Objective To compare the treatment effects of self-designed anti-rotation reduction internal fixators (ARRIF), atlas fixator (AF) and Dick screw in reduction and fixation of different thoracolumbar spinal fractures. Methods Reduction effect, operation time, bleeding volume during operation and complications were observed and compared after ARRIF, AF and Dick screw were used to treat 90 cases of thoracolumbar spinal fractures. Results Compared with AF and Dick screw, the operation time of ARRIF was shorter with less bleeding volume during operation as well as less complications like broken or pulled-out screw or broken rod. Conclusions All three fixation methods can attain the reduction and fixation of various kinds of thoracolumbar spinal fractures. However, ARRIF is the most valuable transpedicular internal fixator and can more conveniently reduce and fixate the different spinal fractures and AF places the second.

Objective To investigate the efficacy and adverse reaction of quetiapine compared to risperidone in female first-episode schizophrenia.Methods Eighty cases met the CCMD-3 criteria for schizophrenia were divided into two groups with random numbers table method,treated with quetiapine(300 ～ 750mg/d) and risperidone(2 ～5mg/d) respectively for 8 weeks.The efficacy was measured with the positive and negative symptoms scale(PANSS),and the side effects were observed.Results The difference between two groups in 2-weekend,4-weekend and 8-weekend PANSS had no statistical meaning(all P＞0.05).The efficient rate of clinial treatment of quetiapine and risperidone groups were 90% and 87.5% respectively,The difference had no statistical meaning(P＞0.05).Risperidone group had higher incidence rate than quetiapine group in adverse reaction such as tremor,muscle rigidity,akathisia,emmenia change and lactation etc.Conclusion Quetiapine haa equivalent clinial effect with risperidone in female first-episode schizophrenia,and had less adverse reaction.

Objective To establish a capillary gas chromatography method for the determination of trinitrotoluene (TNT) in workplace air.Methods Using dichloromethane as the eluent,the air was drawn through a glass fiber filter to collect TNT,TNT was extracted from the filter with dichloromethane by an ultrasonic shaker,and the sample was analyzed by OV-17 elastic quartz electron capture detector capillary gas chromatography.Results Under the optimal condition,the lowest detection limit was 0.006 ?g/ml,the lowest detection concentration was 0.001 3 mg/m~3 (based on 45 L air sample).When the concentration of standard solution was 0.040-2.0 ?g/ml,the linear equation was good,r=0.999 8,RSDs were between 0.66%-3.62%,the recovery rates were 90.4%-95.5%.When sample was collected by fiberglass filter paper,the efficiency of desorption was more than 90%,and was stable for at least 7 days at 2℃-8℃.Conclusion This method is applicable to the determination of trinitrotoluene in workplace air.

Objective To investigate the application of a new type internal anastomotic appliance of pouch pliers in the retention of anus operation of mesal,low rectal carcinoma.Methods The data of 65 patients with mesal,low rectal carcinoma with the technique of the anal retention using KYGW type anastomotic appliance of pouch pliers were reviewed and analyzed retrospectively.Results 65 patients were coincided success only one time. Anastomotic fistula occurred after operation in 1 case,being cured and discharged at last,no anastomotic stricture. Conclusion The internal anastomotic appliance of pouch pliers in the anal retention of mesal-low rectal carcinoma is an efficient method with better cost-effectiveness and fewer complications,which is easy to manipulate and popular- ize.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.

Objective To investigate the possible mechanism of gemcitabine resistance in pancreatic cancer chemotherapy. Methods Recent literatures about the genes and signal pathways those play key roles in mediating gemcitabine chemotherapy resistance of pancreatic cancer were collected and reviewed.Results Oncogenes like c-Src and bcl-X-L, inflammation pathway of NF-?B, cytokines like IL-1? and NO are closely related with the chemoresistance; the relationship between multiple drug resistance relevant genes like MDR1/P-gP and the resistance to gemcitabine remains to be clarified. Conclusion Genes and pathways like c-Src, bcl-X-L, NF-?B, etc. might become new targets to increase the chemotherapeutic sensitivity of pancreatic cancer, however, the mechanism of pancreatic cancer chemotherapy resistance still needs further to be studied.

Objective To summarize the clinical experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas(SPTP),and to work out the diagnosis and treatment process which matches the conditions of China.Methods The clinical data of consecutive 50 patients with SPTP who had been admitted to our hospital from January 2001 to March 2007 were retrospectively analyzed.Of all patients,3 were male and 47 female.Their median age Was 24 years(13-60 years).Preoperative imaging examination revealed typical findings and tumor markers were negative.SPIP of 23 cases were located in the head of pancreas,3 in the neck of pancreas,2 in the uncinate process of pancreas.3 in the body of pancreas,18 in the tail of pancreas,and the location of SPTP of 1 case was uncertain.Forty-eight patients underwent the operation of SPTP resection,1 of exploratory laparotomy and 1 of CT-guided fine-needle aspiration biopsy of metastatic lesions.Results Forty-nine out of 50 patients were diagnosed"pancreatic mass"preoperatively.Eighteen of the 32 patients with intact tumor capsule and 11 of the 16 patients without intact tumor capsule underwent operation without pathological examination.Thirty-two patients were followed up for 3-55 months,and no metastasis or invasion of the SPTP was observed.Conclusions Yong females are in the high risk group of SPTP.CT is the most valuable preoperative imaging test.Complete surgical resection is the first choice treatment with good prognosis.Resection of the head of pancreas with the preservation of duodenum and resection of body and tail of pancreas+splenectomy are the commou modalities used for the treatment of SPTP.The intactness of the tumor capsule is an important factor in making surgical plan and deciding the necessity of intraoperative frozen section pathological examination.The most common postoperative complication of SPTP resection is pancreatic fistula.

