[Objective]To analysis the unstable pathogeny of the superior cervical congenital deformity for the operative method selection. [Methods]65 patients with congenital superior cervical deformity were treated from January 2003 to June 2007,in which there were 39 male patients,and 26 female patients. The X-ray,CT and MRI were examined generally before operation. In the images,there were 32 cases with formation failure deformity,18 cases with segmentation failure deformity,and 15 cases with abnormal structure deformity. 37 cases with easy reduction and no anterior compression were treated with posterior internal fixation and self cancellous bone graft for fusion. The other 28 cases with impossible reduction and anterior spinal cord compression were treated with anterior odontoid resection and decompression,and then posterior internal fixation and self cancellous bone graft for fusion.[Results]All of the operations were sucesseful without never and vascular injury and other serious complication. There were 47 cases following up 12 to 24 months in the 65 cases,and the mean follow up 15 6 months.One case's broken up titanium rod were treated with replacing new rod and bone graft,and the other cases showing bone fusion. There 28 cases following up in 34 cases with superior cervical pain and resticted movement,in which the pain was decreased or disappeared. There were 19 cases following up in 31 cases with numb limbs and superior never center injury. The preoperative Frankel score showed 5 cases B,8 cases C,and 17 cases D. The postoperative Frankel score of following up cases showd 5 cased C,6 cases D,and 8 cases E,and the score increased one or two degree.[Conclusion]The posterior,or anterior-posterior approach was selected by the condition of congenital superior cervical pathogeny,atlantoaxial reduction and spinal cord compression.

Fourty-three cases with spinal tumors treated with vertebral resection were reviewed regarding the preoperative treatment, the operations, and the results, in order to evaluate the value of resection of the vertebral body in prolonging the survival time and in improving the life quality of the patients. All the patients showed neurological recovery after surgical decompression. The average improvement was 2 grades by Frankel system. A second operation was necessary in 3 cases with recurrent lesions. Pulmonary and urinary complications were found in 3 cases. Absorption of bone grafts, collapse of vertebrae and loosening of implants were found in 2 cases. Resection of the involved tissue or segments and re-establishment of stability have become the most important treatment modality for patients with spinal tumors. With the help of adjuvant therapy, the survival time and the life quality of patients have been greatly improved.

Objective To discuss the effect of skill training for staff working in washing rooms of sterilization and supply center after application of centralized management model.Methods The training objects included all the working staff in the washing rooms and the training procedure covered four steps：preparation,discussion,implementation and evaluation.The evaluation indices involved level of post skill,cleaning and sterilization effect of instruments and satisfaction degree of staff.Results After training the level of post skills were increased dramatically(P＜0.01).The cleaning and sterilization effect of instruments was also improved(P＜0.01).96％ of staff considered their post ability elevated after training.Conclusion After skill training for staff working in washing rooms,the post skill and cleaning and sterilization quality of instruments were both enhanced.It proved valuable for guarantee of cleaning and sterilization quality of medical instruments and improvement of professional skills for staff working in washing rooms of sterilization and supply center.

Objective To investigate effect of alendronate on prevention of aseptic loosening prothesis.Method Twelve beagles which had been implanted a titanium plug in femur were divided into two groups randomly,one received alendronate,and the other placebo as control.After 12 weeks,all beagles were sacrificed.specimens of femur were studied by biomechanical test.Independent sample t test was used for statistical analyses.Results The pull-out strength of the experimental group was higher than that of the control (P ＜ 0.05),and the torsion strength was also higher in the experimental group(P ＜ 0.05).Conclusion The therapy of alendronate can change the bone strength,inhibit aseptic loosening of prosthesis in beagle and could be a good drug for the prevention and treatment of aseptic loosening prothesis.

BACKGROUND:Children usually wear school bags when walking, and overweight school bags do harm to the lower extremity and foot, thus affecting the child development. OBJECTIVE:To investigate the effect of obesity on gait characteristics of children wearing school bags during walking. METHODS:Forty pupils were enrolled in accordance with body mass index and China school-age children and adolescents overweight, obesity screening body mass index classification standard, including 20 obese children (body mass index: (28.13±3.4) kg/m2) and 20 non-obese ones (body mass index: (17.44±1.57) kg/m2). The gait parameters of children wearing school bags during walking were measured using a 2-m Footscan Plantar Pressure Plate System from RSscan International. RESULTS AND CONCLUSION: Compared with the non-obese children, the peak pressures under the metatarsal heads II-V, midfoot and heel lateral were significantly higher in obese children wearing school bags during walking (P < 0.05). The time to peak pressures under the toes II-V, the metatarsal heads IV, V and midfoot was also significantly higher (P < 0.05). In addition, the arch index for the foot, and right foot axis angle were significantly larger in the obese children as compared with the non-obese children (P < 0.05). To conclude, obese children wearing school bags during walking have weaker walking stability with flatter foot pattern, the larger foot axis angle and dynamic plantar pressure distribution changes compared with non-obese children, which can result in foot damage.

