Objective To evaluate the clinical efficacy of AF (atlas fixator) internal fixation in treatment of thoracolumbar fracture and dislocation. Methods 42 cases of thoracolumbar fracture were treated by posterior AF internal fixation. Prior to surgery, anteroposterior and lateral radiographs, and CT scan through bone windows were done for all the patients. During surgery, all the pedicle screws were inserted by Mergerls method and proper insertion was confirmed by radiographs. Results The follow ups of 39 patients averaged 21 months (ranging from 6 to 29 months). After surgery, the correction of anterior vertebral body height averaged 40.2%, and of Cobbs angle 23.2?. 12 cases of incomplete spinal cord injury had significant improvement and 2 ones of complete spinal cord injury had no improvement. Conclusion The AF screw is especially helpful in reconstruction of stability of thoracolumbar region after posterior decompression and reduction, because it results in simplicity, safety, less fixation segments, and little invasion or bleeding.

Objective: To analyze the risk factors on acute respiratory dysfunction caused death in patients after type A aortic dissection surgery.
Methods: A total of 223 patients who received aorta replacement surgery in our hospital from 2010-01 to 2012-12 were retrospectively studied. 80 patients suffered from post-operative acute respiratory dysfunction including 61 male and 19 female with the mean age of (49.2 ± 11.6) years. Those patients were divided into 2 groups as Death group, n=18 and Survival group, n=62. We analyzed the most relevant risk factors for death, such as gender, age, histories of smoking, diabetes, hypertension, Marfan syndrome;pre-operative acute or chronic dissection, hypoxemia, mal-perfusion, LVEDD and LVEF;CPB time, aortic-clamping time;post-operative ICU retention time, mechanical ventilation time, permanent neurologic dysfunction, pulmonary infection, MACE, renal failure, hypohepatia, septicemia and wound mal-healing, et al.
Results: The early post-operative (< 3 days) respiratory dysfunction rate was 35.8% and the mortality was 22.5%(18/80). The relevant risk factors of death included female gender (P=0.019), haemorrhage (P<0.01), mechanical ventilation time (P=0.011), permanent neurologic dysfunction (P=0.013), pulmonary infection (P=0.001), MACE (P=0.022), renal failure (P<0.01), hypohepatia (P<0.01) and septicemia (P=0.001). Female gender and renal failure were the independent risk factors for respiratory dysfunction caused death in patients after type A aortic dissection surgery.
Conclusion: The occurrence and mortality were high in patients after type A aortic dissection surgery especially in those with female gender and post-operative renal failure.

Various surgical technologies have been developed to minimize the risk of the operation. With continuous water flow being the dissector, a relatively bloodless operation and a clear view for the operator can be obtained. When applied to the adventitia and the soft tissue adjacent to the vascular structure, it is satisfying and the vessel and ureter can be protected perfectly if ligated selectively. The operation time is also shorter than the routine one. So, further studies of this technology are necessary.

Nano-hydroxyapatite has been widely used as reconstructive and prosthetic material for osseous tissue,owing to its excellent biocompatibility and tissue bioactivity.But the poor mechanical property of hydroxyapatite restricts its further application.In order to enhance the comprehensive performance of the material,many researches have been dedicated to the synthesization of the composite materials.This article reviews the main preparation methods of nano-hydroxyapatite and the advancement in research of its composite.The directions in this research area are described as well.

Objective The purpose of our study was to investigate three dimensional dynamic contrast enhanced MR angiography(3D DCE M RA) in the detection of portosystemic collateral circulation in the falciform ligament in patients with portal hypertension. Methods From April 2003 to July 2008, 53 portal hypertension patients with varices in the falciform ligament were evaluated with 3D DCE MRA.Two radiologists independently assessed the number, diameter, location and drainages of the portosystemic collateral circulation in the falciform ligament according to the information on the 3D DCE MRA.Results The veins in the falciform ligament were classified into the superior and inferior groups, and both groups arise from the left trunk of the portal vein.In our study, the number of varices detected on 3D DCE MRA images varied from 1 to 3, and the diameters of these vessels varied from 0.4 to 2.6 cm.The inferior group consisted of paraumbilical/umbilical veins (47 cases), which flowed toward umbilicus and then drained upwards (n = 16) including deep superior epigastric veins (n = 7), superficial superior epigastric veins (n = 9), downwards (n = 40) including deep inferior epigastric veins (n = 7), superficial inferior epigastric veins (n = 33), or upwards and downwards at the same time (n = 9).The superior group of vessels in the falciform ligament were directly anastomosed with the internal thoracic vessels (n = 6).Conclusion In patients with portal hypertension, 3D DCE MRA can optimally demonstrate the portosystemic collateral circulation in the falciform ligament, which includes the superior and inferior drainage groups.

