Thirty-two cases of calcaneodynia were treated with high-energy vibration wave combined with external application of Shuangbo Ointment (Group 1) and other 32 with high-energy vibration wave only (Group 2) as control. The results showed that the markedly effective rates of short-term treatment (3 weeks) and long-term treatment (3 months) were 56.25% and 84.37% in Group 2, and 81.25% and 93.75% in Group 1 respectively. It is suggested that high-energy vibration wave combined with external application of Shuangbo Ointment exerts a better effect for calcaneodynia, and can decrease the occurrence of hematoma and periosteum stripping induced by high-energy vibration wave.

BACKGROUND: Researches on vitodynamics present that percutaneous vertebroplasty (PVP) can strengthen hardness and intension of single osteoporosis vertebral body after injection of bone cement; however, the infused volume and site of bone cement for maintaining mechanical stability of vertebral body should be further studied.OBJECTIVE: A numerical calculation method on finite element models (FEM) for biomechanical analysis has been developed, while a boundary condition describing the relative L1 -L2 displacement is imposed on the FEM to account for three-dimensional physiological states.DESIGN: Non-randomized control study.SEITING: Beijing Neurosurgical Institute.MATERIALS: One female patient aged 54 years with compressibility fracture at lumbar vertebrae L1-L2 induced by osteoporosis was diagnosed with CT examination, and the patient was told the fact. Based on CT scanning before and after PVP, 90 serial sections with the thickness of 1 mm were obtained and the size of each pixei was 0.33 mm.METHODS: The experiment was carried out Beijing Neurosurgery Institute from October 2005 to June 2006. ①Establishment of three-dimensional FEM: Integrating the anatomical structure from the spine CT and MRI image of a patient, a novel three-dimensional geometric model of lumbar functional spinal units (FSUs) has been built. Meanwhile, 90 serial sections were obtained to exchange data of CT sections and divide imagings. Based on the geometric model, two kinds of three-dimensional FEM of L1-L2 segments for preoperative and postoperative vertebrae were created. ② Model evaluation: The lcad of (500 N, 1 000 N, 1 500 N, 2 000 N, 2 500 N) axial compression were applied to the superior surface of the model in the form of a uniformly concentrated lcad over all L1 superior surface nodes respectively. We could observe the stress distribution of L1-L2 segment by applying the load and clue on the high stress concentration region as the most likely areas fracture.MAIN OUTCOME MEASURES: ① Changes of displacement, stress and strain distributions of FEM at L1-L2 segment of lumbar vertebrae under various loads; ② Effect of increase of bone cement volume on displacement, stress and strain distribution.RESULTS: ① The increase in displacement, stress and strain of FE model with the increase of loading in the postoperarive cases. The tendency was approximately linear which also illustrates the spine have flexible biomechanical characteristics. The region was a common place for injures due to loading. The magnitude of stress in the intervertebral disc depended on the proportion of load applied to the superior surface of the motion segment. The heavier the lcad was, the stronger the stress was. ② With the increase of stress on intervertebral disc, the increasing volume of bone cement could induce transfusion of load of nearby vertebral body.CONCLUSION: Building three-dimensional FEM of L1-L2 segments for preoperative and postoperative PVP can explain three-dimensional physiological status of vertebral body based on calculating relative shift of L1-L2 segment of lumbar vertebrae. Meanwhile, simulative calculation can clearly express distribution of stain and stress and preoperative and postoperative deformity of vertebral body.

Objective To discuss cultivation of higher vocational nursing talents in the model of learning and working rotation during the cooperation of school and hospital. Methods Students were cultivated by two years school study, two years learning and hospital work rotation and one year hospital position practice which was adopted as an "221" mode by means of organizational leadership,agreed safeguard and co-management. Half day learning and half day practice in four learning situation which have been transformed from the real professional workplace. Results Scores of professional core courses and operation skills had been improved significantly; Students cultivated by "221" mode had more superiority on the aspects of post adaptability, hand skills, communication skills and the ability of linking theory to practice. Conclusions The model of learning and working rotation during the cooperation of school and hospital is the important way of cultivating higher vocational nursing talents.

The clinical data of 43 children diagnosed as idiopathic nephrotic syndrome (INS) with frequent relapse and treated with cyclophosphamide (CTX) or mycophenolate mofetil (MMF) were retrospectively analyzed.In this series of patients 18 were treated with CTX and 25 were treated with MMF.After CTX therapy the relapse-free period was round 6.0 months,the relapse rate decreased from 4.8 episodes/y to 1.1 episodes/y(P ＜0.001)and prednisone dose was reduced from 30.0 mg/d to 15.0 mg/d (P =0.002).After MMF therapy the relapse-free period was also round 6.0 months,the relapse rate decreased from 4.8 episodes/y to 1.6 episodes/y(P ＜0.001)and the prednisone dose was reduced from 37.5 mg/d to 12.5 mg/d(P ＜ 0.001).There were no significant differences in relapse-free period,relapse rate and reduction of prednisone dose (P ＞ 0.05) between MMF and CTX groups.This retrospective study shows that both MMF and CTX are effective immunosuppressive agents for children with frequently relapsing INS,however,MMF is more convenient and safe to administrate,it may be proposed before CTX.

