Objective To compare the outcomes of operative with non-operative treatment for thoracolumbar burst fracture without neurological deficit using Meta-analysis.Methods Electronic database were searched from inception to February 2014 by two independent reviewers,including Pubmed Medline,Excerpta Medica Database (Embase),Cochrane Central Register of Controlled Trials,Chinese Biology Medicine (CBM),Chinese Wanfang Database,and China National Knowledge Infrastructure (CNKI).Inclusion and exclusion criteria were applied to select the studies.Quality appraisal and data extraction were based on Cochrane Collaboration guidelines.Results Two randomized controlled trials (RCTs),which reported outcomes for 79 patients (41 with operative treatment and 38 with nonoperative treatment) at a follow-up of two years or more were included.Between-study heterogeneity was found to be significant,for one reported better results in surgery group concerning pain relief,function recovery and returning to work.However,opposite results were found in another trial.Meta-analysis showed surgery led to higher complication rates (RR =2.85,95％ CI 0.83-9.75),including subsequent surgery (RR =8.39,95％ CI 1.12-62.87).Conclusion Operative and nonoperative managements produce similar results with respect to pain relief,function regain,and returning to work when performed for thoracolumbar burst fractures without neurologic deficit,but operation is often associated with more complications.

We investigated the distribution of Chlamydia trachomatis genotypes in the outpatients visiting STD clinics in Fuzhou City ,China .Between 2013 and 2014 ,a total of 2 019 urethral or endocervical specimens from susceptible genital C .trachomatis infections were collected and detected by using real‐time PCR assay kit .The C .trachomatis‐positive specimens were subsequently amplified with nested PCR for Omp1 region and analyzed by sequencing .Genotyping was performed by BLAST similarity search and phylogenetic tree analysis .Eighty‐three of the 86 C . trachomatis‐positive specimens were suc‐cessfully sequenced .Only one specimen was identified as multiple infection .Eight different genotypes were identified .The most prevalent was F (36 .59% ) ,followed by E (24 .39% ) ,D (12 .20% ) ,G (9 .76% ) ,J (9 .76% ) ,H (3 .66% ) ,K (2 .44% ) and B (1 .22% ) .Synonymous mutation rate and non‐synonymous mutation rate among Omp1 genes of different geno‐types were calculated .All genotypes but G showed dN/dS values of<1 .Genotypes F and E were commonest .Synonymous sub‐stitution was the major pattern of variation in the process of Omp 1 gene evolution .

Objective To investigate the value of myocardial enzymes and cerebrospinal fluid examination in diagnosis of hand , foot and mouth disease(HFMD) complicated with systemic inflammatory response syndrome (SIRS) and multi-organ dysfunction syndrome(MODS) .Methods During April 2010 to January 2013 ,204 cases were retrospectively analyzed and checked myocardial enzymes and cerebrospinal fluid examination of the children to analyze the correlation between inspection results and incidence of SIRS and MODS .Results The incidence of SIRS and MODS and mortality rate of severe and critical group was significantly higher than ordinary group(P<0 .05) .CSF protein ,CK-MB ,LDH and cTnT content of SIRS group were significantly higher than non-SIRS group(P<0 .05) .CSF protein ,CK-MB ,LDH and cTnT content of MODS group were significantly higher than non-MODS group(P<0 .05) .Spearman rank correlation analysis showed that CSF protein ,CK-MB and cTnT was positively correlated to inci-dence of SIRS and MODS(P<0 .05 ,P<0 .05) .Conclusion Myocardial enzymes and cerebrospinal fluid examination have a higher value in diagnosis of HFMD complicated with SIRS and MODS .

Objective: To observe the therapeutic efficacy of acupuncture combined with hyperbaric oxygenation for cervical spondylosis of nerve root type in acute phase.
Methods: One hundred cases with cervical spondylosis of nerve root type in acute phase were randomly divided into two groups, with 50 patients in each group. The patients in the treatment group were treated by acupuncture combined with hyperbaric oxygenation, and those in the control group only received the same acupuncture therapy as the treatment group. The therapeutic efficacy was evaluated after 2 courses of treatment.
Results: In the treatment group, 27cases were cured, 9 cases showed markedly effective, and 4 cases were invalid, and the recovery rate was 67.5%, the total effective rate was 90.0%; in the control group, 18 cases were cured, 17 cases showed markedly effective, 15 cases were invalid, and the recovery rate was 36.0%, the total effective rate was 70.0%. There were statistically significant differences between two groupsin the recovery rate and the total effective rate (bothP<0.05). The average cure time of the treatment group was (15.56±7.13) d, and that of the control group was (22.13±7.78) d, which also had significant difference between the two groups (P<0.05).
Conclusion: Acupuncture combined with hyperbaric oxygenationhas rapid and reliable effects for cervical spondylosis of nerve root type in acute phase.

Objective To investigate the condition of the professional identity and learning burnout in the college students majored in re-habilitation therapy, and discuss the correlation between them. Methods From October to November, 2014, students of grades 2 and 3 ma-jored in rehabilitation therapy were investigated with the professional identity questionnaire and the learning burnout questionnaire. Results A total of 127 questionnaires were sent out, and 119 returned. The score of professional identity was (3.36 ± 0.55), with the factors score of the cognition, emotion, behavior, appropriateness as (3.66±0.77), (3.25±0.60), (3.23±0.71), and (3.36±0.61), respectively. The score of learn-ing burnout was (2.90±0.46), the score of factors of low spirits, improper behavior and low achievement as (2.87±0.70), (3.10±0.60), (2.77± 0.52), respectively. There was negative correlation between score of professional identity and learning burnout (r=-0.271, P<0.01), as well as between some factors of the identity and the learning burnout (P<0.05). Conclusion The professional identity and learning burnout are in the middle level in students majored in rehabilitation therapy, which may interact each other.

