Objective To research the efficacy and safety of percutaneous puncture kyphoplasty in the treatment of elderly osteoporotic vertebral fracture.Methods PkP were performed in 23 patients(34 vertebrae),visual analogue scale(VAS)and mobility were evaluated before and three days after operation.Relief of back pain,recovery of mobility and complications(cement leakage,adjacent vertebral body fractures,etc)were observed in the follow up.Results All patients were successfully performed with immediate relief of their back pain.The mean scores of VAS and mobility 3 days after operation were respectively decreased from(7.5 ±0.7),(2.4 ±0.6)preoperative to(2.5 ±0.6),(1.2 ±0.4)at 3 day after operation with a significant difference(t= 23.8,13.4,P ＜0.01).The patients were followed up for average 15.6 months with satisfactory therapeutic effect,one patient died of heart disease two months after discharge,around vertebral fracture occurred in 4 patients,they were no cement leakage in all the patients.Conclusion PKP is one of the new minimally invasive technologies,which can rapidly relieve pain.PKP is an ideal method in treating elderly osteoporotic spinal compression fractures.

Objective To study the feasibility of fluoroscopically guided percutaneous internal fixation with the Universal Spine System(USS) in the treatment of thoracolumbar fractures.Methods A total of 8 patients with thoracolumbar fractures without the need of decompression of the spinal canal underwent posterior percutaneous pedicle screw fixation by using the USS from October 2002 to May 2004.A fixation rod was placed under the vertebrae muscle to complete the reduction and fixation.Results The operation time was 120~240 min(mean,140 min),and the intraoperative blood loss was 20~90 ml(mean,40 ml).The Cobb's angle decreased from 21.5??4.3? preoperatively to 2.7??1.5? postoperatively(t=17.541,P=0.001).The collapse of vertebra was 18.5%?4.1% preoperatively and 2.4%?1.0% postoperatively(t=16.504,P=0.001).All the patients got out of bed 3 weeks after operation with the assistance of girdle brace.Effects of treatment were evaluated according to the Frankel grade at the third postoperative week: 2 patients recovered from grade C to D,1 patient from D to E,1 patient remained in D, and 4 kept in E. Conclusions Percutaneous internal fixation by using the USS in the treatment of thoracolumbar fractures without the need of decompression of the spinal canal offers advantages of minimal invasion and quick recovery,though it has some technical difficulties and disadvantages of long-time exposure under X-ray.

Objective To evaluate the clinica1 value of endoscopic placement of colorectal metal stents for malignant colonic obstruction in aged patients. Methods The 82 cases who were older than 65 years with malignant colonic obstruction were randomly divided into colorectal metal stenting group who were treated with endoscopic Niti-S colorectal metal stenting and emergency surgery group who were treated with tumor resection or colostomy. The average length of stay, average hospitalization charge, median survival time, one-year survival rate, perioperative mortality, and the complications such as anastomotic leakage, incision infection were analyzed. Results In colorectal metal stenting group, in 39 of 41 patients, metal stents were successfully inserted, without complications of hemorrhage, perforation and so on. And the symptoms of obstruction were effectively relieved within 2 days. The 17 cases underwent subsequent elective radical resection of colorectal carcinoma after 1 week, without complications of anastomotic leakage. The 22 cases were treated with colorectal metal stenting for palliative treatment. There were 4 cases of stent migration and 5 cases of stent obstruction again. The average length of inhospital stay was (17.9±6.7) days, the average hospitalization charge was 40 047 yuan, the median survival time was (9.4±4.4) months, and one-year survival rate was 43.9%. In emergency surgery group, 13 cases underwent tumor resection and 28 cases received colostomy. The 14 cases presented with multiple organ dysfunction, 8 cases died preoperatively, 4 cases presented with anastigmatic leakage. The average length of stay was (24.4±4.6) day, the average hospitalization charge was 61 867 yuan, the median survival time was (8.8±4.8) months, and one-year survival rate was 36.6%. Conclusions Endoscopic colorectal metal stenting is a safe, economic and effective treatment for malignant colonic obstruction in aged patients, especially reduces the risk of surgical complications, improves the aged patient's quality of life.

ObjectiveTo investigate the influence factors of operative effect in complex acetabular fracture. MethodsSixty-seven patients with complex acetabular fractures were selected. All patients were used surgical treatment,the clinical curative effect by Merle d'Aubigne-Postel hip scoring function to evaluate,set the age,sex, operation time,operative approach,the quality of fracture reduction,complex dislocation of the hip fracture and type of complex acetabular fractures with comparative index,the results were statistically analyzed. ResultsPatients were followed up for 6-24 months,the mean time was 14.6 months. Univariate analysis showed that the fine efficacy of surgery taken in no more than 2 weeks [84.0％ (42/50)]was better than more than 2 weeks [64.7％ ( 11/17 )](P ＜ 0.05 ). The high-quality of reduction [86.4％ ( 19/22 )]was better than low-quality of reduction [44.4％ (4/9)] (P ＜ 0.01 ). The compare of age,sex,operative approach,complex dislocation of the hip fracture were no statistically different (P ＞0.05).Complex acetabular fractures of T-shaped fracture healing rate was 85.7％ (12/14),the excellent rate was significantly higher than posterior column with posterior wall fractures[77.8％ (7/9)],transverse with posterior wall fractures [75.0％ (15/20)], anterior column with half of transverse fractures [66.7％ (2/3)],double-column fractures[71.4％ (15/21)],the results were statistically different. Conclusion The necessary conditions for ensuring fracture prognosis is the quality of reduction,timing of surgery,and type of fracture.

