Objective To compare safety,completeness and long-term results between lobectomy by video-assisted thoracoscopic surgery(VATS) and thoracotomy for clinical stage Ⅰ / Ⅱ non-small cell lung cancer(NSCLC).Methods Between July 2010 and December 2011,673 patients with clinical stage Ⅰ / Ⅱ NSCLC from 11 hospitals underwent pulmonary lobectomy(425 VATS,248 thoracotomy).Patients were matched by propensity score matoh method to create two comparable groups,402 patients remained eligible for analysis,with 201 patients in each group.Perioperative variables and follow-up results were compared between the two groups.Results Patients characteristics were comparable between the two groups,except for a slight lower preoperative FEV1,FEV1％ and FEV1/FVC in the VATS group (P ＜ 0.05).There was one postoperative death in each group.There was no significant difference in operative time,mediastinal lymph nodes stations/numbers dissected and postoperative drainage time between the two groups.The operative blood loss was lower in the VATS group(P ＜ 0.001),the mean hospital stay was shorter in the VATS group(P ＜ 0.001).Postoperative pneumonia/pulmonary atelectasis rate was lower in the VATS group than in the thoracotomy group (5.1％ vs.10.4％,P ＜ 0.05).Median follow-up time was 20 months in both groups.One-year and two-year recurrence-free survival was 90％ vs.88％ and 80％ vs.70％,respectively(P =0.163).One-year and two-year overall survival were 96％ vs.95％ and 88％ vs.85％,respectively(P =0.226).Conclusion For clinical stage Ⅰ / Ⅱ NSCLC,VATS lobectomy is a feasible procedure with shorter hospital stay and less complications,while its surgical and oncologic outcome is comparable to that of thoracotomy lobectomy.

OBJECTIVE:To improve the accuracy of the Cetirizine hydrochloride syrup pediatric dose for children. METH-ODS:The dosage of Cetirizine hydrochloride syrup for children with chronic urticaria was accurately measured and compared with before and after pharmacists’intervention. RESULTS:The dosage before and after pharmacists’intervention was significantly high-er than prescribed dosage,the dosage after intervention was lower than before intervention,the differences were statistically signifi-cant(P<0.05). CONCLUSIONS:It is commonly existed that the dosage to children is higher than the prescribed dosage. It is sug-gested that doctors should strictly follow the printed label to make a prescription,pharmacists should strengthen the guidance and in-tervention on medication,and pharmaceutical manufacturers can manufacture suitable Cetirizine hydrochloride preparations special-ly for children to improve drug compliance and dosage accuracy.

BACKGROUND:Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue. OBJECTIVE:To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures. METHODS:Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral“L”shaped approach, and then the lateral wal of the bone was reset fol owed by internal fixation with the pre-curved locking plate. Fol ow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score. RESULTS AND CONCLUSION:Total y 21 patients were fol owed up for 8-16 months. The fractures were healed without displacement, col apse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to ful y fil bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.

BACKGROUND:At present, the incidence rates of knee joint diseases such as knee osteoarthritis, knee joint degenerative are high. The major clinical treatment is total knee replacement in the clinic, so it is necessary to evaluate the changes in stress and bone mineral density of the regions surrounding the prosthesis after replacement. ＜br> OBJECTIVE:To explore periprosthetic stress and bone mineral density and to analyze their correlation after total knee arthroplasty. ＜br> METHODS:A total of 20 cases undergoing total knee arthroplasty were chosen.The hospital for special surgery scores were used to evaluate patients’ functional recovery at 12 months after total knee arthroplasty. The periprosthetic femur was divided into four regions of interest (ROI), respectively ROI 1-4;periprosthetic tibia was divided into three regions of interest, respectively ROI 5-7. Stress surrounding the prosthesis was analyzed using three-dimensional finite element analysis at 1, 3, 6 months, 1, 2, 3 years after replacement. Simultaneously, bone mineral density surrounding the prosthesis was measured using dual-energy X-ray absorptiometry. ＜br> RESULTS AND CONCLUSION:No patients affected infection or loosening of the prosthesis. At 12 months after replacement, the score of hospital for special surgery was (90.23±2.37), which showed significant differences as compared with before replacement (39.68±1.31) (P＜0.05). The level of stress shielding was highest in ROI 5 and lowest in ROI 3. Stress shielding rate of ROI increased with statistical difference at 6 months after operation (P＜0.05). At 1, 2, 3 years after operation, shielding rate in periprosthetic femoral stress in ROI 1 decreased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). However, shielding rate of tibial periprosthetic stress in ROI 6 increased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). Bone mineral density after 1 month after operation had no significant decrease (P>0.05). At 3 months after operation, bone mineral density began to decline significantly (P＜0.01). The decrease was most obviously in ROI 5 and the change was least in ROI 3. After 1 year of operation, bone mineral density did not change significantly. These data indicated that changes in bone mineral density were correlated with stress shielding after total knee arthroplasty. Monitoring two variations can provide theoretical data for preventing bone loss, which provides references for clinical rehabilitation guidance.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

