Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use

Objective To evaluate the results of the Secuplate anterior cervical osteosynthesis plate (SACOP) for the treatment of patient with cervical spondylotic myelopathy (CSM). Methods Twenty six patients with CSM underwent anterior decompression fusion and internal fixation with SACOP were reviewed. All patients were followed up for 6 to 12 months (mean, 8 months). Results Neurological deficits improved in 23 of 26 patients after operation. A stable bony fusion according to radiological criteria was achieved in all cases 6 months postoperatively. There was no implants breakage and loosening. Conclusion Intervertebral fusion and internal fixation with SACOP after anterior decompression can offer immediate stability, prevent graft dislodgement, avoid cast immobilization and give a high rate of successful bony fusion for the patient with CSM.

Objective To review and analyze the sexual function of patients with spinal fractures complicated by incomplete paraparesis. Methods A total of 73 patients with incomplete paraparesis resulted from spinal fractures were retrospectively analyzed. Frankel Grade was used to determine the neurologic function and international index of ecrectile function (IIEF) to evaluate patients' sexual function. The patients with sexual dysfunction also were examined for reflex erection and psychogenic erection function. Results There were 21 patients with sexual dysfunction. Through ?2 test, significant difference was found between Frankel grade B and grade C as well as between grade D and grade E (P

Objective To address the standard first-line management under the new diagnostic criteria in adult immune thrombocytopenia (ITP). Methods A retrospective analysis was conducted involving 178 adult ITP patients treated with high-dose dexamethasone or prednisone in Qilu Hospital from March 2004 to November 2009 using new diagnostic criteria. Results The median age was 41 years with a male/female ratio of 0. 73: 1. Among the 178 ITP patients, 87 were newly diagnosed, 30 persistent ITP, 58 chronic ITP, and 3 unable to follow up. The efficacy rates among 167 patients able to assess in the three groups were 77.4% ( 65/84 ), 64. 0% ( 16/25 ) and 62. 1% ( 36/58 ) respectively, and their complete remission (CR) rates were 57. 1% (48/84), 36. 0% (9/25) and 32. 8% (19/58). The efficacy rate and CR rate of the newly diagnosed ITP category were significantly higher than those of the chronic ITP category (x2 = 3. 917, P ＜ 0. 05 ;x2 = 8. 186, P ＜ 0. 01 ). The patients treated with high-dose dexamethasone or prednisone therapy had no significant differences in sex, age or blood platelet count before treatment.Moreover, the short or long term response rates and the CR rates between the two therapies had no statistically significant differences while the former had a shorter onset time ( F = 10. 34, P ＜ 0. 01 ).Conclusions The study sets up a basis for the application of the recommended new definition and outcome criteria for adult ITP. Dexamethasone therapy is favored as first-line therapy.

Objective To study the possibility of the exist of specific antibody against platelet in tumor patients and to evaluate the value of MAIPA in measure of specific antibody against platelet in malignant tumor patients with nonimmune thrombocytopenic purpura. Methods Anti- GPⅡb/Ⅲa and anti- GPⅠb/Ⅸ autoantibodies were detected by a modified monoclonal antibody immobilization of platelet antigens assay(modified MAIPA). Results The positive rate of the platelet antibody in nonimmune thrombocytopenic purpura is very low with MAIPA. Conclusions The platelet GP- specific autoantibody detection is considerably important in discriminating immune from nonimmune thrombocytopenia.

Objective We sought to compare the ability of MEWS score,APACHE Ⅱ score and combination of the two scoring systems to predict the prognosis of patients in emergency medical department.Methods During January to March 2014,640 patients in emergency medical department who met the criteria were set as the research object.The patients admission was the starting point for clinic observation.The relevant data were collected for carrying on the MEWS and APACHE Ⅱ ratings,tracking the patients' prognosis.The corresponding predictors for prognosis of patients such as sensitivity,specificity,positive predictive value,negative predictive value and ROC curve by MEWS score,APACHE Ⅱ score and combination of the two scoring systems were compared.Results The area under the receiver operating characteristic curve was 0.93,0.79 and 0.93 with MEWS score,APACHE Ⅱ score and combination of the two scoring systems.The comparison of either of the two scoring systems showed significant difference.When death was named as the prediction factor,the sensitivity,specificity,positive predictive value and negative predictive value were 76.92％,91.70％,51.02％,97.23％ for MEWS score; 83.08％,62.80％,20.15％ and 97.04％ for APACHE Ⅱ score; 92.31％,86.43％,43.48％ and 97.58％ for combination of the two scoring systems.Conclusions Combination of the MEWS and APACHE Ⅱ scoring systems can be used to predict the prognosis of patients in emergency medical department.It posesses high sensitivity,specificity,positive predictive value and negative predictive value,which indicating a high predictive capability.

