OBJECTIVE:To investigate the influence of cephalosporins antibiotics on cost and length of hospital stay in pa-tients underwent gallbladder calculus resection,and to provide reference for drug use in clinic. METHODS:A total of 1866 patients underwent gallbladder calculus resection were collected from 9 third grade class A hospitals in Guangxi during 2013-2014. SPSS 22.0 software was adopted to analyze cost and length of hospital stay in patients underwent gallbladder calculus resection. RESULTS:Multi-factor analysis showed that the factors which significantly affected the cost and length of hospital stay were antibiotics,hospi-tals,age,surgery types and disease species (all P<0.01). The antibiotics were divided into the subset 1-4 according to the cost of hospital stay:the subset 1 only contained cefuroxime(9454 yuan);the subset 2 contained noncephalosporins(16199 yuan)and ce-fazolin pentahydrate(17241 yuan);the subset 3 contained ceftazidime(20716 yuan),other cephalosporins(21046 yuan)and cefo-taxime sulbactam(22724 yuan);subset 4 contained cefotaxime sulbactam(22724 yuan),cefoperazone sulbactam(23688 yuan), cefoxitin(24685 yuan)and cefodizime(24698 yuan). The antibiotics were also divided into the subset 1-4 according to the length of hospital stay:the subset 1 only contained noncephalosporins (7.61 d);the subset 2 contained cefuroxime (8.94 d) and cefazolin pentahydrate(9.78 d);the subset 3 contained cefoxitin(13.39 d),cefodizime(13.44 d),other cephalosporins(14.32 d)and ceftazi-dime(14.60 d);the subset 4 included cefoperazone sulbactam(16.03 d)and cefotaxime sulbactam(16.91 d). The higher the subset numbers,the higher the cost of hospital stay or the longer the length of hospital stay;there were statistical differences among differ-ent subsets (P<0.05),while there was no statistical difference among the same subsets (P>0.05). CONCLUSIONS:Cephalospo-rins antibiotics can significantly influence the cost and length of hospital stay in patients underwent gallbladder calculus resec-tion. Antibiotics selection canbe considered comprehensively ac-cording to local medical resources and the patients'demands.

BACKGROUND:At present,most general hospitals in China treat patients with neurosis and mental diseases merely by means of clinical psychological consultation,which cannot meet the requirements of social service for metal disorders. Is it feasible to establish open psychology wards?OBJECTIVE:To investigate the feasibility of establishing open psychology ward in general hospitals for patients with neurosis and mental diseases.DESIGN:Case analysis based on patients.SETTING:Department of Psychology of Guangdong Medical College Affiliated Hospital.PARTICIPANTS:Totally 900 patients with various types of neurosis were admitted to the Department of Psychology of Guangdong Medical College Affiliated Hospital between July 2000 and March 2003.There were 688 patients with different kinds of psychoneurosis and112 cases of mental diseases. Of them,there were 523 men and 377women aged from 11 to 80 years.with the mean age of (42±8) years and hospitalization duration of(17.0±6.5) days.METHODS:Open management consisting of open ward,supporting system,humanized restriction,collective physical exercise and psychological support was adopted.Symptom checklist (SCL-90) was used by trained psychological doctors to assess the therapeutic effects in the 900 patients with neurosis and mental diseases after two-month rehabilitation.Meanwhile,169 patients with depression were examined with Hamilton rating scale for depression(HAMD) at 2,4,8 weeks of treatment.patients.RESULTS:Open psychology ward could provide an environment for patients to live and make free contact with the outside world. Of the 900patients with various neurosis and metal diseases,531 (59.0%) had recovery to normal,264(29.4%) had obvious improvement,81(9.0%) had improvement,and 24 (2.6%) had no therapeutic effect,with the total effective rate of 97.4% .None of the patients had any accident. HAMD score of the 169 patients with depression was (32.3±3.6) before treatment,was obviously lower at 2,4 and 8 weeks of treatment [(17.4±4.2),(11.5±4.8) and(5.8±3.6),respectively](P ＜ 0.01).CONCLUSION:The therapeutic effect of the open psychology ward in the general hospital on various neuropathies and mental diseases was 97.4% in the 900 cases,with no accident occurring during hospitalization.Depression of the 169 patients was obviously improved,indicating that it isfeasible to establish open psychology ward in general hospitals.

