Objective To observe the efficacy of Shuilongjian in treating cerebellar infarction, and compare with the pure western medicine. Methods 67 inpatients with cerebellar infarction enrolled were divided into two groups according to the method of random digits table, 36 cases in the treatment group and 31 cases in the control group. The control group was given 500 mL dextran by venoclysis, once a day. The treatment group was given Shuilongjian as an additional drug. The therapeutic effect was evaluated according to the nerve function and the total capability in dealing with daily activities. Result All the 67 cases of cerebellar infarction were included in the analysis. The effective rate of the treatment group was better than that of control group with 83.3% and 58.1% (P

During medical activity,there are theory and realism spring of that the right of emergency treatment is in conflict with the right of informed consent.Simply investigating responsibilities is of no avail to solve the conflicts.To Interpret the real reasons of the conflict through legal and ethical aspects.To avoid and reduce conflict,the effective measures are that perfecting the rules of relevant law,elucidating the rights and obligations of hospital and medical staff;regulating the contents of informed consent form and strengthening medical ethics education.

0 05), and the postoperative pain degree score was (2 0?0 7) points and (2 5?0 8) points respectively (t=-3 02, P

OBJECTIVE To find out fulminate epidemiological features of Stenotrophomonas maltophilia in ICU and the ways to prevent and treat this nosocomial infection.METHODS The case histories from 4 inpatients who developed S.maltophilia infection in the same ward from Feb 5 to 16,2006,were studied retrospectively to find out the reasons of its onset and its treatment based on the sputum culture results.RESULTS The fulminate S.maltophilia was found from the rail of the patient bed,the connection part of water container of 2 respiratory machines of exhalation valve assembly and the liquid of ultrasonic aeriation machine.CONCLUSIONS The infection is a localized one.The main reasons of the infection are unthorough disinfection of respiratory machine and the contamination of medical treatment environment.Whenever the infection is found in the ward,the thorough disinfection needs immediately,and no new patient admitted.

Eleven patients underwent acetabulum revision using modified anterolateral approach due to acetabulum loosening but femoral prosthesis in sound fixation following total hip arthroplasty in Department of Joint Surgery,Tianjin Hospital between August 2002 and February 2005. During the mean follow-up of 4.2 years,all 11 patients gained primary stable fixation and good function. One patient underwent another revision due to infection; one developed femoral prosthesis loosening and underwent femoral revision. X-ray of the other patients showed no loosening or dislocation or radiotransparent region surrounding the prosthesis. One patient developed lateral femoral cutaneous nerve injury and relieved 6 months later.

From February 2002 to May 2007,9 cases(9 hips) of periprosthetic fractures during the primary total hip arthroplasty for developmental dysplasia of the hip were selected,including 1 male and 8 females aged 52-69 years.In the primary total hip arthroplasty,femoral prosthesis with the same size as intramedullary reamer and acetabular prosthesis with 2 mm diameter larger than acetabular reamer were used.The pain,function,range of motion and degree of deformity were accessed using the Harris score.The patients were followed for 1-6 years.Among the 9 patients with periprosthetic fractures,4 acetabular fractures were stable which were treated by additional augmentation screws,and 1 fracture was unstable which was treated by structural bone grafting and additional screws.And there was one Vancouver type AG fracture which was treated by cerclage wire,3 Vancouver B1 fractures which were fixed by locking compression plate(LCP) or cerclage wire,and one Vancouver type C fracture which was also fixed by LCP.No component loosening or migration was found in the postoperative X-ray.The mean Harris score was 87.2 at the final follow-up.The results of the study show that during the primary total hip arthroplasty in patients with developmental dysplasia of the hip,the oversize of the acetabular component should be controlled to equal to or less than 2 mm.For patients with severe osteoporosis,acetabular components with the same size to reamer are recommended combined with additional screws,or cemented cup.When an acetebular fracture is found during total hip arthroplasty,we could use additional screws or bone grafting.Once a periprosthetic femoral fracture occurs during the operation,methods of fixation should be selected based on the type of the fracture and stability of the prosthesis.

