BACKGROUND:Fragile bone in senile osteoporosis patients easily weakened pedicle screw fixation capacity. Therefore, bone cement leakage and screw removal cannot be solved during pedicle screw repair in osteoporotic patients with degenerative lumbar spine. OBJECTIVE:To investigate the biomechanical properties of novel pourable pedicle screws and bone cement application effect in osteoporotic patients with degenerative lumbar spine. METHODS:Six lumbar specimens (T11-L5) at the mean age of (72.9±4.2) years were selected, total y 42 vertebrae. The average bone density was 0.696 g/cm2. Any side of al vertebrae was inserted with pourable pedicle screws. 2 mL of bone cement was perfused under the X-ray fluoroscopy with cement push rod and fil ing cylinder. The same number of conventional screws was inserted into the opposite side of the samples. Three-point bending test was performed in two kinds of screws. The maximum vertebral axial pul out force test and the maximum spin torque test were conducted in vertebra to observe the destruction of the vertebral body and implanted effect. RESULTS AND CONCLUSION:(1) The ultimate strength and yield load of novel pourable cement pedicle screws were significantly more than conventional screws (P<0.05). Ultimate displacement and yield displacement were significantly less in novel pourable cement pedicle screws than in conventional screws (P<0.05). (2) The maximum vertebral axial pul out force and the maximum spin torque were significantly higher in novel pourable pedicle screws than in conventional screws (P<0.05). (3) In summary, novel pourable cement pedicle screw is simple to operate, can effectively control bone cement penetration, and improve screw stability in osteoporotic vertebrae. Moreover, after treatment, the removal of screws is convenient, cannot evidently destroy vertebral body or screw channel, and promote early recovery.

Objective To investigate the clinical effectiveness of ileum circulation loop in the treatment of familial adenomatous polyposis ( FAP) and ulcerative colitis ( UC) by total proctocolectomy or subtotal colectomy. Methods Totally 31 FAP or UC cases who receiving total or subtotal proctocolectomy in our department from January 1987 to June 2007 were divided into 2 groups according to using the ileum circulation loop or not in the different operation methods. The postoperative complications and the times of defecation in 24-hour and during night after 1 month and 1 year of operation were observed and analyzed. Results In the 31 cases,the incidence of postoperative complications were obviously decreased in using the loop group than in those of the without ( P

Objective:To explore the clinical effect of prostatil combined with diosmin on the elderly patients with chronic prostatitis (CP) and the macrophage inflammatory protein-2 (MIP-2) and macrophage inflammatory protein-lα (MIP-lα) in prostate fluid and serum.Methods:126 cases of elderly patients with CP in our hospital fiom January 2015 to September 2016 were selected and randomly divided into two groups.Prostatil combined with diosmin were provided to the patients in observation groups (63 cases) while the control group (63 cases) was treated by prostatil alone.The clinical effect,MIP-2,MIP-1α levels in the prostate fluid and serum before and after therapy as well as the incidence of adverse reactions were observed and compared between two groups.Results:At 12 weeks after treatment,the total effective rate of observation group was 93.7％,which was obviously higher than that of the control group (81.0％,P＜0.05).The MIP-2 and MIP-1α levels in prostate fluid and serum of both groups at 12 weeks after therapy were significantly lower than those before therapy (P＜0.01),which were significantly lower in the observation group than those of the control group at the same time (P＜0.01).There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Prostatil combined with diosmin could more safely and effectively improve the clinical efficacy in the treatment of elderly patients with CP/CPPS,which might be related to reduce the levels ofMIP-2,MIP-lα in serum and prostatic fluid.

Objective To discuss the risk factors and nursing intervention of multidrug-resistant organism (MDRO) infection in patients of traditional Chinese medicine hospital (TCM). Methods By investigating the patients admitted to Beijing Xuan Wu Hospital of Traditional Chinese medicine from June 2015 to June 2016, 756 patients of them who were confirmed with clinical diagnosis of infection and pathogen detection with positive, which were divided into MDRO group including 97cases and non-MDRO group including 659 cases, then the pathogens of MRDO infection species and distributionwere counted, and analyzed risk factors for infection. Results A total of 756 cases were detected positive strains 816 strains, including 611 strains of monitoring target strains, 116 strains of MRDO. The top three were methicillin-resistant staphylococcus aurous 30.17%(35/116), Pseudomonas aeruginosa 18.97% (22/116) and Klebsiella pneumonia 18.10% (21/116). Single factor analysis results showed that the patients' age, hospitalization days, the history of other hospital admission, invasive procedure, basic chronic disease (diabetes, cerebrovascular disease, lung disease) and combined use of antibiotics were MDRO infection risk factors (χ2=9.470-198.609, P < 0.01); multivariate Logistic regression analysis showed that the independent risk factors of MDRO infection were the history of other hospital admission (OR=2.085, 95%CI1.040-4.179), invasive procedure (OR=3.063,95% CI1.526- 6.150), diabetes (OR=2.037,95% CI1.070- 3.877), cerebrovascular disease (OR=4.349,95%CI 2.035-9.293)and combined use of antibiotics (OR=18.723,95% CI9.202-38.094). Conclusions Patients of TCM have many characteristics, such as with more basic diseases, longer length of stay, elder and so on. So we should be alert to the risk of MDRO infection and take nursing interventions to prevent and strengthen the isolation prevention.

