ObjectiveTo study the clinical effect of sodium aescinate on the edema of limb tibial plate fracture.Methods69 patients with edema of limb of tibial plate fracture were randomly divided into two groups,treatment group(46 cases)and control group(23 cases).Both of them were transfused with 20％ mannitol(250ml,Bid ×7days).In addition,these patients in the treatment group were treated with sodium aescinate(30mg Qd × 7days).ResultsThe repercussive effect of the edema grade in the treatment group were obviously better than those in the control group(P ＜0.05 ).ConclusionSodium aescinate had a remarkable repercussive effect on the limb edema of tibial plate fracture.

It is proved that there are significant differences in individual susceptibility to lung cancer.Genetic polymorphisms of several enzymes involved in the detoxification and biotransformation might be related to the lung cancer susceptibility.Cytochromes P450,N-acetyltransferases,microsomal epoxide hydrolase,NQO1 are the most frequently investigated genes in recent years.All theses genes appear to be the candidates for lung cancer susceptibility genes.The studies of the relationship between polymorphisms of metabolic enzymes and lung cancer susceptibility will help to find useful biomarkers.An improved understanding of genetic polymorphisms may help to identify individuals who are at increased risk for lung cancer and decrease the incidence of lung cancer.

[Objective]To demonstrate mechanism of ESW in curing osteogetic disorders,we studied expression of some osteogenetic factors in human mesenchymal stem cells(hMSCs)when exposed to ESW.[Method]After success in marrow aspiration,isolation and obtainment optimal experimental energy,a dose of 5kV and 100 times of ESW was applied to hMSCs of passage 1.The expression of IGF-Ⅰ and TGF-?1 were examined by immunocytochemical staining.[Result]The cytochemical staining results showed that expression of IGF-Ⅰ and TGF-?1 appeared at different passage of hMSCs after ESW intervention.Appearance of IGF-Ⅰ was earlier than TGF-?1 which didnt express until passage 7.At the same interval,the expression of IGF-Ⅰ and TGF-?1 in control group difference is lower than ESW group,respectively(P

OBJECTIVE:To study the effects of topirmate on proliferation of neural stem cells in vitro.METHODS:Primary neural stem cells from newborn mice were cultured.The neural stem cells were incubated together with topiramate at 0.4,2 or 10 ?mol?L-1.A vehicle control and positive control were set up,respectively.The quantity and viability of neural stem cells newly generated were analyzed by a convert phase microscope,the neurosphere numbers were counted,and neural stem cells viability was determined and a MTT assay.RESULTS:The number of neurospheres of groups treated with topiramate at 2 and 10 ?mol?L-1 are 20.67?4.04,49.68?3.79,respectively,and the value of MTT assay of the two groups are 0.354 6?0.070 5,0.501 8?0.036 9,it was higher than the vehicle control neural stem cells(7.34?2.31、0.288 0?0.009 3,P

Objective To investigate the influence of duodenal diverticula on cannulation time and complication in patients undergoing ERCP.Methods Data of 3 265 patients undergoing ERCP in Drum Tower Hospital affiliated to Nanjing Medical University between January 1,2008 and December 31,2014 were enrolled.The patients' information and endoscopic pictures/videos were collected.The duodenal diverticula,cannulation time,postoperative complications were analyzed.Results There were 2 599 (79.6％) cases of non-diverticula,445(13.6％) cases of one-diverticula,122(3.7％) patients with two or more diverticula,and 99 (3.0％) intradiverticular papilla.Patients with duodenal diverticula accounted for 20.4％ (666/3 265) of all patients who received ERCP procedure.The mean cannulation time was 6.62 minutes in all cases,6.30 minutes in non-diverticula group,7.63 minutes in one-diverticula group,8.07 minutes in two-or-more group,8.58 minutes in intradiverticular papilla group,respectively.There were significant differences in cannulation time and complication rate between the groups.Conclusion Duodenal diverticula may be one of the factors that affect the cannulation time.It may enhance the cannulation complications and prolong the cannulation time,especially in those with intradiverticular papilla.

OBJECTIVE:To investigate the role of clinical pharmacists in the drug treatment of infected patients in neurosur-gery department. METHODS:Clinical pharmacists participated in the formulation of anti-infective treatment plan for a infected case after meningioma surgery. According to drug antibacterial spectrum,result of laboratory and image examinations and disease condition of patients,etc.,the patient was given cefoperazone sodium and sulbactam sodium (3 g,ivgtt,q8 h),rifampicin (0.45 g,ivgtt,q12 h)and vancomycin(1 g,ivgtt,q12 h);the body temperature of the patient increased again and clinical pharmacist suggested meropenem 1 g,ivgtt,q8 h and vancomycin 1 g,ivgtt,q12 h. RESULTS:After 53 d treatment,infection was timely brought under control. The patient was discharged from hospital after improved on 72th day. CONCLUSIONS:Through the partici-pation of clinical pharmacists in pharmaceutical care for anti-infective drug treatment in neurosurgery department contribute to ratio-nal drug use in the clinic and guarantee the safety of drug use.

