OBJECTIVE:To investigate the effects of atorvastatin combined with valsartan on efficacy,safety and related indi-cators in patients with chronic nephritis. METHODS:86 patients with chronic nephritis were randomly divided into control group (43 cases)and observation group(43 cases). All patients were given low-salt,low-protein and high-quality diet with protein intake of 0.8 g/(kg·d),appropriately given Cyclophosphamide tablet,Prednisone tablet,Penicillin V potassium tablet and other conven-tional treatment. Based on it,control group was given 160 mg valsartan,once a day in early morning. Observation group was addi-tionally given 20 mg atorvastatin,once a day before bedtime. They were treated for 6 months. Clinical efficacy,24 h protein amount (24 h pro),serum creatinine (Scr),blood urea nitrogen (BUN),glomerular filtration rate (GFR),C-reactive protein (CRP),total cholesterol (TC),triglyceride (TG ),low density lipoprotein (LDL) and high density lipoprotein (HDL) in 2 groups were observed,and incidence of adverse reactions was followed-up for 9 months. RESULTS:The total effective rate in ob-servation group was significantly higher than control group,the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in 24 h pro,Scr,BUN,GFR,CRP,TC,TG,LDL and HDL between 2 groups(P>0.05). After treatment,24 h pro,Scr,BUN and CRP in 2 groups were significantly lower than before,and observation group was lower than control group,GFR was significantly higher than before,and observation group was higher than control group,the differenc-es were statistically significant(P<0.05). TC and LDL in 2 groups were significantly lower than before,HDL was higher than be-fore,the differences were statistically significant(P<0.05);but there were no significant differences in the TG between 2 groups and before and after treatment(P>0.05). And there was no significant differences in the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,the efficacy of atorvastatin combined with valsartan is superior to valsartan alone in the treatment of chronic nephritis,and it can significantly improve renal functions,with similar short-term safety.

Cervical artificial disc replacement (CADR) as a new method for the treatment of cervical spondylosis, is becoming a basic and clinical research. Compared with the anterior cervical discectomy and fusion (ACDF), the biggest difference of CADR lies in the reconstruction of the cervical vertebra height and physiological curvature, retaining the spinal physiological function maximally and reducing the degenerative changes in adjacent segments. A large number of clinical investigation have suggested that ACDR can become an operation method to replace the ACDF. However, the complications and the problems of prosthesis itself are gradually exposed, such as that the prosthesis, can't completely simulate the biological effects of human intervertebral disc, the other factors and including the operation methods and prosthesis itself. At the same time, the problem that how to prevent complications and problems is required to be solved. Whether, the effect of CADR on the activity of the operation segment, and the prevention of adjacent segment degeneration can be guaranteed for a long time has drawn more and more attention from scholars.
Cervical Vertebrae ; surgery ; Humans ; Postoperative Complications ; etiology ; Total Disc Replacement ; adverse effects

Objective To improve the mammographic diagnostic level of breast ductal diseases.Methods X-ray features,operationand pathologic findings in 166 cases of breast disease were retrospectively analyzed.Results The galactography of all 166 cases showed the manifestations including 78 cases of mammoductal ectasis with ductal dilatation,smooth wall;2 cases of ductal ectasis complicated by infection with ductal dilatation,inregular coarsening wall and interstitial extravasation of contrast medium;11 cases of mammoglandular cystic lobular hyperplasia with cyetic dilatation of terminal ducts in different sizes;49 cases of intraductal papilloma with sound as ovoid fillingdefects showing as interrupted smooth bordered,"cupping" in 26 cases of intraductal papillary carcinoma or intraductal carcinoma with post dilatation ductal stenosis and sigid "amputation" absuption together with sound cauliflower or inregular filling defects.In this series of 166 cases,75 cases vice prover to be tumor(45.1%) with malignancy in 26 cases(15.7%).Conclusion Galactography is an important method for diagnosis and differential diagrosis of mammoglandular disease with nipple discharge.

Objective To explore the effect of prevention of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) with hyperhydration, forced diuresis and alkalinizing plus infusion mesna. Methods 32 cases of patients receiving HSCT were included in this study. 2 cases of severe aplastic anemia (SAA) received total body irradiation (TBI)+cyclophosphamide(CTX)(TBI-CTX) regimen,and the remaining 30 patients were using the classic busulfan+CTX (BU+CTX) regimen. All patients were treated with mesna combined with hydration, forced diuresis and alkalization to prevent HC. Ganciclovir and acyclovir were used to prevent cytomegalovirus (CMV) and other viral infections and monitor CMV-IgM levels of the blood. Encourage patients to urinate every hour, testing urine pH value and the calculation of urine output, every 6 h review and testing of urine routine,central venous pressure (CVP), each of 8 h of serum electrolytes. Results Only 1 patient at 6 months after transplantation appeared delayed grade Ⅱ HC after hydration, alkalization, diuretic, hemostatic, anti-graft-versus-host disease (GVHD), and ganciclovir antiviral therapy. The HC patients cured at 35 d. The remaining patients did not suffer HC. Adverse effects such as acid-base balance disturbance did not appear clear. Conclusion Mesna joint hydration, forced diuresis and alkalization was effective and safe to prevent HC.

