[Objective]To investigate the application value of the iliac allograft combined with anterior plate in the cervical anterior operation.[Method]Sixty-eight cases of anterior cervical decompression and fusion were performed with the iliac allograft combined with anterior plate.The data such as operative time,blood loss during operation and continue X-ray on their cervical spine were recorded,and were compared with the correspondent data of the control group which were transplanted of the iliac autograft combined with anterior plate.[Result]Compared with that of the control group(iliac autograft combined with anterior plate),the operative time and blood loss during operation in the group of iliac allograff combined with anterior plate was less(P

Objective To investigate the effects of whole grain-bean mixed staple food on intestinal microecology,anthropometric,and metabolic parameters of obese people.Methods Totally 87 obese people were divided with random number table into whole grain-bean mixed staple food group (test group) and refined grains staple food group (control group).Body weight (BW),body mass index (BMI),waist circumference (WC),hip circumference (HC),waist/hip ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and colony count of intestinal flora (bacillus bifidus,lactobacillus,clostridium perfringens,enterobacteria,enterococcus,bacteroides) were measured at baseline and 3 months after intervention.Results Ten people were excluded from this research,6 in the test group and 4 in the control group.Mter 3 months of dietary intervention,BW,BMI,WC,HC,and WHR were significantly lower in the test group than in the control group [(69.45 ± 7.07) kgvs.(72.42 ±5.79) kg,P=0.000; (26.08 ±1.48) kg/m2 vs.(27.27 ±0.81) kg/m2,P=0.000; (82.48±9.30) cm vs.(86.96±4.93) cm,P =0.000; (90.08 ±6.57) cm vs.(92.42 ±6.67) cm,P =0.000; 0.92 ±0.11vs.0.95 ±0.10,P =0.003].The levels of FPG,TC,and LDL-C in the test group were significantly lower than those in the control group [(4.92 ± 0.75) mmoL/L vs.(5.41 ± 1.21) mmoL/L,P=0.037; (3.85±1.13) mmoL/L vs.(4.38 ±1.26) mmoL/L,P=0.046; (3.55 ±1.04) mmoL/L vs.(4.16 ± 1.40) rnmoL/L,P =0.033] ; the level of HDL-C in the test group was significantly higher than that in the control group [(1.13 ± 0.37) mmoL/L vs.(0.92 ± 0.26) mmoL/L,P =0.004].The colony counts of intestinal bacillus bifidus,lactobacillus,and bacteroides in the test group were significantly higher than in the control group [(7.94 ± 0.58) lg CFU/g vs.(6.95 ± 0.38) lg CFU/g,P =0.000 ; (7.67 ± 0.46) lg CFU/g vs.(6.96 ± 0.57) lg CFU/g,P =0.000 ; (5.53 ± 0.44) lg CFU/g vs.(4.80 ±0.23) lg CFU/g,P =0.000],while the colony count of clostridium perfringens was significantly lower than in the control group [(4.40 ± 0.49) lg CFU/g vs.(5.11 ± 0.63) lg CFU/g,P =0.000].Conclusions In obese people,whole grain-bean mixed staple food can improve anthropometric parameters,some lipid metabolic parameters,and intestinal flora.The underlying mechanism may involve promoting the survival and proliferation of probiotics,thereby improving glucose and lipid metabolism.

