Post-traumatic brain syndrome is a common disease in neurosurgery department, referring to a variety of neurological symptoms after brain traumas. Currently, research shows that this disease involves the fields of neurologic anatomy, pathology, trauma mechanics, neurobiochemistry, cerebral hemodynamics, etc, and the treatment majorly includes medication, hyperbaric oxygen, and psychotherapy, but they don't work so well. In primary hospitals, the convenient, low-cost and safe acupuncture-moxibustion therapy should be paid more attention. By retrieving literatures during the latest 10 years, this article has concluded that the acupuncture-moxibustion treatments for this disease covered acupuncture, auricular acupoint therapy, bloodletting therapy, and moxibustion, and the action mechanisms were mostly the improvement of cerebral circulation and cerebral metabolism, and the change of neurotransmitters and cytokines. The improvement of cerebral circulation and increase of cerebral blood flow can be taken as the future direction in the research on acupuncture-moxibustion for this disease. However, in the treatment of post-traumatic brain syndrome with acupuncture-moxibustion, it still requires the standardization of acupuncture and the objectification of evaluation indexes.

[Objective]To analyze the clinical features of spinal fracture of the injured in Wenchuan Earthquake and to summarize the medical rescue.[Method]The clinical data of 94 injured cases with spinal fracture in the earthquake were collected and analyzed,including the general condition,injury mechanism,associated injuries and the rescue measures.[Result]The incident rate of the male was much higher than that of the female,the incidence of spinal fracture was high in 21~60-years old;the associated injuries were found in 54 cases,taking up 57.4%.The spinal fracture typing showed that 89 cases had flexion-compression fracture and burst fracture,taking up 94.7%.[Conclusion]Earthquakes cause a large amount of the injured with spinal fracture,who are evacuated within a concentrated time,the injuries are severe with many associated injuries.Scientific organization and reasonable division are critical in the immediate medical rescue of the injured in large quantity within the shortest time.

Objective To compare the treatment effects of self-designed anti-rotation reduction internal fixators (ARRIF), atlas fixator (AF) and Dick screw in reduction and fixation of different thoracolumbar spinal fractures. Methods Reduction effect, operation time, bleeding volume during operation and complications were observed and compared after ARRIF, AF and Dick screw were used to treat 90 cases of thoracolumbar spinal fractures. Results Compared with AF and Dick screw, the operation time of ARRIF was shorter with less bleeding volume during operation as well as less complications like broken or pulled-out screw or broken rod. Conclusions All three fixation methods can attain the reduction and fixation of various kinds of thoracolumbar spinal fractures. However, ARRIF is the most valuable transpedicular internal fixator and can more conveniently reduce and fixate the different spinal fractures and AF places the second.

By mechanical comparison study of ARRIF,Dick and AF ,their reliable basis for further clinical application was evaluated. Models of spinal fracture were made using fresh cadavers. According to the Latin squre experimental designing principle, the fracture specimens were fixed with ARRIF,Dick and AF separately. The shift and angle changes were observed under different loads,and the analysis of variance was performed to all the data with the SPSS software . The single spinal compression fracture model showed no significant shift and the mechanical features were similar when it was fixed by ARRIF,Dick and AF. The model of spinal compression fracture with three spinal damages showed significant differences among these three fixings when axial torsion load was given. ARRIF and AF were clearly superior to Dick. The histological observation of ARRIF recorded no significant changes in the bone trabecula around the nail pass and the structure kept normal. The mechanical feature of ARRIF was basically similar to that of AF and Dick. Our conclusion is that because of the characteristics of its designing, the anti-axial torsion ability of ARRIF is outstanding and it can be easily fixed in application, thus it holds certain value in clinical practice.

Objective To explore the effect of breast-conserving operation for the treatment of early-stage breast cancer. Methods From November 1999 to Octorber 2001, the patients with early-stage breast cancer were treated with breast-conserving surgery followed by radical irradiation according to the patients' will. The cosmetic results and quality of life were analyzed after surgery and radiation. Results In all the patients received operation treatment from 1999 to 2001, eighteen patients were treated with breast-conserving surgery with breast conservation rate of 10.2%, of which 7 cases with quadrantetomy plus axillary lymph node dissection (ALND), 8 cases with lumpectomy plus ALND and 3 cases with lumpectomy. Pathological staging was as follow: 4 cases in stage 0, 12 cases in stage Ⅰ, and 2 cases in stage Ⅱ. All cases were followed-up. The cosmetic results were good in 94%(17/18) and fair in 6%(1/18). All the patients had not local recurrence and distant metastasis. Conclusions Breast-conserving surgery followed by radiation therapy is superior to mastectomy in terms of improving breast cosmesis and quality of life. Postoperative radiation therapy does not affect the cosmetic result.

