Reform of the personnel system of a hospital will naturally affect some of its staff and their posts, resulting in misgivings of the mind and psychological pressure. Thus it is imperative to strengthen ideological work of a hospital's staff in the reform of its personnel system. Two things must be done to de a good job of the work. One is to fully grasp the ideological trend of the staff during the reform of the personnel system, affirming the positive effects, responding appropriately to the negative effects, and exerting to educate people whose understanding of the reform lags behind. The other is to do a good job of the ideological work of the staff during the reform, viz. the leading group must seriously study and fully understand the gist of relevant documents, change concepts, unify steps, and reach a common understanding. At the same time, efforts need to be made to properly treat those who have been disengaged or laid off so as to dispel their worries.

Objective To report the clinical outcome of L3～L5 fractures treated with USS short segmental pedicel screw system. Methods From 1994 to 2004, 57 cases of lower lumbar fractures were treated, of which 21 cases were treated with USS pedicel screw system. There were 12 cases of L3 fracture, 8 cases of L4 fracture and 1 cases of L5 fracture. The intervertebral height and lumbar lordosis were evaluated both before and after operation, the spinal impingement of bone was evaluated on CT scan, the neurofunction was evaluated with Frankle system and the clinical outcomes were evaluated with Charles system. Results The operation time ranged from 90 min to 150 min, averaging 120 min. The bleeding volume ranged from 100 ml to 600 ml, averaging 350 ml. The Frankle scores increased from 3.7 to 4.5 after operation. The intervertebral height of the fractured vertebral body increased from preoperative 30%to 60%to postoperative 70%to 100%(averaging 87%). The lumbar lordosis angel increased from preoperative 35.2?8.3o to postoperative 38.3?10.2o. The mobilization time was 3d to 2w, and the time for resuming work was 3 to 6w. The 3 to 30 months follow ups (averaging 15m) showed that the clinical outcomes were excellent in 9 cases, good in 9 cases, fair in 2 in and poor in 1. Conclusion The advantages of treating the lower lumbar fractures with short segmental USS pedicel screw system are effective restoration of intervertebral body height, lumbar lordosis and spinal volume, prevention of long term lumbago and lumbar stenosis, as well as early mobilization and return to work.

[Objective] To discuss the prognostic factors for cervical OPLL treated by anterior decompression.[Method]A total of 48 patients with cervical OPLL,who underwent anterior decompression,were followed up for 1～4 years,with an average of 2.1 years.The patients were classified into a good-prognosis group and a poor-prognosis group according to the JOA neruologic scoring system.Age,sex,JOA score,duration of symptoms,diabetes mellitus,Pavolv ratio,occupying rate,type of ossification,CT double-layer sign,hyperintense areas,level of segments,and treatment of ossification were testified using multiple logistic regression analysis.[Result]Treatment of ossification was the only statistically significant factor predicting clinical results in this study.[Conclusion]It is the most important to resect the ossification and decompress the spinal cord thoroughly in the process of antarior decompression for cervical OPLL.

Objective To investigate the survival principle of SARS-conarovirus (SARS-Cov) in environments and to explore the inactivation effect of chlorine and chlorine dioxide on SARS-Cov with the aim of providing some basis for blocking its'main route of transmission. Methods SARS-Cov were added into the excrement samples, urine samples and other water samples and were disinfected by sodium chlorite and chlorine dioxide. The survival ability of SARS-Cov and the effects of those two disinfectants on the inactivation of SARS-Cov were observed. Results The survival of SARS-Cov changed with the variation of temperature in external environment.It was showed that SARS-Cov could only survive for 2 days in hospital sewage, domestic sewage and dechlorinated tap water, while 3 days in excrement samples, 14 days in physiological saline and 17 days in urine samples protected from light in vitro at 20 ℃ . At 4 ℃, SARS-Cov could survive for 14 days in all above water samples and 17 days in excrement samples and urine samples. Resistibility of SARS-Cov to disinfectants in sewage sample was lower than those of E. coli and f2 phage. At the same disinfectant dosage or residual chlorine concentration , chlorine had better inactivation effect than chlorine dioxide did.The residual chlorine concentration of more than 0.5 mg/L or chlorine dioxide concentration of more than 2.19 mg/L was enough for the complete inactivation of SARS-Cov in sewage, but not enough for E. coli and f2 phage. Conclusion The survival time of SARS-Cov was shorter and more susceptible to chlorine and chlorine dioxide in external environment.

L3、4,and there was no significatant difference between two sides,and the biggest inner diameter of the main vessels averaged 5.3?0.6 mm.[Conclusion]To begin with,the blood supply is adequate in the intertransverse area,and the distribution of blood vessels follows some regularities,so to be familiar with the anatomy and to operate carefully can reduce bleeding.In addition,ILIF in segment L3、4 and L4、5 is feasible.

