Objective:To discuss the effects and limitation of neuronavigation system in neurosurgical operations.Methods:58 cases surgically treated with Stealth Station 4.1 Neuronavigation System were analysed,including 52 cases of intracranial tumor,4 cases of cerebral vascular malformations and 2 cases of intracerebral abscess. The locations of lesion included superficial part of hemisphere (24 cases),deep part of hemisphere (21 cases),skull base (8 cases),cerebellum (2 cases) and brain stem (3 cases).Results:Among 58 cases,total removal of the lesion was performed on 45 cases,comprising 77.6%,subtotal removal on 5,comprising 8.6%,most removal on 2%,comprising 3.4% and partial removal on 6%, comprising 10.3%.Postoperative neurological functions were improved or remained unchanged in 52 cases while they were worsened in 5 cases,and 1 patient died.Conclusion:Neuronavigation system is safe and helpful for improving accuracy of neurosurgical operations and increasing total removal of lesions,and it can be used widely in neurosurgery. However,it can't avoid intraoperative brain shift.The effects of navigation system in different neurosurgical operations are evaluated.

OBJECTIVETo retrospectively analyze therapy comparison between hinged external fixator combining with internal fixation, soft tissue repair and plaster fixation after routine surgery for terrible triad of the elbow.

METHODSFrom January 2003 to June 2011,26 patients with terrible triad of the elbow (posterior dislocation associated with fracture of both the radial head and the ulnar coronoid process) were treated respectively by unilateral hinged external fixator and plaster fixation. Fourteen patients were treated with external fixator combining with internal fixation, soft tissue repair and reconstruction, including 8 males and 6 females,ranging in age from 20 to 62 years with an average of (33.60 +/- 8.53) years. The mean time of fixation was 7.5 weeks (ranged, 6 to 8 weeks), and forearm rotation exercise was performed after the first day of operation, elbow flexion and extension activities after 4 to 6 days. Twelve patients were treated with plaster external fixation combining with open reduction and internal fixation,including 8 males and 4 females,ranging in age from 21 to 63 years with an average of (34.80 +/- 7.41) years. The mean time of plaster fixation was 30.4 days, and functional exercise was carried out after 4 to 6 weeks of plaster removal. JOA assessment score were used to evaluate the elbow joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 36 months,with an average of 18.6 months. The mean time of fracture healing was (8.6 +/- 3.1) weeks in plaster group and (9.0 +/- 2.7) weeks in fixator group, with no statistical difference between the two groups (t =1.47, P > 0.05). The function and are of motion in plaster group and fixator group showed significant difference. While the pain, articular instability and deformity showed no statistical difference. The total assessment score between two groups indicated markedly difference (t = -2.66, P < 0.01).

CONCLUSIONHinged external fixator can enhance lateral stability of elbows,benefit the reduction of fracture dislocation, guarantee early and safe functional exercise, prevent elbow stiffness, and reduce heterotopic ossification. In treating terrible triad of the elbow, the hinged external fixator is superior to other therapies with respect of improving the function of elbow joint.

Adult ; Case-Control Studies ; Elbow Joint ; diagnostic imaging ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

Adolescent ; Adult ; Age Determination by Skeleton ; methods ; Child ; Child, Preschool ; China ; Diagnosis, Computer-Assisted ; methods ; Female ; Humans ; Male

Bilingual teaching is an important method to train international medical students.While the current bottleneck problem is the shortage of teachers during the exploration and practice in bilingual teaching. Proceeding from requirements and current situation of bilingual teachers, the following approaches should be taken to strengthen the teaching stuff construction of bilingual teaching: demonstration teaching, language training infiltrated in clinic job, guiding foreign students, preparing bilingual teaching materials and professional team building.

Objective: To discuss the methods and experience of 64-slice spiral CT which used in infant cases with congenital heart disease, to select the appropriate scan parameters for reducing artifact and the radiation dose. Methods: Thirty-five cases with congenital heart disease were arranged CT examination by using Philips Brilliance 64-slice spiral CT scanner with Blous Tracking techniques. Results: All the images of the heart chambers, pulmonary artery, pulmonary vein, the ascending aorta and the descending aorta contrast agent filling showed good and had clear display. The density of superior vena cava is moderate. The various vascular CT value is approximate, no hardening artifacts. The atrioventricular of Cardiac and vascular of contrast agent filled fully and had clear boundary, no significant artifacts and no effect on the impact reconstruction. Conclusion: Appropriate adjustment of scanning parameters can reduce hardening artifact and the impact of artifacts. Following the principle of as low as reasonably achievable (ALARA) can obtain diagnostic images and reduce radiation damage to the infant.