Objective To investigate the effect of self-efficacy theory in rehabilitation on stroke patients with hemiplegia complicated psychological disorder. Methods 26 cases were divided into the combined therapy group (13 cases, accepted physical therapy with self-efficacy) and the routine physical therapy group (13 cases). They were assessed with General self-efficacy scale (GSES), Fugl-Meyer Assessment before and 1, 3 months after treatment, as well as symptom checklist (SCL-90) before and 1 month after treatment. Results The scores of GSES raise 63% in the combined therapy group 1 month after treatment, obviously different from that of routine physical therapy (P<0.01).The score of Fugl-Meyer Assessment of the combined therapy group were increased from (53.08±13.04) to (90.07±6.54 ) and from (56.46±12.95) to (81.77±8.51)in the routine physical therapy group (F= 85.53,P<0.05). All the scores of depression, anxiety, compulsion, hostility in SCL-90 were markedly lower in the combined therapy group than in the routine physical therapy group(P<0.01). Conclusion Utilization of self-efficacy theory in rehabilitation can improve the emotion and effect of rehabilitation.

Objective To investigate the present situation of retinopathy of the prematurity(ROP)in Guang-dong Province.Methods A total of 1 52 hospitals engaged in neonatal medical service were selected from 1 3 cities in Guangdong Province by stratified random sampling method.The questionnaires of present situation and influential factors for ROP in Guangdong Province were distributed to the hospital officers to survey the special equipment in the Neonato-logy Department,ROP specialists and their training collected,the collected related equipment and the present situation of the disease,et al.Eventually,1 22 questionnaires was collected,and the return rate was 80.26%.One hundred and twenty -two hospitals entered into the study,including 50 tertiary hospitals,72 secondary and primary hospitals.Statisti-cal analysis was done with SPSS 1 9.0.Results Tertiary hospitals were better than secondary and primary hospitals in terms of conducting the oxygen monitoring (χ2 =1 8.639,P <0.01 ),ROP screening (χ2 =40.054,P <0.01 )and ROP treatment(χ2 =8.262,P <0.05).The restriction factors in the present situation of ROP were lack of specialists,tech-nology and equipment,especially the first two factors.The difference in lack of specialists and technology between tertia-ry hospitals and the lower -level hospitals was significant(χ2 =4.520,P <0.05).There were 63 hospitals able to con-duct ROP screening,and 1 6 hospitals without equipment could carry out ROP screening through referral or inviting the experts from other hospitals.Fifty -nine hospitals which couldn′t carry out ROP screening had to refer patients to other hsopitals or invite the experts from other hospitals for consultation of high risk patients.Conclusions The present situation of ROP in the tertiary hospitals in Guangdong Province is generally satisfactory,while that in the secondary and primary hospitals stays behind.The constraints for present situation of ROP examination and treatment were lack of spe-cialists,technology and equipment.The hospitals that can′t implement ROP screening should establish regional co -operation by referral and resource sharing to improve the present situation of ROP in Guangdong Province.

AIM: To examine whether Akt signal pathway proteins, including Akt, NF-?B and I?B?, are activated in kidney tissue of murine chronic graft-versus -host disease (GvHD) lupus nephritis in vivo , and whether prednisone suppres ses activation of them. METHODS: Akt activity and phosphorylated I?B? were detected by Weste rn-blot. Activation of NF-?B was detected by electropheretic mobilit y shift assay (EMSA). RESULTS: Activity of Akt, NF-?B and phosp horylated I?B ? were significantly increased in kidney tissue of murine chronic graft-versus -ho st disease (GvHD) in 8th week and 12th week after monocell injection, respective ly. However, they were no significant elevation in 16th week, when compared with controls. Prednisone treatment significantly prevented the increase in serum an ti-dsDNA antibody level, urinary protein excretion and glomerular cell prolif eration in GvHD mice, indicating the beneficial effects of prednisone on t his model. Prednisone also significantly suppressed the increase in the activities o f glomerular Akt, NF-?B and phosphorylated I?B?. CONCLUSION: T his study provides t he first evidence of marked increase in glomerular Akt-NF-?B signal pathway act ivities in murine chronic graft-versus-host disease lupus nephritis. The benefic ial effect of prednisone on this lupus nephritis model may be partially mediated by the suppression of abnormal Akt- NF-?B activation.

