Objective To compare medium-term therapeutic effect by bilateral and unilateral puncture plasma coblation nucleoplasty(PCN) in the lumbar disc herniation patients. Methods 90 cases confirmed no significant rupture of annulus fibrosus of lumbar disc herniation by CT or MRI were randomly divided into two groups. Bilateral and unilateral puncture plasma coblation nucleoplasty groups were respectively divided into group A and group B, and compared the JOA scores. Results 82 patients were followed up for 10 ～ 32 months,the average follow-up time was 16.2 months. Preoperative JOA scores of the two groups were not statistically significant(P ＞ 0.05) but the postoperative follow-up JOA scores were higher than preoperative(P ＜0.05) and the JOA scores of group A were higher than group B(P ＜0.05). Conclusion The medium-term therapeutic efficacy of bilateral puncture coblation nucleoplasty was superior to unilateral therpy.

Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

Objective To explore the clinical therapeutic effects of postoperative intracranial infection in neurosurgery.Methods Between January 2014 and January 2014,50 patients with postoperative intracranial infection in the department of neurosurgery in our hospital were selected in this study.Among the 50 patients,25 patients were treated by intravenous antibiotic therapy,15 patients were treated with intrathecal and intravenous antibiotics treatment,10 cases were treated by intrathecal injection,intravenous antibiotics and lumbar pool catheter drainage way for treatment,and then we observed the clinical therapeutic effect of three groups of patients.Results In 50 patients,37 patients were cured,3 cases had marked effect,8 patients had effect,2 patients had no effect.Conclusion For patients with neurosurgical operations,to maximally reduce the risk of intracranial infection,it is necessary to take antibiotics according to the actual situation of patients,and make different treatment schemes according to the difference of infection.

ObjectiveTo investigate the efficacy and toxicity of docetaxel combined with compound tegafur capsule(S-1)on anthracycline-refractory recurrent metastatic breast cancer (ARMBC).Methods Thirty-eight ARMBC patients were given intravenous 70 mg/m2 docetaxel at day 1,and oral 60 mg/m2 S-1twice every day at day 1 to 14.Every 3 weeks was one cycle and each patient received at least two cycles.ResultsAfter treatment,among these 38 patients,there was 2 complete response (CR) (5.3 ％),20 partial response (PR) (52.6 ％),10 stable disease (SD) (26.3 ％),and 6 progressive disease (PD) (15.8 ％).Overall objective response rate was 57.9 ％ (95 ％ confidence intervaal: 42.6 ％-74.2 ％) while clinical benefit response rate was 73.7 ％ (95％ confidence interval: 58.4 ％-89.1％).The median time to progression (TTP) was 7.8 months(95 ％ confidence interval:6.7-8.9 months),and median overall survival time(OS)was 15.7 months (95 ％ confidence interval: 12.9-18.8 months).The main toxic reaction was myelosuppression,and grade Ⅲ and Ⅳ adverse events including leucopenia occurred in 21.1％ of all cases.Most common grade Ⅰ and Ⅱ adverse events,such as hand-foot syndrome,nausea,vomiting,diarrhea,liver dysfunction,and oral mucositis,were tolerable.ConclusionGood clinical efficacy is achieved in the therapy of metastatic breast cancer with docetaxel and S-1 combination regimen and toxic reaction is tolerable.

Objective To investigate the role of cell apoptosis in the gut mucosal barrier dysfunction in rats undergoing cardiopulmonary bypass(CPB) . Methods The rat model of CPB was set up. The rats were divided into CPB group, sham operation(SO) group and normal control group. The morphological changes of ileum mucosal tissues were observed by microscope and electron microscope at 3h, 6h, 12h and 24h after operation, respectively. The apoptotic index of gut mucosal epithelial cells was measured with TUNEL method. Results Gut mucosal morphology was normal in CPB group at 3h, 6h and 12h after operation, but gut mucosal epithelial desquamation occurred at 24h after operation. Typical apoptotic cells could be seen with electron microscope in CPB group at every time point. Apoptotic index of gut mucosal epithelial cells significantly increased in CPB group at every time point compared with SO group, and peaked at 6h after operation. Apoptotic cells were mostly located in the gut crypt. Conclusion The data suggested that the apoptosis of intestinal epithelial cells significantly increased at early stage of post-CPB in rats, which might contribute to gut mucosal barrier dysfunction.

