OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).

METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.

RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).

CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.

Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To identify the outcomes and effect of applying the health check-up nursing quality control system developed as supervised by JCI quality assessment standards.Methods The monitoring system for nursing quality in the health check-up department is established within the framework of the hospital quality improvement committee and in line with characteristics of the department.Quality improvement tools may be called into play for analysis and decision making to revolve critical problems found in health check-up nursing,upgrading nursing quality and customer satisfaction.Results Significant rise of health check-up quality and customer satisfaction for nurses,and the nurses are trained in quality control knowledge and get further involved in quality management of their department.Conclusion Health check-up nursing management system under the JCI standard is conducive to raising the nursing quality,and helps nurses with problem analysis and solution.

The earthquake always results in a great number of the injured and disabled patients.So timely and effective psychological rehabilitation interventions are very helpful,especially for those survivors to relieve their psychological traumatic response caused by the earthquake,and renew their healthy psychological situation.The present article analyzes the chief psychological symptoms and influencing factors of the injured and disabled patients after the earthquake,and further provides some principles and strategies for the psychological rehabilitation,such as how to cope with the early stress response(anxiety,depression,self-abasement,and so on),or how to deal with the social phobia.

Objective To study the phylogenetic evolution and genetic variations of gag gene among the prevalent human immunodeficiency virus (HIV )‐1 strains in Guangxi Zhuang Autonomous Region . Methods Plasma samples of 158 HIV‐1 infected patients in Guangxi area were collected during October 2011 to March 2012 .The gag gene fragments of HIV‐1 were amplified by reverse transcription/nested‐polymerase chain reaction and then sequenced .MEGA 5 .03 was utilized to construct phylogenetic tree and to calculate the genetic distances and selection pressures (globle ω) of gag gene and its coding regions . The comparisons between two groups were tested by Student′s t test ,and the comparisons of multiple groups were tested by one‐way ANOVA .Results A total of 140 amplification products of gag gene were obtained from 158 samples .Four subtypes of HIV‐1 were found ,including CRF01_AE (80 ,57 .1% ) , CRF08_BC (46 ,32 .9% ) ,CRF07_BC (10 ,7 .1% ) ,and subtype B (B′) (4 ,2 .9% ) .The genetic distances of gag gene of the above subtypes were 0 .036 ± 0 .001 ,0 .031 ± 0 .002 ,0 .043 ± 0 .003 and 0 .102 ± 0 .006 ,respectively ,with statistical significance (F=220 .62 ,P<0 .01) .The p17 and p24 coding regions suffered negative selection pressure (globleω<1) .Neither the globle ω in p17 region nor that in p24 region had significant differences among different subtypes (F=0 .761 ,P=0 .469 and F=0 .037 ,P=0 .964 , respectively ) . Conclusion CRF01_AE is the major subtypes of HIV‐1 in Guangxi Zhuang Autonomous Region .The coding regions of gag gene are relatively conserved during evolution .Changes of HIV‐1 prevalence ,however ,may affect the genetic variation of gag gene ,which should be continuously monitored .

Objective To study the effects of improving elderly patients with bowel dysfunction after cardiopulmonary bypass.Methods Choose 54 elderly patients with CPB were randomly divided into tree groups:the control group and the Gln group and the Combination group,every group has 18 patients.Glutamine(Gln) at 0.4 g/kg was administrated to the patients in the Gln group and the combination group during the beginning at CPB and two days after the operation.Based on the Gln group,the patients of The Combination group were given the different oral Chinese medicine before and after operation,according to syndrome differentiation classification.Plasma endotoxin,IL-6 and DAO were measured before operation and at the endof operation and 24 h,48 h after operation.At the same time,we used German Siemens Company's X3000 Color Doppler machine to test every group of patients superior mesenteric artery.We tested before surgery,and one to two days after operation,from the starting point within 2cmof the superior mesenteric artery and the angle between the ultrasound beam flow was less than 60 °,the probe frequency was 3.5 MHz.The detection of hemodynamic indexes were EDV and PI.Results After the test,the plasma endotoxin and IL-6 levels and DAO levels of the Gln group were reduced than the Control group after cardiopulmonary bypass.The plasma endotoxin and IL-6 levels and DAO levels of the Combined gnup were decreased than the Gln group after cardiopulmonary bypass and one day after operation.Analyze superior mesenteric artery diastolic velocity (EDV)and pulsatility index (PI) by the Color Doppler.After operation,the EDV in the Gln group and the Combined grup were significantly higher than the control group,the Pl were lower than the control group.The parameters levels have significant difference after cardiopulmonary bypass and one day after operation(P ＜ 0.05 ).The Combined group was improved than the Gln group after cardiopulmonary bypass and one day after operation.According to the traditional Chinese medicine diagnosis,there were eighteen patients in the Combined group,including fifteen patients in type of deficiency of both qi and yin and three patients in type of fu-viscera syndnome.All of the patients have defecated within tree days after operation.In the type of deficiency of both qi and yin nine patients were cured and six were shown to be effective after operation.All the patients in type of fuviscera syndrome were cured.Conclusion N(2)-L-Alanyle-L-Glutmaine have protective effect on the intestinal mucosal barrier after CPB.Combined traditional Chinese Medicine preparation was more conducive to the intestinal function recovery of elderly patients after cartiopulmonary bypass.

The traditional fermentation engineering experiment requires a reform on the experimental con-tents and teaching pattern. According to the production process of industrial enzymes, we set up a two-week comprehensive experiment. The students designed and prepared the experiment by themselves. Moreover, the pattern of self-management was used in the process and the experiment scores included the self-assess-ment and objective assessment. It was proved that the new teaching pattern increased the study interesting of students, inspired their initiative and trained their spirits of team cooperation. The teaching effect was im-proved markedly and good ideas are also put forward to solve the possible problem.

Objective To evaluate the clinical application and safety of CT-guided pereutaneous transthoracic biopsy in the diagnosis of mediastinal masses.Methods Thirty three cases were undertaken CT- guided percutaneous transthoraeie biopsy with automatic biopsy gun and then the sampling specimens were undergone histological examination.The accuracy of puncture,diagnostic correctness and complications were analyzed.Results The operations were performed successfully in all 33 cases(100%),the definite pathologic diagnosis were made in 28 out of 33 cases(85%)and no complications occurred.Conclusion As for midiastinal masses,CT-guided percutaneous transthoracic biopsy is a feasible,successful,efficient interventional diagnostic method with high accuracy in localization,puncture,diagnosis and few complications, which should he recommended in clinical use more widely.(J Intervent Radiol,2007,16:852-854)

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.

Objective To establish an high perfermance liquid chromatography method for determination of five indole alkaloids in Rauvolfia.Methods The Diamonsil C18 column was used at 25 ℃ with methanol-water (gradient elution) as the mobile phase,the flow rate was 1.0 mL·min-1,the detective wavelength was 280 nm,and the injection volume was 5 μL.Results In the range of 1.56-200 μg· mL-1,the correlation coefficients of regression equations of sarpagine,yohimbine,ajmaline,ajmalicine,reserpine were higher than 0.999 0.The average recovery (n =9) of five indole alkaloids was between 95.0％-105.0％.Conclusion This method is simple with good accuracy and repeatability.It can be used for quality control of Rauvolfia.