Objective:To observe the effectiveness of photon therapeutic instrument combined with magnesium sulfate on puerperants with hemorrhoids.Methods: Sixty eight puerperants cases with hemorrhoids were chosen and randomly divided into an observation group and a control group, each with 34 cases. In the control group, Mayinglong hemorrhoids suppository was used on the hemorrhoids. While in the observation group patients were given photon therapeutic instrument combined with magnesium sulfate on the hemorrhoids. The curative effectiveness, the scores of pain, breastfeeding rates were compared between the two groups.Results: After one course of treatment, the treatment effect of observation group was 91.18%, which was higer than control group that was 82.35%, the difference was statistically significant(x2=4.086,P<0.05). After one course of treatment, the scores of pain in observation group was lower than that in control group, the difference was statistically significant(t=2.773,P<0.05). During the four months of postpartum, the breastfeeding rates in observation group was higher than that in control group, the difference was statistically significant(x2=4.403,P<0.05).Conclusion: Treating by photon therapeutic instrument combined with magnesium sulfate on puerperants with hemorrhoids, can increase treatment effect, reduce the severity of pain, and enhance breastfeeding rates, is worthy of clinic application.

Objective To assess the clinical application of microendoscopic discectomy (MED) system in the treatment of 36 cases of special lumbar disc herniation (LDH). Methods Laminectomy and decompression, and removal of fractured end plate or calcified herniated discs were performed by MED using self-made bone chisel, osteotome and L-shaped osteotome. Results Intraoperative dural laceration occurred in 2 cases, and no conversions to open surgery were required. Follow-up observation ranged (3～12) months (mean, 9.5 months). According to Macnab criteria, 28 patients had excellent, 5 had good, 2 had fair, and 1 had poor outcomes, with good or excellent results in 91.7% (33/36) of the patients. Conclusions MED may be carried out in patients in side position. Calcified herniated discs and fractured end plate can be excised by MED with self-made tools.

Objective To investigate the feasibility of thoracoscopic minimal access anterior surgery for thoracic spine. Methods Minimal access anterior thoracic surgery was conducted under thoracoscope in 14 patients in this hospital from October 2001 to October 2002.Six patients with thoracic vertebral metastasis underwent vertebral body excision, reconstruction by cement and steel plate, and anterior internal fixation with screw-rod system;4 patients with thoracic vertebral tuberculosis received focus resection,bone graft and anterior internal fixation with screw-rod system; 2 patients with of thoracic disc herniation received discectomy and fusion;2 patients with thoracic vertebral facture and dislocation received reduction, decompression, bone graft and anterior screw-rod internal fixation. Results Postoperative imageological analysis revealed that the focus had been cleaned completely and the internal fixation was excellent. Follow-up for 4～12 months in 14 patients showed that the pain on chest and back disappeared in all the patients. Of the 13 patients with spinal compression, muscle strength recovered from grade A～D preoperatively to grade C～E postoperatively. Conclusions Thoracoscopic minimal access anterior thoracic surgery is feasible. It offers satisfactory short-term effects.

Objective To explore the application of integrating 64-slice CT image with three-dimensional electroanatomic mapping(Carto-Merge) in guiding catheter ablation of atrial fibrillation(AF).Methods Fifteen patients with drug-refractory AF received catheter ablation of AF.64-slice CT scan was performee 1-3 days prior to the ablation procedures.Using a novel software package,the left atrium(LA)with PVs was segmented and extracted for image registration with a combination of landmark registration and surface registration.Results The integration of the CT image into the electroanatomic mapping system was performed successfully in all patients with an error of 2.11?0.82 mm.Thirty pairs of PVs were electrically isolated after circumferential rediogrequency pulmorary rein ablation.The mean procedure time was 170.51?38.47 minutes.Cardiac tamponade occurred in one patient.All the fifteen patients were free of AF recurrence after 3 months of follow up including the 2 cases of persistent AF who required antiarrhythmic drugs.No thromboembolic events or stenosis were observed.Conclusion Integration of 64-slice CT image into the CARTO system successfully performed in patients undergoing catheter ablation of AF and enhance the ablation success rate.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P

Objective To analyze the therapy and prognosis of palindromic ovarian carcinoma. Methods The clinical data of 40 cases of palindromic ovarian carcinoma were reviewed retrospectively. Results After the first surgery, the mean recurrent time of the patients with remained tumors smaller than 2 0 cm was (37 26?11 79) months, and that of the patients with remained tumors larger than 2 0 cm was (7 88?1 49) months. There was a significnat difference in the mean recurrent time between the two groups of the patients with different size of remained tumors(P0 05). Conclusion The recurrence of ovarian cancer was related to the size of remained tumor. Secondary operation plus chemotherapy could improve the short-term survival rate of the patients with palindromic ovarian carcinoma.

