[Objective]To evaluate the surgical results of spinal scoliosis in the elderly and to investigate the indications,surgical techniques and factors which may contribute to the outcome. [Methods]A retrospective study was held.Sixty-four patients≥65 years undergoing different kinds of operation for lumbar spinal scoliosis from Sep.2004 to Apr.2008 were recruited.The mean patient age at surgery was 69.2 years(61~75 years).[Results]There were a variety of treatment methods of degenerative scoliosis based on symptomatology and radiologic measurements of scoliosis and stenosis.Sixty-four patients were followed up for an average of 37 months.The average correction rate of scoliosis was 51.2% after operation.No case was found spinal cord injury.Clinical symptoms and functional tolerance for daily activities improved after surgery.Radiographic evaluation showed a reduction in the deformity on the frontal and sagittal planes.There were no infections,pseudoarthrosis,instrument related failures or reoperations in this series.[Conclusion]The surgical results of lumbar scoliosis in the elderly are better than to those reported for the general population.Carefully perioperative preparation is very important in the treatment of elderly patients with lumbar spinal scoliosis.

[Objective]To review the clinical data on patients suffering from multi-level lumbar spine fracture treated with TSRH-3D pedicle screw system,and to investigate the post-operative efficacy.[Method]Eighteen patients with multi-level lumbar spine fracture were treated with TSRH-3D pedicle screw system.The operations were performed 4 hours to 2 days after injury,and the follow-up period was 15-32 months(average,23 months).The X-ray and CT scan were taken preoperatively and postoperatively.[Result](1)Twelve patients injured from height falling(67%),5 from traffic accident(28%) and 1 from crush injury(5%).(2)The improvement rates of the spine motion,back pain and the lower extremity pain were 67%,94% and 78%,respectively.(3) Compared with preoperation,the height of anterior border of vertebra improved by 59.2%,lost by 5.2% on average(P

Objective To evaluate the imaging manifestations in diagnosis lipoma of upper alimentary canal.Methods 8 cases with lipoma of upper alimentary canal were performed by barium meal and dual-contrast gastrointestinography(n=8),ultrasound(n=1),computed tomography(n=2)and endoscopy(n=5).Results (1)Barium meal and dual-contrast gastrointestinography could diagnose benign space-occupation of upper alimentary canal.(2)Ultrasound and endoscopy could diagnose benign space-occupation.(3)The density of fat of lesion could well be displayed by computed tomography and contrast-enhenment computed tomography and lipoma could be diagnosed before opertion.Conclusion The combination of gastrointestinography,endoscopy and computed tomography can be regarded as the first procedure for diagnosis lipoma of upper alimentary canal.

Diabetes patients in China is large in number, low level of health literacy, and their self management mainly relies on community doctor's health propaganda and education, as a result, it is very important to train community healthcare professionals to improve their communication skills with patients.Guided by the Social Cognitive Theory (SCT), the researchers developed a literacy-addressing training model specifically through: 1) low literacy healthcare education materials written in plain language, simple text, maximal white space, and behavior-oriented images or pictograms;2) a standardized health communication curriculum to promote simple communication with decreased jargon usage, teach teach back, and enhance shared goal-setting;3) use of standardized patients to enhance doctor-patient communication training;and 4) MOOC and a series of videos demonstrating doctor-patient communication scenarios.The novel training model can be used in continuing medical education through traditional on-site classes or by E-learning platform.It is expected to improve the communication skills of community doctors and patients, improve the satisfaction of both doctors and patients, and the effect of patients' self-management.

Objective To explore the regulation of PI3K-mTOR signaling pathways on autophagy of hippocampus nerve cells after subarachnoid hemorrhage (SAH)in rats.Methods We randomly divided 72 male Sprague-Dawley rats into sham group,SAH model group and LY294002 group with 24 rats in each group.We established SAH model with the secondary injection of blood method while the sham group was not injected with blood.PI3K signaling pathways specific inhibitor LY294002 was injected with 500μmol per rat 30 minutes before modeling.After 6,24,72 and 144 h morphologic changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of PI3K,mTOR,Beclin-1 and LC3-Ⅱ were detected by immunohistochemical method.Results The density of survival neurons in the SAH group was significantly lower than that in the control group (P<0.05),PI3K-mTOR signaling pathways were activated obviously,and the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in the control group (P<0.05 ).The number of survival neurons significantly decreased in the LY294002 group compared with the SAH group at each time point (P<0.05),PI3K-mTOR signaling pathways were suppressed.The expressions of Beclin-1 and LC3-Ⅱ were significantly lower than those in the SAH group (P<0.05).Conclusion PI3K-mTOR signaling pathways protect neurons by activating the autophagy of neurons after SAH.

