Objective To evaluate and compare the clinical effects of forward and reverse anterior cruciate ligament (ACL) reconstruction through the arthroscopy. Methods From April 2008 to August 2009,97 cases with simple ACL injures were treated with eight strands of hamstring tendons in way of two-bundle and four-tunnel reconstruction. The patients were randomly divided into two groups according to the number of hospital admissions: odd numbers (A group, 47 cases) were treated with forward double-bundle reconstruction and even (B group,50 cases) were treated with reverse. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. Mean follow-up exceeded one year. The function of knee joint were assessed by the IKDC, Lysholm and Tegner rating scale. Results Mean follow-up was 13.71 months.At the last follow-up, 2 patients in A group had a 10°extension deformity and 5 had a less than 15° flexion limitation. All patients in B group showed normal knee extension, and 4 had a 5° flexion limitation. According to Lachman test, there were one case with one plus positive and one with two plus positive in A group,and one with two plus in B. KT-1000 examination (30° flexion and 30 N) showed the side to side mean difference of anterior knee laxity was (1.04±1.11) mm in A group and (0.86±1.12)mm in B. According to objective IKDC evaluation, the results were graded as normal or nearly normal in 46 patients in A group and 48in B. There were no statistical differences in the IKDC, Lysholm, and Teguer scores between two groups.Conclusion Forward or reverse ACL double-bundle reconstruction with eight strands of hamstring tendons can both restore knee stability, and there is no significant deviation between the two techniques.

OBJECTIVE:To compare the efficacy and safety of tamsulosin or nifedipine or racanisodamine in the treatment of lower ureteral calculi. METHODS:160 patients with lower ureteral calculi were randomly divided into group A(40 cases),group B(40 cases),group C(40 cases)and group D(40 cases). All patients drank plenty of water to make daily urine output more than 2 000 ml. Based on it,group A orally received 0.4 mg Tamsulosin hydrochloride sustained release capsule,once a day. Group B orally received 10 mg Nifedipine tablet,3 times a day. Group C orally received 10 mg racanisodamine tablet,3 times a day. Group D received no other drugs except for increasing drinking. The treatment course for all groups was 2 weeks. Clinical efficacy,litha-gogue time,lithagogue size,residual calculi size and the incidence of adverse reactions in all groups were observed. RESULTS:The total effective rate in group A was higher than group C,which was higher than group B and group D,the differences were sta-tistically significant(P<0.05). Lithagogue time in group A was shorter than group B and group C,which was shorter than group D,the differences were statistically significant(P<0.05),while there was no significant difference between group B and group C (P>0.05). Lithagogue size in group A was more than group C,which was more than group B and group D,the differences were statistically significant(P<0.05),while there was no significant difference between group B and group D(P>0.05). Residual cal-culi size in group A was less than group B,which was less than group C and group D,the differences were statistically significant (P<0.05). And there were no severe adverse reactions in all groups. CONCLUSIONS:The efficacy of tamsulosin is superior to nifedipine and racanisodamine in the treatment of lower ureteral calculi,while nifedipine and racanisodamine show similar effica-cy,with better safety.

Starting with XIAO Zhi-jun case,this article discussed the construction of a harmonious physician-patient relationship,and the tendency that rules of law were emphasized excessively while ethics was overlooked existing in theoretical research and practice.However,this tendency was theoretically segmentary and practically harmful.By analyzing the correlations between law and ethics,the authors insisted on the mutual dependence between law and ethics and came up with a combination of law and ethics as a basic principle to build a harmonious physician-patient relationship.

Objective To investigate curative efficacy of interferon in combination with ganciclovir in treatment of herpes zoster and its effects on post herpetic neuralgia and IL-6, IL-10.Methods 106 patients of herpes zoster who received therapy in Heilongjiang electric power hospital from January 2014 to February 2015 were selected as research objects.Those patients were divided into control group(n=52) and observation group(n=54) by random number table.All patients were given symptomatic treatments, such as analgesia.Besides that, control group was treated with ganciclovir, while observation group was treated with interferon in combination with ganciclovir.Then, the curative efficacy of herpes zoster, incidence of post herpetic neuralgia, pain score of patients with post herpetic neuralgia and levels of inflammatory factors were compared.And during the treatment, adverse reactions were observed.Results After treatment, the total therapeutic efficacy ratio of herpes zoster in observation group and control group was 92.6% and 78.8% respectively with statistical difference(P<0.05).And incidence of post herpetic neuralgia in observation group and control group was 44.4% and 50.0% respectively with no statistical difference.Score of VAS which reflects pain in observation group after the treatment was statistically lower than that in control group in patients with post herpetic neuralgia(P<0.05).As to inflammatory factors, in comparison with control group, level of IL-6 in observation group was statistically lower [(137.6 ±32.4) pg/mL vs(340.5 ±30.6) pg/mL, P<0.05] and level of IL-10 was statistically higher [(179.3 ±22.5)μg/mL vs(150.6 ±24.1)μg/mL, P<0.05].During the treatment, there was no case of severe adverse reaction. Conclusion Interferon in combination with ganciclovir is effective for herpes zoster, which can significantly increase curative efficacy, alleviate pain degree of post herpetic neuralgia with minor adverse reactions .

