Objective To explore the clinical effect of one new type of short section pedicle of vertebral arch nail system(internal fixation system by nail-stick) on patients with thoracolumbar fracture.Methods 68 patients with thoracolumbar fracture were selected.Internal fixation system by nail-stick was used on the patients with thoracolumbar fracture,the clinical effect was observed.Results After following up for six to eighteen months,the vertebral height was measured by X-ray.The anterior edge height of the vertebral was 47% before operation and 94% after operation,the posterior edge height of the vertebral was 76% before operation and 97% after operation,there was significant difference between preoperation and post operation(P<0.01).All the cases with AF intemal fixation system had better clinical effect,18 cases had satisfactory effect.Except that the neurological deficits of 4 cases had not been improved,those of the other cases all had been impreved at some degree.Conclusion Thoracolumbar fracture should be treated early,AF imtermal fixation system has significant effect on the thoracolumbar fracture,the skilled performance is important during the operation,and contraindications of internal fixation system by nail-stick should be noticed.

Objective To evaluate the accuracy of bispectral index (BIS) in predicting outcomes in patients with cerebral hemorrhage.Methods A total of 103 patients of either sex with acute cerebral hemorrhage,aged 18-77 yr,with body mass index of 17-29 kg/m2,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,undergoing craniotomy for evacuation of hematoma,were enrolled in this prospective study.BIS electrodes were adhered to the forehead of patients,and the BIS value was continuously recorded for 20 min.The maximum BIS value (BISmax) and minimum BIS value (BISmin) were recorded,and the mean BIS value (BISmean) was calculated.The patients were divided into 2 groups according to Glasgow Outcome Scale (GOS) scores assessed at 6 months after surgery:good outcome group (GOS score≥ 3) and poor outcome group (GOS score 1 or 2).The receiver operating characteristic curve of BIS in predicting outcomes was plotted,and the area under the curve (AUC) and 95％ confidential interval (CI) were calculated.The best cut point and sensitivity and specificity were calculated according to the BIS value when Youden index reached the maximal value.Results The AUC (95％ CI) for BISmax in predicting outcomes was 0.903 (0.830-0.976),the best cut point 79,the sensitivity 84％,the specificity 86％,and Youden index 0.695.The AUC (95％ CI) tor BISmin in predicting outcomes was 0.841 (0.760-0.921),the best cut point 43,the sensitivity 86％,the specificity 71％,and Youden index 0.577.The AUC (95％ CI) for BISmean in predicting outcomes w() 0.883 (0.800-0.958),the best cut point 60,the sensitivity 90％,the specificity 76％,and Youden index 0 562.Conclusion BIS can accurately predict outcomes in patients with acute cerebral hemoorrhage,and BISmax provides the highest accuracy.

Gastrointestinal Tract ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; Postoperative Period ; Recovery of Function

At present, the level of diagnosis and treatment of early gastrointestinal cancer has a larger gap between China and developed countries. In recent years, the advent of new endoscopic imaging techniques has improved the detection rate of early gastrointestinal cancer. Along with this, endoscopic submucosal dissection(ESD) enables radical resection for early cancer. In this article, we discuss how to improve the level of endoscopic diagnosis and treatment of early gastrointestinal cancer.
China ; Endoscopy, Digestive System ; Gastrointestinal Neoplasms ; diagnosis ; surgery ; Humans

Maximum Allowable Concentration ; Mineral Fibers ; analysis ; Occupational Exposure ; analysis

Objective To investigate the effect of puerarin and compound salvia injection on P2selectin change in patients with traumatic cerebral infarction(TCI)so as to understand the difference of their curative effect. Methods Twenty patients with TCI were randomly divided into four groups,ie,conventional treatment group,puerarin group,compound salvia injection group and combined treatment group to observe the improvement of the symptoms(Glasgow Outcome Scale,GOS)and change of plasma P2 selecfin after treatment.Results The symptoms(GOS score)and level of plasma P2 selectin in the puerarin group,the compound salvia injection group and the combined treatment group were superior to those of the conventional treatment group(P<0.05).The TCI patients had obviously higher level of plasma P2 Selectin than the healthy persons before treatment.The level of plasma P2 selectin was decreased after treatment,with better curative effect in three other groups compared with the conventional treatment group. Conclusions There is positive synergistic interaction between puerarin and compound salvia injection.Both puerarin and compound salvia injection Can decrease the level of plasma P2 Selectin to reduce the blood viscosity,inhibit the platelet activation,reduce the cerebral vasospasm and inhibit the thrombosis,as contributes to the recovery of the TCI patients.

Objective To compare the therapeutic effect of routine dose of calcitriol and large dose impulsion therapy on hemodialysis patients with secondary hyperparathyroidism(SHPT). Methods 48 uremic hemodialysis patients were divided into group A(routine group, n = 22) and group B(control group, n = 21 ). In group A,22 pa-tients were administered with calcitriol for 6 months at the dosage of 0.25～0.5μg/d,adding calcium agents simul-taneously;the patients in group B were not given calcitriol for economic reason. In group C,21 patients were given calcitriol twice a week at the dosage of 2μg/time after hemodialysis for 3 months. Results Comparing to group B,serum PTH,AKP in group A had no significant difference,but serum hypocalcium and hyperphasphate were partly corrected,symptoms of bone pain, muscular convulsion and akin pruriter were improved. Comparing to group A,serum hypocalcium and hyperphasphate in group C were corrected, serum PTH, AKP were significantly decreased( t=2.031,P<0.05;t =3.317,P<0.001),and no hypercalcium oecurred. Conelosion Routine dose of calcitriol can not control uremic-SHirr,while impulsion therapy with lower dose oral calcitriol is effective and safe.

