[Objective]To discuss the fault and its prevention of thoracolumbar vertebral fracture treated with pedicle screw.[Method]A retrospective study of 13 failure patients of thoracolumbar vertebral fracture were treated with pedicle screws from July 1998 to October 2007.The pedicle screw was found entering into the vertebral canal or being outside of the vertebral pedicle in 6 patients.The broken pedicle screw were found in 3 patients.The fixing position were fault in 3 patients and the system were loosen in 3 patients in the first X-ray photogram.One patient was misdiagnosed and 1 pedicle screw was broken within 6 months.[Result]Two patients refused any treatment.Eleven patients were followed-up in this group ( ranged from 6 months to 4 years,mean 15 months).The fixator were removed in 7 patients and 1 broken screw was left in the vertebral body.Another 4 patients were operated with new fixation and fusion in the second time.[Conclusion]The fixed approach of the vertebral pedicle root is narrow and small.Failure of internal fixation could only be avoided by means of careful reading Roentgen images preoperatively,fluoroscopical examination intraoperatively,and avoiding second implantation.

Based on the problems of the medical software laboratory such as heavy workload of software superposition management and maintenance,low resource utilization rate,difficulty in sharing,the paper takes Shanghai University of Medicine & Health Sciences as an example to introduce the construction of cloud desktop medical software laboratory based on the cloud computing technology,and analyze the using experience.This laboratory helps save costs,simplify deploymem,reduce the intensity of management work,so as to better serve for teaching.

Objective To discuss the efficacy and cosmetic effect of laparoscopic thyroidectomy for patients with thyroid diseases. Methods The clinical data of 160 patients who underwent laparoscopic thyroidectomy through the anterior chest approach were analyzed. The operation was performed under a pressure of 8 mm Hg within the surgical space at the neck. After the thyroid was separated completely, the lesions were resected using an ultrasound knife. Results Laparoscopic thyroidectomy was completed in 157 of the patients including 6 cases of papillary adenocarcinoma. The other 3 patients were converted to open surgery because of hyperthyroidisms complicated with intraoperative hemorrhage (1) or thyroid carcinoma complicated with lymph node metastasis (2). No severe complications involving the trachea and parathyroid occurred in this series. One patient with thyroid carcinoma developed transient hoarseness after the operation; one patient with nodular goiter had postoperative subcutaneous hemorrhage and hydrops; both of them were cured spontaneously. Postoperative hospital stay ranged from 3 to 5 days (mean, 4 days). The patients were followed up for 3 to 24 months with a mean of 6.8 months, during which none of them had recurrence. All the patients were satisfied with cosmetic outcomes of the surgery. Conclusion Laparoscopic thyroidectomy via the anterior chest approach is safe and feasible for patients with thyroid diseases with good cosmetic results.

Objective To study the effect and indication of the shape memory alloy(SMA)embracing fixator for treatment of clavicular fracture.Methods Thirty-six cases with clavicular fr acture were treated with SMA embracing fixator,of which 33we re middle third fracture and 3were between middle and lateral fracture.Results Thirty-five cases were followed up f or an average of 16months(from 8to 20months)and the average clinical healing was 2.8months(between 2and 4months).The results were evaluated accordi ng to Han Pingliang' s criteria and showed that 22cases wa s excellent,and 11cases was good.The excellent and good rate was 94.3percent.Conclusion The internal fixation with SMA embra cing fixator is less traumatic,stab le,safly effective to treat clavicular fracture.It is recommendable for treatment of clavicu lar fracture located in the middle an d proximal.The SMA embracing fixator must be pru dently used when the fracture is in th e curvature of clavicle.