Objective:To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases,and to evaluate the necessity of biopsy following gastric endoscopy.Methods: From Jan.2005 to Dec.2005,320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study.The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups.The 5 patients in each group had reflux esophagitis,non-atrophic gastritis,atrophic gastritis,gastric ulcer and duodenal ulcer,respectively.Patients in the same group were matched with each other in gender,age and their history of diseases.The results of endoscopy,including the exudation,congestion,erosion,roughness,bile reflux,etc.,were read by 2 experienced endoscopists.The biopsy was performed by an experienced pathologist and pathological variables included active inflammation,chronic inflammation,atrophy,intestinal metaplasia and atypical hyperplasia.The status of Helicobacter pylori(H.pylori) infection was evaluated by rapid urea test,silver staining and histological methods;the result was deemed positive when the results of either 2 tests were positive.Results: Erosion,exudation,roughness,and H.pylori infection were related with active inflammation;erosion and H.pylori infection were related with chronic inflammation;roughness of mucosa was related with atrophy;roughness and H.pylori infection were related with intestinal metaplasia;and obsolete hemorrhage,H.pylori infection,roughness mucosa,and bile reflux were related with atypical hyperplasia.Macroscopic diagnosis rate of atrophic gastritis was 71.9%(46/64) with a false positive rate of 28.2%(18/64) and a false negative rate of 34.38%(22/64).Conclusion: Macroscopic diagnosis is indicative to pathological changes of gastric mucosa,but the predictive value is relatively poor,making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.

Objective To investigate the influence of early hyperbaric oxygen (HBO) therapy on cerebral edema and neural function in patients after minimally invasive surgery for intracerebral hemorrhage (ICH).Methods A random number table was used to divide 148 ICH surgery patients into a control group (n =75) and a treatment group (n =73).In the treatment group,HBO was administered in 51 cases 6-24 hours after surgery and then once a day for twenty days.Cerebral edema volume was measured by brain CT before the operation and on the 3rd,7th,14th and 21st day after the surgery.Neurological impairment was scored at the same time points.Results Average cerebral edema volume was significantly smaller in the treatment group than in the control group on the 7th,14th and 21st days,but not on the 3rd day.The neurological impairment scores (NIS) after therapy were significantly lower than that before therapy in both groups.The two groups' average scores were not significantly different before the operation or on the 3rd day,but they were significantly lower in the treatment group thereafter.Conclusion Early HBO therapy can significantly reduce cerebral edema and contribute to nerve functional recovery in patients after minimally invasive ICH surgery.

Objective To explore the effect of FESS on nasal resonance characteristics in patient with chronic sinusitis .Methods Detected 50 cases of adult patients with type Ⅱ chronic sinusitis ,and collected the date about the application of multi-channel voice analysis system that tested the pronunciation /i/before and three months af-ter FESS spectrum - energy distribution while compared with 50 normal subjects .Results Patients with type Ⅱchronic sinusitis before surgery compared with normal subjects ,the head of the low -frequency energy was higher , high-frequency was lower ,the difference was statistically significant (P<0 .001) .Voice energy distribution after three months compared with preoperative ,the head of the high-frequency resonance energy improved than preop-erative ,but still relatively low compared with the normal ,the difference was statistically significant (P<0 .05) . While the mouth ,chest and throat in addition to oral FR3 ,FR4 ,postoperative throat FR4 and preoperative chest FR4 ,other frequency -energy compared with normal subjects no significant change was not statistically significant (P>0 .05) .Conclusion For patients with chronic sinusitis ,low -frequency of the voice of nasal resonance de-creased ,and high-frequency increased after FESS .

Objective To analyze the pathogenesis,initially diagnosed symptoms and clinical manifestations of children with chronic kidney disease (CKD) at stage 2 to 5.Methods The data of 108 children who were hospitalized in Children's Hospital Affiliated to Capital Institute of Pediatrics from September 2007 to April 2016 with CKD stage 2 to 5 were retrospectively analyzed.The etiologies,clinical manifestations and examinations were summarized,and the clinical manifestations were compared between the congenital hereditary urinary diseases group and the acquired urinary diseases group.Results (1) In the 108 cases collected,66 cases were male,42 cases were female,aged from 3 months to 15 years and 1 month old.Twenty-four cases were diagnosed at stage 2,26 cases at stage 3,35 cases at stage 4,and 23 cases at stage 5.(2) Twenty-eight kinds of illness were involved in the cause of CKD.Among them,57 cases (52.8％) had congenital anomalies of the kidney and urinary tract,5 cases(4.6％) had hereditary kidney diseases,41 cases (38.0％) had other primary or secondary kidney diseases,and in 5 cases (4.6％) the causes of disease were unknown.(3) For the initially diagnosed symptoms,29 cases(26.9％) were due to complaints associated with kidney disease,36 cases (33.3％) were of other outside kidney symptoms,and 43 cases (39.8 ％) were of negative symptoms.The results of urinary ultrasound were abnormal in 79 cases(73.1％) and 87 cases(80.6％) showed abnormality in urinary analysis.There were 105 cases (97.2％) with abnormal manifestations either in urinary tract ultrasound or in urinary analysis.(4)The ages on diagnosis as CKD in children with congenital hereditary urinary diseases(5.89 years old) were younger than that of children with acquired urinary diseases (9.20 years old),and the difference was significant(Z =-3.434,P =0.001).The frequency of cases with short stature or lower-weight in group of congenital hereditary urinary diseases[66.1％ (41/622 cases),64.5％ (40/62 cases)] were significantly higher than those of the acquired urinary diseases group[43.9％ (18/41cases),43.9％ (18/41 cases)],and the differences were statistically significant(x2 =4.983,4.263,P =0.026,0.039).Conclusions The causes of CKD are complicated,and the congenital anomalies of kidney and urinary tract are the major causes of CKD at stage 2 to 5 in the cases.The initially diagnosed symptoms of CKD are insidious and atypical.The children with congenital hereditary urinary diseases tend to have more serious growth retardation.Urinary analysis and ultrasound may have an important significance for early diagnosis of CKD in children.

