This paper introduces the structure and principle of a novel low-frequency electronic pulse therapeutic apparatus. Based on a novel single -chip microprocessor, the device can generate multiple special pulse signals and output bi -directional electronic pulse. At the same time, it can detect the impedance automatically and thus its security is improved.

OBJECTIVE:To provide reference for safe application of antibiotic drugs in single or inter-medical institution ser-vices. METHODS:An antibiotic drug safety evaluation index system was established by reference to literatures. Medical records tracing method was adopted to obtain the medical records of children with respiratory infectious diseases under the medical consor-tium model. The medical records were matched and evaluated by experts to analysis the safety of antibiotic drug use in single medi-cal institution and the connection between two medical institutions with respect to the safety of antibiotic drug use. RESULTS:248 effective medical records had been obtained. Under the medical consortium model,the rate of the combination of antibiotic drugs in large hospitals was 86.29%,higher than the community hospitals of 77.02%(χ2=5.49,P<0.05). The error rate of antibiotic drug use by children in large hospitals was 14.52%,lower than the community hospitals of 25.81%(χ2=9.733,P<0.05). There were many contradictions in antibiotic drug use between the medical institution where children received treatment initially and the medi-cal institution which the children were referred to and hospitalized in. There were totally 128 cases of unsafe antibiotic drug use, with the overall incidence of 51.61%. CONCLUSIONS:Under the medical consortium model,the safety of antibiotic drug use by the hospitalized children in single medical institution is worrying,and the connection between two medical institutions with respect to the safety of antibiotic drug use by children who are referred and hospitalized is less reliable.

Pedicle screw loosening and axial dislocation are main reasons for spinal internal fixation failure. Screw loosening and dislocation is caused by screw extraction force,and the screw withdrawl force is related to screw diameter,screw thread design,bone density,and operation skills. Withdrawl intensity is increased with screw diameter and length. Pedicle screw stability can be decreased by osteoporosis. For osteoporotic patients,it is difficult to increase screw diameter alone,so polymethyl methacrylate bone cement is used to enhance screw stability and anti-flexion intensity. However,polymerization heat may induce tissue injury,and long-term stay may produce toxicity and exhibit cancerogenesis. Novel additive materials with good biocompatibility such as hydroxyapatite and calcium phosphate bone cement are gradually replacing polymethyl methacrylate bone cement. In addition,screw entrance point,direction and exact location during screw implantation can decrease pullout strength reducation caused by screw re-twisting and improve screw extraction intensity and stability.

BACKGROUND: There are a lot of controversies regarding the choice of short versus long segment pedicle screw fixation for the treatment of isthmic spondylolisthesis and degenerative spondylolisthesis treatment. OBJECTIVE: To investigate clinical efficacy of short versus long segment pedicle screw fixation in treatment of lumbar spondylolisthesis.METHODS: A total of 146 spondylolisthesis patients were included in this study, 36 males and 110 females, aged 22-73 years at a mean of 53 years; disease duration was from 1 to 18 years at a mean of 5 years. These patients were treated with lumbar spinal window-opened decompression or laminectomy decompression, a short or long segment pedicle screw internal fixation, transverse interbody fusion.RESULTS AND CONCLUSION: Among 146 involved patients, 72 cases were treated with four pedicle screw fixation (short segments), while 74 cases with six pedicle screw fixation (long segments). Interbody graft was performed in 101 cases, while intertransverse fusion given in 45 cases. Totally 134 cases were followed up for postoperative 1.5-14 years. According to clinical grading standards of Steffee system, the clinical efficacy was assayed excellent in 74 cases, good in 41 cases, mild in 13 cases and poor in 6 cases, with good rate of 85.8%. 77 cases achieved a complete reduction, including 32 cases using a short segment fixation and 45 cases using a long segment fixation. 69 cases achieved partial reduction, including 40 cases using a short segment fixation and 29 cases using a long segment fixation. Pedicle screws ruptures were found in 13 screws of eight patients undergoing short segment fixation, while no pedicle screw fracture was found in long segment fixation. Choice of short or long segment for the fixation is based on the analysis of spondylolisthesis type, severity, duration of disease, emergence of adjacent segment disc degeneration and instability.

