Objective:To investigate the clinical effects of dezocine combined with flurbiprofen anesthesia for thoracotomy patients and the influence on postoperative irritability status. Methods:Totally 98 cases of patients with thoracotomy were selected and randomly divided into the control group and the research group with 49 ones in each. The control group was given fentanyl and dezocine patient-controlled intravenous analgesia at the end of surgery, and the research group was given dezocine combined with flurbiprofen instead. The clinical anesthesia effects and postoperative irritability status of the two groups were observed and statistically analyzed. Results:The VAS scores in 2 h and 4 h after the surgery in the research group were significantly lower than those in the control group ( P<0. 05). The Ramsay sedation scores at the extubation and in 5min after the extubation in the research group were significantly better than those in the control group (P<0. 05). Furthermore, the postoperative irritability rate and the probability of adverse reactions were significantly lower in the research group (P<0. 01). Conclusion:The implementation of dezocine combined with flurbiprofen anesthe-sia for thoracotomy patients can fully ensure analgesic effect and relieve postoperative restlessness with good clinical application value.

Objective·To investigate the effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF). Methods·Fifty-four patients who underwent MIS-TLIF were divided into treatment group (n=28) and control group (n=26). The control group received conventional rehabilitation treatment, while the treatment group received neurodynamic mobilization every day after the first post-operative day. The score of visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were evaluated before and after the treatment. Results·There was no significant difference in the score of VAS or JOA between two groups before the treatment or three months after surgery (P>0.05). The score of VAS was significantly lower (P<0.05), and the JOA score was significantly higher (P<0.05) in the treatment group than in the control group four days after surgery. Conclusion·The early neurodynamic mobilization is effective to decrease the recurrence rate of sciatica in patients underwent MIS-TLIF.

Objective To investigate the relationships between aspirin resistance (AR) and laboratory indexes and different types of traditional Chinese Medicine(TCM)syndrome in patients with acute cerebral infarction. Methods Two hundred and eight different types of TCM syndromes of patients with acute cerebral infarction admitted from January 2012 to November 2013 in the Neurology Department of Shanghai Seventh People's Hospital were divided into AR group and aspirin sensitive(AS)group according to the rate of AR. Simultaneously,28 healthy volunteers in the same period were assigned in a healthy control group. The changes of red blood cell volume distribution width coefficient of variation(RDW-CV),platelet count(PLT)and homocysteine(Hcy)levels were observed in the three groups. The correlation between different types of TCM syndromes and AR,PLT,RDW-CV,and Hcy was analyzed by non-conditional logistic regression. Results The total incidence of AR was 29.32%(61/208)in 208 patients with acute cerebral infarction. There were 165 cases with Qi deficiency and blood stasis syndrome,the incidence of AR being 26.06%(43/165);32 cases with wind phlegm obstructing channel syndrome,the incidence of AR, 43.75%(14/32);11 cases with liver yang hyperactivity syndrome,the incidence of AR,36.36%(4/11);in the comparisons,the incidence rates of AR among the above types of syndromes had no statistical significant differences (P>0.05). Compared with the healthy control group,the levels of PLT,RDW-CV,Hcy in AR group and AS group of various types of TCM syndrome were increased,the PLT and RDW-CV levels in patients with Qi deficiency and blood stasis syndrome in AR group were more significantly elevated in the comparisons between AR and AS groups, there were statistical significant differences〔PLT (×109/L):212.16±66.48 vs. 187.54±56.85, RDW-CV:(14.34±3.16)% vs.(13.20±2.16)%,both P<0.05〕;the level of Hcy in patients with wind phlegm obstructing channel syndrome in AR group was increased more significantly than that in AS group,the difference between the two groups being statistically significant(μmol/L:27.29±18.64 vs. 21.36±14.61,P<0.05). Logistic regression analysis showed,increased PLT〔odds ratio(OR)=1.007 2,95%confidence interval(CI):1.001 2-1.013 2,P=0.018 5〕and RDW-CV〔OR=1.165 4,95%CI:1.007 9-1.347 4,P=0.038 8)was independence risk factor of AS development. Conclusion The elevation of RDW-CV,PLT,Hcy in level reflects the index of AR production, especially in patients with acute cerebral infarction accompanied by Qi deficiency and blood stasis syndrome and wind phlegm obstructing channel syndrome.

