Objective To explore the effects and feasibility of minimal local analgesic dose of hyperbaric levobupivacaine in elderly patients undergoing unilateral spinal anesthesia during lower limb orthopedic surgery.Methods Seven hundred and fifty-six elderly patients who scheduled lower limb orthopedic surgery were assigned to levobupivacaine group (383 patients) and bupivacaine group (373 patients) by random digits table method.Haemodynamic change were monitored before,during and after anesthesia.The level and duration of sensory and motor block in each group were evaluated.Results Compared with bupivacaine group,the sensory block and motor block onset time was significantly longer in levobupivacaine group [(5.9 ± 1.4) min vs.(4.2 ± 0.3) min,(11.7 ± 3.0) min vs.(9.1 ± 3.3) min] (P ＜0.05),but the motor block duration was shorter [(152.8 ± 17.5) min vs.(195.4 ± 18.7) min] (P ＜ 0.05).The scores of maximum motor block in levobupivacaine group was significantly lower than that in bupivacaine group[(1.1 ±0.3) min vs.(2.3 ±0.6) min](P＜ 0.05).There was no significant difference in peak sensory block and haemodynamic between two groups (P ＞ 0.05).Conclusions Although levobupivacaine may be less potent than bupivacaine,it may be preferred for elderly patients with lower limb surgery because of satisfactory spinal anesthesia,good hsemodynamic stability and fast motor block regression.

Professor LIU Yan-chi is a well-known Chinese medicine experts at home and abroad,came from family medicine,is the country,s third and fourth groups academic heir tutors of the old Chinese teacher academic experience,full of rich academic experience.This paper introduces the Professor LIU diseases for urban residents to make good use Ziyin academic thinking,followed by the introduction of its common Ziyin drugs(Deodeok,Ophiopogon japonicus,Dendrobium).Finally,through listing,Professor LIU treating habitual constipation with producing Jin and clearing away heat,treating Parkinson,s disease with nouringing yin and calming endopathic wind and removing heat,summarized in flexible mode of thinking and bring us enlightenment.

Tumor stage and lymph node involvement are the most important prognostic factors for patients with locally advanced cervical cancer. For cervical cancer, gynecologic oncologists generally apply the criteria of the International Federation of Gynecology and Obstetrics(FIGO). However, in the current FIGO 2018 staging system, stage ⅢC is based only on the anatomical location of metastatic lymph nodes, without considering local tumor factors and other lymphatic status parameters, which limits its prognostic significance to a certain extent. The aim of this article is to summarize the influence of local tumor factors and different lymphatic status parameters on prognosis and treatment options for stage ⅢC cervical cancer.

Tissue factor is a powerful promoter of blood clotting in vivo , it plays an important role In hematischesis, tissue repair and thrombogenesis. In recent years, it is discovered that tissue factor can discriminate and regulate cell signal transduction, promote neogenesis of blood vessel and inflammatory reaction, regulate cell adhesion and movement, have a intimate relationship with invasion and metastasis of malignant tumor. In this article, we review the effects of tissue factor on malignant tumor metastasis.

Objective To evaluate the effects of intravenous analgesia with dezocine combining sufentanil in hip and knee arthroplasty for elderly patients.Methods Ninety patients with ASA Ⅱ ～ Ⅲ and aged ≥ 65 years who were scheduled for hip and knee arthroplasty under CSEA and treated with intravenous analgesia post-operation were selected and divided into three group (20 cases):group Ⅰ (sufentanil 2.5μg/kg + droperidol 2.5 mg),group Ⅱ (sufentanil 2.0 μ g/kg + dezocine 10 mg + droperidol 2.5 mg) and group Ⅲ (intramuscular dezocine 10 mg and sufentanil 2.0 μ g/kg + droperidol 2.5 mg),which were diluted to be 100 ml by adding saline.VSA,Ramsay score as well as side effects were recorded at 6,12 and 24 h after operation.75 mg meperidine was administered intramuscularly as rescue medication when VAS was above 5.Results Compared with group Ⅰ and Ⅲ,group Ⅱ showed better outcomes regarding to the VAS and less side effects.Ramsay score 6 h after operation and the amount of patients who needed meperidine in group Ⅲ were higher than those in the other two groups (P ＜ 0.05).Conclusion Dezocine combining with sufentanil in elderly patients underwent low limb arthroplasty shows better postoperative analgesia effects with less side effects,and it's worth for clinical application.

