Objective To compare the effects of semi conductor laser nasal cavity irradiation with He Ne laser intravenous irradiation therapy on patients with brain lesion. Methods Ninety six cases of cerebral infarction(CI), traumatic brain injury(TBI) were randomly divided into semi conductor laser group (group A, n =50, ?=650nm , 2.4mW, 30mins/nasal cavity), He Ne laser group (group B, n =46, ?=632.8nm, 2.5mW, 40mins/ intermedia cubiti vein or basilic vein). The changes of the blood lipids, hemorheology parameters, scores with Fugl Meyer movement scale and Barthel index assessment were compared after the semi conductor laser and He Ne laser irradiation. Results After laser irradiation,The CHOL, TG, LDL, ESR and HCT were significantly reduced in both groups( P 0.05). The brain damage area was reduced in all the patients as revealed by CT examination. Conclusion The influence of the two kinds of laser irradiation therapies is similar when applied in patients with brain injury. But semi conductor laser nasal cavity irradiation is a simple, safe, inexpensive therapy for the patients.

BACKGROUND:The effect of proximal femoral anti-rotation nail fixation in repair of intertrochanteric fracture is better than the other fixation materials. Unarmed inserting guided needle plays an important role for the quality of intertrochanteric fracture fixation. At present, there have been short of fast and accurate methods for inserting femoral canal guided needle from trochanter. OBJECTIVE:To investigate the operating skil s and application value of unarmed inserting guided needle in the process of proximal femoral anti-rotation nail Ⅱ fixation in repair of intertrochanteric fracture. METHODS:Standard operating procedures of guided needle inserting were established. The location of the guided needle was correct or was not judged through discriminating the feeling of inserting into the tip of femoral canal guided needle from trochanter. Slight resistance prompted that guided needle was in correct position. The guided needle closed to the medial femoral cortex and moved downward in the medul ary cavity. The guided needle was confirmed in the correct position by the perspective of C-arm in positive side position. This process was just one lateral perspective. Smoothly without resistance prompted that if the guided needle was out of the medul ary cavity, the direction of the inserting needle needed to be changed, without perspective. The resistance would be large if the needle tip piercing the medial femoral cortical bone, at this moment, the direction of the needle needed to be adjusted;or was blocked by malreduction of fracture or the free fracture block off the medul ary cavity;at this moment, fracture ends needed to be further restored. The surgery time, the time required to complete the guided needle inserting, the amount of bleeding, weight-bearing ambulation time and complications of 19 patients with intertrochanteric fracture treated by proximal femoral anti-rotation nail Ⅱ fixation were statistical y analyzed. RESULTS AND CONCLUSION:The average completed time for internal fixation was 45 minutes, the average desired time for guided needle inserting was 80 seconds, the average blood loss was 100 mL. There was no wound infection, or pressure sore formation. The shimoji time was an average of six weeks after treatment. Al patients were fol owed up for 4-9 months. Three patients needed crutches to walk before treatment, and after three months of treatment, they returned to the pre-exercise levels of injury. These results suggest that the procedure of unarmed inserting the guided needle provides guidance for the quick and correct completion of needle inserting, so as to enhance the internal fixation quality of proximal femoral anti-rotation nail Ⅱ in repair of intertrochanteric fracture, with a high reliability. It can significantly reduce the number of perspective, shorten surgery time, reduce the amount of bleeding and reduce complications.

OBJECTIVE:To establish the relationship of clinical pharmacist with hemodialysis patients through pharmaceutical care and select individualized therapeutic regime by pharmacists and physicians in order to reduce high blood pressure and improve quality of life in hemodialysis patients. METHODS:Hemodialysis patients with hypertension being in line with included cretria were collected and randomly divided into pharmaceutical care group(n=20) and non-pharmaceutical care group(n=21). RESULTS:After 3 months of treatment,in pharmaceutical care group SBP was decreased from 158 mmHg to 139 mmHg and DBP from 95 mmHg to 84 mmHg;in non-pharmaceutical care group SBP was decreased from 155 mmHg to 152 mmHg and DBP from 96 mmHg to 93 mmHg. There was significant difference between pharmaceutical care group and non- pharmaceutical care group (P

