[Objective]To analyze the treatment effect of degenerative scoliosis. [Method]A group of degenerative scoliosis patients and their symptoms,signs,imaging,treatment,treatment outcome,statistical analysis of clinical complications were analyzed. [Result]Degenerative lumbar vertebral height was lowered by scoliosis,the facet joint X-ray showed high density,joint process,and some patients MRI imaging performance for the lumbar spinal canal stenosis,nerve root compression. [Conclusion]Scoliosis propose severe degenerative lumbar degenerative disease concept : as the result of the lumbar vertebral height lower after the annex being not parallel with the extent of the decrease is the main reason leading to degenerative scoliosis,and the pathogenesis of idiopathic scoliosis contrary,health scoliosis cause sudden stress-induced arthritis of the joints is a major reason leading to low back pain.The clinical characteristics of severe back pain and / or nerve root pain or intermittent claudication and clinical classification : degenerative scoliosis patients divided into two main types :(1) in accordance with the breakdown of the causes of scoliosis : ①physiological; ②pathological scoliosis;(2) conducted in accordance with the germs are : ①ankylosis,②non-tonic type(third degree,second degree,first degree);(3)in accordance with lumbar scoliosis :①simple shapes into curved,② lumbar curved(lumbar mainly,affect some thoracic),③combined compensatory thoracic-lumbar bends.Treatment principles :in general,under the circumstances permit for scoliosis surgery,orthopedic principles : lumbar curving not totally stressed.

OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Objective To summarize the experiences and results of completed surgical treatment for double outlet of right ventricle in 135 cases.Methods From May 2007 to May 2012,135 cases with double outlet of the right ventricle,males are 79 cases,female are 56 cases,age from 25 days to 12 years,weigh is 3.5-30.0 kg,underwent surgical procedure.There were 89 cases subaortic ventricular septal defect,33 cases doubly committed ventricular septal defect,repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.There are 8 cases subpulmonary (Taussing-Bing)VSD,5 received Rastelli procedure,3 received arterial switch procedure and repaird VSD.There are 5 cases noncommited VSD,3 received Rastelli procedure,2 received arterial switch procedure and repaired VSD.Results Four cases died in the early postoperative period,with a mortality of 3.70％.1 case with subpulmonary VSD was performed arterial switch procedure and repaired VSD.1 case with noncommited VSD,2 cases with subaortic VSD(with pulmonary stenosis) were performed repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.1 case with noncommited VSD was performed Rastelli procedure.Conclusion The anatomic type,especially the position of ventricular septal defect,correlates with surgical strategy significantly.

Objective To conclude the preliminary results of aortic valve repair with autopericardium.Methods After routine median sternotomy the pericardium was isolated and immersed into the 0.6% glutaraldehyde immersion for 10 minutes, then rinsed off before use.Conventional extracorporeal circulation was established and diseased aortic valves were removed.The curves lengths between three commissures measured with the specific sizers.The corresponding size of the pericardial patchs was used to cut the new aortic leaflets.The continuous Johnson Prolene 4-0 sutures were used to fixed the new aortic valve leaflets to the anulus.Another new 4-0 prolene suture were used to fix the new three commissures outside the aortic wall with mat.The new mat stripes were used to fix the sinus in condition with the aortic sinus dilation or bileaflets malformation.Results Since 2015 October total 27 patients received aortic valve repair with autologous pericardium.The age was in the range of 27 to 60 years old including 18 female and 9 male.There were 7 cases diagnosed as aortic valve stenosis and 20 cases aortic insufficiency.And there were 3 cases bileaflets aortic valve deformity.The mean bypass time is(104±25)mins.Postoperative esophageal ultrasound showed good coaptation of the aortic valve without significant regurgitation.The mean transvalve gradient was(8.5±3.2)mmHg(1 mmHg=0.133 kPa).In the early stage one case diagnosed with aortic valve stenosis and regurgitation received monocusp repaired with autologous pericardial leave.But there was still moderate aortic regurgitation and had to receive the aortic valve replacement.All patients recovered well and were treated with Aspirin for 6 months.The followed up lasted for 3 to 13 months.Mean aortic occlusion time was(104±25) minutes.The patients were followed up for 3-13 months, the cardiac function and aortic valve function were stable, and no gradient increased.Conclusion It is relatively simple to perform the aortic valve repair with individual autologous pericardial sizer technique and the primary clinic results are satisfactory.It is worthy of further study and long-term follow-up.

