Objective To investigate the effects of autologous blood transfusion and acute normovolemic hemodilution inflamma‐tory response in patients with spinal surgery .Methods 60 patients with spinal surgery ,were randomly divided into the control group ,autologous blood transfusion group ,acute normovolemic hemodilution group ,20 cases in each group .The control group in in‐traoperative bleeding time and blood input variants of inventory .Autologous blood transfusion group was used in combination with intraoperative autologous blood recovery unit ,lose banked blood hemoglobin was low .Acute normovolemic hemodilution group via peripheral vein input must first crystal liquid or gel liquid ,then through internal jugular vein slowly pulled out the body′s blood into the special bags containing anticoagulant ,swing machine through blood kept shaking ,input when appropriate .Preoperative(T1) , After surgery 2 h(T2) ,6 h(T3) ,12 h(T4) and 24 h(T5) blood at each time point 5 mL ,detect the WBC ,IL‐6 ,TNF‐α.Records with and without postoperative complications .Results WBC in autologous blood transfusion group and acute normovolemic he‐modilution group were higher than that of preoperative ,difference was statistically significant(P<0 .05);In T2 -T5 ,serum IL‐6 , TNF‐a and the WBC concentration compared with the basis of their respective value(T1) increased significantly ,but were signifi‐cantly lower than control group ,the difference was statistically significant(P< 0 .05) .Postoperative follow‐up of the autologous blood transfusion group and acute normovolemic hemodilution group and no complications .Conclusion The autologous blood trans‐fusion group and acute normovolemic hemodilution group could effectively reduce the intraoperative and postoperative systemic in‐flammatory response ,which obviously save blood resources .

Objective To clarify the influence of Ca and P on bone metabolism by investigating theeir effects on proliferation, differentiation and mineralization of osteoblasts (OBs) in vitro. Method OBs were cultured in media with Ca(1, 2,4 mmol/L),P(1, 2,4 mmol/L),Ca:P 1:2 (1 mmol/L Ca+2 mmol/L P), and Ca:P 2:1 (2 mmol/L Ca+1 mmol/L P). Cell proliferation, activity of alkaline phosphatase (ALP), content of osteopontin (OPN) and collagen type I (Col-I) of OBs, and their corresponding mRNA expression were measured. Results Compared with control group,Ca at 4 mmol/L promoted OBs proliferation significanty (P

Surgical treatment is the only cure treatment for patients with inferior vena cava tumor thrombus in hepatic segment and upper hepatic segment.The accurate diagnosis of tumor thrombus is very important.In preoperative imaging examination,the abdominal enhanced CT scan and the inferior vena cava MRI scan were the best methods for the diagnosis and evaluation of the tumor thrombus in hepatic segment and upper hepatic segment.Compared with the tumor thrombus below the liver,the tumor thrombus in hepatic segment or above hepatic segment extend widely,and the operation are more difficult.For simple inferior vena cava tumor thrombus (the top of the thrombus has reached the level of hepatic vein),Retroperitoneal approach combined with transperitoneal approach should be used.Open surgery is the standard procedure for other tumor thrombus in hepatic segment and upper hepatic segment.In addition to exposure of inferior vena cava below the hepatic vein,the liver and the first hepatic hilum should be exposed.For tumor thrombus in the atrium,after the longitudinal incision of diaphragm,we use Milking technology to squeeze thrombus into inferior vena cava.Then we use catheterization technology to remove thrombus.For difficult atrial tumor thrombus,an extracorporeal circulation should be performed.The median incision in the chest should be performed to open the chest and open the pericardium and remove the tumor thrombus.Patients with tumor thrombus in hepatic segment or upper hepatic segment should be diagnosed as early as possible and they need actively treated by operation.

0.05),and presented significant increase after half a year of retention(P

Objective To study the relationship between velocity of middle cerebral artery(MCA),severity of disease and watershed infarction(WSI) in patients with extracranial internal carotid artery(EICA) stenosis or occlusion.Methods Transcranial Doppler(TCD) was used to detect the mean velocity(MV) of MCA in 120 patients with EICA stenosis or occlusion.The National Institutes of Health Stroke Scale(NIHSS) was used to evaluated the patients′ condition.And CT or MRI was used to diagnosised the WSI.Results MV of MCA was severe reduced in 10 cases,middle reduced in 38 cases,and mild reduced in 42 cases,while there were 30 cases with normal MV.The scores of NIHSS in the four groups(12.5?4.7,3.9?4.8,3.2?4.7,2.4?4.9 respectively) had significant different(P

"Treatment based on diseases identification and formulas corresponding to diseases" is one of important therapy modes of Chinese medicine. Although it originates from Huangdi Neijing, it is seldom systematically discussed. Modern Chinese medicine (CM) now faces diseases mostly with comparatively confirmed Western medical diagnoses. Most of them have specific pathophysiological changes. How to interpret these specific pathophysiological changes, play CM's advantages, and improve clinical efficacies has become an inevitable problem for modern CM in clinic. Authors expounded historic development and clinical application of "formulas corresponding to diseases", and its difference from "formulas corresponding to syndromes", put forward that we should combine "formulas corresponding to diseases" and "formulas corresponding to syndromes" in CM clinics. We should focus on the disease and summarize treatment rules, thereby improving targeted CM formulas.
Drug Compounding ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Syndrome