Objective To evaluate the effect of propofol post-conditioning on the expression of GluR1-containing AMPA receptors during cerebral ischemia-reperfusion (I/R) injury in rats.Methods Sixtyfour healthy male Sprague-Dawley rats,aged 7-8 weeks,weighing 250-280 g,were randomly divided into 3 groups (n =18 each) using a random number table:sham operation group (group S),I/R group and propofol group (group P).Focal cerebral ischemia was induced by occlusion of the middle cerebral artery for 1 h followed by reperfusion in I/R and P groups.Propofol was infused at 20 mg · kg-1 · h-1 for 2 h starting from the onset of reperfusion in group P,and the equal volume of normal saline was given in S and I/R groups.Fear conditioning test was performed on 7,14 and 28 days after operation.The time spent freezing induced by context and condition was recorded,and the percentage was calculated.The modified neurological deficit score (NDS) was measured at 24 h of infusion.The cerebral infarct size was measured by TTC.The hippocampal samples were isolated for determination of the expression of protein kinase A (PKA),A-kinase anchoring protein 150 (AKAP150) and AMPA receptor GluR1 subunit and phosphorylation of GluR1 at serine 845 (Ser845) site (pGluR1 Ser845).Results Compared with group S,the NDS and cerebral infarct size were significantly increased,the expression of PKA and pGluR1 Ser845 was down-regulated,and the percentage of time spent freezing induced by context and condition was decreased on 7 and 14 days after operation in I/R and P groups.Compared with group I/R,the NDS and cerebral infarct size were significantly decreased,the expression of PKA and pGluR1 Ser845 was upregulated,and the percentage of time spent freezing induced by context and condition was increased on 7 and 14 days after operation in group P.Conclusion The mechanism by which propofol postconditioning reduces cerebral I/R injury is related to phosphorylation of AMPA receptor GluR1 subunit in rats.

Objective To evaluate the effects of different ratios of medicine dosage for isoflurane and propofol on postoperative cognitive function of rats with mild cognitive impairment (MCI).Methods Healthy male Wistar rats,aged 16-18 months,were used in the study.MCI model was established by occlusion of bilateral common carotid arteries.One hundred and fifty rats with MCI were divided into 5 groups (n=30 each) using a random number table:sham operation group (group S),isoflurane group (group I),propofol group (group P) and different ratios of medicine dosage for isoflurane and propofol groups (IP1,2 groups).The rats inhaled 1.9％ isoflurane for 3 h in group I.Propofol 40 mg · kg-1 · h-1 was infused intravenously for 3 h in group P.The rats inhaled 1.0％ isoflurane,and propofol 20 mg · kg 1 · h-1 was infused intravenously for 3 h in group IP1.The rats inhaled 1.4％ isoflurane,and propofol 10 mg· kg-1 · h-1 was infused intravenously for 3 h in group IP2.After disappearance of eyelash reflex,open reduction and internal fixation was performed after tibial fracture was induced.On 7 days after operation,contextual fear conditioning test and Y maze test were used to assess the cognitive function,and hippocampal tissues were obtained to count the viable neurons (using Nissl's staining) and CCAAT/enhancer-binding protein homologous protein (CHOP) and caspase-12 positive neurons (by immunofluorescence) in hippocampal CA1 region.Results Compared with group S,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the number of CHOP and caspase-12 positive neurons were significantly increased in IP2,I and P groups (P＜0.05),and no significant change was found in the parameters mentioned above in group IP1 (P＞0.05).Compared with group IP1,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the number of CHOP and caspase-12 positive neurons was significantly increased in IP2,I and P groups (P＜0.05).Compared with group IP2,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the nunber of CHOP and caspase-12 positive neurons was significantly increased in I and P groups (P＜0.05).Conclusion Combination of 1.0％ isoflurane and propofol 20 mg · kg-1 · h-1 does not aggravate the postoperative cognitive dysfunction of the rats with MCI.