Objective To investigate the effect of sodium nitroprusside sustained release on cognitive function, S-100βprotein and VILIP-1 in pituitary tumor surgery patients.Methods 156 cases of pituitary tumor patients were selected and divided into two groups according to random number table method,78 patients in each group.All patients underwent general anesthesia induction,the experimental group treated with 0.5~6 μg ( kg· min) infusion of sodium nitroprusside induced hypotension by micro pump at the beginning of operation.MMSE was used to determine the cognitive function of 2 groups of patients 1 day before operation and 2 days after operation,S-100βand VILIP-1 content were determined by ELISA before anesthesia,after surgery,and 0,12,24,48 h after operation.Results There was no statistical significance between the 2 groups in the incidence of postoperative cognitive dysfunction.Compared with control group, the operation time, bleeding volume and the recovery time of the experiment group were lower(P<0.05).S-100βprotein and VILIP-1 showed increased at first and then decreased at the peak of 24h;compared with the normal group, the levels of S-100βprotein and VILIP-1 of the cognitive impairment were higher ( P <0.05 ).Compared with the control group, the levels of S-100βprotein and VILIP-1 of the experiment group were lower(P <0.05).Conclusion Sodium nitroprusside sustained release controlled hypotension can reduce the level of cognitive disorder, patients of S-100βprotein and visinin-like protein 1 and has certain directive significance to the clinical.

Objective:To master with structure and function of ForceTriad energy platform, improve the effect of daily maintenance, use the energy platform safety and accurately.Methods:Specific methods involved in connection to the host and device, circuit plate electrode placed, unipolar and bipolar operation points and attention patient position, the common failures and troubleshooting methods.Results: To prevent electric shock and prevent burn patients are fundamental, the key is to connect closely and good contact, maintenance and troubleshooting is the guarantee. Conclusion:Safely use of energy platform correctly, cleaning maintenance equipment in a timely manner, accurate troubleshooting, to give full play to the advantages of energy platform, improve the operation efficiency and effectiveness.

We innovated video assessment integrated teaching method on the basis of clinical case discussion,teaching rounds,problem-based learning,case method and micro teaching.According to this video feedback teaching,students became teaching subject and teacher acted as guide.In order to realize the purposes of early contact with clinical practice,more clinical practice and repeated clinical practice teaching,we implemented student-centered small class teaching,which was heuristic,inquisitive,interactive and was discussion-based.At the same time with the help of medical simulation equipment and video feedback teaching,this method developed students' life-long learning ability and work competence and combined theory with practice,demonstration with imitation as well as standards with innovation.This method was not only suitable for theoretical study but also for skills training,especially for standardization training.

Clinical teaching plan of pneumothorax and hemorrhagic shock was prepared with mind maps. The process of making this teaching plan was demonstrated as follows:relationship among all levels of subjects in this course was manifested by text and graph as belong and relevance. It is sim-ple, smooth, focused, lucid and easy to understand and remember. Application of mind mapis ex-tremely simple;it is suitable for medical education and is conducive to enhancing teaching efficiency.

Objective To observe the difference of efficacy of three different treatment of internal fixation of intervetebral crasis on cervical spondylosis (spinal cord) .Methods From January 2009 to January 2013 ,There are 167 cases of patients admitted to hospital from cervical spondylosis (spinal cord ) ,randomly selected different fusion fixation methods are divided into three groups :in the first group ,there were 55 patients treated with autologous iliac bone graft fusion plate fixation ;in the second group , there were 60 patients treated with zero profile material PEEK interbody fusion with autologous bone graft ;in the third group ,the 52 patients were treated with the PEEK material MC + self‐locking cervical interbody fusion with autologous bone graft .Observa‐tion and comparison indicators include :spinal cord function JOA scores before and after surgery ,surgical segment intervertebral height and cervical curvature condition .Results Follow‐up lasted from 13 to 50 months ,the average length was 26 months .The difference in operation time ,blood loss during surgery analysis ,wherein the first group and the second or third group of three groups was statistically significant (P<0 .05) ,the difference between the second group and the third group was not statistically significant (P>0 .05) .In the first group ,there were 17 patients had transient throat discomfort and symptom disappeared 48 hours later ;dysphagia relieved or disappeared in one week ;there were two cases of screws and titanium loosen one week after operation , and were treated with immediate revision surgery .In the second ,third group ,there were 19 cases and 13 cases showed temporary throat discomfort disappeared within 48 hours after surgery respectively ,there was no dysphagia .No patient experienced cerebrospi‐nal fluid leakage ,hematoma and wound infection .The postoperative JOA scores spinal cord function (17 points France) ,surgical segmental cervical intervertebral height and curvature of three groups improved significantly compared with preoperative evaluation index ,and there was no significant difference among three groups (P>0 .05) .In the last follow‐up ,the interbody fusion rates of the first ,second and third groups were 67 .1% ,66 .3% and 65 .9% ,the difference between groups was not statistically significant (P>0 .05) .Conclusion Anterior decompression and interbody fusion locking device applications showed good performance in maintai‐ning the intervertebral height segment surgery ,rehabilitation cervical curvature ,and promote bone fusion with autogenous titanium plate fixation comparison .Patients can get a good surgery ,and the former has a simpler surgical fixation method ,shorter time ,less bleeding and less complications .

Avian influenza virus H6N1 subtype has been circulating in aquatic bird and terrestrial bird,and is the most frequently detected subtype of influenza A virus in those hosts.Genetic analysis results suggested that this virus might be the progenitor of the highly pathogenic avian influenza H5N1 virus,as seven of eight gene segments of those viruses had a common source.As continuing evolution of H6N1,it could spread across species barriers to mammals and had strong infection ability in mice,swine and ferrets.Serological epidemiological survey showed that a few people were positive for H6 avian influenza virus antibody and then the world's first human infection with influenza virus H6N1 subtype was reported in May 2013.Therefore,with the expansion of the host range of the virus,gene mutation and gene reassortment of H6N1 virus can occur in these hosts,and then it may evolve into novel variant strain with infected human potential.

