OBJECTIVETo evaluate the efficacy and safety of percutaneous pedicle screw fixation (PPSF) and open pedicle screw fixation (OPSF) in the treatment of single level of thoracolumbar fracture.

METHODSDatabases including Pubmed, Embasem, CNKI were searched to collect clinical trials of the clinical safety and efficiency of PPSF and OPSF for single level of thoracolumbar unstable fracture, relevant proceedings and references were also retrieved manually. Studies from 1990 to 2014 that met the inclusion and exclusion standards were researched. The data were extracted and the methods from the studies were also evaluated. Data analysis was conducted with the Review Manager 5.3 software. Observation targets included operation time, intraoperative bleeding, postoperative bleeding, hospitalization time, the bed time, postoperative vertebral Cobb angle, vertebral body height, pain score and the length of incision operation.

RESULTSFifteen papers were finally studied, including 2 randomized controlled trials (RCT) and 13 case-control studies, involving 789 patients. Compared with OPSF, the PPSF in treating thoracolumbar fracture had shorter operation time, smaller operation incision, less intraoperative and postoperation bleeding, shorter hospitalization days, fewer pain (P<0.00001), the less improvement in the change of Cobb angle (P=0.0006). There was no significant difference in the improvement of vertebral body height (P=0.36), the bed time from operation to exercise (P=0.38) between OPSF and PPSF.

CONCLUSIONCompared with OPSF, PPSF is better, safer, and has fewer pain. But there is no evidence that the PPSF is better in the recovery of the spinal height, and they have the same effect in the long-term follow-up for thoracolumbar fractures. PPSF brines minimally invasive to patients with better effect. It is worth further study and clinical research.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Pedicle Screws ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; surgery ; Treatment Outcome

Based on vector auto-regression (VAR) model, this paper takes advantage of Granger causality test, variance decomposition and impulse response analysis techniques to carry out a comprehensive study of the factors influencing the price of Chinese herbal, including herbal cultivation costs, acreage, natural disasters, the residents' needs and inflation. The study found that there is Granger causality relationship between inflation and herbal prices, cultivation costs and herbal prices. And in the total variance analysis of Chinese herbal and medicine price index, the largest contribution to it is from its own fluctuations, followed by the cultivation costs and inflation.
Agriculture ; economics ; Commerce ; Costs and Cost Analysis ; Drugs, Chinese Herbal ; economics ; Humans ; Models, Statistical ; Plants, Medicinal ; growth & development ; Regression Analysis

Aged ; Humans ; Male ; Palatal Neoplasms ; pathology ; Uvula ; pathology

Sepsis remains the leading cause of death in intensive care unit.The pathogenesis of sepsis is extremely complex.Immune dysfunction plays an important role in the occurrence and development of sepsis.Many mechanisms are responsible for sepsis induced immune-suppression,including apoptotic depletion of immune cells,increased T regulatory and myeloid-derived suppressor cells,and cellular exhaustion.The article provided a brief review on the advance of immunologic mechanisms underlying sepsis.

BACKGROUND: Stellate ganglion block has many functions by improving brain circulation, modulating immunity, reducing plasmic catecholamine content, interleukin-6 is one of the most sensitive and important predictors and mediators for acute organic stress response, playing neuroprotective and neurotoxic double roles in brain ischemic injury.OBJECTIVE: To observe the effect of stellate ganglion block in rat brain during ischemic-reperfusion period on the changes of serum interleukin-6,in order to probe the role of stellate ganglion block in brain ischemicreperfusional injury.DESIGN: Randomized controlled experimentation.SETTING: Anaesthesia Department of Taihe Hospital Mfiliated to Yunyang Medical College, and Anaesthesia Department of Renmin Hospital Affiliated to Yunyang Medical College.MATERIALS: This experiment on animals was carried out at the Experimental Center of Taihe Hospital Affiliated to Yunyang Medical College at March 2003, interleukin-6 reagent kit and determination was provided and conducted by the immunity research institute of Chinese People's Liberation Army General Hospital. Totally 28 big-ear healthy rabbits in which male or female was not limited were selected and randomly divided into stellate ganglion group, saline comparison group, blank comparison group and sham operation group with 7 rabbits in each group.METHODS: A pipe was set approximate to the stellate ganglion of all animals by operative method, six-vessels block method was used to simulate whole brain ischemic-reperfusion model, in stellate ganglion block group,artery clamp was lossen for reperfusiion at 15 minutes after ischemia, simultaneously 2.5 g/L bupivacaine was continuously pumped into left side of stellate ganglion for nerve block, which replaced by physical saline and nothing in respectively physical saline comparison group and blank comparison group, while rabbits in sham operation group were only subjected to surgery without artery clamp. RIA was used to determine serum interleukin-6 content at before ischemia, reperfusion of 10 minutes, 4 hours, 10hours, when 20 hours and 30 hours individually.MAIN OUTCOME MEASURES: Serum interleukin-6 content in each group at various post-reperfusional time points.RESULTS: Totally 28 big-ears white rabbits were enrolled in this experiment and all data was entered the result analysis. Interleukin-6 content was on an increasing tendency in all groups, while was higher in stellate ganglion block group than in sham operation group only at reperfusion 30time point, the difference has significance [(321±52) and (299±45) ng/L,P ＜ 0.05]; Comparing to pre-ischemic group, interleukin-6 in physical saline group began increase remarkably from onset of reperfusion 4 hours[(365±46) ng/L], but began obviously increase at reperfusion 10 hours in blank comparison group [(368±31) ng/L, P ＜ 0.05]. The difference of interleukin-6 among stellate ganglion block group, sham operation group,physical saline group and blank comparison group does not have statistical significance (P＞0.05); the level of interleukin-6 in physical saline group and blank comparison group were higher than in sham at all reperfusion 4-30 hours, and even higher than in stellate ganglion group after reperfusion 10 hours, the difference has significant meaning (P ＜ 0.05). Moreover the increase of interleukin-6 content in stellate ganglion block group was remarkably lower than physical saline comparison group and blank comparison group (P ＜ 0.05).CONCLUSION: Stellate ganglion block may obviously reduce serum interleukin-6 level in rabbit brain during ischemic-reperfusion period, implying stellate ganglion block has a certain protective and curative function on the whole brain ischemic-reperfusion damage, and considered as a promising way in the treatment of brain ischemic-reperfusion damage.