Objective To assess the patient effective dose during SPECT/CT imaging.Methods A total of 157 patients (85 males,72 females;mean age:(60.46±13.44) years,range:24-88 years) who underwent SPECT/CT from April 2013 to September 2014 were retrospectively analyzed.They were divided into 3 groups:99Tcm-MDP bone scan group (n=113),99Tcm-MIBI parathyroid imaging group (n=23) and 99Tcm-MAA pulmonary perfusion imaging group (n=21).The injection dose (MBq) was recorded and the effective dose (mSv) was estimated according to the International Commission on Radiological Protection (ICRP) guideline.The volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) of CT were also recorded and the effective dose (mSv) due to CT was calculated.The effective doses among different groups were statistically compared by Kruskal-Wallis rank sum test and Wilcoxon rank sum test.Results The effective dose from radiopharmaceuticals were (4.02±0.35) mSv for 99Tcm-MDP bone scan,(6.13±0.53) mSv for 99Tcm-MIBI parathyroid imaging and (1.66±0.13) mSv for 99Tcm-MAA pulmonary perfusion imaging (x2=96.853;Z =7.533,7.262 and 5.676;all P＜ 0.05).The effective dose due to CT were (3.84±1.98),(1.04±0.19),(4.05±0.47) mSv respectively (x2 =41.225,P＜0.05),and there were significant differences between 99Tcm-MIBI parathyroid imaging group and 99Tcm-MDP bone scan group,99Tcm-MAA pulmonary perfusion imaging group(Z=6.046 and 5.672,both P＜0.05).The total effective dose during SPECT/CT imaging were (7.86± 1.98),(7.21±0.81) and (5.71±0.45) mSv (x2 =28.988,P＜ 0.05).There were significant differences between 99Tcm-MAA pulmonary perfusion imaging group and 99Tcm-MDP bone scan group,99Tcm-MIBI parathyroid imaging group(Z=4.967 and 4.994,both P＜0.05).Conclusions The increase in effective dose due to spiral CT during SPECT/CT examination should be concerned.Appropriate utilization and optimization of SPECT/CT is needed.

Acute Disease ; Animals ; Charcoal ; therapeutic use ; Enema ; Milk ; Paraquat ; toxicity

In this paper,we analyzed one case of primary multifocal extranodal non-Hodgkin's lymphoma and reviewed the related literatures.We investigated the clinical data of this case with primary multifocal extranodal lymphoma and retrospected the related references.The key words,primary extranodal lymphoma and multifocal,were used to search Pubmed and Wanfang Database,and finally only three cases were found.The 68-yea-old woman was confirmatively diagnosed as primary multifocal extranodal B cell non-Hodgkin's lymphoma.The positron emission tomography/computed tomography (PET/CT) scan showed multiple hypermetabolic lesions in the left humerus,both kidneys and ileum.The confirmative diagnosis was based on clinical manifestations and serological tests,imaging features of CT and PET/CT,and especially on the histopathological and immunohistochemical studies.After one cycle chemotherapy (rituximab,Vincristine and prednisone) and another cycle (rituximab,Vincristine,cyclophosphamide and prednisone),a repeat PET/CT scan showed a complete metabolic resolution of the lesions in the kidneys and ileum,and a partial metabolic resolution of the left humerus.After four cycles of chemotherapy,there were new extensive involvements of the right supraclavicular and intrapulmonary lymph nodes,bilateral pleural and pericardium,and the patient gave up chemotherapy.This case demonstrated the imaging findings of an uncommon primary multifocal extranodal lymphoma in left humerus,both kidneys and ileum,and highlighted the usefulness of CT and PET/CT scan in identifying the extent of disease involvement,in guiding a biopsy,and in assessing the treatment response of lymphoma.It is essential to differentiate between primary multifocal extranodal lymphoma and lymphoma extensive metastases.

Objective To describe a new technique with mini-open reconstruction of lateral ligaments of ankle with partial tendon of its peroneus brevis and evaluate its effect in treatment of chronic lateral ankle instability. Methods A total of 11 cases of chronic lateral ankle instability;at mean age of 27.6 years(16-42 years),were treated with mini-open reconstruction of the lateral ligaments of the ankle with partial tendon of its peroneus brevis.The mean delay between the initial episode of ankle sprain and the surgery was 10.3 months(4-32 months).Postoperatively,all cases were examined with MRI,stress X-rays and comparative stability of bilateral ankle inspection at clinical follow-up.The function of the ankle were evaluated bv American Orthopaedic Foot & Ankle Society (AOFAS)score and ankle-hind foot scale. Results The average duration of follow-up was 17.5 months(12-37 months).The mean AOFAS ankle-hindfoot score was 88.3 points(72-96 points)at the time of the latest follow-up,including excellent result in 6 cases(55%),good in 4(36%)and fair in 1(9%).MRI results showed that the ruptured lateral collateral ligaments of the ankle were repaired and remodeled very well in all patients.There was no recurrence of the ankle instability or other complications. Conclusion Mini-open reconstruction of the lateral ligaments of ankle with partial tendon of its peroneus brevis is safe and effective for treatment of chronic lateral ankle instability.

