Objective To observe the effectiveness of naloxone treatment for acute alcohol toxicosis.Methods The effectiveness of naloxone treatment for 262 cases of acute alcohol toxicosis were compared with the effectiveness of routine treatment for 184 cases of the same toxicosis.Results The mean syptom subsidence time of medium degree toxicosis cases and the mean consciousness regaining time of serious degree toxicosis cases of naloxone treatment group were separately (05?02) hours and (98?21) hours(P

ObjectiveTo observe the affection of cilostazol combined with valsartan in treating patients with early diabetic nephropathy on serum homocysteine and cystatin C,MethodsNinety-six cases with early diabetic nephropathy were divided into two groups by random digits table method with 48 cases each:observation group was treated with cilostazol and valsartan,control group was treated with valsartan alone.The effect and the levels of 24 h urinary albumin,serum homocysteine and cystatin C before and after treatment in two groups were compared.ResultsThe total effective rate in observation group [85.4％(41/48) ] was significantly higher than that in control group [66.7％(32/48) ](P ＜ 0.05 ).The levels of 24 h urinary albumin,serum homocysteine and cystatin C were significantly decreased after treatment of three weeks in observation group and control group [ (125.48±13.76) mg,(9.25±3.52)p mol/L,(7.82±2.14) mg/L and (168.38±15.43) mg,(13.72±4.23) μ mol/L,(9.57±2.85) mg/L vs.(279.31±21.52) mg,(18.52±6.14) μ mol/L,( 13.25±3.79) mg/L and (275.24±19.31 ) mg,( 18.48±6.12) μ mol/L,( 13.19±3.76)mg/L](P＜ 0.05).And the levels of 24 h urinary albumin,serum homocysteine and cystatin C after treatment of three weeks in observation group were obviously lower than those in control group(P ＜ 0.05).Conclusions Cilostazol combined with valsartan in treating patients with early diabetic nephropathy can improve clinical effect obviously,degrade the level of urinary albumin,homocysteine and cystatin C.Therefore,it deserves to be applied in clinic.

Objective To evaluate the clinical therapeutic effects of Vbeam 595 nm pulsed dye laser in114 cases of port wine stains.Methods 114 patients with port wine stains were treated with Vbeam 595 nm pulsed dye laser with 3～10 ms pulse width and 7mm spot size.The energy fluence used varied from 10 to 15 J/cm2.Dynamic cooling device(DCD)was used to protect epiderm,with DCD spray 30～40 ms and DCD delay 10～30 ms.The interval of therapy was 4～8 weeks.The results were graded on basis of cleaning and fading as follows:grade Ⅰ(＞75%),gradeⅡ(50%to 74%),grade Ⅲ(25%to 49%),and grade Ⅳ(＜25%).Results 114 patients completed the therapy.The number of treatments ranged from 1 to 10(mean 5.9).The results evaluated as grades Ⅰ,Ⅱ,Ⅲ and Ⅳ were 74 patients(64.9%),29 patients(25.4%),9 patients(7.9%)and 2 patients(1.8%),respectively.The therapeutic effect was analysed according to number of treatments.the ages of patients,site and color of the lesions.It was found that the therapeutic effect was prominent in patients of younger age,with pink lesions located on the neck and face.No recurrence and scar happened after 6 months to 2 years follow-up.Conclnsions Vbeam 595nm pulsed dye laser is a safe and effective method for the treatent of port wine stains,with less complications.

Objective To improve the operation method of rupture of Achilles tendon for decreasing complication. Methods Total 39cases with closed rupture of Achilles tendon were selected in this study. Short incision was made at achilles tendon wall, reveal and anneal the broken ends, using Kirschner wire and steel-wire to make rectangle frame ,intradermic fixation of fracture away from the broken ends, then sutured ends with rarities and smoothing,functional exercise after 6weeks ankle rest position fixation. Results According to the Arner Lindholm evaluation system,the treatment outcome were excellent in 34 cases ,and good in 5cases. No complication including re-rupture skin ,tendon necrosis and infection were found after operation. Conclusion Repaired closed rupture of Achilles tendon with short incision and rectangle frame, assisted with ankle rest position fixation after operation wasa worthy way for treating closed rupture of a chilles tendon.

Objective To analyze and explore the operative effect of coraccid process basilar part fractures combined injury of ligamental structure. Methods Use ilium-fascia lata complex tissue to reconstruct coronoid process of ulna and medial collateral ligament, recoverd anterior and wall horn anatomic structure of elbow joint. Total 9 cases of ulna coracoid process fractures concomitancy with elbow posterior dislocation . Among these one with olec-ranon fracture,five patients with head of radius fracture. Anterior trance joint approach was used,removal bone chips, restore defect with ilium-fascia lata complex tissue after cuting and trimming. Once reduction was achieved,fixed with screw. Repaird the collateral ligament and anterior joint capsule use the fascia lata, If there were combined fracture of the radius head or olecranon fracture,fixed through lateral approach,All injured extremities were treated with a posterior plaster splint with functional position for 3 weeks followed by elbow rehabilitation training. Results According to Moneys evaluation method,2 patients were classified as excellent ,5 as good,l as fair and 1 as poor. The excellent and good rate was 77. 8%. Two patients with gently ossifying myositis but no patients with wound infection,internal fixation loosening or break,elbow joint destabilizing orcorpus libemm. Conclusions Coracoid process basilar part fractures was simultaneous with the instability of osteal frame and soft tissue. To attain the favourable anatomical foundation for elbow joint functional recovery, it should rebuild the height and shape of coronoid process first and think highly of repair or rebuild medial collateral ligament and joint capsule. It reconstructed the coronoid process osteal frame and soft tissue instability at the same time to use ilium-fascia lata complex tissue. The operative procedure is simplify with reliability effect and fine functional rehabilitation.