Objective To investigate the change of intestine mucosal permeability during cardiopulmonary bypass (CPB) and its effect on gut barrier in rats model. Methods The rats model of CPB was established and samples of tissue and plasma were collected at different intervals. Plasma D-lactate and LPS concentrations were determined and gut tissue was examined microscopically. Results The plasma concentration of D-lactate and LPS increased gradually at 1h CPB, and increased markedly 1h after CPB. They recovered to normal 8h after CPB, respectively. In addition, it was noted that there was a significant positive correlation between the plasma concentrations of LPS and D-lactate (r = 0.8312, P

OBJECTIVE:To observe clinical effects and safety of small dose of octreotide for preventing hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).METHODS:One hundred and twenty ERCP pa tients were selected from our hospital during Oct.2014-Jan.2015 and then divided in to observation group and control group in accordance with random number table,with 60 cases in each group.Both groups were given Diazepam tablet 10 mg+Meperidine hydrochloride tablet 100 mg+Phenobarbital scopolamine tablet 2 tablets 0.5 h before surgery for sedation and analgesia,and routine acid suppression and anti-infective therapy.Observation group was additionally given Octreotide acetate injection 0.1 mg hypodermically and then given Octreotide acetate injection 0.1 mg immediately after surgery,8 h after surgery.The levels of serum amylase and blood glucose were observed in 2 groups,and the occurrence of postoperative complication and ADR were recorded.RESULTS:Before operation,there was no statistical significance in the levels of serum amylase and blood glucose between 2 groups (P＞ 0.05).After operation,the level of serum amylase in control group was significantly higher than in observation group,with statistical significance (P＜0.05).There was no statistical significance in blood glucose level between 2 groups after operation (P＞0.05).The incidence of hyperamylasemia and ADR in observation group was significantly lower than in control group,with statistical significance (P＜0.05),and there was no statistical significance in the incidence of acute pancreatitis between 2 groups after operation (P＞0.05).CONCLUSIONS:Small dose of octreotide can effectively reduce the level of serum amylase and the incidence of hyperamylasemia after ERCP with good safety.

Objective To evaluate the efficacy of intermittent pneumatic compression or sequential compression device in prevention of deep venous thrombosis in long-term bedridden patients.Methods We searched Pubmed (1996～),The Cochrane Library (1997～),CLNAHL (1980～),CNKI (1994～),EM-BASE,Science Direct,Oxford Journals,Wanfang Data(1998 ～),and randomized controlled trials (RCTs) in which IPC or SCD was used as an intervention to prevent DVT,and all the trials were published in English or Chinese.The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review.RevMan 5.0 software was used for Meta-analysis.Results Seven RCTs were included.The results of Meta-analysis showed that the incidence of DVT in the IPC or SCD group was lower than that in the control group.Conclusions IPC or SCD shows an effective tendency in DVT prevention,but because of the low quality and the small sample of the included studies,this conclusion needs to be verified by protocols of more samples and higher quality.

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 investigate the causes and prevention of postpartum hemorrhage. Methods 84 cases with postpartum hemorrhage were analyzed. Results The main cause of postpartum hemorrhage was involved in poor contraction of uterus; The second cause was concerned with placenta; There was higher rate of postpartum hemorrhage after caesarean section than vaginal delivery. Conclusion It was necessary for preventing postpartum hemorrhage to strengthen antenatalcare, improve labor observe, decrease caesarean section.