Objective To explore the clinical outcomes of the removal of nucleus pulposus with vertebral lamia fenestration in the treatment of lumbar disc herniation.Methods A total of 5482 patients with lumbar disc herniation were performed to remove nucleus pulposus with vertebral lamia fenestration.The follow-up study was conducted in 4329 cases for the duration varying from 6 months to 20 years,averaging 6.7 years,and the therapeutic effect of the operation was evaluated.Results After operation,the patients could walk in(3?2) days,resumed their daily activities in (15?6) days and went back to work in(28?9) days.According to the Nakai scale,excellent results were achieved in 3374 cases(77.9%),good in 652 cases(15.2%),improved in 249 cases(5.8%) and poor in 54 cases(1.1%).The rate of excellent and good results was 93.1%.Conclusion The advantages of the removal of nucleus pulposus with vertebral lamia fenestration are the removal of the annulus fibrosus,the calcified ligamentum flavum and osteophyte under direct vision.The operation may preserve the utmost integrity of the posterior lumbar structures,and the operative treatment has shown its good results.

Manganese ; blood ; Spectrophotometry, Atomic ; methods

Objective: To discover and prevent diabetes early in high-risk group. Methods:Chose 323 records of type 2 diabetes or IFG,IGT patients with first course which come from a large hospital in Lanzhou between 2009 January to 2014 March; Use Apriori algorithm and the SPSS Clementine 12 software design;Set up prediction model of type 2 diabetes. Results:A total of 10 strong association rules are formed. The strong association rules contain some associations between factors and type 2 diabetes. Conclusion: Through the association rules, the initial judgment on the high-risk group of diabetes is simple and accurate.

Ojective To evaluate the value of laparoscopic gastrectomy in the management of gastric diseases. Methods 18 laparoscopic gastric operation were performed in our hospital from August 2000 to April 2001. The ages of the patients ranged from 28 to 87 years. One patient received Billroth-Ⅰ gastrectomy, 7 Billroth-Ⅱ gastrectomy, 3 proximal subtotal gastrectomy, 4 distal subtotal gastrectomy and 3 total gastrectomy. Results All the operations were successfull, the duration of operation was 150～340min, the estimated blood loss was 20～120ml, and the average postoperative hospitalized days were 8 days. All patients recovered quickly without any postoperative complication. Flatus was present quickly. no death occurred in all the patients. Conclusions Laparoscopic gastrectomy is an effective and safe technique for the manaqement of gastric disease, if used properly.

BACKGROUND: A process of -80 ℃ profound hypothermia over three months and freeze drying will suppress the histocompatibility antigen of decalcified freeze-dried bone and reduce their immunogenicity. OBJECTIVE: To investigate the effect of treating intraarticular fracture using allogeneic decalcified freeze-dried bone nail alone. DESIGN, TIME AND SETTING: From August 2000 to August 2007, a clinical analysis was performed among 83 patients of cancellous bone fracture involving articulus, who were enrolled from Department of Orthopaedics in the Central People's Hospital of Zhanjiang (Zhanjiang, Guangdong, China). MATERIALS: The involved patients consisted of 64 males and 19 females, aged 16-53 years with a mean of 36.3. The lesioned sites were elbow joint in 28 cases, acetabulum in 6 cases, femoral condyles in 9 cases, tibial plateau in 17 cases and ankle joint in 23 cases. Allogeneic decalcified freeze-dried bone nail was developed by the Biomaterial Laboratory of the Southern Medical University (also known as the First Medical University of Chinese PLA). METHODS: Totally 83 cases of cancellous bone fracture involving articulus were fixed with bone nail or bone screw after reducing of bone fracture. Bone nails or screws were pretreated with saline or allogeneic blood over 30 minutes. Bone nail at 3.5-mm diameter were applied on elbow joints and ankle joints, while those at 4.0-mm diameter for knee joints and hip joints. After implantation, hip and femoral condyles fractures were treated with the traction for 4-6 weeks, and the fractures of elbow joints, ankle joints and tibial plateau were fixed with gypsum for 4-6 weeks. Patients received functional exercise after wound healing. Subsequent to draining for 48 hours, antibiotics were used to prevent infection, but immune depressant was unnecessary. MAIN OUTCOME MEASURES: Wound healing was observed. The growth of osteotylus and the absorption of bone nail were checked with X-ray. Immunological rejection was also checked. RESULTS: One case had dystopia at postoperative 2 weeks, one case with breakage of bone nail was found at postoperative 3 weeks, and two cases developed immunological rejection in advanced stage. The other 79 cases got bone healing without dystopia or immunological rejection, and they achieved bone union within 1-3 months with normal joint function. CONCLUSION: Being internal fixation material of intraarticular fracture, allogeneic bone nail can maintain the stabilization of cancellous bone fracture to bone healing, exhibit complete absorption and be good at bone repair.

