OBJECTIVE To investigate the characteristic computer tomography (CT) changes in cases of one-sided chronic ethmoid-maxillary sinusitis. METHODS The CT results of 76 patients diagnosed with one-sided chronic ethmoid-maxillary sinusitis were reviewed. RESULTS There were 51 patients with one-sided chronic ethmoid-maxillary sinusitis on the right side and 25 patients on the left side. There were 48 cases of obstruction of the ostium of the maxillary sinus. The characteristics of soft tissue lesions were mucosa hypertrophy and polypiform density spot. There were 9 cases with bony destruction. CONCLUSION More cases with pathologic changes on the left side were found. The obstruction of the ostium of the maxillary sinus and the abnormal anatomy of ostiomeatal complex were identified as important anatomical features of one-sided chronic ethmoid-maxillary sinusitis.

Objective To explore the clinical outcome with anterior debridement,bone graft and posterior internal fixation with short nail of treating intervertebral infection.Methods Ninteen cases (11 male and 8 female,aged from 34 to 63,46 on average) of lumbar intervertebral space infection treated in our hospital from June 2008 to June 2013 were retrospectively analyzed.These infections occurred at L2-L3 in 2 cases,L3-L4 in 5 cases,L4-L5 in 8 cases and L5-S1 in 4 cases.All patients had history of disc surgery or puncture.The clinical outcome after operation was analyzed according to the low back paine after operation which analyzed by visual analog scale (VAS),and the bone fusion.Erythrocyte sedimentation rata and C-reactionprotein were aslo recorded before and after surgery.Results All cases were followed up,average 24 months.The lower back pain was improved obviously between preoperation and postoperation (P ＜0.05).Also erythrocyte sedimentation rata and C-reactionprotein returned to normal after the operation and all cases had complete bone union at the end of follow-up with no instrument failure noted.Conclusion Anterior debridement,bone graft and posterior internal fixation with short nail in of treating intervertebral infection not only can effectively reconstruct the stability of the spine,but also retain range of motion segment of spine.

Objective To explore the clinical significance of procalcitonin(PCT) in the diagnosis of bacterial infection in burn pa‐tients .Methods Among 169 burn patients ,96 cases were bacterial infection confirmed by blood ,secretion and puncture fluid culture and 73 cases were non‐bacterial infection .PCT ,WBC and hyper sensitive C reactive protein (hs‐CRP) were detected .The diagnostic values in bacterial infection were compared among these 3 indexes and the relationship between PCT level and burn degree was fur‐ther studied .Results Serum PCT ,WBC and hs‐CRP levels in the bacteria infection group were obviously higher than those in the non‐bacterial infection group(P<0 .05);the sensitivity ,specificity ,positive predictive value and negative predictive value of PCT were 90 .63% ,89 .04% ,91 .58% and 87 .84% respectively ,which indicated that PCT had higher diagnostic value than WBC and hs‐CRP .The PCT level was positively correlated with the degree of burn degree .Conclusion Serum PCT ,WBC and hs‐CRP in the burn patients with bacteria infection are greatly increased .PCT as the marker of bacterial infection has the higher sensitivity and specificity than WBC and hs‐CRP in the diagnosis of bacteria infection .

AIM To study in vitro stereoselective metabolism of mandelic acid (MA) in 3 kinds of laboratory animal tissue fractions and observe the differences of MA biotransformation. METHODS MA enantiomers were incubated with the tissue fractions from rats, mice and rabbits. The phenylglyoxylic acid (PGA) concentrations in incubation mixture were determined by high-performance liquid chromatography. Coenzymes and inhibitors were co-incubated with MA to investigate their effects on MA metabolism. RESULTS Only S-MA showed a unique metabolism in liver and kidneys S9 fractions of rats. No inhibition of the enzyme activity was observed by addition of ethanol or 4-methyl pyrazole. NADPH caused a remarkable increase in S-MA metabolism. CONCLUSION Nonmicrosomal enzymes in kidneys and liver except alcohol dehydrogenase are responsible for the stereoselective metabolism of MA in rats. The MA biotransformation is significantly different between rats and mice or rabbits.

