Objective To explore the clinical effect of disposable root canal treatment for elderly patients with chronic pulpitis.Methods 84 patients with chronic pulpitis were selected and randomly divided into the control group and observation group,each group in 42 cases(42 teeth).The control group was used multiple root canal treat-ment,and the observation group was used disposable root canal treatment,and following-up for 1 year after treatment, the clinical effect and success rates after one year were compared between the two groups.Results The total effective rate of the observation group was 92.9%, which was significantly higher than 69.0% of the control group (χ2 =3.860,P<0.05);After 1 years treatment,the total success rate of the observation group was 83.3%,which was sig-nificantly higher than 54.8%of the control group(χ2 =4.011,P<0.05).Conclusion The disposable root canal treatment for elderly patients with chronic pulpitis has a total effective rate,assembly and high power,which has cer-tain clinical reference.

Objective To compare the efficacy of intra?articular dexmedetomidine or morphine mixed with ropivacaine for postoperative analgesia after arthroscopic knee surgery?Methods Sixty ASA physical status I or II patients scheduled for elective arthroscopic knee surgery were randomly assigned into 3 equal groups using a random number table?The group R received 0?25% ropivacaine, and the group RD received 1 μg/kg dexmedetomidine and 0?25% ropivacaine,and the group RM received 2 mg morphine and 0?25% ropivacaine intraarticularly in a total volume of 20 ml?Visual analogue scales( VAS) scores when the patients actively flexed the operated knee to 90° were recorded at 2, 4, 8, 12, 18 and 24 h after surgery?The analgesic duration and consumption of fentanyl at 24 h after surgery were recorded?The complications such as bradycardia,hypotension, nausea,vomit,cutaneous pruritus and uroschesis were followed up?Results At 8 and 12 h after surgery,VAS scores were significantly lower in group RD ( ( 3?23 ± 0?45 ) points, ( 3?18 ± 0?47 ) points ) and RM ( ( 3?20 ±0?46) points,(3?13±0?45) points) than in group R((4?01±0?74) points,(3?93±0?71) points),and at 18 and 24 h after surgery,they were significantly higher in group R((3?85±0?62) points,(3?72±0?57) points) and RD((3?83±0?57) points,(3?71±0?55) points) than in group RM((3?07±0?43) points,(3?02±0?41) points),and there was significant difference(F between groups=124?65,P=0?021,F inner grouP=11?65,P=0?004,F across groups=67?65,P=0?024)?The analgesic duration was significantly different in three groups (F=45?78,P<0?001),and in group RD((668?3±133?4) min) and RM((1 412?8±275?67) min) was significantly longer than in group R(402?3±81?5) min,P<0?05),and the group RM was longer than the group RD( P<0?05)?The consumption of fentanyl at 24 h after surgery was significantly different in three groups ( F=34?47,P<0?001),and it was significantly lower in group RD((32?6±7?3) μg) and RM((12?8±3?7) μg) than in group R((151?3±28?5) μg,P<0?05),and the group RM was lower than the group RD(P<0?05)?No significant side effects were found?Conclusion Intra?articular dexmedetomidine or morphine all can improve the efficacy of ropivacaine for postoperative analgesia after arthroscopic knee surgery,while morphine is superior to dexmedetomidine.

Objective To summarize the experience in surgical management of hilar cholangiocarcinoma.Methods The clinical data of 88 patients with hilar cholangiocarcinoma who received surgical treatment at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were diagnosed by imaging examination.According to the severity of jaundice and predictive remnant liver volume,19 patients received percutaneous transhepatic cholangial drainage (PTCD) and 4 received portal vein embolization.The fundamental operation consisted of hilar cholangiocarcinoma resection,skeletonization of hepatoduodenum ligament and Roux-en-Y cholangiojejunostomy,and the transanastomotic stent was placed for 6 months.The count data were analyzed using the chi-square test; the survival rate was analysed using the Kaplan-Meier method; the survival was analyzed using the Log-rank test.Results Of the 88 patients,58 patients (including 11 patients who received PTCD) received hilar cholangiocarcinoma resection.Of the 58 patients,43 (including 4 patients who received portal vein embolization preoperatively) received R0 resection,and 15 received palliative resection.Thirty patients received internal and (or) external drainage.Commitant partial hepatectomy was performed on 22 patients (including 9 received left hemihepatectomy,2 received extended left hemihepatectomy,7 received left hemihepatectomy + caudate lobectomy,4 received right hemihepatectomy).Commitant pancreatico-duodenectomy was performed on 7 patients,commitant hepatic artery resection on 3 patients,and commitant portal vein resection on 2 patients.According to the modified Bismuth-Corlette classification,there were 17 patients with type Ⅰ,19 with type Ⅱ,21 with type Ⅲa,20 with type Ⅲb,and 11 with type Ⅳ.Of the 58 patients who received hilar cholangiocarcinoma resection,19 had postoperative complications,and 2 patients died within 30 days after operation.Seventy-three patients were followed up,and the overall 1-,3-,5-year survival rates were 68.5％,28.8％,11.0％,respectively.The 1-,3-,5-year survival rates of patients who received R0 resection were 94.6％,43.2％,18.9％,respectively,which were significantly higher than 78.6％,35.7％ and 7.1％ of patients who received palliative resection (x2=4.77,P ＜0.05).The 1-,3-,5-year survival rates of patients who received palliative resection were significantly higher than 18.2％,0,0 of patients who received biliary drainage (x2 =13.26,P ＜ 0.05).Conclusions R0 resection is the best choice for patients with hilar cholangiocarcinoma,and biliary drainage with no resection is the last choice.Sufficient preoperative treatment,optimized choice of surgical procedure and exquisite surgical techniques are important for the improvement of the prognosis.

A kind of adjustable external fixation device for lower extremity is designed. The circuit is mainly composed of TEC1-00703 semiconductor refrigeration chip, HZC-30A pressure sensor, STC89C52RC single chip microcomputer and other electrical components. It can realize the timing intelligent temperature control and meet the local fixed-point refrigeration. The design of adjustable structure and the application of intelligent air cushion can satisfy the full fixation of lower limbs of different individuals. Its operation does not need much medical knowledge. It can solve the problem of emergency transportation and follow-up treatment of lower limb injury in ice and snow sports. It has a good application prospect and universality.
External Fixators ; Fracture Fixation ; Humans ; Lower Extremity ; Refrigeration ; Semiconductors