BACKGROUND:The posterior lumbar interbody fusion is one of the effective methods for the treatment of lumbar and sacral spine diseases. Most surgeons fix the cage by compressing the disc space in order to keep stability and prevent dislodgement. However, some surgeons think that the non-compression technique does favor for increasing of the disc and foraminal height and thus improving the clinical outcomes, and does not increase the risk of fusion shift.
OBJECTIVE:To compare the effects in fixing the cage by the compression and non-compression techniques on posterior lumbar interbody fusion.
METHODS:Data of 64 patients with single-segment lumbar degeneration undergoing posterior lumbar interbody fusion between August 2009 and June 2014 were retrospectively analyzed. Fusion device was fixed according to compression of intervertebral space. These patients were divided into compression group (n=30) and non-compression group (n=34).
RESULTS AND CONCLUSION:(1) Curative effects:Lumbar and leg pain visual analogue score,
Oswestry disability index, SF-36 score and the height of intervertebral space, intervertebral foramen height and lumbar lordosis were significantly improved postoperatively in each group compared with preoperatively (P<0.05). The intervertebral space, intervertebral foramen height and lumbar lordosis were significantly better in the non-compression group than in the compression group (P<0.05). (2) Lumbar fusion rate:No significant difference in lumbar fusion rate was detected 6 and 12 months after surgery and during final fol ow-up (P>0.05). (3) Correlation analysis:The increase of the intervertebral space and the height of the intervertebral foramen were not significantly correlated with the improvement of the clinical curative effect (P>0.05). (4) Test results demonstrated that outcomes of the compression technique to fix the cage are equivalent to the non-compression in posterior lumbar interbody fusion. Non-compression is advantageous to increase the intervertebral space and the height of the intervertebral foramen. Both of them are conducive to the recovery of lumbar lordosis, but are not correlated with the increase in clinical curative effect.

Efficient use of the hospital information system can protect and promote the orderly operation of medical practice.The HIS usage effect by the medical staff is mainly affected by individual mastery of information technology,IS technical level and the organizational environment.A survey and analysis of these three factors were made at three tertiary hospitals in Anhui,and the results indicate personal command of information technology,technology and organizational impact to bear significant positive impacts on medical staff' use effect.Based on the results,the paper proposed countermeasures and suggestions on strengthening the HIS construction and enhancing medical staffs HIS use effect.

OBJECTIVE To investigate the distribution of Pseudomonas aeruginosa and its antibiotic resistance in(emergency) intensive care unit(EICU) patients with lower respiratory infections.METHODS The data of the pathogens isolated in sputum from the 25 patients with lower respiratory infections admitted to EICU from(Aug) 2005 to Feb 2006 were collected and analyzed.RESULTS Eighty-one bacteria strains were found in these 25 EICU cases.The Gram-negative bacteria were the main pathogens of infection(43.2%),after them were Gram-positive bacteria(32.1%),and fungi(24.7%).The percentage of P.aeruginosa infection was 13.6% of all(patients).The antibiotic resistance for P.aeruginosa was found to the antibiotics,such as cefotaxime,gentamicin,(SMZ-TMP),minocycline,levofloxacin,and gatifloxacin.CONCLUSIONS The P.aeruginosa infection and its(antibiotic) resistance should be paid more attention in the treatment of the lower respiratory infection patients in EICU.

OBJECTIVE:To investigate the effects of aerosol inhalation of ambroxol combined with gentamicin on postopera-tive related indexes of esophageal cancer patients. METHODS:60 patients underwent esophageal cancer operation were retrospec-tive analyzed and divided into control group(30 cases)and observation group(30 cases)according to drug use. Three days before surgery,control group was given 5% Glucose injection 250 mL intravenously,twice a day;observation group was given Ambrox-ol hydrochloride injection 50 mL added into 5% Glucose injection 250 mL intravenously,twice a day. After operation,both groups were given anti-inflammatory and analgesic drugs. Control group was additionally given aerosol inhalation of Gentamicin sulfate in-jection 80000 units added into 0.9% Sodium chloride injection 20 mL,4 times a day. Observation group was additionally given aerosol inhalation of Ambroxol hydrochloride injection 10 mL added into 0.9% Sodium chloride injection 20 mL,4 times a day, on the basis of control group. Both groups were treated for 5 days. The occurrence of postoperative pulmonary complications were compared between 2 groups. The levels of CRP,TNF-α,PaO2,SaO2,oxygenation index (PaO2/FiO2),the occurrence of ADR were observed before and after operation. RESULTS:The total incidence of postoperative pulmonary complications in observation group was significantly lower than control group,with statistical significance(P<0.05). Before operation,there was no statistical significance in the levels of CRP,TNF-α,PaO2,SaO2 and PaO2/FiO2 between 2 groups(P>0.05). After operation,the levels of CRP and TNF-α in 2 groups were significantly lower than before operation;the observation group was significantly lower than the control group. PaO2,SaO2 and PaO2/FiO2 of 2 groups were sig-nificantly higher than before operation;the observation group was significantly higher than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2groups during medication. CONCLUSIONS:The aerosol inhalation of ambroxol combined with gentamicin can reduce postopera-tive inflammatory factors of esophageal cancer patients,and promotes the recovery of respiratory function without increasing the in-cidence of ADR.

