Objective To investigate the relationship between body mass index(BMI)and cardiac structure and function of adult men living in Hebei province.Methods A total of 160 adults were assigned to 4 groups by BMI:normal body weight group(group A,BMI 18.5 to 23.9 kg/m2),overweight group (group B,BMI 24.0 to 27.9 kg/m2),mild obese group(group C,BMI 28.0 to 29.9 kg/m2),and severe obese group(group D,BMI ≥ 30 kg/m2).Left ventricular end-diastolic diameter(EDD),end-systolic diameter(ESD),inter ventricular septal thickness(IVS),left ventricular posterior wall thickness (LVPW),left ventricular mass(LVM),and left ventricular mass index(LVMI)were examined by echocardiography.Early(E)peak diastolic and late(A)diastolic mitral inflow velocity and E/A ratio were measured by Doppler echocardiography.Pulsed wave Doppler tissue image(PW-DTI)of the lateral mitral annulus was performed to evaluate early peak diastolic velocity(Em),late peak diastolic velocity(Am)and Em/Am ratio.Results Compared with group A,EDD,ESD,LNM,LVMI,Am,IVS and LVPW were increased in the other 3 groups(all P ＜ 0.05).E,E/A ratio,Em,and Em/Am ratio were decreased in group B,C,and D(all P ＜ 0.05).Compared with group B,Sm was decreased in group C and D(both P ＜ 0.05).Conclusion Overweight and obesity could contribute to ventricular hypertrophy and deteriorate diastolic function in a BMI dependent manner.Obesity may be also related to decreased Sm.

Objective To evaluate the clinical effect and application value of internal fixation of Magerl combined with Brooks technique for atlantoaxial instability. Methods A total of 18 patients with atlantoaxial instability, reducible atlantoaxial dislocation with reduction after traction and irreducible atlantoaxial dislocation with traction reduction after anterior laxation were treated with internal fixation of Magerl combined with Brooks technique using autologous bone grafts. Results The patients were followed up for an average 18 months (6-36 months). Screw was probably cut into the vertebral artery in one case. The guide needle was cut into the pharynx due to incorrectly penetrating the C 1 anterior arch of atlas for 3.5 cm in one case but no early complications such as spinal cord injury and local infection occurred. The spinal cord function improvement was marked in 3 cases, good in 9, mild in 4 but unchanged in 2. No case got worse. There were no loosening or break of the screw and cable. Conclusions Combined fixation of Magerl and Brooks techniques reaches three-point fixation and improves the reduction effect. It is necessary to use the combined fixation with best biomechanical stability for atlantoaxial dislocation patient with reduction or near reduction if the structure of the posterior arch of C 1,2 is intact.

Objective A design of guide wire localization apparatus for the internal fixation of dens fractures. Methods From October 1999 to February 2000, 5 cases of dens fractures were treated by anterior internal fixation using cannulated compression screws; 4 cases were of Anderson typeⅡ and 1 case was typeⅢ . The guide wire localization apparatus was used for all of the patients during operations. Results The operating time was 2 to 2.5 hours, averaging 2 hours 15 minutes. The amount of bleeding was 20 to 100 ml, averaging 60 ml. The time of follow-up was 5 to 9 months, averaging 6.7 months. The locations of all the 5 cannulated compression screws were excellent, positioning in the center of the odontoid process without deviation. 4 cases healed normally and 1 had delayed bone healing. Conclusion The use of a guide wire location apparatus increased the accuracy of internal fixation of screws in dens fracture, decreased X-ray to radiation to the bodies, and reduced the possibility of pollution in operation.

To summarize the clinical results of combined transoral anterior decompression and posterior decompression and internal fixation of irreducible atlantoaxial dislocation with spinal cord compression. 12 cases of irreducible atlantoaxial dislocation with spinal cord compression were operated on with transoral anterior decompression combined with posterior decompression and occipitocervical internal fixation with occipitocervical CD rod or Cervifix. With an average of 20 month follow up, clinical cure rate was evaluated according to Symon and Lavender . Vertebral canal vector diameters in MR were measured. The results showed that the total clinical effective rate was 91.6%, and the remarkable effective rate was 50%. The average improvement rate of vertebral canal decompression was 73.6 %. These results suggest that transoral anterior decompression combined with posterior decompression and internal fixation is more suitable for irreducible atlantoaxial dislocation with spinal cord compression.

Objective To summarize the experience of preventing infection in atlanto-axial operations via transoropharyngeal approach. Methods The methods and experiences of prevention of infection in 80 cases of atlanto-axial dislocation operated on via transoropharyngeal approach were retrospectively summarized and analyzed. Result There was no infection in all the 80 cases. Conclusion As long as preventive measures were perfectly taken, the post-operative infection could be effectively prevented and the transoropharyngeal operation would be safe.