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

Objective To explore the methods and curative effect of metallic self-expanding stent in inoperable malignant gas-troduodenal obstruction. Methods The data of 15 cases with gastroduodenal obstruction including 9 cases of carcinoma of head of pancreas and 6 cases of carcinoma of stomach were analyzed retrospectively. The operative procedures of the stent implanted and the tors accepted more radiation dose because the manipulation was under the fluoroscopy in a short distance and with a full field of view. sions, the postoperative eating habit and the development turnover of disease. The main death reasons were tumor transfer and sys-tem exhaustion. Conclusion To pay close attention to the details and main points of operative procedure is the key point to implant stent successfully for malignant gastroduodenal obstruction. The determinative factor to influence the curative effect is the develop-ment turnover of tumor.

Objective:To report the preliminary results of intensity modulated radiation therapy(IMRT)for 20 nasopharyngeal carcinoma patients.Methods:A total of 20 patients with nasopharyngeal carcinoma received IMRT in our hospital between January 2007 and April 2008.Five patients were of stage Ⅱ,13 patients were of stage Ⅲ,and 2 patients were of stage Ⅳ.The prescribed dose 69.96 Gy was delivered to the gross tumor volume(PTV)and positive neck nodes(PTVnd);59.36 Gy to the clinical target volume(PTV1),covering the upper neck and area around the nasopharynx;and 50.96 Gy to the low neck and supreclavicular area (PTV2).The dose to 50% of the parotid was≤35 Gy.The maximum dose to the lens.pituitary gland,temporo-mandibular joint,mandible,and temporal lobe was 9,54,60,70,and 60 Gy.The maximum dose to the brainstem,spinal cord,optic nerve and optic chiasma(PRV)was 54,40,54,and 54 Gy,respectively.All of the patients received 1 or 2 circles of chemothrapy before IMRT.Results:The median follow-up time was 14 months.The one-year overall survival was 94.1%.One patient died of osseous metastasis and respiratory failure and 3 patients developed distant metastasis.Acute toxicity was mostly Grade Ⅰ to Grade Ⅱ.Seventeen patients had grade Ⅰ xerostomia.Three patients suffered from grade Ⅰ acute oral mucosa reaction and 12 patients had grade Ⅱ acute oral mucosa reaction.Analysis of the dose-volume histograms (DVHs) showed that the mean dose delivered to the PTV,PTVnd,PTV1 and PTV2 was 73.4,74.1,67.8,and 54.1 Gy,respectively.The median dose to 50% of the right and left parotid glands was 43.9 Gy and 41.9 Gy,respcetively.The average value of maximum dose to the left and right lens was 8.06 and 8.12 Gy,respectively.The average value of maximum dose to the brainstem,spinal cord,left and right optic nerve and optic chiasma PRV was 60.6,46.6,50.0,55.0,and 56.0 Gy,respectively.Conclusion:IMRT can achieve satisfactory dose distdbution to nasopharyngeal carcinoma and surrounding tissues in NPC patients,protect normal tissues during the treatment and improve local control rate.

The incorporation of site-specific recombination systems can help to overcome bottlenecks in livestock transgenic technology. For evaluating the efficiency of Cre/lox mediated DNA recombination in embryos and somatic cells, a working model was established using rat mammary carcinoma cell line SHZ-88, aimed at creation of and use repeatedly of selected "friendly loci" in transgenic livestock. An integration vector pTE-lox2272-DsRed-loxP-GFP-loxP, which red fluorescence gene DsRed served as the first target gene and green fluorescence gene GFP as marker gene, was constructed for introduction of acceptor loci in genome. At the same time a replacement vector pT-lox2272-neo-loxP in which Neo coding sequence served as the second target gene was also constructed for replacing DsRed gene. Transgenic cell clones were produced by electroporating SHZ-88 cell with the integration vector. Cells from three transgenic clones selected randomly were further amplified and were then co-electroporated with the replacement vector as well as cre gene. Analysis of the expression patterns of DsRed and GFP indicated that among the 1 070 cell colonies the efficiency on marker GFP deletion was 91.1% and the efficiency on gene replacement was 29.3%. Molecular analysis by PCR and Southern blotting confirmed that the color patterns as expressed by cell colonies could represent the actual molecular events. This working model mediated by Cre/lox system should be useful for the improvement of the present animal transgenic technology.