Cervical artificial disc replacement (CADR) as a new method for the treatment of cervical spondylosis, is becoming a basic and clinical research. Compared with the anterior cervical discectomy and fusion (ACDF), the biggest difference of CADR lies in the reconstruction of the cervical vertebra height and physiological curvature, retaining the spinal physiological function maximally and reducing the degenerative changes in adjacent segments. A large number of clinical investigation have suggested that ACDR can become an operation method to replace the ACDF. However, the complications and the problems of prosthesis itself are gradually exposed, such as that the prosthesis, can't completely simulate the biological effects of human intervertebral disc, the other factors and including the operation methods and prosthesis itself. At the same time, the problem that how to prevent complications and problems is required to be solved. Whether, the effect of CADR on the activity of the operation segment, and the prevention of adjacent segment degeneration can be guaranteed for a long time has drawn more and more attention from scholars.
Cervical Vertebrae ; surgery ; Humans ; Postoperative Complications ; etiology ; Total Disc Replacement ; adverse effects

Objective: To prepare exenatide-loaded poly (lactic-co-glycolicacid)(PLGA) microspheres and to evaluate their release behavior in vitro. Methods: Exenatide-loaded PLGA microspheres were prepared by W/O/O method using PLGA as vectors. An HPLC approach was established to determine the content and in vitro cumulative release. The physicochemical characteristics of microspheres, including the mean diameter, morphology, drug entrapment efficiency and loading efficiency, were evaluated. Results: The prepared microspheres were well-shaped, with a mean diameter of (51.2±1.97) μm. The drug loading was (4.50±0.13)% and the encapsulation efficiency was (96.5±2.68)%. The first day burst release was (13.19 ± 1.39)% and the in vitro 28-day-cumulative-release was (88.6 ± 0.73)%. Conclusion: The W/O/O method is stable, controllable, and repeatable for preparing exenatide-loaded microspheres using biodegradable polymers PLGA as the vector; the microspheres yield a one-month continuous release and have a bright future in treatment of diabetes mellitus.

Objective To investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing laparoscopic surgery with prospective cohort study.Methods Study subjects were patients,＞ 65 years of age,undergoing laparoscopic surgery,who were enrolled in an ongoing prospective observational study of the pathophysiology of postoperative delirium.Intraoperative blood pressure was measured,and predefined criteria were used to define hypotension.Delirium was measured by the Confusion Assessment Method on the first two postoperative days.Data were analyzed with t-test,two-sample proportion test,and ordered logistic regression muhivariable model,including correction for multiple comparison.Results Data from 213 patients with a mean age of 73.6 years (SD 6.1) were studied.Of these 63 (29.6％) developed delirium on day 1 and 61 (28.6％) on day 2.Relative hypotension (decreases by 20％,30％,or 40％) or absolute hypotension [mean arterial pressure (MAP) ＜ 50mmHg] were not significantly associated with postoperative delirium,nor was the duration of hypotension (MAP ＜ 50 mmHg).Conversely,intraoperative blood pressure variance was significantly associated with postoperative delirium.Conclusions These results showed that increased blood pressure fluctuation,not absolute or relative hypotension,was predictive of postoperative delirium.

Objective To study the effect of hospital disposal manners after workplace violence in hos-pital on organizational commitment and turnover intention among the head nurses. Methods Self-made questionnaire about workplace violence in hospital and general condition, organizational commitment question-naire and turnover intention questionnaire were conducted in 122 head nurses who had suffered hospital vio-lence in recent years from all level hospitals of Fujian province. Results The scores of affective commitment and normative commitment of organizational commitment and turnover intention showed significant difference be-tween the groups who suffered positive disposal and who suffered negative interference by the hospital after the violence events (P<0.05), but aggregate score of organizational commitment and the scores of continuance commitment showed no significant difference between the two groups (P>0.05). Hospital disposal manners af-ter the hospital violence and hospital grade were influence factors on turnover intention among the head nurses.Hospital grade was also an influence factor on organizational commitment among the head nurses. Conclu-sions Hospital positive disposal means after the hospital violence on head nurse help to ameliorate organiza-tional commitment and reduce turnover intention among the head nurses.

Objective To survey changes and the significance of phospholipase A2(PLA2) on brain tissue of SD rat in acute pancreatitis. Methods With retrograde injection of 3% taurocholate sodium into pancreatic and biliary duct, rat model of severe acute pancreatitis (SAP) was made,and it included four groups: the control group, the sham-operation group, the SAP group and the PLA2 inhibitor-treated group of SAP. Serum amylases, PLA2 and PLA2 in brain tissue were measured and the brain tissue changes were observed. Results There were no significant difference in serum amylases, PLA2 and PLA2 in brain tissue between the sham-operation and the control groups; the levels of serum amylases, PLA2 and PLA2 in brain tissue in the SAP group were higher than those in the control. In the SAP group expansion and hemorrhage of meninges, intracephalic arteriolar hyperemia, in meninges and cephalic-parenchyma infiltration of inflammatory cells and interval broaden were observed, significant differences were found between two groups.Compared with the SAP group, the level of serum amylase, PLA2 and PLA2 in brain tissue were reduced significantly in the treatment group of SAP. Pathological damages in the treatment group were significantly reduced when compared with the SAP group. Conclusion PLA2 might play an important role in brain tissue damages in severe acute pancreatitis.

