Background:Studies have shown that patients with peptic ulcer are susceptible to the accompanying of anxiety and depression,and affects the treatment of ulcer. Aims:To study the effect of flupentixol and melitracen combined with quadruple therapy on peptic ulcer patients with anxiety and depression. Methods:Sixty-eight peptic ulcer patients with anxiety and depression from May 2012 to May 2013 at Wuhu No. 2 People’s Hospital were enrolled,and were randomly divided into control group and observation group. Patients in control group were given quadruple therapy( rabeprazole 20 mg + amoxicillin 1. 0 g + clarithromycin 0. 5 g + colloidal bismuth subcitrate solution 10 mL,bid),while patients in observation group were given flupentixol and melitracen in addition to quadruple therapy,the treatment course were both for 2 weeks. Therapeutic efficacy of ulcer,Helicobacter pylori( Hp) eradication,therapeutic efficacy of anxiety and depression,incidence of adverse reaction and recurrence rate of ulcer within one year after treatment were compared between the two groups. Results:Compared with control group,the therapeutic efficacy of ulcer and Hp eradication in observation group were significantly increased(P < 0. 05),therapeutic efficacy of anxiety and depression was significantly increased(P < 0. 05),no significant difference in the incidence of adverse reaction was found between the two groups,and the recurrence rate of ulcer within one year was significantly decreased( P < 0. 05). Conclusions:Flupentixol and melitracen combined with quadruple therapy could significantly improve the therapeutic efficacy and effectively reduce the recurrence rate in peptic ulcer patients with anxiety and depression.

[Objective]To investigate the late results of pedicle screw system and cage fixation for lumbar broken isthmus spondylolisthesis.[Method]Totally 86 patients with broken isthmus spondylolisthesis were collected and analyzed from October 1996 to October 2002,they were all reduced and fixed with pedicle screw system and cage.Group 1,62 patients were put one cage in the interbody at an angle of 45 degree from posterior to anterior,while Group 2,24 patients were put two cages in the interbody vertically from posterior to anterior.The height of interbody and the most proximal interbody' s height were measured,the rate was calculated.These rate were acquired preoperatively,2 weeks postoperatively and follow-up period respectively.[Result]The follow-up period was 24~96 months,averaged 35 months.The excellent and good rates were 80.23 per cent,according to Nakai standard.Ninteen patients with one degree spondylolisthesis were reduced anatomically after surgery.Fifty-one patients with two degree spondylolisthesis were reduced anatomically except 5 patients with one degree spondylolisthesis left.Sixteen patients with three degree spondylolisthesis were reduced anatomically except 4 patients with one degree spondylolisthesis left.There were loss of spondylolisthesis reduction at follow-up period comparing with 2 weeks postoperatively in two groups.However there was no statistical significance between the two groups.[Conclusion]Lumbar spondylolisthesis should be treated with pedicle screw system and cage,which may decrease the complications such as broken screw and spondylolisthesis recurrency postoperatively.One piece of cage is enough to make interbody stable.It is also an ideal procedure for lumbar spondylolisthesis.

[Objective] To evaluate the efficiency of Halovest external immobilization on the treatment of traumatic cervical fracture or dislocation.[Method]From February 1997 to July 2005,129 patients with cervical fracture or dislocation were treated in our hospital;all the patients were divided into two groups randomly.First group: 70 patients were treated with Halo-vest traction,among them 31 patients were treated with Halo vest combined jacket orthosis;others were treated with Halo vests and surgery(anterior route approach 18 cases,posterior route approach 17 cases,4 patients operated by anterior and posterior approach).The second group: 59 patients were treated with skull traction.Among them 13 patients were treated with skull traction and orthosis,others were treated with skull traction and surgery(anterior route approach 22 cases,posterior route approach 20 cases,4 patients operated by anterior and posterior approach).[Result]All the patients were followed 6~48 months(average 12 months).There was no statistical significance in two groups with reduction of upper cervical spine fracture and dislocation.However on the reduction of lower cervical injury groups,the prognosis with Halo-vest is significantly better than the other group.And the time for bed rest was much less than the skull traction.All the patients' spinal cord function improved obviously after treatment.[Conclusion]Halo-vest external fixation is an easy and effective way to treat cervical injuries.It can improve the reduction of the cervical injuries and it's capability of reduction and maintenance are much better than skull traction.

