用秩和比法对37例脑瘫患者施行SPR术中影响应激反应的诸因素进行分析。结果显示：3—6岁小儿、切断后根小束大于50％者、电刺激量平均为5．1—10mA者、芬太尼量大于3μg／kg·h者和于腰骶部行SPR者应激反应最强。3、4级痉挛者、芬太尼量为2．1—3μg／kg·h者、7—13岁儿童、切断后根小束41—50％者和电刺激量平均大于10mA者应激反应较强。5级痉挛、14岁以上青成年和电刺激量平均小于5mA者，应激反应较弱。而芬太尼量小于2μg／kg·h、切断后根小束少于40％和行颈胸段SPR者应激反应最弱。经临床分析，作者提出：SPR中应特别注意6岁前小儿及切断后根小束超过50％的脑瘫患者的应激反应。

To reveal the intrinsic characteristics and rules of change within the system for evaluation of human resources for military medical sciences .We intended to gain insights into the system for the evaluation of human resources for military medical sciences while analyzing the effect of the environment of military medicine , competitions for talents and regulations on the evaluation system .We also interpreted the system structure composed of the evaluation subject , evaluation object and evaluation activity as well as their interactions .We also made an attempt to study value evaluations , judgment functions and functions of selection , guidance , manipulation and supervision and the self-consistency mechanism between the above-mentioned functions .We also analyzed the features of this complicated system and rules of evolution .

BACKGROUND:Knee joint function limitation often occurs after internal fixation of complex femoral condyle fractures, but the mechanism and its influencing factors are also unclear.
OBJECTIVE:To screen and analyze the relevant factors of knee joint function limitation after internal fixation of complex femoral condyle fractures.
METHODS:We retrospectively summarized postoperative fol ow-up data of 6 and 12 months from 121 patients with complex femoral condyle fractures. Knee joint function recovery was evaluated according to Merchan criteria. A multiple stepwise regression analysis was carried out in terms of gender, age, causes, concomitant injuries, skin and soft tissue injury, fracture type, fixed method, operation time, postoperative plaster fixed situation, healing of postoperative incision, bone healing and postoperative functional exercises, to summarize the relevant influencing factors for knee joint function limitation.
RESULTS AND CONCLUSION:Whether the knee joint function after internal fixation was limited acted as the dependent variable Y, and factors with statistical significance of the single factor analysis served as the independent variable X. We used the multiple stepwise regression analysis for multiple factors analysis. Results showed that the gender of patients (X1), with or without concomitant injuries (X3), soft tissue damage (X4) and operation time (X6), a total of four factors, could not be introduced into the model, suggesting that these four factors had no significant correlation with postoperative knee joint function limitation. Another eight factors could be introduced into the factor analysis model, showing that the cause of injury (X2), fracture type (X5), the choice of internal fixation (X7), with or without bone graft (X8), with or without postoperative plaster cast (X9), postoperative knee joint functional exercise or not (X10) and postoperative wound healing (X11), the degree of postoperative bone healing (X12) are closely related to postoperative knee joint function limitation in complex femoral condyles fractures.

AIM: Study results are various in the mechanism and influential factors of backleg pain in patients with lumber intervertebral disc protrusion. This study aimed to explore the correlation of sagittal index and changes in nucleus pulposus inflammatory factor to low back and leg pain. METHODS: The patients with single unilateral prolapse of lumbar intervertebral disc who were non-central type lumbar disc herniation (L3-4, L4-5 or L5-S1) and non-lumbar spondylolisthesis accompanied with spinal canal stenosis and intraspinal canal disease surgically treated with limited laminectomy from October 1999 to February 2005. The total number of subjects was 41 including 30 men and 11 women and the patients ranged from 28 to 72 years old in age. Of them, 12 were the type of bulge, 15 were the type of protrusion and 14 were the type of free disc herniation of the lumbar spine. Another 17 involved intervertebral discs obtained in the decompression of lumbar bursting fractures were taken as a control group, in which were 10 males and 7 females aged 19-73 years. A questionnaire survey of painful symptoms to evaluate degree of low back and leg pain with visual analogue scale (VAS) was performed by the same non-experimental physician on admission. The ratio of the maximum sagittal diameter of protrusion and the sagittal diameter of the same level vertebral canal was sagittal index to describe degree of protrusion. The matrix metalloproteinase (MMP)-3 and interleukin (IL)-1 contents were determined. Backleg pain degree of the protrusion was analyzed. RESULTS: All patients were included in the final results. The MMP-3 and IL-1 contents and the sagittal index of the protrusion in patients with lumbar intervertebral disc herniation were higher than in the control group (P