Objective To explore the treatment of children with hernia,and the advantage of transabdominal extraperitoneal hernia sac exclusion was analyzed.Methods A total of 102 patients in our hospital from January 2005 to January 2015 were randomly divided into 2 groups,55 cases who treated by the surgery of transabdominal extraperitoneal hernia sac exclusion were treatment group,47 cases who treated by the surgery of high ligation of the hernia sac throug the inguinal incision were control group.The operative time,length of hospital stay, length of incision,postoperative pain and hospitalization costs between two groups were compared.Results The effect of the treatment group was superior to the control group on operative time,length of incision and postoperative pain,the difference was significant(P <0.05).Con-clusion There are some advantages of more simplified operation,shorter time of the surgery,less complication,lower recurrence rate and more reliable curative effect in the treatment of transabdominal extraperitoneal hernia sac exclusion for children with hernia,which is worthy of clinical promotion.

Objective To investigate the neurosurgery nurses turnover intention and the psychological contract status to analyze the relationship between them. Methods The Departure Will Scale and Questionnaire of Psychological Contract were used to survey 128 neurosurgery nurses from seven general hospitals in Lishui city. Results Of neurosurgery nurses turnover intention scale was (2.24±0.71) points, whose leaving intend was stronger;Psychological contract items was (4.17±0.67) points, which organization responsibility score wasbelow employees responsibility; Hierarchical regression analysis showed that the psychological contract in the organization responsibility (organization specification responsibility, organization, personal responsibility and organizational development responsibility) could predict neurosurgery nurses′ willingness to leave, which could be able to explain their willingness to leave 13.5%of the variation. Conclusions Neurosurgery nurses′willingness to leave is strong, and psychological contract is an important factors affecting the will of their departure.

BACKGROUND:Artificial hip replacement by the posterolateral approach is generally introduced as a treatment for femoral neck fracture in the elderly, but it is limited by the need for a large incision, cutting off the extortor, and postoperative hip dislocation. The supercapsular percutaneously-assisted total hip (SuperPATH) approach was developed based on the original lateral approach. The SuperPATH approach for hip replacement is characterized by the reduced chance of damaging blood vessels and nerves, reducing intraoperative blood loss, retaining all the joint capsules and supinator, and significantly reducing the incidence of postoperative hip dislocation. OBJECTIVE:We hypothesized that the SuperPATH approach for hip replacement can achieve better efficacy in the elderly with femoral neck fractures and promote the recovery of postoperative hip function compared with the posterolateral approach. METHODS/DESIGN:This is a prospective, single-center, open-label, randomized control ed clinical trial that will be completed at the Pudong Hospital of Fudan University, Shanghai, China. Forty patients with femoral neck fractures were randomly divided into two groups to undergo femoral head replacement by the SuperPATH approach in the experimental group, and by the conventional posterior approach in the control group. The follow-up period is 1 week and 6 months. The main outcome measures are Harris hip scores at baseline, and at 1 week and 6 months postoperatively to assess functional recovery of the hip. Secondary outcome measures to evaluate the advantages of the SuperPATH approach include the length of surgical incision, intraoperative blood loss, operative time, 24-hour postoperative drainage, and hospital stay. Other outcome measures include the incidence of adverse reactions at 1 week and 6 months after surgery. The study protocol was approved by the Ethics Committee of the Pudong Hospital of Fudan University, China, and performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent was obtained from all participants. DISCUSSION:The aim of this trial is to test our hypothesis that the SuperPATH approach is safer and more reliable for hip functional recovery compared with the posterolateral approach for the artificial hip replacement in femoral neck fractures of the elderly.

Objective To investigate the clinical and imaging features of Foot-Yangming meridian-muscle syndrome of knee osteoarthritis(KOA) so as to promote the normalization and standardization of the meridian-muscle therapies. Methods A total of 31 KOA cases (involving 31 knees) of Foot-Yangming meridian-muscle syndrome were included into the study group , and 31 healthy volunteers (involving 31 knees) served as the control group. A retrospective research of patellofemoral relationship was carried out based on the clinical and imaging features. Results The differences of Insall index and patella index between the study group and control group were insignificant(P> 0 . 05), but the differences of patellofemoral index , patellofemoral congruence angle, and external patellar angle between the study group and control group were significant(P<0.01). Conclusion The patellofemoral relationship disorder is one of main lesions in Foot-Yangming meridian-muscle syndrome of KOA.

Objective This paper provides an anatomical and theoretic basis for the reverse transposition of proximal ulnar or radial periosteal flap to repair non-union in distal humerus.Methods The origin,course,meanwhile,the outside diameter and length of relevent vessels were measured,on 30 upper limb cadaveric specimens.Results The recurrent interosseous,radial recurrentand the posterior branch of radial collateal arteries,their origin outside diameter and length from the origin to the humerus extermal epicondyle were (1 47?0 2)mm,(65 1?9 5)mm,(2 1?0 3)mm,(63 7?0 8)mm,(1 48?0 22)mm and (104 5?8 9)mm,respectively.Anastomoses pattern existed 3 types: in vicinity of the external epicondyle"Reverse Y"73 3%(22 cases)."Meeting in one point 13 3%(4 cases)"."Arteries networks"13 3%(4 cases).Conclusions It's possible that the reverse transposition of proximal ulnar or radial periostea flap pedicled with recurrent interosseous membrane or radial recurrent vessel for repairing non-union in distal humerus.