Objectives:To study the clinical results and feasibility of continuous brachial plexus nerve block and postoperative anagesia with catheters located by nerve stimulator in interscalene approach. Methods:60 ASAⅠ~Ⅱ patients receiving continuous interscalene brachial plexus block and postoperative analgesia for forearm,wrist or hand surgery were randomized into two groups.In group I,nerve blocks were performed using a normal venous needle located with traditional method which elicites numbness of the limb. Then a epidural catheter was passed and secured. Group Ⅱ were guided by nerve stimulator and special catheters were placed. Results:Compared with group I,time to perform the block,time to block and time to obtain satisfactory sensory and motor blockade in group II were shorter(P

Innovation team is an independent and open complex adaptive system, which provides new ideas for recognizing and understanding the inner operating mechanism of innovation teams. This article analyzed the mechanisms of communication and exchange, competition and cooperation, incentive and con-straint as well as the conflict management from the perspective of complex adaptive system.

BACKGROUND:Anterior cervical discectomy and bone graft fusion are effective method to treat cervical spondylosis. This method can provide firm fixation and the fusion rate is high. However, for cervical vertebra involved in more than two segments, the stability of fixator and bone graft is poor due to big bone graft span, which may easily cause fusion failure and pseudarthrosis, and impact curative effects. OBJECTIVE:To investigate biomechanical stability of anterior cervical pedicle screw implantation for osteoporosis in the vertebra. METHODS:A total of 12 human cervical vertebrae were col ected, including 6 vertebrae with normal bone density and 6 vertebrae with osteoporosis. Data of 60 vertebra specimens were analyzed. 30 osteoporotic specimens implanted in anterior cervical pedicle screw were set as anterior cervical pedicle screw group. 30 normal specimens implanted in anterior cervical pedicle screw were set as anterior vertebral screw group. According to bone density, 40 vertebrae were col ected in above two groups, and were considered as normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group (n=10). Bone mineral density of each vertebra was detected using dual-energy X-ray absorptiometry. Biomechanical index of two kinds of screws was detected using ElectroForce 3510 material testing machine. RESULTS AND CONCLUSION:Bone mineral content, vertebral screw pul-out strength, vertebral screw pul-out stiffness, pedicle screw pul-out strength, and pedicle screw pul-out stiffness were significantly higher in the anterior cervical pedicle screw group than in the anterior vertebral screw group (P<0.05). The maximum axial pul-out strength of normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group was significantly higher than in the anterior vertebral screw group (P<0.05). The results confirmed that osteoporotic vertebral biomechanical performance is more stable in anterior pedicle screws compared with the anterior vertebral screw.

Objective To discuss and summarize the effects of arthroscopic treatment of posterior ankle impingement syndrome.Methods The study enrolled 30 patients with posterior ankle impingement syndrome treated from January 2008 to November 2015.There were 18 males and 12 females,aged 19-58 years old (mean,37.6 years old).Right ankle injury was noted in 19 patients and left in 11 patients.A total of 27 patients had a history of obvious ankle injury (7 cases of acute sprains and 20 cases of chronic sprains).Arthroscopic surgery,including osteophyte removal,cartilage formation and joint clearance,was performed through the posterolateral and posteromedial approaches.Postoperative outcome was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores.Results All the patients were followed up for 8-27 months (mean,22 months).These patients got a good healing without nervous and vascular injuries.At the last follow up,the AOFAS score was (89.8 ± 3.8) points,significantly higher than before operation [(35.0 ± 10.1) points,t =-26.456,P =0.000].The VAS score was (2.5 ± 1.3) points,significantly lower than before operation [(6.6 ± 1.9) points,t =12.427,P =0.000].The ankle joint flexion angle was improved significantly from 29.4° ± 2.3° to 43.4° ± 1.4° as compared to preoperative status (t =-32.625,P =0.000).There were 21 cases of excellent result and 9 cases of good result,with an excellent and good rate of 100％.Conclusion Debridement and treatment of complications under arthroscopy is one of the effective methods for the posterior ankle impingement syndrome,which has advantages of minimal invasion,safety,targeted operation,and fast postoperative recovery.

Objective To Discuss the Clinical Recognition of Acute Myocardial Infarction(AMI) caused by aortic valve incompetence.Methods Data of 275 AMI patients in our hospital recent two years,7 of them were caused by aortic valve incompetence; all of patients(7 AMI) were received coronary artery angioplasty,ultrasound,left ventricular angiography examination,its clinical feature was analyzed.Results All of 7AMI patients have normal coronary without limited constriction or plaque and with aortic valve incompetence.

The thesis,from the aspect of professional guidance of education,focuses on the outstanding problems that exist in the work of professional guidance,analyzes the main reasons that caused those outstanding problems,and gives the feasible suggestions to professional guidance in current university education.

Objective To observe the expression and the distribution of Netrin-1 in the spastic and normal segment of colon in patients with Hirschsprungs disease (HD) and investigate the relationship between Netrin-1 and development of HD.Methods Colon specimens of 36 cases with HD were selected for this study.Normal segment of colon served as the control group,while the spastic segments of colon as the lesion group.Immunohistochemical staining was applied to detecte the expression and the distribution of Netrin-1.Results Immunohistochemical staining showed that the expression of netrin-1 was positive in the intestinal muscular layers (longitudinal muscle,circular muscles),myenteric ganglias and mucosal layers in the control group.However,the expression of Netrin-1 was also positive in muscular layers and mucosal layer in the lesion group.There was no significant difference in the expression intensity of Netrin-1 between the two groups (P ＞0.05).Conclusion The expression of Netrin-1 in both the control group and the lesion group may indicate that netrin-1 have no significant correlation with genesis of HD.

