[Objective]To observe the clinical outcome of rotator cuff-reserved calcium deposit removal on extensive shoulder calcific tendinitis.To discuss if it is necessary to sacrifce the cuff integrity for a completely removal of calcium deposit.[Method]From Oct.2004 to Apr.2006,15 cases(15 shoulders)of extansive shoulder rotator cuff calcific tendinitis were treated with calcium removal under arthroseopy.Among them there were 6 males and 9 females with an average age of 44.7.The average pre-operative evaluation grade with Constant-Murley were 56(49~62).During the operation,the rotator cuff integrity were reserved in 8 cases and most of the deposits were removed with some calcium left in the reserved cuff layer.In the other 7 cases,complete deposit clearance were performed and the rotator cuff was repaired subsequently,average follow-up were 16.7 months(3~25).The Constant-Murley score and X-ray were taken after operation to evaluate shoulder function and the changes of remnant calcium were observed.[Result]13 cases reported significant pain dissolved and 2 reported pain relieved.The average postoperative Constant-Murley score of cuff-reserved group was 91(81~95),while the cuff-repaired group was 90.3(80~94).On postoperative radiograph,only 3 cases demonstrated remnant deposit,and disappeared within 3 months after operation.[Conclusion]Both of the two kinds of operations showed good clinical outcome.The rotator cuff-reserved calcium deposit removal has simplified operation techniques,less costs and fewer complications.It is unnecessary to sacrifice cuffintegrity for complete calcium removal.The remnant deposit could be absorbed when it is opened after operation.

Objective To investigate the clonal rearrangement of T cell receptor (TCR) ? gene which was of monoclonality,oligoclona-lity or clonal evolution /subclonality during the course of disease in patients with acute lymphoblastic leukemia (ALL) and its significance.Methods Between Sep. 2004 and Sep. 2007,70 patients with ALL were diagnosed in Department of Pediatrics of the First Affiliated Hospital of Guangxi Medical University,among which 51 cases were boys and 19 cases were girls.Their ages ranged from 2 years to 14 years (average age was 8.5 years).DNA samples were extracted from bone marrow cells or venous blood cells by phenol/phenol-isoamyl alcohol-chloroform/isoamyl alcohol law.DNA was amplified by polymerase chain reaction (PCR).Single strand conformation polymorphism analysis (SSCP) of silver stained technique was employed to detect PCR products.Results The amplification products of 23 cases of the 70 ALL patients were positive,in which 10 cases still had positive results in period of complete remission and had poor sensitivity to chemotherapeutic drugs,4 cases were of oligoclonality/ subclonality,and 2 cases were of clonal evolution with poor prognosis.Conclusions Detecting TCR ? gene rearrangement reflects clonal evolution of leukemia cells.The oligoclonality clonal evolution continues to exist,whose multiplication is the main reason of recurrent ALL.Detecting TCR? gene rearrangement,evaluating ALL of the patient's prognosis,the judgment of recurrence and the development of individualized treatment programs have great guiding significance,which can maximize the possibility of the sick children to make long-term disease-free survival and reduce the side effects of chemotherapy on the long-term basis.

Objective To detect the infection of human papillomavirus (HPV)in patients with non-small cell lung cancer (NSCLC)and explore the relationship between HPV infection and clinicopathological features.Methods HPV detection and genotyping in 156 cases of NSCLC were performed using a new liquid chip based on Luminex.Patient clinical characteristics were also recorded,and the relationship between HPV infection and clinicopathological features was studied.Results Of the 156 tumor-DNA samples tested,40 (25.6%)cases showed presence of HPV-DNA,of which 37 cases were of a high-risk HPV type (16,18,33, 58).The differences were statistically significant between the HPV-positive and HPV-negative groups in gender (χ2 =4.387,P =0.036),smoking (χ2 =8.130,P =0.004),histologic type (χ2 =4.075,P =0.044)and lymph node metastasis (χ2 =7.082,P =0.008).The differences were not statistically significant between the HPV-positive and HPV-negative groups in age (χ2 =0.013,P =0.910),differentiated degree (χ2 =1.727, P =0.189),clinical stages (χ2 =0.179,P =0.672),distant metastasis (χ2 =3.012,P =0.083).Logistic regression analysis revealed that lymph node metastasis alone was an independent predictive factor of HPV infection in NSCLC (OR =0.384,95%CI:0.153-0.967,P =0.042),and gender (OR =1.402,95%CI:0.522-3.769,P =0.503),smoking (OR =0.506,95%CI:0.194-1.322,P =0.506),histologic type (OR =0.393,95%CI:0.133-0.161,P =0.091)were not independent predictive factors of HPV infection. Conclusion The infection of HPV presents in part of Chinese NSCLC patients,and HPV infection may be connected with occurrence and development of lung cancer.