OBJECTIVE: To evaluate the clinical and radiological results of patients with thoracic and lumbar fracture and dislocation treated by posterior transforaminal decompression and interbody fusion. METHODS: From June 2010 to June 2017, posterior transforaminal decompression, interbody fusion combined with pedicle screw fixation were performed in 21 patients with thoracic and lumbar fracture and dislocation. Their clinical and radiological data were collected and retrospectively analyzed, including 15 males and 6 females, aged from 25 to 58 years with an average of 45 years old. According to the criterion of American Spinal Injury(ASIA), preoperative neurological function was graded A in 3 cases, B in 7 cases, C in 6 cases, D in 4 cases and E in 1 case. Operative time and intraoperative blood loss and correlative complications were recorded. And VAS score, ODI and Cobb angle were evaluated before and after surgery. The improvement of neurological function was also analyzed at the final follow-up. Intervertebral bony fusion was observed during the follow-up by CT three-dimensional reconstruction. RESULTS: The operative time was 150 to 240 min with an average of (192±47) min. The intraoperative blood loss was 380 to 750 ml with an average of(603±120) ml. Dura sac tearing and cerebral fluid leakage occurred in 3 cases and were repaired during operation; superficial wound infection occurred in 1 case, and got healing after dressing change. The postoperative follow-up duration was 24 to 45 months with an average of(37.0±9.5) months. VAS score was improved from preoperative 8.9±0.4 to immediately postoperative 4.2±1.3(<0.05). At the final follow-up, VAS score decreased further to 3.6±0.8. ODI was decreased from preoperative (95.30±3.52)% to (32.51±6.30)% at the final follow-up (<0.05). Cobb angle was corrected from preoperative (21.2±8.8)° to immediately postoperative(2.3±3.1)° (<0.05). At the final follow-up, Cobb angle was (3.2±2.5)°, showing no significant difference with immediately postoperative value. The neurological function was grade A in 3 cases, B in 3 cases, C in 5 cases, D in 6 cases and E in 4 cases at the final follow-up. All the patients got solid intervertebral bone fusion in 8 to 13 months after operation, with an average fusion time of (10.3±2.5) months. CONCLUSIONS For the patients with thoracic and lumbar fracture and dislocation mainly involving intervertebral disc and endplate plane, posterior transforaminal decompression and interbody fusion not only is less invasive, but also can effectively reconstruct spinal three column and obtain good biomechanical stability. And, it is beneficial for the good recovery of neurological function.
Adult ; Decompression, Surgical ; Female ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

BACKGROUND:Electron beam melting rapid prototyping technology, has the characteristic of shaping precisely and complexly, is a new type of rapid prototyping technology using metal powder. Now, it has shown unique advantages in the fields of aerospace, automotive and medical implant equipments.
OBJECTIVE: To explore the properties of the product, the customization ability of orthopedic implants through electron beam melting rapid prototyping, especial y the ability of inducing bone ingrowth.
METHODS:We retrieved PubMed Database, China Journal Ful-text Database, and China National Knowledge Infrastructure, as wel as Dongfang Daily, World Science, and Chinese Journal of Orthopaedics by hand, and assembly documents in Chinese and English. Retrieval time was up to September 2013. Inclusion criteria: ① articles concerning electron beam melting rapid prototyping technology; ② articles addressing surgical implants. A total of 50 articles were included.
RESULTS AND CONCLUSION:Electron beam melting state Ti6Al4V orthopedic implant has a good comprehensive performance, since the three-dimensional porous structure via electron beam melting rapid prototyping, which has a characteristic of customization, can induce bone ingrowth.

