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.

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

0 05.Only the level of TNF ? decreased obviously at the later stage of chemotherapy,P

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.

Ninety fresh umbilical cords of newborns were harvested and dissected. There were 86 cords with double arteries and single vein and 4 cords with only 1 artery and 1 vein. The outer and inner perimeter of single artery, double arteries and the vein was 3 8?0 3mm vs 6 2?0 3mm, 2 4?0 2mm vs 4 6?0 2mm and 10 0?0 4mm vs 10 8?0 4mm at empty and flatened state, respectively. The diameter of vein at 20mmHg filling pressure and single and double arteries at 80mmHg was 7 2?0 3mm, 4 8?0 1mm and 3 9?0 8mm, respectively. According to these values, various drainage and perfusion metal tubes were designed and evaluated both in vitro and in vivo. By using these tubes,extracorporeal circulation was established successfully via umbilical artery and vein in a newborn who suffered from cardiac arrest after birth. The results suggest that CPB through umbilical artery and vein is simple, practical and effective.

Objective To evaluate discuss the effect of percutaneous vertebraplasty in the treatment of compression fracture of vertebra in elderly patients with osteoporosis. Methods The clinical history of 13 elderly patients (5 male and 8 female), aged 61 to 78 years (nean 67 years), of spinal suffering from compression fracture of the vertebra, were retruspectively reviewed. Among them, 2 patients suffered compressed fracture of T11, 5 with fracture of T12, 3 with fracture of L1, 4 fracture of L2, and one suffered fracture of four vertebral bodies from T10 to L1. Percutaneous puncture were guided by C-arm X-ray or by computer navigation system, and a canal of 4.5 mm in diameter was created in the pedicle. A balloon was then introduced into the canal, and it was expanded. with radioopaque contrast medium under high pressure. The balloon was then removed after the height of the vertebral body was resumed as verified by X-ray. Bone cement in same volume and temperature was injected in the cavity which was newly formed. The treatment was completed with solidification of the bone cement. Results Low back pain disappeared in all 13 cases. Patients can be ambulatory in 6-8 hours postoperatively. The height of the vertebra body was basic recovered on postoperative X-ray, and kyphosis was rectified to a mean of 14 degrees (range10-28 degree). There was no relapse of low back pain or collapse of vertebral body after 1 to 12 months' follow up. Conclusion Percutaneous expansion of compressed vertebral body is a new kind of microsurgical, treatment for spinal compression fracture in elderly patients with osteoporosis, and it is simple and effective in relieving pain and recovering function.

BACKGROUND:Anterior cervical discectomy and intervertebral disc replacement have been extensively used in treatment of cervical degenerative disease. Its short-term therapeutic effects are encouraging, but it lacks of long-term and comprehensive evaluation.
OBJECTIVE:To observe the folow-up results of a group of cases of anterior cervical discectomy and Mobi-C intervertebral disc replacement for more than 5 years.
METHODS:A total of 25 cases of cervical spondylosis were treated in the 309 Hospital of Chinese PLA from January to September 2009. 19 of them were folowed up. Al patients received anterior cervical discectomy and Mobi-C intervertebral disc replacement. Twenty-three Mobi-C intervertebral disc prostheses were implanted. The range of motion was measured using lateral X-ray films during extension and flexion. Ectopic ossification was assessed by McAfee method. According to the cervical vertebra MRI images, the degeneration of adjacent segments was determined using Pearce classification. NDI score was used to evaluate the function of cervical spine. Pain improvement was evaluated using visual analogue scale score.
RESULTS AND CONCLUSION: A total of 19 patients were folowed up for 59-65 months, averagely 62 months. No significant difference in range of motion was detected before surgery and during final folow-up (P > 0.05). Ectopic ossification in two cases and the degeneration of adjacent segments in one case were found during final folow-up. No prosthesis loosening or displacement appeared. Visual analogue scale score and NDI score were significantly lower during final folow-up compared with that before surgery (P < 0.05). These results indicate that under the premise of reasonable choice of indications, the therapeutic effect of Mobi-C intervertebral disc replacement for degenerative cervical spondylosis was satisfactory in five-year folow-up. The range of motion was good, and the incidences of ectopic ossification and the degeneration of adjacent segments were low.