Objective To evaluate the causes,clinical manifestations and diagnosis of tarsal tunnel syndrome. Methods Operation was performed for 18 patients ( 21 sides) with tarsal tunnel syndrome. Preoperative Takakura index was 3-7 points with an average of 6.4 points. Ganglion was found in 15 cases (17 sides), varicosity in 2 cases (3 sides) and lipoma in 1 case. Results The symptoms disappeared without recurrence in 0.5 to 17 years' follow-up (average 7.3). Postoperative Takakura index was 9-10 points (average 9.7). Conclusion Tarsal tunnel syndrome is rare in the clinical practice with varied causes and different clinical manifestations. Operation can be performed with satisfactory results for the patients unsuitable for conservative treatment.

Background Diabetes mellitus (DM) can provoke the apoptosis of retinal cells and downregulate the expression of calcitonin gene related peptide (CGRP) in the retina.Capsaicin promotes the release of CGRP and elicits protective effects on human organs.However,whether CGRP protects retinal cells in diabetic retinopathy (DR) is still unclear.Objective The study was designed to examine the effect of capsaicin on the apoptosis of retinal cells in diabetic rats and its relationship with CGRP.Methods Forty clean healthy adult male Sprague-Dawey rats were randomly divided into the diabetes group,capsaicin pretreated group,streptozocin (STZ)control group,capsaicin control group and plain control group,with 8 rats per group.The diabetic model was established by the intraperitoneal injection of 60 mg/kg in all rats except those of the plain control group.0.4 mL of a 1％ capsaicin injected at 20 mg/kg was subcutaneously injected for 3 consecutive days prior to model establishment in the capsaicin pretreated group,after which 1.2 mL of STZ was intraperitoneally injected on the fourth day.Rats from the STZ control group were administered intraperitoneally 1.2 mL of 0.1 mol/L,pH 4.5,citrate buffer.The capsaicin control group received subcutaneous injections of 0.4 mL of 1％ capsaicin at 20 mg/kg for 3 consecutive days,after which 1.2 mL of 0.1 mol/L,pH 4.5,citrate buffer was administered intraperitoneally.The rats were sacrificed at the tenth week after model establishment and retinal specimens were prepared for the apoptosis assay by TUNEL staining and the quantitative analysis of caspase-3 activity.Expression of CGRP in the retina and serum was detected using ELISA.The use of experimental animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Retinal cell apoptosis was mainly localized to the retinal ganglion cell (RGC) layer.The apoptosis rate of RGCs was (43.4±5.0)％ in the DR model group and (30.0±5.1)％ in the capsaicin pretreated group,showing a significant difference (t =5.930,P＜0.01).Compared with the DR model group and capsaicin pretreated group,the apoptosis rates of the DR control group (12.4±9.9) ％ and the capsaicin control group (17.6-±6.1) ％ were significantly lower (t =8.800,t =4.925,P＜0.01).The apoptosis rate of the plain control group was (16.2±6.9)％,exhibiting significant differences in comparison with the DR control group and capsaicin control group (t =-0.989,t =0.951,P＞0.05).The specific activity of caspase-3 was (2.19±0.86) in the DR model group and (1.96±0.56) in the capsaicin pretreated group,presenting a significant difference (t =-0.515,P＜0.05).Those of the DR control group and capsaicin control group were (1.47±0.14) and (0.74±0.27),respectively,with considerable decline in comparison with the DR model group and capsaicin pretreated group (t=2.142,t=2.797,P＜0.05).The retinal and serum CGRP levels were (424.4±44.2)and (148.8±39.1) ng/L,respectively,displaying significantly lower levels than (543.2±74.4) and (237.5±78.7) ng/L (t =3.070,2.359,P＜0.05) from the capsaicin pretreated group.Conclusions Apoptosis of retinal ganglion cells occurs in the STZ-induced diabetic rats.Pretreatment of capsaicin reduces retinal cell apoptosis,which may be associated with an increase of CGRP in the retina.

