BACKGROUND: Many clinical cases have proved that the satisfactory reposition, fusion and internal fixation in the internal fixation for inferior lumbar spondylolisthesis are not consistent with the postoperative symptoms and physical signs, and functional restoration.OBJECTIVE: To investigate the application of somatosensory evoked potential(SEP) in the monitoring during internal fixation for inferior lumbar spondylolisthesis, and the effects of SEP monitoring on the improvement of postoperative symptoms and the spinal functions as well.DESIGN: A randomized controlled trial.SETTING: Inpatient department of spinal surgery, an affiliated hospital of a university. PARTICIPANTS: Fifty-two patients with inferior lumbar spomlylolisthesis including 23 male and 29 female cases aged between 18 and 68 years old were admitted by the Department of Spinal Surgery, Second Affiliated Hospital(Shenzhen People's Hospital) of Jinan University, from June 2000 to December 2003. All cases were randomly divided into control group(n = 20) and monitor group ( n = 32).METHODS: SEP induced by segmental stimulation in cutaneous nerve was used in the control group for preoperative and intraoperative monitoring, and postoperative follow up. The intraoperative potential changes in patients with excellent and good improvement in postoperative functions had been retrospectively investigated to confirm the effective indices for intraoperative monitoring, which thereby provided references for intraoperative monitoring in patients of monitor group.MAIN OUTCOME MEASURES: ① Evaluation of postoperative spinal function; ② SEP latency and amplitude.RESULTS: SEP values after postoperative anesthesia were set as basis.The manifestations of intraoperative potential alterations: ① If the latency reduced 10% -15% or the amplitude increases more than 40% after fixation, it suggested favorable prognosis; ② The potential indices were stable during monitoring, or the reduction of latency was less than 10%,or the increase of amplitude was less than 30%, the fixation could be continued, and partial functions of nerve root and symptoms could be improved after surgery; ③ During the surgery, if potential indices had transient lluctuation, which could be recovered to basic potential within 15 to 20 minutes, fixation should be stopped during the fluctuation. Still partial functions of nerve root and symptoms could be improved after surgery; ④If the intraoperative latency prolonged more than 5%, or amplitude reduced more than 10%, or part of the components disappeared, or the wave shape dispersed, it might suggest postoperative aggravation of pain and dyskinesia. So intraoperative adjustment was necessary. The coincident rate of the improvement of the indices of intraoperative monitoring and the improvement of postoperative spinal function reached 93.75%.CONCLUSION: SEP induced by segrmental stimulation in cutaneous nerve is an objective and effective method in the monitoring and instruction of decompression, reposition, fixation of internal fixation for inferior lumbar spondylolisthesis, which has important merits in the improvement of the function of nerve root and the restoration of spinal function.

Objective:To explore the protective mechanisms of You-gui-wan on hydrocortisone-induced apoptosis of murine thymocytes.Methods:Annexin V/ PI double stain was applied to analyze the apoptotic states of thymocytes after injection with hydrocortisone coupled with or without administration You-gui-wan.The transcriptions of Bcl-2 and Bax were tested by RT-PCR.Results:The apoptotic rate of thymocytes was seriously increased in hydrocortisone-injected mice contrasted to matched control mice(P