Objective To explore the clinical efficacy of polymethyl methacrylate (PMMA) augmented pedicle screw instrumentation and fusion for old osteoporotic vertebral compression fractures complicated with spinal instability. Methods The clinic data of 26 old patients with osteoporotic vertebral compression fractures complicated with spinal instability treated from June 2011 to June 2015 were retrospectively analyzed. Among them, there were 5 male patients aged from 61 to 72 years and 21 female patients aged from 56 to 75 years. All patients had history of chronic low back pain. The clinical outcome after operation was analyzed according to visual analog scale (VAS) and Oswestry dysfunction index (ODI). The status of bone fusion were aslo recorded before and after surgery. Results There were no pulmonary embolism, infection, toxic reaction of PMMA, and no nerve root compression and damage occurred in patients. The operation time was (105.0 ± 20.5) min, and bleeding volume was (200 ± 55) ml. The operative incision was healed in Ⅰ stage. All patients were followed up for 12-27 months, and average was 14 months. The levels of VAS scores and ODI scores after operation and 1, 3, 6, and 12 months after operation were significantly increased compared with those before operation (P<0.05). Conclusions PMMA augmented pedicle screw instrumentation and fusion is an effective method for old osteoporotic vertebral compression fractures complicated with spinal instability.

ive] To observe the effects of Shengjiang Capsule (SC) on gastric evacuation and to study its mechanism. [Methods] Eight-week-old SD rats were randomly allocated to five groups. Group A served as normal control, and Group B were treated with high dosage of SC, Group C with low dosage of SC, Group D with Zhike Baizhu Decotion and Group E with cisapride. After ten days of treatment, gas tric evacuation of rats was detected by isotope tracing method, erythrocyte-acetycholinesterase activity by micro-hydroxylamine method and plasma motilin (Mot) and somatostatin (SS) levels by radioimmunoas-say. [Results] Thirty-minute gastric evacuation rate was (51.44?.38)%, (40.82 + 7.24)% and (40.22?.16)% in Group B, Group C and Group D respectively, which was higher than that in Group A [ (33.18?.32)%]. Erythrocyte-acetycholinesterase activity, Mot and SS levels were (0.856?.128) umol/h, (124.26?5.94) ng/L and (39.42?.96) ng/L, and (0.726?.164 ) umol/h, (119.86 ?9.38) ng/L and (38.33 ?.64) ng/L in Group B and Group C respectively, which were higher than those in Group A [ (0.576 ?.150)/umol/h, (91.28 + 26.84) ng/L and (28.22 ?7.68)ng/L]. [Conclusion] SC can promote gastric evacuation, and its mechanism may be re lated to the increase of the cholinergic nerve function and plasma Mot and SS levels.

Objective To evaluate the clinical efficacy and safety of Xuebijing injection in treatment of sepsis and multiple organ dysfunction syndrome ( MODS ). Methods A prospective multicenter clinical study was conducted. The patients with sepsis, severe sepsis, or MODS admitted to Department of Emergency and Critical Care Medicine of 70 hospitals across the country during 2006 to 2008 were enrolled. All of the patients received the basis treatment of conventional therapy, plus Xuebijing injection of 50-100 mL, 2-3 times a day for 5-7 days, and the dose might be increased in serious cases. The vital signs, 24-hour urine output, Glasgow coma score ( GCS ), white blood cell count ( WBC ), platelet count ( PLT ), Marshall score, gastrointestinal function score, syndrome of traditional Chinese medicine ( TCM ), blood lactate ( Lac ), blood glucose, serum creatinine ( SCr ), and total bilirubin ( TBil ) were observed before treatment, 1, 3, and 5 days after treatment, and at the end of the treatment. The results of above mentioned parameters after the treatment were compared with that before treatment in each patient. At the same time, the occurrence and the degree of adverse reactions were recorded to evaluate the safety of Xuebijing injection. Results A total of 2 574 patients were enrolled, and in 2 509 cases the treatment was completed in, with a drop of 65 cases. 704 cases were diagnosed to have sepsis, 768 with severe sepsis, and 1 037 with MODS. According to TCM, in 1 951 cases syndrome of stasis-toxin in the interior, and in 558 syndrome of excessive exuberance of heat-toxic in the interior were diagnosed. After the treatment of Xuebijing injection combined with conventional therapy, the temperature, heart rate, respiration rate, blood pressure, WBC, PLT, GCS, 24-hour urine output, blood glucose, Lac, SCr, TBil, Marshall score, gastrointestinal function score, as well as the symptoms, signs and TCM tongue condition and pulse condition, and TCM scores were significantly improved in all patients as well as the patients with sepsis, severe sepsis, or MODS ( P < 0.05 or P < 0.01 ). The effective rate of all patients and the patients with sepsis, severe sepsis, or MODS was 89.20%( 2 238/2 509 ), 92.76%( 653/704 ), 91.54%( 703/768 ), 85.05%( 882/1 037 ), respectively, and the 28-day survival rate was 93.90%( 2 356/2 509 ), 98.01%( 690/704 ), 96.35%( 740/768 ), 89.30%( 926/1 037 ), respectively. In 3 patients with MODS adverse events ( 0.12%) occurred, including 2 cases of stress ulcer and 1 case of Adams-Stokes syndrome. After clinical evaluation, the adverse events were found to be unrelated with the study medication, and Xuebijing injection was continued till the end of treatment. Conclusion Xuebijing injection combined with conventional therapy may effectively ameliorate systemic inflammatory response, protect organ function, alleviate the symptoms, improve organ functions, and elevate the clinical cure rate. Adverse events occur occasionally. Xuebijing injection is found to be safe.