Esophageal Atresia ; complications ; Humans ; Infant, Newborn ; Male ; Respiratory System Abnormalities ; complications ; Trachea ; abnormalities ; Tracheoesophageal Fistula ; complications

Animals ; Cerebral Cortex ; metabolism ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred Strains ; Morphine Dependence ; metabolism ; Neurotrophin 3 ; metabolism ; Prosencephalon ; metabolism

Adult ; Female ; Humans ; Insecticides ; poisoning ; Ivermectin ; analogs & derivatives ; poisoning ; Male ; Middle Aged

Objective To discuss the selection of short- or long-segment posterior fixation for treatment of unstable thoracolumbar fractures. Methods A total 134 patients with thoracolumbar fractures treated with pedicle instrument fixation from January 2005 to December 2008 were studied retrospectively. According to AO fracture classification, there were 70 patients with type A fractures, 37 with type B and 27 with type C. The patients were divided into two groups according to the number of instrumented levels; short-segment posterior fixation (SSPF) group (four screws; one vertebral body above or below the fractured vertebrae) and long-segment posterior fixation (LSPF) group (eight screws; two vertebral bodies above or below the fractured vertebrae). Clinical outcomes and radiological parameters (superior-inferior endplate angle, vertebral body angle, displacement of vertebral body) were compared according to AO fracture classification. Results All type A fractures were treated with SSPF, mean superior-inferior endplate angle changed from preoperative 21.3° to postoperative 8.5° and 11.1° at final follow up. There was no statistical difference in the correction of Cobb angle for type B fractures in SSPF group (26 patients) and LSPF group (11 patients), while the correction loss of vertebral body angle was 3. 64° in SSPF group and 1.09° in LSPF group, with statistical difference (P < 0. 05). There was no statistical difference in the correction of Cobb angle for type C fractures in SSPF group (7 patients) and in LSPF group (20 patients), but the correction loss of vertebral body angle was 3.6° in SSPF group and 0. 8° in LSPF group, with statistical difference (P < 0. 05). There was no statistical difference in vertebral displacement correction. Conclusions Most types A and Bl fractures should be treated with SSPF; most types B2, B3 and C fractures should be treated with LSPF.

Objective To investigate the clinical efficacy of laparoscopic versus open omental patch repair for perforated peptic ulcer. Methods One hundred and twenty-seven patients who underwent omental patch repair for perforated peptic ulcer were analyzed retrospectively. There were 74 cases in the laparoscopic repair group (LR group) and 53 cases in the open repair group (OR group) respectively. Operative time, intraoperative blood loss,postoperative pain at 1 d and 3 d.time to first flatus and resumption of diet, time to drainage removal,surgical site infections (wound infection and intra-abdominal abscess),systemic complications and length of postoperative hospital stay were compared. Results LR group experienced less intraoperative blood loss[(32.7 ±25.6) ml], lower postoperative pain at 3 d[(2.8 ±1.5) scores], earlier time to first flatus [ (25.8 ± 20.1) h] and resumption of diet [ (2.7 ±2.1) d ], shorter time to drainage removal [(2.0±1.5) d], less wound infection (0) and shorter hospital stay[(4.8 ±2.3) d] than those in OR group [(53.2±30.0) ml, (36.9±27.9) h, (3.7±2.0) scores, (3.6±2.3) d,(2.9±2.2) d,9.4%(5/53), (6.6±4.0) d](P< 0.01 or <0.05). There were no significant differences in operative time,postoperative pain at 1 d, incidence of intra-abdominal abscess and systemic complications between the two groups. There were no suture-site leakage, reoperation and death in two groups. Conclusions Laparoscopic omental patch repair for perforated peptic ulcer is safe and efficacious. It has significant advantages over open approach with respects of less postoperative pain,earlier return of bowel function,less wound infection and shorter hospital stay.