Objective: To evaluate the therapeutic effects of Tuina and hyperbaric oxygen on prolapse of lumbar intervertebral disc. Methods: The included 160 cases of prolapse of lumbar intervertebral disc were allocated into a treatment group and a control group. The 100 cases in the treatment group were treated with tuina manipulation and hyperbaric oxygen. The 60 cases in the control group were treated with tuina manipulation. The total effect and scores of symptoms and signs were compared before and after treatment. Results: The total effective rate in the treatment group was 100.0%, and 83.0% in the control group. Conclusion: Tuina and hyperbaric oxygen had excellent effects on the prolapse of lumbar intervertebral disc, by improving the clinical symptoms and signs of ache and movement restriction of lower back and leg, and recovering the ability of work and daily life.

Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P<0.01). Some patients with typeⅢDSWI showed only local symptoms of surgery. The organisms most common?ly isolated in patients with DSWI were gram gram?negative bacilli(GNB,54.8%). Although there was no significant difference between the 3 types of DSWI patients(P>0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.

[Objective]To investigate the feasibility and short-term effects of arthroscopic suture fixation with cannulated screw and washer for bony avulsion of the posterior cruciate ligament.[Method]Arthroscopic suture fixation with cannulated screw and washer was carried out in 30 patients with bony avulsion of the posterior cruciate ligament.The posterior cruciate ligament and avulsion bone fragment were held together with two Ethibond 5 polyester threads,which were first wrapped around the posterior cruciate ligament from the anterior to the posterior,and then tied behind the posterior cruciate ligament and over the bone fragment.The threads were pulled out through tibia tunnels,tighted and fixed on cannulated screw and washer under the tibia tunnels 2 cm.[Result]The operation time were 60-90 min.A follow-up was made in 10 patients for 6-12 months.All fractures were united without displacement at 6 weeks after operation.No postoperative complications occurred.The Lysholm scores were 83-95(89.6?4.03).[Conclusion]Arthroscopic suture fixation with cannulated screw and washer for bony avulsion of the posterior cruciate ligament technique is simple to perform and gives a satisfactory short-term results.

Objective To investigate the diagnosis and treatment of latent perforation of peptic ulcer (LPPU) during laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 13 cases of LPPU diagnosed during LC from January 1994 to November 2005. Results All the 13 cases were misdiagnosed before the LC and clarified as having LPPU during the LC. Three cases of anterior duodenal bulbar perforation (0.4~0.5 cm in size) were laparoscopically repaired, whereas conversions to open repair were performed in 5 cases of duodenal perforation (0.5~1 cm in size) and 5 cases of gastric perforation (0.6~1 cm in size) because of severe adhesion or difficult performance. No surgical complications occurred. Twelve cases were followed for 6~36 months (mean, 27 months). The symptoms disappeared and gastroscopy showed healed ulcer. No recurrence of perforation was found. Conclusions Underestimation of LPPU leads to misdiagnosis, and preoperative gastrosopy can prevent it. For small perforation, laparoscopic repair and abdominal drainage can be employed. But in most cases, a conversion to open surgery is required. It is necessary to give regular internal medicine for peptic ulcer after operation.

Objective To investigate laparoscopic treatment of hepatic cysts in the right posterior lobe.Methods A four-port laparoscopic fenestration and drainage was performed in 35 patients with symptomatic hepatic cysts in the right posterior lobe(the lesion was located at the segment Ⅳ in 21 patients and at the segment Ⅶ in 14 patients) from January 1998 to December 2005.For cysts located at the superior segment of the right posterior lobe,the operation was performed through the suprahepatic approach. The liver was pressed along the anterior and inferior direction by using a pair of traction tongs for the exposure of hepatic cysts.Then the cyst was fenestrated and filled with pedicled greater omentum.For cysts located at the inferior segment of the right posterior lobe,the operation was conducted through the infrahepatic approach.The hepatocolic ligament,right triangular ligament,and connective tissues between the liver and the kidney were opened by using a harmonic scalpel.The liver was lifted with the traction tongs,and the cyst was fenestrated and filled with greater omentum.Results Laparoscopic fenestration and drainage was accomplished in all the 35 patients,without conversions to open surgery.The suprahepatic approach was adopted in 15 patients and the infrahepatic approach,in 20 patients.The operation time was 30～95 min(mean,46 min).No surgery related complications occurred.Pathological examinations in the 35 patients showed congenital cysts of liver.After operation,patients' symptoms all disappeared.The postoperative hospitalization time was 2～5 days (mean,3.8 days).All the 35 patients were followed for 6～36 months(mean,34 months).The cyst did not completely disappeared but significantly subsided in 2 patients(suprahepatic approach),without remarkable symptoms.The cysts were not obviously enlarged within 6 months.Conclusions Laparoscopic fenestration and drainage via suprahepatic or infrahepatic approach is an effective treatment for hepatic cysts in the right posterior lobe.