Objective To compare the application of debridement combined with vacuum sealing drainage (VSD) versus debridement combined with conventional dressing change in patients with subscalp infection following surgical treatment of traumatic brain injury (TBI) and investigate the effect of VSD in treatment of wound infection associated with surgery for TBI.Methods A retrospective review was conducted on clinical data of 60 TBI patients with combined wound infection after decompressive craniotomy between August 2005 and January 2012.According to the treatment modalities after admission,the patients were divided into debridement combined with VSD group (Group A) and debridement combined with conventional dressing change group (Group B),with 30 patients per group.Then wound healing,infection relapse rate and length of hospital stay were compared between the two groups.Results All 60 patients were followed up for 12-36 months (mean 21.6 months).The wound infection did not recur after surgery in Group A and sutures were removed in time.Seven patients (23％) in Group B presented with recurrent wound infection after the removal of wound drainage tube,which was healed after an additional debridement and drainage as well as the delay of suture removal.Wound healing time (13 d vs 22 d),dressing change frequency (3 times vs 8 times),length of hospital stay (17 d vs 26 d),antibiotic use duration (7 d vs 14 d),and time to drop the body temperature to normal after operation (2 d vs 4 d) in Group A and B respectively showed significant difference (P ＜ 0.05).Conclusion In treatment of wound infection associated with decompressive craniotomy for TBI,VSD is beneficial for rapid healing of the infected wound and is worthy of wide clinical use.

Objective To systematically review the efficacy of glutamine enriched nutrition support for patients with severe acute pancreatitis (SAP).Methods Database including PubMed,Embase,HighWire,Cochrane Central Register of Controlled Trials,Wanfang Database,CJFD and CBM were searched with glutamine,severe acute pancreatitis,SAP,谷氨酰胺,重症急性胰腺炎.Literatures published before March 2014 were searched.Randomized controlled trials containing the comparison of conventional treatment and glutamine enriched nutrition support were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.SAP was diagnosed according to The revised Atlanta classificantion for acute pancreatitis or guideline for the diagnosis and treatment of SAP which was composed by the pancreatic surgery Branch of Chinese Medical Association.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using standard mean difference (SMD) and 95 ％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Ten literatures including 433 cases were enrolled in the study,and all of them were prospective randomized controlled studies.There were 218 patients treated by conventional methods (control group) and 215 patients received glutamine enriched nutrition support (experimental group).Compared with the control group,glutamine enriched nutrition support could elevate the albumin level,decrease the C-reaction protein level and shorten the hospital stay in the experimental group (SMD=1.00,-0.93,-0.71,95％CI:0.50-1.50,-1.25--0.61,-1.10--0.32,P＜0.05),glutamine enriched nutrition support could decrease the morbidity and mortality (RR =0.56,0.34,95％ CI:0.41-0.77,0.15-0.76,P ＜ 0.05) without increasing the expenses (SMD =0.03,95％ CI:-0.88-0.95,P ＞ 0.05).Conclusion Glutamine enriched nutrition support is superior to conventional methods for the treatment of SAP.

Objective:To evaluate the prevalence of Pe in clinical samples of chronic periapical periodontitis.Methods:A total of 100 clinical samples of chronic periapical periodontitis were collected and Pe 16S rDNA was detected by using 16S rDNA gene-directed PCR.The detection rate of Pe were calculated.Results:The detection rate of Pe was 50% in the 100 clinical samples.Conclusion:The results indicate that Pe is closely associated with endodontic infections.