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Objective To evaluate the dosimetry accuracy and clinical efficacy of 125I radioactive seed implantation using coplanar template (CPT) in the treatment of metastatic or recurrent chest wall tumor.Methods Thirty-one patients with metastasis or recurrence of chest wall tumor,who had been diagnosed with pathology between July 2005 and July 2015,were retrospectively studied.All patients underwent CPT-assisted 125I radioactive seed implantation.Brachytherapy radiation treatment planning system (BTPS) was used to make preoperative plans,and the prescribed dose (PD) was 110 Gy.CPT was used to assist CT guided 125I radioactive seeds implantation.Dose evaluation was performed immediately after implantation.The difference of dose parameters was compared between preoperation and postoperation,including Dg0,D100,V90,V100 and the numbers of seeds.Postoperative chest CT was conducted regularly to assess the treatment efficacy based on the response evaluation criteria in solid tumors (RECIST Version 1.1).The patients were followed up till July 2016.Results All patients went through implantation procedure successfully and there was no significant statistical difference between preoperative and postoperative dose parameters (P ＞ 0.05).The conformal index (CI) was 0.951 ± 0.13,external index(EI) was 6.5％ ±0.9％.Six months after implantation,CR,PR,SD and PD were 25.8％ (8/31),51.6％ (16/31),6.5％ (2/31) and 16.1％ (5/31),respectively.The effective rate was 77.4％,and local control rate was 83.9％ (26/31).Skin pigmentation occurred in 13 patients during the follow-up period,without any special treatment.Conclusions The auxiliary of CPT in the treatment of metastatic or recurrent chest wall tumor under the guiding of CT could achieve quality control,safety and effectiveness.

Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.

Stage T4 colon cancer is divided into two categories:tumor penetrating the visceral peritoneum(T4a)and tumor directly invading or attaching to adjacent organs or structures(T4b).Treatment of T4 colon cancer requires technically demanding surgical procedures,including total resection of adjacent infiltrating organs or structures,and is characterized by a high incidence of postoperative complications and a high rate of positive surgical margin microscopy.It has been found that taking laparoscopic surgery for T4 colon cancer may decrease long-term survival and increase the rate of peritoneal metastasis,but taking laparoscopic surgery for colon cancer also has the potential advantages in increasing perioperative benefits and improving the prognosis.With the upgrade of laparoscopic equipment and the improvement of surgeons'surgical skills,more and more surgeons have adopted laparoscopic surgery to treat T4 colon cancer.Currently,the oncologic safety of laparoscopic surgery for T4 colon cancer has not been effectively evaluated.Therefore,this article reviews the advantages,risks,and the choice of treatment strategies for laparoscopic surgery for T4 colon cancer,taking into account the current status and progress of domestic and international studies.

Objective To explore the therapeutic effect of radioactive 125I seeds combined with chemotherapy on the treatment of inoperative pancoast tumor by CT-guided percutaneous implantation of treatment planning system (TPS).Methods From December 2002 to December 2010,36 patients with pancoast tumor were confirmed by imaging and pathology.Among them,26 cases suffered from squamous cell carcinoma and 10 cases with adenocarcinoma.At 1 week after radioactive 125I implantation,chemotherapy was administered as intravenous 1 000 mg / m2 gemcitabine at 1 and 8 d and intravenous cisplatin 75 mg/ m2 at 1 d for 4 consecutive cycles.The prescribed dose (PD) was 120 Gy,and the median activity of the seeds was 0.7 mCi (2.59 × 107 Bq) with the range of 0.68-0.82 mCi (2.52 × 107-3.03 × 107 Bq).The patients were followed-up and the median follow-up time was 48 months.The survival rate was observed.Results The mPD of the target tumor was (118.7 ± 7.2) Gy,D90(126 ± 4.7) Gy,D90 ＞ mPD.The rate of CR (11 cases) was 63.6％,and the effective rate (CR + PR) was 83.4％.The follow-up last till December 1st,2016.1-,3-and 5-year local control rates were 92％,83％,and 67％,respectively.1-,3-and 5-year cumulative survival rate were 84.1％,56.7％,and 36.8％,respectively.Median survival was 38 months.Conclusions Chemotherapy combined with tissue radioactive 125I seed implantation is a minimally invasive and effective method for the treatment of pancoast tumor.