150 cases of pediatric surgery with cleft lip and palate were randomly divided into two groups:During extubation of group A retired the pipe to the throat,when stable vital signs appeared,pulse oxygen saturation(SpO2) sustained more than 95% in 5 min or when patients were not tolerant,pulled it out.Group B pulled out the catheter directly if there was a sign of extubation.The oxygen saturation was observed in two groups before extubation,5 and 10 min after extubation.Retiring to the throat and then pulling out is an effective way to prevent tongue falling and occurrence of hypoxemia.

The patent strategy is one of the significance strategies of intellectual property rights that are severe competitive key-point in all country.Based on the characteristics of the pment strategy and actualities of Chinese medicine patent,as well as the macroscopical analysis of key-issues of patent this paper put forward several suggestions on the patent strategy of Chinese medicine patent.which could offer some information to help making decision for the government official.

As one of the most catastrophic complications, prosthetic joint infection remains one of the most stubborn medical problems.However, the biomarkers and laboratory tests commonly used often exhibit either a low sensitivity or a low specificity, which makes it still difficult to diagnose.Therefore, we summarize a number of recent new developments home and abroad, and overview from the aspects of serological markers, synovial fluid markers, radionuclide imaging methods, preoperative periprosthetic tissue biopsy, in-traoperative periprosthetic tissue culture, histological analysis of periprosthetic tissue and new molecular technology.

Objective:To study the promotion effect of recombinant human acidic fibroblast growth factor ( rh-aFGF) on wound healing in children with surgery or accident injury. Methods: Totally 206 cases of injured children were randomly divided into two groups, the treatment group was given rh-aFGF, and the control group was treated with basic fibroblast growth factor (bFGF). The ob-servation of wound healing, infection and fat liquefaction in the children was recorded in 7 days,and the modification of scar, pigmenta-tion and adverse reactions were observed in 6 months after the treatment. Results:After the 7-day treatment by rh-aFGF and bFGF, the healing rate respectively was 88. 4% and 74. 2%, and the residual wound area was (2. 2 ± 1. 1) cm2 and (3. 9 ± 2. 4) cm2,respec-tively. Six months after the treatment, the scar incidence rate of the treatment group and the control group was 27. 2% and 67. 5%, and the incidence of pigmentation was 30. 1% and 69. 9%, respectively. Conclusion:Rh-aFGF is more effective than bFGF in pro-moting wound healing in children with surgery or accident injury. It can effectively promote wound healing, shorten the healing time, and diminish the area of scar and pigmentation.

Objective To explore the relationship between postoperative cancer-related fatigue and nutritional risk in patients with colorectal cancer. Method Using convenience sampling method, 159 postoperative colorectal cancer patients were interviewed with cancer-related fatigue scale and PG-SGA 7 days after operation. Results The average score of CRF was (21.28 ± 6.06). The score by PG-SGA was (15.18 ± 5.55). About 94.34%patients were in need of nutritional intervention. The postoperative cancer-related fatigue was positively related to PG-SGA scores(all P<0.05). Conclusions The postoperative colorectal cancer patients are at a high risk of malnutrition, with nutrition risk positively related with somatic cancer-related fatigue. The clinical nursing staff should pay attention to the nutritional status of patients and correct their malnutrition so as to reduce the symptoms of cancer-related fatigue.

BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis. OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications. METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patel a was not replaced. Posterior stabilized prosthesis was used. Al patients were successful y fol owed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final fol ow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.

BACKGROUND:Vacuum-sealing drainage in wound skin grafting can close wound, reduce the leakage, promote granulation hyperplasia and improve skin new speed.
OBJECTIVE:To compare the clinical effects of two kinds of wound surface dressings used in wound skin grafting.
METHODS: Eighty patients who needed skin grafting for trauma were retrospectively studied and chosen from September 2010 to March 2012. They were divided into two groups: biomaterial group (dressings mainly made of luffa fibers) and synthetics group (seaweed polyvinyl alcohol foam). The vacuum-sealing drainage device and wound dressing were removed after 1 week treatment. The skin grafting coverage and wound healing time were recorded.
RESULTS AND CONCLUSION:Al patients of two groups got effective skin grafting coverage rate, and no patient appeared with infection and nonunion. The skin grafting coverage and wound healing time of the biomaterial group significantly differed from the synthetics group (P< 0.05). These findings indicate that compared to the synthetic material group, the biomaterial group can be better for effective drainage, good circulation, bacteria inhibition and fast repair.

Objective To discuss the principles of surgical treatment of closed spinal cord injury. Methods The treatment and outcome of a series of 210 patients with closed spinal cord injury admitted to our department from Jan, 1990 to Jan, 2003 were retrospectively analyzed. Results Of the 210 patients, 113 cases (53.8%) were classified as grade A, 49 cases (23.3%) as grade B, 37 cases (17.6%) as grade C, and 11 cases (5.2%) as grade D, respectively, according to Frankel's classification. After treatment and followed-up for 3 months to 10 years, 42 cases (20.0%) were re-classified as grade A, 15 cases (7.1%) as grade B, 45 cases (21.4%) as grade C, 61 cases (29.0%) as grade D, and 47 cases (22.4%) as grade E. Conclusion Surgical treatment for a patient with closed spinal cord injury depends on findings of examination of the nervous system, tomographic examination of the spinal cord, indications for decompression of the spinal cord, stabilization of the spine, early ambulation and rehabilitation. Principles of the treatment of closed spinal cord injury include early treatment, decompression of the spinal cord with operation, reduction and fixation, prevention of complications, and rehabilitation.

Objective To observe the recombinant human acidic fibroblast growth factor (rh-aFGF) treatment of open fractures of the tibia and fibula efficacy and safety.Methods Seventy-two cases of open fractures of tibia and fibula patients were selected,all patients were given the C-arm X-ray machine to guide needle,debridement,the entire complex fractures,external fixa tion device postoperative were given anti-infection treatment.Treatment group were given rh-aFGF 1-5 soluble solvent cleaning wounds and skin grafts,suture given daily dressing (3-4 spray/cm2,6-8 times/d).The control group was not given medication,continuous treatment after 7-14 d assess wound healing,wound complications and infection.Results Treated the wounds healing time,healing time,the incidence of delayed fracture healing,skin graft survival area,walking function recovery time,edema score,pain score,the incidence of severe infection and late healing in treatment group were significantly better than those in control group:(27.2 ± 13.1) d vs.(34.7 ± 12.3) d,(55.4 ± 17.4) d vs.(62.2 ± 18.7) d,(99.2 ± 1.2) ％ vs.(92.6 ± 3.6) ％,(2.2 ± 0.4) scores vs.(3.8 ± 0.4) scores,(2.1 ± 0.4) vs.(3.7 ± 0.2) socres,5.6％ (2/36) vs.30.6％ (11/36),2.8％ (1/36) vs.19.4％ (7/36),there were statistical differences (P ＜ 0.05).rh-aFGF treatment of major adverse reactions were mild itching.Conclusion The recombinant human acidic fibroblast growth factor can accelerate wound healing and reduce post-operative complications,reducing infection.

The early diagnosis , the prediction of recurrence and metastasis of osteosarcoma and avoiding chemotherapy resist -ance play a key role in the therapeutic areas of osteosarcoma .DNA methylation is the main reason of activation of oncogene and inacti-vation of tumor suppressor gene .It has been proven that the methylation of multiple genes is closely related to clinical indicators and targeted therapy of osteosarcoma .It is expected that DNA methylation can be used for the clinical diagnosis and treatment of osteosarco -ma.In this paper, the relationship between DNA methylation and osteosarcoma is reviewed .