Objective To evaluate the clinical results of subtotal vertebrectomy of the axis for spinal canal decompression by transoral anterior approach in the treatment of atlanto-axial dislocation with spinal cord compression. Method fifteen cases of atlanto-axial dislocation with spinal cord compression caused by congenital deformity or trauma were subjected to subtotal vertebrectomy of the axis via transoral anterior approach . Results After an average follow-up of 20 months, curative effect was evaluated according to Symon and Lavender. Vertebral canal vector diameters in MRI were measured. The total clinical effective rate was 100%, and the remarkable effective rate reached 60%. The average improvement rate of vertebral canal decompression was 79.8%. No sign of spinal cord and arteries injury and infection were observed. Conclusion Subtotal vertebrectomy of the axis via transoral anterior approach is proved to be feasible to treat cervical spinal cord compression on C 2 vertebra level.

This essay analyzes the weak legal consciousness of medical staff and illustrates the formation of legal mechanism from different aspects,such as the medical staff,the inner regulations of the hospital,the hygiene administrative department,the legislative institution which helps to raise the legal consciousness of the medical staff,reduce the medical risk effectively and promote the health development of the medical industry.

Objective To explore the possibility of expending indications of VATS though auxiliary mini-incision. Methods 54 patients with thoracic injury underwent pulmonary lobectomy or pulmonary wedge resection or pulmonary rupture repair or diaphragm rupture repair using VATS combined with auxiliary mini-incition. Results All of 54 patients were cured. with primary wound healing .Hospital stay was 8d~10d with a mean of 10d.. No complication occurred. Conclusions VATS combined with auxiliary mini-incision could provide a possibility of simultaneous diagnosis and treatment and obtains as the same therapeutic result as conventional open surgery and expends indication of VATS.

Objective To investigate morphologic characteristics of myocardial bridge(MBs)in optical coherence tomography(OCT)and to investigate the relationship between MBs and atherosclerosis in the proximal segments to MBs.Methods Twelve patients(age:58.07?12.08)with MBs were examined with OCT.The location and length of the most stenosis area of MBs were observed and compared between the CAG and OCT results.The intima thickness of the proximal 2 cm arterial segment of MBs was measured.Results All the 12 MBs were found in LAD.The length of the MBs measured in OCT and CAG respecgtively was 20.5?4.2 mm vs 15.6?3.5 mm(P

Objective To explore the effects of tumor necrosis factor-α induced protein 6 (TSG-6) on acute kidney injury (AKI) following paraquat poisoning in rats.Methods Twenty-four male Sprague-Dawley (SD) rats were randomly divided into sham group (n=8),model group (n=8) and TSG-6-treated group (n=8) using a randomized number table.Rats were given an injection of 50 mg/kg of paraquat intraperitoneally (total volume was equalled to sterile normal saline) in model and TSG-6-treated groups.Rats in sham group were given 2 mg/kg of sterile saline.Mter 1 hour of paraquat administration,rats were treated with 30 μg of recombinant human TSG-6 intraperitoneally in TSG-6-treated group.After 6 hours of paraquat administration,serum was collected to assess renal function,then rats were sacrificed and renal tissues were immediately harvested.AKI score was evaluated by renal histopathology and gene expression of pro-inflammatory cytokines including interleukins (IL-1β and IL-6) and tumor necrosis factor-α (TNF-α) in kidney was assayed with real-time reverse transcription-polymerase chain reaction (RT-PCR).Results Compared with sham group,blood urea nitrogen (BUN),creatinine (Cr) and AKI score were significandy increased in model group [BUN (mmoUL):22.64 ±2.36 vs.7.09 ±0.65,t=6.986,P=0.000; Cr (μmol/L):177.28 ± 18.67 vs.60.32 ± 3.11,t=7.134,P=0.000; AKI score:9.14 ± 0.28 vs.0.30 ± 0.23,t=9.013,P=0.000].Moreover,the mRNA expressions of IL-1β,IL-6 and TNF-α were significantly elevated in model group (IL-1β mRNA:3.23 ± 0.28 vs.1.00 ±0.07,t=5.874,P=0.000; IL-6 mRNA:4.16 ±0.37 vs.1.00 ±0.08,t=7.125,P=0.000; TNF-α mRNA:3.85 ±0.31 vs.1.00 ±0.10,t=6.342,P=0.000).However,serum BUN,Cr,AKI score and the mRNA expressions of IL-1β,IL-6 and TNF-α in TSG-6-treated group were significantly lower than those in model group [BUN (mmol/L):14.07 ± 5.23 vs.22.64 ± 2.36,t=2.533,P=0.026; Cr (μmol/L):112.76 ± 14.81 vs.177.28 ± 18.67,t=2.778,P=0.016; AKI score:5.35 ±0.19 vs.9.14 ±0.28,t=2.885,P=0.013; IL-1β mRNA:2.26 ± 0.19 vs.3.23 ±0.28,t=2.457,P=0.023; IL-6 mRNA:2.92 ±0.29 vs.4.16 ±0.37,t=2.975,P=0.011; TNF-α mRNA:2.58 ± 0.23 vs.3.85 ± 0.31,t=2.564,P=0.019].Conclusion TSG-6 attenuates AKI following paraquat poisoning by suppressing inflammatory response.