OBJECTIVE:To put forward a proposal for the name standardization of Chinese herbal pieces. METHODS:Through searching literatures and analyzing each edition of Chinese Pharmacopoeia,the existing problems about the name of Chi-nese herbal pieces in the 2015 edition of Chinese Pharmacopoeia were found out to put forward solutions. RESULTS & CONCLU-SIONS:There are many non-standard problems,such as non-standard name of crude Chinese herbal pieces,non-standard name of processed Chinese herbal pieces,jingandganadded before the name of Chinese herbal pieces,pianadded after the name of Chinese herbal pieces. Based on these problems,suggestions for naming processed and non-processed Chinese herbal pieces were put forward,including noting processing method before the name of Chinese herbal medicines,adding processed form name after the name of Chinese herbal medicines,adding accessories name before the name of Chinese herbal medicines,maintaining the consistency and completeness of the names of Chinese herbal pieces and medicines,must markingshengwhen using toxic Chi-nese medicine pieces in medical treatment,and no appearing of the tablets in the name,etc.

OBJECTIVE:To study the pharmacokinetics of triptolide in Tripterygium glycosides tablet in normal rats and adju-vant arthritis model rats in vivo,and provide reference for clinical rational drug use. METHODS:12 SD rats were randomly divid-ed into normal group and model group,6 in each group. Model group was subcutaneously injected complete Freund's adjuvant 0.1 mL to induce adjuvant arthritis model,normal group was subcutaneously injected the same volume of saline. After 14 d model-ing,2 groups were given Tripterygium glycosides tablet suspension 96 mg/kg intragastrically,the blood sample of eyes 0.4 mL were respectively taken before and 10,30,45,60,90,120,150,180,240,300,420 min after administration. The plasma con-centration of triptolide was determined by HPLC,the pharmacokinetic parameters were calculated by DAS 2.0 software,and the parameters were compared. RESULTS:The pharmacokinetic parameters of triptolide in normal group were cmax of(1.139±0.114)μg/mL,tmax of(2.167±0.606)h,t1/2α of(5.500±3.610)h,AUC0-7 h of(5.052±0.371)μg·h/mL,MRT0-7 h of(3.224±0.119)h, and CL of(11.616±2.986)mL/h;and those in model group were cmax of(0.916±0.103)μg/mL,tmax of(3.083±0.801)h,t1/2αof(5.593±1.795)h,AUC0-7 h of(4.707±0.347)μg·h/mL,MRT0-7 h of(3.429±0.139)h,and CL of(11.246±2.638) mL/h. Compared with normal group,cmax in model group was significantly decreased,tmax and MRT0-7 h were significantly prolonged(P<0.05). CONCLUSIONS:Adjuvant arthritis can affect the pharmacokinetics of triptolide in rats in vivo,and promote its absorption and removal.

Objective To explore the effect of 10％ and 25％ oral glucose on neonatal pain during blood sampling through radial artery.Methods 90 newborns were randomly divided into group A,B and C,each group with 30 cases.2 min before the blood sampling,group A was offered 2ml 10％ oral glucose,group B was offered 2ml 25％ oral glucose,and group C was offered 2ml plain boiled water by oral intake.Pain was evaluated based on Neonatal Facial Coding System (NFCS),Neonatal Infant Pain Scale(NIPS),raise of heart rate and crying cases.Results The scores of NIPS during puncture,the scores of NFCS and NIPS after puncture,the raise of heart rate and crying cases were significantly different between three groups.Group B were lower than group A and group C,while differences between group A and group C had no statistical significance.Conclusions During blood sampling through radial artery,offering newboms 2ml 25％ oral glucose can reduce the pain,while 2ml 10％ oral glucose was ineffective.

Objective To investigate the effects of mild hypothermia on the expression of Dickkopf-1(Dkk1)in rats'brains after focal cerebral ischemia and reperfusion and to explore the molecular mechanism of any neuroprotective effects of mild hypothermia. Methods A focal cerebral ischemia and reperfusion model was established in rats by intraluminal filament occlusion of the middle cerebral artery.The adult rats were randomly divided into four groups:a sham-operation group,a sham-operation plus mild hypothermia group,a model group,and a model plus mild hypothermia group.The expression of Dkk-1 mRNA and protein in the ischemic cortex at different phases afterreperfusion were assessed using a reverse transcription polymerase chain reaction(RT-PCR),Western blotting and immunohistochemical staining.Results There was little expression of Dkk-1 mRNA or its protein in the sham-operation group or in the sham-operation plus mild hypothermia group.Expression of Dkk-1 mRNA and its protein began to increase after 2 h of cerebral ischemia and 3 h of reperfusion,with expression peaking at the 24th h after the start of reperfusion and then decreasing markedly.But expression was still stronger than in the sham-operation group at the 72nd h.At every reperfusion time point,expression of Dkk-1 mRNA and its protein were markedly less in the model plus mild hypothermia group than in the model group. Conclusion Dkk-1 probably participates in the pathologic process of injury caused by focal cerebral ischemia and reperfusion.Inhibiting the expression of Dkk-1 after focal cerebral ischemia and reperfusion is partly responsible for the neuroprotective effects of mild hypothermia.

Objective To study the influence of CRT brightness on image reading. Methods Both physical testing and compared viewing were used in the study. (1) Setting the CRT brightness at high and low grade (the blank brightness of CRT was 112 cd/m 2 and 82 cd/m 2, respectively). (2) 21 films with the density ranging from 0.27 to 2.71 were digitized by a scanner and displayed on the CRT. The brightness of CRT that varied with film density was measured by a bright meter, then the relation chart between CRT brightness and the film density was drawn. (3) Thirteen films on which there were many small and low contrast signals were viewed on CRT by three doctors. The tested data were calculated by statistics (? 2 test, the difference was significantly marked when P 0.05), but the signals viewed in the lung were 87 and 29, and the difference was significantly marked (? 2=53.73, P

BACKGROUND: Apoptosis secondary to ischemia and hypoxia is the main cause of spinal cord dysfunction. Because of the decrease in atmospheric pressure, patients living on the Qinghai-Tibet Plateau are in a hypoxic environment, which is very unfavorable for the recovery of spinal cord injury. Hyperbaric oxygen therapy can improve the postoperative function of patients with incomplete spinal cord injury, and its effect is better on the plateau than at normal altitudes.OBJECTIVE: To observe the effect of hyperbaric oxygen therapy on traumatic spinal cord injury in patients living on the Qinghai–Tibet Plateau.METHODS: This prospective, open-label, randomized controlled clinical trial was performed at the Department of Spine Surgery, Affiliated Hospital of Qinghai University, China. In total, 164 patients with incomplete traumatic spinal cord injury were equally and randomly assigned to a control group and a hyperbaric oxygen therapy group. Patients in the control group were treated with pedicle screw fixation and decompressive laminectomy. In addition to the surgical treatment performed in the control group, patients in the hyperbaric oxygen group underwent hyperbaric oxygen therapy at 0.2 MPa once a day for four treatment courses. Ten treatment sessions constituted one course, and each course was separated by a 5- to 7-day rest interval. The primary outcome was the modified Barthel index to assess activities of daily living. The secondary outcomes were the American Spinal Injury Association (ASIA) impairment scale grade, sensory score, and motor score. The study protocol was approved by the Ethics Committee of the Affiliated Hospital of Qinghai University, China (Approval number: QHC011K). Written informed consent was provided by a relative or legal representative of each patient after they had indicated that they fully understood the treatment plan. RESULTS AND CONCLUSION: The partial results demonstrated that after four treatment courses (55-61 days), the modified Barthel index and ASIA tactile, pain, and motor scores were higher in the hyperbaric oxygen group than in the control group. The ASIA grades were significantly different between the hyperbaric oxygen group and control group. The proportion of patients with ASIA grades D and E was higher in the hyperbaric oxygen group than in the control group. In this trial, we aim to determine the efficacy of hyperbaric oxygen therapy on the treatment of incomplete traumatic spinal cord injury in patients living on the plateau and to provide clinical evidence for treating incomplete traumatic spinal cord injury in these patients.