Based on a correct understanding of the related concepts and system of the evaluation of human resources for military medical sciences ( EHRMMS), this thesis established a three-dimension model of EHRMMS that is composed of the evaluation goal, evaluation subject and evaluation object, and analyzed the factors that affect the crucial parameters in the model.We also analyzed the features and regularity of the evaluation model, and tentatively explored the application of the model.

Objective To explore the way to compile a global military medical literature collection and perspectives for its research.Methods The names of military medical research institutions and their trends of development were summa-rized via semantic analysis.The collection of retrieval words for military medical research institutions( then the collection) was constructed based on expert consultation.The names of military medical research institutions were collect-ed with manual screening after retrieval withthe collection.The literature collection of military medical research institu-tions was completed with coordinated retrieved of their papers and other publications.Results According to different needs of information analysis, the literature collection of military medical research institutions could be analyzed in terms of their size, types of development, and academic authority.Conclusion Based onthe collection, the military medical research institutions collected in this article included institutions that used to be neglected during the course of information tracking of military medicine.Three kinds of institutions should be paid more attention to.The institutions were the ones with a large number of papers and citations, the ones whose papers increased or decreased dramatically, as well as the ones whose research directions were the priority fields of Chinese PLA.

Objective To investigate protective effects and mechanisms of lipoxinA4(LXA4)on human umbilical vein endothelial cells(HUVEC)under hypoxia in vitro.Methods The HUVEC culture were divided into groups as followed:added M199 cudture medium as normal contml groups,added CoCl2 to mimic hypoxia in vitro as hypoxia group and added different concentrations of LXA4(1,10,100 nmol/L)were added to the induced hypoxiai HUVEC as agents intervention group.Morphological changes of HUVEC were observed by using inverted phase contrast mieroscope.The influence of LXA4 on cell survival was investigated by methyl thiazolyl tetrazolium(MTT) assaying method after the treatment with different concentrations of LXA4 and 100 nmol/L lipoxinA4 according to different time(4,8,12 and 24 hours).The expression of von-willebrand factor (vWF) was detected by immunocytoehemistry method. The changes of cytosolic Ca2+ were measured by laser scanning confocal microscope. Results ( 1 ) Morphological changes:the cells under hypoxia lost its normal shapes and showed necrosis, while the cells cocuhured with 100 nmol/L LXA4 were normal appropriately. (2)Survival rate: the survival rates of HUVEC under hypoxia was (40. 1±3.9) % and increased to ( 52. 9 ± 1.4) %, (64. 1 ± 3. 3 ) %, ( 76. 6 ± 1.6) % respectively when added with LXA4 with concentration of 1,10, 100 nmol/L into culture medium. There was significant different survival rate when compared with that of hypoxia group. (3) The level of vWF: The expression of vWF was decreased with the increasing concentrations of LXA4 added into culture medium, the gray values were 203.9 ±0. 7 in 1 nmol/L,204.6 ±0. 9 in 10 nmoL/L,191.8 ±0. 5 in 100 nmol/L respectively, which reached statistical difference in comparison with that of hypoxia groups (P<0. 05). (4) Confocai analysis:the intracellular free Ca2+ concentrations of HUVEC were intensified with LXA4 treatment. Conclusions LXA4 plays an important role in keeping the normal shape of HUVEC under hypoxia, can enhance survival of hypoxial HUVEC and decrease the level of vWF in cytoplasm. The protective mechanism might be via decreasing mitochondria Ca2+ overload and increasing cytoplasm Ca3+ by nucleus Ca2+ transference.

