BACKGROUND:Bennett fracture repair is one of the problems for orthopedic surgeons, although there are a variety of clinical treatment for Bennett fracture, no treatment strategy is widely accepted. ＜br> OBJECTIVE:This study aims to provide evidence for developing an effective treatment strategy for Bennett fracture. ＜br> METHODS:A computer-based retrieval of PubMeb database (http://www.ncbi.nlm.nih.gov/PubMed), CNKI China Journal Ful-Text database (http://www.cnki.net/) and Wanfang database (http://g.wanfangdata.com.cn/) between January 2004 and July 2014 was performed by the first author. Meantime, Campbel ’s Operative Orthopaedics, Shiyong Guke Xue and other orthopedic monographs were manual y retrieved, to analyze research progress about Bennett fracture. ＜br> RESULTS AND CONCLUSION:A total of 37 literatures associated with Bennett fracture were involved in this study. Conventional closed reduction plaster or Kirschner wire fixation is characterized by low cost and easy operation, but it fails to achieve anatomical reduction. AO principle for fracture treatment has been widely accepted in recent years, the application of AO screw and AO plate is increasing in treatment of Bennett fracture, it can not only repair bone fracture but also repair and reconstruct the damaged ligament, but the cost is very high and secondary surgery is needed to remove the implant. Traditional Chinese orthopedics and integrated traditional and western medicine are experienced methods for treatments of Bennett fracture, and Chinese herbs have obvious symptomatic treatment effect and effectively improve the symptoms of patients. As the thumbs play a crucial role in the hand movement, the optimal treatment strategy for Bennett fractures has important clinical significance.

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopic-assisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006-August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm×4.2 cm to 3.5 cm×2.0 cm in uhrosonography. An incision of about 1.5-2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with ultrosonic scalpel assisted with laparoscope. Partial thyroideetomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50-146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.

Objective To investigate the effect of the treatment of children with mycoplasma pneumonia and the level of inflammatory factors in the serum of children with mycoplasma pneumonia. Methods 180 cases of mycoplasma pneumonia in our hospital from July 2015 to June 2016 were randomly divided into observation group and control group,90 cases in each group. The control group were treated with azithromycin,and the observation group were treated with combination of hydrochloric acid and bromine on the basis of control group. The course of the two groups were all 12 days.The efficacy of the treatment, fever subsided time, the disappearance time of cough and pulmonary rales, before and after treatment serum inflammatory factor interleukin-6 (IL-6),interleukin-10 (IL-10),interleukin-17 (IL-17) and procalcitonin (PCT) levels between two groups were compared,and the incidence of adverse reactions. Results The observation group treatment efficiency 93.33% was higher than the control group 82.23% (P<0.05); The observation group dissipated time of fever,cough disappeared time and pulmonary rales disappeared faster than the control group (P<0.05);After treatment,the levels of serum IL-6, IL-17 and PCT in two groups were decreased,the level of IL-10 increased,the difference was statistically significant (P<0.05); the level of serum IL-6, IL-17 and PCT in observation group were lower than the control group, while the level of IL-10 was higher than that of the control group, the difference was statistically significant (P<0.05);There were no significant differences in the adverse reactions between the two groups . Conclusion The curative effect of bromhexine hydrochloride combined with azithromycin in treatment of mycoplasma pneumonia in children, and can reduce the serum inflammatory cytokines IL-6, IL-17 and PCT level and increase the level of IL-10 and lessen inflammatory reaction, has important research significance.

Objective To clarify weather or not lymph node dissection can achieve the requests of gastric carcinoma radical degrees under laparoscopic operation for advanced gastric careinoma. Methods Sixty-five cases of advanced gastric carcinoma with under 1/3 stomach lesions and three cases with middle 1/3 stomach lesions. were randomly divided into tow groups: assisted laparoseopic group(n=33)and conventional gastric carcinoma D2 radical surgery group(n=35).The number of lymph node dissection, and the incidence of positive lymph nodes oecnred in damaged capsule. the margin necrosis analyzed. Results The average lymph node dissection of the laparoscopic group were 20.79±5.21 were ohscrved. the positive oases were 9.63±4.64.The average lymph nnde dissection of the control group were 21.20±5.04.the positivecases were 9.63±4.64. The two groups had no significant difference f (P>0.05)1. Positive-margin lymph node in the control gmup was 6 and 14 in the experimenl group ( P>0.05). The experlment gnmp margin appeared necrosis under eletronic microseope and the control group appeared degeneratinn. Conclusions Laparoscopic advanced gastric carcinoma lymph node dissectinn can D2 radical of advanced gastriC carcinoma demands(D>N), have significant difference with conventional surgery. Positive lymph node dissection margin of treatment is better than traditional surgery.

