Objective To compare the effects of total intravenous anesthesia or Intravenous-in-halation combined anesthesia on intraoperative somatosensory evoked potential (SSEP)and motor evoked potential (MEP)in spinal surgery.Methods Sixty patients scheduled for spinal surgery under general anesthesia were divided randomly and equally into 2 groups.The anesthesia was maintained with TCI propofol (plasma target concentration 3.0-3.5 μg/ml)and 1% sevoflurane+propofol in group T or group I respectively.BIS was monitored and maintained at 40-50.SSEP and MEP was re-corded before induction of anaesthesia (T0 ),5 minutes after tracheal intubation (T1 ),during skin in-cision (T2 )and at the time of decompressing spinal canal (T3 ).Results The latency of P38 and N45 prolonged,and the amplitudes of P38 and N45 was significantly depressed at T1-T3 compared to those at T0 (P <0.05).No statistically significant differences in cortical SSEP amplitudes or latency was observed in each time point.There was no case who could not detect the wave of MEP intraoperative-ly in this study.Conclusion The data from these cases indicates that 1% sevoflurane can be used in conjunction with SSEP and MEP monitoring for some adult patients undergoing spinal surgery.

Objective To understand the distribution of medical resources in the various regions of Zhejiang so as to provide basis for furthering the rational allocation of health resources.Methods Using two-step cluster analysis based on intelligence cluster theories,medical resources in the 11 regions of Zhejiang were classified by calculating and comparing log-likelihood distances.Results The 11 regions were clustered into 4 different types of distribution according to AIC value,BIC value,and the principles of maximum distances and most optimal cluster and differentiation between the various types: type 1 included Hangzhou and Ningbo;type 2 included Zhoushan,Jinhua and Lishui;type 3 included Huzhou and Quzhou;type 4 included Wenzhou,Jiaxing,Shaoxing and Taizhou.Conclusion Medical resources in Zhejiang are unevenly distributed.The various regions there ought to take relevant measures to rationally allocate medical resources and improve the structure for the allocation of medical resources.

Objective To investigate the quality of life for clinical patients with malignant tumors and the influencing factors so as to provide health departments with basis for improvement. Methods(Using) methods of interviews and questionnaires,investigations were made on the quality of life for 639 patients with malignant tumors diagnosed between January 2001 and July 2002 in the various cities and regions of Sichuan and the influencing factors by means of filling out quality of life assessment scales.(Results) The quality of life for patients with malignant tumors was in general pretty low,scoring 54.40?10.95.Careers in management were positively related to psychological status(P

Objective To discuss the correlation between residual urine volume after catheterization and body positions for patients with spinal cord injury using B-ultrasonography. Methods 34 patients with spinal cord injury were randomly selected, the residual urine volume in urinary bladder was detected with bed-side B-ultrasonography under different body positions such as supine position, lateral position and fowler position, the results underwent variance analysis. Results No significant difference was seen in residual urine volume in urinary bladder under different body positions. Conclusions Body positions play no significant influence on residual urine volume in urinary bladder after catheterization.

Purpose To investigate the effect of sensitivity on image quality and radiation dosage of digital chest radiography. Materials and Methods A total of 300 healthy people undergoing chest X-ray examination were randomly enrolled and divided into two groups according to body weight (150 people with normal weight and 150 overweight), which were further randomly divided into three subgroups (S200 subgroup with low-sensitivity, S400 subgroup with mid-sensitivity, S800 subgroup with high sensitivity, each subgroup contained 50 people). With other parameters unchanged, digital chest photography with different sensitivities was performed to each subgroup (S200, S400 and S800, respectively), and then uploaded the data to PACS and recorded mAs value and dose area product (DAP) value for each time. Then the image quality was assessed by three doctors in terms of mAs value, DAP, image quality score and noise score. Results In all subgroups of normal weight, differences on mAs and DAP were significant (F=1443.191-1829.895, P<0.05) whilst differences on image quality score and noise score were not significant (F=0.686-2.516, P>0.05). In all overweight subgroups, differences in mAs, DAP, image quality score and noise score were significant (F=163.358-290.656, P<0.05). According to one-factor analysis of variance, mAs value was S200>S400>S800 (F=0.626-3.210, P<0.05), DAP value was S200>S400>S800 (F=0.416-1.416, P<0.05), there was no difference in image quality score and noise score (F=0.001-0.100, P>0.05). In overweight group, there was no difference between subgroups of S200 and S400 (F=0.120-0.145, P>0.05); whilst differences between subgroups of S200 and S800 were significant, the same appeared in subgroups of S400 and S800 (F=1.655-2.360, P<0.05). Conclusion Radiation dose can be effectively controlled by regulating sensitivity with image quality unaffected. It is advisable to choose high-sensitivity photography for patients with normal weight and low or mid-sensitivity photography for overweight patients.

