[Objective] To investigate the causes,indications,operative methods and clinical results of lumbar reoperation.[Methods]Twenty-eight failure lumbar procedure cases were received reoperation from May 2003 to May 2005.There were 16 males and 12 females.These cases were from 31 to 70 years old(mean 47).It took a mean 1 year and 8 month(from 1 month to 8 year)from last operation to this registry.The causes of reoperation included rehemiated disc nucleus pulpous,degeneration of adjacent segment and instability and insufficiency of canal decompression.Some cases of discogenic back pain were operated by mistaken procedure.Some cases involved severe complications including infection in disc space or vertebral itself,pedicle screws misposition,aneurysm formation and CSF leakage.The operative methods included rediscectomy,lumbar canal decompression,and lumbar reconstruction by implant and fusion.[Results]The operative time and blood lose were from 50 to 350 minutes(mean 213)and from 100 to 3 000 ml(mean 760 ml)respectively.One patient died because of severe abdominal cavity infection.The other cases were recovered and clinical complaint became less.The VAS and Oswestry Disability Index decreased from(7.9?1.6)and(52.4?7.2)to(2.8?1.0)and(8.3?3.6)respectively(the decrease rate:64.3% and 66.5%)after 24 to 48 months follow-up(mean 32.8 months).[Conclusion]The causes of failure lumbar procedure must be analyzed as soon as possible.The risks and benefits of reoperation must be balanced although it may make patients get more chance to recovery.It is very difficult for these procedures and the risks are also high.The dura sac rupture is the most common complication.It is the most important to deal with the adhesion and bleeding control in canal.The use of the magnification and lighting equipment can reduce the complications.

Objective To observe the change of serum TG in elderly diabetic patients after fatty meal.Methods The diabetic patients and non-diabetic patients of fasting normotriglyceridemia ate the fatty test meal after having been fasting for 12h.Serum lipid were measured at 0,2,4 and 6h after the meal.Results The serum TG level increased in the two groups after the meal,the diabetic patients had a higher TG-AUC than the non-diabetic patients (P

Objective To evaluate the efficacy of telbivudine in HBeAg-positive chronic hepatitis B (CHB) patients by comparing the efficacy of initial telbivudine therapy in treatment-naive patients with sequential telbivudine therapy in patients with poor response to adefovir.Methods A total of 90 HBeAg-positive CHB patients were assigned to receive sequential telbivudine therapy following poor response to adefovir dipivoxil (n=45),or initial telbivudine therapy in antiviral treatment-naive patients (n=45).All patients were treated with telbivudine 600 mg daily for 104 weeks.The efficacy was evaluated in terms of liver function tests,serum HBV markers,HBV DNA and antiviral drug resistance.Results Telbivudine showed good overall efficacy after treatment for 104 weeks in terms of alanine aminotransferase normalization rate (91.1％),HBV DNA negative conversion rate (80.0％),HBeAg loss rate (57.8％),and HBeAg/HBeAb seroconversion rate (30.0％).The HBV DNA negative conversion rate in initial treatment group was significantly higher than that in sequential treatment group (P＜0.05).However,among the patients with early response,the efficacy did not show significant difference between groups (P＞0.05).The patients with early response showed significantly better efficacy than those without early response,in terms of higher HBV DNA negative conversion rate,higher HBeAg loss rate and HBeAg/ HBeAb seroconversion rate (P＜0.000 1 or P＜0.05),but lower virological breakthrough rate (P＜0.05).Conclusions Telbivudine has shown reliable efficacy in CHB patients.Initial telbivudine therapy is better than sequential therapy in CHB patients with poor response to adefovir.However,for patients with early response to telbivudine,no statistical difference is found between initial and sequential therapy in long-term treatment efficacy (104 weeks).The patients receiving sequential telbivudine therapy should be monitored closely for early antiviral response to optimize treatment.

Paroxysmal nocturnal haemoglobinuria ( PNH) is a clonal hematopoietic stem cell disease characterized by intravascular hemolytic anemia , pancytopenia and thrombosis .Although PNH is an non-malignant disease , its complications have very negative impacts on patient's quality of life .The most common serious complication is thrombosis formation .

