Objective To compare treatment and efficacy of thoracolumbar fractures by using three different screw fixations:traditional approach,the vertebral side clearance into the road and percutaneous pedicle. Methods A total of 82 single segmental thoracic lumbar fractures cases hospitalized from March 2011 to March 2014 ,with male 67 cases ,female 15 cases ,and average age(33.7+/-12.5)years old. Patients were randomly divided into three groups:traditional approach group (n = 23),operation through paraspinal muscle gap group (n = 30),percutaneous group(n = 29). These following indicators will be compared in three groups:duration of operation ,intraoperative blood loss ,intraoperative fluoroscopy time ,postoperative flow ,VAS scores before and after operation and Oswestry disability index , difference of spinal sagittal position Cobb′s Angle. Results Compared with the traditional approach group ,operation through paraspinal muscle gap group and percu-taneous group have obvious advantages in duration of operation,intraoperative blood loss,postoperative flow,VAS scores before and after operation ,the Oswestry disability index. Additionally ,above mentioned three surgical methods could recover kyphosis deformity ,and there was no statistically significant difference among three groups (P > 0.05). Conclusion In the treatment of monosegmental thoracolumbar fractures ,compared with traditional approach ,operation through paraspinal muscle gap and percutaneous pedicle screw internal fixation have more advantages which includes fewer trauma,less bleeding,faster recovery and lower incidence of postoperative low back pain.

As the change of medicine mode,measuring approaches of patient satisfaction have been widely focused on and become an important tool to improve the quality of medical service.This paper is aimed to analyze the latest development of patient satisfaction questionnaires including relevant content and methods by literature review.

Objective To explore the solid gastric emptying characteristics of awake gastroparesis Beagle. Methods A Beagle model of gastroparesis was established by truncal vagotomy combined injection glucagon. Solid gastric emptying of the Beagle under normal and gastroparesis were evaluated with ultrasound imaging,and compared with the results of radionuclide SPECT scintigraphy. Results The solid gastric emptying process of the Beagle was in accordance with modified power exponential models: Y =1-(1-e-kt)β, half time of the gastric emptying of gastroparesis Beagle was obviously longer than normal, there was a significant difference between the two situation ( P ＜ 0.05). Conclusions The solid gastric emptying characteristics of the gastroparesis Beagle has a stable mathematical expression.

Objective To investigate the effects of levator ani muscle exposure in abdominal periueal resection for rectal cancer.Methods The clinical data of 109 patients with rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2001 to January 2008 were retrospectively analyzed.There were 55 patients received traditional procedure (conventional method group) and 54 patients received modified procedure with levator ani muscle exposure (levator ani muscle exposure group).The mesorectum was sharply dissected according to the total mesorectal excision principle.It is essential to remove the rectum along with the mesorectum up to the level of the levators.Preoperative bowel preparation,anesthesia,body position,abdominal incision,perineal incision and suture of the 2 groups were the same as Miles procedure.In the conventional method group,the superficial dissection was carried out with electrocautery or ultracision harmonic scalpel.The presacral space was entered by dividing the rectococcygeus muscle,commencing at the level of the tip of the coccygeus.The levators were then divided near the pelvic wall attachments and next procedures were performed without levator ani muscle exposure.In levator ani muscle exposure group,once the ischiorectal fat was cleared by electrocautery,the planes of levator ani muscle were identified and exposed after dividing the rectococcygeus muscle and next procedures were performed.The patients in stage Ⅰ only needed to follow-up; the patients in stage Ⅱ had to receive chemotherapy with following situation:poor differentiation,T4 stage,blood vessel or lymphatic invasion,number of lymph nodcs detected ＜ 12.Patients in stage Ⅲ or Ⅳ needed adjuvant chemotherapy.The follow-up evaluation included blood routine examination,hepatic and renal function examination,chest radiography,hepatobiliary ultrasonographic evaluation and determination of CEA levels (once every 3 months in the first year after operation,and once every 6 months after one year).Abdominal CT scan and colonoscopy should be employed every year.All the patients were followed up till December of 2012.All data were analyzed using the chi-square test or t test.The survival curve was drawn using the Kaplan-Meier method,and the prognosis was analyzed using the Log-rank test.Results The operation time were (60 ± 15)minutes and (30 ± 10) minutes in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =3.936,P ＜ 0.05).The intraoperative blood loss were (300 ± 60) mL and (30±20) mL in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =5.687,P ＜ 0.05).Three patients were with rectal injury,1 with urethral injury,1 with vaginal injury,and 10 with incision infection in the conventional method group.There were 9 patients with incision infection in the levator ani muscle exposure group.The course of chemotherapy was under 12 in 30 patients,and above 6 in 41 patients.The median time of follow-up of the patients was 56 months (range,15-95 months).Of the 109 patients,10 missed the follow-up,15 patients had local recurrence,30 had distal metastasis,and 35 patients died.The 1-,3-,5-year cumulative survival rates were 93.4％,76.0％ and 65.6％.The 5-year survival rates were 65.2％ and 66.3％ for patients in the conventional method group and the levator ani muscle exposure group,with no significant difference between the 2 groups (x2=4.210,P ＞0.05).Conclusion Levator ani muscle exposure method provides clearer vision of operational field,shorter operation time,less blood loss and less injury to the rectum or urinary tract (vagina).

