Since the instability of the spine caused by trauma,tumor,tuberculosis,deformity cor-rection and other reasons requires reconstruction,many scholars have conducted a large number of thorough researches,but the treatment options for unstable cervical spine still plague the clinicians.Considering the factors of stability and safety,more and more clinicians choose cervical pedicle screw placement as the treatment for spinal instability.In this work,the most common methods and the latest technologies of cervi-cal pedicle screw placement at home and abroad are summarized and reviewed.It provides references for clinical practices and presents the significance of high-tech assisted screw placement in the future.

ObjectiveTo investigate advantage and disadvantage of different rehabilitation therapies used for cerebral palsy (CP) children complicated with epilepsy (EP).Methods140 CP children complicated with EP screened from 1402 CP cases, were analyzed for CP and EP types, MRI or CT, brain stem auditory evoked potentials (BAEP). All cases were treated with anti-epilepsy drugs (AEDs). Different rehabilitation therapies, including electrotherapeutic modalities, acupuncture, point injection, cerebroprotein hydrolysate injection, manual therapy, functional training, Chinese herb braising therapy, and cattle encephalon glycoside and ignotin injection were assessed.ResultsIn all 140 cases, a majority of EP types were myoclonic seizure and west syndrome, CP type was spasticity. Abnormality showed in MRI or CT (98%) and BAEP (90%). AEDs were effective for all 140 cases. Electrotherapeutic modalities, acupuncture, point injection, and cerebroprotein hydrolysate injection could make EP severely, but manual therapy, functional training, Chinese herb braising therapy, cattle encephalon glycoside and ignotin injection had no adverse effects on EP cases.ConclusionThe principles of rehabilitation treatment for the CP children complicated with EP are taking AEDs early and in a long term, avoiding electrotherapeutic modalities, acupuncture, point injection, and cerebroprotein hydrolysate injection, using manual therapy, functional training, Chinese herb braising therapy, and cattle encephalon glycoside and ignotin injection.

Objective To investigate the effects of ropivavaine on gamma -aminobutyric acid(GABA)-activated membrane cur-rents in isolated dorsal root ganglion(DRG) neurons of the rats with ischiadic nerve chronic constriction injury (CCI) and to discuss the possible analgesia mechanism of ropivacaine .Methods The whole-cell patch clamp technique was used to record and compare the changes of GABA receptor activation currents of acute isolated DRG neurons after 30 s of ropivacaine preperfusion in the oper-ating side and the operative opposite side of the CCI model rats and the sham-operation group .Results (1)Compared with the oper-ative opposite side ,the sham-operation group and the control group ,the thermal withdrawal latency in the operative side group of the CCI model rats was notablely shortened(P<0 .05);(2)the amplitude of GABA-activated currents with different concentration GABA(0 .1-1 000μmol/L) in the operative opposite side group of the CCI operation was significantly greater than that of the op-erative side group and the sham-opeartion group ;(3)DRG neurons after ropivacaine preperfusion (0 .1-1 000μmol /L) showed va-rying degrees of enhancement effect on the 100 μmol/L GABA-activated currents ,the enhancement amplitude in the CCI operative opposite side group was significantly greater than that in the operative side group and the sham-operation group ;(4)The dose-re-sponse curve of DRG neurons GABA (0 .1-1 000μmol/L) activated current in the operative side group of the CCI rats after ropiva-caine pre-perfusion (100 μmol/L) was shifted to the left ,the difference between two EC50 had no statistical significance (P>0 .05) .Conclusion Ropivacaine has the enhancement effect on GABA activated currents in the DRG neurons of the CCI model rats , which could be one of reasons for ropivacaine producing the anesthetic and analgesic effect .

Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

Childhood malignant solid tumors exhibit a wide variety of vagueness signs and symptoms in the early stage,which are usually nonspecific,therefore the diagnosis of childhood malignant solid tumor can be challenging when the disease is in the early stage.As a result,the delay of diagnosis causes mistreatment,and which makes childhood malignant solid tumors become a leading cause of death in children.Physicians should recognize the early warning signs of childhood cancer,and a good clinical history and careful physical examination can help physicians determine whether the children have cancer and make referrals in time.Some children with possible cancers require immediate initial treatment before referral to be stabilized in order to make the referrals possible and increase the chance of receiving appropriate treatment in time and the possibility of being cured,saving more children with malignant solid tumors to the maximum extent.

