Objective To evaluate the application effect of bedside evaluation of deglutition function and predictive nursing intervention on patients with dysphagia in neurology department. Methods 320 Patients with dysphagia were divided into the observation group and control group with 160 cases in each group. The observation group was given admission nursing evaluation and bedside evaluation of deglutition function while the control group only received admission nursing evaluation. The incidence of complications in each group were assessed. Results The incidence of complications such as aspiration, pulmonary infection, asphyxia and metabolic disturbance in the observation group was lower than that of the control group(P＜0.01).Conclusion The bedside evaluation of deglutition function could accurately evaluate the degree of swallowing disorder and supply theoretical evidence for predictive nursing intervention by in structing clinical application of selective measures for patients with dysphagia. This could guarantee safe food intake and reductive incidence of complications of patients. So we advocated that bedside evaluation of deglutition function should be a routine admission nursing evaluation in neurology department.

[Objective]To evaluate the diagnostic value of ultrasonography in patients with carpaltunnel syndrome (CTS) by measuring the thickness of transverse carpal ligament.[Method]Forty patients who had clinically and electrophysiologically confirmed as CTS underwent surgery and ultrasonographic examination by the same operator for the thickness of transverse carpal ligaments at the level of the hook of the hamate bone in transverse plane preoperatively.Twenty-four asymptomatic normal wrists served as control.Data of the ultrasonography and surgey from patients and the control groups were compared to determine the diagnostic parameters.[Result]The ultrasonographic thickness of transverse carpal ligaments in CTS patients was (0.42?0.08)cm at hamate hook leve and the data from surgey was (0.40?0.10).The data in control group was (0.29?0.07)cm.There was significant difference in the mean value of thickness of transverse carpal ligaments between the two groups at the same level.There was no significant difference between the data of CTS from surgey and ultrasonography.[Conclusion]Ultrasonography examination of the thickness of transverse carpal ligamentsis is a new and feasibile method in the diagnosis of carpal tunnel syndrome.

Malignant tumor is typically characterized by fast proliferation and invasiveness. As such, tumor blood supply often fails to satisfy tumor growth requirements, resulting in a stressful cancer microenvironment with low oxygen level and insufficient nutri-ents. Cancer cells survive in such stressful environments by activating various signals (such as unfolded protein response), changing metabolic pathways, and undergoing autophagy. Hence, the cross-talk among these mechanisms should be determined to provide new insights into the interdynamics of cancer cells and their microenvironment. Furthermore, results would provide relevant information for the development of novel therapeutic strategies.

Objective To investigate the clinical application value of fluorescence PCR in vitro diagnosis(IVD)reagent kits in the HLA-B27 detection by comparing 2 kinds of HLA-B27 IVD reagent kit approved by CFDA.Methods A total of 573 clinical blood samples were collected and detected for HLA-B27 by the approved reagent kits based on the fluorescence PCR technique and the flow cytometry.The samples with inconsistent testing results by the two kits were further confirmed by the PCR sequencing.At the same time,about 5% samples of the positive results detected by the fluorescence PCR method were extracted for conducting the re-testing.Results Among 573 samples,191 samples were HLA-B27 positive and 382 cases were HLA-B27 negative by flow cytome-try;the same samples had 194 cases of HLA-B27 positive and 379 cases of HLA-B27 negative by real-time PCR.With flow cytome-try as reference of the final results,the positive coincidence rate of the two kinds of kit was 96.33%(184/191),the negative coinci-dence rate was 94.76%(362/382),27 samples had inconsistent results from the two kinds of assay(accounting for 4.71% of the to-tal number of samples),the total coincidence rate was 95.29% [(184+362)/573],the Kappa value was 0.896(P =0.02);the chi-square test P =0.021,the two kinds of testing method had the high consistency,but the differences existed in the testing results. The re-testing results by PCR sequencing(including 27 samples with inconsistent results by two kinds of kit)were entirely consist-ent with the fluorescence PCR testing results.Conclusion Compared with the authority method flow cytometry for HLA-B27 tes-ting in clinic,the fluorescence PCR kit may present more accurate judging ability for the HLA-B27 testing on the basis of ensuring the higher consistency of the testing results,is easier compared with the sample preparation and operating procedures,and has the stronger clinical application value and prospects s.