Objective To investigate the clinical value of three dimensional dynamic contrast enhanced MRA(3D DCE MRA)on esophageal and gastric varices compared with endoscopy.Methods From April 2003 to June 2008,153 patients with portal hypertension who underwent both 3D DCE MRA and endoscopy were reviewed retrospectively.All the patients were divided into bleeding group and non-bleeding group according to the clinical symptoms.The location and degree of the esophagogastric varices on 3D DCE MRA were assessed with postprocessing images,including subtraction,MIP and thin-slab maximum intensity projection(thin-MIP),and were compared with the results of endoscopy.The maximum,minimum and mean diameters of esophagogastric varices inside and outside of the wall were measured on the reformed images.The correlation between the findings of 3D DCE MRA and endoscopy were analyzed with Spearman rank correlation coefficient test The rates of esophagogastric varices outside of the wall in bleeding and non-bleeding group were compared by means of Chi-square test Results In bleeding group,severe esophageal varices were documented in 59 patients,moderate in 6 patients,mild in 5 patients;in non-bleeding group,severe esophageal varices were documented in 32 patients,moderate in 4 patients,mild in 5 patients.Severe,moderate,and mild gastric varices were documented in 28,34 and 16 in bleeding group,while they were 7,12 and 9 in non-bleeding group.Esophageal and gastric varices can be wholly presented on MIP images after subtraction,while the esophagogastric varices inside and outside of the wall can be differentiated on thin-MIP images.The location and degree of esophagogastric varices on 3D DCE MRA were correlated with the findings of the endoscopy.The range of r was from 0.544 to 0.878(P＜0.01).In 91 patients with severe esophageal varices,27 patients presented outside esophageal varices in bleeding group(n=59)and 24 patients presented outside esophageal varices in non-bleeding group(n=32).There was a significant difference in ratio of outside esophageal varices between bleeding group and nonbleeding group(X~2=7.199,P＜0.01).In 35 patients with severe gastric varices,22 patients showed adventitial gastric varices in bleeding group(n=28)and 4 patients showed adventitial gastric varices in non-bleeding group(n=7).The ratio of adventitial gastric varices in bleeding group was not significantly different from that of non-bleeding group(P=0.340).Conclusions 3D DCE MRA can display and differentiate the esophagogastric varices both inside and outside of the wall by three dimensional reconstruction.The results of 3D DCE MRA and endoscopy have good correlation.It is of importance in evaluating the esophageal varices outside of the wall,because they may indicate decreased risk of haemorrhage in patients with severe degree of esophageal varices.

Taste-masking effect of pharmaceutical formulation is important for the pharmacy worker to carry out study on taste-masking of pharmaceutical formulation. This study discussed the feasibility of electronic tongue in the evaluation of taste-masking effect. The berberine hydrochloride was used as model drug of bitterness. Sodium cycla-mate, 2,4-Dihydroxybenzoic acid and sodium cyclamate were used as bitterness inhibitors. Through detection of elec-tronic tongue, results from principal component analysis (PCA), and indexes such as distance of bitterness (D), dis-tance of bitterness reduction, inhibition rate (Ir), the determination was given on whether results from the bitterness inhibition of berberine hydrochloride and taste results from volunteers were the same. In addition, sodium cyclamate, which was the best bitterness inhibition, was made into different concentrations in order to optimize its using dosage. The data analysis results showed that in the berberine hydrochloride solution with the concentration of 0.005 mg/mL, the ranking order of the bitterness-masking efficiency was sodium cyclamate > 2,4-Dihydroxybenzoic acid > sodium acetate anhydrous. Along with the increasing concentration of sodium cyclamate, the taste-masking effect is better. However, after the concentration level of 0.2%, the change on taste-masking effect was relatively small. In the prac-tical work, the concentration of sodium cyclamate can be selected at the level of 0.2%. This experiment effect was the same as the human taste results. This study showed that the electronic tongue may be a useful tool in the evalua-tion of taste-masking efficiency to some extent.