Objective To investigate the clinical characteristics of septicemia in type 2 diabetes mellitus,to enhance prevention level and decrease death rate.Methods A retrospective study was carried out,the data were collected from 58 cases of type 2 diabetes mellitus complicated by septicemia in our hospital in the past 13 years.Results The pathogenic invasive pathways included:19 cases of urinary tract,17 cases of respiratory tract,7 cases of intravenous catheter detain,7 cases of biliary tract,1 case of skin breakage,and 7 cases of unclear origin.Twenty-three of 58 cases were from nosoeomial infection (39.7%),among which 10 cases of urethral detain,7 cases of intravenous catheter detain,and 6 cases of respiratory tract infection.Pathogenic distribution was as following:24 cases of klehsiella pneumoniae,16 cases of escherichia coli,10 cases of staph aureus,2 cases of staphylococcus cohnii cohnii,2 cases of staphylococcus epidermidis,2 cases of pseudomonas putida,2 cases of candida glabrata.Among the 24 cases of llehsiella pneumoniae,12 cases showed migrating hepatapostema (50.0%),and 15 showed pneumatosis phenomenon in the intrahepatie bile (62.5%).Two cases originated from fungal septicemia.Among 56 cases under antibacterial therapy 15 cases developed fungal septicemia (26.8%).Fifty-eight cases were treated with insulin for forcing down serum glucose,56 cases of bacterial septicemia were treated with the third generation cephalosporins and fluoroquinolones.Two cases of pseudomonas putida septicemia were treated with intravenous injection of fluconazole.Seven cases died (12.1%).Conclusions Gram-negative bacilli were the major pathogens of septicemia in type 2 diabetes mellitus.Migrating hepatapostema and pneumatosis phenomenon in the intrahepatic bile often showed klebsiella pneumoniae septicemia.The important risk factors for septicemia were intravenous catheter detain and urethral detain.Therefore,strictly aseptic operation and removing vessel detain in time is very important.It is key points to make an early diagnosis,have a strong antibiosis therapy and treat the migrating pathogenic focus.And it is important to intensify serum glucose monitoring and strengthen supportive treatment.

Objective To discuss the modern surgical treatments for congenital choledochal cysts complicated with anomalous junction of pancreaticobiliary ductal system through analyzing data in 30 cases. Methods The 30 cases were diagnosed with ERCP, MRCP, cholangiography or dissection, respectively. Then 28 of them were treated with external drainage (n=2), internal drainage (n=9) and Roux-en-Y hepaticojejunostomy (n=22), respectively. Of the 28, 5 received operations twice. Results External drainage was helpful in emergency cases while internal drainage frequently resulted in recurrent cholangitis, choledocholith, anastomotic stenosis or cyst malignancy that needed to be operated on again. Choledochocyst resection and pancreaticobiliary shunt achieved satisfactory results. Conclusions Congenital choledochal cyst is usually complicated with anomalous junction of pancreaticobiliary ductal system (88.2%). As for its treatment, choledochocyst resection, pancreaticobiliary shunt and hepaticojejunostomy should be of the first choice.

Objective To explore the protective effect of salidroside on early reperfusion in patients with acute cerebral infarction treated with urokinase intravenous thrombolysis.Methods 98 patients with acute cerebral infarction who were consistent with intravenous thrombolysis after screening were enrolled in the study.They were equally divided into the control group and the treatment group by sealed envelop method in one to one ratio.The control group received urokinase intravenous thrombolytic therapy on the basis of dehydration,anticoagulation,brain rehabilitation,regulating blood pressure,blood glucose and other conventional treatment.Based on the treatment in the control group,the treatment group was treated with Hongjingtian injection for 10 days.The serum malondialdehyde(MDA),superoxide dismutase(SOD),plasma endothelin-1(ET-1) and high sensitive C-reactive protein(hs-CRP),neurological deficit score(NIHSS),Barthel index and clinical effect in the two groups were observed.Results There were no significant differences in levels of MDA,SOD,ET-1,hs-CRP,NIHSS and Barthel index between the two groups before treatment (t=0.30,0.26,0.41,004,0.57,0.33,all P>0.05).After treatment,there were statistically significant differences between the control group and the treatment group in levels of MDA,SOD,ET-1,hs-CRP,NIHSS score and Barthel index[(7.54±1.14)nmol/mL vs.(6.04±1.21)nmol/mL,(92.42±15.28)U/mL vs.(108.54±19.24)U/mL,(64.5±7.4)pg/mL vs.(41.4±8.1)pg/mL,(3.84±1.04)μmol/L vs.(2.54±0.84)μmol/L,(16.5±5.4)points vs.(11.2±3.1)points,(62.1±12.4) vs.(71.4±10.4)](t=6.31,4.59,14.74,6.81,5.96,4.02,all P<0.01).The total effective rate of the treatment group was 91.84%,which of the control group was 63.39%,the difference was statistically significant(χ2=8.83,P<0.05).Conclusion Salidroside can relieve lipid peroxidation in patients with acute cerebral infarction,promote decomposition of oxyradical,reduce inflammatory reactions,improve neurological function and quality of life.The curative effect is significant.It has protective effect on early reperfusion in patients with acute cerebral infarction treated with urokinase intravenous thrombolysis.