Objective To summarize the clinical experiences in setting up cardiopulmonary bypass(CPB)using extracorporeal membrane oxygenation(ECMO)circuit and turning CPB to ECMO after open heart operations in 16 cases.Methods In the group of 16 cases,the annulations were via femoral vessels:by Medtronic ECMO machine and membrane oxygenator was used in all patients.All patients accepted A-V bypass.Results CPB was running smoothly during the operations,and converted to ECMO after the surgeries without complications,and the rate of ECMO withdraw was 93.75%.Mortality was 18.5%,and 81.25%of patients were discharged.Conclusion ECMO is an effective device for cardio and pulmonary support.Many patients with severe cardiac diseases and marginal cardiac function will need mechanical support after surgery.For these patients,setting up CPB using ECMO circuit during the operation and converting it to ECMO after surgery can prevent patients from additional exposure to a standard CPB circuitry.It helps decrease the inflammatory response,avoid dilution of patient's volume of cells and factors,and reduce expenses.

Objective To investigate the relationship between serum progesterone level at the day with human chorionic gonadotrophin (hCG) administration and pregnant outcome from in in-vitro fertilization-embryo transfer(IVF-ET). Methods From Mar. 2002 to Apr. 2007, 786 cycles with serum progesterone measurement on the day of hCG administration for final oocyte maturation in IVF were analyzed retrospectively in Reproductive Medicine Center in First Affiliated Hospital of Nanjing Medical University.All stimulations were down-regulated with gronadotrophin release hormone agonist (GnRH-a) in both long protocols and short protocols before gonadotrophin stimulation. When the thresholds of serum progesterone were set at 5.5, 6.0,6.5,7.0,7.5,8.0,8.5 and 9.0 nmol/L, respectively. If the level of progesterone was less than the thresholds, those patients were in lower progesterone group, on the contrary, more than the threshold value, those patients were in higher progesterone group. The laboratory results and the clinical outcomes between all patients at lower and higher progesterone group at different thresholds value were analyzed. Results The rate of normal fertilization, quality embryos, successful implantation, chemical pregnancy, clinical pregnancy and live birth did not exhibit remarkable difference between patients with higher and lower serum progesterone level at multiple thresholds on the day of hCG administration in the 786 cycles (P >0.05). However, when the thresholds of serum progesterone were at 8.5 and 9.0 nmol/L, early abortion rates of 27.3% (3/11) and 3/7 in higher progesterone group were significantly higher than 8.8% (26/297) and 8.6% (26/301) in lower progesterone group (P<0.05). And the total abortion rates of 3/7 in higher progesterone group were significantly higher than 11.0% (34/301) in lower progesterone group when the thresholds of serum progesterone were 9.0 nmol/L (P<0.05). Conclusions This study did not prove the correlationship between progesterone level at the clay with hCG administration and the probability of clinical pregnancy or live birth. However, early abortion rates or the total abortion rates were associated with higher progesterone level when the thresholds of serum progesterone were at 8.5 nmol/L or 9.0 nmoL/L.