Objective To establish the reconstructive ladder for the leg without sufficient recipient vessels by case analysis and literature review.Methods From January,2009 to January,2015,772 cases were treated in our center using free flap for leg coverage and 129 cases were found intra-operatively to have insufficient recipient vessels.There were 113 males and 16 females,and the age ranged from 4 to 71 years,averaging 36.5 years.The wounds were post-traumatic (n=108) and non post-traumatic (n=21).The management methods included elongating incision (n=25),vessel transfer(n=22),Flow-through anastomosis(n=17),end-to-side anastomosis (n=13),useing neighboring vessels (n=1S),anastomosis distal to the injured zone (n=14),cross-leg free flap (n=7),and abandoning free flap transfer(n=13).Results Except for the cases of abandoning surgery (n=13,10.1％),there were 86 cases whose flap healed totally (66.7％),9 cases total lost(7.0％),and 11 cases marginal loss (8.5％).It established a reconstructive ladder for this special situation according to the principle of difficulty level.Conclusion The insufficient recipient vessels of the leg were had multi-causes which should be taken account generally before surgery.The optimal protocol for each case should be chosen from the reconstructive ladder based on the technical difficulty level.

Based on the concept of environmental factors of ICF, together with the practice of environmental assessment and reform in the recent years, this paper discussed the principle, specification, procedures and content of environmental assessment.

Objective To analyze the relationship between needs of assistive devices and the three other factors (age, disability categories, severity levels of disability) in order to scientifically formulate subsidy policy on assistive devices.MethodsThe assessment of rehabilitation needs for 928 Shenzhen citizens with new disability certificates in its six districts was performed by professionals, and the data was recorded into ACCESS database and analyzed.ResultsThe sequence of demand rates on assistive devices among disability categories was vision disability (78%), hearing disability (76%) and physical disability (74%); but speech, mental retardation and psychological disabilities had a low demand. The demand rates of assistive devices were dissimilar among four age groups for persons with vision, hearing and physical disabilities; for severity levels of three disability categories of vision, hearing and physical disabilities: the milder the vision disability was, the greater demand rates of assistive devices were; the demand rate of those with the second level of hearing disability was the highest; the demand rates of persons with the first and second levels of physical disability were relatively higher.ConclusionWhen drawing up subsidy policy on assistive devices for persons with disability, the disability categories, ages of persons with disability and severity levels of disability should be considered; the different types of assistive devices should be supplied according to rehabilitation goals at different age group; and necessary assistive devices should be provided according to severity levels of disability.

The study aims to investigate the embryo-fetus development toxicity of the novel PPAR-δ agonist HS060098 on SD rats. The pregnant rats that were randomly divided into the solvent control group (1% hydroxypropyl methyl cellulose water solution) and HS060098 suspension groups (10, 30 and 100 mg x kg(-1) xd(-1)) were orally administered with HS060098 suspension or vehicle during the gestation of 6 -15 days (GD6-15). At termination (GD20), female rats were sacrificed. The pregnant females were evaluated by corpora lutea count, implantation sites, existence and death of embryos. Fetal sex, weight, externals, variations and malformations of viscus and skeleton were observed. The results show that there were no significant abnormality in maternal general conditions and fetal appearance as well as viscera, but in the 100 mg x kg(-1) x d(-1) group, the maternal weight gain decreased greatly (P < 0.01) and the skeletal ossification delayed remarkably (P < 0.01); in the 30 mg x kg(-1) xd(-1) group, the fatal and litter number of incompletely ossified sternebrae II was higher than those of the control group (P < 0.05); the skeletal malformations occurred in all dose groups, which indicate that the novel PPAR-δ agonist HS060098 had maternal toxicity and adversely effected fetal skeletal development under the experimental conditions.
Animals ; Bone and Bones ; drug effects ; Embryonic Development ; drug effects ; Female ; Fetal Weight ; PPAR delta ; agonists ; Pregnancy ; Rats ; Toxicity Tests

Objective To analysis the clinical manifestations of a large Spinocerebellar Ataxia 3 pedigree to pro-vide the information for the early diagnosis of Ataxia 3. Methods SCA3/ATXN3 gene was determined by using Poly-merase Chain Reaction and fragment analysis in the large pedigree members and patients ’clinical data was collected. Five patients underwent MRI imaging and fundus examination. Results There were eighteen clinical patients and twelve ATXN3 carriers in this Pedigree . In addition to ataxia, three patients presented with intellectual disability, one with cer-vical spondylosis, one with dysmyotonia, one with disorder in visual system, and seven with abnormality in autonomic ner-vous system. The MRI revealed that pons and cerebellar atrophy in some patients inordinately. Undus examination did not reveal any obvious abnormality. Conclusions The symptoms of SCA3 are heterogeneous in the same pedigree. When patients present with symptoms of cerebellar system, visual system and autonomic nervous system, or cervical spondylosis and intellectual disability, SCA3 should be considered.