BACKGROUND:Non-operation therapies are commonly used in the treatment of cervical spondylopathy. All of these therapies involve biological mechanics; especially for traction and massage of the cervical vertebrae, they have an obvious property of biological mechanics in rehabilitation of the cervical vertebrae. OBJECTIVE: To probe into the biological mechanics of different rehabilitation methods through comparing the intervention effects between traction and traction combined with massage on cervical spondylopathy.DESIGN: A case-controlled observation. SETTING: Rehabilitation Center of West China Hospital of Sichuan University. PARTICIPANTS: Among the patients who came to the Rehabilitation Center of West China Hospital of Sichuan University between October 2002 and July 2003 for the treatment of spondylopathy, totally 52 patientsmet the criteria for non-operation therapy. They participated in the experiment voluntarily and were randomly divided into 2 groups: the experimental group and the control group, with 26 patients for each. METHODS: ①The patients in the experimental group were treated by traction in combination with massage. Traction was performed once a day,30 minutes each time, 5 times as a course of treatment, and one or two courses of treatment in total. Massage was performed for 8 to 10 minutes each time, once a day, 5 times as a course of treatment, and one or two courses in total. ② The patients in the control group were treated with traction only. Cervical Spondylopathy Therapeutic Effect Rating Scale was adopted to evaluate the effects, three items were selected to set as our scoring criterion, which included clinical symptoms, physical examinations and activities of the daily life (ADL). The improvement index was figured out on the basis of the pre-treatment score and post-treatment score. The improvement index is worked out by the following equation: improvement index = (The post-treatment score-pre-treatment score) / the post-treatment score. The improvement index was evaluated by physicians after the treat ment. Effectual: Clinical symptoms and body symptoms were obviously improved; work, learning, and daily life are not affected. Effective: Clinical symptoms and body symptoms have improved , and work, learning, and the daily life are partially affected. In-effective: There was no improvement in clinical symptoms and body symptoms and showed no effect on the work ,learning, and the daily life. MAIN OUTCOME MEASURES: ① Score of the treatment of cervical spondylopathy of the patients before and after the treatment. ② Intervention effect on the patients after the treatment RESULTS: Totally 52 patients with cervical spondylopathy entered the stage of result analysis with none missing in the midway. ① Comparison of the scores of the treatment of cervical spondylopathy of the patients before and after the treatment: After the treatment, the score in the experimental group was significantly higher than that in the control group [ 16.431 ±3.212,13.147 ±3.036 ( t =4.676, P ＜ 0.01 )], and the improvement index of the patients in the experimental group was significantly higher than that in the control group [0.505±0.163,0.368±0.145 (t=3.860, P ＜ 0.01 )]. ② Comparison of the intervention effects on the patients after the treatment: The effectual rate of the experimental group was higher than that of the control group (80.8%,46.2%).CONCLUSION: The approach of traction combined with massage is superior to simple traction. Different rehabilitation approaches have different properties in biological mechanics. It has showed that the force change is important to therapeutic effectiveness on cervical spondylopathy.

Objective To study the effect of various methods determining lung volume and fraction dose on the lung dose-volume parameters for lung cancer patients. Methods Twenty patients with lung cancer were rantdomly enrolled into our study and the plan of three dimensional eonformal radiation therapy(3DCRT)was designed by Varian Eclipse TPS.The lung volumes and the dose-volume parameters were measured under CT value of-300- -980, -400- -980 and -500- -980.Under CT value of -400- -980,total lung volumes were confirmed.The dose-volume parameters of V30,V20,V10 and mean lung dose(MLD)were reevaluated after GTV,CTV and PTV were subtracted from the total lung volumes and when the fraction dose was elevated from 2.0 Gy to 10.0 Gy. Results When the CT value ranged from-300--980 to-500--980,the median reduction of the total lung volumes(-9.10%)was significantly higher than that of V30,V20,V10 and MLD(-3.18%,-1.13%,0.82%and-0.79%,respectively).When the total lung volume was fixed at CT value of-400--980,the alterations of V30,V20,V10 and MLD became more apparent as the increase of the subtracted lung volume,among which the alteration of V30 was most significant while V10 the least.Among five cases with a fixed total dose of 60 Gy and PTV less than 140 cm3,the V30,V20,V10 and MLD were increased to a similar extent(about 40%)when the fraction dose was increased from 2.0 Gy to 10.0 Gy.MLD was increased(36%)when the fraction dose was above 6.0 Gy. Conclusions When CT value ranges from-300- -980 to-500- -980,the total lung volume is influenced most.The alteration of V30,being statistically significant,might have some significance but is not enough to determine the plan of radiotherapy clinically.The alteration of V20、V10 and MLD is not statistically significant.When the overlapped target volume is subtracted from the total lung volumes,the alteration of V30 is the most sign:tifhcant while V10 the least.The fraction dose,being the most consuming factor(＞10%)when comparing with the CT valHe and targeted volume,can significantly influence the dose-volume parameter.