Objective To investigate whether expression quantity of HLA-B27 and its subtypes associated with incidence of AS,the gene expression of HLA-B27 and its subtypes were detected in patients with AS.Methods 120 cases patients sus-pected with AS and 50 healthy subjects were enrolled in the study.Main demographic and clinical characteristics of the sub-jects were collected.Meanwhile total RNA was isolated from peripheral blood and real time RT-PCR was used to measure the quantitative expression of HLA-B27 gene.Besides RT-PCR,sequence-based typing (SBT)method was used to confirm the HLA-B27 subtype.All experimental data were analyzed by SPSS17.0 software and P values <0.05 were considered to be significant.Results Firstly,there were 55 subjects were finally diagnosed as AS patients among the 120 patients suspec-ted with AS.There were 53 subjects whose HLA-B27 was positive (96.36%)in 55 patients with AS.It showed that there was a correlation between BASDAI and expression quantity of HLA-B27 gene (r=0.845,P =0.000).Five subtypes were found and which were HLA-B27∶04 subtype (29/53,54.72%),HLA-B27:05 subtype (20/53,37.74%),HLA-B27 ∶02 subtype (2/53,3.77%),HLA-B27∶03 subtype (1/53,1.89%)and HLA-B27∶07 subtype (1/53,1.89%),respectively. Among the 50 healthy subjects,there were only one kind of subtype (2/50,4%),which was HLA-B27∶04.There were no statistical difference in the age (t=0.711,P =0.480),sex (χ2 =0.880,P =0.348),family history (χ2 =0.011,P =0.916) and treatment (χ2 =0.113,P =0.736)between the HLA-B27∶04 and HLA-B27∶05 subtypes.Conclusion HLA-B27∶04 and HLA-B27∶05 were primary subtypes in AS patients which HLA-B27 positive.There was a correlation between gene expression quantity of HLA-B27 and AS disease activity index.

Objective To compare PCR-SBT to IMS-ELISA in the HLA-B27 detection in the ankylosing spondylitis (AS)pa-tients.Methods Simultaneously,PCR-SBT and IMS-ELISA were used to detect the HLA-B27 expression in peripheral blood samples which were suspected patients with AS from 120 cases.Chisquare test of paired design and the area under curve of receiver operating characteristics of SPSS17.0 software were used to evaluate the value of PCR-SBT and IMS-ELISA in HLA-B27 detection of AS patients.Results Among 120 cases of suspected patients with AS,the positive rates of HLA-B27 detected by PCR-SBT and IMS-ELISA were 45.83%(55/120)and 37.50% (45/120),respectively.There was statistical difference between the two methods in the HLA-B27 detection (χ2 =59.455,P =0.000).The sensibility and spe-cificity of PCR-SBT were 96.36% and 96.92%,respectively.While the sensibility and the specificity of IMS-ELISA were 69.09% and 89.23%,respectively.Area under the curve of two methods were 0.966 and 0.792,respectively.Conclusion In comparison with IMS-ELISA,the sensibility and the specificity of PCR-SBT in HLA-B27 detection were higher in AS diag-nosis,that is to say,PCR-SBT is better in HLA-B27 detection and AS diagnosis.

A total of 64 patients with lumbar spondylolisthesis were enrolled from Department of Bone Surgery in the People's Hospital of Haian Province between January 2002 and December 2007, including 19 males and 45 females. They aged 26-73 years with a mean of 48.5 years. Their disease course was 1-15 years with a mean of 4 years. All patients complained about the repeated low back pain accompanied with lower limb radiating pain and intermittent claudication (50-300 m). Fifty-nine patients suffered from lumbar spondylolysis, including L3 Ⅰ degree in 3 cases, L4 Ⅰ degree in 31 cases,L4, Ⅱ degree in 13 cases, Ls Ⅰdegree in 9 cases and L5 Ⅱ degree in 3 cases. The remaining 5 cases were present with lumbar degenerative pseudo-spondylolysis. All patients were processed into whole laminectomy for decompression or vertebral canal decompression by fenestration, domestic vertebral internal fixation, reduction and interbody fusion. Fifty-five patients were followed up for an average of 3.1 years whereas 9 patients were lost. According to Steffee clinical effect grading, the curative effect was evaluated as excellent in 28 cases and good in 19 cases, the rate of excellence and good accounted for 85.5%. Within one week following bone graft, all patients were rechecked with X-ray plain film, 28 of them had shown complete reduction and 36 cases were present with part reduction. The fusion rate of interbody graft was 100%. These findings demonstrated that vertebral internal fixation system possesses a simple structure, convenient operation and solid fixation, resets the slipped vertebral body and significantly increases the fusion rate of vertebral graft.

