BACKGROUND: The minimally invasive axial lumbar interbody approach (AxiaLIF) for L4–S1 fusion has been applied in America and Europe, and has obtained satisfactory curative efficacy. Because of significant anatomical differences between Chinese and Europeans and Americans, whether AxiaLIF is appropriate for Chinese remains unclear. Moreover,there are some problems in the application of AxiaLIF, so how to optimize AxiaLIF is a key to its promotion in China.OBJECTIVE: To provide anatomical data for the design of axial screws suitable for Chinese through measuring the mid axial line of the lateral lumbar radiograph and cross sections of L5 and S1 on lumbar CT in normal Chinese population.METHODS: The lateral lumbar radiographs from Chinese healthy population were selected, including 35 males and 30 females, the axial height of S1, the disc distance between L5 and S1, and the axial height of L5 were measured so as to provide anatomical data for designing the length of the axial screw. The transverse and sagittal diameters of L5 and S1 in the lumbar CT of 26 adult healthy males and 24 healthy females were measured to provide anatomical data for designing the diameter of the axial screw.RESULTS AND CONCLUSION: (1) The axial height of S1 in males and females was (26.76±3.94) mm and (22.91±2.91) mm, respectively (P < 0.05). The disc distance between L5 and S1 was (12.62±1.90) mm for males and (11.92±1.78) mm for females (P > 0.05). The axial height of L5 was (29.12±2.18) mm for males and (26.91±2.47) mm for females (P <0.05). (2) The transverse diameter of S1 was (49.14±4.14) mm for males and (46.11±4.44) mm for females (P < 0.05).The transverse diameter of L5 was (41.34±4.31) mm for males and (43.12±3.71) mm for females (P < 0.05). The sagittal diameter of L5 was (34.48±2.32) mm for males and (33.03±3.48) mm for females, and the sagittal diameter of S1 was (35.65±4.28) mm for males and (33.53±3.26) for females, (both P > 0.05). (3) That is to say, this study provides the anatomical data for designing the axial screws suitable for the lumbar fusion of Chinese by measuring the mid axial line of the lateral lumbar radiographs and the cross sections of L5 and S1 on lumbar CT. The image measurement method can be used to analyze the preoperative images of the patients to predict the feasibility of the surgical approach and pre-select the internal fixation model for personalized screw positioning.

Objective To compare the eficacy and safety of flexible laryngeal mask (FLMA) and endotracheal tube (ETT) in children undergoing adenoidectomy and tonsillectomy. Methods Forty children with snoring disease scheduled for selective adenoidectomy and tonsillectomy surgery under intravenous compound inhalation general an-esthesia were divided randomly into either FLMA group or ETT group. MAP,HR and SpO2 were recorded before an-esthesia induction(T0 ), 1 (T1 ),3 (T2 ),5 (T3 ) min after intubation,1(T4 ),3 (T5 ) min after extubation. Param-eters for respiratory mechanics included peak airway pressure (Ppeak ), mean airway pressure (Pmean ), end tidal CO2 (PetCO2 ),and airway sealing pressure. All of the above indicators were recorded 5 min (T6 ) after intubation, 10 (T7 ),20 (T8 ) min after put in mouth gag,5 (T9 ) min after removing mouth gag. Meanwhile,chievement ratio of first time insertion,incidence of regurgitation aspiration,bucking,laryngospasm,wheezing when extubation and af-ter extubation,anesthesia time,surgery time,extubation time were recorded. Complications such as nausea and vomi-ting,pharyngeal pain,hoarseness were followed up 24 hours after surgery. Results MAP, HR during T1 , T2 , T3 , T4 ,T5 were significantly higher in group T than T0 , and those in group FLMA (P<0.05). MAP, HR were not sig-nificantly changed in group FLMA during each time. Ppeak , Pmean was significantly lower in group FLMA than that in group ETT. The extubation time was shorter and the incidence of coughing and pharyngalgia after operation was low-er in group FLMA than that in group ETT. Conclusion Compared with endotracheal intubation, on the basis of not affecting surgical operation, FLMA is an effective, safe anesthesia for adenoidectomy and tonsillectomy surgery in children, with the advantages of hemodynamic stability, mild airway trauma,and is a easy handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory me-chanics and low incidence of postoperative upper airway complications.

Objective To investigate the effect of partial nephrectomy of anatomical solitary kidney on tumor control and renal function preservation.Methods 10 patients with anatomical solitary kidney underwent partial nephrectomy from December 2007 to May 2016,including 6 males and 4 females ranged from 38 to 71 years old with an average of 57 years old.The PADUA score ranged from 6-10,with an average of 7.6.The tumor diameter ranged from 1.0 to 7.4 cm,with an average of 3.2cm.Results 7 cases underwent laparoscopic surgery.3 cases underwent open surgery.Mean operation time was 168min (ranged 103-217min).Mean blood loss was 135ml (ranged 20-400ml).The renal arteries were blocked in all patients.The ischemia time ranged from 9 to 33min,with an average of 20.6min.The mean estimated glomerular filtration rate at one week after surgery [40.7ml/(main · 1.73 m2)] decreased 44.7％ compared with pre-operation [73.6 ml/(min · 1.73 m2)].Acute kidney injury developed in 2 patients.One required temporary dialysis.The other improved after conservative treatment.There were no other complications such as urinary fistula and hemorrhage.The pathology analysis confirmed that 2 cases were angiomyolipoma,one case was benign cyst,6 cases were renal clear cell carcinoma,and one case was multilocular cystic renal cell carcinoma.4 cases were stage pT1a,one case was stage pT1b,one case was stage pT2a,and one case was stage pT4.Positive margin was found in one case.The average follow-up period was 28.2 months(ranged 3-58months).Only one patient need long-term dialysis 20 months after surgery at the latest follow up.Another patient had local recurrence and ipsilateral adrenal metastasis.Conclusions Satisfactory effect of tumor control and renal function preservation can be achieved by partial nephrectomy in solitary kidney,which prevent or delay the occurrence of hemodialysis effectively.