Objective To explore the treatment of neuropathic pain,the combined use of parecoxib sodium after treatment based ontheuseoffentanyl on transparent paste.Methods In the period from August 2014 to August 2015 by the neuropathic pain patients in our hospital were selected in 38,they were divided intotwogroups,1groupsusingonlyfentanyltransparent paste treatment,2 group based on the use of fentanyl transparent paste on the combined use ofparecoxibsodium,comparingtwotreatmentsoftreatment effect.Results After five days,fifteen days and twenty-five days after treatment,the vas of the patients in the two groups was lower than that before the study,and there was a significant difference between the two groups(P<0.05).There is a big gap between the two groups(P<0.05).Conclusion Fentanyl transparent dressing in treating neuropathic pain can play an ideal therapeutic,for the use of a drug when the poor efficacy of the patient alone combined with parecoxib sodium can significantly improve the therapeutic effect.

Observations were carried out in 10 moderately well controlled diabetic patients on their usual therapeutic regimens from 10Pm to 10Am on two days.On the control day,samples were obtained without intervention.On another day,nocturnal hypoglycemia was induced.Nocturnal hypoglycemia did not appear to cause clinically important fasting and postprandial hyperglycemia in diabetic patients.It is sug- gested that the morning hyperglycemia is not caused by Somogyi effect but dawn phenomenom.

砄bjective:To study the characteristics of proliferation and differentiation of malignant ameloblastoma.Methods:The expression of PCNA,Ki 67, CK19 and CK10 and CK13 proteins in 17 cases of malignant ameloblastoma was detected immunohistochemically by SP method. Results: The proliferating indices of PCNA and Ki 67 were significantly higher in malignant ameloblastoma than those in benign ameloblastoma ( P

OBJECTIVE:To observe the effects of Paclitaxel,Cisplatin combined with Recombinant human (Rh) endostatin on the efficacy and related indexes of patients with non-small cell lung cancer(NSCLC). METHODS:78 patients with Ⅲb or ⅣNSCLC were randomly divided into control group(39 cases)and observation group(39 cases). Control group received Paclitaxel injection 135-175 mg/m2,d1,intravenous infusion,once a day+Cisplatin injection 25 mg/m2,3 times a day,d1-3,intravenous infu-sion. Observation group additionally received Rh endostatin injection 15 mg/m2,adding into 500 ml 0.9% Sodium chloride injec-tion by slow intravenous infusion 3-4 h,d1-14,then stopped for 7 d. 21 d was regarded as 1 treatment course,it lasted 6 courses. Clinical efficacy,programmed death ligand-1(PD-L1)level,quality of life(QOL)score before and after treatment,and the inci-dence of adverse reactions in 2 groups were observed. RESULTS:All patients completed 2 courses of chemotherapy. There were 3 patients in observation group and 4 patients in control group quitted the study with uncompleted 6 weeks of chemotherapy due to in-tolerance or adverse reactions. The remission rate in observation group was significantly higher than control group,with statistical significance (P<0.05). Before treatment,there were no significant differences in PD-L1 level and QOL score in 2 groups (P>0.05). After treatment,PD-L1 level and QOL score in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significance (P<0.05). And there was no significant difference in the incidence of ad-verse reactions in 2 groups (P>0.05). CONCLUSIONS:Paclitaxel,Cisplatin combined with Rh endostatin can improve the short-term efficacy of patients with NSCLC,inhibit PD-L1 expression,improve QOL,and do not increase the incidence of adverse reactions.

Objective To introduce the arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament through double posteromedial portal and "Y" shaped bony tunnel, and to evaluate the clinical results. Methods 33 cases of acute tibial insertion avulsion fracture of posterior cruciate ligament were treated arthroscopically through routine portal and double posteromedial portal. The high posteromedial portal was 4 cm proximal to the joint line, and the low posteromedial portal was just at the level of the joint line. The posterior cruciate ligament and avulsion bone fragment were held together with two USP 6 Aesculap polyester threads, which were first wrapped around the posterior cruciate ligament from anterior to posterior, and then tied behind the posterior cruciate ligament and over the bone fragment. The "Y" shaped bone tunnel was made with the common opening at the anteromedial aspect of the tibia and the tunnel arms opened backward at the inferomedial and inferolateral side of the tibial bed respectively. The threads were pulled out through the "Y" shaped bony tunnel and fixed on titanic button. With twisting of the button the threads were tightened and the fixation was insured. The patients were followed up for six months. Fracture reduction and union, knee stability, range of motion, as well as the total knee function were evaluated. Results All fractures were united without displacement. Six months postoperatively, except for one case with Ⅰ degree of positive posterior drawer test, no knee instability was detected; knee extension restored to normal in all cases and average range of flexion were 139??4.1?. 10? to 15? flexion limitation was found in 3 cases. The mean Lysholm knee score was 91.4?3.6. Conclusion Arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament is minimally invasive. The procedure through double posteromedial portal is appropriate, the use of "Y" shaped bony tunnel and button twisting are useful to assure the fixation.

Objective To introduce the way of arthroscopic patellar retinaculum adjustment and Fulkerson osteotomy, and to study its clinical results. Methods 35 cases of recurrent patella dislocation were treated by modified Fulkerson tibial tubercle anteromedial transfer, and arthroscopic patellar retinaculum adjustment including the medial retinaculum plication and lateral retinaculum releasing. The tibial tubercle was transferred 1.5 cm anteriorly and medially, and fixed with three Kirschner wires. The patients were followed for 25 months in average. The rate of reccurence, the subjective symptoms and the function of the injured leg were evaluated according to the IKDC and Lysholm rating scale. X-ray examination was taken to evaluate the patella-femur congruence. Results There were no recurrence at the last follow-up. Anterior knee pain, though in slight degree, still existed in 8 cases. The IKDC subjective knee scores were 37.4?4.9 and 92.1?5.3(P