Objective To study and observe the clinical efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture.Methods Twenty eight cases of patients who were treated for fixing splitting or compression tibial plateau fracture from January 2014 to January 2016 in people's hospital of Xinyu were retrospectively reviewed.All patients were treated byposterior medial approach with non skid plate for fixation,all patients were followed up by postopera tive imaging and clinical follow-up to observe its clinical curative efficacy.Results Twenty-eight patients were followed up,the mean follow-up time was 12 months.All patients had no internal fixation loosening fracture,send,vascular and nerve damage and other adverse reactions.All the patients were healed within 4 to 7 months,the average healing time was 18.5 weeks.After healing,knee joint function was evaluated,18 cases were excellent,5 cases were good,the excellent and good rate was 82.1 ％.Conclusion The efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture is good,it is worthy of clinical application.

OBJECTIVE: To study the status quo and future trend of digestive system drugs used in our hospital. METHO-DS: The digestive system drugs used in our hospital between 2001 and 2005 were analyzed retrospectively in respect to drug kinds, consumption sum, DDDs, daily costs etc. RESULTS: Drugs for peptic ulcer and hepatobiliary diseases took a big proportion and experienced a year- on- year increase. No significant change was noted for the top 10 drugs on the lists of DDDs and consumption sum before and after the medical insurance reform, but their order changed a little. The DDDs of most of the cheap and effective drugs increased after the medical insurance reform. CONCLUSION: The consumption of antiulcer drugs and drugs for hepatobiliary diseases in our hospital assume an increasing tendency.

Objective To investigate the effect and clinical significance of HBV replication on the serum levels of IL-12 and IL-18 in patients with hepatitis B-related cirrhosis.Methods The levels of HBV-DNA and IL-12 and IL-18 in peripheral blood from 136 patients with different clinic types chronic hepatic diseases(102 patients with chronic hepatitis B,34 patients with hepatitis B-related cirrhosis ),95 HBV carriers and 20 healthy people (as control group) were respectively detected with ELISA and real time PCR.Results The levels of IL-12 and IL-18 in chronic hepatitis B and hepatitis B-related cirrhosis groups were significantly increased compared with control group(P0.05); and there was positive relationship between prevalence of HBV replication and IL-12,IL-18 levels in different chronic hepatic disease groups(r=0.74,P

Objective To investigate the value of surgical biopsy with guidance of indwelling wire through stereotactic puncture in the diagnosis of occult breast cancer (OBC) and the clinical usage. Method Surgical biopsy was performed on 22 patients with suspected nonpalpable breast lesions. ResultsSurgical biopsy, including localization and resection of the lesion, under the guidance of a guide wire was successful with single procedure for all 22 lesions. The accuracy of qualitative diagnosis was 100%. Pathological examination showed malignant in 9 lesions and benign in 13 lesions. ConclusionThe surgical biopsy with the guidance of indwelling wire through stereotactic puncture is valuable technigue for the diagnosis of occult breast lesions.

Objective To evaluate the effects of parecoxib sodium for preemptive analgesia in patients undergoing cerebral angiography. Methods Sixty patients undergoing cerebral angiography were divided into two groups by random digits table with 30 cases in each : group P and group F. Patients in group P received parecoxib sodium 40 mg 30 min before operation, while group F received fentanyl 1 μ g/kg 2 min before operation. The changes of hemodynamics were observed before operation (To), immediately right internal carotid artery angiography during operation (T1), immediately right vertebral artery angiography (T2),immediately left internal carotid artery angiography(T3), immediately left vertebral artery angiography(T4), 10min after operation (T5). The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2)and visual analogue score (VAS) were recorded at different times during the whole operation. Results There were no significantly differences on MAP, HR and VAS between group P and group F (P ＞ 0.05 ). But the SpO2 at T1 ,T2,T3 in group F (0.94±0.03,0.95±0.02,0.95±0.02) were significantly lower than those in group P (0.98 ± 0.01,0.98 ± 0.02,0.98 ± 0.02 )(P＜0.05 ), and 2 cases SpO2 ＜ 0.90 at Ti. Conclusion Parecoxib sodium administered preemptively provides a nice analgesic effect in patients undergoing cerebral angiography, and is more safe than fentanyl.

Objective Through the investigation of the compliance and impact factors of prenatal check to the pregnant women,we aimed to supply the ideas and methods to improve antenatal care compliance. Methods This investigation used the questionnaire which was designed by the author to survey 100 pregnant women in class three level hospital in Guangzhou.The results underwent subsequent analysis. Results There were 68.4%of the pregnant women didn't finish the check.The average check times Wag only five.70.4%of them who were younger than 30 hadn't fulfilled seizure frequency rates,while 65.9%for who were older than 30(P＞0.05).The pregnant women with school-age≤9 and school-age＞9 who hadn't fulfilled seizure frequency rates were 83.3%and 50.0%.Irregular check rates were 59.3%、29.5%(P＜0.01).The floating population and the local population in the area of prenatal compliance results showed statistical difference.P＜0.01.The family whose income was higher than 3000 yuan per-month were better than those lower than 3000 yuan per-month about the antenatal check compliance(P＜0.05).More than 70% of pregnant women felt risk factors of pregnancy complications,their partners' support,local medical conditions and attitudes of medical staff had influence of their antenatal check compliance.Conclusions The compliance of the low education and low family income group is relatively low.For the affecting factors.how to improve the prenatal check compliance of such crowd is worthy of further study.