Uncoupling protein 2 (UCP2) is a proton transporter which presents in the mitochondrial inner membrane.Recently studies found that UCP2 plays important roles in regulation of reactive oxygen species production,maintenance of mitochondrial function,as well as inflammation and blood glucose control.These features have important relevance with the pathophysiologic mechanism of sepsis.

Objective To investigate the awareness of osteoporosis and its influential factors in middle-aged and older people. Methods By using self-designed questionnaire, 354 middle-aged and old people were investigated as to their awarness of osteoporosis in Chajiao street community in Guangzhou. Among them, 58 people were measured the bone density in the calcaneal bone by Ultrasound. Results The average score of the questionnaire was 9.46 ± 5.13, and the accuracy was 39.4%. In the diagnosis and treatment, the accuracy was just 17.8%. The diet (the accuracy in 54%) and sport (the accuracy in 50.3%) were good. The statistical analyses showed the linear relationship between the T value of bone density and the age (P = 0.021), between the T value and the score (P = 0.047). Wilcoxon rank sum test found that the T value between female and male was significantly different (Z = -3.749, P < 0.000). With multiple linear regression analysis, the T value had a linear correlation with the score (F = 4.224, P = 0.045) positively. Conclusions Currently, the awareness of osteoporosis in the middle-aged and old people was inadequate. To better prevent osteoporosis, the propogation of knowledge and guidance provided by clinicians in osteoporosis should be improved necessarily and emergently.

Objective To systematically evaluate the efficacy and safety of posterior short segment and long segment pedicle screw internal fixation in the treatment of thoracolumbar burst fracture. Methods By searching the database, including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, a comprehensive study was carried out to make a comparison between the posterior short segment and the long segment pedicle screws internal fixation in treatment of thoracolumbar burst fracture, and Meta analysis was performed. Results A total of 14 related studies and 658 patients were enrolled in the study, including 320 patients in short segment group and 338 cases in long segment group, and Meta analysis was performed. The results suggested that there was no significant difference between the short segment group and the long segment group in terms of the deformity angle of the injured vertebra measured after operation and at the last follow?up, and sagittal index at the last follow?up ( MD=-0. 22,95%CI -2. 73,2. 28,P=0. 86;MD=-0. 28,95%CI -2. 23,1. 67, P=0. 78;MD=0. 47, 95%CI -3. 45, 4. 39, P=0. 81 ) . Besides, both groups had no statistical difference in post?operative COBB angle,anterior vertebral height and compression rate of injured vertebrae ( MD=0. 21,95%CI -0. 65,1. 06,P=0. 64; MD=-0. 46,95%CI -1. 40,0. 49,P=0. 34; MD=0. 47,95%CI -2. 28, 3. 21, P= 0. 74 ) , while the differences in COBB angle, anterior vertebral height, compression rate, correction loss were statistically significant at the last follow?up (MD=5. 11,95%CI 2. 81,7. 40,P<0. 0001;MD=-11. 89,95%CI-15. 28,-8. 50,P<0. 00001;MD=6. 46,95%CI 3. 85,9. 07,P<0. 00001) . There was no significant difference in VAS scores and the ODI scores between the two groups at the last follow?up ( MD =0. 01,95%CI -0. 15,0. 17,P=0. 9; MD=-0. 47,95%CI -2. 68,1. 74,P=0. 86),while the two groups showed statistically significant difference in fixation failure ( RR = 0. 08, 95%CI 0. 01, 0. 15, P = 0. 02 ) . Conclusion Posterior long segment pedicle screw internal fixation is more effective in treating thoracolumbar burst fracture than short segment surgery. It can reduce the COBB angle,restore the anterior height of the injured vertebra,and decrease the anterior vertebral pressure.