Objective To study proloning the surviving time limit of servered skeletal muscle through intermittent ischemia Methods We use canine gracilis as experimental object to observe its changes by"4C" (colour,capillary bleeding,contractility and consistency of muscle),succinic,dehydrogenase and electron microscope Result (1) At normal temperature the ischemic time limit of skeletal muscle was 7 hours (2) At low temperature (4℃),the surviving time limit of skeletal muscle was 15 hours.(3) However, intermittent ischemia, the surviving time limit of skeletal muscle was 25 hours. Conclusion Intermittent ischemia can prolong the surviving time limit of skeletal muscle obviously So, intermittent ischemia may be used as a new better method of servered limb perservation

Objective To retrospectively analyze the indication of endosseous dental implant,evaluate the effectiveness of clinical application of endosseous dental implant for tooth loss,and study the possible factors which may affect the success rate of implant denture.Methods One hundred and fifty-seven endosseous dental implants in 94 patients were followed up for 4 months to 8 years.The indications of endosseous dental implant were studied based on the changes in the distribution of dental implants in jawbone.The success rate of osseointegration and restoration of the endosseous dental implant were evaluated by checking the soft tissue around the implants,the stability of the implants,the bone resorption around the implants,and the degree of stability against rotation of the implants.Results The rate of performing endosseous dental implant for restoration of full-mouth anodontia was 7.6%,the rate of endosseous dental implant used in the free end anodontia was 25.5%,and it was 66.9% in non-free end anodontia.The success rate of osseointegration in the endosseous dental implant was 98.1%,and 5 years after prosthesis the success ratio of the endosseous dental implant was 93.8%.The success ratio of the endosseous dental implants which the primary stability(anti-rotation torsion)

Objective To observe the effects of 6%hydroxyethyl starch(Volven 130/0.4)infusion on hemodynamics and coagulation.Methods 60 cases of open heart surgical children under cardiopulmonary bypass were randomly divided into two groups(30 cases for each):The control group(group C)were infused with 400 ml plasma and volven group(group V)were infused with 400 ml Volven before cardiopulmonary bypass.Then mean aterial pressrue(MAP),heart rate(HR),and central venous pressure(CVP)were measured.The venous blood samples were collected before and after infusion for the measurements of the following parameters:haematocrit(HCT),blood sedimentation(BSR),platelet count(PLC),prothrombin time(PT),and activated whole blood clot time(ACT).Those indexes before operation,15 min after bypass,after returning to ICU,and 24 hours after operation were observed.Results HCT and PLC after infusion were significantly lower than that before infusion.BSR after infusion was significantly faster than that before infusion.There were no significant changes in MAP,HR,CVP,PLC,ACT and PT.Conclusion 6%Hydroxyethyl starch infusion is safe and beneficial during cardiopulmonary bypass.