Objective To compare the effects of application of clavicular hook plate combined with wire anchors anatomical coracoclavicular ligament reconstruction and application of clavicular hook plate in the treatment of NeerII distal clavicle fracture and Tossy Ⅲtype~V acromioclavicular joint dislocation. Methods A retrospective analysis of the clinical data from June 2006 to June 2013. Total 73 cases patients suffered with Neer Ⅱtype distal clavicle fractures and Tossy Ⅲtype~V acromioclavicular joint dislocation. Of which , 41 cases were subjected to treatment with clavicular hook plate , 32 patients subjected to treatment of using clavicular hook plate combined with anchors .The incision length, operative time, postoperative complications, length of hospital stay and postoperative 1 month, 6 month shoulder VAS score of two groups were analyzed; the shoulder function of both groups after 1 month, 6 months were assessed by using Constant shoulder function assessment method. Results Surgical incision length and operational time between the two groups were statistically significant (P<0.05), while the amount of bleeding was not statistically significant. All patients were followed up . The two groups did not occur any complications such as loosening, decoupling, acromioclavicular joint dislocation and wound infections. Hospitalization time was 5~14 d (averaged 10d), no significant difference between two groups. 4 the shoulder Constant score and VAS scores showed no significant difference 1 months postoperation; 6 months after hook plate removed, VAS score and Constant shoulder score improved significantly in anchors hook plate group (P<0.05). Conclusion Anatomical coracoclavicular ligament reconstruction by application of hook plate combined with anchors is a good biomechanical model characterized with simple surgery , less trauma and good clinical outcomes , worthy of clinical application.

BACKGROUND:Vertebroplasty with bone cement injection can achieve a correction of kyphosis, enhancement of vertebral strength, and elimination of vertebral lesions during reduction of the fracture. OBJECTIVE: To analyze the efficacy of vertebroplasty with bone cement injection on osteoporotic vertebral compression fracture. METHODS:Totaly 84 patients with osteoporotic thoracolumbar vertebral compression fractures (T6-L4), 37 males and 47 females, aged 58-80 years, were randomized into two groups: study group undergoing vertebroplasty with bone cement injection and control group subject to bed rest and conservative treatment (functional exercise of the back muscle). Visual analog scale score, Oswestry disability index and vertebral height were detected and compared between the two groups before and after treatment. RESULTS AND CONCLUSION:There was no difference in vertebral height, visual analog scale score and Oswestry disability index between the two groups before treatment. At 3 months after treatment, the vertebral height was (1.653±0.168) cm in the study group and (1.521±0.200) cm in the control group, with a significant difference (P< 0.05). The visual analog scale scores and Oswestry disability index scores in the study group were both lower than those in the control group at 3 months after treatment and at the last folow-up (P < 0.05). After treatment, there were two cases of pressure sores, three cases of deep venous thrombosis, one case of pneumonia and two cases of urinary tract infections in the control group; while only 4 cases developed bone cement leakage in the study group, but with no obvious clinical symptoms. No difference in re-fracture rate occurred between the control group (n=3) and study group (n=4;P > 0.05). These findings suggest that the bone cement injection as vertebral augmentation therapy can rapidly relieve pain, improve patients' quality of life within a short term and restore the vertebral height in patients with osteoporotic vertebral compression fractures.

Objective T o observe cardiac ultrastructure and the expression of heat shock protein 70 (H SP70) and hypoxia inducible factor-1α (H IF-1α) in electric shock death rats and to explore the application of these indexes as the basis of m edical identification in electric shock death. Methods Seventy-tw o SD rats w ere random ly divided into electric shock death group, postm ortem electric shock group and the control group. T he changes of m yocardial ultrastructure w ere observed by transm ission electron m icro-scope, and the expressions of m yocardial H SP70 and H IF-1α w ere observed by im m unohistochem ical technology. Results M yocardial m yofibril fracture, m itochondrial cristae and m em brane dissolution, and disordered arrangem ent of Z lines and M lines w ere observed in electric shock rats. H SP70 and H IF-1αw ere strong positive expressions in the electric shock death group, significantly com pared w ith the con-trol and postm ortem electric shock groups (P<0.05). Conclusion T he expressions of H SP70 and H IF-1αw ere obviously increased in electric shock death group, w hich m ay be used as the diagnostic indicator of electric shock death.