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Capillary Leak Syndrome ; complications ; Cholestasis, Intrahepatic ; complications ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications

Objective To introduce the operation method and curative effect of posterior dislocation and acetabular posterior column ( wall) fracture with greater trochanteric osteotomy via Kocher-Langenbeck approach. Methods 14 cases of posterior dislocation and ace-tabular posterior column( wall) fracture who were treated by greater trochanteric osteotomy via Kocher-Langenbeck approach were collected, and the surgical methods, intraoperative situation and postoperative recovery were analyzed. Results The mean operating time is 105 min and the mean bleeding volum is 600 mL. After operation, there were 5 cases of anatomical reduction;8 cases of good reduction;1 cases of unsatisfactory reduction. Among the patients, 7 cases were of excellent clinical effect;4 cases were of good clinical effect, 3 cases were of medium clinical effect. Heterotopic ossification occurred in 3 cases and traumatic arthritis occurred in 4 case. Both acetabular posterior col-umn ( wall) and trochanter osteotomy ends were healed, and there was no iatrogenic sciatic nerve and femoral head necrosis injury. Conclu-sion In treatment of posterior dislocation and acetabular posterior column ( wall) fracture, greater trochanteric osteotomy via Kocher-Lange-nbeck approach can provide excellent exposure, and it is conducive to the reduction and fixation of fracture and dislocation.

Drug dependence has been a hot topic in neuroscience research due to its complicated pathogenesis. Recently, huge scientific efforts have been continuously put into understanding the association between drug dependence and polymorphism in ATP-binding cassette subfamily B member 1 transporter ( ABCB1 ) gene, especially a mutation in exon 26 at position 3435 (3435C>T). This article reviews the relationship between opioid dependence and analgesic tolerance and ABCB1 gene pol-ymorphism, which will shed light on the underlying mechanisms of drug dependence and optimal MMT programs for individuals.

OBJECTIVE:To investigate the perioperative prophylactic utilization of antibiotics in cataract patients in ophthalmology department of our hospital.METHODS:100 cases of cataract surgery in 2009 were randomly collected from our hospital.Category of antibiotics,administration time point,medication time,wound healing and drug costs in hospitalization period were analyzed statistically and the rationality of above indexes was evaluated.RESULTS:100 cases all received prophylactic antimicrobials by local and systematic administration in the perioperative period(100%).Drugs for systematic administration contained Levofloxacin(n=67,67%),Cefuroxime sodium for injection(n=25,25%),Clindamycin phosphate injection(n=2,2%) and Ceftazidime for injection(n=6,6%).63 cases were only given drugs 30 min before operation(63%);12 cases were given medicine 30 min before operation and within 24 h after operation(12%);above situation accounted for 75%.25 cases were given medicine before operation and within 24 h after operation(25%),in which the average medication duration was 2.5 days and the longest was 4 days.CONCLUSION:The irrational use of drugs in our hospital manifests inappropriate selection and too long use of antibiotics after operation.The interference of perioperative prophylactic utilization of antibiotics should be reinforced and it is urgent to intensify consciousness of physicians about rational use of antibiotics in perioperative period.

Objective: To evaluate left ventricular myocardial systolic function in patients with type 2 diabetes mellitus (T2DM) combined with abdominal obesity with three-dimensional speckle tracking imaging (3D-STI). Methods:A total of 56 T2DM patients were enrolled, including 26 patients with abdominal obesity (abdominal obesity group) and 30 without abdominal obesity (non-abdominal obesity group), while 30 healthy volunteers were selected as the control group. Conventional ultrasound parameters and strain parameters, including left ventricular end-diastolic diameter (LVDd), two-dimensional ejection fraction (2D-EF), relative wall thickness (RWT), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), three-dimensional ejection fraction (3D-EF), as well as left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), left ventricular global area strain (LVGAS) and left ventricular global radial strain (LVGRS) were compared among 3 groups. Results :Among the three groups, LVDd, RWT, LVEDV and LVESV in abdominal obesity group were higher than those in control group and non-abdominal obesity group (all P<0.05), while 2D-EF and 3D-EF were lower than those in control group (both P<0.05). LVGLS, LVGCS, LVGAS and LVGRS in abdominal obesity group and non-abdominal obesity group were lower than those in control group (all P<0.05), while in abdominal obesity group were lower than in non-abdominal obesity group (all P<0.05). Conclusion: 3D-STI can be used to evaluate left ventricular myocardial systolic function in patients with T2DM combined with abdominal obesity.