Objective To treat upper and middle trunks or C 5～7 avulsion of brachial plexus by neurotization using a part of median nerve and ulnar nerve Methods All patients were divided into 2 groups according to the surgical procedures Eleven cases were involved in the first group The phrenic nerve was chosen to anastomose with musculocutaneous nerve or through a sural nerve graft and the spinal accessory nerve was anastomosed with suprascapular nerve Eleven cases from 1997 were classified into the second group A part of the fascicles of median nerve was transferred to coapt with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to harvest with axillary nerve The cases were followed up from 0 5 to 3 years and the clinical outcome was compared between the two groups Results There were 2 cases(16 6%)who got the recovery of M 4 strength of biceps muscle in the first group and 7 cases(63 6%)in the second group,and the difference was statistically significant( P

Objective To introduce a new surgical procedure for the treatment of axillary nerve injury:neurotization from one of triceps branches of radial nerve to one of axillary branches Methods To study the anatomical relationship between the nerve branches to triceps and the axillary nerve branches to deltoid muscle by anatomical dissection as well as to measure the diameters of the nerve branches,and to complete the performance in clinic in six patients and follow up for 6～16 months Results The branches to long head of triceps of radial nerve were near to branches of axillary nerve and the difference among the nerve branches are little in diameter,and there were 5 patients who got M4 recovery of the muscle strength and 1 patient M3 Conclusion The new surgical procedure is easy to manipulate,with a satisfactory result,and is suitable for the partial brachial plexus injury patient with axillary nerve dysfunction but the radial nerve function formal

Objective To investigate the expression and distribution of cyclooxygenase-2(COX-2) in periodontal tissues during experimental tooth movement in rats,and study the relationship between COX-2 and vesscular reconstruction in experimental tooth movement process.Methods Thirty-five healthy Wistar rats were divided randomly into 7 groups on average:normal group and experimental groups for 1,3,5,7,14 and 21 d.A NiTi coil spring with 0.294 N mesial force was connected between first molars of maxillary and the upper incisors.The histological sections were stained with goat anti rat COX-2 antibody,and computer image analysis was used to study the expression of COX-2 in the periodontal tissues of rats.Results Pressure area:compared with normal group(134.75?5.25) the COX-2 expression in 1 d group (147.73?3.27)increased(P0.05).Conclusion The expression of COX-2 in periodontal tissues during experimental tooth movement increase,suggesting that COX-2 can promote the vascular reconstruction in periodontal tissues during orthodontic tooth movement.

BACKGROUND: Autologous tendon and artificial tendon are both the important grafts that can reconstruct the ruptured anterior cruciate ligament, but each has their defects and excellents. OBJECTIVE: To investigate the biomechanical change and histological rejection of reconstructing the anterior cruciate ligament of the rabbits with autologous tendon and artificial ligament. DESIGN, TIME AND SETTING: A controlled observation was performed from September 2007 to February 2008 in the Orthopedics Laboratory and the Biological Laboratory of Zhengzhou University (Zhengzhou, Henan, China). MATERIALS: Twenty-eight adult New Zealand rabbits of SPF grade were offered by Zhengzhou University Animal Experimental Center, weighing 2.4-3.1 kg with a mean of 2.8 kg, irrespective of genders. MB66 braid was produced by Smith & Nephew Medical (Shanghai) Limited. METHODS: The tendons of extending toe were harvested in both lower extremities, one tendon was wrapped with artificial ligament, while the other was only processed into the terminal wove dovetail. Anterior cruciate ligament was excised from bilateral knee joints in rabbits through the parapatellar incision, then femoral and tibial bones were drilled to implant the autologous tendon and artificial ligament on one side (serving as combined tendon group), whereas only autologous tendon on the other side (serving as pure tendon group). Both sides were sutured through bone bridge. Every 7 rabbits were killed under anesthesia at 2, 4, 6, and 8 weeks postoperatively. MAIN OUTCOME MEASURES: Gross observation and histological determination were carried out in the reconstructed anterior cruciate ligament of rabbits. The maximal breaking force of both grafts were detected. RESULTS: At 2 and 4 weeks postoperatively, the cells of reconstructed grafts disappeared and showed necrosis. Inflammatory cells infiltrated between autologous tendon and artificial ligament, there were cells growing from the edge to the center. At 6 weeks postoperatively, the autologous tendon had a little loose and disfiguration. The synovial membrane and cells hyperplasia were obvious. The synovial membrane filled the combined tendon and the infiltrative inflammatory cells reduced. The proliferative cells remarkably trended to the center. At 8 weeks postoperatively, the grafts were mostly substituted by new cells, and the artificial ligament was completely parceled by the synovial membrane, but there were still some gaps; The combined tendon exhibited no loose or disfiguration, the infiltrative inflammatory cells disappeared. The cells in grafts were close to normal cells in anterior cruciate ligament, but fibrocytes arranged in disorder and fibers showed a verticality. Biomechanics test results demonstrated the maximal breaking force of combined tendon was more than that of pure tendon (P