Objective: To evaluate the mitral, aortic and tricuspid valve replacement for rheumatic heart disease. Methods: From June 1990 to June 2001, 941 patients underwent valve replacement. Among them, 24 patients underwent simultaneously mitral, aortic and tricuspid valve replacement. There were 17 females and 7 males, with mean age of 36 years (ranged from 18 to 59 years). Eight patients had previous closed mitral valvotomy. Eleven patients complicated with left atrium thrombus, 16 with hapotomeglia, and 8 with ascites. The X ray results showed that the C/T ratio was 0.66 to 0.91. The heart function (NYHA) was class III in 9, and class IV in 15. All patients had combined mitral, aortic valve lesions associated with severe tricuspid valve regurgitation. Results: One patient died postoperatively with an operative mortality of 4.2%. 23 patients followed up from 20 to 36 months (mean, 26.4 months). There was no thrombolism and anticoagulant related hemorrhage. The echocardiography demonstrated the diameter of left atrium right ventricle, and LVDd significantly decreased after operation. The heart function was also significantly improved. Conclusion: The combination of mitral, aortic and tricuspid valve replacement could achieve a satisfactory result with low mortality and better recovery of heart function.

This paper was aimed to study the quantitation method of bitterness intensity of bitter drug, and to ex-plore the mutual relations between the bitterness intensity and the concentration of bitter drugs solution. The mod-el drug of berberine hydrochloride, which was made into a series of solutions of different concentrations, was ap-plied. Twenty volunteers, who were screened, trained and qualified, tasted the different concentration of aqueous solution, with the purpose of detecting the rank bitterness intensity. After analyzing the features of the data and testing the logarithm model and Weibull curve model, as well as nonlinear fitting, we finally set up the appropri-ate relationship curve between the concentration and the bitterness intensity. There is a good curve positive corre-lation between the bitterness intensity and the concentration, which is consistent with the Weibull curve model (R2= 0.9973, RMSE = 0.0976, RMSECV = 0.1453). The fitting degree of the model established in this paper is high, which provides a reference for quantitation and forecast of the drug bitterness.

Objective To analyze the risk factors of postoperative acute renal injury (AKI) for acute Stanford type A aortic dissection in 137 cases.Methods From January 2010 to December 2011,137 patients with acute Stanford type A aortic dissection were received surgical operations in our hospital.There were 106 males and 31 females with their mean age of(46.8 ± 13.1)years and mean weight of (69.9 ± 18.0) kg.The postoperative acute renal injury diagnosis was according to AKIN diagnosis standard of acute kidney injury network working group in 2005.All patients were received surgical repair with cardiopulmonary bypass,including 120 patients with deep hypothermic circulatory arrest and selective cerebral perfusion.Among them,there were 54 cases with total arch replacement and 66 with right half arch replacement.The postoperative managements were include control the patients' mean arterial blood pressure at 80 to 90 mmHg (1 mmHg =0.133 kPa),supplement the blood volume timely,and correction of hypoxia and hypoproteinemia.The patients were received renal replacement therapy if still oliguria after medical treatments,or their blood creatinine raising continually more than 500 μmol/L.Results A total of 12 patients died in hospitalization with a total in-hospital mortality of 8.74％ (12/137).76 cases had AKI in the first day after operations,including 38 cases (27.7％) with stage Ⅰ and 21 cases (15.3％) with stage Ⅱ and 17 cases (12.4％) with stage Ⅲ.There were 36 patients have acute renal failure (ARF) with morbility of 26.3％ (36/137),and 34 patients among them were received renal replacement therapy.Single factor analysis showed that preoperative creatinine,total arch replacement,cardiopulmonary bypasstime,intraoperative day transfusion of concentrated red cells are risk factors of ARF.Logistic regression was used for multivariate analysis showed that total arch replacement and preoperative creatinine abnormalities are independent risk factors for postoperative AFR.Conclusion Total arch replacement and preoperative creatinine abnormalities were independent risk factors of AFR for acute type A dissection after operation.