Objective To study the clinical efficacy of Akin combined Scarf osteotomies for moderate and severe hal?lux valgus. Methods Thirty-nine (58 feet) patients received Akin combined Scarf osteotomies, in which 12 patients (16 feet) with moderate hallux valgus received the single scarf osteotomy. Hallux valgus angle (HVA), intermetatarsal angle (IMA), tibial sesamoid position and American orthopedic foot and ankle society score (AOFAS) were measured and compared before and after operation respectively. Results All operations were successfully completed patients were followed up for 8-22 months. The mean operation time was (55.0±6.8) min. The amount of intraoperative bleeding was 3-20 mL with an aver?age of (11.0±5.4) mL. All patients were healed except for a delayed union of Akin on a severe hallux valgus patient. Two cas?es (2 feet) were found inflammation in surgical incision. Two cases (2 feet) were found numbness in dorsal medial side of hal?lux, which was considered nerve damage and improved in 3-5 months. There was no recurrence of hallux valgus in the peri?od of following up. After surgery, HVA (14.1°±5.3°), IMA (7.7°±3.8°) and tibial sesamoid position (2.58±0.61) were signifi?cantly decreased compared with those before operation (39.6° ± 6.8° , 18.7° ± 5.4° and 4.87 ± 0.59, P<0.05). AOFAS score (84.4±8.7) was significantly higher after surgery than that before surgery (37.3±9.5, P<0.05). Conclusion Akin combined Scarf osteotomies can achieve a excellent therapeutic effect for moderate and severe hallux valgus with very few complica?tions and recurrence, which is worth for clinical application.

Objective To investigate the effect of corpectomy decompression by subtotal vertebrectomy and fusion of adjacent segmental artificial disc replacement through anterior intervertenral spance (Hybrid Surgery) in the anteriorcervical spondylotic myelopathy treatment . Methods Hybrid Surgery were operated on 18 patients who suffered from anterior cervi?cal spondylotic myelopathy . Follow up of 1-50 months. Patient’s conditions were assessed according to the Japanese Associ?ation for Department of orthopedics assessment score (JOA score) before and after operation. Effects of Hybrid operation were assessed by the improvement of JOA score, Odom’s follow-up grade and cervical mobility . Results The JOA scores of all 18 operated patients were improved from 10.6 ± 1.7 before operation to 13.5 ± 2.4 after operation. And the difference is statistically significant (t=1.314, P < 0.05). Among all the operated patients, 16 were cured and 2 were effective. As to Odom’s follow up grades, 6 cases were excellent, 11 cases were good and 1 case was acceptable. The postoperative move?ment range of cervical spine (40.1° ± 8.4°) show no statistically difference compared with that in preoperation (42.6° ± 11.9°) (t=0.68, P > 0.05). Conclusion Hybrid Surgery of anterior cervical decompression and fusion can both improve the nerve function and preserve cervical mobility.

Objective To investigate short?term clinical outcomes of XLIF through small incision approach combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis. Methods From December 2011 to June 2013, 15 pa?tients with degenerative lumbar scoliosis were treated by XLIF combined with percutaneous pedicle screw fixation (XLIF group). There were 6 males and 9 females, with an average age of 68.27±5.70 (ranging from 58 to 75) years old and Cobb angle of scoliosis 22.20°±6.66° (ranging from 14° to 35°). Meanwhile, 23 patients were treated with posterior lumber inter?body fusion (PLIF) com?bined with pedicle screw fixation (PLIF group). There were 9 males and 14 females, with an average age of 63.26 ± 6.03 (ranging from 49 to 73) years old and Cobb angle of scoliosis 23.17°±6.95° (ranging from 13° to 36°). The efficacy was assessed through cor?rection rate of Cobb angle, VAS and lumbar JOA score at the time of the latest follow?up. Results The operation time was 224.35 ± 51.53 min in the PLIF group and 197.47 ± 31.84 min in the XLIF group. No significant differences were found, but there was significantly difference in the intraoperative blood loss (PLIF group: 576.52 ± 227.89 ml, XLIF group: 181.33 ± 47.37 ml, t=-8.054, P<0.001). No patient accepted blood transfusion in the XLIF group, but in the PLIF group, 11 patients accepted blood transfusion. The Cobb angle, VAS and JOA score in two groups were improved compared with the preoperative. 38 patients were followed up for 12 to 32 months, with an average of 23 months. The correction rate of Cobb angle, VAS and JOA scores were 56.90%±11.51%, 87.97%±12.07%, 84.00%±5.59%in the XLIF group, and 62.88%±8.28%, 83.68%±12.33%, 84.79%±6.76%in the PLIF group. No significant differences were found between the two groups (P>0.05). Conclusion Treatment of degenerative lumbar scoliosis with XLIF through small incision approach combined with percutaneous pedicle screw fixation is a kind of safe and effective minimally invasive spine surgery with small trauma and less bleeding, and the recent surgery efficacy was close to PILF.