OBJECTIVE: In order to study the mechanism of the aqueous humor circulation and its relationship to the glaucoma macroscopically with engineering methods. METHODS: A dynamistic model was presented, which can be used to simulate the situation and the treatment of the primary open angle glaucoma (POAG). The frame of the model was built based on the ophthalmically accepted feedback mechanism between the aqueous humor circulation and the intraocular pressure (IOP). The transfer functions and the parameters were educed from the analysis of physiological theories, the basic elements of hydrodynamics, and the clinical parameters. The relation between the parameters of the system and the episode mechanism of POAG was discussed. A digital method was used to simulate the Challenge test and some medicines' treatment of POAG, and the results were consistent with clinical observations. RESULTS: The results of simulation illuminate that the model can simulate the mechanism of the aqueous humor circulation and the curative mechanism of some medicines under the physiological condition and the pathological condition of the POAG. CONCLUSION: A few parameters which can hardly be captured with clinical method could be obtained from the model. These parameters can be helpful for the diagnosis and prediction of the curative effect.
Aqueous Humor* ; Diagnosis ; Glaucoma ; Glaucoma, Open-Angle* ; Hydrodynamics ; Intraocular Pressure

The following curriculum reforms in medical functional experiment have been performed in Guangzhou Medical University: taking comprehensive experiments as main contents, supported by self-designed experiments and innovative experiments after class, applying the blended teaching mode by combining virtual simulation experiments and animal experiments, setting up "simulative functional experiment" as an optional course based on intelligent simulated human system, and developing medical popular science education for teenagers. Questionnaire results show that, through these reforms, remarkable effects have been achieved in students' integrated practical ability, scientific accomplishment, clinical and innovative thinking ability.

Objective To compare the clinical characteristics and influence factors of hyperuricemia between genders,in order to provide references for better controlling and preventing the occurrence and development of hyperuricemiaprovide.Methods A total of 5 783 people who underwent physical examination in two Baoding Health Screening Centers from January 1st to June 1st,2016 were enrolled in this study,and all volunteers completed physical examination,laboratory examination and questionnaire survey.Patients with hyperuricemia were selected to analyse the clinical characteristics and influence factors.Results There were statistically significant differences in clinical characteristics,including obesity,blood pressure,blood glucose,blood lipids,liver function,renal function,anemia,blood rheology examination,thyroid ultrasound and lateral radiographs,between male and female patients with hyperuricemia (P＜0.05).The survey showed that there were statistically significant differences in age,education level,marital status,work status,sleeping status,smoking and drinking between male and female patients with hyperuricemia (P＜0.05).The red blood cells counts,marital status and education level were influence factors for female patients with hyperuricemia,while have little effect on male patients.The smoking,creatinine and diastolic blood pressure were influence factors for male patients with hyperuricemia,while have no effect on female patients.Conclusion The clinical characteristics and the influencing factors of male and female patients with hyperuricemia are different,so corresponding preventive and therapeutic measures should be taken for male and female patients.

Objective To evaluate the biomechanical stability of anterior odontoid screw plate (AOSP).Methods Eight fresh-frozen cadaveric cervical spine specimens were subjected to stepwise destabilization of the C1-Ca complex,simulating a type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury.Intact specimens,fractured specimens,and fractured specimens with posterior,anterior fixation techniques were divided into six groups:control group (intact),injury group of type Ⅱ odontoid fracture and type Ⅰ Hangman fracture combined with C2-3 disk injury,after anterior cervical plate + odontoid screw + cage (ACP + OS + cage) group,after anterior odontoid screw plate (AOSP) fixation system group,after affixing rods from pedicle screws in C2 to lateral mass screws in C3 + odontoid screw (C2PS + C3LMS +OS) group,after affixing rods from pedicle screws in C1 to pedicle screws in C2 and lateral mass screws in C3 (C1 PS + C2PS + C3LMS) group.The range of motion (ROM) and neutral zone of C1-C2 and C2-C3 segment was tested.Results There was statistically significant difference between the C1PS + C2PS + C3LMS fixation group and the AOSP fixation group of ROMC1-C2 (P ＜ 0.05).During all loading modes,AOSP + Bone graft fixation significantly outperformed the ACP + OS + cage fixation in limiting ROMC2-C3.During flexion and extension,AOSP fixation significantly outperformed the C1PS + C2PS + C3LMS fixation and C2PS + C3LMS + OS fixation in limiting ROMC2-C3.Conclusion The AOSP fixation system has excellent biomechanical performance when dealing with type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury,and appear to be a safe and effective technique for dealing with the combined injury.

