Objective To observe the treatment effect of joint manipulation under brachial plexus anesthesia combined with comprehensive physical therapy in treatment of periarthritis of shoulder. Mehods From 2010.3 to 2010.9, 60 patients with periarthritis of shoulder in the Department of Pain, The First People's Hospital of Jingzhou,were divided into 3 groups:group A,B and C.Twenty patients in Group A were given Joint manipulation under brachial plexus anesthesia for treatment of the periarthritis of shoulder. Twenty patients in Group B were given comprehensive physical therapy fro treatment of periarthritis of shoulder. Twenty patients in Group C were given Joint manipulation under brachial plexus anesthesia combined with comprehensive physical therapy for treatment of periarthritis of shoulder.Results All 60 patients were followed up for 1 months. At the 1st month after surgery, vas score was evaluated for patients. Postoperative and preoperative vas score difference was compared between 3 groups by t test. There was statistically significant difference in the postoperative and preoperative vas score between Group C and Group A,and between Group B and Group A (P<0.05) . Conclusion The treatment effect of Joint manipulation under brachial plexus anesthesia combined with physical therapy in treatment of periarthritis of shoulder is good, but has no obvious difference compared with comprehensive physical therapy.

Objective To observe the treatment effect of radio frequency target combined with collagenase in treatment of cervical intervertebral disc herniation. Methods From March 2011 to September 2011, 40 patients with cervical intervertebral disc herniation were divided into 2 groups: Group A and Group B. Patients in Group A were given radio frequency target radiofrequency for treatment of the cervical intervertebral disc herniation and patients in Group B of 20 were given radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation. Results 40 patients were followed up for 6 months. At the 1st week and 6 months after surgery, the VAS score difference between before and after surgery in patients were compared between two groups by t test. There was no statistically significant difference at the 1st week after surgery between two groups (P>0.05), while 6 months after surgery, there was statistically significant difference between two groups (P<0.05) .Conclusion Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation can alleviate the pain symptoms of patients,and the short-term and long-term curative effect is very good. The long-term curative effect has statistically significant difference with pure target radiofrequency ablation treatment. Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation has good safety, few side effects, low risks and good short-term and long-term curative effect, so it deserves to be generalized.

Objective To observe the relationship of right internal jugular vein (RIJV)and common carotid artery (CAA)by scanning strictly from the anterior to posterior using ultrasound at different head rotation.Methods Using ultrasonic scanning,the anatomic features of RIJV and CAA both at thyroid cartilage level (prominentia laryngea level)and at the apex of the angle formed by the division of the sternocleidomastoid muscle (triangle level)with 0°,1 5°,30° and 45° right rotation were observed in 131 patients with ASA physical status Ⅰ or Ⅱ (male 55 cases,female 76 cases, aged 18~74 years).Based on the ultrasound images,the safe puncture range,the overlapping ratio, the angle between the horizontal axis and the line from the midpoint of RIJV to that of CAA (αangle) were measured.In addition,the relationship between the RIJV and CAA was defined as anterior-lat-eral, lateral, posterior-lateral or extremely-posterior-lateral position according to α angle. Results The safe puncture range of RIJV augmented as head rotated from 0° to 30° position(P <0.05);The safe puncture range of RIJV at triangle level was significantly higher than at prominentia laryngea level at all the four head positions(P <0.05).The overlapping degree decreased as head rota-ted from 0°to 30°head position at prominentia laryngea level(P <0.05).No siginificant differences of the overlapping degree were found between head positons at triangle level;The overlapping degree at triangle level was less than at prominentia laryngea level when at 0°and 1 5°head positon(P <0.05). At both prominentia laryngea and triangle levels,RIJV located mainly at lateral and posterior-lateral positions.In addition,the part of lateral position increased while the part of posterior-lateral position decreased as the head rotated from 0°to 45°position(P <0.05).Conclusion The puncture conditions for RIJV catheterization were more optimal at 30°to 45°head rotation for a safer puncture range and less overlapping between RIJV and CAA.RIJV located mainly at lateral and posterior-lateral positions at different rotations and RIJV gradually shifted to lateral position while head rotation increasing.It would be much better to select triangle level for central venous catheterization than prominentia laryn-gea level.

Substantial progress in the use of chemo-photodynamic nano-drug delivery systems (nano-DDS) for the treatment of the malignant breast cancer has been achieved. The inability to customize precise nanostructures, however, has limited the therapeutic efficacy of the prepared nano-DDS to date. Here, we report a structurally defined tandem-responsive chemo-photosensitive co-nanoassembly to eliminate primary breast tumor and prevent lung metastasis. This both-in-one co-nanoassembly is prepared by assembling a biocompatible photosensitive derivative (pheophorbide-diphenylalanine peptide, PPA-DA) with a hypoxia-activated camptothecin (CPT) prodrug [(4-nitrophenyl) formate camptothecin, N-CPT]. According to computational simulations, the co-assembly nanostructure is not the classical core-shell type, but consists of many small microphase regions. Upon exposure to a 660 nm laser, PPA-DA induce high levels of ROS production to effectively achieve the apoptosis of normoxic cancer cells. Subsequently, the hypoxia-activated N-CPT and CPT spatially penetrate deep into the hypoxic region of the tumor and suppress hypoxia-induced tumor metastasis. Benefiting from the rational design of the chemo-photodynamic both-in-one nano-DDS, these nanomedicines exhibit a promising potential in the inhibition of difficult-to-treat breast tumor metastasis in patients with breast cancer.