Objective:To discuss the effects and limitation of neuronavigation system in neurosurgical operations.Methods:58 cases surgically treated with Stealth Station 4.1 Neuronavigation System were analysed,including 52 cases of intracranial tumor,4 cases of cerebral vascular malformations and 2 cases of intracerebral abscess. The locations of lesion included superficial part of hemisphere (24 cases),deep part of hemisphere (21 cases),skull base (8 cases),cerebellum (2 cases) and brain stem (3 cases).Results:Among 58 cases,total removal of the lesion was performed on 45 cases,comprising 77.6%,subtotal removal on 5,comprising 8.6%,most removal on 2%,comprising 3.4% and partial removal on 6%, comprising 10.3%.Postoperative neurological functions were improved or remained unchanged in 52 cases while they were worsened in 5 cases,and 1 patient died.Conclusion:Neuronavigation system is safe and helpful for improving accuracy of neurosurgical operations and increasing total removal of lesions,and it can be used widely in neurosurgery. However,it can't avoid intraoperative brain shift.The effects of navigation system in different neurosurgical operations are evaluated.

OBJECTIVETo retrospectively analyze therapy comparison between hinged external fixator combining with internal fixation, soft tissue repair and plaster fixation after routine surgery for terrible triad of the elbow.

METHODSFrom January 2003 to June 2011,26 patients with terrible triad of the elbow (posterior dislocation associated with fracture of both the radial head and the ulnar coronoid process) were treated respectively by unilateral hinged external fixator and plaster fixation. Fourteen patients were treated with external fixator combining with internal fixation, soft tissue repair and reconstruction, including 8 males and 6 females,ranging in age from 20 to 62 years with an average of (33.60 +/- 8.53) years. The mean time of fixation was 7.5 weeks (ranged, 6 to 8 weeks), and forearm rotation exercise was performed after the first day of operation, elbow flexion and extension activities after 4 to 6 days. Twelve patients were treated with plaster external fixation combining with open reduction and internal fixation,including 8 males and 4 females,ranging in age from 21 to 63 years with an average of (34.80 +/- 7.41) years. The mean time of plaster fixation was 30.4 days, and functional exercise was carried out after 4 to 6 weeks of plaster removal. JOA assessment score were used to evaluate the elbow joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 36 months,with an average of 18.6 months. The mean time of fracture healing was (8.6 +/- 3.1) weeks in plaster group and (9.0 +/- 2.7) weeks in fixator group, with no statistical difference between the two groups (t =1.47, P > 0.05). The function and are of motion in plaster group and fixator group showed significant difference. While the pain, articular instability and deformity showed no statistical difference. The total assessment score between two groups indicated markedly difference (t = -2.66, P < 0.01).

CONCLUSIONHinged external fixator can enhance lateral stability of elbows,benefit the reduction of fracture dislocation, guarantee early and safe functional exercise, prevent elbow stiffness, and reduce heterotopic ossification. In treating terrible triad of the elbow, the hinged external fixator is superior to other therapies with respect of improving the function of elbow joint.

Adult ; Case-Control Studies ; Elbow Joint ; diagnostic imaging ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

Adolescent ; Adult ; Age Determination by Skeleton ; methods ; Child ; Child, Preschool ; China ; Diagnosis, Computer-Assisted ; methods ; Female ; Humans ; Male

OBJECTIVETo study the synergistic effects of electroacupuncture on the treatment of knee osteoarthritis after arthroscopic debridement.

METHODSFrom May 2008 to July 2010, 78 patients with knee osteoarthritis were randomly divided into two groups. There were 42 patients in the experimental group, including 16 males and 26 females, ranging in age from 41 to 63 years, with an average of (53.62 +/- 6.53) years; the disease course ranged from 8 to 24 months, with an average of (10.35 +/- 6.42) months. The patients were treated with arthroscopic debridement combined with electroacupuncture after operation. There were 36 patients in the control group, including 14 males and 22 females, ranging in age from 40 to 62 years, with an average of (54.34 +/- 7.67) years; the disease course ranged from 6 to 25 months, with an average of (11.94 +/- 5.13) months. Those patients were treated only with arthroscopic debridment. All the patients performed isometric quadriceps femoris contraction exercise and knee flexion and extension activities after operation. The visual analog scale(VAS) score and Lysholm knee score were used to evaluate the therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 30 months, with an average of 15.6 months. At the final follow-up, VAS score was significantly decreased, and the Lysholm score, except for the item demanding for support, significantly increased, compared with those before surgery respectively in both groups. There was significant difference in VAS score between two groups after treatment. As to Lysholm score, there were significant differences in limp, pain, swelling, stair activity and squat, but there were no significant differences in items of interlocking and instability between two groups after treatment.

CONCLUSIONElectroacupuncture can effectively improve the clinical symptoms and knee joint's motor function of knee joints in patients with knee osteoarthritis, as well as the synergistic effects on the treatment of knee osteoarthritis after arthroscopic debridement, leading to a much better long-term therapeutic effect with respect of improving the function of knee joint. This therapy, combined with traditional Chinese medicine and Western Medicine,is worth of clinical application in the treatment of knee osteoarthritis.

Adult ; Aged ; Arthroscopy ; Case-Control Studies ; Combined Modality Therapy ; Debridement ; Electroacupuncture ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; therapy ; Treatment Outcome

In the teaching of Medical Microbiology,the writers use problem based learning pattern and traditional teaching methods together to complement each other according to the characteristics of students. They improve the quality of teachers constantly,reform the old methods of teaching and evaluation system in order to improve the students'clinical work ability and train their innovation thoughts.