Acupuncture Therapy ; Bloodletting ; Combined Modality Therapy ; Facial Muscles ; physiopathology ; Female ; Humans ; Spasm ; physiopathology ; therapy ; Young Adult

Acupuncture Therapy ; Female ; Humans ; Hyperhidrosis ; physiopathology ; therapy ; Sweating ; Young Adult

Objective:To improve the teaching quality of in-service clinical pharmacist training. Methods:According to the traits of in-service pharmacists and teaching methods, combined with problem-based learning ( PBL), peer-led team learning(PLTL) and lecture-based learning ( LBL) , a standard teaching mode for in-service clinical pharmacists was explored and established. Results:The teaching mode could not only improve the study enthusiasm of students, but also let them master the study methods, and team co-operation consciousness was strengthened. Conclusion:An integrated teaching mode of LBL, PBL and PLTL has a good teaching effect on clinical pharmacist training.

Objective To investigate the effect of vitrification on the biomechanics of tendon tissue in rabbit.Methods Two frozen methods were adopted.The first group was treated with Cryoprotective Agent,which was composed of 18.64%DMSO(V/V),13.37% Acetamide(V/V),9.17% 1,2 Propylene glyco(V/V),0.10mmol/LTrehalose and 10% Calf serum.The tendon tissue with three steps of preliminary treatment,preserved in Cryoprotective Agen was conserved in liquid nitrogen(-196℃)for 14 days;The second group treated with 15% DMSO and 10% Calf serum served as control group.Transmission electron microscope was used to observe the Histiooytic shape of tendon.Each group was performed with tendon tensile test,which could detect maximum load,the maximum shifting quantity and Young's Elastic Modulus.Results There was no significant damage in the tissue's micromechanism of vitrified tendon.But in cryopreservation group,the tissue's micromechanism was apparently damaged.There was no significant difference between test group and control group in maximum load(P=0.256).The same was the maximum shifting quantity(P=0.065).There was significant difference between test group and control group in Young's Elastic Modulus(P=0.006).Conclusion The damage of vitrification to tendon is less than that of profound hypothermia preservion,especially to tendon's corpuscular shape,but there is no significant difference between test group and control group in tendon's biomechanics.

OBJECTIVE:To observe the clinical efficacy and safety of recombinant human endostatin (rh-endostatin) combined with Lobaplatin for injection and irinotecan injection in the treatment of advanced recurrent small cell lung cancer (SCLC). METHODS:A total of 88 patients with advanced recurrent SCLC in our hospital were divided into control group (41 cases) and observation group (47 cases) according to random number table. Control group was given Irinotecan injection+Lobaplatin for injection. Observation group was additionally given Recombinart human endostatin injection 15 mg added into 0.9%Sodium chloride injection 250 mL,ivgtt,qd,for consecutive 14 d,every 14 d. A treatment course lasted for 28 d,and both groups were treated for 2 courses. The clinical efficacy,the levels of serum carcinoembryonic antigen(CEA),the scores physical state (ECOG) and quality of life (QOL) before,after treatment were observed in the two groups,and the survival and adverse reactions of the two groups were compared. RESULTS:The total response rate of observation group was 59.6%,which was higher than 43.9% of control group,but there was no statistical significance (P>0.05). Before treatment, there was no significant difference in serum CEA levels,ECOG scores or QOL scores,between 2 groups(P>0.05);after treatment,the serum CEA levels of the two groups were significantly decreased,and the observation group was significantly lower than the control group,with statistically significant (P<0.05). In observation group,ECOG scores decreased while QOL scores increased significantly,and significantly better than the control group,with statistical significance(P<0.05). The overall survival(OS)of observation group was 16.8 months,which was significantly higher than 11.5 months of control group,with statistical significance (P<0.05). The incidence of leucopenia in observation group was significantly higher than control group;the incidence of leucopenia and abnormal liver function were significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Rh-endostatin injection combined with lobaplatin and irinotecan can improve serum CEA levels and the quality of living aswell as prolong the survival time.