Objective To investigate the expression and significance of E-cadherin and β-catenin in type Ⅰ endometrial carcinoma.Methods The expression of E-cadherin and β-catenin were detected by immunohistochemistry in 60 patients with type Ⅰ endometrial carcinoma and 10 normal endometrial tissues.The patients were followed-up postoperatively for the survival rate.Results Expression of E-cadherin and β-catenin in 10 normal endometrial tissues was all high expression,while those of both abnormal expression in type Ⅰ endometrial carcinoma with expression rates with 60.0 ％ (36/60) and 55.0 ％ (33/60),respectively,which were difference compared with both in normal endometrial tissues (P ＜ 0.05).The expression rates were markedly decreased in carcinoma with lymph node metastasis than those without lymph node metastasis.The proportions of abnormal expressions of E-cadherin and β-catenin were positively correlated with tumor grade and myometrial invasion in type Ⅰ endometrial carcinoma (P ＜ 0.05).The postoperative two-year survival rate in the patients with abnormal expression of E-cadherin and β-catenin were much lower than those with normal expression (P ＜ 0.05).Conclusions Abnormal high expression of E-cadherin and β-catenin may play important roles on generation and metastasis in type Ⅰ endometrial carcinoma.Both of them may be promising method for predicting invasion and metastasis and can be prognostic predictors in type Ⅰ endometrial carcinoma.

Objective To study the effect of pelvic autonomic nerve preservation(PANP)on urination and sexual function in total mesorectal excision(TME). Methods Two hundred and forty cases of male rectal cancer patients,divided into the PANP who accept the pelvic autonomic nerve preservation in TME,and the control group of 120 patients who do not.The urination and sexual function were observed and compared.3-year-survival rate,local recurrence rates of the two groups were recorded. Results The urinary disorder rates,erective disorder rates and ejaculation disorder rates of PANP group were 30.8%,28.3%and 34.2%,while values of control group were 55.0%、60.0%and 62.5%.The difference between them had statistical significance(P<0.05).The 3-year-survival rate and local recurrence rate of PANP group were 9.4%and 75.0%.The 3-year-survival rate and local recurrence rate of control group were 9.0%and 65.0%.There was no significant difference between them(P>0.05). Conclusion The PANP technique in TME could improve the urinary and sexual function of male patients without affect the prognosis.

Objective To study the real world of bicyclol tablets in the treatment of viral hepatitis and its influence on platelets.Methods The hospital information system (HIS) was selected from 18 Triple-A hospitals in China on patients with bicyclol tablets information as exposed group (2 690 cases),patients with unused bicyclol tablet (2 690 cases) as an exposed group,an exception occurs of platelet as an index of the ending.Results The incidence of abnormal platelet difference in two groups before the treatment were not statistically significant.The incidence of abnormal platelet reduce between two groups have statistical significance,can be thought of exposure of abnormal lower rate (11.75%)lower than that of non exposed group(15.17%) (P<0.01).Conclusion Bicyclol piece have signficantly curative effect on the treatment of viral hepatitis.It shows more safety,and less impact on platelets.It is worth to be used in clinical practice.

Objective To identify and analyze the homology of Ochrobactrum isolated from clinical blood samples of children.Methods The 26 strains of Ochrobactrum anthropi were identified by Vitek 2 Compact and test strips of API 20 NE bacterial identification system.The biochemical phenotypes were identified by manual tests.The 16S rRNA and recA gene were amplified by PCR and sequenced.The drug sensitivity tests of Ochrobactrum anthropi were performed by Vitek 2 Compact and matched GN13 card.The homology was analyzed by pulsed field gel electrophoresis.Results Based on the identification of the instruments and the manual tests for biochemical phenotype,all the 26 experimental strains were Ochrobactrum anthropi.The results of sequencing for 16S rRNA and recA gene amplification products showed 25 strains were Pseudochrobactrum saccharolyticum and the other 1 was O.grignonensein.Drug sensitivity analysis showed that the all the 26 strains were resistant to aztreonam,but the sensitive rates to quinolones,aminoglycosides,trimethoprim sulfamethoxazole,four generation of cephalosporins and the antibiotics compound of piperacillin/tazobactam were all more than 80％.Pulsed field gel electrophoresis analysis showed that the 25 strains were highly homologous with differences of only 1 to 3 bands in fingerprint profiles.Conclusion Based on the biochemical phenotype and the sequencing of 16S rRNA and recA gene,the Ochrobactrum-like bacteria could be identified to the level of species.The highly homologous strains of Pseudochrobactrum saccharolyticum may be sourced from a clustered infection.