BACKGROUND: Many studies have shown that different types of anterior cervical surgery in the treatment of two-level contiguous cervical disc herniation can obtain satisfactory results, but which method is the best has not yet reached a consensus. OBJECTIVE: To compare the efficacy and safety of three types of anterior cervical surgery for treating two-level contiguous cervical disc herniation. METHODS: We retrospectively analyzed clinical data of 62 patients with two-level contiguous cervical disc herniation who underwent anterior decompression and fusion. These patients were assigned to three groups. Bone graft group received anterior cervical discectomy with autogenous iliac bone graft fusion. Titanium mesh group received anterior cervical corpectomy with titanium mesh fusion. Cage group received anterior cervical discectomy with cage fusion. Fusion rate of bone graft and improvement of neurological function (Japanese Orthopaedic Association Scores) were evaluated and compared after treatment in the three groups. Cervical vertebra anteroposterior and lateral images were used to measure height of anterior and posterior margin of vertebral body and Cobb angle changes of fusion segment. RESULTS AND CONCLUSION: Al 62 patients were fol owed up and the fol ow-up time was ranged from 8 to 30 months. Operation time was significantly longer in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Intraoperative blood loss was larger in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Japanese Orthopaedic Association Scores were significantly improved after treatment (P < 0.05). No significant difference was found at different time points (P > 0.05). The fusion rate of bone graft was higher in the bone graft group than in the titanium mesh and Cage groups (P < 0.05) at 3 months after treatment, and bone union was found in the final fol ow-up. Height of anterior and posterior margin of vertebral body was significantly increased after treatment (P < 0.05). No significant difference in the increase of the height of anterior margin was detected among the three groups (P > 0.05). The increase in the height of posterior margin was higher in the Cage group than in the bone graft group and titanium mesh group (P < 0.05). Vertebral height loss of the anterior margin was higher in the bone graft group than in the titanium mesh and Cage groups, but vertebral height loss of the posterior margin was highest in the bone graft group, fol owed by titanium mesh group and Cage group at 3 months after treatment (P < 0.05). The increase value of Cobb angle was higher in the titanium mesh group than in the bone graft group and Cage group (P < 0.05). At 3 months after treatment, the altered value of Cobb angle was highest in the bone graft group, fol owed by titanium mesh group and Cage group (P < 0.05). No significant difference in the height of anterior and posterior margins of the vertebral body and Cobb angle was detectable between final fol ow-up and 3 months post-treatment (P > 0.05). These findings indicated that the three kinds of fusion method for treating two-level contiguous cervical disc herniation could obviously lessen nervous systems and improve cervical vertebra functions. In the bone graft group, operation time was long. Intraoperative blood loss was more. Postoperative height loss of the posterior margin of the vertebral body was visible. Cervical lordosis could be easily induced. Compared with the bone graft group, titanium mesh and Cage groups could better maintain the height and curvature of the cervical vertebra, but the Cage group had apparent advantages.

BACKGROUND:Several studies have demonstrated embryonic stem cells induced neural precursor cells can promote functional recovery in rats with spinal cord injury.
OBJECTIVE:To study the effect of in vitro cultured embryonic stem cells induced neural precursor cells in rats with spinal cord injury.
METHODS:Total y 144 rats were randomly divided into three groups. Experiment group and control group rats had spinal cord transection injury. Embryonic stem cells-derived cells were injected into the vertebral canal at rostral and caudal segment perilesional y for the experiment group whereas PBS solution was injected instead of cells in the control group. Sham surgery group rats had only laminectomy without any spinal cord injury and treatment.
RESULTS AND CONCLUSION:The experimental result showed that at day 21 post-injury, the regional expression of transforming growth factor-β1 was greater in rats from the control group in comparison to the experiment group (P<0.05). At each time point after spinal cord injury in rats, the expression of myelin basic protein in the spinal cord was significantly higher in the experiment group than the control group (P<0.05). After celltransplantation, Basso, Beattie, and Bresnahan scores of the experiment group at different time points were significantly higher than those of the control group (P<0.05). Transplantation of in vitro cultured embryonic stem cells induced neural precursor cells can reduce the late expression of transforming growth factor-β1, and can increase the expression of myelin basic protein which contributes to the recovery of rats with completely transected spinal cord injury.

BACKGROUND:Currently, discectomy, fusion or decompression is considered an effective and conventional method for the treatment of spinal disease. Although there have been many reports on the adverse effects of diabetes on spinal surgery, but there are stil some differences. OBJECTIVE:To systematical y evaluate the observational studies and case-control studies about the effect of diabetes on the complications of spinal surgery. METHODS:The control ed and comparative studies regarding the effect of diabetes on the results and complications of spinal surgery were searched from the database according to the inclusion criteria. The observed indicators including mortality, revision rate, surgical site infection, the incidence of venous thrombosis, blood loss, operative time and hospitalization time. Two authors participated in extracting the data and evaluating the methodology and quality of the included studies. Meta-analysis was conducted according to the guidelines of epidemiological observational studies (MOOSE). The risk assessment of the extracted data was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION:Eighteen literatures, involving 2 824 063 patients, were eventual y enrol ed. The experimental result showed that the mortality, surgical site infection, incidence of venous thrombosis of diabetic patients after the spinal surgery were significantly higher than those of non-diabetic patients;the hospital stay was significantly longer than that of non-diabetic patients (P<0.05). There were no significant differences in the risk of revision, intraoperative blood loss and operation time between diabetic patients and non-diabetic patients (P>0.05). These results suggest that diabetic patients take a higher risk once accepting the spinal surgery than the non-diabetic patients. Diabetes increases the risks of postoperative mortality, surgical site infection, venous thrombosis and hospitalization time after spinal surgery.