Objective To investigate the mid-and long-term effects of metal-on-metal hip resurfacing arthroplasty (HRA),and to analyze its related factors.Methods A total of 64 patients (81 hips) who underwent metal-on-metal HRA from June 2005 to January 2013 were recruited in the present study.There were 35 males (44 hips) and 29 females (37 hips) with the mean age of 48.26±10.45 years (20-65 years),including 47 unilateral and 17 bilateral HRAs.The cohort consisted of osteoarthritis secondary to the developmental dysplasia of the hip (23 cases,29 hips),necrosis of the femoral head (19 cases,22 hips),osteoarthritis (8 cases,10 hips),rheumatoid arthritis (5 cases,9 hips),ankylosing spondylitis (6 cases,8 hips),pigmented villonodular synovitis (2 cases,2 hips) and Otto's disease (1 case,1 hip).During the follow-up duration,radiographic features,including acetabular inclination angle,stem-femoral shaft angle,component loosening,osteolysis,femoral neck narrowing and heterotopic ossification,were evaluated by hip X-rays in straight and froglike position.The size and type of pseudotumor were assessed by MRI and ultrasonography.Clinical efficacy was evaluated by Harris hip score and the University of California at Los Angeles (UCLA) hip score.Considering revision surgery as the end point,the component survivorship was calculated.Results The mean follow-up was 7.98±2.21 years,ranging from 5.0 to 12.8 years.The mean postoperative Harris hip score (92.01 ±5.69) was higher than the preoperative score (41.93 ±9.09).The mean postoperative UCLA pain,walking,function,activity scores (9.37±0.86,9.14± 1.01,8.77± 1.09,6.47± 1.27,respectively) were improved when compared with the preoperative UCLA scores (3.57± 1.23,5.99± 1.30,5.00± 1.01,3.84± 1.41,respectively).The postoperative flexion,abduction and adduction,medial and lateral rotation of the hip was larger than the preoperative ones.Complications occurred in 10 hips (12.3％,10/81).Seven patients (8 hips) experienced early and intermediate complications,including one intraoperative femoral nerve injury,one deep femoral artery and saphenous nerve injuries during the same surgery,one unexplained pain of hip,one femoral neck fracture,three hips of heterotopic ossification,and one pseudotumour.There were mid-and long-term complications in two hips,including one narrowing of the neck and one pseudotumour which was occurred at 9 years.There was one patient (2 hips) underwent revision surgery twice at 5 months and 9 years.The former cause of revision was femoral neck fracture and the latter one was pseudotumour.The Kaplan-Meier survivorship was 98.8％ at five years,and 95.0％ at ten years.Conclusion Patients who underwent metal-on-metal HRA could obtain good mid and long-term results.Pseudotumour and unexplained pain of the hip are critical factors which can affect the mid-and long-term results and survivorship of metal-on-metal HRA.

Objective To investigate the risk factors of complications after CT-guided percutaneous transthoracic needle biopsy(PTNB)in the plateau environment.Methods A total of 858 patients who underwent CT-guided PTNB were selected,and the clini-cal data of patients,imaging features of lesions,information related to puncture operation,complications,and pathological results were analyzed retrospectively,then the independent risk factors of postoperative pneumothorax and pulmonary hemorrhage were summarized.Results Among 858 patients with lung biopsy,816 cases(95.1％)were successfully sampled,including 203 cases(23.7％)in the pneumothorax and 140 cases(16.3％)in the pulmonary hemorrhage.The statistical analysis results of the pneumo-thorax revealed significant differences in lesion location and lesion size(P＜0.05).The statistical analysis results of the pulmonary hemorrhage showed significant differences in lesion location,lesion size,puncture angle and puncture depth(P＜0.05).Independent risk factors affecting pneumothorax and pulmonary hemorrhage were illustrated in a forest plot.Conclusion Because the oxygen partial pressure and climate temperature are relatively low in the plateau environment,the cardiopulmonary function of patients will be affected by the living environment.Therefore,on the premise of ensuring the success rate of CT-guided PTNB,the optimal path and timing should be selected to reduce the risk of complications.

"Symptoms such as syncope, constipation or incontinence all belong to the lower part" comes from Bing Ji Shi Jiu Tiao ( Su Wen Zhi Zhen Yao Da Lun). Doctors mostly recognize the meaning of this pathogenesis from macroscopic symptoms. From a microscopic point of view, proteinuria and increased SCr are the most common clinical manifestations of most kidney diseases, which can be classified into the categories of "incontinence" and "constipation" respectively. The meaning of "lower" is mostly thought to refer to or include kidney. Therefore, microscopic detection methods can be used in clinical practice. The pathogenesis of many kinds of kidney diseases can be explored based on the changes of kidney microstructure combined with the theory of TCM to establish a diagnosis and treatment system of microscopic TCM syndrome differentiation and differentiate and treat nephropathy by combining micro and macro evidence.

Objective To investigate the efficacy of CT-guided percutaneous microwave ablation for the treatment of primary hepatocellular carcinoma.Methods A total of 132 patients with primary hepatocellular carcinoma were divided into control group and study group(66 cases in each group)according to different treatment plans.The control group received transcatheter arterial chemoembolization(TACE)treatment,while the study group received TACE combined with percutaneous microwave ablation under CT guidance.The changes in serum tumor markers and liver function indicators were observed before and after treatment in the two groups,and the efficacy(short-and long-term)and safety of the two groups were compared.Results The levels of serum carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 125(CA125),and carbohydrate antigen 19-9(CA19-9)in both groups decreased significantly after treatment compared to those before treatment,and intergroup comparison showed that the levels of CEA,AFP,CA125,and CA1 9-9 in the study group were significantly lower those after treatment(P＜0.05).Compared with those before treatment,the levels of alanine transaminase(ALT)and aspartate transaminase(AST)were decreased,and the level of albumin(ALB)was increased of both groups after treatment.The intergroup comparison showed that the study groups ALT and AST levels were lower and ALB level was higher(P＜0.05).The total effective rate of the study group was clearly higher than that of the control group(75.76％vs 46.97％,P＜0.05).The 1-year survival rates of the two groups were similar(90.91％vs 81.82％,P＞0.05),however,the 2-year survival rate of the study group was clearly higher than that of the control group(84.85％vs 63.64％,P＜0.05).Conclusion CT-guided percutaneous microwave ablation for the adjuvant TACE treatment of primary hepatocellular carcinoma can effectively reduce tumor burden and lower tumor marker levels,its short-and long-term efficacy is significant,with a low incidence of adverse reactions and good safety.