Objective To evaluate the efficacy and safety of endoscopic therapy in the treatment of symptomatic pancreatic divisum (PD).Methods Data of 8 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with the diagnosis of pancreas divisum at our institution from June 2006 to June 2013 was retrospectively analyzed.Results The patients were identified as pancreatic divisum with 28 ERCP procedures.All patients received stent placement,7 underwent minor papilla sphincterotomy,6 pancreatic duct stricture dilatation,and 1 stone extraction.Post-endoscopic retrograde cholangiopancreatography pancreatitis occurred in 1 patient,and no other complications occurred.After a follow-up of 2-47 months,1 patient died of pancreatic carcinoma,3 patients removed the stents,3 patients were followed up regularly,and 1 was unavailable for the interview.The episode of chronic pancreatitis and the extent of abdominal pain decreased after the operations.Conclusion Endoscopic therapy is effective and safe for the pancreatic divisum patients.It can reduce the episode of chronic pancreatitis and relieve the chronic abdominal pain in PD patients with low incidence of complication.

BACKGROUND:Self-made Distraction Reduction Fixation System is characterized by Distraction Reduction Fixation functions,which can completely fuse to the design of steel plate,and by no need to provide many surgical instruments,by reduction of bleeding and trauma.OBJECTIVE:To test changes in the stiffness of porcine short spinal segments in integrity and following destabilizing and internal fixation of the Distraction Reduction Fixation System.DESIGN,TIME AND SETTING:The control observation experiment was performed at the Laboratory of Biodynamics,Institute of Onhopedics,General Hospital of Chinese PLA from December 2004 to December 2005.MATERIALS:Twelve fresh porcine lumbar spines(T11-S2 segments)were bought from a market.Upper and lower segments were crossed and inserted with Kirschner wire to make porcine spine samples of the L1-7 segments.METHODS:Stiffness of intact samples was recorded during forward-bending,backward-bending,lateral-bending and axial rotation.Intervertebral discs,facet ioints,anterior and posterior longitudinal ligaments were removed to loose the spine.Stifrness of each motion was measured.Stiffness tests were repeated again after internal fixation on short segments using Distraction Reduction Fixation System.MAIN OUTCOME MEASURES:Stiffness in the intact,unstable and internal fixed spines during each motion.RESULTS:The stiffness iu unstable porcine spine were significantly lower than those in intact porcine spine(P<0.05),but the stiffness after internal fixation was significantly higher than in unstable porcine spine(P<0.05).No significant difference was detected in stifiness during forward-bending,lateral-bending and axial rotation(P>0.05)except that it was significantly higher during backward.bending after internal fixation compared with the intaet spine(P<0.05).CONCLUSION:Biodynamics confirms that the stiffness in short-segment fixation porcine after using Distraction Reduction Fixation System is markedly increased than in unstable porcine spine,except during backward-bending,which is comparable with that in intact porcine spine.

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.

objective To evaluate the clinical effect of touqing capsule associated with Fengchi on the vertebral artery type of cervical spondylosis(CSA)in the attack stage.Methods A total of 100 patients with CSA, according to the doctor order, were randomly divided into a control group and a treatment group respectively, with 50 patients in each. The control group was treated with acupuncture therapy, the treatment group was additionally treated with Touqingcapsule on the basis of the control group, and both groups were treated for 20 days. The hemodynamics was detected by transcranial doppler, the change of TCM syndrome integral was observed before and after the treatment, and the clinical efficacy was evaluated.Results After treatment, the treatment group dizziness (1.10 ± 0.33 vs. 2.01 ± 0.26,t=14.909), neck shoulder ache (0.87 ± 0.16 vs. 1.92 ± 0.69,t=10.266), numbness (0.95 ± 0.14)vs. 1.87 ± 0.16,t=29.844), the total integral (2.16 ± 0.75 vs.3.89 ± 1.14,t=8.756) integral were significantly lower than the control group(P<0.01).Treatment group RVA (40.03 ± 5.89 cm/svs. 34.26 ± 6.26 cm/s,t=4.628), the LVA (42.14 ± 5.42 cm/svs.33.89 ± 6.08 cm/s,t=6.985) rise and PI (0.79 ± 0.14 vs.1.04 ± 0.19,t=7.312) reduction were significantly better than those of the control group (P<0.01). The total effective rate in the treatment group was significantly better than the control group (91.7%(44/48)vs. 74.5%(35/47),χ2=3.863, P=3.863).Conclusion Touqing Capsule associated with Fengchi is effective for CSA. Its functional mechanism is correlated with improvement of haemodynamics of vertebral-basilar artery of the CSA patients.