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Objective To explore the protective effect of a small balloon on bifurcation lesions by applying a single stent treatment of coronary bifurcation lesions strategy. Methods Fifty patients with coronary bifurcation lesions were randomly divided into A group and B group( 25 cases for each group ). Patients in A group were treated with the pre-entry protection branch guide wire to complete the main branch balloon pre-dilation,stenting,while in B group were treated with the set aside the branches of a small balloon. The information of main branch balloon pre-dilation,stenting were recorded. The blood flow slowed down,the incidence of side branch occlusion or stent placement,and the incidence of postoperative 24 h troponin I( cTnI) levels were measured. Results Nine cases(36%)in A group occurred lower branch blood flow,which due to 4 cases(16% )with significantly narrow branch stenting,2 cases(8%)with complete occlusion. There were only 2 cases(8%)with decrease branching blood flow in B group,and the difference was significant(P=0. 041, 0. 022). The cases with higher cTnI after 24 h in A group were 11( 39%),significantly higher in group B (3(12 %);P =0. 027 ). Conclusion Compared with the traditional protection guidewire,the approach of setting aside a small balloon to protect important branch can effectively prevent important branch occlusion, branch involvement due to lower incidence of myocardial infarction.

Objective To investigate the clinicopathological characteristics, diagnosis and treatment of huge adrenal tumor.Methods Retrospectively analysed the clinical data of the 2 patients with huge adrenal tumor more than 10 cm in diameter, who were admitted in our hospital from September 2013 to January 2015.Clinical manifestations, treatment and prognosis were evaluated.Results Two patients were both suspected of adrenocortical carcinomas.Case 1 was a 28-year-old female.Laparoscopic surgery was performed at first but was conversed to open palliative adrenalectomy due to tumor rupture and bleeding.The postoperative pathology was adrenocortical carcinoma.The patient died of gastrointestinal bleeding caused by tumor metastasis 10 months later.Case 2 was a 39-year-old female, who underwent laparoscopic adrenolectomy with tumor excision completely.The postoperative pathology showed neoplasm of malignant potential, and no tumor recurred in 15 months follow-up.ConclusionsOpen surgery should be the priority if the diameter of adrenal tumor is more than 10 cm and diagnosis as suspicious of malignancy.Huge adrenocortical carcinoma is related to poor therapeutic response,and multimodality therapy may improve the prognosis.

Objective:To analyze the learning effect of laparoscopic radical cystectomy(LRC)+ modified ileal conduit(MIC).Methods:From 2014 to 2019, 42 patients underwent MIC and their clinical data was retrospectively analyzed. 34 operations were performed by surgeon 1 and 8 operations by surgeon 2. We divided the 34 patients of surgeon 1 into three groups according to their surgical sequence (group A, 1st to 12th; group B, 13th to 23th; group C, 24 th to 34 th), the 8 cases of surgeon 2 was regarded as group D. The history of abdomen surgery in the 4 groups were 0, 1, 4, 3 cases, respectively ( P<0.05). There was no significant difference of the other baseline characteristics, such as age, BMI, American Society of Anesthesiologists. Then we compared several variables between the 4 groups like operation time, time of ileal conduit construction, blood loss, complication rate, lymph node yield, surgical margin, etc. The key steps of the MIC included isolating terminal ileum when the mesentery was transilluminated, performing end-to-end reflux ureterointestinal anastomosis after the efferent loop was fixed, closing the rent of the retroperitoneum. Results:All operations were performed intracorporeally with no transition to open surgery. The operative time for group A, B, C were 330.0(320.0, 360.0)min, 300.0(250.0, 308.0)min, 270.0(216.0, 324.0)min, respectively ( P =0.010). The time of ileal conduit construction of the 3 groups were 136.5(131.3, 147.5)min, 92.0(79.0, 119.0)min, 79.0(72.0, 115.0)min, respectively ( P <0.001). In addition, the difference of the two variables above between A and B, A and C groups separately reached statistical significance ( P<0.05), while the difference between B and C groups did not ( P>0.05). Other variables, such as blood loss, complication rate, lymph node yield, surgical margin, between the 3 groups reached no statistical significance ( P>0.05). The operative time of group D was 420.0(350.0, 450.0)min, and it reached statistical significance ( P<0.05) when compared with group A. There were no significant differences in other variables, such as blood loss, complication rate, lymph node yield, surgical margin, among the 2 groups ( P>0.05). Conclusions:The learning effect of LRC+ MIC was obvious. When surgeon volume increased, the operative time decreased significantly. Variables like estimated blood loss and complication rate of the 2 surgeons did not reached significant difference, which indicated reproductivity and safety of this procedure.

