Objective To investigate whether the bone harvested from Cloward discectomy with trephine could substitute for iliac-crest bone grafts in arthrodesis procedure. Methods We reviewed the 30 patients with cervical spondylotic myelopathy involving a single level, which had been managed with anterior trephination discectomy and arthrodesis by the bone chips harvested from within the trephine. The bone chips harvested with trephine were then trimed and implanted erectedly similar to Robinson arthrodesis procedure. All cases had been followed-up for an average of 4.75 years. The latest results were analyzed according to JOA score system and recovery rate. The fusion outcome were assessed by anteroposterior and flexion and extension lateral radiographs of the cervical spine. Results At the latest followed-up examination, clinical results were excellent in fifteen patients(50％ ), good in eleven(36.7％ ), fair in three(10％ ) and poor in one (3.3％ ). X-ray showed solid fusion in all, and no dislodgment of the grafts. However, the cervical curves had a little loss. There was no significant bone grafts subsidence. Conclusion In cervical anterior decompression the bone chips obtained in trephination could substitute for other type of bone grafts for arthrodesis. The postoperative outcomes were not affected by the loss of the cervical curves.

Objective To evaluate the surgical techniques of open reduction and internal fixation and its clinical results of trimalleolar fractures retrospectively. Methods Between March 1996 and October 2002, 48 consecutive patients, including 27 males and 21 females with an average age of 42.8 years, were treated for trimalleolar fractures. According to the system of Lauge-Hansen, the fractures were classified as pronation-external rotation(grade Ⅳ) injury in 20 cases, and supination-external rotation(grade Ⅳ) in 28 cases. The time from injury to operation was from 2 hours to 21 days. The operation was delayed due to associated injury, skin conditions and so on, and then the patients were manipulated primarily and immobilized with a posterior plaster splint. The medial, lateral and posterior malleolus were exposed by anteromedial and Gatellier-Chastang approaches. The reduction and internal fixation started with the posterior, then the medial and the lateral malleolus and distal tibiofibular syndesmosis in sequence. The ankles were immobilized with plaster in neutral position and elevated. All patients were assessed with Baird and Jackson ankle scoring system based on pain, instability, walking ability, movement and radiological manifestations. Results The follow-up period varied from 6 to 36 months with an average of 13 months. The rates of clinical result were excellent in 26, good in 15, fair in 5 and poor in 2 respectively. The total rate of good to excellent results was 85.4%. There were no local complication, malunion and nonunion of the fractures and the deformity of the ankle. However, the inserted screw to distal tibiofibular syndesmosis was broken in one case. Conclusion Trimalleolar fractures require open reduction and internal fixation more often, especially while the fragment of posterior malleous is so large that it should be anatomically reduced and immobilized with internal fixation. It can ensure anatomical joint restoration and union for the ankle trimalleolar fractures, only by achieving most satisfied kinematics of the ankle joint.

Objective To study the relationship of intestine permeability with post hepatitis cirrhosis. Methods Serum DAO levels were measured by Holt method and lactulose/mannitol absorption tests were performed in 96 patients (Child A, n =11; Child B, n =37; Child C n =48) with post hepatitis cirrhosis and 49 healthy control subjects to evaluate the intestine structure and function of the patients. Lactulose and mannitol levels in 5 hours urine were determined by gaschromatographic assay. Results DAO activity and lactulose/mannitol ratio were higher in each patient group than those in normal control group (DAO Child A 4.68?0.97, Child B 6.05?1.02, Child C 7.80?1.34 vs 3.98?0.93, P

0.05). PET/CT was more sensitive than B ultrasound and mammography in diagnosing axillary disease(P

Humans ; Pancreatitis, Acute Necrotizing ; diagnosis ; therapy ; Practice Guidelines as Topic

Objective To investigate the effects of glucagon like peptide 2(GLP 2) on the mRNA expressions of GLP 2 receptor (GLP 2R) and proglucagon gene(PG) in postburn rats. Methods A total of 55 Wistar rats were randomly divided into three groups including burn group, GLP 2 treatment group(treated with GLP 2, 200 ?g/kg, b.i.d ) and normal control group. Rats were sacrificed at 6, 12 h and 1, 3 and 5 d after burn injury. The proliferating cell nuclear antigen(PCNA) expression and the histological changes of the intestinal mucosa were determined by immunohistochemical staining. mRNA expressions of GLP 2R and PG were detected by RT PCR at 6, 12 h and 1, 3 and 5 d after burn injury. Results The expression of PCNA in rat intestinal mucosa decreased at 1 d after burn injury, but it was stronger in GLP 2 treatment group than that in burn group. Histological observation revealed that intestinal villi in GLP 2 treatment group were regularly arranged without obvious epithelial shedding. PG mRNA expression peaked at 12 h, 1 and 3 d after burn injury. No change of PG mRNA expression was found after treatment with GLP 2. Decreased GLP 2R mRNA expression was found in postburn rats, but after treatment with GLP 2, increased GLP 2R mRNA expression was found. Conclusion GLP 2 supplementation can keep the structure of the postburn rat intestinal mucosa without affecting PG gene expression. The mechanism may probably be related to the promotion of the mRNA expression of GLP 2R of the intestinal mucosa in rats.

Objective To investigate the anti-HBs level in 15 years after vaccination in adults and newborns in Beijing and provide the suggestion for the adult hepatitis B (HB) immunization plan.Methods A serological survey was conducted in 6 705 subjects aged > 1 year old by multistage randomized cluster sampling in Beijing during August 2013 to February 2014.The subjects who had received a 3-dose recombination HB vaccine when they were newborns or adults aged ≥15 years old and did not undergo revaccination were selected.Antibody to hepatitis B surface antigen (anti-HBs) titers and positive rates in 15 years after vaccination were evaluated.Results A total of 129 and 463 subjects who were vaccinated in adults and newborns were enrolled in the study.Based on the self-limited rate(30%) of HBV infection among the general population aged 15 to 59 years, anti-HBs positive rates for the subjects vaccinated in adults were estimated to be 58.6%,62.5 % and 48.4% during 0-4, 5-9 and 10-15years after vaccination respectively.The corresponding median of anti-HBs titers were 288.8, 120.6 and 62.6 mIU/mL.The anti-HBs positive rates for the subjects vaccinated in newborns during 0-4, 5-9 and 10-15 years after vaccination were 83.3%, 47.3% and 43.5%, respectively.The corresponding anti-HBs titers were 71.8, 8.9 and 6.7 mIU/mL.Conclusions The protection afforded by primary immunization with recombination vaccine in adults and newborns lasts at least 15 years.

Adolescent ; Adult ; Automobile Driving ; China ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Exposure ; adverse effects ; Stress, Psychological ; etiology ; physiopathology ; Vibration ; adverse effects

Objective To design a data management solution based on geographic information system for health service units to deal with health resources of subordinate medical institutions.Methods The whole solution was developed with layer logic function of data service, application and presentation. Storage, transformation and relationship of both spatial data and health service data were totally managed by relational database.Results The system was able to import, export, maintain, sum, query and analyze geography spatial information and health service information.Conclusion A new method is provided to improve capability of health support and health service management efficiency.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoembryonic Antigen ; blood ; Catheter Ablation ; methods ; Colorectal Neoplasms ; pathology ; Combined Modality Therapy ; Fluorouracil ; therapeutic use ; Humans ; Leucovorin ; therapeutic use ; Liver Neoplasms ; blood ; drug therapy ; secondary ; surgery ; Neoplasm Recurrence, Local ; Organoplatinum Compounds ; therapeutic use