[Objective]To determine a surgical plan for the treatment of scoliosis. [Methods]A consecutive series of scoliosis patients were admitted from Oct. 1,2007 to Feb. 29,2008. The preliminary operation programs (including diagnosis,operative approach,upper instrumented vertebra,lowest instrumented vertebra,whether to need selective fusion of main thoracic curve and multiple operations) were formulated by the attending physicians.Preliminary operation programs were decided on by a symposium. A comparison was made between the two kinds of programs.[Results]Data from 143 consecutive scoliosis patients were reviewed. The average age at the time of operation was 16.1 years (2-49 years) and the average curve was 56.9? (range,15?~115? ). There were 6 spine surgeons involved in the study. The accepted programs formulated by the symposium occurred in 46 (32.2%) cases. One of these cases was changed in surgical approach and need selective fusion of main thoracic curve,19 in upper instrumented vertebra and 29 in lower instrumented vertebra. There were no changes in diagnosis and need multistage operations. Operation programs were difficult to formulated in patients aged less than 20,with Cobb's angle≤70?and thoracic curve patterns. [Conclusion]Preoperative symposium for treatment of idiopathic scoliosis influenced the preliminary operation programs in 32.2%. Sympoium appears to have a significant role in drawing up a more perfect operation program.

0.05). No death, pseudoarthrosis, or implantation failure occurred. Conclusions One-row portal pattern is suitable for patients with long-segment deformity and short anteroposterior thoracic diameter, while double-row portal pattern is suitable for patients with short-segment deformity and long anteroposterior thoracic diameter.

[Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of scoliosis.[Method]Nine patients(7 female and 2 male)with scoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study.The etiological classification of scoliosis were idiopathic for 7,congenital for 1,neurofibromatosis(NFl)for 1.The average age was 13.5 years(ranged 11～18 years).The average preoperative Cobb's angle was 54?(ranged 48?～68?).Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation;the NFl patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation.[Result]There was no death,no infection and no neurological complication.No intra-operative fracture,no dura matter or pleuml laceration occurred.Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment.Posterior Cobb's angle averaged 20? with correction rate of 63%.The duration of follow-up averaged 23 months(ranged 20～30 months).Surgical time averaged 260 min(ranged 210～300 min)and mean EBL was 700 ml(300～1 000 ml).Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred.The loss of correction at last follow-up was 4? with 7.4% loss of correction rate.[Conclusion]The clinical results of CDH Legacy are as good as the other three generation implants,its advantage lies in lower profile,solid inter-locking,versatile implants and handy manipulation.

Objective To compare the clinical outcomes of selective thoracic spinal fusion in adolescent idiopathic scoliosis using either iliac bone or autologous rib combined with allografts. Methods A retrospective study was made in 84 cases of idiopathic thoracic scoliosis, who were operated on with posterior instrumentation of CD, CDH or TSRH from 1999 to 2000. These patients were divided into two groups. In Group A, 34 patients, who were 12 to 20 years with a mean age of 14.5 years with a mean Cobb angle 56?(range, 40? to 82?), received autologous iliac bone grafting, and no thoracoplasty were performed. In group B 50 patients, who were 13 to 19 years with a mean age of 15.4 years with a mean Cobb angle of 54? (range, 38? to 80?), had allograft bone grafting combined with the ribs from thoracoplasty. The patients were followed up for at least 2 years with an average of 3.4 years regarding the clinical and radiographic outcomes. Results For group A, an average of 73.2% correction rate was achieved, and average 10% loss of correction and 3% of pseudoarthrosis was recorded at 2 year follow-up. The incidence of donor site morbidity was 26%, which included deep infection, hematoma, delayed healing of incision and continuous pain. For group B, an average of correction rate was 70.4% with 9% average loss of correction and 2% of pseudoarthrosis at 2 year follow-up. The complications related to thoracoplasty consisted of intraoperative tear of parietal pleural, pneumothorax, effusive pleuritis, and chest pain. Conclusion The clinical outcomes are comparable between the group of iliac bone grafing and the group of rib grafing associated with allografts in terms of fusion rate and loss of correction. If chose appropriately, allografts plus autologous rib harvested from thoracoplasty will be a good alternative to iliac crest regarding its safety, efficacy and reliability.

OBJECTIVE:To explore the role of clinical pharmacists in cancer pain management. METHODS:The cases were presented to investigate the content and method of clinical pharmacists participating in cancer pain management. RESULTS:The clinical pharmacists could provide professional analgesic recommendations and participated in the formulation of individual analge-sic plan. By carrying out pharmaceutical care and patient education,clinical pharmacists could find potential medication risk,cor-rected medication errors and improved patient compliance. By carrying out patient family members training,clinical pharmacists could help to strengthen patient support system and improve cancer pain management effectiveness. CONCLUSIONS:Clinical phar-macists participating in cancer pain management can promote rational use of analgesics,guarantee the safety of drug use,and im-prove cancer pain management.