Objective To investigate the role of the extended-care in improving the compliance with low-salt diet in elderly patients with hypertension.Methods We selected 100 cases of elderly patients with hypertension in hospital.The 100 cases were divided into control group (50 cases) and observation group (50 cases) randomly.Observation group was given comprehensive intervention in low-salt diet education and control group was given traditional low-salt diet education.Tow groups were divided into three stages (on the day of admission,seven days after admission,one month after discharge).We analyzed low-salt cognitive scores,low-salt behavioral scores and salt-intake/d comparably.Results On the day of admission,tow groups had no statistically significant difference (P＞0.05) in low-salt cognitive scores,low-salt behavioral scores and salt-intake/d;seven days after admission,tow groups had statistically significant difforence (P＜0.05) in low-salt cognitive scores,low-salt behavioral scores and salt-intake/d;one month after discharge,tow groups had statistically significant difference (P＜0.05) in low-salt cognitive scores,low-salt behavioral scores and salt-intake/d.Conclusion We use comprehensive intervention method to elderly patients with hypertension in low-salt diet education,through personalized low-salt diet education following evidence-based nursing,we can increase the compliance with low-salt diet in elderly patients with hypertension after discharge and improve blood pressure control effectively and to promote the image of the hospital and achieve the higher satisfaction from patients and families.

ObjectiveTo observe the effect of community-based rehabilitation (CBR) on older stroke patients in ability of activities of daily living (ADL).Methods50 older stroke patients were randomly divided into the rehabilitation group and control group. The rehabilitation group was treated with motor function exercise and ADL training, while the control group only took medicine. Two groups were evaluated with Barthel index before and after treatment. ResultsScores of Barthel index on the rehabilitation group were higher than that on the control group after treatment, and there was a significantly difference between two groups (P<0.01). Conclusions CBR has the significant effect on improving ADL in older stroke patients.

Objective To investigate the effect of acteoside on injury PC12 cells induced by glutamate. Methods PC12 cells were assigned into normal control group, model control group, positive drug group and acteoside(AS) treated group. Every group was treated by 1. 5 mmol·L-1 glutamate for 24 hours except for the control group, and the injury was antagonized by 10 μmol·L-1 Vit E and acteoside at different concentration(15. 625, 31. 25, 62. 5, 125 and 250 μmol·L-1 ). Cell morphology was observed by inverted microscope, cell survival was determined with MTT, LDH activity was measured by enzyme label kit, the MDA content and SOD activity were measured by TBA kit and WST kit, and the ROS was measured by Elisa kit. Results Compared with the model control group, all doses of acteoside could significantly improve the PC12 cell morphology and survival (P<0. 05), inhibit LDH activity and production of MDA and ROS (P<0. 05), increase the activity of SOD (P<0. 05), except for the lowest dose group. Conclusion Acteoside has protective effects on PC12 cells injured by glutamate.