Objective To evaluate impacts of acute hypervolemic hemodilution (AHH) and intra-operative cell salvage (ICS) with 6％ volume fraction of hydroxyethyl starch (HES) on hemodynamics,blood saving efficiency and renal function of orthopedic surgery patients.Methods A total of 58 patients from orthopedic surgery were involved and randomly divided into AHH + ICS group (30 cases) and control group (28 cases).Changes of hemodynamic indices (HR,MAP and CVP) and renal function indices (BUN,BCr,UCr and ALB) in both groups were compared before operation (T0),immediately after operation (T1) and at postoperative 4 hours (T2),1 day (T3) and 2 days (T4).CCr was counted and intraoperative blood conservation was observed at each time point as well.Results HR,MAP and CVP of the two groups had no significant differences.Both groups showed some drop of HR (P ＜ 0.05),but an increase of MAP and CVP at T1-T4 (P ＜ 0.05),in contrast with levels at TO.BUN,BCr and ALB also showed insignificant differences between groups or within group at each time point.CCr in the control group showed no significant difference at each time point.On the contrary,CCr in the AHH + ICS group had a fall at T1-T4 and was declined to the lowest level at T2.CCr in the AHH + ICS group showed a recovery at T3-T4 and its level at T4 was still lower than that at TO,with no significant difference.CCr in the two groups showed insignificant difference at TO,but its level in the AHH + ICS group was lower than that in the control group at T1-T4,at T2 in particular (P ＜0.01).Moreover,CCr in the two groups was still significantly different at T4 (P ＜ 0.05).Renal function indices of the two groups were all within normal range at each time point.Intraoperative blood loss and unrine volume of the two groups had no significant differences,but intraoperative fluid requirement,allogenic blood transfusion volume and transfusion rate of AHH + ICS group were notably lower than those of control group (P ＜ 0.05 or P ＜0.01).Conclusions AHH plus ICS using HES are safe,effective and promising integrated blood conservation measures,which significantly reduces intraoperative allogenic blood transfusion volume and transfusion rate and has few impacts on fundamental vital signs and renal function.However,prolonged use of large dose of HES may do harm to renal function and therefore should be carefully considered in treatment of patients with severe renal dysfunction.

Objective To observe the in vitro inhibitory effects of brucea javanica oil on human washed platelet and explore the possible mechanism.Methods Human washed platelets were mixed withdifferent concentration of brucea javanica oil which were divided into four groups[untreated control group,negative control group,9.0% of brucea javanica oil group,and 22.5%of brueea javanica oil group].The maximal ratio of platelet aggregation induced by adenosine liphosphate(ADP),arachidonic acid(AA),collagen,and thrombin,respectively,was measured with platelet aggregation analyzer.The expressions of fibrinogen receptor(FIB-R)and P-selectin(CD_(62p))on external membrane of activated platelet were determinated with flow cytometry.The F-actin of cytoskeletal structure in activated platelet was detected by SDS-PAGE.Results At 9.0% of brucea javanica oil,the maximal ratio of platelet aggregation[(57.7±4.0)%,(62.2±3.9)%,(66.9±5.0)%and(71.8±5.1)%]induced by ADP,AA,collagen,and thrombin,was significantly lower than that[(75.3±4.1)%,(79.3±4.8)%,(80.6±5.4)%,(84.1±6.2)%]at negative control(0% of brucea javanica oil)(P<0.01),but makedly higher than that[(39.2±3.5)%,(45.8±3.4)%,(51.2±3.9)%and(56.7±4.8%)]at 22.5%,respectively(P<0.01).The inhibitory rate of platelet aggregation(47.9%,42.2%,36.5%and 32.6%)at 22.5%of brucea javanica oil was notably higher than that(23.4%,21.6%,17.0%and 14.6%)at 9.0%,respectively(P<0.001).There was a negative correlation between brucea javanica oil concentration and the aggregation ratio of platelet stimulated by the four agonists,respectively(r=-0.952,-0.961,-0.970,-0.975,P<0.001).At 9.0% of brucea javanica oil,the expression levels of FIB-R[(64.7±4.0)%]and CD_(62p) [(3.91±0.21)%] of platelet activated by ADP were significantly lower than that[(85.5±4.6)%and (5.05±0.27)%]at negative control,but remarkably higher than that[(36.2±3.9)%and(2.34±0.15)%]at 22.5%,respectively(P<0.01).There was a much higher inhibitory rate of platelet aggregation(57.7%)at 22.5%than that(24.3%)at 9.0%(P<0.01).The ratios(1.68±0.10 and 1.77±0.12)of F-actin photodensity at 22.5%and 9.0%to that in blank control were significantly lower than that(2.22±0.15)at negative control(P<0.01)but there was no statistical difference between the ratios in the group of 9.0%and 22.5%brucea javanica(P>0.05).Conclusions brucea javanica oil has special inhibitory effect on activated platelet and thrombosis in a dose-dependent manner.The mechanism is to inhibit the expression of fibrinogen receptor on external membrane of activated platelet,which is also related to the inhibition of F-actin and secretion of platelet.