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Objective:The one-way communication between traditional LIS system and equipment has been unable to meet the needs of business development of medical laboratory in our hospital, we need to upgrade our equipment and to develop the bidirectional communication interface between LIS and equipment.Methods: Our hospital has invested a lot of money to upgrade previous One-way communication interface based on ASTM, the new instrument specifications conform to HL7 standard, and develop bidirectional transmission program based on HL7.Results: After the implementation of the bidirectional communication, testing equipment can automatically identify bar code to get the test request information, after the completion of the test instrument, the inspection unit can automatically send sample results to LIS.Conclusion: Bidirectional transmission improves the work efficiency, transmission based on HL7 is not only fast, but also conducive to the sharing of data between heterogeneous medical information systems, and it is a general tendency.

OBJECTIVE:To promote effective supervision of key monitoring drugs by provincial pharmaceutical quality control center,and to improve rational drug use. METHODS:The effects of No.2 district of Sichuan province pharmaceutical quality con-trol center on 3 categories of key monitoring drugs guidance and supervision,through urging medical institution in the area to estab-lish key monitoring drugs supervision system,formulating prescription review guideline for 3 categories of key monitoring drugs [TCM injection,adjunctive drug,proton pump inhibitors (PPIs)],developing baseline data survey,inspecting the application of key monitoring drug in medical instaurations on the spot and other measures,were introduced. Through collecting the reports of re-gional quality control center to the provincial quality control center,supervision system of medical institutions were analyzed statisti-cally. Key monitoring drugs of medical institutions in the area were analyzed statistically in respects of rational utilization ratio,uti-lization quantity,utilization amount,etc.,so as to evaluate supervision effects. RESULTS:Up to Apr. 2016,92.26%medical insti-tutions had been aware of the relevant requirements of the documents;84.25% had established the hospital supervision system. 3 categories of key monitoring drugs prescription(orders)comment guideline had been developed in Mar. 2016. 18 third-grade class-A general medical institutions were randomly selected;among 3 categories,irrational utilization ratio of TCM injection decreased by 12.35%(35.41% vs. 47.76%);that of adjunctive drugs decreased by 9.64%(20.95% vs. 30.59%);that of PPIs decreased by 7.44%(40.49% vs. 47.93%) in May 2016,compare to Jan. 2016. Average consumption sum of them decreased by 12.07%, 13.30%,9.49%,respectively in Apr. 2016,compared to Jan. 2016. 55.02% medical institutions had started to collect the baseline data. CONCLUSIONS:The provincial pharmaceutical quality control center has played an important role on establishing a supervi-sion system,it can promote the effective supervision by guiding and supervising the medical institutions evaluating the supervision of medical institutions and pointing out the problems.

In the teaching of Medical Microbiology,the writers use problem based learning pattern and traditional teaching methods together to complement each other according to the characteristics of students. They improve the quality of teachers constantly,reform the old methods of teaching and evaluation system in order to improve the students'clinical work ability and train their innovation thoughts.

AIM: To investigate whether carnosine can inhibit cataract formation and protect Na+-K+ATPase against inactivation induced by a glucocorticoid.METHODS: Two hundred and twenty clear lenses cultured in vitro were randomly divided into five groups: control group (DMEM), steroid group (DMEM+Dexamethason 10μmol/L),lower concentration carnosine-treated group (DMEM+Dexamethason 10μ mol/L+Carnosine 2mmol/L), higher concentration carnosine-treated group (DMEM+Dexamethason 10μmol /L+Carnosine 5mmol/L) and carnosine group (DMEM + Carnosine 5mmol/L). Progression of cataract formation was evaluated daily using a dissecting microscope. On 1, 3, 5 and 7d, 10lenses of every group were homogenized and the activity of Na+-K+ATPase was measured by using spectrophotometer.RESULTS: During the incubation, mistlike opacity was observed in the lenses of the control group and carnosine group,but in the steroid group appeared dense nuclear opacity, while both two carnosine-treated groups came out visible demarcation between nuclear and cortical regions on 7d. A decrease in the activity of Na+-K+ATPase was found in the lens of the steroid group. On 3, 5, 7d, Na+-K+ATPase activity decreased 22.34% (P=0.002),47.98% (P＜0.001),75.37% (P＜0.001) compared with that at 1d, respectively. In the carnosine group,the activity of Na+-K+ATPase remained at the level of the control throughout the 7-d incubation, indicating that carnosine itself did not interfere with the original lens enzyme activity. In the lower concentration carnosine-treated group, on 3, 5, 7d,the activity of Na+-K+ATPase increased 10.8% (P＜0.05),44.6% (P＜0.01), 57.4% (P＜0.01) of control activity, respectively. In the higher concentration carnosine-treated group, on 3, 5, 7d, the activity of Na+-K+ATPase increased 11.3% (P＜0.05), 45.7% (P＜0.01), 57.6% (P＜0.01) of control activity,respectively. The activity of Na+-K+ATPase in both two carnosine-treated groups were only 6.7% and 6.5% lower than that of the control group after 7-d incubation. After the 7-d incubation, the Na+-K+ATPase activity of the lenses in the steroid group decreased significantly compared with carnosine-treated groups (P＜0.01).CONCLUSION: Carnosine prevents the cataract formation induced by a glucocorticoid, and significantly inhibits the inactivation of Na+-K+ATPase induced by a glucocorticoid.