Objective To investigate the effect of medical rescue of the Maritime Medical Team (Corps) for mass sick and wounded in maritime disaster so as to improve the medical rescue capacity for maritime disasters.Method The construction of maritime medical teams (corps) constituted with various numbers of 10, 15,50 and 120 team members, and the development of algorithm in practice were reviewed. In 68 maritime disasters from January 2003 to December 2009, 937 wounded were rescued by first-aid at sea. The patients were classified and given cardiopulmonary cerebral resuscitation, emergency operation, complication prevention, comprehensive treatment for seawater immersion wound and rapidly referred to hospitals. Results Of 937 patients, 872 survived (93%) and 65 died (7%). Of the dead, 16 died in one hour (25%), 43 died in 24 hours after injury (66%),andofthem, 61died of trauma (94% ) , 2 died of drowning and 1 died of poisoning. Conclusions Besides a good command of the features of mass sick and wounded, organization and program, treatment strategies and measures, the timely and effective assignment for on-site first aid at sea and safe transfer were very important for medical rescue of mass patients in maritime disaster. After the practice of maritime medical team (corps) in medical rescue during maritime disaster, the rapid response capability, cooperation and the quality of rescue were improved, and the experience of medical service of marine medical team (corps) was enriched.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Middle Aged ; Plague ; epidemiology ; Yersinia pestis

Objective To determine the value of lymph node ratio (LNR) in prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods The pathological and survival data of ICC patients were extracted from the Surveillance Epidemiology and End Result Database (SEER).The value of LNR in prognosis of patients with intrahepatic cholangiocarcinoma was evaluated by the Kaplan-Meier and Cox proportional hazard models.Results A total of 357 pathologically confirmed ICC patients were included in this study (158 males,199 females).The results showed that patients with lymph node metastasis had significantly shorter survival time than patients without metastasis [(41.6 ± 1.8) vs.(23.2 ± 2.2) months,P＜ 0.05].Multivariate analysis on survival showed that the status of lymph node metastasis was independent prognostic factor of survival,after adjusting for age,gender and tumor stage.Only a LNR ≥ 20％ was an independent risk factor of prognosis (HR=2.3,95％CI:1.4～3.8,P＜0.05).Conclusion A positive lymph node ratio was superior to lymph node metastasis in predicting survival in patients with intrahepatic cholangiocarcinoma.

Objective To analyze the causes,cardiac function grading and drug application related to heart failure of the patients with chronic heart failure in Yongchuan district people's hospital.Methods The cases of chronic heart failure of department of cardiology in our hospital from January 1st,2012 to December 31st,2015 were counted and retrospectively analyzed.Results 3 320 cases of chronic heart failure in our hospital chosen from 8 126 medical records accounted for 40.86% of total discharged patients in the same period,including 2 262 cases of coronary disease (68.13%),353 cases of rheumatic heart disease (10.63%)and 265 cases of pulmonary heart disease (7.98%),who took up the top three in the spectrum of disease;2 683 cases of NYHA heart function Ⅲ magnitude accounted for 80.81%;The utilization rate of diuretic,digoxin,spironolactone,angiotensin -converting enzyme inhibi-tor,angiotonin receptor blocker,beta adrenergic receptor were 71.23%,27.23%,70.48%,30.75%,30.78%respectively.The statistical analysis showed that the differences were statistically significant between the patients using diuretics and the patients using spirolactone(χ2 =2.386,P <0.001),the patients with hypertension and the patients with no hypertension using ACEI /ARB(χ2 =2.727,P <0.001),and merged chronic bronchitis patients and the chro-nic bronchitis patients using beta -blocker(χ2 =61.807,P <0.001).Conclusion The patients with chronic heart failure takes up a higher portion among the inpatients in department of cardiology in the district level hospital.The heart function decreases significantly and the normative drug therapy needs to be improved.