Objective To assess the perioperative safety and postoperative function of the pure 3-dimensional laparoscopic cystectomy and urinary diversion (P3DLC-UD).Methods From April 2014 to July 2015,P3DLC-UD was performed in 15 patients diagnosed with the bladder cancer in our center (orthotopic ileal neobladder for 8 cases and ileal conduit for 7 cases).Perioperative data,postoperative continence and overall survival rate were retrospectively analyzed.Results Fifteen patients underwent P3DLC-UD successfully as planned,with 8 patients underwent orthotopic ileal neobladder and 7 patients underwent ileal conduit.In neobladder group,the operative time were 300-600mmin (mean 428 min),estimated blood loss were l 00-400ml (mean 210mml),and dissected lymph nodes were 11-29 (mean 16).One patient required blood transfusion (800ml) and one patient was diagnosed of constipation.The patients were followed up for a median period of 10 months (3-15 months).The renal function was normal with serum creatinine of 36.4-99.0 μ mol/L (mean 77.3 μmol/L).One patient died of intestinal obstruction and 8 patients had no recurrence in neobladder group.As to postoperative continence,only 2 patients demanded 1 pad at daytime,while all patients needed 1 pad at nighttime.In ileal conduit group,the operative time were 300-390 min (mean 354 min),estimated blood loss were 50-400ml (mean 190ml),and dissected lymph nodes were 9-41 (mean 22),while 9-41 (mean 19) lymph nodes were got for all 15 cases.Two patients were diagnosed with urinary infection after the surgery.The patients were followed up for a median period of 5 months (1-9 months).The renal function was normal with serum creatinine of 36.4-74.0 μmol/L (mean 60.8 μmol/L).One patient died of cerebral infarction,and 1 patient found distant metastases in lung and died of cancer after chemotherapy during the follow-up period.There were no recurrent tumors of the other 5 patients in ileal conduit group.Conclusions P3DLC-UD is safe and feasible.More extensive,longer-term randomized trials are required to comprehensively assess the appropriateness and potential of this technique.

OBJECTIVETo propose measures for enhancing thermal energy utilization by analyzing drying process and operation principle of fluidized bed dryers,in order to guide optimization and upgrade of fluidized bed drying equipment.

METHODThrough a systematic analysis on drying process and operation principle of fluidized beds,the energy conservation law was adopted to calculate thermal energy of dryers. The thermal energy of fluidized bed dryers is mainly used to make up for thermal consumption of water evaporation (Qw), hot air from outlet equipment (Qe), thermal consumption for heating and drying wet materials (Qm) and heat dissipation to surroundings through hot air pipelines and cyclone separators.

RESULTEffective measures and major approaches to enhance thermal energy utilization of fluidized bed dryers were to reduce exhaust gas out by the loss of heat Qe, recycle dryer export air quantity of heat, preserve heat for dry towers, hot air pipes and cyclone separators, dehumidify clean air in inlets and reasonably control drying time and air temperature.

CONCLUSIONSuch technical parameters such air supply rate, air inlet temperature and humidity, material temperature and outlet temperature and humidity are set and controlled to effectively save energy during the drying process and reduce the production cost.

Air ; Chemistry, Pharmaceutical ; methods ; Conservation of Energy Resources ; methods ; Hot Temperature ; Humidity ; Pharmaceutical Preparations ; chemistry ; Technology, Pharmaceutical ; methods ; Temperature ; Water ; chemistry

Objective:To analyze the mean levels of skeletal muscle mass and strength in elderly patients with type 2 diabetes mellitus(T2DM), and to investigate the effects of chronic inflammatory factors and oxidative stress on them.Methods:A cross-sectional study was conducted on 120 patients with T2DM aged over 60 years and 126 elderly patients without diabetes(the control group). Skeletal muscle mass, strength and serum levels of chronic inflammatory factors interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and 8-hydroxy-2′-deoxyguanosine(8-OHdG)were determined, and their effects on skeletal muscle mass and strength in elderly patients with T2DM were analyzed.Results:Compared with the control group, grip strength decreased in elderly patients with T2DM(25.03±7.85)kg vs.(29.52±7.73)kg( P<0.01), and skeletal muscle mass decreased(21.36±5.46)kg vs.(22.01±5.22)kg with no significant difference( P>0.05). Serum levels of 8-OHdG were higher in elderly patients with T2DM than in the control group(3.08±0.26)ng/L vs.(2.59±0.16)ng/L( P<0.01). Correlation and regression analysis results showed that 8-OHdG was an influencing factor for muscle strength in elderly patients with T2DM( R2=0.457)and that height and weight could be influencing factors for skeletal muscle mass in elderly patients with T2DM( R2=0.822). Conclusions:Skeletal muscle mass and strength decline in elderly T2DM patients, probably as a result of increased levels of oxidative stress.These findings may serve as evidence for sarcopenia intervention in elderly T2DM patients.