Objective To investigate the effects of negative pressure wound therapy (NPWT) on the expression of EDA+ FN in granulation tissues of human diabetic foot wounds.Methods Forty patients with diabetic foot wounds fitting the inclusion criteria,admitted from Jan.2014 to Jun.2016,were randomly and equally apportioned to receive either NPWT or conventional gauze therapy (control) for 14 days.Granulated tissue biopsies were collected before (0 day) and after (14 day) treatment in both groups.All biopsies were subdivided into two parts.One part was preserved in 4％ paraformaldehyde for immunocytochemical staining of EDA+FN,and the other part was stored at-80 ℃ for Western blotting and PCR analysis of EDA+FN.Results The immunohistochemical analysis revealed that the mean area density of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of mean area density was higher in NPWT group than in control group (P＜0.01).Western blotting showed that the relative protein levels of EDA+FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative protein levels of EDA+FN was higher in NPWT group than in control group (P＜0.01).The real time PCR analysis demonstrated that the relative mRNA levels of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative mRNA levels of EDA+ FN was higher in NPWT group than in control group (P＜0.01).The results demonstrated the higher protein and mRNA levels of EDA+FN in NPWT group than that in control group.Conclusion NPWT obviously enhances EDA+FN expression in granulation tissue of diabetic foot wound,as a result promotes wound healing.

Objective To analyze the dose‐effects of different doses of dexmedetomidine for sedation and sleep of the patients under epidural nerve block anesthesia .Methods A total of 82 patients undergoing elective lower limbs surgery(ASA grade Ⅰ - Ⅱ) were randomly divided into 4 different doses of dexmedetomidine groups(group 1 ,n=19 ;group 2 ,n=22 ;group 3 ,n=20;group 4 , n=21) ,under continuous epidural nerve block ,the loading dose of dexmedetomidine 0 .7 ,0 .8 ,0 .9 ,1 .0μg · kg -1 · h-1 was intrave‐nously pumped for 30 min ,then pumped at a rate of 0 .7 ,0 .8 ,0 .9 ,1 .0 μg · kg -1 · h-1 in the group 1 ,2 ,3 and 4 respectively .If any patient in 4 groups fell asleep at less than half an hour ,the loading dose was stopped and the continuous dose was changed to pump , the drug administration was discontinued at wound dressing after operation .Whether the patient falling asleep was recorded ,and the mean arterial blood pressure ,heart rate at 4 time points of 10 ,30 ,60 ,90 min after infusion of dexmedetomidine were also recorded . The 50% effective dose(ED50 ) ,ED95 and 95% confidence interval(CI) were calculated by using the Probit method .Results ED50 and ED95 of dexmedetomidine were 0 .65μg/kg(95% CI:0 .36-0 .73μg/kg)and 1 .00 μg /kg(95% CI:0 .90-1 .74μg/kg) ,which could decrease the heart rate and increase the arterial blood pressure .Conclusion Although dexmedetomidine can decrease the heart rate and increase the arterial blood pressure ,but the patients quietly fall asleep without discomfort and pain occurrence by the intra‐venous administration under continuous epidural nerve block .

