Objective To introduce the method,characteristics and indication of unreamed in-tramedullery nailing in treatment of open tibia fractures.Methods 28 cases were classified according to the Gustilo method:18 belonged to type I,8 type II and 2 type III a.26 nails with 8mm in diameter and 2 nails with 7mm in diameter were used.Results All cases were fixed successfully with unreamed nailing without any X-ray aids.All of fractures had no infection,and healed in an average time of 5.6 months.There were no broken nails and screws in this series.Conclusion The unreamed intramedullary nailing is an advantageous therapeutic method with simple management,little trauma and wide indication in management of open tibia fractures.

Objective To compare the accuracy of bispectral index (BIS) and cerebral state index (CSI) used to measure depth of sedation during target-controlled infusion (TCI) of propofol. Methods After obtaining written informed consent we studied 20 ASA Ⅰ-Ⅱ patients aged 25-40 years undergoing elective operation under general anesthesia. The patients were premedicated with intramuscular atropine 0.5 mg. The electrodes of BIS and CSI were placed according to the instruction manuals before induction of anesthesia. Anesthesia was induced with TCI of propofol. The target effect-site concentration was set initially at 0.5 ?g?ml-1 followed by increments of 0.5 ?g?ml-1 every 5 min until 5 min after the patients lost consciousness and did not respond to pain stimulation (OAA/S= 0) . BIS and CSI were continuously monitored and their values recorded every 2-6 seconds. OAA/S score (5 = alert, 1 = loss of consciousness) was recorded every 20 seconds. Spearman correlation coefficient between OAA/S score and BIS and CSI and their prediction probabilities (Pk) were calculated. BIS05, BIS50, BIS95 and CSI05, CSI50, CSI95 at loss of consciousness (LOC) (OAA/S = 1) were also calculated.Results CSI arid BIS correlated well with sedation depth. There was no significant difference in the prediction probability between CSI and BIS. BIS05 and CSI05 were 79.1 and 74.9; BIS50 and CSI50 67.5 and 65.9; BIS95 and CSI95 55.9 and 56.8 respectively at LOC. Conclusion During TCI of propofol both CSI and BIS can be used to measure sedation depth fairly accurately. CSI appears to be more accurate then BIS in predicting both loss of verbal contact and LOC.

OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.

Objective To evaluate the efficacy of tolterodine in preventing bladder spasm during the operation to BPH.Methods One hundred and twelve cases of BPH patients were randomized to two groups:56 cases in one group were prescribed tolterodine 4-5 d before operation and 3-4 d after operation (2 mg twice daily),another 56 cases did not take any anti-spasm drugs.The bladder spasm occurring or not,frequency and continuing time of bladder were evaluated and recorded.Results In the controlling group:the non bladder spasm in 12.5% (7/56),mild bladder spasm in 14.3% (8/56),severe bladder spasm in 73.3% (41/56),In the treatment group:non bladder spasm in 87.5% (49/ 56),mild bladder spasm in 8.9% (5/56),severe bladder spasm in 3.6% (2/56).There was signifi-cant difference between the 2 groups (P<0.001).Conclusion Tolterodine could alleviate bladder spasm around the operation to BPH.

Objective To evaluate fixation of anatomic plate by comparing ou tc omes of surgery and conservative therapy for proximal humeral fractures. Methods 24 cases of proximal humeral fractures were fixed with anatomic plate, lag scre ws and kirschner wire. 19 cases were managed with conservative therapy of manual reduction and external wood splint fixation. The results were evaluated by Neer classification and Constant-murley scoring system. Results All the case were f ollowed up 10 to 19 months(averaging 11.5 months). In the 24 operated cases, 11 patients were graded as excellent, 8 as good, 4 as fair, 1 as poor. In the 19 ca ses of conservative therapy, 6 patients were graded as excellent, 7 as good, 6 a s fair, most of which were Neer types Ⅲand Ⅳ. The operative treatment produced better outcome than the censervative treatment ,far the difference was statisti cally significant(P

Objective: To apply level set motion-based elastic registration method to radiotherapy CT image, then to provide technical support for the accurate evaluation of tumor and changing process of patients with endanger organ and its accumulative dose. Methods: Based on Vemuri’s level set motion method, we wrote the algorithm program using Matlab software and applied on two sets of 3D CT images from patients with cervical cancer and NPC for fully automatic elastic registration. Results: Comparing CT images before and after registration, for the cervical cancer patient, the minimum mean square error (MSE) decreased by 55.1%and correlation coefficient (CC) increased by 5.3%. For the NPC patient, MSE decreased by 32.1%and CC increased by 4.6%. Conclusion: From the image difference and evaluation parameters, the efficacy of level set motion-based elastic registration method was preliminarily demonstrated. In order to apply this method to clinical radiotherapy, dit needs to find a more accurate mathematical algorithm further in order to compute human anatomy deformation through image motion.