Objective The study is intended to examine changes in prefrontal cortex ATP concentrations over time in PCPA induced insomnia rats,and to examine the intervention effects of Suanzaoren decoction.Methods SD rats randomly assigned to normal control,control,model,SZRD control,SZRD treatment,5-HTP,and 5 HTP + SZRD groups.PCPA was injected intraperitoneally over three days to induce the insomnia model.One day after induction,at the fourth,fifth,sixth,eighth,and tenth days after experiment,subjects from each group were examined for prefrontal cortex ATP concentration using the HPLC method.Results Prefrontal cortex ATP concentrations in the PCPA Model group at the fourth,fifth,sixth,eighth,and tenth days were declined significantly compared with the Control group (P＜0.01).Compared with the PCPA Model group,the SZRD treatment group showed significant (P＜0.05) increase at the fourth,fifth,sixth,and eighth days after assay,and a significant increase (P＜ 0.01) on the tenth day.A comparison of the Control group with the Normal control group,and a comparison among the SZRD control group,the 5 HTP,and 5-HTP+SZRD groups showed no significant differences in prefrontal cortex ATP concentrations.Conclusion SZRD with 5 HTP itself has no significant effect on normal rats prefrontal cortex ATP levels,SZRD role of the prefrontal cortex appear to the ATP after PCPA caused insomnia.

Objective To explore the efficacy of tigecycline combined with cefoperazone/sulbactam in the treatment of infections due to multiple drug resistant strains and pandrug-resistant acinetobacter baumannii, so as to guide the reasonable clinical medication.Methods A total of 16 cases of ventilator associated pneumonia caused by multiple drug resistant strains and pandrug-resistant acinetobacter baumannii treated in the First Hospital of Shijiazhuang from November 2012 to November 2014 were retrospectively analyzed, and the severity of the infection, clinical efficacy and mortality were observed.Results The multiple drug resistant strains and pandrugresistant acinetobacter baumannii were frequently detected in the 16 patients.Fifteen cases had been used other antibiotics before tigecycline, such as imipenem, cefoperazone/Shubatan, minocycline etc.The severity of underlying disease was assessed with the acute physiology and chronic health score(APACHE Ⅱ sore) within 24 h of admission, on the first day of tigecycline (TGC) therapy and after 7 days of TGC therapy.It showed that the average APACHE Ⅱ score were (25±6.0), (24.2±6.4) and (17.8±6.6) within 24 hours of admission(P＜0.01), on the first day of TGC therapy and after 7 days of TGC therapy.Thirty days after application of the TGC, the bacterial eradication rate was 56.25％ (9/16).The effective rate was 87.5％ (14/16).The failure rate was 12.5％ (2/16).Conclusion The effect of the tigecycline combined with cefoperazone/sulbactam on the clearance of the multiple drug resistant strains and pandrug-resistant acinetobacter baumanniiis is satisfied.

Abstract: Mosquitoes are involved in the transmission of serious diseases such as malaria, dengue, chikungunya, yellow fever, Zika virus disease, and filariasis, and their prevention and control have always been a research hotspot. Currently, mosquito control methods mainly include physical control, chemical control and biological control. Physical control methods are environmentally friendly, but they are slow to take effect and have unsatisfactory control effects; although chemical control can quickly eliminate mosquitoes, it has been eliminated due to its high pollution, high residual, and easy drug resistance; biological control uses natural enemies or pathogens to kill mosquitoes and reduce their ability to transmit disease. Therefore, environmentally friendly biological control has become the main measure for controlling and preventing mosquitoes. In recent years, significant progress has been made in bacterial mosquito control agents, among which Bacillus thuringiensis has been the most extensively studied. Bacillus thuringiensis is a Gram-positive soil microorganism, which is the pathogenic bacterium of a variety of agricultural pests such as Lepidoptera, Coleoptera and Diptera. During the sporulation process, its strains produce a variety of insecticidal crystal proteins (ICPs) or δ-endotoxins with insecticidal activity against mosquito larvae. This review firstly introduces the crystal proteins of Bacillus thuringiensis, describes in detail the types and structures of crystal proteins in detail, and also reveals the mechanism of action of crystal proteins related to receptors.