Objective To assess the impact of antithymocyte globulin (ATG) on the incidence of graft-vs-host disease (GVHD) in hematopoietic stem cell transplantation from unrelated donors.Methods A total of 92 patients with hematological malignancies including leukemia,myelodysplastic syndrome (MDS) and lymphoma who underwent hematopoietic stem cell transplantation from unrelated donors from January 1999 to December 2011 were included in this retrospective analysis.Patients were classified into ATG group (n =66)and non-ATG group (n =26) according to the GVHD prophylaxis regimen.The incidence of acute GVHD (aGVHD) and chronic GVHD (cGVHD),risk factors of aGVHD and cGVHD and impact of ATG on the overall survival (OS),treatment related mortality (TRM) and relapse rate were analyzed.Results Grade Ⅱ-Ⅳ aGVHD (26.7 ％ vs 44.0 ％,P=0.12) or grade Ⅲ-Ⅳ aGVHD (13.3 ％ vs 8.0 ％,P =0.74) were not significantly different between ATG and non-ATG group.However,the incidence of cGVHD in the ATG group was significantly lower (34.0 ％ vs 72.2 ％,P =0.005) than non-ATG group.The incidence of extensive cGVHD was also significantly reduced (10.0 ％ vs 44.4 ％,P =0.005) compared to non-ATG group.In multivariate analysis,the use of ATG prophylaxis significantly decreased the cGVHD (RR =0.22,95 ％CI 0.081-0.599,P =0.003) while one allele mismatch of human leukocyte antigen (HLA) was associated with increased risk of cGVHD (RR =3.25,95 ％ CI 1.39-7.61,P =0.007).As to the extensive cGVHD,the use of ATG was the only independent factor (RR =0.05,95 ％ CI 0.009-0.240,P ＜ 0.001).With a median follow-up of 12 months (1-84 months),ATG prophylaxis had no impact on OS rate (60.4 ％ vs 43.1％,P =0.41),TRM rate (19.8 ％ vs 34.3 ％,P =0.43) and relapse rate (40.6 ％ vs 33.6 ％,P=0.54).Conclusion In hematopoietic stem cell transplantation from unrelated donors,ATG prophylaxis total dose of 6 mg/kg may significantly decrease the incidence of cGVHD and extensive cGVHD without increase of TRMand relapse rate and impairment of OS.

ObjectiveTo investigate the feasibility and effect of complete thoacoscopes and laparoscopes combination operation for thoracoabdominal injuries.MethodsFrom March 2007 to March 2011,the clinical data of 36 patients (observation group) with thoracoabdominal injuries who were performed with complete thoracoscopes and laparoscopes combination operation were analyzed retrospectively,and compared with 36 patients (control group) treated with traditional standard operation in the same period.The intraoperative and postoperative situation was compared between two groups.ResultsAll the patients in observation group were successfully performed by complete endoscopic surgery.There were no operative mortality and complications related to operation,such as diaphragmatic hernia,delayed hemopneumothorax.The operative time of observation group was (98 ±38 ) min,operative blood loss was ( 120±45 ) ml,drainage flow within 24 h was(230 ±55) ml,drainage tube duration was(5 ±2) d,postoperative pain vasual analogue scale (VAS) score was (3.31±0.87) scores,hospitalization cost was ( 1 2.3±7.6) thousand yuan,postoperative recovery time of intestinal function was (2.29±1.02) d,hospital stay was ( 10±3 ) d.Those values of control group were respectively ( 135±31 ) min,(220±30) ml,(400±160) ml,(9±3) d,(6.82±1.67) scores,(23.4±8.5) thousand yuan,(5.46 ±2.31 ) d and ( 16±2) d.There were significant differences between two groups(P ＜0.05).The occurrence rate of cardiopulmonary complication of observation group [ 11.1％(4/36) ] and control group [ 13.9％(5/36) ] had no significant difference (P＞0.05).ConclusionsComplete thoracoscopes and laparoscopes combination operation for thoracoabdominal injuries is a safe and mini-invasive treatment with quicker recovery,less cost and morereliable effect.Therefore,it deserves further clinical application.

Objective To compare the humoral immunity features of acute glomerulonephritis and nephritic syndrome(NS) in children for earlier differential diagnosis and rational administration.Methods Nephelometry was used to determinate the serum level of immunoglobulin(Ig)G,IgA,IgM,C3,C4 in children by England MININEPH machine and correlated reagent. The serum level of IgE was determined by IgE enzyme linked immunosorbent assay(ELISA),assay ELISA kit of America E&ELABSINC company. Immunoturbidimetry and westergren method were used to detect anti-streptolysin O(ASO) and erythrocyte sedimentation rate(ESR),respectively.Results There were significant diffe-rence features of humoral immunity between acute glomerulonephritis and NS in children.IgG,IgA,IgE,C3,C4 had significant difference between acute glomerulonephritis children and healthy children(Pa