Objective To investigate effects of hyperbaric oxygen (HBO) therapy on C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels in patients with moderate or severe traumatic brain injury (TBI)and to analyze its therapeutic efficacy. Methods One hundred and eight patients with moderate or severe TBI were randomly divided into a control group (54 cases) and an HBO adjunctive therapy group (HBO group, 54 cases).Both groups received essential neurosurgical treatment and conventional drug treatment, and the HBO group was given one session of HBO therapy in addition. Serum CRP and TNF-α were detected, and the scores on the Glasgow coma scale (GCS) were measured before and after treatment. CRP was detected by turbidimetric immunoassay and TNF-α using ELISA. Glasgow outcome scale (GOS) scores were evaluated in a follow-up 6 months after injury. Results Average CRP, TNF-α and GCS measurements showed no statistically significant difference between the groups before treatment. After treatment, CRP and TNF-α were significantly lower and GCS scores significantly better in both groups, but patients in the HBO group were, on average, significantly better than the controls on all three measures.Six months later, GOS evaluation gave a significantly larger number of patients with a better prognosis in the HBO group compared with the controls. Conclusion HBO therapy can significantly decrease serum CRP and TNF-α after severe TBI, thus enhancing therapeutic efficacy.

The clinical data of 30 patients with vesical calculus of 1.5 cm to 4 cm in diameter,who underwent combination of transurethral pneumatic and ultrasonic cystolithotripsy,were retrospectively analyzed.During the procedure the resectoscopic sheath was inserted into bladder through urethra,then the nephroscope was placed through the sheath.When the stone was located,the ultrasonic and pneumatic devices were used for lithotripsy and the fragments were cleared out.The procedures lasted from 10 to 25 min,all operations were successful.Transurethral resection of prostates (TURP) was performed simultaneously in 28 patients.No serious bleeding,bladder injury or transurethral resection syndrome occurred.One patient with simultaneous TURP developed bladder neck contracture one month after surgery and was later cured by endoresection.No residual chip or stone recurrence was detected.This procedure appears to be safe and highly efficient with low rate of urethrostenosis and is suitable for simotaneous prostate surgery.

Objective To observe the correlation of histologicalactivity(HAI) of chronic hepatitis B (CHB) with CCL20 expression, and to investigate the impact of CCL20 expression in CHB infection. Methods On the basis of established competitive quantitative RT-PCR with an internal standard, the expression of the CCL20 in the hepatocytes in different infected patterns of HBV infected cells and liver biopsies were quantified and at the same time its correlation to HAI were explored. Results In the cell levels, the expression quantity of CCL20 in control cells (HepG2), persistent HBV infected hepatocytes( HepG2. 2. 15) are (2. 65 ± 0. 02) pg/106 cells, ( 1.22± 0. 04) pg/106 cells, respectively. There were significantly differences between them ( t = 39. 66, P < 0. 01 ). The expression of CCL20 was enhanced in hepatocytes stimulated by PMA but their expression pauern was not changed. Moreover, CCL20 expression in liver biopsies with CHB was (3.54 ± 0. 65 ) pg/20 mg and CCL20 expression in control groups was ( 8. 74±0. 56) pg/20 mg. The expression of CCL20 between two groups was different (t =30. 09,P <0. 01 ) and correlation lied in between HAI and CCL20 expression in liver biopsies of CHB patients ( r = 0. 675, P =0. 023 ). Conclusion CCL20 expression was down-regulated and it was correlated to HAI of liver biopsies in CHB patients.