Objective To investigate the resistant mechanism of Streptococcus pyogenes to ciprofloxacin and its homology.Methods Forty-eight isolates of Streptococcus pyogenes were collected from patients diagnosed with scarflet fever in districts of Beijing in March,2012 and MIC to ciprofloxacin and other 7 common antibiotics in clinic were detected by using blood M-H agar dilution method.Thirteen isolates,which have MICs≥4 mg/L against ciprofloxacin,were detected for mutations of Fluoroquinolone resistance genes gyrA,gyrB,parC,parE.At the same time,4 isolates,with MIC ≤ 0.25 mg/L against ciprofloxacin,were used for comparison.Homology analysis of 17 isolates from different areas of Beijing was performed by using the method of pulsed field gel electrophoresis.Results Sensitive rates of Streptococcus pyogenes to levofloxacin,ampicillin and penicillin were all 100％.The resistance rates to tetracycline,erythromycin and clindamycin were 91.7％ (44/48),91.7％ (44/48) and 89.6％ (43/48),respectively.MIC50 of ciprofloxacin,levofloxacin and moxifloxacin was 2 mg/L,1 mg/L and ≤ 0.25 mg/L,respectively ; MIC90 was 4 mg/L,2 mg/L and 0.5 mg/L,respectively.Of the 48 isolates of Streptococcus pyogenes,12 isolates showed the MIC at 4 mg/L,while one isolate has a MIC against ciprofloxacin at 8 mg/L,which isolated from Chaoyang district.Analysis of sequence of chromosome mediated fluoroquinolone resistance genes in those 13 ciprofloxacin non-susceptible isolates exhibited that there were 12 isolates that harbored Ser79Phe/Tyr mutation and 10 isolates harbored Ala121Val in parC gene.It is shown that one isolate contained Ser79Phe mutation in parC gene in the occurring of Ser371Leu mutation in parE gene for the first time,but there was no marked increase in ciprofloxacin MIC (MIC =4 mg/L).There were no mutations in gyrA and gyrB genes.The PFGE results demonstrated that the 17 tested isolates could be divided into 7 clones.The clone A isolates from Chaoyang,Daxing,Fengtai,Shunyi and Shijingshan district have a MIC ≥ 4 mg/L against ciprofloxacin,which covered 69.2％ of all MIC ≥4 mg/L isolates.The clone C isolates from Huairou district were MIC ≥4 mg/L isolates.B,D,E,F and G clones isolates come from different districts.Conclusions The mutation of parC gene was the main reason that contribute to the slightly increase of ciprofloxacin MIC in Streptococcus pyogenes isolated from Beijing.The PFGE analysis showed that there was a small scale prevalence caused by the infection of Streptococcus pyogenes in some districts.

Objective To discuss the efficacy and advantage of dolabriform flap in repairing periorbital skin and soft tissue defects.Methods 21 patients with periorbital skin disease were treated by radical resection,and then the adjacent or distant dolabriform flaps were designed for the one stage repair of skin and soft tissue defects in these cases according to the defect location,size,shape and neighborous skin conditions.The largest defect size was 3.5 cm × 4.5 cm,The smallest defect size was 1.2 cm × 1.5 cm.The largest ratio of hatchet pedicle width to axe handle length reached 1 ∶ 5,and the largest ratio of hatchet pedicle width to hatchet edge length was 1 ∶ 4.Results All of these dolabriform flaps in 21 patients survived well with primary incision healing.18 cases had been followed up for 3 to 12 months,showing that there was no deformation found on eyelids,eyebrow and nose,the colour of these flaps were similiar to that of the normal skin,without being fat and clumsy,all scars were almost invisible,and the cosmetic results were satisfactory.Conclusions Larger diameter of skin and soft tissue defect in different periorbital parts could be repaired individually with dolabriform flap according to the characters of natural lines,and it is a simple and flexible method for repairing periorbital skin defects,and can achieve satisfactory functional and cosmetic results.