Background and purpose:This study aimed to estimate the spike-effect of domestic nanometer activated carbon on the radical operation for early stage low-lying rectal cancer. Methods:From Jan. 2013 to Dec. 2015, 66 patients with early stage low-lying rectal cancer were randomly divided into two groups:study group and control group. The patients of study group were treated with injection of carbon nanoparticles suspension in tumor vicinity before the operation. This study compared the total number of lymph node, the scale percentage of micro lymph node between two groups. SLNs of study group were obtained for pathological examination. Results:The differences in the total number of lymph node and the scale percentage of micro lymph node between two groups were statistically signiifcant (P<0.05). The diagnostic sensitivity and false-negative rate were 90.9%and 3.8%, respectively. Conclusion:Local injection of nanometer activated carbon around the tumor is important to the metastasis lymph node resection, especially to SLN biopsy in the radical operation for rectal cancer.

OBJECTIVE To discuss the liable episodes of the urinary tract infection with relation of catheter and propose the prevention measures.METHODS We radomly selected 536 patients with catheter.The urinary tract infection,as well as related factors were observed in patients with indwelling catheter.RESULTS The catheter replacement time interval as well as indwelling time were the risk factors,when the indwelling catheter time was 1-3 days,the CAUTI rate was 10.3%,if the time was ≥10 day,the CAUTI rate was 97.6%.Additionally the antibiotic use would cause dysbacteriosis which also easily caused the urinary tract road infection.CONCLUSIONS When taking care of the patients who had catheter,we should grasp the indications of catheterization,reduce the indwelling time,apply the effective nursing measures and correct choice of antibiotics,that can evidently control the infection.

Objective To evaluate the clinical effect of vertebra pedical nail strengthened by bone cement.Methods 48 cases with vertebral illness were divided into two groups,each group of 24 cases.One group goes ahead of the restvertebra pedical nail dishpour into viscous polymethyl methacrylate(PMMA),another group fixed by regular vertebra pedical nail.VAS score,spinal stability and JOA score were adopted to evaluate curative effect synthetically.Results After 1 month,6 months,12 months,the VAS scores in the treatment group were(3.12 ± 1.65),(3.08 ±1.10),(3.09 ± 1.25),and the VAS scores in the control group were(4.31 ±2.13),(4.22 ± 1.48),(4.12 ±1.34),the VAS scores had statistically significant differences between the two groups postoperative 1 month,6months,12 months(t =2.15,2.08,1.97,all P＜0.05);after 1 month,6 months,12 months JOA scores in the treatment group were(26.76 ±4.36),(26.78 ±2.10),(26.96 ± 1.89),and JOA scores in the control group were (24.13 ± 5.28),(24.32 ± 1.68),(24.32 ± 1.99),the JOA score differences had statistically significances between the two groups(x2 =5.031,P ＜0.05);the excellent rates of the treatment group was 90.13％,which was higher than 85.01％ of the control group(t =3.54,3.39,3.56,all P ＜ 0.05).Conclusion Patients receiving vertebra pedical nail strengthened by bone cement was better than regular vertebra pedical nail skill.

Objective To investigate whether there has any difference of gastric and small bowel transit time and completion rates between two capsule endoscopes with different size and weight. Methods Clinical data of patients who had undergone OMOM or MiroCam (smaller and lighter than OMOM) capsule endoscopy were retrospectively studied. Comparison of gastric and small bowel transit time and completion rates were made between the two kinds of capsule endoscopy. Results 1, 448 patients (628 in OMOM group and 820 in MiroCam group) were finally includ-ed. In patients with Crohn's disease or suspected Crohn's disease, gastric transit time of OMOM was significantly longer than that of MiroCam [(53.4 ± 52.6) minutes vs (41.1 ± 47.9) minutes, = 0.022]. In patients with gastroin-testinal bleeding, gastric transit time in OMOM was significantly shorter than that in MiroCam [(42.1 ± 44.8) minutes vs (62.0 ± 78.6) minutes, = 0.016). No significant difference in small bowel transit time or completion rate was found. Conclusions We conclude that the differences of gastric transit time, small bowel transit time and completion rates between the two kinds of capsule endoscopy with different size and weight are not significantly. Whereas, in patients with Crohn's disease or suspected Crohn's disease, gastric transit time of smaller and lighter capsule en-doscopy is shorter in patients with gastrointestinal bleeding, but longer of gastric transit time in smaller and lighter capsule endoscopy.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

Objective To detect CD_(36) expressions in polycystic ovary (PCO), and to explore its correlation with local androgen and insulin at transcription level. Methods From August 2002 to February 2003, 12 patients with asymmetric PCO, 15 primary or secondary infertile patients without endocrine disorders and 8 polycystic ovary syndrome (PCOS) with bilateral PCO were recruited. Extraction of follicular fluid and detection of testosterone(T), dehydroepiandrosterone sulfate (DHEAS), insulin (INS) and androstenedione (A_2) were performed. Relative CD_(36) mRNA expression level of human ovarian inner thecal cells was analyzed by auto image analysis system (IAS) after RT-PCR. Results The level of CD_(36) mRNA expression in thecal cells was 0.24?0.07 in polycystic ovary of PCO group and 0.21?0.05 in bilateral ovaries of PCOS group, respectively, which were significantly lower than 0.83?0.13 in normal ovaries (P