Objective To evaluate the effect of percutaneous transforaminal endoscopic discectomy (PTED) using tar?get puncture and 2-stage procedures in treating lumbar disc hernia. Methods Patients present in our clinic from January 2014 to June 2014 with lumbar disc hernia who were treated with PTED were collected (n=36). Lower back and leg pain were evaluated by visual analog scale (VAS) while clinic outcome were assessed by Oswestry disability index (ODI) and modified Macnab criteria. Results All surgeries were carried out successfully. On average, operation time was(125±31)min, blood loss was(8.5±2.9)mL in each operation. The average length in hospital stay was(7.6±3.5)day. Compared with the preoper?ative VAS scores,the postoperative and last follow-up scores for lower back and leg pain decreased significantly (P<0.01). The ODI of pre-operation and last follow-up were (18.90 ± 7.78)%and (73.30 ± 18.21)%respectively with statistic differ?ence. As to the modified Macnab criteria,theexcellent and goodratio was 94.4%. One case present hyperalgesia in L4 der?matome which recovered through conservative treatment. No complications such as permanent nerve root injury ,cerebrospi?nal fluid leakage,or infection were found during or after operations. All patients are in stable conditions during follow-up pe?riod without recurrence. Conclusion PTED using target puncture and 2-stage procedures is an effective method with mini?mal trauma, less bleeding, quick recovery, high security, short hospitalization time. what′s more, it can remove protruded disc and broken nucleus from the intervertebral space. It ensure efficacy and avoid recurrence.

AIM: To analyze the pathogens and drug sensitivity of chronic dacryocystitis in order to provide evidence for clinical drug use.
METHODS:Lacrimal secretion of 171 cases with chronic dacryocystitis was sampled for pathogenic bacteria culture identification and drug sensitivity test. Based on the results, the isolation rate of pathogens strains, the pathogens kind of chronic dacryoeystitis, main pathogens of chronic dacryocystitis, and sensitive drug for pathogens were analyzed.
RESULTS: The isolation rate of pathogens strains was 76. 61% ( 131 cases ). The pathogens constituting the chronic dacryocystitis were predominantly gram-positive coccus,the percentage was 72. 52% (95 cases), among which staphylococcus hominis occupied 27. 48% ( 36 cases), staphylococcus epidermidis 16. 79% (22 cases), streptococcus viridans 12. 98% (17 cases). The majority of these bacteria were sensitive to cefoperazone-sulbactam, tobramycin, gentamicin and levofloxacin. For gram -positive coccus, cefoperazone - sulbactam, gentamicin and tobramycin were the most sensitive drug. For gram-negative bacilli, cefoperazone - sulbactam, tobramycin and levofloxacin were most sensitive drug.
CONCLUSION: Staphylococcus hominis is the main pathogen of chronic dacryocystitis, tobramycin can be used as the first choice for local treatment of chronic dacryocystitis.

Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii ,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012 - 2014 .Methods Strains of Pseud‐omonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected .Antimicrobial suscep‐tibility of clinical isolates was tested by Kirby‐Bauer method .Results In the past three years ,214 strains of Pseudomonas aerugino‐sa and 347 strains of Acinetobacter baumannii were isolated .The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year ,while the Acinetobacter baumannii ′s increased .Most strains were isolated from sputum ,wound secretion and urine . The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital .The detection rates of these strains were the highest in ICU ,respectively 27 .6% and 34 .9% .Both the resistance rates of Pseudomonas aeruginosa to ceftazidime ,imipenem ,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had in‐creased ,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year .Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates in‐creased ,especially the resistance rates to carbapenem are becoming more higher in recent years .Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B .Therefore ,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics .

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Wounds and Injuries ; epidemiology ; Young Adult

OBJECTIVETo study the therapeutic mechanisms of Danshen injection in intrahepatic cholestasis of pregnancy (ICP).

METHODThe experimental serum was collected from 6 patients with ICP before therapy when in hospital. Endothelial cells were isolated from human umbilical veins chosen among the 10 normal pregnancy according to Jaffe's method. Serum of 20% concentration of ICP and different concentration of Danshen injection were cocultured with human vascular endothelial cells (HUVECs) for 24 hours. MTT method was applied to measuring the vitality of HUVECs. The expression value of vascular endothelial growth factor (VEGF) of different groups was detected by immunocytochemistry and enzyme-linked immunosorbent assay (ELISA) respectively.

RESULTCompared with ICP group, the value of MTT and VEGF in the Danshen injection therapeutic groups were increased with the increase of concentration and moreover, 8 g x L(-1) of Danshen injection was the optical concentration. By immunocytochemistry, the expression of VEGF in HUVECs in the Danshen injection therapeutic groups was also enhanced with the increase of concentration.

CONCLUSIONDanshen injection can protect HUVECs against the injury of ICP serum and promote the expression of VEGF. Danshen injection improves HUVECs by increasing the value of VEGF.

Cells, Cultured ; Cholestasis, Intrahepatic ; blood ; Coculture Techniques ; Cytoplasm ; metabolism ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Endothelial Cells ; cytology ; metabolism ; Female ; Humans ; Injections ; Plants, Medicinal ; chemistry ; Pregnancy ; Pregnancy Complications ; blood ; Protective Agents ; administration & dosage ; isolation & purification ; pharmacology ; Salvia miltiorrhiza ; chemistry ; Serum ; physiology ; Umbilical Veins ; cytology ; Vascular Endothelial Growth Factor A ; metabolism

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.

The mRNA levels of adiponectin in adipose tissue and adiponectin receptor R1 in skeletal muscle of type 2 diabetic rats were examined by semi-quatitative RT-PCR.The expression of adiponectin receptor R1 was not altered in the skeletal muscle of type 2 diabetic rats as compared with normal rats.The serum adiponectin level was decreased in diabetic rats due to the decline of adiponectin mRNA level in adipose tissue and rosiglitazone improved the adiponectin deficiency.