Objective: To observe relation among sICAM-1 level in the sera of patients with chronic viral hepatic disease, viral replication and the clinical significance. Methods: The level changes of sICAM-1, IL-1,IL-8 and TNFa in the sera of patients with chronic hepatitis B(CH),chronic severe hepatitis B(CSH) and hepatocirrhosis (HC) were detected by ELISA. Results: The levels of sICAM-1,IL-1,IL-8 and TNFa in sera of the patients with chronic viral hepatic disease were significantly higher than those of healthy control group(P<0.01). The bilirubin level in the sera of patients with chronic viral hepatic disease of different clinical types positively correlated with sICAM-1 and cytokine activities. The sICAM-1 level in the sera of HBV-DNA or HBeAg positive patients was significantly higher than those of negative patients(P<0.05,P<0.01). Conclusion: The sICAM-1 level and activities of cytokine IL-1,IL-8 and TNFa as well as the bilirubin level in the sera of the patients can reflect the necrosis degree of hepatocytes, and the sICAM-1 level and activities of IL-1,IL-8 and TNFa were related to state of HBV carrier or the active degree of HBV in patients with hepatic disease.

Objective To investigate the methods and effects in repairing fracture of the fifth metatarsal base bone with Acutrak headless compression screws.Methods From May 2006 to October 2012,75 patients with fracture of the fifth metatarsal base bone were reduced and fixed using Acutrak headless compression screws.There were 38 males and 37 females with a mean age of 36 years (range,21-65 years).Injury arose from fall from height (35 cases),road traffic accidents (23 cases),and fall of heavy objects (17 cases).Fracture of the left foot occurred in 29 cases and the right foot in 46 cases.Results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) ankle and midfoot score.Results Seventy-two patients were followed up for mean 15 months (range,13 months5 years).Operative incision obtained primary healing without any complications.Mean AOFAS ankle and midfoot score increased to (93.0 ± 6.5) points (range,79-100 points) at postoperative 1 year,compared with the preoperative (28.0 ± 3.9) points (range,0-42 points) (t =7.650,P ＜ 0.05).Muscle force and valgus or abduction of mid-forefoot of the affected and unaffected sides demonstrated no significant difference after operation.Conclusion Acutrak headless compression screw system shows advantages of rigid fixation,few complications,and early healing in treatment of the fifth metatarsal base fracture.

Objective To compare DHS(dynamic hip screw )with PFNA(proximal femoral nail antirotation) treatment for intertrochanteric fractures and to analyze their postoperative complications .Methods A total of 107 patients with inter-trochanteric fractures were treated with DHS and PFNA fixation respectively .The type of fracture , postoperative complica-tions and overall efficacy were compared .Results After the follow-up of 28(24 to 36) months.DHS group had a higher overall incidence of postoperative complications than the PFNA group and the difference was statistically significant ( P<0.05).Conclusion In order to reduce the intertrochanteric fracture fixation complications , the type of fracture, osteoporo-sis and biomechanical fixation characteristics need to be considered when selecting surgical procedures .Postoperative func-tional rehabilitation is to be improved .The curative effect of PFNA is better than that of DHS .