Objective To study the effects of treating intracranial hypertension(ICP) with different dosage Mannitol alone or combined with Furosemide.Methods 60 patients with high ICP after all kinds of operations on cranium and brain were divided into 4 groups according to the dosage of Mannitol alone or combined with Furosemide: 0.5 g/kg Mannitol(group A),1.0 g/kg Mannitol(group B),0.5 g/kg Mannitol and 20 mg Furosemide(group C),1.0 g/kg Mannitol and 20 mg Furosemide(group D).The effective power,rebound ratio,average effective time,average amplitude of decreasing ICP,plasma osmolarity and renal function were evaluated by monitoring intracranial pressure.Results In response of the effective power,rebound ratio of ICP and average effective time,groups C and D were more noticeable than groups A and B(all(P

Objective To study the preventive effect of recombinant streptokinase (r-SK) on cerebral vasospasm (CVS) after subarachnoid hemorrhage(SAH).Methods Rabbit models of SAH were made by double blood injection into cisterna magna. A tube was inserted into lateral ventricle after 24 h. In group treating one, 1.25 mg r-SK were injected into lateral ventricle, and the tube was opened for drainage after closed 6 h, and then 6 h later, injection, closed pipe and drainage were recycled for another 2 times. In the group SAH , 1 ml normal saline (NS) was injected into lateral ventricle, and then the way was the same as group treating one. In group treating two, 3.75 mg r-SK were injected for once. 6 h, 12 h ,1 d, 3 d, 5 d and 7 d later, 1 ml CSF was drained from the lateral ventricle in groups SAH , treating one and treating two ,respectively. The level of OxyHb in CSF was detected, angiograms of basilar artery(BA) were performed before and after 7 d of SAH,calculation the rate of calibre and histological examinations were also performed. Results (1)The level of OxyHb in CSF of group SAH was increased gradually while decreased in groups treating one and treating two. Compared with group SAH, the levels of OxyHb were significant lower in groups treating one and treating two at 1～7 d after administration(P

Objective To evaluate the clinical factors of recurrent intracranial aneurysm with endovascular embolization.Methods DSA was performed in 70 cases with 74 intracranial aneurysms after endovascular embolized treatment,of them,8 cases(9 aneurysms)were detected having recurrent.The geometry form of aneurysms,embilized method,material of endovascular embolization and DSA images pre-and post-embolized were analysed.Results In all recurrent intracranial aneurysms,five located at posterior communicating artery,two at anterior communicating artery and two at the first crotch of right middle cerebral artery.Four were wide-necked aneurysms,five were irregular aneurysms in form.Before recurrence,three aneurysms were embolized completely,six were proportion occlusion.Conclusion Aneurysms localized at the branching region of artery,being wide-neck,large,irregular form and residual neck are facility factors for intracranial aneurysm recurrence after endovascular embolization.

OBJECTIVE:to provide reference for the continuous improvement of surgical site infection (SSI). METHODS:There were totally 7 472 patients with typeⅠand typeⅡincision surgeries in a hospital after the targeted monitoring and special recti-fication(Jul. 2012 to Jun. 2013,monitoring group)and 5 958 patients with surgeries during the same period before special rectifi-cation(Jul. 2010 to Jun. 2011,control group). The clinic data of typeⅠand typeⅡincision surgical was compared,including infec-tion,the perioperative antibiotics use and hospitalization time after surgery,etc. RESULTS:The infection rate of typeⅠand typeⅡstandardized incision in monitoring group was respectively 0.35% and 0.43% and control group was respectively 0.60% and 1.36%(P<0.05). The rate of typeⅠincision perioperative antibiotics use in monitoring group was 10.72% and control group was 86.88%(P<0.05). The post-operative non-medication rate of patients was increased from the 6.98%(control group)to 49.20%(monitor-ing group)(P<0.05),the discontinuance rate within 48 h was increased from the 32.09%(control group)to 44.11%(monitoring group),and the ratio of patients who took antibiotics after the surgery for more than 3 d was decreased from the 42.82%(control group)to 3.05%(monitoring group)(P<0.05). The inguinal hernia repair time in monitoring group was 3.90 d,shorter than con-trol group(4.22 d)(P=0.018). The patient with gallbladder surgery in monitoring group was 6.47 d,compared with control group (6.38 d),there was no significant difference (P=0.619). CONCLUSIONS:The special rectification can obviously promote the standardized of perioperative antibiotics use,reduce the incidence of SSI and shorten the hospitalization time after operation.

Catheter Ablation ; Child ; Humans ; Male ; Tachycardia, Atrioventricular Nodal Reentry ; surgery