Objective To explore the clinical efficacy of combined anterior and posterior operation in the treatment of cervical spondylotic myelopathy.Methods 50 patients with cervical spondylotic myelopathy,in accordance with anterior,posterior surgery and combined anterior and posterior operation three different surgical methods,were divided into the treatment group A(21 cases),group B(16 cases) and group C(13 cases).The surgical efficacy was analyzed.Results Before treatment,the JOA score among the three groups had no significant difference [Cgroup (9.3 ± 2.3) points,B group (9.4 ± 1.4) points,A group (9.2 ± 2.2) points].After treatment,the JOA score in group C (14.5 ± 3.4) points was significantly higher than that of group A (12.6 ± 1.2) points (t =3.09,P ＜0.05) and group B (11.3 ± 1.4) points (t =4.62,P ＜ 0.05).The excellent and good rate of C group was 76.9％,which was significantly higher than that in group A 43.8％ (x2 =3.84,P ＜ 0.05) and group B 42.8％ (x2 =4.11,P ＜ 0.05).Conclusion Combined anterior and posterior operation in the treatment of cervical spondylotic myelopathy has better recovery of spinal cord function,complete decompression,significant effect,less complications,etc.,it is an effective,safe and reliable treatment.

Objective To investigate the effect of local delivery of paclitaxel on bile duct scar formation and biliary stricture in guinea pig.Methods Models of end-to-end anastomosis of the common bile duct were established in 42 guinea pigs.The animals were randomly divided into paclitaxel and control groups.In the paclitaxel group,the drug solution(1000 ?mol/L,0.05 ml) was smeared onto the anastomotic wound before closing the abdomen.The animals were killed in 3 days,2 weeks,and 1 month after the operation(7 in each group at each time point).The sepcimens of the common bile duct were obtained for histological examination.Transmission electron microscopy was employed to observe the ultrastructure of paclitaxel-induced apoptotic cells.Results Histological examination showed inflammatory reaction and hyperplasia of the bile duct wall.The bile duct wall of the paclitaxel group was significantly thiner than that of the control group in 3 days and 1 month after the operation [3 days:(574.41?24.53)?m vs(802.98?24.42) ?m,t=-6.604,P=0.000;1 month:(1383.36?36.64) ?m vs(1518.56?34.89)?m,t=-2.672,P=0.020].Paclitaxel-induced cell apoptosis and injured cell organs were found by transmission electron microscopy.Conclusion Single local delivery of paclitaxel can inhibit biliary stricture in one month.

The effect and safety of radio frequency identification in the treatment of the wounded person are investigated.The application of the technology is valid in improving the effectiveness of the emergency communication system with a rapid and precise information acquisition.Radio frequency identification technology used in case of emergency makes the treatment available in the shortest time,and the mortality is reduced thereby.

Objective To discuss the relationship between clinical pathway management and semi-structured electronic medical record(EMR),and explore the effects of EMR on hospital information system and its management quality.Methods EMR was used in combination with quality management and clinical pathway management.The relationship between clinical pathway management and semi-structured electronic medical record(EMR) was researched.Results Semi-structured EMR can increase the clinical pathway managerment and improve the clinical quality of management,the competitiveness of hospital can be upgraded.Conclusion Hospital should widely develop semi-structured EMR and promote the clinical pathway managerment in the future.

