Objective To evaluate the clinical efficacy of Achillon,a novel guide for Achilles tendon suture produced by Newdeal Ltd in France,in the mini-invasive surgical treatment of acute Achilles tendon rupture. Methods Between December 2010 and March 2011,7 patients(7 feet) with acute Achilles tendon rupture were treated in our department.They were 5 males (5 feet) and 2 females (2 feet),with an average age of 34.2 years (range,21 to 53 years).The interval between injury and operation ranged from 1 to 11 days(3.8 days on average).A longitudinal incision approximately 2.0-3.5 cm in length was made around the ruptured Achilles tendon for minimally invasive repair after insertion of the Achillon.Postoperative rehabilitation was carried out. Results All the wounds healed at the first stage.All patients were followed up for 5 to 11 months, with an average of 7.2 months. All patients regained normal weight-bearing walking 3 months after operation without any re-rupture. According to the ankle-hindfoot scoring system of American Orthopaedic Foot and Ankle Society (AOFAS),they scored 93.2 points.By the visual analogue scale(VAS),they scored 1.2 points at the operation site. Conclusion The surgical treatment of acute Achilles tendon rupture with Achillon has advantages of mini-invasion,a low rate of incision problems and quick function recovery.

The medical consumable material management is an important part of logistic support in the management of hospital, but the hospital has many weak links in the management of supplies. This paper aims to explore the common problems (especially in clinical use) existing in the management of medical consumables and years of management experience in Changhai hospital's practice, then discusses lean management from the perspective of lean management
Equipment and Supplies, Hospital ; Materials Management, Hospital ; organization & administration

BACKGROUND: The injury of peripheral nerve may cause electroneurographic changes. However, what is the correlation between electroneurographic changes and the extent of nerve injury?OBJECTIVE: To probe into the changes of evoked electroneurography in early stage after nerve injury for clinical application and reference.DESIGN: Paired t-test in three groups of samples.SETTING: Department of Traumatic Orthopaedics People' s Hospital of Beijing University.MATERIALS:The trial was conducted in the Animal Center of the People's Hospital of Beijing University from August 2003 to December 2003. The subjects were 8 adult New Zealand rabbits of SPF grade(weighing 1.5 kg) and either gender from the Animal Center of Medical College of Beijing University.METHODS:The model of nerve injury was made in the 16 tibial nerves of the 8 rabbits, in which one third or two thirds of each nerve was ligated at the same transverse part. The samples were thus divided into three groups: non-injury (normal) group, 1/3 nerve injury group and 2/3 nerve injury group.MAIN OUTCOME MEASURES: The indices of evoked electroneurography, i. e. motor nerve condution velocity, negative M wave amplitude, negative M wave area, maximal M wave amplitude and maximal M wave area were measured in the three groups. The correlation between the extent of nerve injury and the 5 indices was analyzed.RESULTS: All the 5 indices of the 3 groups were significantly different( P＜ 0.05). The mean values of the 5 indices were 1.00 ±0.0,0.97 ±0.18,1.01 ±0.22;0.98 ±0.16 and 0.98 ±0.19 in normal group, 0.76 ±0.12,0.41 ± 0.24, 0.47 ± 0.30, 0.48 ± 0.27 and 0.50 ± 0.29 in 1/3 nerve injury group, and 0. 62±0. 10, 0. 11 ±0. 11, 0. 11 ±0. 10, 0. 12 ±0. 14 and 0.13± 0. 12 in 2/3 nerve injury group. The coefficient of correlation between the 5 indices and the injury were 0. 902, 0. 938, 0. 936, 0. 907, and 0. 914, respectively.CONCLUSION: In the early stage after peripheral nerve injury, the electroneurographic indices negatively correlate with the extent of nerve injury. The negative M wave amplitude and area are relatively more closely correlated with the extent of injury.

Objective To analyze the early clinical efficacy of alendronate sodium on residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.Methods By drug single treatment method,a total of 30 elderly patients with residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures were included.Patients were randomly divided into 2 groups:the treatment group and the control group.All patients were given calcium carbonate D3 treatment,and the treatment group was given alendronate sodium treatment additionally.6 weeks after the treatment,visual analogy score (VAS) was used for the evaluation of pain relief.Results All patients were followed up for 6 weeks.At the end of follow-up,the rates of pain relief were 86.8％ in treatment group and 13.2％ in control group.There was a significant difference in visual analogy scores between the treatment group and the control group[(0.51±0.32),(1.59±1.21) ; t=3.4,P＜0.001],which showed the degree of pain relief was higher in the treatment group than in control group.Conclusions Alendronate sodium is effective and reliable for the treatment of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.This study provides the scientific reference for the treatment and research of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.

Objective To analyze the effect of ankle joint proprioceptor injury on the functional ankle instability. Methods The study enrolled 18 ( 13 males) with chronic ankle instability treated with ligament reconstruction operation. The American Orthopaedic Foot and Ankle Surgeons (AOFAS)score was used for evaluation of the function before and after operation and the balance system evaluate the proprioception function. The two ankle ligament specimens from fresh frozen body and the tissue samples from operation were used for investigation of the structure and distribution of the sensory corpuscles by using histology and immunohistoehemical staining. Results The sections were evaluated with a microscope and an image analyzer. Labeled nerve endings were mapped, measured and categorized. Type Ⅰ ( Ruffini-like ending) , type Ⅱ ( Pacinin-like corpuscle ) and type Ⅳ- (noncorpuscular) nerve endings could be identified in all the lateral ankle ligaments, with majority of types Ⅰ and Ⅱ nerve endings.These receptors were distributed primarily over the superficial ligament and near the bony attachments.There was statistical difference between preoperative and postoperative sway distance as well as between preoperative and postoperative AOFAS score. Conclusions This study suggests that the longer history,severer symptoms and lower AOFAS score may lead to the severer injury of the mechanical proprioceptors.The proprioceptor injury is correlated with ankle joint instability and the ligament reconstruction is effective to avoid the repeated injury of the proprioceptor.