Objective By contrasting and analyzing the clinic manifestations, radiological features and pathological results of patients with bone invasion from skin of the lower limbs that were associated with malignancy, authors advanced X-ray diagnostic evidence to promote its diagnostic accuracy. Methods The radiological appearances of squamous cell carcinoma arising in chronic ulcers, sinus and scars of the lower limbs in 16 patients from February 1968 to April 2002 confirmed by pathology, were analyzed retrospectively. All cases were taken posterior-anterior and lateral radiograph before operation. There were 15 males and 1 females aging from 15 to 67 years (mean, 50.4 years). The lesion was located at the front of tibia in 15, and the middle inferior part of femur. The medical history of primary diseases varied from 1 to over 50 years with an average of 20 years and 3 months. Of 16 cases, the duration of 8 cases from a sudden change of state of an illness to the final diagnosis was 4 to 6 months, 4 cases above 1 year, and 4 cases were found with no any change of state of an illness. Results There were 14 cases observed as typical chronic osteomyelitis, which demonstrated peripheral osteolytic defect, 13 cases with osteolytic destruction spreading outwards from front of tibia, and 1 case with widespread osteolytic destruction in the middle and inferior part of femur. Floating-ice-like rudimental bone in the defect was found in 11 cases, and 4 case were observed with old fracture. 2 cases without obvious history of typical chronic osteomyelitis, 1 case with soft tissue trauma and 1 case of burn, showed small Saucer-like erosion of the cortex and huge lobar soft tissue masses. Moreover, patchy shadow and Codman's triangle were found in 1 case of burn. Furthermore, lobar soft tissue masses and huge ulcer accord with osteolytic destruction was observed in all cases, and soft tissue masses were larger than the area of bony destruction in 6 cases. Conclusion Roentgenogram could display shape, location and extension of bone invasion from skin of the lower limbs that were associated with malignancy, which contribute to diagnose the lesion and provide useful evidence for surgical plan.

Objective To research the connection between the sagittal orientation of facet joints and disc degeneration in lumbar spine and to investigate the contribution of which to development the degenerative spondylolisthesis. Methods A new effective CAD method was used to accurately establish 9 finite element models(FEM)which were assembled respectively with facet-joint angle 65?, 45?, 25?, with normal disc, light degenerative disc and severe degenerative disc. The biomechanical parameters of 9 finite element models were measured under axial compressive load within physiological range. Results Compared with FEMs with facet-joint angle 45? and 25?, anterior displacement of L4 vertebra in FEMs with facet-joint angle 65? was increased, where the maximum von Mises stresses on facet surface, isthmus and the contact force on facet surface in horizontal orientation were obviously increased. Meanwhile, FEMs with facet-joint angle 65? showed a decrease in end-plate bulge and an increase in stress of annular matrix. The stiffness in light degenerative disc FEMs was reduced and the von Mises stresses on facet surface and isthmus was slightly increased compared with the normal disc FEMs. Among all, the FEM with facet-joint angle 65? combined with light degenerative disc showed the poorest resisting anterior shear force. Conclusion Sagittal orientation of facet joints is not only the primary inducement of the degenerative spondylolisthesis but the secondary pathological change of remodeling of the facet-joints induced by the regional stress change. The inherent instability of lumbar motion segment of sagittal orientation of facet joints is influenced by the lumbar disc degeneration. The lumbar disc degeneration has no manifested contribution to the aggravation of the sagittal orientation of facet joints.

Objective To observe the effect of ischemic postconditioning on myocyte apoptosis in hyperlipemia rats with myocardial ischemic reperfusion.Methods Total forty-eight hyperlipemia SD rats were randomly divided into the sham-operation group, ischemic reperfusion group and ischemic postconditioning group with 16 rats in each group. The myocardial ischemic reperfusion model of rat was made. Rats in the ischemic reperfusion group were ligated for 40 min ischemia, and then reperfused for 240 min. Rats in the ischemic postconditioning group were treated for 40 min ischemia, reperfused for 10 s and 10 s ischemia for three cycles, and then reperfused for 240 min. Rats in the sham-operation group were opened the chest to braid for ringer without deligation. The presence of apoptotic myocytes was detected by the method of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). Meanwhile, the serum creatine kinase activity and myocardial infarct size were measured.Results The creatine kinase activity was 734.86±25.48 U/L in the ischemic postconditioning group and 967.64±28.16 U/L in the ischemic reperfusion group after reperfusion, all significantly higher than that (274.28±16.94 U/L) in the sham-operation group ( P<0.05), and it was significantly lower in the ischemic postconditioning group than that in the ischemic reperfusion group ( P<0.05). There was no significant difference in ratio of myocardial ischemic size and left ventricle after reperfusion between the ischemic postconditioning group and the ischemic reperfusion group. But the ratio of myocardial necrotic size and ischemic size of the ischemic postconditioning group was 24.8%±6.7% and significantly lower than that (38.2%±7.1%) of the ischemic reperfusion group ( P<0.05). No apoptotic myocardial cells were found after the reperfusion in the sham-operation group. The apoptotic rate in the ischemic postconditioning group (12.7%±2.8%) was significantly lower than that (20.9%±3.7%) in the ischemic reperfusion group ( P<0.05).Conclusion Ischemic postconditioning can relieve the ischemic reperfusion injury in hyperlipemia rats, the mechanism of which may be related with decreased myocardial apoptosis.