Objective To discuss how to reduce the incidence of postoperative infection and am-putation of patients after earthquake.Methods The wound infection and corresponding therapeutic outcome were analyzed in 592 patients in front line hospitals and station hospitals.Results The inci-dence of infection was 30. 7% in patients treated in front hospital within 8 hours post-trauma but 79. 9% after 8 hours post-trauma. There included 1 patient(0. 2%) with amputation due to clostridial myonecro-sis and 5(1. 2%)with amputation due to serious infection. Incidelice of postoperative wound infection was 7. 1% after selective operation for close injury. The incidence of infection in patients in station hospi-tals was 50. 8%, with no amputation, because they received debridement and antibiotics in site or front line hospitals. No postoperative infection was found in patients with close injury treated with selective op-eration in station hospitals. The major bacteria of wound infection in either front line hospitals or station hospitals were enterococcus faecalis and Eschrichia Coli. Incidence of combined infection was higher than that of single infection. And Gram-Negative bacillus infection exceeded Gram-Positive bacillus infection. The major wound infection obrained effective control through treatment with sensitive antibiotics.Con-clusions After earthqiale, the incidence of infection in patients with open injury is high, with high am-putation rate due to serious infection. Therefore, we propose performing as soon as possible debridement and external fixation with antibiotic treatment but reducing internal fixation. The postoperative infection late of patients with close injury in front line hospitals is much higher than that in station hospitals;their-fore, patients with stable vital signs should be transported to station hospitals as early as possible in order to reduce incidenee of infection.

Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g · kg±1 · d±1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor± ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera± tion but without significant difference [control group: (2. 24 ±0. 84) fig/ml, study group: (2. 32 ±0.92) μg/ml, normal value: (1.27 ±0.44) μg/ml]. On the post±operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31 ±1. 05) μg/ml] was significantly higher than that of control group [ (3. 04± 1. 01) μ/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with± out significant difference [ (33. 3 ±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.

Objective To discuss the application value and improvement of principle of multi-echelon medical care in emergent rescue of the injured in Chinese Wenchuau earthquake. Methods The author analyzed and evaluated the medical rescue that was done at disaster site, in the front line hospital and higher level hospitals during earthquake. Results A total of 4 689 patients were treated at disaster site, including 413 patients with severe injury, of whom 3 died. Different kinds of operations including debridement were performed at disaster site, with infection incidence of open wound was nearly 80%. In the front hne hospital, 1 400 patients were treated, with 200 operations done. Of all, 110 patients with severe trauma were treated emergenfly, with an amputation rate of 3.0% and postoperative infection incidence of 66.8%. In the station hospitals, 125 patients received definite surgeries, with 1-5 surgeries per injury site. There was no postoperative cross infection, amputation or death. Conclusions The multi-echelon medical care is the basic mode for medical rescue of large number of patients in natural disaster rescue. First aid at disaster site should be performed as early as possible. Transportation is crucial for successful rescue and an improved patient grading system can help increase the efficiency of rescue. The front line hospitals should mainly provide life support, debridement and fixation of simple fracture, while the specific treatment and definite surgery should be carried out in the station hospitals.

Objective To strengthen the understanding of granulocytic sarcomas(GS)by investigating the clinical characteristics of GS of spine. Methods The clinical data of 2 GS patients were retrospectively analyzed, and the related literature was reviewed. Results Because of the double lower limbs numbness, the 2 GS patients came to orthopedics department of the 306th Hospital of PLA. Magnetic resonance imaging (MRI) of the 2 patients showed an epidural mass located at the 9th-11th and 2nd-4th thoracic levels. Their histopathological examination and immunohistochemistry revealed GS.For example 1,she was diagnosed with acute promyelocytic leukemia(APL)and has been morphologic complete commission(CR) from 1995 to 2015. Chemotherapy and all-trans retinoic acid (ATRA) were performed after extramedullary relapse in thoracic spine,breast,ovary,sternum bone and lymph nodes.So far,the patient is still in follow-up.For example 2,he was diagnosed as isolated GS by morphology, immune phenotype, chromosome and gene examinations. Because he refused chemotherapy, radiotherapy was performed after surgical intervention. So far, he is loss of follow-up. Conclusions Spinal epidural of GS is rare. Surgery can reduce or remove nerve compression symptoms, and help clear diagnosis. The current recommended treatment regimen in patients presenting with isolated GS or GS presenting concomitantly with AML is conventional AML-type chemotherapeutic protocols. The differences in prognosis of GS patients may be partially attributed to different characteristics of patient.