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.

The asialoglycoprotein receptor (ASGPR) was used to mediate drug carrier for hepatic targeted drug delivery, this article showed the enzyme-catalyzed esterification of galactose and vinyl stearate and a kind of ASGPR ligand-targeted which was used to insert the surface of liposome has been synthesized. The structure of product has been confirmed by TLC, ESI-MS and 1H NMR. The factors of types and quantity of enzyme, organic solvents, molar ratio of substrate, temperature and time of reaction have been studied. Results showed when using acetone as reaction medium, the quantity of Novozym 435 immobilized lipase was 30 mg mL(-1), molar ratio of galactose to vinyl stearate was 1:5, and reacted at 60 degrees C for 12 h, the transformation of vinyl stearate reached more than 70%. This study provides a novel and efficient route to the synthesis of ligand-targeted modifier.

Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.

Objective To explore the value of Ligasure vessel sealing system(LVSS)during resection of retroperitoneal tumor.Methods Group 1 including 32 cases were performed resection of retroperitoneal tumor with LVSS and electrosurgical seapel from Jun.2004 to Oct.2008.group 2 including 26 cases were done with electrosurgieal seapel from Jan.2001 to Jun.2004.Operating blood loss,operating time,iatrogenic injury,postoperative blood loss and hospital stay were compared between the two groups.Results There was no significant difference in hospital stay[(11.7±0.7)d vs.(12.3±1.4)d)]and iatrogenic injury(9.38%vs.16.00%)between two groups statistically(P＞0.05),but the intraoperative blood lose[(403.1±37.1)ml vs.(704.0±129.0)m1)s,postoperative blood loss[(131.5±18.4)ml vs.(214.8±29.2)ml)]and operating time[(166.5±8.9)min vs.(186.8±15.4)min]were less in group 1 than that in group 2(P＜0.05).Conclusion Ligasure vessel sealing system has advantages of safe coagulation,shortening operation time in resection of retroperitoneal tumor.