Objective To investigate the effect of BQ-123 on the ability of learning and memory and nerve cell autophagy in hippocam-pus in rats with subarachnoid hemorrhage (SAH). Methods 72 male Sprague-Dawley rats were randomly divided into sham group, SAH model group (SAH group) and BQ-123 group with 24 rats in each group. SAH model was established by injecting the autologous blood into cisterna magna twice. The sham group was not injected blood. BQ-123 group received intracerebroventricular injection with BQ-123 18μg 30 minutes before modeling. 6, 24, 72 and 144 hours after modeling, the passive avoidance latency (PAL) and active avoidance reaction rate (AARR) were tested with Shutter Box Test, the nerve cell morphological changes of hippocampus were observed with HE staining, and the expressions of Beclin-1 and LC3-II were detected with immunohistochemical staining. Results Compared with the sham group, the PAL pro-longed, the AARR decreased (P<0.05), the nerve cells in the hippocampus reduced (P<0.05), and the expressions of Beclin-1 and LC3-II in-creased (P<0.05) in SAH group. Compared with SAH group, PAL shortened (P<0.05), AARR increased (P<0.05), the nerve cells in the hip-pocampus increased (P<0.05), and the expressions of Beclin-1 and LC3-II increased (P<0.05) in BQ-123 group. Conclusion BQ-123 can promote the recovery of learning and memory ability, which may relate to the activation of nerve cell autophagy in the hippocampus.

Objective To discuss the clinical characteristics,injury mechanisms,and treatment options of atlantoaxial complex fractures.Methods Twenty-three patients with atlantoaxial complex fractures were enrolled in the study,including 13 men and 10 women with age ranging from 23 to 63 years (average 42.6 years).Treatment options were determined on the basis of injury patterns of the patients,including nonoperative treatments for 11 patients and operative treatments for 12 patients.Complications and prognosis were evaluated for all patients in follow-up.Results All patients were followed up for average 32 months (range,6-58 months),which showed the recovery of atlantoaxial stability and the bony union or fusion.At postoperative six months,Japanese Orthopedics Association (JOA) score of all patients averaged 14.1 points (range,11.5-15.8 points) with the improvement rate of 82.7％.No complications like spinal cord injury,vertebral artery injury or cerebrospinal fluid leakage occurred in operative treatment group.Conclusions Mechanisms of atlantoaxial complex fractures are largely overextension/compression and lateral bending/compression.Furthermore,treatment plans should be determined in the light of fracture types.

Objective To investigate the surgical effect on complex spinal canal stenosis of lumbar spine through the technical of transforaminal lumbar interbody fusion (TLIF).Methods The retrospective analysis was performed on 46 patients admitted from December 2008 to March 2012.Of all patients,spinal canal stenosis of lumbar spine associated with lumbar scoliosis were 13 cases,lumbar sondylolisthesis for 17 cases,lumbar discogenic pain for 11 cases,lumbar revision surgery for 5 cases.All were underwent the surgical procedures including correction,internal fixation with pedicle screw,then use TLIF technology to compression and fusion.JOA,VAS,Nahal evaluating standards were applied to evaluate the therapeutic effect.The intervertebral height and bone fusion were observed by X ray.Results Forty-six patients were get follow-up for 6-36 months with an average of 12 months.There was significant difference (P ＜0.05) in JOA score between preparation (11.5 ± 2.2) and postoperation (22.5 ± 3.5).VAS score was (2.68 ± 2.08) at pre-operation,lower than that in postoperation (7.25 ± 1.85).There showed the excellent bone fusion,non loss of correction angle and the height of intervertebral disc space.Conclusion The complex of lumbar stenosis is difficult to operate and with high risk.Application of the TLIF procedure combined with clinical symptom,imaging of the spinal cord to decompression,fusion and fixation can restore the spine physical curve and improve patient's symptom.

Objective:To provide reference for the pharmacy automation construction in outpatient pharmacy of domestic hospitals. Methods:The work process, application effect and patient satisfaction before and after the use of automatic drug dispensing machine were analyzed and compared by the data collection and questionnaire according to the operation practice of automatic drug dispensing machine in the outpatient pharmacy of our hospital. Results:After using the automatic dispensing machine, the work flow could be op-timized, the comprehensive benefit and the satisfaction of patients could be improved, and the investment return rate was promising. Conclusion:Automatic pharmacy is the direction of modern pharmacy construction, which has a good application prospect.

Objective By using PEG-PLL and OPG-expressing plasmid to synthesize a nanocompound PEG-PLL-OPG (PPO), to investigate its effects on osteoblasts (OB) and arteriosclerosis (AS) in mice. Methods The incidences of osteoporosis (OP) and AS were studied in people. Collect people′s serum , and divide them into different groups According to the results of diagnosis, the patients were grouped into the groups of Control, AS, OP, and AS. PPO was used to deal with OB in different groups. The cell apoptosis, cell activity, the adhersion and calcification to scaffold PCL were determined by flow cytometry, MTT, alizarin red stain and SEM,respectively. PPO was also injected intp the ApoE-/-RANKL+/+ mice via caudal vein to demonstrate its effects on BMD and AS. Results PPO could increase the cell activity , inhibit OB apoptosis and promote cell adhersion and calcifica-tion on scaffold PCL in vitro. PPO could also decrease the area and calcification of atheromatous plaque , and in-crease the BMD of collum femoris in vivo. Conclusion PPO may be a new drug for OP and AS treatments.