AIM: To establish a HPLC method for determination of curcumol and germacrone in Zedoary Turmeric Oil and Glucose Injections. METHODS: RP-HPLC was applied for quantitative analysis of curcumol and germacrone. Hypersil ODS2 column (250 mm? 4.6 mm, 5 ?m) and gradient elution was used. Mobile phase A was acetonitrile and mobile phase B was water. Phase A time-percentage composition was as follows:0-3 min,45%;3-30 min,45%→65%;30-38 min, 65%; 38-45 min, 65%→90%;45-55 min,90%→100%;55-65 min,100%. The flow rate was at 1.0 mL?min -1 . Diode array detector was set at 214 nm and column temperature was at 25 ?C. RESULTS: The calibration curves of curcumol and germacrone were linear in the range of 0.26 - 6.5 ?g(r= 0.999 9 ) and 0.112 5 - 2.812 5 ?g(r=1), The average recoveries of them were 102.1% and 98.8% (n=5), respectively. CONCLUSION: Curcumol and germacrone can be determined by the method, and this will improve the quality control of Zedoary Turmeric Oil and Glucose Injections.

0.05).There were more complaints of postoperative pain and discomfort after LASEK procedure.No severe vision threatening complications in these two groups were found.Conclusion:Both LASIK and LASEK are safe and effective in treating eyes with severe myopia.

Objective To explore the expression of TLR4/MyD88/NF-κB signaling and its correlation with the progression of acute intestinal graft-versus-host disease (iGVHD) after allogeneic bone marrow transplantation in mice.Method Recipient BALB/c female mice were lethally irradiated and were reconstituted within 4-6 h with a transplant of bone marrow cells (1 × 107) and different amounts of splenocytes (1 × 107,n =12 or 2 × 107,n =12) from MHC-mismatched C57BL/6 donors to induce iGVHD,and 6 healthy BALB/c mice served as controls.A globe survey observation of GVHD by survival,clinical manifestation,and histological detection was performed.RT-PCR,immunohistochemistry,and Western blotting technology were used to detect the mRNA and protein levels of TLR4,MyD88 and NF-κB p65 in the small intestine tissue.Result The exacerbation of iGVHD was associated with the increasing dose of allogeneic spleen lymphocytes.The mRNA expression of TLR4,MyD88 and NF-κBp65 was increased as the iGVHD progressed.All of them in severe iGVHD model were significantly increased as compared with the healthy controls (P＜0.05).The expression of corresponding proteins had the same tendency as mRNA.All of the three genes expression was not only positively correlated with each other,but also with the clinical GVHD score:TLR4 (R =0.814,P＜0.001),MyD88 (R=0.828,P＜0.001),and NF-κB p65 (R=0.568,P =0.034).Conclusion Excessive activation of TLR4/MyD88/NF-κB signaling pathway does exist in iGVHD,and the enhanced levels of gene transcription and translation are positively correlated with the deterioration of iGVHD.