Objective For realizing the simultaneous detection of multiple pathogens,by looking for a method with a combination of the new gene chip detection system based on nano-gold with the technology of restriction endonuclease without PCR.Methods Helicobacter pylori,Mycoplasma pneumoniae,Chlamydia trachomatis,Candida albicans,Ureaplasma urealyticum,and EB virus were selected as the experimental targets.Endonuclease Hha Ⅰ was selected as tool enzyme.After bering digested by Hha Ⅰ,the digested fragments of samples were tailed with poly-A.The samples were then detected by the gene chip detection system based on nano-gold.Both specific and common probes were used in the hybridization.The coincidence rate of the detection results between the new constructed chip test and the fluorescence quantitative PCR test in 168 clinical samples was examined.The stability and sensitivity of chips detection were also checked.Results The new constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR could be used to detect the target pathogens.The coincidence rate of the chip detection test and fluorescence quantitative PCR test in 168 clinical samples was 89.2%.Chip detection results showed that the stability of chips detection was 100% and the sensitivity was 50pmol/L.Conclusion The newly constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR can be widely applied in the simultaneous detection of Mycoplasma,Chlamydia,fungus,virus and bacteria.It shows a bright prospect in increasing the throughput of identifieation of pathogene.

OBJECTIVE:To provide reference for rational drug use in pediatric department. METHODS:The utilization of pe-diatric prescription drugs in inpatient department of our hospital during 2008 to 2014 was analyzed in respects of number,consump-tion sum,DDDs,etc. RESULTS:The consumption sum of antimicrobial drugs increased from 657 000 yuan in 2008 to 1 453 000 yuan in 2014. The consumption sum of creatine phosphate sodium increased from 384 000 yuan in 2012 to 889 000 yuan in 2014. The consumption sum of Lysine hydrochloride and sodium chloride injection entered the top 5 in 2014,reaching 205 000 yuan. The consumption sum of essential medicines changed greatly due to varieties. Top 5 antimicrobial drugs in the list of DDDs mainly wereβ-lactam,showing a descreasing trend on the whole. CONCLUSIONS:There are some problems in use of part drugs. It is need to strengthen propaganda and intervention of rational drug use.

BACKGROUND:Posterior cervical open-door expansive laminoplasty is one of the simple and effective methods to treat cervical spinal diseases, has satisfactory results but low complications. However, the imbalance of sagittal plan, loss of lordosis or axial pain is often reported recently. OBJECTVE:To analyze the correlation between cervical sagittal alignment and clinical outcomes after laminoplasty. METHODS:Between January 2011 and June 2015, 122 cases of cervical spinal disease, who were treated with open-door expansive laminoplasty with mini-titanium plate, were retrospectively analyzed. Clinical outcomes were evaluated by Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale. Radiographic results were assessed by C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope. The correlation between sagittal alignment and clinical outcomes were analyzed. RESULTS AND CONCLUSION:(1) Al patients were fol owed up for 7-32 months. (2) Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale scores were improved in the final fol ow-up (al P<0.001). No significant difference in upper limb Visual Analogue Scale scores was determined (P=0.142). In the final fol ow-up, C2-7 sagittal vertical axis increased (P=0.036), but neither the C2-7 Cobb angle nor the C7 slope significantly changed (P=0.092, P=0.184). (3) There were no correlations between sagittal alignment parameters (C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope) and clinical outcomes (Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale) (al P>0.05). (4) These findings indicated that posterior cervical open-door expansive laminoplasty with mini-titanium plate can significantly improve the neurological function of patients. However, there is no correlation between cervical sagittal alignment and clinical outcomes.

Objective To observe the effects of action observation therapy based on mirror neuron theory on upper-extremity motor function and performance in activities of daily living(ADL) after stroke.Methods Eightyone stroke patients were randomly assigned to an observational group (41 cases) or a control group (40cases).Both groups received conventional rehabilitation,and the observational group also received action observation therapy for 16 weeks,10 times per week.Upper-extremity motor function and ADL performance were assessed before treatment using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) and then again after 4,8 and 16 weeks of treatment.Results The average FMA scores and BI scores in the observational group at the 4th week (32.50 ± 9.32 and 67.41 ± 16.81),the 8th week (36.35 ± 8.32 and 78.74 ± 15.63) and the 16 th week (41.32 ± 13.45 and 93.85 ± 13.45) had increased significantly compared with the pre-treatment assessment and were significantly better than at the same time point for the control group (P ＜ 0.05).Conclusion Action observation therapy based on mirror neuron theory can promote the recovery of upper-extremity motor function and ADL performance after stroke.

Objective To investigate the feasibility and outcome of resection and reconstruction of hepatic artery in hilar cholangiocacinoma (HCC).Methods The data of 29 patients with HCC with hepatic artery reconstruction carried out from March 2009 to August 2013 in our center were retrospectively analyzed.23 right hepatic arteries and 6 common hepatic arteries were involved.In-situ anastomosis was carried out in 20 patients and a double anastomosis using gastrodoudenal artery grafts was carried out in 9 patients.Results There were no arterial thrombosis or other related complications on prolonged follow-up.Conclusion Hepatic artery resection and reconstruction should be carried out if the artery was invaded by a hilar cholangiocarcinoma to produce a high resection rate and a better outcome.