BACKGROUND:Epidural scar after laminectomy is one important reason for the secondary spinal stenosis, and local application ofSanqi sodium hyaluronate gel can prevent epidural scar adhesion after laminectomy. OBJECTIVE: To study the effects ofSanqisodium hyaluronate gel on α-smooth muscle actin expression in the process of rabbit's epidural scar formation. METHODS: In this study, there were ninety-six rabbits which were randomized into four groups and given 0.5 mL normal saline, 0.5 mLSanqi concentrated solution, 0.5 mL sodium hyaluronate and 0.5 mLSanqisodium hyaluronate gel around the dura. At 1, 2, 4, 8 weeks after treatment, immunohistochemistry staining was employed for analysis of α-smooth muscle actin expression. RESULTS AND CONCLUSION:At the end of weeks 1 and 2, the expression of α-smooth muscle actin antibody in the normal saline group was significantly higher than that in the other three groups (P < 0.01 orP < 0.05), but there were no significant differences among the Sanqi, sodium hyaluronate andSanqisodium hyaluronate gel groups (P> 0.05). At weeks 4 and 8, the expression of α-smooth muscle actin antibody in theSanqi sodium hyaluronate gel group was significantly lower than that in the other three groups (P < 0.01 orP < 0.05), and there was no significant difference among the latter three groups (P > 0.05). These findings suggest thatSanqi sodium hyaluronate gel can inhibit the expression of α-smooth muscle actin, and thus ease scar contracture.

Objective To evaluata the effect of dexmedetomidine on myocardial ischemia-reperfusion injury in the patients undergoing cardiac surgery with cardiopulmonary bypass:a meta-analysis.Methods We searched the China Integrated Knowledge Resources Database,Chinese Biomedical Database,Wanfang Database,Weipu,PubMed,Cochrane Library (from inception to July 2015) to identify randomized controlled trials involving dexmedetomidine-induced cardioprotection in the patients undergoing cardiac surgery with cardiopulmonary bypass.The following data were extracted from the trials included:the mean arterial pressure and heart rate at breast bone splitting,the spontaneous recovery of heart beat during surgery,the plasma concentrations of creatine kinase-MB and cardiac troponin I at 6,24 and 48 h after surgery,and heart rate at 24 h after surgery.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results Twelve prospective randomized controlled trials involving 750 patients were included in this meta-analysis.The patients were divided into 2 groups:dexmedetomidine group (n =376)and control group (n =374).Compared with control group,the plasma caradiac troponin I concentrations at 6,24,and 48 h after surgery,and creatine kinase-MB concentrations at 6 and 24 h after surgery were significantly decreased,the mean arterial pressure and heart rate were decreased at breast bone splitting,heart rate was decreased at 24 h after surgery,and the percentage of spontaneous recovery of heart beat was increased in dexmedetomidine group (P＜0.05).Conclusion Dexmedetomidine can mitigate myocardial ischemia-reperfusion injury in the patients undergoing cardiac surgery with cardiopulmonary bypass.

Objective To observe the clinical curative effect of fumigation and steaming with traditional SHE medicine and life intervention on women patients with metabolic syndrome( MS) .Methods 60 women with MS were randomly divided into treatment group and control group,30 cases in each group.The control group was orally given western medicine.The treatment group used fumigation and steaming with traditional SHE medicine and life interven-tion on the basis of oral western medicine therapy,3 days every 1 time,10 times for a period of treatment.The changes of triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),blood pressure, body mass,waist circumference,body mass index(BMI),abdominal fat thickness and body fat percentage(PBF) before and after treatment were observed.Results Before treatment,there were no statistically significant differences in TG,HDL-C,FPG,blood pressure,body mass,waist circumference,BMI,abdominal fat thickness,PBF between the two groups.After treatment, TG, HDL -C, FPG, SBP, DBP, body quality, waist circumference, BMI, abdominal fat thickness and body fat in the treatment group were (1.52 ±0.32) mmol/L,(1.36 ±0.31) mmol/L,(6.12 ± 0.31)mmol/L ,(140.67 ±9.32)mmHg,(82.23 ±7.03)mmHg,(65.50 ±11.35)kg,(79.09 ±19.67)cm, (21.30 ±6.12) kg/m2,(26.63 ±3.77) mm,(23.6 ±3.18)% respectively,which in the control group were (1.76 ±0.31) mmol/L,(1.18 ±0.32) mmol/L,(6.40 ±0.32) mmol/L,(150.83 ±12.10) mmHg,(86.50 ± 6.97)mmHg,(71.57 ±12.07)kg,(89.65 ±20.92)cm,(25.15 ±7.41)kg/m2,(30.40 ±3.22)mm,(26.5 ± 3.32)%respectively.The differences between the two groups were statistically significant( t=2.950,2.211,3.414, 3.644,2.362,2.007,2.014,2.194,4.165,3.455,all P<0.05).Conclusion It has obviously improved clinical curative effect for patients with MS,and has certain advantages in the reshape by fumigation and steaming with tradi-tional SHE medicine and life intervention.