Objective To compare the influence for intravenous dexmedetomidine and midazolam during combined spinal and epidural anesthesia (CSEA) on sedation,respiratory and circulatory.Methods Ninety patients with lower extremity fractures and internal fixation,were divided into dexmedetomidine group,midazolam group and control group by random digits table with 30 cases each.CSEA was performed at L3-4 interspace.After block reached T8 level,dexmedetomidine,midazolam and 0.9％ sodium chloride were given to the three groups.Ramsay score,mean arterial pressure (MAP),heart rate (HR),partial pressure of carbon dioxide in end expiratory gas (PErCO2),respiratory rate (RR) were recorded before anesthesia(T0),after CSEA (T1),and 10,15,30,45,60 min after giving drug (T2-T6),and intraoperative awareness was recorded.Results Ramsay score in dexmedetomidine group and midazolam group at T2-T6 were higher than those in the group T0,T1 and concurrent control group (P ＜ 0.05),MAP were lower than those in the group T0,T1 and concurrent control group (P ＜ 0.05).HR in dexmedetomidine group at T2-T6 were lower than those in concurrent midazolam group and control group (P ＜ 0.05).PETCO2 in midazolam group at T2-T6 were higher than those in concurrent dexmedetomidine group and control group (P ＜ 0.05),RR were lower than those in concurrent dexmedetomidine group and control group (P ＜ 0.05).The rate of intraoperative awareness in dexmedetomidine group and midazolam group was lower than that in control group [16.7％(5/30) and 13.3％(4/30) vs.93.3％(28/30),P＜0.05].Conclusions Dexmedetomidine and midazolam provide good sedation to reduce intraoperative awareness,slight inhibition of blood pressure.Dexmedetomidine can decrease HR,but it does not influence respiratory function.Midazolam restrains respiratory function.

Extracorporeal membrane oxygenation(ECMO) is a kind of extra life support technique that can support cardiac and pulmonary function in a relatively long time.With the application of nitric oxide,pulmonary surfactant and high frequency ventilation,the use of ECMO in neonatal respiratory failure decreased.Although received these treatment,there are some newborn with respiratory failure still required ECMO at last.On this paper,the application of ECMO in neonatal respiratory failure from foreign medical institute was introduced,and compared with the domestic situation,in order to improve the application of ECMO in neonatal respiratory failure.

Objective To investigate the effect of jejunal infusion of amino acids on secretion of gastrointestinal hormone in healthy dogs.Methods Six healthy adult dogs were treated with jejunal fistulas and femoral vein intubation.Twenty-four hours after the operation,solution of 8 different amino acid monomers (experimental group) or normal saline (control group) were infused into the jejunum of the dogs every 24hours.The levels of cholecystokinin (CCK),motilin,and gastrin in the peripheral plasma were measured using radioimmunoassay at the start of infusion (0 minute),and 30,60,90,and 120 minutes after infusion.Results Compared with the control group,the serum CCK level in the phenylalanine group was significantly higher 30 and 60 minutes after infusion [(1.25 ±0.19) ng/L vs.(0.66 ±0.14) ng/L,(1.23 ±0.12) ng/L vs.(0.80 ± 0.03) ng/L,both P ＜ 0.01],while that in the tryptophan group was significantly higher 30 minutes after infusion [(1.08 ±0.26) ng/L vs.(0.66 ±0.14) rig/L,P ＜0.01].The other measurement results showed no statistically significant differences.Conclusions Jejunal infusion of phenylalanine or tryptophan may stimulate the secretion of gastrointestinal hormone to some extent.Aromatic amino acids (phenylalanine and tryptophan) is more potent in triggering the release of CCK than aliphatic (leucine,isoleucine,and methionine) and charged amino acids (aspartic acid,arginine,and glutamate).The mechanism may be related to the properties of the amino acids.

Objective To explore the effect of different doses of tirofiban for PCI, myocardial injury and arterial flow conditions.Methods 70 patients undergoing PCI elevation acute myocardial infarction, were randomly and equally divided into the observation group and the control group.The control group of patients before PCI given haplotype character loading dose of tirofiban, the observation group were given a double load before PCI tirofiban.Recording and analyzing two groups of patients cTnI (cardiac troponin I), 90 minST section down percentage circumstances.Results The patients after 6h, 12h, 24hcTnI contents were (2.11 ±0.50,3.50 ±1.64,3.28 ±1.15) ng/mL was significantly lower than the control group (4.09 ± 1.13,9.48 ±2.61,5.79 ±1.26) ng/mL, and the difference was significant(P<0.05); the observation group were CTFC, 90 min fall within ST respectively was significantly better than the control group ( P<0.05 ) .Conclusion Preoperative use of double loading dose of tirofiban can effectively improve the blood flow after PCI,, and reduce the incidence of myocardial injury and postoperative cardiovascular events.