.In terms of stage,there were three cases of cervical segment (C3 - C7 ),four cases of thoracic (T1 - T10 ),nine cases of thoracic and lumbar ones (T1 1 - S2 ). In pathology, there were nine cases of neurilemmoma, two cases of neurofibroma,four cases of meningeal tumor and one case of neuroepithelial cyst.The postoperative symptoms and signs of the patients were significantly improved,and no recurrence or complications occurred in the follow-up 2-10 months.Conclusion Quadrant pathway can be used in removing spinal epidural and subdural tumor,which is shorter than two vertebral segments in length,and the cross-sectional area is less than 2/3 of the spinal cord. However,surgery with extensive adhesion and intra-medullary lesions should be performed carefully,and the surgical techniques are more demanding and a longer learning curve is needed.

Objective To discuss the related risk factors of diabetes complicates with Carpal Tunnel Syndrome (CTS).Methods Retrospectively analyzed 467 cases of Type Ⅱ diabetes mellitus (T2DM) patients' medical history data; Selected CTS group (n =122) and normal group (n =175) according to the electrophysiology test results.Compared basic clinical data of two groups,and used logistic regression analysis to investigate the risk factors for diabetes complicates with CTS.Results In the CTS group,74.6％ of the patients are female; the disease duration between two groups,glycated hemoglobin (HbA1c),2-hour postprandial blood glucose (2 hPG) level differences are statistically significant (P ＜ 0.05).Logistic regression analysis showed significant difference in "women" (P =0.001),disease duration (P =0.043)and HbA1c value (P =0.001).Conclusions Female,long disease duration and high level of HbA1c are risk factors of diabetes complicates with CTS.

Objective:To explore the effect of laparoscopic minimally invasive on anorectal dynamics and serum carcino-embryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in patients with rectal cancer.Methods:38 cases of rectal cancer patients were selected as the research group from March 2014 to March 2016 and 40 cases of non neoplastic intestinal polyps as control group,Preoperative anorectal dynamics index (anal resting pressure (ARP),rectal resting pressure (RRP)and anal maximal contraction pressure (MSP),rectal maximum tolerated volume (MTV) of two groups were compared,Preoperative and 3 d,1,2 weeks after operation of serum CEA and CA724 levels were detected in the research group and the clinical curative effect was observed.Results:There was no significant difference of ARP,RRP,MSP,MTV before operation in research group compared with the control group(P＞0.05),and was significantly reduced 2,4 weeks after operation(P＜0.05),then gradually restored,and basically recovered to the preoperative level 12 weeks after operation.There was no significant difference of serum CEA and CA724 levels 3 d after operation compared with preoperative in research group (P＞0.05),and were significantly lower 1,2 weeks after operation compared with preoperative (P＜0.05).The clinical effective rate was 65.8％.Conclusion:Efficacy of laparoscopic minimally invasive in treatment of rectal cancer is effective,can effectively reduce the levels of tumor markers,although there are some influence on anorectal dynamics,but it can be returned to normal in the short term.