Objective To evaluate the efficacy of decortication by video-assisted thoracic surgery (VATS) in pa﹣tients with tuberculous empyema, and discuss its indications. Methods 60 patients with tuberculous empyema who underwent decortication by VATS for surgical management from December 2010 to December 2015 were included. Under a thoracoscope, we cleaned up the pus, separated adhesions, scraped granulation tissues and caseous necrosis on the inner wall of the abscess cavity, and stripped the thickened fiberboard of the parietal and visceral pleurae. Af﹣ter the procedure, sufficient drainage and antituberculosis therapy were carried out. Results All the patients in this group were operated successfully. All the patients were cured without perioperative death and complications. No re﹣currence of empyema was observed at the follow-up examination from 2 months to 5 years, and suffered pulmonary reexpansions were better. Conclusions The decortication by VATS for tuberculous empyema is safe, effective, mini﹣mally invasive. The imaging manifestations of pleural thickening in 1 cm, no obvious calcification, no serious lesions in the lungs are the indications for the operation.

Cardiomyopathy, Dilated ; etiology ; genetics ; Humans

Objective To evaluate the usefulness and necessity of spiral computer tomography (SCT) and color-Doppler ultrasonography (CDU) in primary hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods Plain SCT scanning and contrast-enhanced SCT scanning or / and CDU were performed for 68 HCCs before and four weeks after TACE. Factors related to overall survival (OS) were observed as tumor size necrosis, relapse, lipiodol deposition, blood supply of the survived tumor. Images of SCT and CDU were compared. Clinical significance obtained through direction of diagnostic radiology was evaluated. Results 139 masses observed in the 68 cases were shranked or necrotized in a different degree after TACE. 8 new metastasized massed were observed. Complete lipiodol deposition was observed in 27 masses and no lipiodol deposition in 14 masses. As for estimating the types of lipiodol deposition, SCT was better than CDU with significant difference. SCT could indirectly estimate the blood supply of tumor after TACT through 3 dynamic enhanced phases, while CDU could directly visualize the hemodynamic changes of liver, internal and peripheral parts of the tumor. Conclusion TACE is an effective way to treating HCC. SCT scanning and / or CDU are necessary before and after TACE to estimate the imaging changes so as to provide indispensable information for the best therapeutic schedule in the future.

Objective To set up the medical quality information statistics resource database of No.1 Military Medical Project by data warehouse technology. Method The front-end display tool of OLAP is applied to the setup of the database. Result OLAP platform is established and convenient query, statistics can be realized. Conclusion A great deal of aid decision making information can be got. Thus, the hospital resource utilization and medical quality management are improved.

ObjectiveTo investigate whether early goal-directed therapy (EGDT) could improve the mortality rate in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed, Cochrane Library, Embase data, Wanfang data, and CNKI from January 1980 to May 2015. Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT), clinical controlled trial (CCT), case-control studies, cohort studies with complete data, which endpoints were the short-term mortality [in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day, 90-day or 1 year). RevMan 5.2 software was used for Meta analysis of effect of EGDT on mortality rate in patients with severe sepsis or septic shock, and funnel plot was drawn to evaluate the quality of enrolled literature.Results There were 12 studies meeting inclusive criteria including 5 528 patients, 4 RCTs, 3 case-control studies, 4 cohort studies, and 1 quasi-experimental research. It was shown by Meta analysis that EGDT was associated with significant decrease in the short-term mortality [relative risk (RR) = 0.72, 95% confidence interval (95%CI) = 0.64-0.80,P< 0.000 01], but not associated with decrease of long-term mortality (RR = 0.99, 95%CI = 0.92-1.06,P = 0.81). The funnel plot showed that there was no publication bias. EGDT was recommended as grade C.Conclusions EGDT was associated with significant improvement in short-term mortality but not with long-term mortality in patients with severe sepsis or septic shock. Grade C was recommended by our study.

Objective To observe changes of motilin(MTL) levels in gastric body, duodenum and plasma in rat model of acute incisional pain.Methods A total of 156 healthy male adult SD rats,weighing 180-220 g,were randomized into two groups:control group (group C,n=78) and incisional pain group (group P,n=78),Rats in P group received incision on the right plantaris. Values of paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) at dif?ferent time points of 24 hours before operation (T0) and 1 hour (T1),6 hours (T2),24 hours(T3),48 hours (T4) and 72 hours (T5) after operation were measured in six rats chosen randomly from each group. Twelve rats were chosen from each group at T 0-5, and sacrificed. The MTL levels in plasma, the mucosal tissues of gastric body and duodenum were detected by ELISA. Re?sults Compared with group C, PWMT and PWTL were significantly decreased at T1-4 in group P. The MTL levels were sig?nificantly decreased in plasma and gastric body (P<0.05).The MTL level was significantly increased at T1-4 in duodenum (P<0.05),and no significant changes were found at T0 and T5 in P group(P>0.05). The plasma MTL levels were positively correlated with PWMT and PWTL (r=0.952,r=0.879,respectively,P<0.01) in P group. The MTL levels in gastric body were positively correlated with PWMT and PWTL(r=0.970,r=0.931,respectively,P<0.01) in P group. The MTL levels were neg?atively correlated with PWMT and PWTL(r=-0.991,r=-0.975,respectively,P<0.01) in duodenum in P group. Conclu?sion The MTL levels in plasma and gastric body are decreased in rat model of acute incisional pain, and increased in duo?denum.