Objective To identify the effect of morphology of adult upper and middle thoracic pedicle on security of screw implantation.Methods Five fresh adult cadaveric thoracic spine from T1 to T8 were harvested.Pedicle transverse diameters were measured and compared with the smallest diameter(4.5 mm) of screw used in clinic.The screws were inserted and implant effect was observed.Results The mean transverse diameter of adult thoracic(T1-T8) were T1:4.74(3.85-5.25)mm,T2:4.51(3.45-5.25)mm,T3:4.15(3.60-4.65)mm,T4:3.75(3.10-4.50)mm,T5:4.25(3.70-4.65)mm,T6: 4.53(4.40-4.70)mm,T7:5.38(5.25-5.60)mm,T8:5.55(5.50-5.80)mm.Of all specimens,there were 9 specmen(22.5%) whose tranverse diameters were smaller than 4.5 mm.After implantation,two screws broke through pedicle lateral wall.Conclusion Adult pedicle transverse diameters in T3-T4 are smallest,transpedicular screw placement is difficult in some of these vertebrae,but in most of thoracic vertebrae,pedicle tranverse diameter could permit screw implanting in security.

Objective To investigate mental symptoms of SARS patients and its related factors for three period-admission, discharge and three months after SARS crisis and to carry out mental intervention and effect evaluation.Methods The mental problems of SARS patients in three periods of admission, discharger and three months after discharger were continuously investigated.114 SARS patients came from seven designated hospitals in Taiyuan of Shanxi. The participants were assessed by self- compiled stressor Questionnaire, PSSS, SCSQ, SES, SCL-90 and EPQ.Results 1.Change tendency of factor score: The SCL-90 total and factors scores including obsessive-compulsion, phobic anxiety went up during discharge compared with admission. After that,these factors scores went down. The factors scores of somatization and depression descended continuously for three period. 2.Change tendency of the incidence:The incidence on factors of obsessive-compulsive, interpersonal sensitivity, phobic anxiety ascended during discharge compared with admission. Then,these factors scores descended. The other factors went down continually for three periods.3. The self-esteem was influencing factor on mental symptoms of SARS patients for three periods.Conscientious condition severity was influencing factor in admission and discharge.Negative coping was influencing factor in discharge and three months after SARS crisis. Education was influencing factor in three months after SARS crisis.4.After intervention ,the most mental symptoms of 35 SARS patients had mental problems were improved. Dissimilarly, a part of mental symptoms got severity.Conclusions 1.SARS patients exist severe mood disorders and have different influencing factors for three periods. They should be evaluated continuously and be intervened in time.2.The effect of mental intervention by telephone is not uncertainty.

Objective This paper focuses on the investigation of the occurrence and influential factors of post-traumatic stress disorder (PTSD)in SARS patients, hospital staffs and the public expo sed to SARS. Methodes Three groups were assessed by scale of self-compiled stressor Questionnaire, impact of event scale-revised (IES-R) , PSSS, SCSQ, SES and EPQ. Results 1. The incidence of PTSD symptoms in the three groups were 55.1% ,25.8 % and 31.18 %. 2. The main cause of the different incidence was the difference of the stressor intensity and characters. Negative coping was the risk factor of SARS patients and the public; Self-esteem was the protected factor of SARS patients and the hospital staffs; Social support was a protected factor on the hospital staffs. 3. Comparing to the first investigate in September,2003 ,the data of follow-up study in September,2004 showed that the prevalence items significant decreased. Conclusions 1. The investigation concludes that all three groups of people exposed o SARS exhibit PTSD symptom. SARS patients have the highest occurrence ( P ＜ 0.01 ). 2. The main influencing factors of different incidence of PTSD in different groups are intensities and characteristics of stressors. Different people who had PTSD symptoms have different influencing factors. 3. With the change of time , the PTSD symptoms significant relieve with the attenuation gradually of exposure degree of stressor.

Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.