Objective To explore the effect of TNF-α in intracellular Ca~(2+)-overload associated myocardial injury. Methods Thirty Wistar rats were randomly divided into three groups:control group,Ca~(2+)+-paradox group,and pentoxifylline treatment group. The intracellular Ca~(2+)-overload rat model was established by pre-filling the rats with Langendorff for 20 minutes,isolated rat hearts subjected to Ca~(2+)-depletion for 5 minutes and Ca~(2+)-repletion for 30 minites(Ca~(2+)-paradox). Changes in hemodynamics indexes were monitored continuously. TNF-α in cardiac tissues was tested by ELISA method,and nuclear factor-κB(NF-κB)in cardiac tissues was detected with Western blot. Results Dramatic depression in left ventricle contraction function was found in the Ca~(2+)-paradox hearts:significant decrease in left ventricular diastolic pressure(LVDP),markedly elevated left ventricular end diastolic pressure(LVEDP),decreased dP/dt ratio,increased TNF-α content,decreased cytosolic/homogenate NF-κB ratio. All these changes in Ca~(2+)-paradox group were significantly attenuated upon the treatment with 100 μmol/L pentoxifylline. Conclusions Activation of NF-κB and increased production of TNF-α may play important roles in cardiac injury associated with intracellular Ca~(2+)-overload.

Objective To explore an operative method which can adequately enlarge the inner canthus with inconspicuous scar and perfect shape based on the transverse incision for epicanthus correction,and to evaluate the short-term results and long-term effects comprehensively.Methods The surface projection of tears port medial point was designed as a new inner canthal point,the full thickness skin from new inner canthal point was cut to the free edge of epicanthus,and an outward prolonged incision was made along the lower eyelid edge,separating the subcutanous dissociation or cutting off part of displaced orbicularis,so to relieve the skin tension of inner canthal and reset skin,suturing the new inner canthal point and lower eyelid edge.Results 120 cases were followed up for more than one year,the complication rate at different postoperative time points and patient satisfactory rate one year after operation were compared.12 cases had mild scar formation,from six months to one year after operation,the scar gradually became softened and then inconspicuous.22 cases had a little skin fold at the inner canthal in postoperational one month.2 cases were unsatisfied with the shape of inner canthal,Others were satisfied with therapeutic efficacy,the correction was sufficient with inconspicuous scar and 1ess recrudescence.Conclusions Epicanthus correction by subciliary incision epicanthoplasty is a simple and effective method and suitable for all types of epicanthic fold,and it has the advantages of sufficient enlarged inner canthus,inconspicuous scar and 1ess recrudescence.

Objective To investigate the expression of E-cadherin and matrix metallopeptidase 7(MMP-7)and their significance in basal-like and Her-2 over-expressing breast carcinoma. Methods The protein expression of E-cadherin and MMP-7 were analyzed by immunohistochemical method in 20 cases of basal-like breast carcinoma and 21 cases of Her-2 over-expressing breast carcinoma.Statistical method was used to analyze the clinicopathological performance.Patients were followed up from 6 to 60 months.Results The ratio of basal-like breast carcinoma and invasive ductal carcinoma was 3.4%(20/501).the mean age was 49 years.The mean size of basal-like breast carcinoma(2.1 cm)was smaller than that of Her2 over-expressing breast carcinoma(3.0 cm)(P<0.05).The 5-year survival rate of patients with basal-like breast carcinoma was obviously(40.0%) lower than that of Her-2 over-expressing breast carcinoma (71.4%)(P<0.05),though,the 3-year survival rate was similar between the two groups.The protein expression of E-cadherin was down-regulated and even deficient in basal-like breast carcinoma(P<0.05).The protein expression of MMP-7 was higher in basal-1ike breast carcinoma than that in Her-2 overexpressing breast carcinoma(P<0.05).Conclusion Down-regulated expression of E-cadherin and upregulated expression of MMP-7 may be one of the mechanisms leading to high metastasis of basal-like breast carcinoma.

Objective To understand the epidemic characteristics of imported malaria in Henan Province from 2012 to 2014,so as to provide the evidence for proposing the reasonable suggestions for imported malaria prevention and control. Meth?ods The data of imported malaria were collected and the epidemic characteristics were analyzed in Henan Province from 2012 to 2014. Results A total of 569 imported malaria cases were reported in Henan Province from 2012 to 2014,including 445 cas?es of falciparum malaria,48 cases of vivax malaria,61 cases of ovale malaria,14 cases of quartan malaria,and 1 case of mixed infection. All the malaria cases were confirmed in laboratory. During the three years,the time of higher incidence was in Spring Festival,and May and June,and the cases mainly distributed in Luoyang,Zhengzhou,Puyang,Xinxiang,Anyang,Xuchang and Nanyang cities,accounting for 68.54%. Totally 82.43%of the patients were male youth and middle?aged. Of the 569 pa?tients,534(93.85%)returned from Africa and 35(6.15%)returned from Southeast Asian countries. The average time was 6.22 d and the median was 4 d from the onset to diagnosis. Among 569 cases,290(50.97%)were confirmed by different levels of cen?ters for disease prevention and control,and 279(49.03%)were diagnosed by different levels of medical institutions. Conclu?sions The imported malaria cases have been increased obviously in recent 3 years in Henan Province. Therefore,the health ed?ucation for the knowledge about malaria prevention and control,and the technician training should be strengthened.