Objective:To observe the color change of tooth i nduced by hydrogen peroxide gel. Method:12 extracted teeth were randomly assigned to two groups (n=6) and treated with 350 g/L and 75 g/L hy drogen peroxide gel respectively. One of the 6 samples in each group was used as the control. The bleaching gel was placed onto the enamel surface of the sample s. In 350 g/L gel group digital photographs were taken just before,10 and 30 min after the process, in 75 g/L gel group digital photographs were taken before an d 1.5?N(N=0,1,2,3,4,5,6,7) hours after the process respectively. All photograph s were taken at the same illuminating conditions and photographic parameters wer e analyzed with Photoshop7.0 software. Results:10.5 h after trea tment in the 75 g/L gel group L *, a * and b * values on the teeth surface were in creased(+) or decreased(-) by +4.5,-1.4 and -0.5,those on the inner sections 2.7 ,-1.0 and -0.8,respectively. 30 min after treatment in the 350 g/L gel group L *, a * and b * values on the teeth surfaces were increased(+) or decreased (-) by +1.9,-0.6 and 0,those on the inner sections +0.4,-0.4 and -0.6,respectively. Conclusion:Effective bleaching effect may be obtained in 10~30 min b y 75 g/L or 350 g/L hydrogen peroxide gel on teeth surface and in inner dentin. 75 g/L hydrogen peroxide bleaching gel may produce more reliable and save effect than 350 g/L.

Objective To report a newly designed method of cervical subtotal corpectomy with the posterior vertebral wall retention. Methods 89 cases of cervical spondylotic myelopathy(CSM) or cervical injury were treated with subtotal corpectomy with the posterior vertebral wall retention from March 2001 to March 2004. 61 males and 28 females, aged from 25 to 76 years(mean, 47 years) were included, which involved 62 cases of multiple level in CSM with or without radiculopathy, 14 fractures of cervical vertebral body with or without cervical dislocation, 13 cervical instability with or without cervical disc disease. Subtotal corpectomy with 2 mm retention in posterior wall of the vertebral body were performed, in which 23 cases' level were C4,55 C5 and 11 C6. Extensive decompression through intervertebral body space was performed and bone fusion with autogenous iliac bone graft or titanium mesh supplemented with anterior locking plates were used, the bone graft or mesh were impacted into the decompression slot between the upper to lower endplate as well as the preserved lateral and posterior wall stably. Bone fusion were assessed with roentgenogram during the 3rd, 6th, 12th month follow-up and neurological function was recorded. Results The average operation time is 100 min, ranged from 55-130 min, the blood loss were 120 ml, ranged from 30 to 300 ml. Neither plate or screw migration, nor bone graft loosening or subsidence were found in 77 patients with over 6 months follow-up. Bone fusion happened in all patients, and Frankel score improved 1.0 level averagely after operation. 3 patients with hoarseness recovered 2 weeks later. Conclusion Subtotal corpectomy with posterior wall of vertebrae retention was a feasible anterior decompression procedure with advantage of safety, completely decompression and reliable bone fusion. This method included double level of CSM, and cervical fracture as well as two level of local ossification of posterior longitudinal ligament.

[Objective]To discuss surgical approaches,results and complications of ossification of posterior longitudinal ligament(OPLL)of cervical spine.[Method]The clinic data of 48 patients from 2000 with cervical OPLL were reviewed and analyzed.Eighteen of them were decompressed from an anterior approach and 30 from a posterior approach.The improvement rate according to JOA scoring system were evaluated,some relevant imaging examination data including X-rays,CT and MRI were also measured,which were taken preand post-operatively.Surgical complications were also recorded.[Result]Of 48 patients,23 had cervical stenosis,the mean occupancy rate was 41.4%,and 19 had the abnormal signal in spinal cord.The mean postoperative improvement rate was 68.3% in patients treated by anterior decompression and 51.3% in those treated by posterior decompression.There were 2 patients with dural tear,5 with segmental nerve root palsy and 2 with hematoma after operation.[Conclusion]Suitable operation methods should be chosen according to the location,extent and occupancy ratio of OPLL,which is important for avoiding complications and improving surgical results.

Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

Objective To observe the impacts of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variability (BPV) in elderly hypertensive patients.Methods Eighty elderly patients with hypertension were randomized into valsartan and amlodipine (the amlodipine group, n=38) or valsartan and hydrochlorothiazide (the hydro-chlorothiazide group,n=37) group.The 24-hour dynamic blood pressure was monitored at baseline, 6-week and 12-week after treatment for the blood pressure and blood pressure variability. The control rate of blood pressure was calculated at 6-week after treatment, and side effects were observed during the treatment.Results Values of 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP, morning SBP and 24 h systolic blood pressure variability (SBPV) were significantly low-er at 6-week and 12-week than those of baseline in both two groups(P<0.05). There was an interaction between the group-ing factors and time on 24 h SBP, daytime SBP, nighttime SBP, 24 h SBPV and daytime SBPV (P<0.05). At the 6 and 12-week treatment, 24 h SBP, daytime SBP, nighttime SBP and daytime SBPV were significantly lower in amlodipine group than those in hydrochlorothiazide group (P<0.05). At 12-week treatment, 24 h SBPV was significantly lower in amlodipine group than tjat in hydrochlorothiazide group (P<0.01). There were no significant differences in control rate of blood pressure and side effects between two groups. Conclusion Valsartan in combination with amlodipine or hydrochlorothiazide can both ef-fectively control BPV in elderly hypertensive patients, and valsartan conbined with amlodipine has better effects on lowering blood pressure and BPV.