Objective To study the sedative and analgesic effects of butorphanol combined with midazolam on critically ill patients treated by mechanical ventilation. Methods Fifty-eight patients who received mechanical ventilation, sedation and analgesia in intensive care unit (ICU) of Affiliated Huaian No.1 Hospital of Nanjing Medical University from January 2012 to December 2013 were enrolled. The patients were divided into a single midazolam group (30 cases) and a combination of butorphanol and midazolam group (combination with butorphanol group, 28 cases) according to the difference in types of sedative. The sedation for patients in the single midazolam group was induced firstly by intravenous injection of 0.05-0.10 mg/kg midazolam and followed by continuous infusion of the same drug 0.05 - 0.15 mg·kg-1·h-1 with a micro injection pump. The patients in the combination with butorphanol group were given a loading dose of butorphanol 10μg/kg and followed by continuous infusion of 10-20μg·kg-1·h-1 butorphanol combined with 0.05 - 0.15 mg·kg-1·h-1 midazolam by a micro pump. The Ramsay anesthesia score and visual analogue scale (VAS) were used to evaluate the sedative and analgesic effects. According to the Ramsay score, the sedation depths of patients in the two groups were maintained at 2-4 grades, and reassessed every 1-2 hours. The mean arterial pressure (MAP), heart rate (HR) and pulse blood oxygen saturation (SpO2) were observed before and after the drug administration in two groups. Results There were no statistically significant differences in MAP, HR and SpO2 between single midazolam group and combination with butorphanol group before treatment [MAP (mmHg, 1 mmHg=0.133 kPa): 121.3±6.2 vs. 118.6±8.7, HR (bpm):129.5±14.1 vs. 125.5±16.3, SpO2:0.744±0.112 vs. 0.756±0.131, all P>0.05]. Compared with those before treatment, after treatment, the above indexes in two groups were significantly improved, the differences being statistically significant [single midazolam group:MAP (mmHg) 88.7±6.5 vs. 121.3±6.2, HR (bpm) 85.3±13.4 vs. 129.5±14.1, SpO2 0.937±0.056 vs. 0.744±0.112; combination with butorphanol group: MAP (mmHg) 82.6±7.3 vs. 118.6±8.7, HR (bpm) 89.6±14.7 vs. 125.5±16.3, SpO2 0.943±0.078 vs. 0.756±0.131, all P < 0.05], and the degree of improvement of the combination with butorphanol group was better than that of the single midazolam group. The initial acting time of drugs and the time awakening from anesthesia in the combination with butorphanol group were shorter significantly than those in the single midazolam group (minutes: 33.6±6.2 vs. 73.3±12.2, 71.8±19.3 vs. 103.5±30.1, both P < 0.05), and the incidence of adverse reaction was lower obviously than that in the single midazolam group (0 vs.13.3%, P < 0.05). Furthermore, the score of VAS in the combination with butorphanol group was lower significantly than that in single midazolam group (8.4±1.2 vs. 2.4±0.8, P < 0.05). Conclusions Butorphanol combined with midazolam for treatment of critically ill patients with mechanical ventilation is a very effective sedative method, which may improve the degree of patients' tolerance towards the measure and reduce the incidence of adverse reactions.

Objective To discuss the mid?to long?term results and possible prognostic factors of Bernese periacetabu?lar osteotomy for adolescents and young adults with developmental dysplasia of the hip. Methods Bernese periacetabular os?teotomy was performed on 162 patients (171 hips) with hip dysplasia from August 1997 to July 2009. Follow?up data was ac?quirable completely in 123 cases (137 hips), including 30 males (33 hips) and 93 females (104 hips). Age of surgery was 12-48 years (average 27.1 years). The X?ray radiographs and Harris scores were recorded preoperatively and at the last follow?up. The lateral center?edge angle (LCE), acetabular incline angle (AI), continuity of Shenton's line were also recorded. The grades of the hip osteoarthritis were classified by T?nnis classification. Insufficient corrections of osteotomy, excessive corrections of osteotomy, nonunion of the pubis, nerve injuries, and vascular injuries were recorded as complications. Results All the con?tactable cases was followed up again in June and July in 2014. Follow?up duration was 5-17 years (mean, 8.1 years). The LCE angle improved from 7.13° ± 8.86° preoperatively to 30.17° ± 14.98° at the final follow?up. The T?nnis acetabular incline angle decreased from 27.84° ± 12.85° preoperatively to 7.06° ± 10.58° at the final follow?up. The continuity of Shenton's line was in?tact in 106 cases postoperatively, compared with 87 cases preoperatively. Harris score improved from 83.34±9.82 preoperative?ly to 92.79±7.05 at the last follow?up. There was significant correlation between preoperative Harris score and Harris score at the last follow?up. Early complications were observed in 15 cases (15 hips), along with 17 cases (17 hips) of progressions of hip osteoarthritis. Survival rate of the hip at the last follow?up was 97.8%. Conclusion Bernese periacetabular osteotomies can significantly improve bone coverage and joint function of hip dysplasia patients with low rate of short?term complications. Further?more, there was little osteoarthritis progression observed, with good survival rate of the joint in mid?to long?term follow?up. Lower pre?operative Harris scores and higher pre?operative T?nnis classifications are important prognostic factors for post?operative pain.