Objective: To study the factors and preventive method of post-operative complications of spinal implant operation. Methods: The post-operative complication of 451 cases who had undergone spinal implant operation were analysed retrospectively. The relative factors of complications were analyzed. Results: Infection, thrombosis of deep vein and failed fusion were the most common complications. Among the factors, the age, operation time and blood lose during operation were closely related with the complication. Using antibiotic was effective to reduce the infection. Conclusion: It is effective to reduce the post-operative complication of spinal implant operation by proper pre-operative evaluation. Using antibiotic to control other diseases is also effective.

Objective To establish normal reference indexes of aorta during gestation and cut-points for detection of fetuses with coarctation of aorta.Methods From long-axis views of the aortic arch,the internal diameter of the aortic root,ascending aorta,transverse aortic arch,aortic isthmus,descending aorta,anonyma,left common carotid artery,left subclavian artery were measured in 234 normal fetuses at different time ranging from 14 to 41 weeks during gestation.Reference values of each aortic segment were constructed by linear regression analysis.The ratio of each aortic segment to the ascending aorta were calculated.ResultsThe internal diameter in each aortic segments increased as pregnancy progressed (P<0.01).In the prenatal diagnosis of fetus with coarctation of the aorta,the ratio of the aortic isthmus to the ascending aorta and descending aorta to the ascending aorta were significantly lower than the normal fetuses(all P<0.01).Conclusions The ratio of the aortic isthmus to the ascending aorta and ratio of descending aorta to the ascending aorta detected by echocardiography may be helpful in the prenatal diagnosis of coarctation of aorta.

Objective The study aimed to evaluate the application effect of clinical pathways in laparoscopic cholecystectomy patients by using the meta-analysis.Methods Published randomized controlled trials (RCT) about laparoscopic cholecystectomy patients were searched and screened in China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP,Wanfang Database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.2 software was used for analysis.Results Totally 29 studies including 5 570 cases were eligible to the criteria (2 753 in the experimental group and 2 853 in the control group) altogether.The meta-analysis showed that the hospitalization time and hospitalization costs in the clinical nursing pathway group were significantly less than those of the control group (SMD=-1.69 and-3.75),the satisfaction degree and the mastering of health knowledge in the clinical nursing pathway group were significantly higher than those of the control group (RR=1.16 and 1.26),the differece had statistical significance.Conclusions Application effect of clinical nursing pathways is superior to the traditional nursing method in laparoscopic cholecystectomy patients.

BACKGROUND:The outcomes of SL-Plus? stem in primary total hip arthroplasty have been proved good, but whether SLR-Plus? revision stem can obtain a good outcome in revision hip arthroplasty needs more studies. OBJECTIVE:To observe the clinical results of revision hip arthroplasty with Zweymül er SLR-plus ? stem. METHODS:Revision hip arthroplasty of 41 hips in 39 patients was performed from November 1997 to May 2013 using SLR-plus ? stem. There were 26 hips (male) and 15 hips (female). They were at the age of 34-73 years old, 53 on average. In the 41 hips, 36 cemented and 5 uncemented femoral prostheses were used. Prosthetic changes on radiographs were observed. In accordance with Brooker classification, heterotopic ossification was classified to record the region and incidence of heterotopic ossification. Hip joint function was evaluated using Harris Hip Score, and survival rate of the prosthesis was analyzed. RESULTS AND CONCLUSION:A total of 31 patients (33 hips) were fol owed up for 1 to 16 years. The mean preoperative Harris hip score of 34 (range, 13-64) points improved to 85 (range, 55-94) points at the time of final fol ow-up. 32 hips (97%) had an excellent result. A 1 mm width radiolucent line was found in 1 femoral component without any symptom. Osteolysis and migration were seen in 1 hip, which needed re-revision. Heterotopic ossification developed in 9 hips, including 2 hips of Brooker grade 1, 4 hips of grade 2 and 3 hips of grade 3. No re-infection was found. Kaplan-Meier survivorship was 92%with radiographic loosening as the end point. Results demonstrated that the SLR-Plus? stem has sufficient immediate and long-term stability, which is reliable for patients undergoing hip revision surgery.