Objective: To explore the efficacy of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods: A retrospective analysis of 76 patients with OVCF treated with single and double pedicle approach PVP from April 2016 to June 2017 in the First Affiliated Hospital of He′nan University was conducted.According to the operation method, the patients were divided into unilateral group (42 patients, unilateral pedicle approach), and bilateral group (34 cases, bilateral pedicle approach). The operation time, number of intraoperative X-rays, amount of bone cement injection, height of the vertebral body and the complications were compared between the two groups.The visual analogue scale (VAS) and the Oswestry dysfunction index(ODI) score were used to assess the recovery of the patients. Results: The unilateral group had less operative time[(33.01±3.78)min], intraoperative X-ray number[(22.06±3.85) times]and bone cement injection[(3.53±0.42) mL] compared with the bilateral group (t=8.54, 5.98, 4.74, all P<0.05). There were no statistically significant differences in the recovery of vertebral height and complications between the two groups (all P>0.05). The postoperative VAS and ODI of the two groups were significantly improved compared with those before operation (all P<0.05). Conclusion In the case of reasonable indications, the unilateral approach PVP is better than bilateral, and unilateral approach PVP should be the first choice for OVCF.

Objective To explore the apphcation of the integrated teaching method of PBL and TBL based on cases in pharmacology teaching.Method Ninety-two students majored in Pharmaceutical Preparations were selected into the control group,and 184 students majored in pharmacy were enrolled into the experimental group.The teaching effect was comprehensively evaluated by using the combination of theoretical examination and student feedback.Results In the experimental group,the average score of students in Pharmacology (73.68 ± 9.40) was significantly higher than that of the control group (67.34 ± 7.18),and the feedback of the students in the experimental group was significantly better than that in the control group.Conclusion Compared with the traditional teaching method,the integrated teaching method can significantly improve the students' theoretical examination results and students' learning interest.

Objectives To investigate the changes of cystatin C in the serum of patients with acute kidney injury ( AKI) or end-stage renal disease ( ESRD), and study its significance in the early diagnosis of AKI and its correlation with the degree of renal function injury. Method The cases in Xiangya hospital were enrolled in this study according to the RIFLE criteria, including 20 cases of slight acute kidney injury, 30 cases of medium-severe acute kidney injury, 48 cases of victims of the 5. 12 wenchuan earthquake, 32 cases of end-stage renal disease and 20 healthy patients. The microparticle-enhanced immunoturbidimetry method was used to detect serum cystatin C, and the colorimetric method was used to detect urine N-acetyl-beta-D-glucosaminidase (NAGase). The enzymic method was used to detect serum creatinine. The correlation between serum cystatin C and serum creatinine was analyzed, and the sensitivity and specificity of serum cystatin C were evaluated with the receiver operator characteristic curve (ROC curve). Results Compared with healthy control group, the serum cystatin C increased obviously in acute kidney injury group and ESRD group( P <0. 05 and P <0. 01). The serum cystatin C was positively correlated with serum creati-nine( P <0.01). The serum cystatin C in the 5. 12 wenchuan earthquake injured group was also higher than that in healthy control group ( P <0.05), an the serum cystatin C had an AUC - ROC of 0.931 ( P <0. 01). Conclusion Compared to the conventional biomarkers, the earlier emergence of serum cystatin C can contribute better to early clinical diagnosis of AKI. The serum cystatin C is positively correlated with renal function, and reflect changes in renal function accurately.

Objective To understand the current status of disinfection and sterilization of medical institutions at all levels in 30 counties in Chongqing ,and to guide the work that medical institutions regulate and improve the quality of disinfection and steriliza‐tion ,and urge the relevant departments to strengthen the monitoring of disinfection quality of medical institutions .Methods Using field investigation and sampling inspection method ,the disinfection quality of medical institutions at all levels in 30 counties of Chongqing city was monitored and analyzed .Results From 30 districts and counties ,the medical institutions were sampled from 28 510 parts ,the overall average pass rate of 93 .3% .The qualified rate of medical institutions at all levels from high to low were as follows ,the village health room (96 .7% ) ,urban community medical institutions (96 .6% ) ,district level medical institutions (96 .1% ) ,individual clinic (90 .9% ) ,private hospitals (93 .7% ) and township (street) medical institutions (86 .5% ) .Different types of medical institutions got different qualified rate ,and the difference was statistically significant(χ2 =666 .84 ,P<0 .01) .Pro‐ject with the lowest qualified rate was radiation intensity of ultraviolet lamp(52 .8% ) ,secondly was indoor air (80 .4% ) and differ‐ent projects′qualified rate was significantly different(χ2 =1 706 .81 ,P<0 .01) .Conclusion Medical and health institutions at all levels′s disinfection quality were generally good ,but the village health room monitoring coverage ,ultraviolet light intensity and oth‐er individual monitoring projects need to be improved .

OBJECTIVETo investigate the characteristics of pain in temporomandibular disorders (TMD) through analyzing the description of pain by the TMD patients.

METHODSNinety TMD pain patients were included and the glossary in description of the intensity, rhythm and degree of disability due to TMD pain were recorded.

RESULTSThe descriptive pain by 90 patients was slight to moderate. There was no significant difference between males and females or between chronic and acute patients in the description of pain intensity (P > 0.05). The chewing disability was the most often reported complaining, and then was mental status. The probability of pain at rest was not different between in chronic pain patients and acute pain patients(P > 0.05). The acute pain patients often used aching, slight and tingle to describe their pain, while the chronic pain patients used dull, gas and numb more.

