Objective Retrospectively investigate 76 cases of traumatic amputation and limb salvage so as to provide clinical reference for children amputation .Methods We retrospevtively investigated 38 cases of traumatic amputation admitted during July 1996 to May 2013(experimental group) ,and 38 cases of limb salvage cases at the same time(control group) ,and re‐evaluated them according to the MESS standards and LSI score .Statistical analysis of the two scoring systems for the inosculation of amputation was conducted .Results Both Mangled Extremity Severity Score and Limb‐salvage index system can be used as the estimation for the traumatic amputation .Conclusion Mangled Extremity Severity Score (MESS) and Limb‐salvage index (LSI) can be used as an evaluation of the traumatic amputation in children ,and LSI was more suitable for the children .

Objective To explore the independent design of database for radiologic report.Methods Using the Access2000 to establish the corresponding objects in the database; Using software EasySetup to make the installing software.Results The established software (CT Diagnosis Center, CT-DDC) included menu user-defined, interface of reporting input, interactive interface of query and printing, data sheet editing and backup, it could be carried by floppy disk easily, the installing and running were stable. Conclusion The database for radiolgic report can be exploited independently,using for radio-diagnosis by the clinical doctor,it is economic and available for popularizing use in the basic medical units.

Objective To investigate the association of C3435T genetic polymorphism of MDR1 gene with paliperidone plasma concentration in the patients with schizophrenia by detecting the paliperidone plasma concentration change and C 3435T genetic pol‐ymorphism of MDR1 gene during medication process .Methods The paliperidone plasma concentration in 61 patients with schizo‐phrenia was detected by adopting the liquid chromatography tandem mass spectrometry at the end of 1 ,2 ,4 ,6 weeks after medica‐tion .Meanwhile C3435T MDR1 genotype was determined by adopting the LDR‐PCR method .The paliperidone plasma concentra‐tions in the patients with different genotypes and different alleles were compared .Results Among 61 patients with schizophrenia , CC ,CT and TT genotypes accounted for 24 .59% (15/61) ,63 .30% (38/61) and 13 .11% (8/61) respectively ,in which the propor‐tion of heterozygote CT was significantly higher than that of homozygote CC and TT (P<0 .05) .The proportion of C and T allele were 55 .74% and 44 .26% respectively(P<0 .05) .The paliperidone plasma concentration at 4 detection time points in the patients with TT genotype at 4 time points was significantly higher than that in the patientis with CC genotype ,and paliperidone plasma concentration only at the end of 1 week in TT genotype was significantly higher than that in CT genotype ,CT genotype was higher than CC genotype (P<0 .05) .The paliperidone plasma concentration at 4 detection time points in the patients of T allele was higher than that in the patients with C allele ,but statistically significant difference was only found at the end of 1 week (P<0 .05) .Conclu‐sion The C3435T genetic polymorphism of MDR1 gene has certain relationship with paliperidone plasma concentration in the pa‐tients with schizophrenia .

Objective To evaluate the treatment and p re vention of urethral stricture complicated by transurethral vapo-resection of pr ostate (TVP). Methods Retrospective analysis was conduct ed by reviewing medical records and following up the patients under study.Among 3012 patients with benign prostatic hyperplasia treated with TVP, urethral stric ture occurred 4 weeks to 22 months following surgery in 95 cases (3.15 %), inclu ding anterior in 47 (49.5%),posterior in 31 (32.6 %) and bladder neck contractur e or occlusion in 17 (17.9%).Their mean age was 68.7 years (range, 55 to 85 year s). Results The 95 patients were followed up for 4～36 m o nths (mean,14 months).Of them,65 cases underwent conventional dilation, in them 59 (90.8%) were cured and 6 had failure,then turning to internal urethrotomy;19 cases underwent internal urethrotomy plus dilation,in them,13 (68.4%) were cured and 6 had failure,then turning to urethroplasty;17 cases of bladder neck contra cture or occlusion underwent transurethral resection of bladder neck scar tissue ,with a cure rate of 88.2% (15 were cured and 2 experienced failure). Conclusions Urethral stricture is a common complication after TVP. The key points of managing the strictures are patients’ alert,close follow-up and early effective treatment.

Objective To investigate the effects of DRD1 rs265981,rs4532,rs686 and rs265976 polymorphisms on response to clozapine in resistant schizophrenic patients.Methods DRD1 genotype was determined by SNaPshot SNP technique for 154 patients with resistant schizophrenia.Clinical symptoms were evaluated by Positive and Negative Syndrome Scale (PANSS),and the responder was defined as a reduction of 50％ on PANSS score from baseline after the patients were administered orally clozapine for 8 weeks.Results The frequencies of rs265981 genotypes,alleles and rs265976 genotypes had significant differences between clozapine responder group (88 cases) and nonresponder group(66 cases) in total clinical efficacy ( x2 =10.215,P =0.004 ; x2 =4.082,P =0.041 ; x2 =14.083,P =0.007 ).The frequencies of rs265976 genotypes had significant differences between clozapine response (58 cases) and nonresponse (96 cases) to negative symptom ( x2 =9.805,P =0.046).Conclusion The polymorphisms of DRD1 gene rs265981 and rs265976 may relate with clinical response to clozapine in resistant schizophrenias.rs265981 T/T,allele T and rs265976 genotype A/A are likely to be predictive factors to the improvement of total clozapine therapeutic effects.rs265976 genotype A/A are likely to be predictive factors of negative symptom with treatment of clozapine.