Catheter Ablation ; methods ; Child ; Epicardial Mapping ; Female ; Heart Aneurysm ; complications ; surgery ; Humans ; Tachycardia, Ventricular ; complications ; surgery

Objective To investigate the clinical safety of preoperative lymphatic chemotherapy in the treatment of reetal cancer.Methods The regional and systemic symptoms,postoperatwe stoma healing,haematogenesis.functions of hean,liver and kidney after lymphatic chemotherapy,and the level of CD3+,CD4+,CD8+,CD4+/CD8+,CD(16+56)+in blood 30 minutes before and 48 hours after lymphatic chemotherapv were detected.Results There were no significant effects of lymphatic chemotherapy on the regional and systemic symptoms,postoperative stoma healing,haematogenesis and the functions of heart,liver and kidney.The level of CD4+/CD8+48 hours after lymphatic chemotherapy was significantly increased(t=7.145,P＜0.05),while no significant changes of CD3+,CIM+,CD8+,CD(16+56)+were detected(t=1.782,1.151,1.184,0.955,P＞0.05),when compared with those 30 minutes before lymphatic chemotherapy.Conclusions Preoperative lymphatic chemotherapy is safe and can enhance patients'immunity in early stage.

Objective To summarize our preliminary experience and evaluate the clinical value of laparoscope diagnosis and treatment for annular pancreas in neonates.Methods A retrospective review of laparoscope diagnosis and treatment for annular pancreas in 9 children from September 2009 to January 2013 was performed.Among them,5 were male,4 were female.The age was ranging from 1 to 13 d.A lowerpressure pneumoperitoneum of 5 ～ 8 mm Hg (1 mm Hg =0.133 kPa) was used.Eight cases of diamond duodenal anastomosis were performed under laparoscope after the diagnosis was established,and 1 case underwent procedure through slightly enlarged umbilical port site.Results Eight cases of diamond duodenal anastomosis were performed under laparoscope,and the operation time was 80 ～ 140 min (mean 105 min),in 1 case it was performed through umbilical port incision,the operation time was 64 min,and the length of incision was about 2.5 cm.Feedings were started at postoperative day 4 to 7 (mean 5 d),and patients were discharged at postoperative day 8 to 14 (mean 10 d).The cases were followed-up for 3 ～ 20 months (mean 6.7 months),and I case complicated with anal atresia died of pneumonia 6 months later.Other cases were uneventfully recovered and symptoms were alleviated with normal gastroenterological function,no preoperative symptoms recurred,and the nutrition and growth status was excellent.Conclusions Annular pancreas can be diagnosed through laparoscopy.Laparoscope diagnosis and treatment for annular pancreas has the advantages of small incision,micro-invasion and faster recovery,can be safely performed in neonatal period.

BACKGROUND: The blood oxygen saturation is an important physiological parameter of human hfe; it can be affected by multiple factors due to the imbalance of oxygen supply and consumption, and consequently, the normal physical metabolism is affected. The existing manufacturing techniques are complex and are used with higher demands. OBJECTIVE: To investigate the accuracy of the novel reflecting oximeter designed on the basis of reflecting principle in monitoring the variance of blood oxygen saturation with the change of its concentration. DESIGN: To introduce the structure, working principle and design of the reflecting oximeter and make comparative study with adult rabbits as the subjects. SETTING: Cardiopolmonary Bypass Department of Cardiovascular disease hospital of the Chinese Academy of MedicalSciences. MATERIALS: The study was performed at the Departments of Anesthesiology and Cardiopulmonary Bypass of the Cardiovascular Disease Hospital,Chinese Academy of Medical Sciences from August to October in 2001.Ten adult rabbits were selected. METHODS: The oximeter consists of a converter, a driver, a central processing mould and liquid-crystal monitor. It is characterized by the onethree optical cable connected with reflecting probe, postcentral management system and digital displayer. This oxmeter was developed basing on the basis of fixed relationship between blood oxygen saturation and radiant absorbency (or reflecting). In this study,cardiovascular-pulmonary bypass was established on rabbits that were then exposed to oxygen and NO mixture supply of different concentrations,and then the corresponding blood oxygen saturations were determined with the new oximeter and compared with series-wound Baite saturation meter and blood-gas analysis. MAIN OUTCOME MEASURES: The blood oxygen saturation at different concentrations determined with the reflecting oximeter and Baite saturation meter. RESULTS: At the same oxygen concentration, the blood oxygen saturation determined with the new measure was not significantly different from that determined with Baite blood oxygen saturation meter(P＞0.05 ). CONCLUSION: The variance of blood oxygen saturation with the change of oxygen concentration can be detected by the reflecting oximeter with the result similar to that by Baite blood oxygen saturation meter.

Bronchi ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Male ; Pneumopericardium ; etiology ; Spinal Diseases ; etiology

Adolescent ; Adult ; Bundle of His ; pathology ; physiopathology ; Child ; Female ; Humans ; Male ; Purkinje Fibers ; pathology ; physiopathology ; Tachycardia, Ventricular ; pathology ; physiopathology