Objective]To evaluate the reliability and validity of Chinese version of the Pediatric Quality of Life Inventory PedsQL multidimensional fatigue scale among short stature.[Methods]The Cross-sectional surveys was made using this Chinese scale. A total of 570 children and adolescents and their parents were investigated. 522 valid questionnaires were collected,of which 138 were short stature and 384 with normal height ,Analysis feasibility ,reliability and validity of this Chinese version scale.[Results]Cronbach alpha coefficients of the parent-proxy report was 0.89,the dimensions ranged from 0.75 to 0.87,Cronbach alpha coefficients of the child self-report was 0.86,the dimensions ranged from 0.70 to 0.80;Test retest reliability was satisfied for intra-class correlation coefficient(ICC)exceeded 0.9 in all dimensions. Correlation coefficients between items and their belong dimensions higher than those with other dimensions;The result of confirmatory factor analysis indicated the main indexes χ2/df = 2.62,CFI =0.93,TLI=0.92,NFI=0.89,RFI=0.87,IFI=0.93,RMSEA=0.056 of self-report andχ2/df=3.12,CFI=0.94,TLI=0.92, NFI=0.91,RFI=0.89,IFI=0.94,RMSEA=0.064 of proxy-report all met the criteria of psychometrics.[Conclusion]The Chinese version of PedsQL Multidimensional Fatigue Scale has good feasibility ,reliability and validity ,and can be used to evaluate the fatigue of short stature in children and adolescents in Chinese cultural background.

Objectives To study the risk factors for influencing recrudescence after endovascular embolization of intracranial aneurysms and to establish a regression model to predict the risk of recrudescence in patients with specific intracranial aneurysm after endovascular embolization. Methods From May 2012 to May 2014,429 patients (a total of 441 aneurysms)with intracranial saccular aneurysm who met the inclusion criteria and treated with endovascular embolization at the Cerebrovascular Treatment Center, Changhai Hospital,the Second Military Medical University were analyzed retrospectively. Multiple aneurysms were calculated separately according to per aneurysm. The aneurysms were divided into either a recurrent group (n = 66)or an unrecurrent group (n = 375)according to whether they had recrudescence or not. The differences of 11 factors such as clinical features,treatment technology and materials,and aneurysm anatomy of both groups were compared. Logistic regression was used to analyze the risk factors for recrudescence after endovascular embolization of intracranial aneurysms,and its effectiveness of predicting recrudescence was evaluated. Results There were significant differences in the size of aneurysms (χ2 = 46. 352,P <0. 01),rupture or not (χ2 = 4. 198,P = 0. 040),using stents or not (χ2 = 9. 554,P = 0. 002),and results of immediate postoperative embolization (χ2 = 10. 397,P = 0. 003). The results of multivariate logistic regression analysis showed that non-stent-assisted embolization (OR,4. 076,95% CI 2. 147 -7. 736,P <0. 01),Raymond grade Ⅱ (OR,4. 222,95% CI 1. 537 -11. 579,P = 0. 005),Raymond grade Ⅲ (OR, 4. 467,95% CI 1. 600 -12. 470,P =0. 004),large aneurysms (> 10 -25 mm)(OR,4. 914,95% CI 2. 277 -10. 604,P < 0. 01),and giant aneurysms (> 25 mm)(OR,35. 743,95% CI 3. 511 -363. 837,P = 0. 003) were the risk factors for recrudescence after aneurysm embolization. The effective test results of the regression model in predicting recrudescence showed that the area under the curve of the recrudescence predicting model was 73. 5% . Raymond grade was 56. 6%,and the non -stent embolization was 60. 1%,and the size of aneurysms was 40. 3% . Z test was used to calculate the differences of recurrent scores and non-stent embolization,Raymond grade,the area under ROC curve of aneurysm size. The Z values were 2. 662, 3. 513,and 6. 308,respectively,and the P values were 0. 007,0. 004,and 0. 001,respectively. Conclusions Large or giant aneurysms,non - stent - assisted embolization,incomplete embolization immediately after procedure were associated with the recrudescence after endovascular embolization of intracranial aneurysms. The established regression model may reflect the size of the recurrent risk.