Objective To observe the effects of dexmedetomidine on the perioperative stress response and immunologic function in hepatectomy patients with hepatitis cirrhosis.Methods Forty patients(Child-Pugh A or B),ASA Ⅱ or Ⅲ with hepatitis cirrhosis undergoing hepatectomy were randomly divided into dexmedetomidine group(group D)and control group(group C)with 20 cases in each.Patients in group D were administered 0.5 μg/kg bolus dose of dexmedetomidine over 10 min, followed by 0.4 μg·kg-1 ·h-1 infusion until closing abdomen.And patients in group C were given normal saline by the same way as in group D.Flow cytometry was used to detect peripheral blood T lymphocytes (CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + ),NK cells at 30 min before anesthesia(T0 ),imme-diately(T1 ),24 h(T2 )and 48 h(T3 )after surgery.Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2,IL-10)at T0-T3 and stress hormones (Cor,ACTH,ALD)at T0 ,T2 and T3 .The levels of SBP,DBP and CVP at T0 ,immediately with intu-bation(Ta ),T1 and extubation(Tb ).Results Compared to those at T0 ,the levels of CD3 + ,CD4 + , CD8 + ,CD4 +/CD8 + at T1 and T2 were significantly lower in both groups(P <0.05),and the levels in group D were obviously higher than those in group C(P <0.05).The levels in group D were back to preoperative levels at T3 ,but the levels in group C were still lower than those at T0 (P <0.05).The levels of NK cells were higher at T1 in both groups,and the levels in group D was significantly higher than those in group C(P <0.05).Compared to those at group D,the concentration of IL-2 was lower at T1 and T2 ,the concentration of IL-10 was higher at T2 and T3 in group C (P <0.05).The levels of Cor,ALD,ACTH at T2 and T3 were significantly higher than those at T0 in both groups,but those in group D were markedly lower than those in group C (P < 0.05 ).The SBP,DBP and CVP of two groups was no statistically significant difference at T0 ,and SBP,DBP and CVP of the group D at Ta , T1 ,Tb was lower than that of T0 and group C (P <0.05).Conclusion Patients with hepatitis cirrho-sis underwent general anesthesia has certain immune suppression after liver cancer surgery,and con-tinuous intravenous infusion of dexmedetomidine during anesthesia may suppress the perioperative stress reaction effectively and alleviate the inhibition of immunologic function.

Objective To explore the psychological experience and the needs of parents who had children with leukemia in order to provide the theoretical and practice reference for clinical nursing work.Methods A qualitative phenomenological methodology was used in this study.10 parents of children with leukemia were interviewed with semi-open-ended questions.The NVivo10.0 software was used to supervise,excavate and seek data.The Colaizzi phenomenological methodology was used to analyze the data.Results Through careful analysis,four themes were identified:leukemia news was like crowning calamity; psychological changes generally varied in different stages; pressure had pluralism as well as the diversity of coping.The demand had multipolarity.Conclusions Attention should be paid closely to parents with leukemia children.The individualized measures should be taken by medical workers in order to provide them with mental nursing and holistic nursing and make them stay in a best health state,so that they can supply better social support for these children.

[Objective]To discuss the fractures classification,operative route,internal fixation and operative therapeutic effection of acetabular fractures.[Method]Thirty-four cases of acetabulum fractures and femoral head dislocation were involved from November 2001 to August 2006 in our hospital throught operative treatment.The classification according of AO system:type A fractures 24 cases,type B 10 cases.Applicated Kocher-Langenbeck operative route was applied in 20 cases,Gibson route 2cases,illioinguinal route 4 cases and anteriorcombined posterior route 4 cases.Thirty-two cases were adopted reconstruction plates and screws and 2 cases steel-wire cerclage to fix fracture.All patients were followed up.[Result]Acorrding to evaluation system of AAOS:excellent in 12 cases,good in 12 cases,fair in 4 cases,poor in 6 cases.Total exellence rate were 71%.[Conclusion]Combinate full-scale imageology information,correct classification of fracture according of AO,reasonable surgical approach and fixation,correct subtle technique during the operation and effective fracture resetting are keys to improve the effect of acetabular fractures.

[Objective]To probe the standard of early diagnosis of femoro-acetabular impingement(FAI),and the imageological appearance of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction,and MRI of progression of FAI patients.And to approach the significance of using the imageology result to identity doubtful FAI patients with other patients.[Methods]Six FAI patients were enrolled.CT and MRI noncontrast enhanced scan and CT three-dimensional reconstruction were performed to assess the hip joint.The CT scan was performed on the GE Lightspeed 16 row spiral at 1.25 mm slice reconstruction.The MRI scan was performed on the Siemens Avanto 1.5T supraconduction magnetic resonance meter.The CT and MRI scan included the acetabulum to the lesser trochanters.[Results]The results of DR of pelvis orthophoria discovered subtotal congenital anatomic abnormality of hip.The result of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction discovered total congenital anatomic abnormality of hip.The result of MRI noncontrast enhanced scan discovered phlegmasia of hip joint of midanaphase patients of FAI.[Conclusion]Non-buninoid femoral head,hyper-deep of hip,acetabular anteversion and hypsokinesis,and typical sings and symptoms lead to early and exactitude diagnosis.The results of 16 row spiral CT three-dimensional reconstruction and MRI can provid straight reference operation schedule;The result of MRI noncontrast enhanced scan can detect FAI with early avascular necrosis of the femoral head.