Purpose Cortex is one of the frequently involved sites of multiple sclerosis (MS),and the cortex and corpus callosum lesions of MS are gradually concerned.The study aims to observe the changes of cerebral cortex and corpus callosum of MS in experimental autoimmune encephalomyelitis (EAE) model by using 7.0T MRI diffusion tensor imaging (DTI).Materials and Methods Twenty female C57BL/6 mice of 6-8 week old were enrolled in the study,10 of which were induced by MOG35-55 to make EAE models and the rest 10 of which were taken as control group.On the 20 days after model establishment,the head T2WI and DTI were performed on both control and EAE mice.DTI quantitative indicators such as fractional anisotropy (FA),mean diffusivity (MD),axial dispersion coefficient λ//,and radial dispersion coefficient λ ⊥ in region of interest including bilateral prefrontal cortex,bilateral cingulate cortex and corpus callosum were compared between the two groups.Results No obvious lesions were observed on the T2WI in both control and EAE groups.In the experimental group,the FA mapping suggested the integrity of the left side of the corpus callosum was destroyed.The FA,MD,λ// λ ⊥ of bilateral prefrontal cortex and corpus callosum showed significant difference between experimental group and control group (P＜0.05);the increase of λ ⊥ in bilateral cingulate was significantly different from that in the control group.Meanwhile,HE staining in the experimental group showed that inflammatory cells gathered around the cortical and subcortical vessels.The LFB staining in experimental group showed a bit paler than that in the control group,and the corpus callosum showed patchy demyelination.Conclusion The technique of 7.0T MRI DTI sequence can detect cortex and corpus callosum lesions which cannot be found by conventional MRI,so that it provides radiological evidence for the study of MS with cortex and corpus callosum lesions.

Objective To investigate the clinical efficacy of ultrasound-guided and nerve stimu-lator-guided modified fascia iliaca compartment block combined with popliteal fossa sciatic nerve block in patients undergoing unilateral great saphenous varicose veins surgery.Methods Sixty patients, male 32 and female 28,aged 42-76 years,ASA Ⅰor Ⅱ,scheduled for unilateral great saphenous var-icose veins surgery were randomly divided into two groups (n =30 each):modified fascia iliaca com-partment block with popliteal fossa sciatic nerve block group(group N)and epidural anesthesia(group E).Firstly,popliteal fossa sciatic nerve block was performed in group N.Then confirmed iliac fascia and femoral nerve position on the ultrasonic image and the femoral nerve was blocked.The 1% lido-caine 10 milliliters and 0.5% ropivacaine 10 milliliters were injected in the fascia iliaca compartment block from medial border of sartorius to upward site of femoral artery.Meanwhile,the ultrasonic probe was moving inside in the level of inguinal ligament.The SBP,DBP and HR were recorded be-fore block(T0 ),10(T1 ),30(T2 )and 60 minutes(T3 )after block.The block working time and onset time of sensory block,use of ephedrine after anesthesia,anesthesia efficacy and the postoperative ad-verse reactions in the last 48 hours ,including nausea,vomiting,headache and urinary retention, were also recorded.Results Compared with T0 ,the SBP and DBP was significantly decreased at T2 in group E(P <0.05).Compared with group E at the same time,the SBP and DBP was significantly higher at T2 in group N(P <0.05).The onset time of sensory block was significantly shortened and the use of ephedrine after anesthesia was also less in group N(P <0.05 ).Group E was better than group N in the whole anesthesia efficacy (P <0.05),but there was no significant difference in the ex-cellent rate of anesthesia efficacy between the two groups.The incidence of postoperative urinary re-tention was significantly decreased in group N(P <0.05)and there was no significant difference of the rate of nausea,vomiting and headache.Conclusion Modified fascia iliaca compartment block with popliteal fossa sciatic nerve block has excellent anesthetic quality in patients undergoing unilateral great saphenous varicose veins surgery,which ensures more stable hemodynamics less side effects and more indications when compared with epidural anesthesia.

Objective To design a new frequency domain magnato-aoustic imaging system to image the conductivity of medium.Methods A continuous sine wave signal was adopted to stimulate the MAT signal. The lock-in technique was applied to measuring the amplitude and phase of the magneto-acoustic signal. The drive control program of the imaging system was designed using virtual instrument tools. The experiments were conducted on the phantom made of coper wire.Results The amplitude precision was improved up to 10-7 Pa, while the system could locate the sonic source with locating precision of millimeter.Conclusion A new magneto-acoustic imaging system is proposed with high locating precision as well as low frequency excitation, which is significative to the study on the sonic source theory and improvement of the imaging precision.