OBJECTIVE To find the best way to evaluate the hearing threshold with the objectivethresholds of auditory brainstem response(ABR) and 40Hz auditory event related potential(40Hz AERP) . METHODS Pure tone audiometry,ABR and 40Hz AERP detection were performed in 120 recipients from whom 86 ears were available to be analyzed. According to the styles of configuration of hearing,we divided the 86 ears into 3 groups. There were 37 ears in flat style group,29 ears in descent style group,20 ears in ascent style group. The values were statistically analyzed with SPSS software. Correlations and multiple linear regression analysis were used in each group separately and three kind of mathematic models were established to estimate the subjective auditory thresholds. Then the models were simplified and tested. At last the models were checked out in 10 new recipients separately. RESULTS The pure tone audiometric threshold had good liner correlations with ABR and 40Hz AERP in three groups(R2=0.932,0.944,0.934) . In the flat style group,the subjective average auditory threshold can be estimated by ABR threshold. The predict mathematic model of the descent style group was 1/3(40HzAERP) +2/3ABR and the model of the ascent style group was 2/3(40HzAERP) +1/3ABR. Mean square deviation test showed equation manners were better than ABR means. CONCLUSION We can predict the subjective average auditory threshold more accurately than ABR only from ABR threshold and 40Hz AERP values with the predict mathematic models in young child and patients difficult to be test with subjective audiometry.

OBJECTIVE: To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery. METHOD: Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.
Adult ; Endoscopy ; Female ; Headache ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; Nose Diseases ; complications ; diagnosis ; surgery ; Ultrasonography ; Young Adult

Objective To summarize the clinical experiences in setting up cardiopulmonary bypass(CPB)using extracorporeal membrane oxygenation(ECMO)circuit and turning CPB to ECMO after open heart operations in 16 cases.Methods In the group of 16 cases,the annulations were via femoral vessels:by Medtronic ECMO machine and membrane oxygenator was used in all patients.All patients accepted A-V bypass.Results CPB was running smoothly during the operations,and converted to ECMO after the surgeries without complications,and the rate of ECMO withdraw was 93.75%.Mortality was 18.5%,and 81.25%of patients were discharged.Conclusion ECMO is an effective device for cardio and pulmonary support.Many patients with severe cardiac diseases and marginal cardiac function will need mechanical support after surgery.For these patients,setting up CPB using ECMO circuit during the operation and converting it to ECMO after surgery can prevent patients from additional exposure to a standard CPB circuitry.It helps decrease the inflammatory response,avoid dilution of patient's volume of cells and factors,and reduce expenses.

Objective To investigate a new strategy of bone marrow transplantation (BMT) for donor-specific tolerance induction after heart transplantation. Methods Donor bone marrow cells (BMCs)were harvested simultaneously with donor cardiac graft using modified perfusion method (PM) ,then stored in a -80 ℃ refrigerator after filtration and centrifugation. Whole BMCs (IBM-BMT) (monocytes 1.2 ×107/kg,CD34+ cells 2.38× 105/kg) in host iliac bones were injected into the bone marrow cavity 40 days after heart transplantation. Preconditoning regimens that consisted of fludarabine, antithymoctye globin and total lymphoid irradiation were performed 3 days before BMT. Tacrolimus (Tac) was administrated intravenously after BMT or orally in conjunction with mycophenolate mofetil (MMF) 3 weeks later.Cyclosporine and MMF were orally administrated 6 weeks later. Donor chimerism was detected using short tandem repeats-polymerase chain reaction in monocytes from peripheral blood at the 2nd,4th, 8th or 12th week after BMT or BMCs at the 4th, 8th or 12th week after BMT. Intramyocardium electrocardiography examination or endomyocardial biopsy was performed weekly or monthly respectively. Mixed lymphocyte reactions (MLR) were performed 3 months after BMT. Results Donor chimerism in monocytes in peripheral blood or BMCs in iliac bones measured at the 1 st,2nd and 3rd month after BMT was 26.3%, 19.1%,4.8% ,and 46.3%, 24.4%, 7.6%, respectively. After 3-month follow-up, there was no rejection confirmed by endomyocardial biopsy or intramyocardium electrocardiography. Echocardiography revealed that the diastolic and systolic function of the cardiac graft was maintained well 3 months after BMT. MLR revealed donor-specific hyporesponsiveness while immunocompetence was preserved to third-party antigens. Conclusion These findings indicate that the two-stage BMT strategy is a safe and feasible method for the induction of donor-specific tolerance via stable mixed chimerism and needs to be further confirmed after a long-term observation.

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