Objective To establish a three-dimensional finite element model and make mechanical analysis of "V"-type atlantoaxial reduction and internal fixation. Methods According to "V"-type atlantoaxial and internal fixation,based on screw-type Ⅱ design parameters,and using Pro/E 2001 and MSC.Patran 2005 software,we set up a finite element model and calculated the region containing the node scope of the force as the sites binding and 100N mechanics adding. Results The model looked realistic,geometric similarity.The deformation stress field mainly concentrated in the reset device V-tip arm bending and stability.The strength of its maximum stress was 4.78MPa,and the scope had 2794 nodes.V-type wing of the acute angle point of convergence of the premises to bear the stress intensity followed.It was 0.31MPa,and the scope had 1953 nodes.V-type wing by the end of edge was the smallest for the 1.22?10-3MPa,and there was the scope of 1730 nodes. Ⅱ-shaped fixed nail stress concentrated at the central parts of tooth and the art on both sides of teeth,with maximum stress intensity of 1.68?10-2MPa,and there was the scope of 1146 nodes. Conclusion The reduction and fixation devices to load at the time of recovery deformation forces and mechanical characteristics adapted to Ni-Ti shape memory alloy material functions and super-elasticity completely,which meets the clinical needs.

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From July 1997 to March 2000, internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were used in 25 patients suffering from Pott's paraplegia in our department. 17 of them were involved in a longitudinal study and followed up for a mean of 2(1 5～4)years postoperatively. The beginning of neurologic recovery was during the first 2 to 3 weeks postoperatively in 16 patients. 9 were completely recovered,7 were partly recovered 6 months postoperatively. At final follow up, 2 of the 7 patients were completely recovered, 5 had significant improvement of one grade(2 patients) or two (3 patients) according to ASIA Grades. It is concluded that internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were found to be helpful in strengthening the stability of the spine in spinal tuberculosis, providing successfu recovery of paraplegia and preventing the recurrence of paraplegia.

Posterior transpedicle instrumental fixation and anterior arthrodesis were performed in 34 patients with spinal tuberculosis.Antituberculous chemotherapy was qiven for nine months postoperatively, and the surgical outcomes were followed up for three to five years.All the patients were cured and there was no recurrence two years after stopping chemotherapy.Tubercular kyphosis was 24?preoperatively and 9?postoperatively, and deformity correction was maintained during the follow up period.Interbody fusion was achieved in all the patients after surgery,four months for one segment fusion, six months for two segments fusion.It is concluded that posterior instrumental stabilization and anterior interbody fusion are helpful in providing rigid stabilization,correcting or preventing progression of kyphosis, and that transpedicle instrumental fixation can accelerate interbody fusion, shorten chemotherapy course and improve its cucative ratio.

Objective To investigate T cell-mediated anti-HBV effects of dendritic cells (DCs) sensitized by HBsAg in patients with HBV infection in vitro. Methods DCs isolated from peripheral blood mononuclear cells of HBV patients were cultured and proliferated in vitro, and then were stimulated with pure HBsAg before DCs maturation, and co-cultured with auto-T lymphocytes after DCs maturation. The T lymphocytes were then harvested 5 days later and added into the supernatant of 2.2.15 cell cultures. The supernatants were collected on 1st, 3rd, 5th and 7th day, respectively. ELISA was employed to detect HBeAg and the secretion of HBsAg, as well as to measure the concentration of IFN-? and IL-12 in culture supernatents. Results The proliferation and cytotoxicity of auto-T cells were markedly enhanced in the antigen stimulated DCs group compared with that of DCs without loaded antigen and only T lymphocyte group (P