Objective To explore the applications and effect of experience-based health education in maternal nursing in community.Methods According to the random number table,150 women pregnant for the first time were divided into control group and observation group with 75 in each group. In the control group,the traditional method for health education was used and in the observation group the experience-based teaching based on traditional health education.The two groups were compared in terms of the awareness rate of knowledge about maternal and infant health care and the incidence of postpartum depression.Result The awareness of knowledge about maternal and infant health care in the observation group was significantly higher than that of the control group and the incidence of postpartum depression in the observation group was significantly lower than that of the control group(P<0.01).Conclusion Experience-based health education can improve the level of knowledge about maternal and infant health care and reduce the incidence of maternal postpartum depression.

BACKGROUND: Carbonated hydroxyapatite cement (CHC) s a new kind of biomaterial for bone defect, which is made of powder and fluid, and can be mixed to be pasty to repair various bone defects.OBJECTIVE: To observe the improvement of vertebrae height and pain in patients with osteoporosis vertebral compression fracture (VCF) after vertebroplasty by using a new kind of bone graft biomaterial, taking CHC as the filling material to reinforce the vertebral body.DESIGN: A contrast observation trial taking patients as subjects.SETTING: Department of Orthopaedics, General Hospital of Chinese PLA.PARTICIPANTS: Totally 34 patients with thoracic or lumbar osteoporosis VCF who received the treatment in the Department of Orthopaedics, General Hospital of Chinese PLA between October 2000 and August 2003. Inclusive criteria: ①Definite diagnosis by CT; ② Informed consents were obtained from the patients. Exclusive criteria: The patients with osteoporosis vertebral compression fractures who suffered vertebral posterior wall fracture. There were 6 males and 28 females, and they were aged (72±13)years; Among the patients, 27 were diagnosed as postmenopausal osteoporosis, 1 as cortical hormone-induced osteoporosis and 6 male patients weresenile osteoporosis.METHODS: ①All the patients were randomly divided into two groups: Experimental group (n =23) and control group (n=11). All the patients were performed percutaneous operation with local anesthenia. All cases were performed percutaneous operation under local anesthesia. Under the C-arm monitored, one side pedicle puncture was performed to enter the anterior column of the involved VCF. Patients of the experimental group were filled with CHC. Patients of control group were filled with polymethyl Methacrylate (PMMA) with the same way. ② Referred to McGill-Melzack scoring. Among the scale 0-100 mm (0 was no pain, 100 was acute pain), the value indicated the painful intensity and mental assault degree. ＜ 30 scores indicated good, 30-40 basically satisfied and ≥ 50 poor .③ Referred to the method from Lee et al, the preoperative height (A1) and postoperative height (A2) of compression fracture position of VCF were measured according to the lateral X-ray film. At the same time, the upper vertebral height (A3) and the inferior vertebral height (A4) were measured at the same position. The original height (A) of the involved vertebra was calculated as (A)= (A3+A4)/2,and the preoperative vertebral compression rate =(A-A1 )/A, the postoperative vertebral compression rate =(A-A2)/A, the restoring rate = (the preoperative vertebral compression rate-the postoperative vertebral compression rate)/the preoperative vertebral compression rate. ④ The wounds of the patients were observed after operation. The levels of blood routine, serum calcium and serum phosphorus were detected before, one day and one week after operation. MAIN OUTCOME MEASURES: ① Preoperative and postoperative VAS scoring. ② The vertebral compression rate and restoring rate. ③ Wounds were observed after operation. The blood routine, the serum calcium and serum phosphorus were detected before, one day and one week after operation.RESULTS: Totally 34 patients were involved in the result analysis. ①The preoperative visual analogue scale (VAS) score of experimental group were (91.5±21.7) points, and the postoperative ones were (44.5±27.2) points. The difference of VAS score reduced gradually along with the postoperative time. There was no difference of VAS score between experimental group and the control group 4 weeks after operation. ② The biocompatibility of CHC in the vertebral body was fine. The vertebral compression rate of experimental group was recovered from (43.1±21.4)％ preoperatively to (27.3± 18.5)％ postoperatively. The rate of restored heights was (27.3±18.5)％. ③ All patients obtained Ⅰ stage wound healing, and none of them had infection, inflammatory secretion and nervous symptom. There were no differences in blood routine test, serum calcium, serum phosphorus between patients in two groups. One case filled by PMMA and two cases filled by CHC presented leakage, and none had nervous symptom.CONCLUSION: As the filling materials for vertebropalsty, CHC can restore the vertebral heights and relieve pain safely and effectively, however, its efficacy to relieve pain is not significant as PMMA in the short term.