10.3969/j.issn.2095-4344.2013.23.015

Objective: To explore influence of p38 mitogen-activated protein kinase (p38MAPK) inhibitor on myocardial cell apoptosis and expression of tumor necrosis factor (TNF)-α in rats with ischemia/reperfusion (I/R) injury. Methods: According to number table method, a total of 30 SD rats were randomly and equally divided into blank control group, I/R group and inhibitor group. p38MAPK mRNA expression, TNF-α level and myocardial cell apoptotic rate were measured, compared and analyzed among three groups. Results: Compared with blank control group, there were significant increase in TNF-α level [(3.68±0.16) μg/L vs. (5.02±0.09) μg/L], p38MAPK mRNA expression [(1.76±0.46) vs. (2.35±0.02)] and myocardial cell apoptotic rate [-(3.51±0.40) % vs. - (1.8±0.23) %] in I/R group, P=0.001 all. Compared with I/R group, there were significant decrease in p38MAPK mRNA expression (2.09±0.16), TNF-α level [(4.15±0.11) μg/L] and myocardial cell apoptotic rate [-(2.9±0.50) %] in inhibitor group, P=0.001 all. Conclusion: Inhibition of p38 mitogen-activated protein kinase expression in myocardium of rats can decrease production of tumor necrosis factor-α and myocardial cell apoptosis, then relieve ischemia/ reperfusion injury of myocardial cells.

BACKGROUND:Bone loss to different degrees may appear within 1 year after hip replacement in the femoral or acetabular sides, and severely affect long-term stability of the prosthesis and bone strength. Thus, to reduce bone loss around the prosthesis stem after total hip replacement is significant to prolong the use time of the prosthesis and to prevent fractures surrounding the prosthesis.
OBJECTIVE:To observe the preventive effect of zoledronic acid on bone loss surrounding the prosthesis stem after hip replacement.
METHODS:A total of 80 patients after total hip replacement in the People’s Hospital of Shenxian from February 2011 to September 2014 were enrol ed in this study. They were divided into two groups (n=40). At 4 days after replacement, patients in the observation group received treatment with zoledronic acid, but those in the control group did not give zoledronic acid. The rest medication was identical between the two groups. Bone mineral density in the hip was measured before replacement and at 1 year after replacement in both groups. Serum calcium and
phosphorus levels and alkaline phosphatase activities were observed before replacement, 3 days and 1 year after medication in the two groups. Adverse reaction during medication was recorded in the observation group.
RESULTS AND CONCLUSION:The average bone mineral density was significantly decreased in both groups at 1 year after replacement, and significant differences were found as compared with before replacement (P<0.05). The average bone mineral density was significantly higher in the observation group than in the control group at 1 year after
replacement (P<0.05). Calcium and phosphorus levels were significantly diminished at 3 days after medication as compared with that before replacement (P<0.05). Calcium and phosphorus levels maintained at the level before replacement at 1 year after medication. Alkaline phosphatase activities were slightly reduced within a short time after replacement in both groups, but no significant difference was found as compared with before replacement (P>0.05). Alkaline phosphatase activities were low in the observation group at 1 year after medication, and significant difference was detected as compared with the control group and that before replacement (P<0.05). No significant difference in alkaline phosphatase activities was detectable in the control group between 1-year post medication and pre-replacement (P>0.05). Within two or three days after medication, nine patients suffered from varying degrees of muscle aches and fever in the observation group, and above symptoms were lessened after taking acetaminophen. These results verify that after total hip replacement, zoledronic acid injection can effectively prevent bone loss around the prosthesis in early stage after replacement, but fever symptoms may occur within a week after replacement. Thus, it is recommended that zoledronic acid injection can be given at 1 week after replacement. If fever and other symptoms appear, acetaminophen can be given.

Objective To investigate the effect of rocuronium 0.3 mg/kg(ED95)for anesthesia induclion on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods Seventy-five patients,ASA Ⅰ or Ⅱ,aged 20-70 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into two groups:rocuronium group(groupⅠ,n=38)and sevoflurane group(group Ⅱ,n =37).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 ug/kg.After loss of eyelash reflex,group Ⅰ received rocuronium 0.3 mg/kg(ED95)and was intubated with the electromyographic(EMG)endotracheal tube under glidescope al 2 min after rocuronium administration.Group Ⅱ received sevoflurane inhalation and was endotracheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4％.Anesthesia was maintained with inhalation of sevoflurane in both groups.SP,DP,and HR were monitored continuously through the surgery.Cooper's score and the success of attempt at endotracheal intubation were recorded.Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 min intervals from 30 min to 70 min of surgery duration.Results SP,DP and HR remained within normal range in both groups.The success rates of endotracheal intubation were 100％ in both groups,but the Cooper' s score of group Ⅰ was significantly higher than that of group Ⅱ(P ＜ 0.05).Compared with group Ⅱ,the amplitude of EMG respouses was significantly decreased in group Ⅰ(P ＜ 0.05).However,the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve.Conclusion Rocuronium 0.3 mg/kg(ED95)for anesthesia induction can not only provide satisfied endotracheal intubation conditions,but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.