Fertilization is a crucial step for origin of life.During Assisted Reproductive Technologies (ART),total fertilization failure is complex and unpredictable.Total fertilization failure may related to some abnormal cellular mechanistic events,such as:any stage of sperm and cumulus-oocyte-complexes penetration,sperm-zona pellucida binding / penetration,sperm-oocyte membrane binding,oocyte activation,sperm discondensation or pronuclear formation.Most of total fertilization failure could be solved by intracytoplasmic sperm injection.But oocytes of some patient still can't fertilize successfully,even though assisted oocyte activation be used.As for total fertilization failure patients in ART,combining the mature of oocyte,sperm quality and some trail to improve clinical protocol in later cycle may prevent failure to happen again.

BACKGROUND:C2 transpedicle screw fixation for Hangman fractures has been paid more attention due to reliability and no loss of physiological function.However,there are lacks of biomechanical evidences for indication treatment because the fixation is single segmental.OBJECTIVE:To investigate the biomechanical stability of C2 transpedicle screw fixation for Hangman fractures.DESIGN,TIME and SEITING:This was a contrast study which was performed at the General Key Laboratory of Biomechanics,First Military Medical University of Chinese PLA from May to August 2004.MATERIALS:AO-universal titanium alloy transpedicle screw of 18 25 mm in length and 3.5 mm in diameter was adopted in this study.Six fresh C1-C4 cervical vetebrae samples were ordiually made into type Ⅰ,ⅡA,and Ⅱ Hangman fracture models.METHODS:After transpedicle screw fixation.Hangman fracture models were measured by non-destroyed style with spinal anterior flexion/posterior extension,left/right lateral curvature,and left/right axial direction.Loading/unlonding circulation was performed three times during each testing.Kinematics indicators were measured on the 3rd circulation.MAIN OUTCOME MEASURES:Spinal motor images at zero load and maximal load were obtained with laser photoscanning(0.1% in precision),and the corresponding systematic software was adopted to calculate 3D range of movement.RESULTS:The relative stability of type Ⅰ Hangman fracture models after C2 transpedicle screw fixation was 100.62%(inflexion),96.91%(posterior extension),99.19%(lateral curvature),and 97.12%(rotation)as compared to control group (P＞0.05).The relative stability of type Ⅱ Hangman fracture models after C2 transpedicle screw fixation was 47.84%(inflexion),21.29%(posterior extension),65.98%(lateral curvature),and 41.69%(rotation)as compared to control group (P＜0.05).CONCLUSION:Biochemical evaluation suggests that type Ⅰ and Ⅱ A Hangman fractures do fit for C2 transpedicle screw fixation,and the fixation may generate well physiological fixation or stability.However,stability of type Ⅱ Hangman fracture is poor,so it is not suitably adopted single transpedicle screw fixation.

BACKGROUND: Decompression-internal fixation is needed in the treatment of atlantoaxial dislocation accompanying with spinal compression caused by cranium-neck junction area malformation and other diseases.Different internal fixation methods are chosen according to different conditions, including anterior atlantoaxial internal fixation, posterior atlantoaxial internal fixation or occipitocervical internal fixation. Transoralpharyngeal atlantoaxial plate internal fixation is a method for atlantoaxial anterior fixation. It is developed recently and used for difficult and complicated atlantoaxial dislocation induced by congenital disease, trauma or rheumatoid arthritis.OBJECTIVE: To probe into the clinical application of transoralpharyngeal atlantoaxial reduction plate system in the atlantoaxial dislocation caused by obsolete odontoid fracture.DESIGN: Single Sample observation SETTING: Department of Orthopaedics, Guangzhou General Hospital of Guangzhou Military Medical University of Chinese PLA PARTICIPANTS: Twelve patients with atlantoaxial dislocation caused by obsolete odontoid fracture were selected in the Department of Orthopaedics, General Hospital of Guangzhou Military Medical University of Chinese PLA from January 2003 to October 2005. Among them, 7 were male and 5 were female, they were aged 47 years on average ranging from 36 to 59 years. The mean injured time was 19 months ranging from 4.5 to 36 months; 6 patients were graded as C degree, 3 as D degree and 3 as E degree in Frank gradation.METHODS: Twelve obsolete odontoid fracture caused by atlantoaxial dislocation underwent transoralpharyngeal anterior decompression. Transoralpharyngeal atlantoaxial reduction plate system was used in reduction and fixation. Autogeneic ilium was implanted into bilateral articulatio atlantoepistrophica.MAIN OUTCOME MEASURES: ① Frank gradation of patients at the 4th week after operation. ② whether the internal fixation is loose or not after operationRESULTS: ①Frank gradation at the 4th week after operation: Among the 6 patients who were primarily graded as C degree, 4 patients improved to be E degree and 2 patients D degree; Three patients who were primarily graded as D degree all improved to be E degree; Patients who were primarily graded as E degree did not changed. ② Except for one patient who suffered dislocation again for loosening of screw caused by tumble, the other patients had firm fixation, ideal fusion and satisfying spinal decompression.CONCLUSION: Transoralpharyngeal atlantoaxial reduction plate system finishes atlantoaxial reduction and fixation once. It avoids conducting posterior fusion fixation operation after anterior decompression. It also avoids fetal injury for spinal cord caused by extreme atlantoaxial unsteadiness in the process of movement and turning over.

Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.