ObjectiveTo observe the effect of combined rehabilitative training on stroke patients in convalescent stage.Methods52 stroke patients with hemiplegia were divided into rehabilitation group (n=26, receiving combined rehabilitative training) and control group (n=26, not receiving combined rehabilitative training). Scores of functional independence measure (FIM) and Fugl-Meyer assessment (FMA) of all patients were assessed when admission and discharge.ResultsFor patients of rehabilitation group, FMA scores when discharge was not significant difference compared with admission, but FIM scores was significantly higher than that of control group (P<0.01).ConclusionCombined rehabilitative training can improve function and living quality of stroke patients in convalescent stage.

ObjectiveTo explore the relationship between flash visual evoked potentials (fVEP) and intracranial pressure (ICP), and the effect of fVEP on monitoring ICP treatment.MethodsICPs of 37 patients with large area cerebral infarction and intracranial hypertension were measured before and at 10 min, 20 min, 30 min, 40 min, 50 min and 60 min after mannitol treatment.ResultsThe mannitol effect to cure the large area cerebral was not well.ConclusionfVEP can monitor ICP exactly and harmless, and has importance value to instruct therapy of ICP in clinic.

BACKGROUND: Fibrin is a kind of high polymer materials with biodegradation and good histocompatibility, and is a vector that can promote celland exogenous growth factor release. Fibrin stabilizing factor XIII has been verified to contribute to the migration of undifferentiated mesenchymal stem cels in gel scaffold with high crosslinking, and promote cellproliferation and differentiation. OBJECTIVE:To observe rat mesenchymal stem cellbehavior in a fibrin gel. METHODS:The rat fetal limbs cels was separated under the aseptic condition. The passage 3 cels were seeded in 0, 5, 10 and 20 g/L fibrin gel. cellmorphology was observed by inverted phase microscope and laser scanning confocal microscopy. Alkaline phosphatase activity and calcium deposition were measured respectively using a microplate reader and von Kossa staining. RESULTS AND CONCLUSION: 5 g/L fibrin gel contributed to cellmorphological changes, and 20 g/L fibrin gel contributed to osteogenic differentiation. Compared with the control group, alkaline phosphatase activity was higher in the formulations containing a 20 g/L fibrinogen concentration. Smal mineralization nodules were observed at 21 and 28 days in a formulation containing both 10 and 20 g/L fibrinogen concentration, but no mineralization was detected in the control group. These results indicate that morphology and osteogenic differentiation of rat mesenchymal stem cels depended on the fibrinogen concentration, suggesting that fibrin gel is conducive to osteogenic differentiation of mesenchymal stem cels.

Objective To explore the value of non-spiral mode of low-dose chest scan in diagnosis of pulmonary nodules.Methods Thirty patients with chest X-ray suspected pulmonary nodules underwent spiral low-dose and non-spiral low-dose CT scan under Toshiba 4 row multi-slice spiral CT (Asteion 4).The parameters were defaulted as 35.5 mAs,20 mm/ round (pitch=l),0.75 s/rot in spiral scan,while in non-spiral scan wree defaulted as 24 mAs,20 mm/round (thickness = layer distance),0.48 s/rot.Other parameters including 120 kV,collimator 0.5×4,DFOV 300 mm,reconstruction slice thickness 5 mm were chosen in both scans.CT imaging quality was evaluated according to the degreex of image artifacts and the distinguishment of nodule,and the pulmonary nodules were counted,then the differences of finding the pulmonary nodules and effective radiation dose of both mode were analyzed.Results The images were good in one patient in both scanning mode,and excellent in 29 patients in spiral scanning mode,28 patients in non-spiral scanning mode.A total of 108 nodules were found with two modes.The effective radiation dose in non-spiral scan was lower than that in spiral scan.No significant difference was found between non-spiral mode scanning and spiral scanning mode in the low-dose chest examination in the discovery and diagnosis of pulmonary nodules.Conclusion Lower dose of non-spiral scanning mode is feasible in diagnosis of pulmonary nodules.

Objective To investigate osteoporosis prevalence in the elderly with type 2 diabetics. Method Osteoporosis prevalence in 338 elderly patients with type 2 diabetics (60-69 and 70-79 years old, respectively) was compared with 199 non-elderly (50-59 years old) patients and 531 elderly subjects from local reference data. Bone mineral density was measured at lumbar spine and proximal femur in DPX-L. Results (1) In female patients, osteoporosis prevalence at both sites in the elderly group was higher than that in non-elderly group (all P