Objective To explore the clinical effects of aminophylline on bronchiolitis in children.Methods One hundred and twen-ty-eight children with bronchiolitis in our hospital were randomly divided into the experiment and treated control group,in the meantime,and divided into the severe and mild group according to their condition.The children in control group were treated with traditional methods,in experiment group were treated with aminophylline(2 mg/kg,every day one time),as well as used traditional methods.All patients in 2 groups were checked by volume (VT), inhale time and exhale time ratio (Ti/tE),time to peak expiratory flow and expiratory time ratio(tPTEF/Te),time to peak expiratory flow to total expiratory time and volume ratio(vPTEF/vE) respectively. Meanwhile pulmonary function,alkyla-denine glycosylase in trachea secretion,IL-8,cytotaxonomy in trachea secretion on time,after the third day and the 7th day.Their curative effects were evaluated.All parameters were analyzed by statistical methods.Results Cytotaxonomy of the patients in the experiment were more improved than that of control group(P

Objective To study the therapeutic effect of EUS-guided rendezvous (EUS-RV) when ERCP failed in patients with malignant obstructive jaundice. Methods 12 cases of malignant obstructive jaundice patients were underwent EUS-RV after unsuccessful ERCP. The operation success rate, liver function recovery 1 week and 1 month after operation, complication rates, hospital stay and patient survival were observed. Results All 12 patients were successfully operated and placed stents by endoscopic ultrasound puncture following by ERCP: 8 patients by the stomach, 4 patients by duodenum, the operation success rate was 100.00%; There were significant difference between the liver function recovery of preoperative and postoperative one week or postoperative one week and postoperative one month (P < 0.05). 1 bleeding occurred and were improved after conservative treatment, the complications rate was 8.33%; the hospital stay was (20.68 ± 5.76) d; the average survival time of patients was 224 d. Conclusion EUS-guided rendezvous may be the alternative treatment due to the diminutive trauma and good effect when ERCP failed in patients with malignant obstructive jaundice.

Objective Investigate the clinical features,diagnosis and treatment of the scimitar sydrome.Methods A retrospective analysis of clinical data of six children with scimitar syndrome from 2008 to 2014,including clinical symptoms and signs,chest X-ray,echocardiography,chest CT and cardiac catheterization,treatment outcome and follow-up and review of the literature.Results Six patients with scimitar syndrome were diagnosed between 2008 and 2014.There were 3 girls and 3 boys;5 cases ＜ 6 kg in weight.Scimitar syndrome was suspected in 5 cases because of extroversion,and diagnosed by color Doppler echocardiography in all 6 when a scimitar vein was detected entering the inferior vena cava.Computed tomography confirmed the diagnosis in all patients.One patient had horseshoe lung,3 had a unilobar right lung,3 had a hypoplastic right lower lobe.Three patients had severe pulmonary arterial hypertension,1 had moderate to severe pulmonary arterial hypertension,and 2 had moderate pulmonary arterial hypertension.All patients had lower respiratory tract infections,volume loss of the right lung,a normal or hyperinflated left lung,dextroversion of the heart,and scimitar arteries from the descending aorta.4 cases of pulmonary venous drainage correction surgery,3 underwent body-pulmonary embolism,1 case of 9-year-old asymptomatic children without surgery,and 1 patient with heart failure,severe pulmonary hypertension,pulmonary infection,septicemia died before surgery.Conclusion Clinically,found children with heart of dextrocardia position,growth retardation,recurrent lung infections,unexplained right heart failure,pulmonary hypertension,should consider the possibility scimitar syndrome.Early diagnosis and early treatment of pulmonary venous drainage and pulmonary vascular embolization,can significantly improve the clinical symptoms in children and reduce mortality.