AIM: To investigate whether carnosine can inhibit cataract formation and protect Na+-K+ATPase against inactivation induced by a glucocorticoid.METHODS: Two hundred and twenty clear lenses cultured in vitro were randomly divided into five groups: control group (DMEM), steroid group (DMEM+Dexamethason 10μmol/L),lower concentration carnosine-treated group (DMEM+Dexamethason 10μ mol/L+Carnosine 2mmol/L), higher concentration carnosine-treated group (DMEM+Dexamethason 10μmol /L+Carnosine 5mmol/L) and carnosine group (DMEM + Carnosine 5mmol/L). Progression of cataract formation was evaluated daily using a dissecting microscope. On 1, 3, 5 and 7d, 10lenses of every group were homogenized and the activity of Na+-K+ATPase was measured by using spectrophotometer.RESULTS: During the incubation, mistlike opacity was observed in the lenses of the control group and carnosine group,but in the steroid group appeared dense nuclear opacity, while both two carnosine-treated groups came out visible demarcation between nuclear and cortical regions on 7d. A decrease in the activity of Na+-K+ATPase was found in the lens of the steroid group. On 3, 5, 7d, Na+-K+ATPase activity decreased 22.34% (P=0.002),47.98% (P＜0.001),75.37% (P＜0.001) compared with that at 1d, respectively. In the carnosine group,the activity of Na+-K+ATPase remained at the level of the control throughout the 7-d incubation, indicating that carnosine itself did not interfere with the original lens enzyme activity. In the lower concentration carnosine-treated group, on 3, 5, 7d,the activity of Na+-K+ATPase increased 10.8% (P＜0.05),44.6% (P＜0.01), 57.4% (P＜0.01) of control activity, respectively. In the higher concentration carnosine-treated group, on 3, 5, 7d, the activity of Na+-K+ATPase increased 11.3% (P＜0.05), 45.7% (P＜0.01), 57.6% (P＜0.01) of control activity,respectively. The activity of Na+-K+ATPase in both two carnosine-treated groups were only 6.7% and 6.5% lower than that of the control group after 7-d incubation. After the 7-d incubation, the Na+-K+ATPase activity of the lenses in the steroid group decreased significantly compared with carnosine-treated groups (P＜0.01).CONCLUSION: Carnosine prevents the cataract formation induced by a glucocorticoid, and significantly inhibits the inactivation of Na+-K+ATPase induced by a glucocorticoid.

OBJECTIVE:To promote effective supervision of key monitoring drugs by provincial pharmaceutical quality control center,and to improve rational drug use. METHODS:The effects of No.2 district of Sichuan province pharmaceutical quality con-trol center on 3 categories of key monitoring drugs guidance and supervision,through urging medical institution in the area to estab-lish key monitoring drugs supervision system,formulating prescription review guideline for 3 categories of key monitoring drugs [TCM injection,adjunctive drug,proton pump inhibitors (PPIs)],developing baseline data survey,inspecting the application of key monitoring drug in medical instaurations on the spot and other measures,were introduced. Through collecting the reports of re-gional quality control center to the provincial quality control center,supervision system of medical institutions were analyzed statisti-cally. Key monitoring drugs of medical institutions in the area were analyzed statistically in respects of rational utilization ratio,uti-lization quantity,utilization amount,etc.,so as to evaluate supervision effects. RESULTS:Up to Apr. 2016,92.26%medical insti-tutions had been aware of the relevant requirements of the documents;84.25% had established the hospital supervision system. 3 categories of key monitoring drugs prescription(orders)comment guideline had been developed in Mar. 2016. 18 third-grade class-A general medical institutions were randomly selected;among 3 categories,irrational utilization ratio of TCM injection decreased by 12.35%(35.41% vs. 47.76%);that of adjunctive drugs decreased by 9.64%(20.95% vs. 30.59%);that of PPIs decreased by 7.44%(40.49% vs. 47.93%) in May 2016,compare to Jan. 2016. Average consumption sum of them decreased by 12.07%, 13.30%,9.49%,respectively in Apr. 2016,compared to Jan. 2016. 55.02% medical institutions had started to collect the baseline data. CONCLUSIONS:The provincial pharmaceutical quality control center has played an important role on establishing a supervi-sion system,it can promote the effective supervision by guiding and supervising the medical institutions evaluating the supervision of medical institutions and pointing out the problems.

Bilingual teaching is an important method to train international medical students.While the current bottleneck problem is the shortage of teachers during the exploration and practice in bilingual teaching. Proceeding from requirements and current situation of bilingual teachers, the following approaches should be taken to strengthen the teaching stuff construction of bilingual teaching: demonstration teaching, language training infiltrated in clinic job, guiding foreign students, preparing bilingual teaching materials and professional team building.

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Selective serotonin reuptake inhibitors (SSRIs),a new generation of anti-depressant agent,are mainly used to treat emotional disorders in clinical practice now.Recent studies have found that SSRIs can increase neurogenesis after cerebral ischemia,promote neurovascular reconstruction,and are conducive to the recovery of neurological function.Furthermore,SSRIs can improve the tolerance of ischemic tissue,exert anti-inflammation and anti-oxidation properties,reduce the blood-brain-barrier injury,and inhibit excitatory amino acid toxicity in order to exert neuroprotective effect.This article reviews the related research progress in SSRIs and ischemic stroke.