Objective The changes of VGluT1-like immunoreactivity(VGluT1-LI) in the trigeminal complex of the rat in different survival time after unilateral mandibular nerve transection were examined. Methods Immunocytochemical staining method and image analysis technique were performed. Results Many VGluT1-LI were observed in the trigeminal complex of the normal rat and were mainly distributed in the terminals.A weak decrease of VGIuT1-LI in the dorsal part of principal trigeminal nucleus(Vp) could be detected at the first week after unilateral transection of mandibular nerve(P

Objective To evaluate the results and relating factors in the treatment of proximal humeral fractures by replacement of humeral head prosthesis. Methods From March 2000 to March 2003, 21 cases with proximal humeral fractures, which were 10 males and 11 females aging from 62 to 82 years with an average of 72.3 years, were admitted to our hospital. All the patients were underwent one-stage operation of humeral head hemiarthroplasty through the anteromedial approach of shoulder joint. The average operative time was 60 minutes (range, 40 to 80 minutes) with a blood loss ranging form 200 ml to 300 ml. According to Neer classification, 6 cases were three-part fractures, 13 four-part fractures, and 2 head-splitting fractures. There were 18 fresh fractures and 3 old fractures. All the fractures were treated with replacement of humeral head prosthesis. After operation, the upper extremity was immobilized for 6 weeks, however, physical therapy, including pendulum, isometric elbow, and wrist and hand exercises, was begun on the first day after surgery. Results The follow-up ranged from 6 to 36 months with a mean period of 14.6 months. No lessening prosthesis, prosthesis dislocation, postoperative infection, nerve damage or periprosthesis fractures occurred. According to the scoring system modification for hemiarthroplasty (SSMH) of UCLA (Los. Angeles, California, USA) based on shoulder pain, functional status, muscle strength and range of motion, the average score was 24.5. Furthermore, the score was above 27 (excellent) in 3 cases, and 24 to 27 (good) in 14, and the excellent rate was 86%. The average score of pain was 9.3, function 8.6, muscle strength 8.2 in 21 cases. Conclusion Replacement of humeral head prosthesis is a preferable method for the treatment of proximal humeral fractures in the elderly patients, with significant effects in keeping the function and relieving the pain of the shoulder joint postoperatively.

[Objective]To evaluate and compare the effects of fibial-tibial fracture(FTF) treated by interlocking intramedullary nail (I I N group A) and intramedullary expand expanded self-lock nail (IESN group B).[Method]From June 2000 to September 2003,one hundred sixteen cases of FTF were treated by I I N(N=60)or IESN (N=56) and followed-up for 12~24 months (average 17.9 months).Results were compared between group A and group B.[Result]In group A,the satisfactory rate,union rate,close reduction rate,medullary expanding rate,complication rate and antirotation ability were 89.5%, 96.7%, 71.6%, 51.6%,21.6% and +++ respectively.In group B,that were correspondently 91.0%,98.5%,89.3%,5.3%,3% and +.[Conclusion]Adopting the biological osteosynthesis either the I I N or IESN for treatment of FTF could get a result of more satisfactory rate and higer union rate.Applying a stable fixation,the IESN is more suitable for instable FTF.Such as multisegmental or comminuted targe oblique FTF,while of fering a flexible fixation,IESN is preferable for transverse fractures of middle and lower third tibia and fibula.

[Objective]To explore the methods and effects of closed reduction and percutaneous internal fixation to treat intercondylar fractures of humerus.[Method]From 2001,3 to 2004,9 we selectively treated 6 cases(group A) of Rise-Borough Ⅱ,Ⅲ type of humeral intercondylar fractures with closed reduction and percutaneous internal fixation with hollow screw and Kirschner's wire.Others(group B) treated with opened reduction and internal fixation with plates and screws.[Result]Following up 6～12 months,the outcome were evaluated with Aitken and Rorabeek rating system.Group A:5 patients were graded as excellent,1 as good.Group B:7 patients were graded as excellent,7 as good,1 as fair,1 as poor.[Conclusion]To treat Rise-Borough Ⅱ,Ⅲ type of humeral intercondylar fractures with closed reduction and percutaneous internal fixation with hollow screw and Kirschner's wire,can decrease iatrogenic impairment,receive reliable fixation and early functional exercise.The fracture union quickly,and the patient has excellent joint function and less postoperative complication.