Objective To evaluate the biomechanical stability of anterior odontoid screw plate (AOSP).Methods Eight fresh-frozen cadaveric cervical spine specimens were subjected to stepwise destabilization of the C1-Ca complex,simulating a type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury.Intact specimens,fractured specimens,and fractured specimens with posterior,anterior fixation techniques were divided into six groups:control group (intact),injury group of type Ⅱ odontoid fracture and type Ⅰ Hangman fracture combined with C2-3 disk injury,after anterior cervical plate + odontoid screw + cage (ACP + OS + cage) group,after anterior odontoid screw plate (AOSP) fixation system group,after affixing rods from pedicle screws in C2 to lateral mass screws in C3 + odontoid screw (C2PS + C3LMS +OS) group,after affixing rods from pedicle screws in C1 to pedicle screws in C2 and lateral mass screws in C3 (C1 PS + C2PS + C3LMS) group.The range of motion (ROM) and neutral zone of C1-C2 and C2-C3 segment was tested.Results There was statistically significant difference between the C1PS + C2PS + C3LMS fixation group and the AOSP fixation group of ROMC1-C2 (P ＜ 0.05).During all loading modes,AOSP + Bone graft fixation significantly outperformed the ACP + OS + cage fixation in limiting ROMC2-C3.During flexion and extension,AOSP fixation significantly outperformed the C1PS + C2PS + C3LMS fixation and C2PS + C3LMS + OS fixation in limiting ROMC2-C3.Conclusion The AOSP fixation system has excellent biomechanical performance when dealing with type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury,and appear to be a safe and effective technique for dealing with the combined injury.

Objective To detect the dynamic visual acuity ( DVA) before and after vestibular habituation of subjects in order to optimize the DVA assessment criteria .Methods The vestibular function examination system was applied to the detection of static and dynamic visual function in 16 healthy subjects .Results When the speed of left or right swinging was fast enough , DVA before and after vestibular habituation was different .Conclusion Subjects with vestibular habituation can reduce their sensitivity to the vestibular system , the changes in DVA are better than before habituation , and the vestib-ular function adaptability training may have effect on DVA .

Objective:To explore the predictive value of fractional excretion of IgG (FE IgG) on drug responsiveness and remission in patients with idiopathic membranous nephropathy (IMN).Methods:Retrospective analysis of 82 patients with IMN diagnosed by clinical and pathological data and regularly followed up from April 2014 to August 2017. Receiver operating characteristic (ROC) curve was used to determine the FE IgG threshold. Comparing the difference of remission time under different baseline levels of FE IgG, and analyzing the effect of different levels of FE IgG on the drug responsiveness of immunosuppressive therapy (tacrolimus or cyclophosphamide) and supportive therapy.Results:Areas under the curve (AUC) of estimated glomerular filtration rate (eGFR), 24-hour urinary protein quantity and FE IgG were 0.509, 0.701 and 0.948, respectively. Before treatment, there was no significant difference in gender, age, mean arterial pressure and eGFR between the high FE IgG group (FE IgG>0.029) and low FE IgG group (FE IgG<0.029) ( P>0.05). The remission time of high FE IgG group was (18.75±6.81)months, while it was (8.46±3.74)months in low FE IgG group, with significant difference ( P<0.01). There was no difference in remission time of immunosuppressive therapy and supportive therapy in low FE IgG group ( P=0.265), bo-th of which were lower than the high-level immunosuppressive therapy group ( P<0.001). The remission time of tacrolimus was shorter than that of cyclophosphamide in high FE IgG group, but with no significant difference ( P=0.131). There was significant difference in the remission time of tacrolimus between the high and low level groups of FE IgG ( P<0.01). Under electron microscope, the ratio of foot process fusion and podocyte diffuse vacuolar degeneration in the high level group of FE IgG was higher than that in the low level group ( P<0.01). Conclusions:FE IgG can be used as a clinical indicator for predicting drug responsiveness and remission in patients with IMN, and is essential for early identification of high-risk patients and for making clinical decisions. Patients with high FE-IgG may benefit from early initiation of immunosuppressive therapy.