Objective:To compare the efficacy of cervical decompression performed at different times in the treatment of incomplete cervical spinal cord injury.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 96 patients with incomplete cervical spinal cord injury admitted to six hospitals including Honghui Hospital affiliated to Xi'an Jiaotong University, etc, from May 2018 to May 2021. There were 36 females and 60 males, aged 28-42 years [(35.2±6.7)years]. The injured segments were at C 3 in 7 patients, C 4 in 15, C 5 in 20, C 6 in 23 and C 7 in 31. According to the American Spinal Injury Association (ASIA) scale, there were 59 patients with grade B, 27 grade C, and 10 grade D. A total of 36 patients underwent cervical decompression within 24 hours after injury (early group), 33 patients within 24-72 hours after injury (late group), and 27 patients within 4-14 days after injury (delayed group). The operation time, intraoperative blood loss, postoperative drainage, length of hospital stay, Cobb angle, height of intervertebral space and space occupation of the spinal canal before surgery and at postoperative 3 days, and ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, visual analog scale (VAS) score, Japanese Orthopedic Association (JOA) score, neck dysfunction index (NDI) before surgery and at postoperative 3 months, 1 year and at the last follow-up and incidence of complications were compared among the three groups. Results:All the patients were followed up for 12-21 months [(16.4±4.2)months]. There was no significant difference in the operation time among the three groups (all P>0.05). The intraoperative blood loss and postoperative drainage volume in the early group were (312.5±5.2)ml and (165.3±45.8)ml, which were higher than those in the late group [(253.5±40.0)ml, (120.4±60.6)ml] and the delayed group [(267.3±36.8)ml and (130.4±38.6)ml] (all P<0.01). There was no significant difference between the late group and the delayed group (all P>0.05). The length of hospital stay in the early group was (5.2±1.6)days, which was shorter than that in the late group [(7.6±2.3)days] and the delayed group [(8.0±1.3)days] (all P<0.05), but there was no significant difference between the late group and the delayed group ( P>0.05). There was no significant difference in the Cobb angle, height of intervertebral space and space occupation of the spinal canal among the three groups before and at postoperative 3 days (all P>0.05). There was no significant difference in the ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, VAS score, JOA score and NDI among the three groups before surgery (all P>0.05). At postoperative 3 months, 1 year and at the last follow-up, the ASIA grading of the early group was better than that of the late group and the delayed group ( P<0.05 or 0.01), but there was no statistically significant difference between the late group and the delayed group (all P>0.05). The ASIA motor scores of the early group were (56.4±4.5)points, (76.3±3.6)points and (85.4±6.5)points at postoperative 3 months, postoperative 1 year and the last follow-up, respectively, which were higher than those in the late group [(52.3±2.4)points, (60.3±8.6)points and (72.3±2.4)points] and the delayed group [(51.9±2.3)points, (62.8±4.6)points and (71.9±1.3)points]; the ASIA light tactile scores of the early group were (70.2±2.9)points, (72.6±4.3)points and (78.3±2.3)points, which were higher than those in the late group [(66.2±3.7)points, (68.3±1.6)points and (73.3±1.6)points] and the delayed group [(65.2±2.1)points, (67.8±1.9)points and (72.3±2.5)points]; acupuncture sensation scores of the early group were (71.9±3.1)points, (80.1±3.8)points and (89.1±7.6)points, which were higher than those in the late group [(67.4±2.7)points, (72.6±3.7)points and (77.9±1.8)points] and the delayed group [(68.3±2.2)points, (72.6±3.1)points and (77.2±1.9)points] (all P<0.05). VAS scores of the early group at postoperative 3 months, 1 year and at the last follow-up were (4.3±0.6)points, (2.4±0.3)points and (1.6±0.2)points, which were lower than those in the late group [(5.1±1.3)points, (4.1±0.6)points and (3.0±0.6)points] and the delayed group [(5.0±1.7)points, (4.0±0.8)points and (3.1±0.2)points]; JOA scores of the early group were (12.8±1.6)points, (14.4±2.6)points and (17.9±3.3)points, which were higher than those in the late group [(11.9±1.9)points, (13.3±1.6)points and (8.9±1.3)points] and the delayed group [(11.6±1.8)points, (13.2±1.4)points and (9.3±2.1)points]; NDI scores of the early group were 12.1±3.3, 10.1±2.1 and 7.3±1.4, which were lower than those in the late group (14.4±3.1, 12.3±1.6 and 8.9±1.3) and the delayed group (14.1±2.3, 12.9±1.9 and 9.5±2.1) (all P<0.05). There was no significant difference in all the above-mentioned scores at postoperative 3 months, 1 year and at the last follow-up between the late group and the delayed group (all P>0.05). The incidence of complications was 25.0% (9/36) in the early group, 27.3% (9/33) in the late group and 37.0% (10/27) in the delayed group (all P>0.05). Conclusion:Compared with within 24-72 hours and 4-14 days after injury, cervical decompression performed within 24 hours after injury for patients with incomplete cervical spinal cord injury can shorten the length of hospital stay, improve the function of the spinal cord nerves and relieve pain, with no increase of the incidence of complications.