OBJECTIVE: To study the bioequivalence of Bei Shi metformin hydrochloride(METBS) and Bo Lai metformin hyddrochloride tablets(METBL) in healthy volunteers.METHODS: A single oral dose of 1 OOOmg METBS and METBL were given to 20 healthy volunteers in an open randomized crossover study.Drug concentrations in serum were determined by HPLC.The pharmacokinetic parameters were calculated and analysed by 3p97 program with a statistic analysis of ANOVA, two-one-side t - test and confidence zone of (la-2a)% .RESULTS: The Tmax, Cmax and AUC(10-24) of METBS tables and METBL tables were (2.42 + 1.03) h and (2.50+1.08) h, (2.22+0.69) ug/ml and (2.1210.47) ug/ml, (16.491 5.70) mg/ (h . L) and (16.98 + 6.38) mg/ (h . L), respectively.There were no significant differences between the two formulations in the Tmax, Cmax and AUC (0-24).CONCLUSION: The mean relative bioavailability of METBS tables was(98.29 + 11.98) % compared with METBL tables.The RESULTS: suggest that two products are bioequivalent.

BACKGROUND:Common therapies for damage to the central tendon of finger extensor tendon include Matev, Carrol, Fowler methods as wel as residual central tendon flipping repair, but the therapeutic effects are no satisfied with bloated appearance, tendon adhesions, limited joint function. OBJECTIVE:To investigate the clinical effects of dorsal longitudinal driling and segmental tendon graft to repair old central tendon injury. METHODS:Eighty patients with old central tendon injury were randomized into treatment group and control group, with 40 cases in each group. In the treatment group, dorsal longitudinal driling and segmental tendon transplantation were given; while in the control group, Carrol, Matev, Fowler methods were chosen according to the individual conditions. Then, the therapeutic outcomes were compared between two groups. RESULTS AND CONCLUSION:The excelent and good rate was 85% in the treatment group and 65% in the control group, and there was a significant difference between the two groups (P < 0.05). Results from Valpar Component Work Samples showed that the number of cases adapting to the original work was 30 cases (75%) in the treatment group and 16 (40%) in the control group, and there was also a significant difference between the two groups (P < 0.05). The degree of proximal interphalangeal joint flexion was increased gradualy in the two groups at admission, at 15 days after hospitalization, at 1 day before discharge and at 4 months after discharge, and meanwhile, the degree of proximal interphalangeal joint dorsiflexion was reduced gradualy (P < 0.05). There were significant differences in the degree of proximal interphalangeal joint flexion and degree of proximal interphalangeal joint dorsiflexion between the two groups at 15 days after hospitalization, 1 day before discharge, and 4 months after discharge (P < 0.05). These findings indicate that the dorsal longitudinal driling and segmental tendon graft for repair of old central tendon injury can play an effective role in the recovery of articular flexion and extension function.

Objective To evaluate the differences of bone mineral density in congenital scoliosis (CS) and adolescent idiopathic scoliosis(AIS) patients compared with age-matched normal control, and quantitatively investigate the microstructure of trabecular bone by micro computer tomography scan in AIS and CS patients. Methods 15 AIS women(12-19 years old, Cobb angle 48?-104?) and 16 CS patients (4 male, 12 female; 13-18 years old, Cobb angle 40?-125?) were recruited into this study. The normal control group consisted of 35 female adolescents(13-16 years old). Bone mineral density was assessed at the lumbar spine and femur neck in every patient before operation and every subject in control group by DEXA. Corrective surgery was indicated to AIS and CS patients and iliac crest biopsy was collected during autograft harvesting. Bone specimens were scanned by micro CT. Results The BMD of lumbar spine and femur neck in AIS patient were significant lower than that in normal control. The BMD and BMC were significantly lower in CS patients compared with normal control. The BMD and BMC of femur neck were significantly lower in CS than that in AIS. The BV/TV in micro CT was significantly associated with the BMD in DEXA. In 3-D model BV/TV value was significantly greater in AIS (19.9%?3.4%) compared with CS (13.3%?3.0%). Significant differences between AIS and CS were also found in the parameters of trabecular thickness and bone surface/bone volume (155.5?54.9) ?m vs (108.1?17.4) ?m and 16.4%?3.3% vs 22.0%?3.4%. Lower trabecular connectivity density and number of trabecular number were observed in CS compared with AIS patient, but without significant difference between them. Conclusion Lower bone mineral density,microstructural abnormalities, lower BV/TV, and weak trabecular bone of ilia were observed in AIS. Both BMD and trabecular bone microstructure in CS patients were lower than those in normal control and AIS patients.