OBJECTIVE:To realize the current situation of patient's compliance with medication in Tibetan and to evaluate the methods of increasing patient's compliance METHODS:Questionnaire inquisition was adopted in 188 Tibetan patients to investigate the type of diseases,situation of medication and condition of compliance RESULTS:The compliance with medication was related with the type of diseases,patient's educational background and knowledge about diseases It was a good way to raise the patient's compliance that the patient's recognition of diseases and pharmacotherapy should be improved and communication between doctor and patient and guidance on drug use should be enhanced CONCLUSION:Aiming at patients in different ages,the subject matter of medication consultation service should not be the same

Objective To evaluate the clinical efficacy of ultrasonic ablation in patients with chronic deep vein thrombosis of lower extremities. Methods Fifty-six patients with chronic deep vein thrombosis resulting in total occlusion of iliac-femoral veins accepted intra-venous ultrasonic ablation. The time for ultrasonic ablation was 12-24 minutes with the mean being 18 minutes. After the procedure, anti-coagulation was performed through the retaining catheters and venous propeller was utilized for promoting blood reflow. Results Ultrasonic ablation easily created a channel within the occlusive iliac-femoral veins and achieved successful recanalization in 49 of 56 patients (87.5%). Five patients (8.9%) were partially re-canalized and 2 (3.6%) had no recanalization. Thirty-eight of the 49 re-canalized patients were followed up, including 22 with no stent placement showed 9 (40.9%) re-occlusion and 16 received stent placement, and 2 had (12.5%) re-occlusion. Conclusions Intravascular ultrasonic ablation is an effective therapeutic modality to recanalize chronic thrombosed occlusion of iliac-femoral veins and can lay down a foundation for further balloon-expansion or stent-placement with long term patency.

Objective:To investigate outpatient's medicine knowledge and satisfaction degree and analyze their correlation.Method:150 outpatients,their doctors and pharmacists were investigated with a fieldwork method.Patients' medical knowledge and satisfaction degree were measured with a quantitative scale table,and their correlation was calculat- ed with a linear regression method.Result:Almost all the doctors and pharmacists could provide their patients with their guidance about medicines,which focused on drug dosage and taking ways.Fewer than 20% patients could take medical ad- vice of potential risks and notice of taking medicine.A significant correlation was shown between patient's medical knowl- edge and satisfaction degree(r=0.76).Conclusion:More guidance from doctors and pharmacists should be provided for outpatients.The medical knowledge learned by patients could influence patient's satisfaction degree significantly.

OBJECTIVE: To discuss the way to evaluate outpatient prescription in medical institutions according to Prescription Administrative Policy so as to provide reference for the practice of prescription evaluation system. METHODS: 500 outpatient prescriptions from April 16 to April 20 in 2007 in our hospital were sampled randomly for an evaluation in respect of drug utilization, prescription behavior, pharmaceutical care level etc. RESULTS & CONCLUSIONS: To evalnation from The prescriptions involved use of injections and of antibacterials, prescribed drugs were covered in "national essential drugs" , prescriptions with general name, the knowledge of patients on the administration and dosage were drectively.It is supply reference for the prescription evaluation system.