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Objective To investigate the actuality and risk factors of mild cognitive impairment among the elderly in Xi'an. Methods The elderly from 10 urban communities in Xi'an were selected using random cluster sample method. Mini-Mental Status Examination and cognitive function questionnaire self-designed were assessed. Results and Conclusion There were 396 (25.02%) elder people with cognitive impairment in 1583 cases. The morbidity of mild cognitive impairment was inverse to the educational level, and was related to age, gender, job category, marriage and social support (P<0.05).

Objective: To discuss the effect of intensive insulin therapy on D-lactic acid and diamine oxidase level in patients with sepsis.Methods: 48 patients was divided into control group and conventional group randomly.Content of D-lactic acid and diamine oxidase in serum was detected with absorption spectrometry before and after therapy.Result: D-lactic acid and diamine oxidase in patients decreased significantly in control group compared to that of conventional group.Conclusion: Insulin can depress interstinal permeability and ameliorate sepsis symptom resulted from bacterial translocation from intestine.

Objective To explore the diagnosis and treatment of altitude sickness combined with urinary retention. Methods 30 cases of altitude sickness combined with urinary retention were treated from April 16th to 26th,2010.They were all male,The average age of them was 24 years (range,19 -38).All were the first time entering the high altitude area (3600 -5000 m) from low altitude area (600 - 1800 m ).The urinary frequency of 25 patients reduced from 8 to 10 times/d to 2 to 4 times/d,the urine output reduced from the 1500- 2400 ml/d to 600- 800 ml/d; the other 5 patients had no urine in 12 -18 h,even had no sense to urinate.26 patients also combined with altitude pulmonary edema and 4 combined with altitude cerebral edema.30 patients had double renal columns enlarged,21 cases had urinary protein ( + ～ ++ ). Results 30 patients were exported urine 300 -600 ml within 10 min,leaded to urine 1800 -2300ml in 12 h,returned to normal voiding after catheter removal in 18 -24 h. After comprehensive treatment such as oxygen,dehydration,diuretic,sedative,antispasmodic and anti-infection,22 cases who with chest tightness,shortness of breath,dyspnea,hemoptysis foam sputum,headache,vomiting and other symptoms of jet-like improved apparently after hospital admission within 1 hour.Their heart rate downed from 90 - 145beats/min to 68 -92 beats/min,respiration from 28 -45 times/min to 18 - 28 times/min,oxygen saturation from 48％ - 84％ to 92％ - 100％ ; 8 cases who with shortness of breath,palpitation and headache improved not obviously.After the antihypertensive treatment,their blood pressure was still high (systolic blood pressure 150 - 180 mm Hg,diastolic blood pressure 90 -110 mm Hg),oxygen saturation between 78％ to 87％,so they were carried to rear area for further treatment.30 cases were all cured no death. Conclusions The high altitude urinary retention is reversible disease,which is often associated with high altitude pulmonary edema,altitude cerebral edema,acute subclinical renal dysfunction and gastrointestinal disorders.They are easily being induced by elements such as gastroenteritis,lung infection,tonsillitis,periodontitis,tiredness and so on; low atmospheric pressure,hypoxia and high altitude is the possible cause; the ratio of missed diagnosis is high; the treatment of oxygen and indwelling catheterization is better; The best method of prevention is to wear pressurized suits and adapt the environment in a ladder-step gradual way.

Objective To extract the loci of murine MHC gene and construct plasmids.Methods The RNA of mice was extracted and reversely transcribed into cDNA.By using nested PCR,the products were connected with T vector,cloned,and sequenced.Subsequently,the genes were digested by endonucleases,connected with expression vector,and sequenced again to choose the correct clones.Results After the nested PCR,the products were approved by sequencing.After being connected with the vectors,they were approved again by sequencing and the correct clones were chosen.Conclusion All of the loci of the MHC gene can be obtained by nested PCR.The plasmids from the correct clone can be used in the further experiments of transferring the gene to mitigate the transplantation rejection.

Objective In order to study the hemodynamics changes of the Budd Chiari syndrome vascular based on Computer Sim-ulation.Methods Three dimensional reconstruction model is established based on MRA medical images.Then take use of Ansys Fluent software to simulate hemodynamic parameters.Results Budd Chiari syndrome vascular model is established successfully. The hemodynamics changes on/above the vascular confluence of inferior vena cava with three main hepatic veins.Contract to the flow inlet of inferior vena cava,blood pressure becomes larger,the speed becomes slower and shear stress becomes smaller.Conclu-sion The inferior vena venous hemodynamics changes region is almost consistent with inferior vena venous predilection location. The study lays the groundwork for future study of Budd Chiari syndrome negotiations.