Objective To observe the clinical efficacy of flexor-extensor alternate electroacupuncture with low-frequency stimulation in improving the wrist-hand function after high spinal cord injury.Method Forty patients with high spinal cord injury were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by flexor-extensor alternate electroacupuncture with low-frequency stimulation, while the control group was by electroacupuncture. The Lindmark score, MAX and IEMG of sEMG were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The MAX, IEMG of sEMG and Lindmark scores were significantly changed after the treatment in both groups (P<0.05). The sEMG signal values and Lindmark score of the treatment group were significantly different from that of the control group after the treatment (P<0.05). The total effective rate was 95.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Flexor-extensor alternate electroacupuncture with low-frequency stimulation is an effective method in improving the wrist-hand function after high spinal cord injury.

Objective:To observe the clinical effects of half puncture plus transcutaneous acupoint electric stimulation in the treatment of infantile facial paralysis. Methods:A total of 60 patients with infantile facial paralysis were divided into a treatment group and a control group by the random digital table, 30 cases in each group. The treatment group was treated with half puncture plus transcutaneous acupoint electric stimulation. The control group was treated with routine acupuncture. Before and after treatment, House-Brackmann (H-B) grading was used to evaluate the sick children respectively. The total effective rates were compared between the two groups after treatment. Results:After 6-course treatments, the total effective rate was 96.5% in the treatment group and 80.0% in the control group, there was a statistical difference between the two groups (P<0.05) in comparison of the total effective rate. After 6-course treatments, H-B scores were all elevated than those before treatment in the two groups (P<0.05); there was a statistical difference between the two groups (P<0.05). Conclusion:Half puncture plus transcutaneous acupoint electric stimulation is better than routine acupuncture in curative effect for infantile facial paralysis.

Objective　To investigate dynamic changes of the p53 gene and its protein during occurrence and metastasis of colorectal cancer and explore the relationship between p53 mutation and survival of the patients. Methods　p53 gene (exon 5-9) was examined by PCR, denaturing gradient gel electrophoresis (DGGE) and automated sequencing. Results　p53 alterations were found in exons 5 through 9 in 26 of the 41 patients (63%). Of the 26 patients, 6 had the alterations in the liver metastatic lesions but not in the original colorectal lesion. The other 20 had the alterations in both of the primary colorectal and hepatic metastatic lesions. Meanwhile, an additional mutation in the metastatic lesions was found in 3 cases. The analysis about the survival revealed that the patients with mutant p53 in the metastatic lesions had a longer survival as compared with those with wild type p53. Conclusion　In the process of liver metastasis of the colorectal cancer, p53 mutations mainly start in the primary colorectal lesion and then is kept and brought into the liver. It also might start from metastatic lesion in a few cases. For the patients who had liver metastasis of colorectal cancer and underwent hepatectomy, the survival is longer in mutant p53 group than in wild type p53 group.

Objective To systematically review the efficacy and safety of prolapse surgery versus combined prolapse and midurethral sling surgery in women with pelvic organ prolapse and stress urinary incontinence.Methods Databases including PubMed,EMbase,the Cochrane Library(Issue 7,2016),Web of Knowledge,CNKI,CBM,WanFang Data and VIP were searched from inception to July 31th 2016,to collect randomized controlled trial(RCT) of combined prolapse and midurethral sling surgery versus prolapse surgery for pelvic organ prolapse and stress urinary incontinence.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 4 RCT involving 446 patients were included.The results of meta-analysis showed that,for postoperative outcomes,compared with prolapse surgery,the incidence of urinary incontinence,stress urinary incontinence,urgency urinary incontinence,any treatment for SUI,surgery for stress urinary incontinence[RR=0.57,95%CI(0.46~0.70),P<0.000;RR=0.24,95%CI(0.10~0.60),P=0.002;RR=0.58,95%CI(0.39~0.85,P=0.006;RR=0.20,95%CI(0.06~0.67),P=0.009;RR=0.07,95%CI(0.01~0.56),P=0.010]were lower in combined prolapse and midurethral sling surgery.For complications,the incidence of bladder perforation or injury,urinary tract infection,incomplete bladder emptying at 1 week[RR=9.72,95%CI(1.78~53.01),P=0.009;RR=1.77,95%CI(1.23~2.54),P=0.002;RR=1.39,95%CI(1.06~1.81),P=0.020]were higher in combined prolapse and midurethral sling surgery,while there were no statistical differences between the two groups in the incidence of voiding dysfunction,vaginal tape erosion,major bleeding or vascular complication.Conclusion For women with pelvic organ prolapse and stress urinary incontinence,compared to prolapse surgery,the incidence of urinary incontinence and treatment of urinary incontinence is lower in combined prolapse and midurethral sling surgery,the incidence of partial complications is higher in combined prolapse and midurethral sling surgery.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.

