0.05).The scores of MMSE increased significantly(all P

Bacterial infection is frequently seen in patients with liver cirrhosis,and the most common type of bacterial infection is spontaneous bacterial peritonitis (SBP).In clinical practice,antibacterial agents are widely used in the treatment of SBP.In addition,antibacterial agents can reduce rebleeding and mortality rates in patients with upper gastrointestinal bleeding.However,in order to avoid bacterial resistance,the appropriate use of antibacterial agents is very important.This article reviews the indications and resistance of antibacterial agents in patients with liver cirrhosis.

Esophageal variceal bleeding is a major complication of liver cancer and a major cause of death in patients with liver cancer.This article summarizes the current status of the treatment of liver cancer complicated by esophageal variceal bleeding, including drugs and endoscopic and interventional treatment, with an emphasis on treatment options for liver cancer complicated by esophageal variceal bleeding.

Objective To study the clinical efficacy and safety of Bryan-Morrey approach combined with anatomic locking plate fixation for the treatment of type C fractures of distal humerus.Methods Performed a prospective study from from Mar.2011 to Aug.2014.Thirty-three cases of distal humerus fracture were included in our study,and the mean age was (37.3 ±4.1) years old.The fracture type of distal humerus was 13-C according to Mayo classification.All the fractures treated with a Bryan-Morrey approach and anatomic locking plates.In the follow-up,Mayo scores of elbow,measurement of range of motion,elbow flexion and extension muscle strength were recorded and analysed.Results In this study,there were no serious complications,such as nonunion,rupture of triceps tendon and the infection,except partial sensory function injury of ulnar nerve in 5 cases.At the last time of the follow-up,elbow flexion muscle strength and extension muscle strength did not significantly decreased significantly compared with strength of the normal side.The mean flexion of the injured side was (134.5 ± 10.1) degrees,and the mean extension was (-1 1.5 ± 8.1) degrees.According to Mayo elbow performance score,the average scores of elbow was (86.2 ± 7.8),84％ of the patients got excellent or very excellent function results.Conclusion The Bryan-Morrey approach combined with anatomic locking plate fixation is a good choice for the treatment of distal humerus fractures of AO C type.

Liver cirrhosis is a common gastrointestinal disease. Portal vein thrombosis( PVT ) can increase the mortality of patients with liver cirrhosis. Studies showed that increased D-dimer level,spleen thickness and Child-Pugh score are independent risk factors of PVT in liver cirrhosis. In addition,increased portal vein diameter,reduced portal vein blood velocity,elevated P-selectin level can predict the development of PVT after portal hypertension surgery. This article reviewed the advances in study on risk factors of PVT in liver cirrhosis.

Objective To determine the prevalence and clinical features of peripancreatic vascular abnormalities in patients with pancreatitis.Methods The clinical data of 102 pancreatitis patients between January 2013 to December 2014 in the General Hospital of Shenyang Military Command who underwent contrast enhanced CT or contrast enhanced MRI scans were retrospectively analyzed.The radiological features of peripancreatic vascular abnormalities in such patients were examined, and the clinical features of pancreatitis patients with or without peripancreatic vascular abnormalities were investigated.Results Peripancreatic vascular abnormalities were found in 18 patients(17.6%), and vascular abnormalities were relatively common in portal vessels.No significant differences were observed on the age at onset, gender ratio, smoking status, alcohol consumption and length of stay between patients with and without peripancreatic vascular abnormalities.Compared with those without peripancreatic vascular abnormalities, patients with peripancreatic vascular abnormalities had a significantly higher incidence of peripancreatic fluid collection, pancreatic pseudocyst and gastric varices, and the differences were statistically significant(all P<0.05).Conclusions Peripancreatic vascular abnormalities can be complicated with pancreatitis.Enhanced CT or enhanced MRI were valuable in the diagnosis.Pancreatic pseudocyst, peripancreatic fluid collection and gastric varices were more common in pancreatitis complicated with peripancreatic vascular abnormalities.

