[Objective]To evaluate the outcomes of treating thoracolumbar burst fractures in young adults with posterior short-segment pedicle screw fixation without fusion by analyzing the clinical and radiographic parameters.[Method]Fifty-four patients with thoracolumbar burst fractures from June 2002 to April 2006 were investigated retrospectively.Thirty-one patients were male and 23 were female.The mean age was 31 years.All patients underwent open reduction and posterior short-segment pedicle screw fixation without bone graft fusion,and had their implants removed at 12 to 20 months post-operatively.Pain status was evaluated using the visual analog scale(VAS).Changes in the anterior vertebral height ratio,Cobb′s angle,and vertebral wedge angle were measured preoperatively,postoperatively,before implant removal,and at 2 years after implant removal.[Result]Thirty-two patients were available to follow-up,with an average period of 43 months(range,36-56 months).A good correction was gained and pain was released significantly after surgery.The loss of correction was statistically significant and there were 4 patients suffering from screw broken before the instrumentation removal,however.A progressive kyphotic deformity (Cobb′s angle increased while vertebral wedge angle unchanged) was caused by the collapse of the intervertebral disc space while the reduced vertebral height was stable after the implant removal.No significant correlation was found between the final kyphosis and pain scale.[Conclusion]Short-segment pedicle screw fixation without fusion can provide good reduction and sustained corrective height if adequat indication of thoracolumbar burst fractures has been choosen.Earlier implant removal can regain local segmental motion.

Objective To analyze the utilization and the development trend of TCM decoction pieces for relieving exterior syndrome in Affiliated Hospital of Nanjing University of TCM;To provide references for clinical rational medicine use and purchase. Methods Excel software was used to analyze the consumption quantity and consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital during 2009-2013. Results The consumption quantity of TCM decoction pieces for relieving exterior syndrome in our hospital increased year by year with average growth rate of 11.52%, among which the consumption quantity of medicine for diverging wind-cold was more than medicine for diverging wind-heat. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital have been increasing significantly. The proportion of which in the total TCM decoction pieces for relieving exterior syndrome and the medicine utilization structure were stable, and the use of TCM decoction pieces for relieving exterior syndrome was rational on the whole.

Objectives To compare the co-infection statues of HSV, HBV and HCV in patients with STD and HIV infection for providing evidence of developing prevention and control strategies. Methods Serum samples confirmed to be infected with HIV/AIDS by Western blot, and serum samples of patients with STDs (syphilis, gonorrhoea and chlamydial infection) were tested for HSV2-IgG, HSV2-IgM, HBsAg and HCV-IgG by ELISA. The detection levels were compared between the two groups. Results Out of 76 specimens in STD group, HSV2-IgG was detected in 24 specimens (31.58%), HSV2-IgM in one specimen (1.32%), HBsAg positive in 8 (10.53%), and HCV antibody positive in 4 (1.32%). In 14 specimens of HIV/AIDS group, HSV2-IgG were detected in 7 (50.00%); HSV2-IgM in 5 (35.71%);8 (578.14%) were positive for HBsAg and 3 (21.43%) for HCV. In a total of 90 specimens, both HSV and HBV were detected in 6 specimens, both HSV-IgM and HBV in 2, and the four above-mentioned antibodies in 2. The infection rates of HSV, HBV and HCV were significantly higher in HIV-infected specimens than those in the STD specimens (P

AIM: To investigate the protective effects and its mechanism of Jinkui Gastric Drug(JK). METHODS: The model of gastric mucosal lesion in rats induced by hydrochloride acid-aspirin was used.The indexes of gastric mucosal lesion in JK and control groups were observed.The contents of nitric oxide(NO) and the activity of nitric oxide synthase(NOS) in blood serum and gastric tissue in rats,the levels of 6-keto-PGF_(1?),thromboxane B_2(TXB_2) in blood plasma and epidermal growth factor(EGF) in blood serum were examined. RESULTS: The index of gastric mucosal lesion after administration of JK reduced obviously.The contents of NO and the activity of NOS in serum and gastric tissue increased markedly.The levels of 6-keto-PGF_(1?),TXB_2 and EGF increased significantly. CONCLUSION: JK can protect experimental gastric mucosal lesion and its mechanism may be related to increasing the protective factors.

Objective To study the effects of rehabilitation training on learning and memory ability and the expression of growth-associated protein-43(GAP-43)in rats with vascular dementia.Methods Forty-four female Sprague-Dawley rats were randomly assigned to a rehabilitation group(n=20),an immobilization group(n=20),and a sham-operation group(n=4).The rats in the former 2 groups were operated on to establish the experimental vascular dementia model by repeatedly ischemia/reperfusion injury of brain induced by ligation of bilateral common carotid arteries and lowering of blood pressure induced by intraabdominal injection of sodium nitroprusside.The rats in rehabilitation group were administered with rotating bar and rolling cage exercises for 1 hour once daily,while those in the immobilization group were immobilized and without any exercise:the rats in sham-operation group could move freely in cage.Learning and memory tests were preformed by using step-down avoidance test at the 27th and 28th days after operation.Immunohistochemical staining was used to detect GAP-43 expression in hippocampus CA1 area at different time points after operation. Results The rats in rehabilitation group demonstrated better learning and memory ability than those in immobilization group(P<0.01),and more GAP-43 expression in hippocampus CA1 ar-ea than those in immobilization group and sham-operation(P<0.01).Conclusion Rehabilitation training can im-prove the learning and memory ability of rats with experimental vascular dementia,and the mechanism is probably re-lated to the increase of GAP-43 in hippocampus CA1 area.

Objective To explore the ideal choice of feeding artery which is used for regional arterial infusion (RAI) in severe acute pancreatitis. Methods Forty-five patients with SAP were treated with RAI. The ideal feeding artery was that can supply entire pancreas according to arteriography and can maximize concentration of drug at pancreatic tissue. The pancreatic arteriography was considered as the final objective evidence for choice. Results (1)Gastroduodenal artery was chosen as feeding artery in forty-four cases, and superior mesenterlc artery was chosen in only one case because of vascular abnormity. (2)According to splenic arteriography, blood of splenic artery was supplied to spleen chiefly, and only partial tail of pancreas was applied by splenic artery. (3)According to celiac trunk arteriography, blood of celiac trunk could be supplied to entire pancreas, but a considerable proportion of the total blood was supplied to spleen through splenic artery and liver through hepatic artery proper.Therefore, the drug utilization index was lower. (4)According to gastroduodenal arteriography, blood of gastroduodenal artery could be supplied to entire pancrea, and almost all of the blood that contains drug flowed into pancreas. Therefore, the drug utilization index was higher. Conclusions Gastroduodenal artery is the ideal choice of artery which is used for regional intra-arterial infusion in sever acute pancreatitis. Pancreatic arteriography should be applied routinely when yever acute pancreatitis was treated with RAI.

Objective To assess the clinical results of the treatment of the 211 cases of long bone shaft fractures at lower limbs with intramedullary interlocking nails. Methods 211 cases of femoral and tibial fractures were treated chiefly with unreamed intramedullary interlocking nails and postoperative functional exercises including continuous passive motion (CPM). Results 189 cases were followed up for an average of 9 months (ranging from 4 to 26 months). All the cases achieved bone union, and no nonunion occurred. Delayed union occurred in 7 cases and limited knee joint function in 4 cases. According to the Johner-wruhs criteria, 178 cases were assessed as excellent, 24 as good and 9 as fair. The total excellent and good rate was 95.6%. Conclusions The intramedullary interlocking nail is a good device for the treatment of long bone shaft fractures at lower limbs. Its indications have become wider. It is correct to pay equal attention to the blood supply of the fractured bone and the reduction of the fracture during the operation.

Objective To compare the difference of three methods testing the antibiotic susceptibility of mucoid Pseudomonas aeruginosa in order to provide accurate and reliable antibiotic susceptibility result for clinic.Methods A total of 630 mucoid Pseudomonas aeruginosa were collected from Linyi People′s Hospital during January 2015 to December 2016.They mainly come from respiratory medicine and the most common specimen source was sputum.All specimens were examined in 2 h.The strains isolated from the same patient were discarded.Antibiotic susceptibility was tested by the automatic microorganism analyzer VITEK2 compact, E-test, which was reference method, and K-B disk.The results of three methods were analyzed and compared by χ2 test.Results The result of E-test showed that antibiotic sensitivity of 630 mucoid Pseudomonas aeruginosa was above 52.7% except for Cefepime (39.2%).The result of K-B disk was compared with E-test, the antibiotic sensitivity of mucoid Pseudomonas aeruginosa to imipenem (72.4% vs 52.7%) and amikacin (48.6% vs 71.1%)had significant difference (χ2=8.283 7 and 10.533 8, P<0.05).The result of VITEK2 compact showed that the antibiotic susceptibility of mucoid Pseudomonas aeruginosa to imipenem(70.8% vs 52.7%), cefepime(60.8% vs 39.2%), gentamicin (87.6% vs 74.1%)and levofloxacin(81.3% vs 65.4%) was significant higher than the result of E-test (χ2=6.935 2,9.331 2,5.885 6 and 6.466 5, P<0.05).For tobramycin, piperacillin/tazobactam and ciprofloxacin, the result of three methods is more consistent.Compared to VITEK2 compact, the consistency between K-B disk and E-test was higher.The rate of very major error and major error were between 0.0%-4.8% (Amikacin 12.2%) and minor error was 4.6%-20.3%.Conclusions The drug sensitivity of mucoid Pseudomonas aeruginosa is different between various methods.The result of K-B disk and E-test using blood MH is more reliable than VITEK2 compact.

Objective To investigate the nursing care perception of patients, for reference of improving the evaluation methods and service level of nursing care. Methods A customized questionnaire was used to survey 357 discharged patients from June to July 2018 from the medical wards and surgical wards of two tertiary hospitals in Hangzhou. The data were subject to factor analysis. Results Four factors were extracted by a factor analysis from 20 survey items, by means of face-to-face interviews of these patients. The study showed that the patients perceive nursing care from 4 dimensions, i. e. , demand-directed nursing, information providing, nurse attitude and timely nursing. There exists strong complementarity between patients′ perception of good nursing and high quality nursing as recognized by the three-dimension model. Patients pay more attention to need fulfillment and non-technical service. Conclusions To provide high quality nursing in need, a comprehensive system should be built for general and objective evaluation of nursing care, which combines both patients′ perception and a three-dimension model.

Objective To study the susceptibility of Neisseria gonorrhoeae to antibiotic agents from 1988 to 2002 in Shanghai. Methods The clinical isolates from patients with gonorrhea were collected and tested for their susceptibility to five antibiotics. Agarose-dilution-method was used to detect minimal inhibitory concentration (MIC) of anti-microbial agents including penicillin, tetracycline, spectinomycin, ciprofloxacin and ceftriaxone, and penicillinase producing Neisseria gonorrhoeae (PPNG) were tested with acidometric method. Results Susceptible strains to penicillin decreased from 11.28% in 1988 to 0 in 2002, MIC50 and MIC90 increased 8 and 4 times, respectively, the resistant rate and proportion of PPNG were 94.29% and 50.95%, respectively in 2002. The strains of high resistance to tetracycline increased from 0 in 1995 to 20.95% in 2002. The susceptible strains to ceftriaxone decreased from 100% in 1995 to 23.80% in 2002. The susceptibility to ciprofloxacin decreased significantly and resistant rate reached 99.05% in 2002. However, these strains were kept highly susceptible to spectionmycin. Concerning the multi-drug resistance, we found that the strains resistant to penicillin, ciprofloxacin and tetracycline simultaneously increased from 20.87% in 2001 to 23.30% in 2002, those resistant to both penicillin and ciprofloxacin reached to 70% in the past 2 years. Conclusions In Shanghai the resistant rates of Neisseria gonorrhoeae to antibiotics increased year by year in the past 15 years. The study indicates that spectinomycin and ceftriaxone should be the first choice for the treatment of gonorrhea at present and new sensitive antibiotic should be developed for the treatment of gonorrhea.