Objective To establish the reconstructive ladder for the leg without sufficient recipient vessels by case analysis and literature review.Methods From January,2009 to January,2015,772 cases were treated in our center using free flap for leg coverage and 129 cases were found intra-operatively to have insufficient recipient vessels.There were 113 males and 16 females,and the age ranged from 4 to 71 years,averaging 36.5 years.The wounds were post-traumatic (n=108) and non post-traumatic (n=21).The management methods included elongating incision (n=25),vessel transfer(n=22),Flow-through anastomosis(n=17),end-to-side anastomosis (n=13),useing neighboring vessels (n=1S),anastomosis distal to the injured zone (n=14),cross-leg free flap (n=7),and abandoning free flap transfer(n=13).Results Except for the cases of abandoning surgery (n=13,10.1％),there were 86 cases whose flap healed totally (66.7％),9 cases total lost(7.0％),and 11 cases marginal loss (8.5％).It established a reconstructive ladder for this special situation according to the principle of difficulty level.Conclusion The insufficient recipient vessels of the leg were had multi-causes which should be taken account generally before surgery.The optimal protocol for each case should be chosen from the reconstructive ladder based on the technical difficulty level.

Objective To investigate the correlated factors of compliance to dietary therapy in hyperuricemia patients.Methods 388 hyperuricemia patients were investigated with the questionnaire developed by ourselves.Results 119 cases(31.6%)complied to the dietary control program,and 257 cases(68.4%)didn't controlled food and drink or controlled disqualification.The compliance to alimentary control of hyperuricemia patients was correlated intimately with family history,occupation,the degree of nosography,heathy education,propaganda of the masses media,family supporting and satisfaction.Conclusion The alimentary control compliance and related knowledge about dietary therapy of hyperuricemia of hyperuricemia patients were poor.The alimentary control compliance was better in patients with more serious illness,more heathy knowledge,more family supporting,more propaganda of the masses media and more satisfaction.

objective To investigate the value of NT-proBNP in assessing the volume status in maintenance hemodialysis patients with non-dominant edema.Methods One hundred and forty-five patients were recruited.Bioimpedance measurements were performed for overhydration (OH).NT-proBNP was detected by colloidal gold method.Patients were divided into three groups by levels of OH variability (△ OH,equal to OH minus weight increase) as group H (hypervolemia,n=90); group N (normovolemia,n=36) and group L (hypovolemia,n=19).Hemoglobin,albumin,blood urea nitrogen and serum creatinine were assayed,blood pressure and body mass increase were recorded.Dry weight of patients in Group H were adjusted in 3 months,the relationship between NT-proBNP and volume change were assessed.Results (1) At baseline,overall plasma NT-proBNP levels were higher than normal range.The median NT-proBNP levels in group H and group N were [1318.50(IQR 717.00,3154.25) pg/ml] and [703.50 (IQR 873.00,450.50) pg/ml],respectively.NT-proBNP was positively correlated with △OH value (r=0.801,P ＜ 0.001).(2) After 3 months,NT-proBNP levels in group H was significantly lower than baseline.Forty-one patients reached normal volume range (group H1),49 patients were resistant hypervolemia (group H2).The median NT-proBNP levels in group H1 and group H2 were [685.00 (IQR 422.50,988.50) pg/ml] and [1569.00 (IQR 982.50,2500.50) pg/ml],△ OH in group H1 and group H2 were [(0.63±0.23)L] and [(1.75±0.71)L],respectively.NT-proBNP and △ OH value in two groups had significant difference (P ＜ 0.05).NT-proBNP was positively correlated with △ OH value (r=0.684,P ＜ 0.001).(3) The area under ROC curve for NT-proBNP was 0.818,95％CI (0.733～ 0.904),P ＜ 0.001,since the absolute value of normovolemia was defined as ≤ 1.The cut off value of plasma NT-proBNP was set at 962.50 pg/ml in MHD patients with non-dominant edema,the diagnostic specificity and sensitivity were 79.6％ and 73.2％.Conclusion NT-proBNP could be used to assess volume status in MHD patients with non dominant edema.