Objective To discuss the value of the posterior long segments pedicle screws fixation in surgical treatment of thoracolumbar fracture-dislocation,and summarize the experience.Method s We reviewed the clinical information of 27 cases of thoracolumbar fracture-dislocation since July 2007 to March 2010; all the cases were treated with the posterior long segments pedicle screws fixation.In these cases,20were male,7 were female.And the age ranged from 18 to 58 years old (average age was 35 years).The posterior approach was used,and the pedicle screws were inserted into the 2 vertebrae above and below the fractured vertebrae.Posterior decompression and bone grafts for fusion were also accomplished during the operation.Results Follow-up ranged from 7 to 25 months,averaging 14 months.Completely restoration of the dislocation was got in 25 cases and the spine sequence resumed to nearly normal.One case with lateral dislocation failed to complete correction; another 1 case operated 20 days after surgery failed to complete correction of forward dislocation.At the last follow-up,the mean Cobb angle loss was 3 degrees,the height of the vertebral had obvious loss compared with that of post-operation.The loosen of screw nut was found during the follow-up,but no dislocation and secondary deformity were observed after fixation.There was no death,no infection.Conclusions The technique of posterior long segments pedicle screw fixation is of great value in the clinical applications,since it has the following advantages:the operation is simple,trauma is small,the fixation is firm,good restoration of fracture and dislocations can be easily got,and most importantly,it can effectively prevent long-term vertebral height loss and the backward protruding deformity.

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Budd-Chiari syndrome (BCS) is characterized by the hepatic outflow obstruction from the small hepatic vein to the superior hepatic inferior vena cava. Portal vein thrombosis (PVT) refers to the development of thrombosis in the main portal vein, with or without thrombosis in the superior mesenteric or splenic vein. A large number of studies have shown that prothrombin (factor II, F2) G20210A mutation is related to BCS and PVT. F2 and its G20210A mutation are introduced, the effect of F2 G20210A mutation on thrombosis is reviewed, and the prevalence of F2 G20210A mutation in China is analyzed. An attempt is made to focus on the association of F2 G20210A mutation with PVT and BCS. It is believed that F2 G20210A mutation to some extent increases the risk for PVT and BCS. However, the prevalence of F2 G20210A mutation is extremely low in the Chinese population. Thus, this mutation may not be regarded as the cause of PVT and BCS in China.

Objective To explore the clinical efficacy and application value of hemivertebra resection for treating congenital ky‐phoscoliosis .Methods 30 cases of congenital kyphoscoliosis and hemivertebral deformity in our hospital from January 2011 to Jan‐uary 2013 were selected as the research subjects .Among them ,12 cases of simple vertebral and non‐structural bending were per‐formed the posterior hemivertebral resection and short segment pedicle screw fixation ;3 cases of complicating lordosis and hemiver‐tebral protruding to the ventral side were performed the anterior hemivertebral resection and bone graft fusion fixation ;15 cases of complicating structural compensatory curve were performed the posterior transpedicle hemivertebral resection and compensatory bend long segment fixation and fusion .The clinical effects of surgical treatment for all patients were performed the comparative a‐nalysis .Results The mean postoperative kyphosis Cobb angle and the average final follow‐up Cobb angle were (8 .6 ± 3 .14) °and (11 .2 ± 7 .23) °respectively .The ultimate orthopedic rate of kyphosis was 58 .6% ;the average postoperative Cobb angle and and the average final follow‐up Cobb angle of scoliosis were (12 .8 ± 5 .47)°and (16 .2 ± 6 .24)°respectively ,the final orthopedic rate of scoliosis was 66 .5% .The mean Cobb angle of kyphosis and scoliosis after operation was significantly less than that before opera‐tion ,the difference was statistically significant(P< 0 .05) .Kyphosis and scoliosis were significantly improved .No significant post‐operative complications occurred .The effects were satisfied by the patients .Conclusion The hemivertebral resection has significant effect for treating congenital kyphoscoliosis with high kyphoscoliosis orthopedic rate and is worthy of further clinical study .