Objective To investigate the changes of bone tunnel and differences of clinical outcomes after anterior cruciate ligament (ACL) reconstruction with hamstring tendons from autografts and allografts. Methods The study involved in 61 patients with ACL injury undergone arthroscopic ACL reconstruction from June 2008 to November 2009.According to ACL graft differences,61 patients were assigned to two groups,ie,Group A ( reconstruction with tendon allografts,n =27 ) and Group B ( reconstruction with tendon autografts,n =34).MRI examination was performed one week and 6-12 months post-operatively to measure the sagittal bone tunnel diameters at the aperture location,at the location of 1cm away from the aperture and at the widest location of tunnel.Taking the bone tunnel diameter at each location one week post-operatively as the measurement criteria,the differences of bone tunnel diameters at each corresponding location were analyzed statistically.Lysholm score was used to evaluate the clinical effects in the two groups. Results Group A and B were followed up for average 8.4 months and 8.5 months,respectively.Pre-operative clinical data of the two groups had no significant difference.MRI follow-up showed that the tunnel diameters at femoral side and tibial side both had different degree of enlargement.Meanwhile,the enlargement degree at the tibial side was larger than that at the femoral side,with no statistical differences of the two groups regarding tunnel enlargement of the three measurement locations at femoral and tibial sides.Joint stability in all patients was good.The two groups showed no significant difference in Lysholm score after operation ( P ＞ 0.05 ). Conclusions Graft difference is a factor for bone tunnel enlargement after ACL surgery.Autologous and allogenic tendons show no difference in their role in bone tunnel enlargement after ACL surgery or correlation with clinical effects.

Objective To discuss the cause,treatment and prevention of splenic injury during the urological surgery.Methods The clinical data of 16 cases with splenic injury in operation for renal and adrenal tumors in 496 cases were retrospectively analyzed.Nine cases were left radical nephrectomy,3 cases were left renal hamartoma enucleation,4 cases were left adrenal tumor resection.Damage located at outer edge of the spleen in 8 cases,the splenorenal ligament in 6 cases,and the splenic hilum in 2 cases.In these 16 cases,14 patients spared the spleen (Ⅰ Grade injury 8 cases,Ⅱ grade 6 cases).The injuryed spleen was directly pressed with hemostatic gauze in 3 cases; 5 patients used coagulation,bonding,hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injury used U-shaped suture and coated with fibrin glue,then compressed with hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injuries with the greater omentum stitched into the seam,sprayed biological glue,were compressed with gelatin sponge; 2 cases of grade Ⅱ injury underwent splenic artery branch ligation.The other 2 cases (1 Ⅱ grade and 1 Ⅲ grade) underwent splenectomy.Results All of the 16 patients were cured and followed up for 6 months to 5 years.There was no delayed bleeding of spleen and splenic dysfunction.One patient died of tumor recurrence 6 months after operation.Conclusions Splenic injury is a common complication during urological surgery,especially the tumor is large or adhered to spleen in the upper pole of left kidney.Once spenic injury occurs,doctors should choose the right treatment plan according to surgical injury,and try to save the spleen.

Objective To describe and analyze the distribution of medical expenditure of Liaoning province in 2014 in terms of population beneficiary based on the System of Health Accounts 2011(SHA 2011).Methods By means of multistage and stratified sampling, a total of 252 medical institutions were selected from four cities in Liaoning province according to their economic status and geographical distribution.Macro data including the outpatient income and hospitalization income were taken into account, to calculate the beneficiary population of the province in 2014 according to SHA2011.Results GBD classification found that the highest medical expenditure category was non-communicable diseases, accounting for 63.02% in total medical expenditure.ICD classification found that respiratory disease as consuming the highest medical expenses (43.76%).The average medical expenditure of the elderly population was the highest per person, up to 3 041.70 yuan per person.Conclusions Medical expenses of non-communicable diseases, respiratory disease and elderly population were still high.Thus we need to emphasize disease prevention, and take efficient measures against such key diseases to curb the medical expenses.The elderly population calls for specific and effective measures to reduce their medical expenses.

Objective To investigate question comprehension and production among agrammatic aphasics, and to explore the mechanisms of any dysfunction in questioning.Methods Twenty aphasics were recruited in this study.According to the Chinese Agrammatism Battery,10 were classified as agrammatic (the agrammatic group) and 10 as non-agrammatic (the non-agrammatic group).Ten normal subjects served as a control group.All the subjects were tested in terms of their comprehension and production of questions using a set of general and what-where-who- why questions (wh-questions).Results No significant difference was found between the two experimental groups with regard to the correct comprehension and production of both general and wh-questions.However,there was a sig- nificant difference in correctness between comprehension and production.The performance of the agrammatic aphasics was worse than that of the non-agramatics and the normal subjects.Conclusion The impaired question comprehen- sion and production of Chinese agrammatic aphasics has its own characteristies which can form a basis for rehabilita- tion planning and outcome prediction.