Objective To discuss the application value of the capillary electrophoresis in detecting the glycosylation hemoglobin (HbA1c)level.Methods By utilizing the uncoated fused silica capillary column(30 cm in length and 25 μm in diameter)and the specific adsorption peak,the HbA1c levels in the healthy people,patients with diabetes mellitus(DM)and high risk people were de-tected by the photodiode array(PDA)method at the wavelength of 415 nm.During the research process,the precision and accuracy were perfomred the accuracy analysis.Results HbA1c could be effectively separated from non-HbA1c,with a sharp peak.And the relative quantity of HbA1c could be determined.Conclusion The capillary electrophoresis is characterized by specificity,high precision,and high accuracy.Therefore,it should be widely applied in clinic.

Objective To observe the clinical efficacy and safety of Shenxiong glucose injection and lipo PGE1 injection in treating the lower extremity arteriosclerotic occlusive disease (LEAOD).Methods 80 patients with LEAOD were randomly divided into control group and treatment group. Both groups were given conventional therapy, including reducing blood pressure, blood sugar, blood lipid and anti-infection therapy.Control group was additonally given intra-femoral arterial infusion with urokinase 150000 units plus 15mL 0.9% sodium chloride and 10 mg anisodamine alternately every other day, 5 days for one course, stopping 3 days after another course.Treatment group was treated with intravenous injection Lipo PGE1 injection plus 10 mL 0.9% sodium chloride and intravenous Shenxiong glucose injection per day for 14 days.Clinical efficacy, changes in clinical symptoms, whole blood viscosity, high sensitivity C-reactive protein(hs-CRP), fibrinogen, ankle-brachial index(ABI), the inner diameter of the dorsalis pedis and the peak systolic velocity( PSV) of dorsalis pedis were compared and analyzed pre and post-treatment.Adverse drug reactions were recorded during the treatment.ResuIts The efficiency for the patients in the treatment group (90.0%) was higher than that in control groups(72.5%) (P<0.05).The symptoms of numbness and cold limbs, whole blood viscosity, ABI, hs-CRP improved more significantly in the treatment group (P<0.05).No adverse event occurred in the treatment group and 2 patients in control group had mild dry mouth.ConcIusion Shenxiong glucose injection combined with lipo PGE1 injection for the treatment of LEAOD is effective and safe and should be introduced in clinical practice.

BACKGROUND: The postnatal sexual health of women is crucial in reproductive health, due to lack of sexual knowledge and sexual heath care service as well as conventional idea, the medical staff and postnatal women themselves pay little attention and discussion on the sexual health after childbirth.OBJECTIVE; To investigate the prevalence and types of women's sexual problems after childbirth, identify the factors associated with dyspareunia and investigate the status quo of postnatal sexual health care service. DESIGN: Cross-sectional study and follow-up survey within six months after delivery.SETTING: Department of Reproductive Medicine, Chongqing University of Medical Sciences. PARTICIPANTS: A total of 798 primiparous women delivering a live birth in Department of Obstetrics at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 2000 and July 2001, and 79 husbands who accompanied their wives during the follow-ups were adopted in this study.METHODS: The primiparous women after 6 months of childbirth and husbands conducted routine postnatal follow-ups and were informed of the follow-up content. The interview was used in this cross-sectional study and the questionnaires were finished under the help of health professional. And some advice, consultations and treatments can be given in time. MAIN OUTCOME MEASURES; ①main change of postnatal sexual life;②postnatal sexual problems and related factors. RESULTS: Totally 460 out of 798 primiparous women in accordance with the inclusive and exclusive criterions received follow-up surveys after telephone or letter notification. ①Main change of postnatal sexual life: Of the 460 respondents, 94.74% had resumed sexual activity within six months after delivery. Compared with one year pre-pregnancy, the number of sexual activity decreased obviously within 3-6 months after delivery, and 66.0％ of postnatal women decreased the sexual desire.②Postnatal sexual problems and related factors: Sexual morbidity increased significantly after the childbirth: In the first three months after delivery, 70.6％ of women experienced sexual problem(s), declining to 55.6％ during the 4th-6th months, and reduced to 34.2％ at the 6th month, but not reaching pre-pregnancy levels of 7.17％. The sexual problems of women after delivery included dyspareunia, vaginal dryness, orgasm disorder and vaginal relaxation, etc.4. And dyspareunia was the most common type. Between the 4th and 6th month after delivery, dyspareunia was significantly associated with the effect of traditional sexual ideas, experience of dyspareunia before pregnancy and current breastfeeding (P ＜ 0.05), while the association of dyspareunia with delivery mode was not significant.③Sexual care service and sexual counseling after delivery: Only 20.8％ of women received information about sexual health from health care personnel within 42 days after delivery, and consultation rate of sexual intercourse problems was 8.0％.④Husbands' comprehension of postnatal problems in women: Only 59.2％ of partners whose wives had postnatal sexual problem(s) knew that their wives had ever experienced sexual problem(s) and 8.1％ of partners had sought medical help. CONCLUSION; Sexual health problems are very common in women after childbirth, taking up for 70.6％. And the quality of postnatal sexual health is unrelated with delivery mode, but postnatal health care service are often overlooked, additionally lack of professional counseling and treatment. The current practices of encouraging the husband's supports after the childbirth may well influence the prevention and treatment of postnatal sexual problems in women.