Objective To evaluate the changes in cerebral oxygen delivery/consumption and glucose metabolism during laparoscopic gynecologic surgery under propofol-fentanyl anesthesia.Methods Fifteen ASA Ⅰ or Ⅱ patients aged 20-59 yrs weighing 47-65 kg undergoing laparoscopic gynecologic surgery under propofol-fentanyl anesthesia were studied. The patients were premedicated with scopolamine 0.3 mg, midazolam 0.02 mg?kg-1 and fentanyl-droperidol mixture 0.03 ml?kg-1 Ⅳ. Anesthesia was induced with fentanyl 2 ?g?kg-1, propofol 2 mg? kg-1 and vecuronium 0.1 mg?kg-1 and maintained with TCI of propofol with target effect-site concentration set at 3-4 ?g? ml-1 and intermittent Ⅳ boluses of fentanyl and vecuronium. The patients were mechanically ventilated (VT = 7 ml? kg-1 RR = 14 bpm, I: E = 1:2). PET CO2 was maintained at 35-45 mm Hg. Radial artery was cannulated for BP monitoring and blood sampling. Left internal jugular vein was cannulated and advanced cephalad until a resistance was met. The depth of insertion was about 11-14 cm. After the pneumoperitoneum was established ( Ultra-abdominal pressure = 15 mm Hg) , the patients were placed in head-down position. Blood samples were taken from radial artery and internal jugular vein simultaneously before anesthesia ( T1 , baseline), before pneumoperitoneum (T2) and at 10, 20 and 60 min after pneumoperitoneum was established (T3-5) for blood gas analysis and determination of plasma glucose and lactic acid concentration. Arterio-jugular oxygen content difference ( Da-jv O2 ), arterio-jugular plasma lactic acid difference ( Da-jv. Lac ), cerebral oxygen consumption and cerebral glucose extraction rate (GluER) were calculated. Jugular bulb pressure (JBP) was recorded at blood sampling.Results After pneumoperitoneum was established JBP increased significantly. Jugular bulb oxygen saturation (Sjv O2 ) increased significantly. Da-jv, O2 and cerebral oxygen extraction rate ( OER) decreased significantly after pneumoperitoneum (T3-5 ) . Plasma glucose level increased along with the pneumoperitoneum, while the Da-jv Glu, Da-jv Lac remained constant. Conclusion During laparoscopic gynecologic surgery under propofotfentanyl anesthesia cerebral venous pressure is elevated and cerebral oxygen supply exceeds oxygen consumption. Blood glucose level increases during pneumoperitoneum. However brain energy metabolism is not affected during pneumoperitoneum with patient in head-down position.

OBJECTIVETo compare the effect of three cannulated screws and dynamic hip screw (DHS) combined with antirotation screw in treating patients with comminuted fractures of femoral neck.

METHODSFrom January 2008 to December 2012,67 patients with comminuted fractures of femoral neck were treated with three cannulated screws or DHS combined with antirotation screw. Among them, 36 patients were treated with DHS combined with antirotation screw including 24 males and 12 females with an average of 43.7 years old ranging from 22 to 58 years old; 31 patients were treated with three cannulated screws including 22 males and 9 females with an average of 43.0 years old ranging from 24 to 56 years old. The incision size, operation time, blood loss, blood transfusion rate, postoperative hospital stay, walking time, weight-bearing time, union time, incidence of complication were recorded and compared between two groups, and functional outcomes were evaluated by Harris scoring.

RESULTSAll incision healed at stage I. The differences in operation time, blood loss, blood transfusion rate and postoperative hospital stay between two groups were not significant (P > 0.05). Incision size of DHS group (5.00 ± 0.86) cm was larger than that of cannulated screw group (3.30 ± 0.57) cm (P < 0.01). All patients were followed up more than one year, and the follow-up time showed no significant difference between two groups (P > 0.05). Walking time of DHS group (19.0 ± 3.5) d was less than that of cannulated screw group (37.0 ± 6.3) d (P < 0.01. Partial and full weight-bearing time of DHS group (23.0 ± 7.0) d and (138.0 ± 13.0) d was less than that of cannulated screw group (38.0 ± 5.7) d and (164.0 ± 12.0) d (P < 0.01). Union time of DHS group (151 ± 11) d was less than that of cannulated screw group (162 ± 11) d (P < 0.01). Harris hip score of DHS group (91.0 ± 5.7) was higher than that of cannulated screw group (85.0 ± 12.0) (P < 0.01). No significant differences were found in the incidence of postoperative complications between two groups (P > 0.05).

CONCLUSIONThe DHS combined with antirotation screw is superior to three cannulated screws for treatment of comminuted fractures of femoral neck due to earlier weight-bearing, faster fracture healing and better hip function

Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged