[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 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 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 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.

Purpose　The aim is to modify the pyrogenic pathol ogy mo del induced by injection of saccharomycetet water in rats,and to eliminate the t emperature decline period after injection of saccharomycete water sc.Metho ds　It was measured that the anus temperature of both two groups of rats (one group was injected of incubated saccharomycete water and the other inj ected unincubated saccharomycete water sc) 1,2,3,4,6,8 h after injection respect ively.Results　The anus temperature had no decline period and the temperature rose quickly in the group of injected with incubated saccharomyc ete water (in 34℃thermostasis water).There was significant difference(P＜0.05 or P＜0.01)between incubated group and unincubated group in temperature risin g by t-test.Conclusion　No temperature declining peri od was observed in the pyrogenic pathology model of rat, if those rats were trea ted with saccharomycete water which was incubated at 34℃for 0.5 h.

Objective To investigate the effect of flow management of cerebral perfusion during aortic arch surgery on the neurological complication.Methods From March 2007 to November 2011,189 patients underwent aortic arch surgery with hypothermic circulatory arrest plus antegrade cerebral perfusion in our department.The clinical data were analyzed retrospectively.According to the different methods of cerebral perfusion flow nanagement,patients were divided into two groups.Single pump with double limb (to the lower body and brain) perfusion was used in group A (96 patients),based on natural distribution of petfusion flow without control.Modified flow management was used in group B (93 patients).A magnetic flow sensor probes was installed on the brain perfusion limb to monitor and control the cerebral perfusion flow precisely (10 ml · kg-1 · min-1).Postoperative neurological complications were compared between two groups.Results There was no significant difference between the two groups in CPB time,aortic clamping time and circulatory arreating time.However,the morbidity of postoperative neurological complications in group B was much lower than that in group A (1.1％ vs 5.2％,P ＜0.05).Conclusion When performing antegrade cerebral perfusion during aortic arch surgery,precisely control of cerebral perfusion flow can reduce the morbidity of postoperative neurological complications effectively.

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.