Objective To evaluate the effect of tranexamic acid on the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.Methods Fifty-six ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 35-64 yr,with body mass index of 20-25 kg/m2,scheduled for elective revision total hip arthroplasty,were randomly divided into 2 groups (n =28 each):control group (group C) and tranexamic acid group (group T).After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.After intubation,tranexamic acid 15 mg/kg was injected intravenously followed by infusion at a rate of 10 mg·kg-1 ·h-1 in group T,while the equal volume of normal saline was given instead of tranexamic acid in group C.Before operation,at the end of operation,and at 6 and 24 h after operation,venous blood samples were obtained for routine blood test and for determination of parameters of coagulation.The intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were recorded.The development of venous thrombosis in the lower extremity was recorded with Doppler ultrasound on 7th day after operation.Results Compared with group C,the intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were significantly reduced,and hemoglobin and hematocrit were increased at the end of operation and different time points after operation (P ＜ 0.05),and no significant changes were found in activated partial thromboplastin time,prothrombin time and fibrinogen in group T (P ＞ 0.05).The incidence of venous thrombosis in the lower extremity was 18％ and 14％ in C and T groups,respectively,and there was no significant difference between the two groups (P ＞ 0.05).Conclusion Tanexamic acid infused at a rate of 10 mg· kg-1 · h-1 after a loading dose of 15 mg/kg injected during operation dose not increase the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.

Objective To compare the efficiency of compressive bandage dressing and drainage on the blood loss after total knee arthroplasty (TKA). Methods Patients (n=120) who visited Tianjin General Hospital Bin Hai Branch and Tianjin People's Hospital due to varus knee osteoarthritis and underwent TKA were retrospectively analyzed.There are 20 males and 100 females with, mean age was 65.18±6.88 years. Depending on whether placement of drainage, patients were divided into drainage group (60 cases) and pressure bandage dressing group (60 cases). Blood loss, blood transfusion and full blood count (FBC) were all analyzed after TKA in both groups. Results Blood loss after TKA in drainage and pressure dressing group were (1 026.85±274.44),(789.52±251.58) mL respectively. Blood loss was less severe in pressure dressing group than that in drainage group (t=4.938, P<0.01). Allogeneic transfusions were needed in 14 cases of drainage group and five cases of pres?sure bandage dressing group. The circumstances that requires blood transfusion was significantly lower in pressure bandage group than that in drainage group (χ2=5.065, P<0.05). The postoperative limb swelling and postoperative joint mobility did not show statistical significance (P>0.05). Conclusion Application of compressive bandage dressing in TKA surgery is easy to be operate and can reduce perioperative blood loss and allogeneic transfusion incidence.

PET and PET/CT are the methods of displaying the functional and metabolic changes in tissues. With its high sensitivity and specificity, it can be used as a noninvasive systemic functional examination. There are significant values in its diagnosing, staging, treatment directing and prognosis assessing in the malignant lymphoma.

Objective To investigate the dynamic changes of endothelial progenitor cells (EPCs) in peripheral blood of patients with hypertensive cerebral hemorrhage.Methods Flow cytometry was used to detect the dynamic changes of EPCs in 79 cases of hypertensive cerebral hemorrhages as the experimental group and 70 cases of normal healthy people as the control group.Results In the acute phase after hemorrhage (3 days),EPCs in experimental group [(51.3 ±9.3) × 103/ml,(52.0 ±6.3) × 103/ml,(53.1 ±9.3) × 103/ml] were significantly lower than the control group [(75.4 ± 15.6) × 103/ml] (P ＜0.05).However,after that the level of EPCs in experimental group [(110.9 ± 12.0) × 103/ml,(132.8 ± 11.8)× 103/ml,(115.3 ±9.9) × 103/ml] increased rapidly and was significantly higher than the control group (P ＜0.05),and approximately two weeks later it reduced to normal levels [(83.1 ±7.9) × 103/ml].Conclusions In patients with hypertensive cerebral hemorrhage,the levels of EPCs in peripheral blood were closely related with the disease and might become a prognostic marker.

Objective To evaluate the relationship between the anesthesia factor and myocardial injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eightyeight patients of both sexes,aged 42-71 yr,weighing 59-83 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective coronary artery bypass grafting with CPB,were divided into 4 groups (n =22 each) using a random number table:routine anesthesia control group (group C),dexmedetomidine-based anesthesia group (group D),sevofluranebased anesthesia group (group S) and dexmedetomidine combined with sevoflurane anesthesia group (group DS).After tracheal intubation,0.2％-2.1％ sevoflurane was inhaled until the beginning of CPB in S and DS groups.In D and DS groups,dexmedetomidine was intravenously infused as a loading dose of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of surgery.Before induction of anesthesia,before CPB,after the end of CPB,immediately after the end of surgery and at 24 h after surgery,venous blood samples were collected for determination of plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations by immunofluorescence.The restoration of spontaneous heart beat and adverse events such as hypotension,malignant arrhythmia,cardiac arrest and respiratory depression during surgery and within 24 h after surgery were recorded.Results Compared with group C,the plasma concentrations of CK-MB and cTnI were significantly decreased in the other three groups (P＜0.05).The plasma eoncentrations of CK-MB and eTnl were significantly lower in group DS than in S and D groups (P＜0.05).There were no significant differences in the rate of restoration of spontaneous heart beat among the four groups (P＞ 0.05).No adverse events were found during surgery and within 24 h after surgery in the four groups.Conclusion Dexmedetomidine combined with sevoflurane anesthesia is helpful in reducing myocardial injury and provides better efficacy than either alone in the patients undergoing cardiac surgery with CPB and is more suitable for cardiac surgery with CPB.