CONCLUSIONPain intensity in acute or chronic TMD patients is both low. The pain mainly influences chewing function and mental status in patients. Descriptive characteristic with chronic orofacial pain is different from acute.

Long-term medical education program requires that the medical students should ac-quire both professional knowledge and scientific research ability. These students,with heavy task and course,have difficulty in performing the scientific research systematically. It is very important to develop the early scientific research training. Department of pathology in Central South University,took early sci-entific research activities in various forms,such as literature searching,reviews writing,research design-ing,experiment performing,lecture communicating and clinical practicing after combining the discipline characteristic and arranging the overall process. Satisfactory effects were achieved with efforts.

Objective To investigate the application value of the modified Overlap method in digestive tract reconstruction of totally laparoscopic total gastrectomy (TLTG).Methods The retrospective cohort study was conducted.The clinicopathological data of 50 patients with gastric cancer who underwent TLTG with Overlap anastomosis between January 2016 and December 2016 in the Tangdu Hospital of the Fourth Military Medical University were collected.Twenty-six patients using classic Overlap method and 24 patients using modified Overlap method were respectively allocated into the classic Overlap group and modified Overlap group.All the patients underwent D2 lymph node dissection.Patients in the classic Overlap group underwent totally laparoscopic catastalsis side-to-side esophagojejunostomy.During digestive tract reconstruction in the modified Overlap group,there was no esophageal transection before anastomosis,and gastric fundus traction fully exposed to the lower esophagus.Esophagus was spun anticlockwise,and a hole was opened at the left posterior esophageal wall.Transection of jejunum was 25 cm away from Treitz ligment,and opening a hole at mesenteric margin was 6 cm away from distal jejunum to transected end of jejunum.Esophagus-distal jejunum side-to-side anastomosis was done using 60 mm linear stapler,and then laterally closing openings and transecting esophagus.Observation indicators:(1) intra-and post-operative recovery:total operation time,time of esophagus-jejunum anastomosis,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,cases with complications and duration of postoperative hospital stay;(2) follow-up and survival.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative tumor-free survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the independent-sample t test.Comparison of count data was analyzed using the chi-square test or Fisher exact probability.Results (1) Intra-and post-operative recovery:all the 50 patients underwent successful TLTG using Overlap method,without conversion to open surgery.Total operation time and time of esophagus-jejunum anastomosis were respectively (278.6± 14.9) minutes,(46.5 ± 4.4) minutes in the classic Overlap group and (253.3 ± 12.8) minutes,(20.4 ± 2.3) minutes in the modified Overlap group,with statistically significant differences between the 2 groups (t =5.459,22.482,P＜0.05).Volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,cases with complications and duration of postoperative hospital stay were respectively (73±25) mL,34±6,(2.7± 1.0) days,2,(9.7± 1.6) days in the classic Overlap group and (71 ± 22) mL,35± 5,(2.6± 1.3) days,2,(9.8± 1.5) days in the modified Overlap group,with no statistically significant difference between the 2 groups (t =0.175,-0.616,0.293,-0.217,P＞ 0.05).Two patients in the classic Overlap group were respectively complicated with esophagus-jejunum anastomotic fistula and pancreatic leakage,2 patients in the modified Overlap group were respectively complicated with pulmonary infection and subcutaneous emphysema,and they were improved by symptomatic treatment.(2) Follow-up and survival:41 of 50 patients were followed up for 3-15 months,with a median time of 7 months,including 20 in the classic Overlap group and 21 in the modified Overlap group.During follow-up,patients had tumor-free survival,without tumor recurrence and metastasis.Conclusion Compared with classic Overlap method,the modified Overlap method can simplify the anastomotic procedures,shorten operation time and achieve similar efficacy,and it is also a simple and effective method for digestive tract reconstruction after TLTG.

Animals ; Biofilms ; Caenorhabditis elegans ; metabolism ; Genes, Bacterial ; Yersinia pestis ; genetics ; metabolism

Gastrectomy ; Humans ; Laparoscopy ; Stomach Neoplasms/surgery*

Objective To evaluate the clinical efficacy and safety of glyburide combined with insulin on patients with gestational diabetes mel-litus.Methods Sixty patients were randomly divided into control group and treatment group , each group 30 cases.Patients in control group were treated with insulin , and patients in treatment group treated with gly-buride 2.5 mg· d-1 combined with insulin.Record the general informa-tion of all patents before treating, glycosylated hemoglobin ( HbA1c), dose of insulin and peripheral blood glucose at the time of 12 weeks after treatment, index at perinatal period and index of newborn period in both groups.Results Compared with control group , there was no significant different in HbA1c, peripheral blood glucose , pregnancy hypertension , premature rupture of membranes , hydramnios , prolonged labor , cesarean delivery , macrosomia , neonatal respiratory distress syndrome , hyperbil-irubinemia , admission to neonatal intensive care unit.The time of blood glucose up to standard in treatment group was (11.5 ±4.0 ) d, signifi-cantly longer than that in control group , which was (7.2 ±2.0 ) d.Dose of insulin in treatment group was ( 10.50 ±3.18 ) U · d-1 , lower than ( 30.25 ±3.28 ) U· d-1 in control group.The incidence of hypoglycemiaand premature infant in treatment group were 7%, 7%, significantly lower than 20%and 23% in control group ( P<0.05 ).Conclusion The treatment of glyburide combined with insulin on patients with gestational diabetes mellitus treated is a safe and effective method.