ObjectiveTo explore the application of finasteride during ipratropium bromide treatment in the elderly with chronic obstructive pulmonary disease. Methods The 263 patients who were hospitalized for chronic obstructive pulmonary disease (COPD) and treated with ipratropium bromide (aged 63-89 years) in Cadre Wards of Ji Shui Tan Hospital from Jan.2006 to Jan.2011 were reviewed.They were divided by gender and combination of benign prostatic hyperplasia (BPH) and treatment of finasteride.The duration of ipratropium bromide treatment,time to dysuria and the severe degree of dysuria were evaluated.Results None of the female patients suffered from difficult urination or discontinued impratropium bromide for abnormal urination,while there were 23.3％ cases with difficult urination,5.8％ catheterization and 3.4％ discontinued bromide in male patients.More patients suffered from catheterization and bromide discontinuance in prostatic hyperplasia group (8.0 ％ and 4.7 ％ ) as compared with non-prostatic hyperplasia group (P＜ 0.05).The occurrence of urethral catheterization for dysuria or ipratropium bromide discontinuance obviously decreased 40％ and 30％,respectively,after finasteride treatment (P＜0.01). Conclusions The COPD patients complicated with BPH should be treated with finasteride to prevent the occurrence of abnormal urination and urinary retention during the treatment of ipratropium bromide.

Objective To discuss application of initiative infrared ray computer assisted 3D navigation system in spinal complex operation to improve surgical safety. Methods From December 2002 to July 2004, we performed 90 cases of spinal operation assisted by computer 3D navigation system. There were 38 cases of spinal fractures, and 236 cases of pedicle fixation. In lumbar spine surgery, fluoroscopy was commonly used, because the pedicle of lumbar spine was thick enough. 3D computer navigation was used in the other cases. Results 4 screws (1.7%) were not in good position, and the position error rate was 0.23 to 0.56 mm (automatically calculated by the computer). But we had once performed 272 cases of fixation with cervical pedicle screws just assisted by G arm or C arm fluoroscopy, 29 (10.7%) of which were not in good position. Conclusion In comparison, computer navigation assisted operation can make pedicle screw positioning more correct.

Technological advances in spinal surgery have brought about changes to the theories and methods of treatment of spinal fractures. New techniques, such as pedicle screw fixation, upper cervical fixation, minimal invasive method, computed navigation method, have made it possible that much more spinal fractures can be treated operatively rather than conservatively. These changes have also made the recovery of patients more satisfactory. But if the new techniques are not used properly, they can do harms to the patients. Therefore, how to apply the new techniques properly and avoid unnecessary harms to the patients at the same time is a serious problem that we must face and solve.

Objective To report a case of neuromyelitis optia with hiccups as the first symptom. Methods 1 case received laboratory examination according to the clinical symptoms, signs, especially aquaporin-4. Results Aquaporin-4 antibody was positive. Conclusion Aquaporin-4 may play an important role in the pathogenesis of neuromyelitis optia.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Objective:To investigate the protective effects of Ruanmai Capsules on cerebral ischemia-reperfuse injury in rats.Methods:A cerebral ischemia-reperfuse model in rats was established by ligaturing bilateral arterial carotis communis and vagus nerve. NO, 6-keto-PGF 1a and TXB 2 in serum were examined. Results: Ruanmai Capsule (0.81g/kg and 2.43g/kg,po) increased the levels of NO, 6-keto-PGF 1a. It also had the tendency to decrease TXB 2 in serum. Conclusions: Ruanmai capsules can alleviate brain injury caused by cerebral ischemia reperfusion. The effect is achieved perhaps by inhibiting platelet aggregation and increasing NO.

Axial symptom,also called axial pain or axial neck pain,is a common complication after posterior cervical spine surgery.The symptom can be neck pain,as well as rigid,tension and dullness.The incidence of axial syndrome is estimated between 5.2％ and 61.5％.Often,the symptom does not disappear spontaneously.The quality of patients' life as well as the effectiveness of cervical laminoplasty is affected.It can be divided into early and late axial pain based on the onset time.The mechanism and reason are different,but both are difficult to subside.The incident of axial symptom is relatively high in conventional laminoplasty.However the modified one which preserve posterior ligament-muscular structure can reduce the incidence significantly.C2 spinal process as the attachment of cervical semispinalis,could reduce the incidence of kyphosis after operation.And C7 spinal process is an important structure in posterior ligament-muscular structure.Both should be preserved as much as possible in order to maintain intact attachment of muscles,which facilitates the patient to restore soft tissue tension by rehabilitation.Rigid fixation is another method of modification,it could avoid re-close of the open door,and reduce soft tissue injury.However,attention must be paid not to destroy facet joint to cause new axial symptom.Risk factors of axial symptom include past shoulder and neck pain and stiffness,others remain controversial.There is no correlation between loss of range of motion after surgery as well as change of cervical alignment and axial symptom.It is more likely to be a different result due to muscle atrophy.Although there are no golden standard of laminoplasty,doctors should follow these principles:preserve C2 and C7 spinal process when possible,rigid fixation to avoid reclose,reduce immobilization after operation,and encourage patient to start rehabilitation as early as possible to reduce incident of axial symptom.