The postoperative evaluation of cleft lip is an important means to improve the operation method and the effect of the restoration. In recent years, the methods of cleft lip repair, such as Chinese western rotary propulsion, reconstruction of labial and nasal muscle tension band+trefoil flap, etc., have been developed. However, at present, there are still many secondary deformities, such as obvious scars and alar collapse. In this paper, in a review of the previous literature, the existing methods, advantages and disadvantages, and the application of the evaluation of the postoperative effect of cleft lip were reviewed. To date, there are many methods that can be used to evaluate the effect of cleft lip surgery. These research methods can be divided into subjective evaluation and objective evaluation, such as subjective evaluation, direct measurement, photo measurement, and three-dimensional scanning measurement. Among them, the subjective evaluation is simple, but the reliability is poor, and this method is suitable for all patients with cleft lip. The direct measurement has a low cost and is only suitable for one-dimensional information measurement, but the accuracy is poor, so it is difficult to determine the endpoints. The time of the photo measurement method is short, which can avoid tissue deformation, but it is easy to produce errors; this method is suitable for patients with cleft lip who can cooperate. The three-dimensional scanning measurement has a high accuracy, is time consuming and is a simple method but has a high cost and is suitable for areas with appropriate equipment conditions. Overall, the evaluation of the postoperative effect of cleft lip surgery should combine subjective evaluation with objective evaluation, dynamic evaluation with static evaluation, and utilize long-term follow-up to obtain comprehensive and accurate information and provide a reference for clinicians to carry out cleft lip surgery.

Objective: To evaluate the performance of a chromogenic agar developed by our laboratory for the isolation and culture of Clostridium difficile (CDCA). Methods: The chromogenic specificity of CDCA was evaluated by inoculation of C. difficile and other standard strains, and the sensitivities of CDSA (BD), CDIF (BioMérieux) and CDCA were determined by the C. difficile standard strains respectively. A total of 120 clinical stool specimens were cultured for C. difficile by three chromogenic media respectively. The colonies were further identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and tpi gene was also detected. The sample which could be identified as C. difficile in any of the three chromogenic medium was defined as true positive. Results: Most of standard strains were inhibited by CDCA, however some Clostridium species including C. clostridiiforme, C. bifermentans, C. tertium and Bacteroides fragilis grew lightly with chromogenic reaction. The sensitivities of CDSA, CDIF and CDCA were 2.0×105 CFU/mL, 8.0×101 CFU/mL and 4.0×10 2 CFU/mL, respectively. Among the 120 samples, 31 (25.8%) were defined as true C. difficile positive samples, while the positive rate of CDSA, CDIF and CDCA were 25 (20.8%), 28 (23.3%) and 26 (21.7%), respectively. There was no significant difference for clinical diarrhea specimens among the three chromogenic media (χ 2 =0.418, P=0.811). In comparison to the standard, the sensitivity, specificity, positive predictive value and negative predictive value were 83.8%, 100%, 100% and 94.7% for CDCA; 90.3%, 98.9%, 96.6% and 96.7% for CDIF; and 80.6%, 100%, 100% and 93.7% for CDSA. Conclusion The CDCA developed by our laboratory could be used to preliminarily isolate C. difficile with good specificity and sensitivity.