Objective:To study the effect of Cyclosporine A preconditioning on liver preservation and transplantation in rat.Methods:Rats were divided randomly into control group (group A,HTK solution preservation) and CsA precondioning group (groupB,HTK solution preservation+1?M CsA).The livers of two groups were had been all preservated for 12 hours before operation of orthotopic liver transplantation.The content of serum AST,ALT,LDH were all assayed during preservation in 0h,12h and 7d post liver transplantation,as well as determination of mitochondrial respiration function parameters (RCR and P/O).The change of cell morphology and apoptosis were also observed by TUNEL stain,and miclroscopes in two groups.Results:The content of serum ALT,AST and LDH in group B were less than in group A after presenvation for 12 hours.RCR and P/O parameters of mitochondrial respiration in group B on preservation for 12h.and for 30 min after operation were more than in group A.Cell morphology and apoptosis changed slingtly compared with group B.Conclusion:CsA preconditioning can relieve injury of donated liver during cold preseration and reperfusion.It protects mitochondrial fuction of liver cells and inlibits cell apoptosisa.

Objective To build the index about the training effect of oncology specialist nurse and test the reliability and validity.Methods By consulting literature and the methods of Delphi,which was consulted by the 9 experts and the two rounds of 35 experts,the original index was estabhshed.The correlation coefficient and validity of the index was evaluated.Results A total of the index was consist of 106 first-l,second-land third-llevel items.Questionnaire recovery rate was 100％ (35/35).The level of authority was 0.816.Expert opinion concentration in various purposes mean variation coefficient was less than 0.244 2.The coordination level of expertise was 0.302.The overall reliability Cronbach α was 0.963.Adopting the method of double variable Spearman calculated the correlation coefficient was above 0.428.Cronbach a of second-and third-level indexes were 0.512-0.895.The second-land third-level indexes correlation coefficient were 0.428-0.931.Conclusions The index about the training effect of oncology specialist nurse has the high authority and representative.The reliability and validity of the index are better,which can be used to evaluate the efficacy of the evaluation about the training of oncology specialist nurse.

Objective To know the remote quality of life of patients with tumor of larynx when ab-scised by different type, and then summarize proper countermeasures of nursing. Methods Selected 82 laryngocarcinoma patients with exacte]y diagnosis. There were 40 cases had received total laryngectumy, 42 cases had received partial laryngectomy. Evaluated the level of remote quality of life of 82 patients by QLQ-H&N65, and then analyzed the datum. Results The level of quality of life of patients with total laryn-gectomy were worse than those in patients with partial laryngectomy in the aspects such as general health, swallow, language, emotional function, social function, body fuction and so on. Conclusions The quality of life of patients with tumor of larynx is influenced by several factors, their remote quality of life should be emphasised by nurses.

Objective To investigate the effect of ischemia/reperfusion(I/R) on tumor metastasis in a experimental mouse model of hematogenous metastasis after I/R; we also quantitated expression of matrix metalloproteinases-9 (MMP-9) during I/R.Methods An experimental mouse model of metastasis after partial hepatic I/R was designed to determine the effects of I/R on tumor metastasis to liver.Tumor loads were valued 7 days after operation.In addition,tissue analysis for alanine transaminase,aspartate transaminase (AST) and matrix metalloproteinases and 8 h reperfusion were performed.Results After 2 h hepatic reperfusion,ALT and AST in I 45 min group were higher than the sham group and I 30 min group (P ＜0.05).ALT and AST in the sham group were both a little higher than the normal.ALT and AST in the I 45 min group and I 30 min group at 8 h were both higher than those at 2 h reperfusion(P ＜0.05).The tumor load (valued by Hepatic replacement area) and the expression of MMP-9 in ischemic lobe in I 45 min group were greater than that after 30 min group and sham group.(P =0.013,P =0.007).There was no statistical difference on tumor load between the right lobe of sham operated mice and the right lobe (non-ischemic lobe) of mice subjected to I/R(P =0.089).Mouse survival were compared among the groups.Mice in Sham group lived longer than I 30 min group (P =0.041).And there were no statistical significance between I 45 min group and I 30 min group (P =0.055).MMP-9 expression in I 45 min group was higher than I 30 min group(P ＜ 0.001).Conclusion Hepatic I/R promotes liver hematogenic metastasis of hepatocellular carcinoma in mice through induction of MMP-9 expression.

Objective To evaluate the outcome of the surgical-treated ankle fractures. Methods We reviewed the outcomes of 92 cases of ankle fracture which had complete follow-up data from January 2000 to April 2008. The outcomes were assessed by AOFAS (American Orthopaedic Foot & Ankle Society) scoring scale, VAS scale, satisfaction degree of patients and range of ankle motion. The differences in AOFAS scoring and ankle motive range between involved and contralateral extremity, AO fracture types, involved positions (solemaleolar, bimaleolar, trimaleolar), follow-up timing were statistically analyzed. Results Follow-ups averaged 55 months. All cases had fracture healed. The average AOFAS score was 93.6 points. The excellent to good rate was 100%. VAS score was 0.17 points on average. Satisfaction score was 9.62 points on average. Statistical analysis showed that the motive range of ankle joint between involved and con-tralateral extremity had a significant difference, but there were no significant differences in AOFAS scores and range of ankle dorsiflexion-plantarflexion between AO fracture types, involved positions and different follow-up durations, Conclusion Surgical treatment for ankle fractures can have a good clinical result.