Objective To discuss postoperative analgesia effect of patient automatic controlled epidural analgesia (PCEA) and cocktail therapy (CT) after total hip replacement. Methods Eighty-eighty patients of selective total hip replacement were selected, and the patients were divided into PCEA group and CT group by random digits table method with 44 cases each. The postoperative resting state and active state visual analogue score (VAS), dosage of opioid, discharge time, postoperative complications, postoperative sleep quality score and hip joint mobility were compared between 2 groups. Results The resting state and active state VAS in PCEA group 12, 24 and 48 h after operation were significantly lower than those in CT group, resting state: (3.68 ± 1.45) scores vs. (4.23 ± 1.14) scores, (2.61 ± 1.04) scores vs. (3.92 ± 1.23) scores and (2.31 ± 0.97) scores vs. (3.56 ± 1.21) scores, active state:(4.54 ± 1.63) scores vs. (5.87 ± 2.11) scores, (3.51 ± 0.94) scores vs. (4.34 ± 1.07) scores and (3.01 ± 0.95) scores vs. (4.05 ± 1.17) scores, and there were statistical differences (P<0.05). But there were no statistical differences in VAS 72 h after operation and at discharge between 2 groups (P>0.05). The dosage of opioid in PCEA group was significantly lower than that in CT group:(9.58 ± 5.35) mg vs. (11.27 ± 4.48) mg, and there was statistical difference (P<0.05). The incidences of nausea vomiting and headache dizziness in CT group were significantly lower than those in PCEA group: 20.45% (9/44) vs. 45.45% (20/44) and 4.55% (2/44) vs. 13.64% (6/44), and there were statistical differences (P<0.05). There were no statistical differences in length of hospital stay, postoperative sleep quality score and postoperative hip joint mobility between 2 groups (P>0.05). Conclusions Choice of analgesic regimen of choice should not be made only according to the length of hospital stay. Individualized treatment is recommended. According to specific circumstances and needs of patients, patients with less anesthetics and a tendency to nausea should use PCEA, and for chronic pain patients CT may be more effective.

Objeetive To evaluate the effect of single-level Discover cervical artificial disc replacement on cervical sagittal alignment.Methods Retrospective analysis was conducted on patients who underwent single-level Discover cervical artificial disc replacement in our hospital from February 2012 to September 2014.Sixty-two patients (34 males,28 females) with an average age of 45.2±8.2 (31-61) who were diagnosed with single-level cervical disc herniation were included (C3-4 3 cases,C4-5 12 cases,C5-6 34 cases,C6-7 13 cases).We measured the cervical sagittal alignment parameters:index level disc angle,functional spinal unit (FSU) angle,C2-C7 angle, anterior disc height (ADH),middle disc height (MDH),posterior disc height (PDH),anterior FSU height (AFH),middle FSU height (MFH),posterior FSU height (PFH) on neutral lateral radiographs before surgery and 3 months after surgery.Results All of the patients were followed up for 3 months.The cervical sagittal alignment parameters before surgery and 3 months after surgery were as follows.Index level disc angle increased from 0.0°±4.2° to 7.3°±3.9°,FSU angle increased from 2.3°±5.0° to 6.9°±4.8°,C2-C7 angle increased from 9.5°±10.8° to 13.1°±9.1°,ADH increased from 4.3±1.0 mm to 7.9±1.1 mm,MDH increased from 5.8±0.9 mm to 8.1±0.9 mm,PDH increased from 3.7±0.9 mm to 5.5±0.9 mm,AFH increased from 34.1±3.5 mm to 36.2±3.4 mm,MFH increased from 32.3±3.5 mm to 33.6±3.3 mm,PFH increased from 33.9±3.5 mm to 34.6±3.2 mm.All changes were statistically significant (P＜0.05).Conclusion Single-level Discover cervical artificial disc replacement can improve the disk angle,FSU angle,and disk height effectively in early follow-up period,thereby improving the cervical sagittal alignment.

Objective To investigate the expressions of RTN4 and TG2 in papillary thyroid cancer tissues and their clinical pathological significance.Methods A total of 40 samples of papillary thyroid cancer tissues and 20 samples of para‐carcinoma tissues were collected from the Department of Pathology ,Renmin Hospital of Wuhan University ,China.The expression levels of RTN4 and TG2 were detected by means of immunohistochemical staining and their relationship with clinicopathological charac‐teristics of papillary thyroid carcinoma was analyzed.SPSS 13.0 soft package was used for one‐way analysis of variance and SNK test of the average absorbance and the average positive area rate (α=0.05).Bivariate correlation analysis of the positive area rate of the expressions of RTN4 and TG2 was conducted (α=0.05).Results ①The expression levels of RTN4 and TG2 were much higher in the papillary thyroid carcinoma tissues than those in the para‐carcinoma tissues (P<0.05). ② The expres‐sion levels of RTN4 and TG2 were significantly higher in lymph node metastasis group than those in the group without lymph node metastasis (P<0.05).The positive expression rates of RTN4 and TG2 were much higher in clinical stage Ⅰand Ⅱ groups than those in clinical stage Ⅲ and Ⅳ groups (P<0.05).They were significantly increased in low differentiation group than in high or moderate differentiation group (P< 0.05).The expressions of RTN4 and TG2 were not statistically associated with tumor size ,age and sex (P>0.05). ③The positive correlation was found between the expressions of RTN4 and TG2 in papilla‐ry thyroid carcinoma tissues (r=0.587 ,P<0.05).Conclusion ① The expressions of RTN4 and TG2 were up‐regulated in pa‐pillary thyroid carcinoma tissues ,which is related with over‐proliferation and increase of apoptosis resistance of cancer cells. ②RTN4 and TG2 play an important role in the proliferation and metastasis of papillary thyroid carcinoma. ③ RTN4 and TG2 may play a synergistic role in the development of papillary thyroid carcinoma.