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.

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 investigate the influence of six-minute walking training on autonomic nerve function in patients having chronic heart failure.Methods Eighty chronic heart failure patients with heart function Ⅱ-Ⅲ grade were divided into training group (40 cases) and control group (40 cases) by random digits table method.Patients in two groups were treated with conventional anti heart failure drug.Patients in training group insisted six-minute walking training twice a day on the basis of the conventional treatment.Changes of the index of heart function,heart rate variability (HRV) and heart rate deceleration force (DC) before and after treatment were tested in two groups.Results After treatment,the cardiac function in training group and control group was significantly improved (P ＜ 0.05).The indexes of HRV and DC in two groups were significantly higher than those before treatment (P ＜ 0.05).After treatment,the indexes of HRV and DC in training group were significantly higher than those in control group (P ＜ 0.05).Conclusion Six-minute walking training in patients having chronic heart failure can significantly improve the autonomic nerve function,which is an effective and safe rehabilitation exercise for patients having chronic heart failure.

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.

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 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 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.

Objective To investigate the relationship between metabolic syndrome (MS) and female subclinical carotid atherosclerosis. Methods A total of 835 female subjects were enrolled in this study. MS was defined based on the ATP Ⅲ criteria. Age groups were ＜45,45 to 65,and ≥65 years. The participants were evaluated by the number of components of MS and clusters of MS components. Measurement of carotid arteries with B-mode ultrasound imaging was performed. Intima-media thickness and plague of the carotid arteries were regarded as the indicators of subclinical carotid atherosclerosis. Results The prevalence of carotid atherosclerosis, MS components and MS was significantly increased with the increased age. After age was adjusted, multiple logistic regression analysis showed that every component of MS was independently associated with carotid atherosclerosis; the increased waist circumstance and blood pressure and reduced HLD showed stronger effect. The prevalence of carotid atherosclerosis was increased with increasing number of components of MS. When compared to the 0 MS component group,the odds ratio (OR)of carotid atherosclerosis of the groups with 1, 2,3,4, or 5 components were 1.4,2. 0,3.4,5. 7 and 7. 1,respectively. The altered cluster components of MS impacted differently on carotid atherosclerosis. The clusters of components of MS with increased waist circumstance were more frequent than without ones. Conclusion Every component of MS may be an independent risk factor of carotid atherosclerosis;increased components of MS could contribute higher odd risk to carotid atherosclerosis; clusters of MS components might show different impacts on carotid atherosclerosis.

Objective To study the relationship between pedometer-based daily physical activity and obesity measurements in adult male leaders living in countryside.Methods A total of 136 men who received routine health screening were measured for body weight,body mass index (BMI),waist circumstance,and total body fat.Daily walking activities were determined by pedometer for 7 days.Results Ⅰ to Ⅱ grade walking activities was found in 58% participants.Daily physical activities were negatively correlated with body weight,waist circumference,BMI and total body fat.Body weight,waist circumference,BMI and total body fat were almost normal when walking activities increased to Ⅲ grade.Only 7% of the subjects participated in exercises.Conclusion Pedometer-based daily physical activities may be significantly correlated with obesity arameters.Increased walking activities will help to loss weight.