The neonatal resuscitation program consisted of three stages:pilot promotion, provinces promotion and grass-roots promotion in China. Neonatal resuscitation was easy to learn, training forms were various, the duration was different. There were regional differences in the pass rate of examination and standard recovery rate. The neonatal resuscitation training rate, the system execution rate and the equipment rate in primary hospitals was lower than secondary hospitals and tertiary hospitals. The primary hospitals would be the key link of the neonatal resuscitation program. We suggested to build neonatal resuscitation training and treatment system.

Objective To discuss the diagnosis and treatment of inflammatory granuloma in central nervous system(CNS)to provide reference for clinic.Methods Retrospective data included 8 patients with CNS inflammatory granuloma in Department of Neurosurgery,Shanxi People's Hospital,2012 -2015.We analyzed the imaging features, postoperative symptoms,blood and cerebrospinal fluid changes and prognosis.Results 8 cases all received surgical treatment.All the symptoms were improved,and the CT showed that the lesions were disappeared.All the patients had recovered to normal life and work.Conclusion The diagnosis of CNS inflammatory granuloma is difficult.Clinical manifestations are lack of specificity.The blood and cerebrospinal fluid laboratory examination have no abnormal changes.CT and MRI are the main diagnostic methods.Postoperative pathology is the gold standard for diagnosis.The large lesion,frequent episodes of epilepsy,severe neurological deficits and possibility of brain tumor all should be treated by surgery.

Objective To understand the distribution characteristics and drug resistance of bacteria isolated from blood cul‐ture in Xinjiang area during 2013 .Methods The identification of isolated bacteria were performed by adopting the France VITEK‐Compact and the ABI series bacterial identification instruments .The antimicrobial susceptibility test was carried out by using the minimum inhibitory concentration (MIC) and Kirby‐Bauer (K‐B) methods .Results A total of 3 962 strains of bacteria were isola‐ted from clinical blood culture ,in which Gram‐positive bacteria and Gram‐negative bacteria accounted for 50 .8% and 49 .2% respec‐tively .The most frequent strains were coagulase‐negative staphylococci (31 .7% ) ,Escherichia coli (23 .2% ) ,Staphylococcus aureus (9 .5% ) ,Klebsiella pneumoniae (8 .7% ) ,Acinetobacter baumannii (3 .6% ) ,Enterobacter cloacae (2 .5% ) ,Enterococcus faecium (2 .5% ) ,Pseudomonas aeruginosa (2 .2% ) ,Enterococcus faecalis (2 .0% ) and Streptococcus pneumoniae (1 .1% ) .The detection rate of extended‐spectrum beta‐lactamase (ESBLs) producing Escherichia coli ,Klebsiella pneumoniae and Proteus mirabilis were 69 .8% ,62 .6% and 66 .7% respectively .The detection rates of methicillin‐resistant Staphylococcus aureus(MRSA) and methicillin‐resistant coagulase‐negative Staphylococcus (MRCNS) was 36 .2% and 86 .3% respectively .The pan‐drug resistant (XDR) strains of Acinetobacter baumannii ,Pseudomonas aeruginosa ,Klebsiella pneumonia were 14 strains(9 .9% ) ,1(1 .2% ) ,2 strains(0 .1% ) ,16 strains(0 .6% ) .No strains resistant to vancomycin or linezolid were found in Staphylococcus and Enterococcus faecalis .Conclusion Among blood culture isolated bacteria in Xinjiang area ,the proportion of Gram‐positive bacteria and Gram‐negative bacteria have little difference .The diversity of bacterial species exist .The resistance to commonly used antibiotics is serious .The distribution situ‐ation of blood culture isolated bacteria should be timely understood .The bacterial drug resistance monitoring should be strengthened to control the nosocomial infections ,guide rational drug use in clinic and control the generation and spread of drug resistant bacterial strains .