Objective To compare the neuromuscular blocking effects of rocuronium given by intermittent bolus injection, continuous infusion and target-controlled infusion during liver transplantation. Methods Thirty-six patients with hepatic failure of both sexes aged 21-63 yr weighing 48-80 kg undergoing liver transplantation were studied. The donor livers were obtained from living donors. The patients were divided into 3 groups according to the mode of rocuronium administration ( n = 12 each): group Ⅰ intermittent bolus injection (group Ⅳ); group Ⅱ continuous infusion (group CI) and group Ⅲ target-controlled infusion (group TCI). Neuromuscular block was assessed by TOF stimulation of ulnar nerve (TOF-Watch SX). Anesthesia was induced with midazolam 5 mg,fentanyl 4-6 μg/kg and propofol 1.0-1.5 mg/kg, and rocuronium was administered using different modes of administration. A bolus of rocuronium 0.6 mg/kg was given during induction and supplemental rocuronium 0.15 mg/kg was given when T1 was returned to 25% in preanhepatic stage and T4/T1 (TOFR) returned to 25% in anhepatic and neohepatic stages in group Ⅳ. TCI at an initial target effect-site concentration of 3 μg/ml was started during induction, the concentration was adjusted to maintain T1 at 5%-10% , TCI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then TCI at a target effect-site concentration of 0.1 μg/ml was started again and the concentration was adjusted to maintain T1 at 5%-10% in group TCI. A bolus of rocuronium 0.6 mg/kg was given during induction, the initial infusion rate was set at 30 μg· kg-1 ·min-1 and then adjusted to maintain T1 at 5%-10% in preanhepatic stage, CI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then it was started again at 1 μg· kg-1 · min-1 in preanhepatic stage and the infusion rate was adjusted to maintain T1 at 5%-10% in group CI. Tracheal intubation was performed when the maximal effect was achieved. The administration was stopped after suture of the peritoneum. The onset time, the maximal depression of T1 , intubation condition, recovery time and the total amount of rocuronium consumed were recorded.Results There was no significant difference in onset time, the maximal depression of T1, intubation condition,ecovery time and the total amount of rocuronium consumed among the 3 groups ( P ＞ 0.05). Conclusion There is no significant difference in the onset and recovery when neuromuscular blocade was induced by rocuronium via Ⅳ, CI and TCI, but neuromuscular blockade induced by rocuronium via TCI and CI is more stable than that induced by rocuronium via Ⅳ during liver transplantation.

Objective To investigate osteoporosis and its main associated factors in patients with type 2 diabetes (DM). Methods Bone mineral density(BMD)of lumbar vertebrae 2～4 and proximal femur in 40 type 2 diabetic patients were measured with dual energy X-ray absorptiometry and compared with control group(30～35 years old). Serum Ca, P, ALP and connective peptide in type 2 diabetes mellitus patients were measured. Results The area under the connective peptide releasing curre in osteoporosis group was lower than that of non-osteoporosis in type 2 diabetes. Conclu.sion BMD is correlated with the pancreatic islet function. The patients with pancreatic islet failure develop osteoporosis easily.

Adult ; Arterio-Arterial Fistula ; complications ; Coronary Vessels ; pathology ; Embolization, Therapeutic ; Humans ; Male ; Myocardial Ischemia ; etiology ; therapy ; Pulmonary Artery ; pathology

[Summary] A 60-year-old man was admitted with main complaint of chest pain on exertion.Coronary angiogram showed severe triple vessel disease.He underwent the hybrid technique of treatment through two left minithoracotomy incisions.Both internal thoracic arteries were harvested under direct vision.The left internal mammary artery (LIMA)and right internal mammary artery (RIMA) compositing Y grafts was constructed. The LIMA was anastomosed to the left anterior descending branch and the RIMA was anastomosed to the ramus intermedius.The operation time was 306 min.The amount of bleeding during operation was 50 ml.Five days later he underwent percutaneous coronary intervention at right coronary artery lesion successfully.He was discharged from hospital 8 days after operation,and didn’t complain of chest pain during fellow-up for one month.This technique demonstrates to be an effective and minimally invasive alternative to treat patients with multivessel coronary artery disease.

Objective To explore the feasibility of B-ultrasound guided ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi. Methods A total of 32 cases of complex renal calculi was included in the study. Under local anaesthesia and B-ultrasound guidance, a percutaneous nephrostomy was performed untill a F_ 16 catheter could be introduced, with the sheath indwelling in the tract. Then under a F_ 8/9.8 ureteroscopy, holmium laser nephrolithotomy was conducted for 1~3 fractions with an interval of 3~5 d. Results The renal puncture was successfully accomplished in all the cases. The stone-free rate was 75% (24/32) at 4 weeks, and 94% (30/32) at 12 weeks after procedure. No serious hemorrhage or infection happened. No conversion to open surgery was required. Conclusions Under local anaesthesia and B-ultrasound guidance, ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi is safe, effective, and feasible.

Objective: To study 63 cases of nasal tumors treated by dermatologic surgery, and analyze their generality and characters. Methods: The cases were analyzed with SPSS 10.0 and SAS6.12. Results: The average age of the patients was 46.92?18.63.The number of man was about equal to that of women. Most cases were basal cell carcinoma (42.9%). Nevus came second (38.1%). The other cases were benign tumors. The distribution of operational locations showed the character of nasal surgery. Operations of Alar occupied 52.4%,22.2% were on the dorsal and 15.9% on the tip. Other locations occupied 9.5%. Cases of primary close occupied 69.8%. Cases applying complex close were 30.2%. Statistic analysis illustrated that primary close was different from complex close with distribution of operational locations. The area of defects between primary close and complex close was also different. At the same time, the differentiation of applying complex close was obvious between malignant tumors and benign tumors. Conclusion: Skin cancers and benign tumors usually occur on the nose, so it is very important to master the techniques of plastic surgery to repair the defects of nose, besides removing tumors perfectly by the classical way of dermatologic surgery, Mohs Micrographic Surgery.