Objective To find the source of CA 125 in serum and the values of the expression of CA125 in serum, ascites and tissue in patients with epithelial ovarian cancer. Methods Detected the expression of CA125 in the primary lesions of epithelial ovarian cancer and the metastasis in abdominopelvic cavity (peritoneal and omental metastatic lesions) by S-P immunohistochemical methods. Compared the expression of CA 125 in tuberculose focus and acute inflammation focus in abdominopelvic cavity and detected CA125 in serum and ascites by ELISA. Results The levels of CA125 in serum of the patients with epithelial ovarian cancer [(523.66±158.02)kU/L],benign epithelial ovarian tumor [(138.11±26.52)kU/L] and tuberculosis of abdominopelvie cavity [(486.56±147.10)kU/L] were higher than that with the normal ovary [(17.48±3.37)kU/L], and there were significant differences (P<0.05).The levels of CA125 in serum of the patients with epithelial ovarian cancer and tuberculosis of abdominopelvic cavity were significantly higher than that with benign epithelial ovarian tumor, and there were significant differenees (P<0.01). The levels of CA125 in ascites of the patients with epithelial ovarian cancer [(996.85±337.87)kU/L] and tuberculosis of abdominopelvic cavity [(596.78±197.10)kU/L] were higher than that with benign epithelial ovarian tumor [(179.48±63.08)kU/L] and normal ovary [(177.70±51.72)kU/L], and there were significant differences (P<0.01).The level of CA125 in ascites of the patients with epithelial ovarian cancer was higher than that with tuberculosis of abdominopelvic cavity, and there was significant difference (P<0.01). By correlation analysis, the relationship of the level of CA 125 in serum and in ascites of the patients with epithelial ovarian cancer was positive correlation(r=0.687). Conclusion Besides the original and metastatie lesions (greater omenta and peritoneum) of epithelial ovarian cancer can express CA 125, the second Maller canal, for example the peritoneum mesothelial cell can be stimulated to express CA125 by ascites, which results in the increase of CA125 in serum.

Education history and characteristics of oral implantology especially in China were reviewed and commented.Curriculum establishment in China medical universities was proved to be necessary and feasible by analysis of current domestic education condition of graduate and postgraduate.education in oral implantology.In recent three years.practices in implantology education was carried out in School of Stomatology,Fourth Military Medical University.Implantology curriculum was established,with teaching experiences and methods summarized for reference of lmplantology education in other universities.

Objective To compare the efficiencies of enteral nutrition with nasogastric tube with that of enteral nutrition with endoscopic gastrostomy tube in ICU long-term bedridden patients. Methods A total of 6 patients who were admitted in our ICU between January 2008 and September 2009 were enrolled in this study. The expected completion of daily calorie supply, completion of total volume of nutrient fluid feeding, nutrient fluid backstreaming condition, and incidence rate of tube obstruction were compared between those supported with nasogastric tube and endoscopic gastrostomy tube. Results The completion of daily calorie supply and completion of total volume of nutrient fluid feeding were significantly superior in patients who were supported with endoscopic gastrostomy tube than those with nasogastric tube (P = 0. 002 and P = 0. 008, respectively). In addition, nutrient fluid backstreaming condition and incidence rate of tube obstruction were significantly lower than with nasogastric tube (P= 0. 011 and P = 0. 021, respectively). Conclusion Enteral nutrition with endoscopic gastrostomy tube is more efficient in reaching the nutrition support target than with nasogastric tube.

BACKGROUND:With the improvement of cervical posterior surgical techniques, lateral mass screw fixation technology has been widely used in the reconstruction surgery of the cervical spine for stability. However, currently, the finite element study on the lateral mass screw fixation reconstruction of the cervical spine is rare. OBJECTIVE:To establish a fine normal lower cervical spine (C3-C7 ) three-dimensional finite element model and a reconstructed finite element model with three-segment laminectomy with lateral mass screw fixation. Then, to do an initial biomechanical analysis of the lateral mass screw fixation reconstructed lower cervical finite element model. METHODS:We col ected a normal female volunteer aged 30 years old to do CT scan for the whole cervical spine. The Dicom data were obtained. Then, the CT scanning images were dealt with software Mimics 10.01, Geomagic Studio 12.0, Solidworks2012, HyperMesh 10.1 and Abaqus 6.12 software to build the normal lower cervical spine (C 3-C7 ) finite element model, the laminectomy finite element model and the rebuilt finite element model. At last, we analyzed the stress changes of reconstructed models under the state of flexion, extension, lateral bending and rotational motion. RESULTS AND CONCLUSION:The lower cervical spine finite element model contained 503 911 elements and 93 390 nodes with a fine realistic appearance. It successful y passed the validation. The surgical procedure was completed in the software, and the lateral mass screw fixation reconstruction finite element model has been established. Lateral mass screw fixation system provides good stability for the postoperative finite element model. The activity of rebuilt finite element model is much lower than the normal finite element model. In the extension condition, the stress of lateral mass screw fixation system becomes strong.

Objective To explore the clinical effect of endoscope emergency operation in the treatment of gastric variceal bleeding.Methods According to the digital table,90 patients with acute bleeding gastric varices were randomly divided into the control group and the observation group,each group 45 cases.The control group only received drug treatment,and the observation group was given endoscopic therapy.The clinical effect of the two groups were compared.Results The immediate hemostatic rate,rebleeding rate,varicose veins subsided total efficiency of the observation group were 100.00％,17.78％,86.67％,respectively,which were better than those of the control group (84.44％,44.44％,28.89％) (x2 ＝ 5.72,P ＜ 0.05).Conclusion Endoscope emergency operation combined with oral drug in treatment of gastric variceal bleeding has good effect,can achieve rapid hemostasis,prevent recurrence,and it is worthy of clinical application.