Objective To evaluate the clinical efficacy and safety of adapalene0.1%gel with individ-ualized treatment regimen for acne vulgaris(ITRAV).Methods Eighty-one patients with acne vulgaris of mild to moderate severity were treated with adapalene0.1%gel topically1to3times daily for6to8weeks according to the severity of the disease.Clinical responses were recorded and photographed weekly in30pa-tients randomly selected from the81patients,and treatment regimens were adjusted accordingly.Results It was shown that cure rates were44.4%and73.4%,in81recruited cases and30selected cases,respectively.Seborrhea decreased remarkably(83.3%)in the treatment.Side effects took place in39.5%of patients with-out interruption of the treatment.Conclusions ITRAV with adapalene0.1%gel has been proved to have an excellent response.Reasonably increasing the daily dosage could improve the cure rates.The cutaneous tolera-bility of the drug was generally good.Seborrhea could be reduced considerably during the treatment

Objective To evaluate the efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension in comparison with losartan. Methods Two hundred and thirty-seven patients with mild to moderate essential hypertension were enrolled in a randomized, double-blind, multi-center, paralleded and active-controlled trial, and were divided into olmesartan group (olmesartan 20 mg + losartan 50 mg placebo) and losartan group (losartan 50 mg + olmesartan 20 mg placebo) for a 8-week therapy. Four weeks after treatment, dosages of drugs were doubled in patients with seated diastolic blood pressure ≥90 mmHg (1 mmHg =0.133 kPa). All patients were followed up every two weeks, and the efficacy and adverse effects were observed. Another 32 patients with mild to moderate essential hypertension were enrolled and given olmesartan only, and ambulatory blood pressure monitoring was performed before and 8 weeks after treatment. Results Compared with those before treatment, both systolic blood pressure and diastolic blood pressure significantly decreased in olmesartan group and losartan group 8 weeks after treatment [(15.2 ±13.3) mmHg and (19.5 ±11.8) mmHg, respectively for systolic blood pressure (P <0.001); (15.9 ±7.48) mmHg and (16.2 ± 5.95) mmHg, respectively for diastolic blood pressure (P < 0.01) ], while there was no significant difference between these two groups (P > 0.05). There was no significant difference in total effective rate and incidence of adverse effect between these two groups (86.9% vs 93.7% and 7.63% vs 5.88% , P > 0.05) . Ambulatory blood pressure monitoring demonstrated that trough to peak ratios of systolic blood pressure and diastolic blood pressure were 86% and 71%, respectively. Conclusion Domestic olmesaratan provides an effective, safe and long action in the treatment of mild to moderate essential hypertension.

This study was aimed to investigate the effect of Nan-She-Teng (Celastrus orbiculatus) extract on epithe-lial-mesenchymal transition(EMT) in HepG2 cells. Except the control group, human hepatocellular carcinoma HepG2 cells in other groups were treated with Celastrus Orbiculatus extract in different concentrations (10, 20, 40, 80, and 160 μg·mL-1). The protein expression levels related to EMT were detected by western blotting. At 48 h after fertiliza-tion, the zebrafish embryos were randomly assigned to 7 groups as follows: untreated control group (E3 buffer), DMSO group (E3 buffer with 1% DMSO), and different dosages treatment of C.orbiculatus extract (10, 20, 40, 80, and 160μg·mL-1) for 24 h. The protein expressions of mTOR signaling pathways were detected by western blotting. The re-sults showed that compared with the control group, C.orbiculatus extract significantly increased E-cadherin protein expression. Simultaneously, C.orbiculatus extract inhibited vimentin and mTOR signaling pathways at protein levels. It was concluded that to a certain extent, C.orbiculatus extract prevented EMT in HepG2 cells by modulating the mTOR signaling pathway. Therefore, it suggested that mTOR can be chosen as a new therapeutic target for clinical treatment of hepatic carcinoma.