[Objective]To explore the techniques and effect of atlantoaxial instability with posterior transarticular screw fixation.[Method]A prospective clinical analysis was performed for the results of the modified posterior C1、2 transarticular screw fixation,in which the middle site of lower margin in the axial inferior articular process was used as the screw entry point in the procedure.Twenty cases of atlantoaxial instability underwent the modified C1、2 stabilization with morselized autograft from September 2001 to September 2006.There were 15 males and 5 females,averaged 32.2 years(range 17 to 49 years).Of them,4 cases suffered from fresh injuries,14 from old trauma,1 from congenital deformity,and 1 from intraspinal tumor.Postoperative indexes including the reduction extent of vertebral body,internal fixation,bone fusion,clinical symptoms and their complication were observed periodically.[Result]Bilateral screw fixation was used alone in 17 cases,with Gallie interspinous wiring for added stability in 3.Anatomical reduction of the atlantoaxial joints was achieved in19 cases,while rotational dislocation was restored to a great extent in 1.Fixation of all the internal devices was very well in the group.All cases were followed up from 16 to 64 months(21 months on average).C1、2 bony fusion was obtained in postoperative 2 to 3 months,clinical symptoms relieved and no complications occurred.[Conclusion]The modified posterior transarticular screw fixation using new screw entry site is recommended as an effective treatment for C1、2 instability due to its simple procedure and satisfying curative effect.

The aim of the eight year medical education program is to cultivate high-leveled and high qualified clinical and research personnel.Constructing forensic interest group for medical students of eight year program can not only cultivate the students' English learning,innovative thinking and practice ability,which is their Achilles heel but also combine eight year medical education with forensic science teaching reform.

Eight-year-system medical education is a kind of elite education. The object of this education model is to train medical personnel with medical doctorate. Forensic science is a highly practical medical discipline, closely related with the clinical medicine. This paper performs some explorations of the role of forensic science in 8-year-program medical education. Eight-year-program medical education should be combined with the high practicality of forensic science. For the Eight-year-program students, we should focus on cultivating their creative ability, practical ability, and sense of self-protection.

Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon-tipped floating catheter by femoral vein approach.Methods 86 patients in this study were treated with bedside temporary cardiac pacing by femoral vein for arrhythmias.A balloon-tipped floating catheter was inserted through the femoral vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG).After that,the pacing site was identified by X-ray fluoroscopy.Then,the feasibility and successful rate of this bedside temporary cardiac pacing,and the causes for failure were analyzed.Results Guided by the length of catheter and the QRS morphology of pacing ECG,the succesful rate of balloon-tipped floating catheter putted into right ventricle was 98.8%.The most successful pacing sites were located at the right ventricular apex(RVA) and right ventricular out-flow tract(RVOT).The lengths of catheter from the puncture sites to RVA and RVOT were (57.2?3.2)cm and (54.3?3.1)cm,respectively.Incidence of undersensing in RVOT pacing group was significantly higher than that in RVA pacing group(P

Objective To study the effects of enhanced external counterpulsation (EECP) on the diastolic heart failure in hypertensive patients.Methods 104 hypertensive patients with diastolic heart failure were randomly divided into treatment group and control group,52 patients were given 36 hours of treatment EECP.After 6 months,Doppler ultrasound recordings were obtained from all patients to determine the left ventrlcular diastolic function.Resuits Left ventricular diastolic function index and the left ventrich mass weight index (LVMI) wero impmved after treatment in both groups(P＜0.01),and EECP treated group was better than control group(P＜0.05).Conduslon For hypertensive patients with diastolic heart failure,EECP could not only improve heart diastolic function,but also reverse reconstruction of the left ventricuhr.

Objective To evaluate the efficacy of anatomical locking titanium plate via the posterior elbow approach in the treatment of comminuted fractures of proximal ulna.Methods From January 2011 to December 2013,22 comminuted fractures of proximal ulna were treated by anatomical locking titanium plate via the posterior elbow approach.They were 14 men and 8 women,from 21 to 57 years of age (average,42.7 years).Nine cases were on the left side and 13 on the right.All were unilateral closed fractures.By the Schatzker classification,12 cases were type Ⅲ A,6 type Ⅲ C and 4 a combination of type Ⅲ A and type Ⅲ C.The Broberg & Morrey criteria were used to evaluate the elbow function one year postoperation.Results The follow-ups for the 22 cases ranged from 12 to 24 months (average,16 months).All the cases obtained clinical healing after 10 to 16 weeks (average,13 weeks).According to the Broberg & Morrey criteria,12 cases were evaluated as excellent,7 as good,and 3 as fair,yielding an excellent to good rate of 86.4％.No such complications as infection or necrosis of soft tissues,elbow stiffness,or obvious pain were observed during the follow-up period.Conclusion It is an effective treatment of comminuted fractures of proximal ulna with anatomical locking titanium plate through the posterior elbow approach.

Objective To establish the diagnosis of am niotic fluid em bolismwith blood sam ples by liq-uid-based cytology technique and to study the validity of m ethod. Methods The blood sam ples were collected from patients who suffered from am niotic fluid em bolism. The com ponents of am niotic fluid in blood samples were examined with blood smear by two direct smear methods(supernatant smear, sedi-ment smear) and two liquid-based cytology methods(autom atic smear, manual smear). The positive de-tection rate of each m ethod was calculated. Results The positive detection rates of two liquid-based cy-tology methods(84.6% and 92.3%, respectively) were m uch higher than those of two direct methods(53.8% and 61.5%, respectively). Conclusion The liquid-based cytology technique could im prove the positive detection rate of am niotic fluid em bolism.

Objective To investigate the relationship between resting heart rate(RHR) and prognosis of acute coronary syndromes without ST-segment elevation.Methods 167 patients of ACS without ST-segment elevation admitted to hospitals consecutively from Oct. 2001 to Oct. 2004 were divided into five groups according to the levels of RHR[RHR 1 group:RHR

An autopsy case of sudden death induced by alimentary tract hemorrhage was presented, which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic a-neurysm (TAAA). The initial diagnosis was made of the syndrome of coronary heart disease and hyper-tensive disease. The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sud-den rupture of the mass after posture changing was ascertained as the cause of death. The diagnosis of TAAA was determined by the autopsy findings. Analysis for the medical dispute of TAAA was de-scribed, and the difficulty of the diagnosis and medico-legal implications were also discussed.

Objective To study the effects of hyperbaric oxygen on the diastolic heart failure in hypertensive patients. Methods 60 hypertensive patients with diastolic heart failure were randomly divided into treatment group and control group. Conventional therapies were given to patients of both groups. In addition, hyperbaric oxygen therapy was applied to those of treatment group. After 3 months, Doppler ultrasound recordings were obtained from all patients to determine the left ventricular diastolic function. Results The indexes of left ventricular diastolic function were im-proved after treatment in both groups(P < 0.01) ,and treatment group was better than control group(P < 0. 05). Conclusion For hypertensive patients with diastolic heart failure, hyperbaric oxygen can improve heart diastolic function.