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 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 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.

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.

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.

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

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.

To meet the needs of society,the Academic Degrees Committee of the Chinese State Council set up a Medical Degree in 1998 to train senior clinicians.In order to reveal the influencing factors of the education quality of clinical medicine doctoral programmes,this paper used a questionnaire to evaluate the education experience of clinicians with clinical MD degrees of Peking University Health Science Center.

Objective To explore the application value of thromboelastography(TEG) in perioperative evaluation of patients with antiplatelet therapy-associated cerebral hemorrhage. We aimed to investigate whether platelet transfu-sion, compared with standard care, reduced bleeding in patients with antiplatelet therapy-associated cerebral hemor-rhage. Methods A retrospective analysis of clinical data was conducted in 30 patients (12 patients receiving platelet transfusion) with antiplatelet therapy-associated basal ganglia hemorrhage who underwent emergency surgery. TEG was used to evaluate the intraoperative bleeding, postoperative bleeding and transfusion treatment. Results The routine co-agulation test was in the normal range in the two groups. However, TEG showed that the platelet function was exces-sively inhibited in patients with antiplatelet therapy before spontaneous cerebral hemorrhage (Platelet inhibition rate>90%). There were significant differences in the intraoperative blood loss (t=-3.998, P=0.008), total transfusion volume (Z=-3.245, P=0.001), postoperative hematoma volume (t=-2.909, P=0.043) and lead volume (t=-8.790, P=0.041) between two groups (P<0.05). One case from platelet transfusion group, and 4 cases from no-platelet transfusion group re-ceived a second surgical operation. However, the difference was not statistical significant ( P=0.317). Conclusion TEG can effectively assess the preoperative coagulation status in the patients with spontaneous cerebral haemorrhage after antiplatelet therapy. Platelet transfusion can reduce intraoperative and postoperative bleeding, decrease blood transfu-sion in the patients with antiplatelet therapy-associated cerebral hemorrhage.

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.