BACKGROUND:The patients with lumbar intervertebral disc protrusion can be treated with internal fixation of posterior surgery way. We can choose the conventional posterior intervertebral fusion nail stick system internal fixation. Isobar non-fusion internal fixation system was used in recent years. As a kind of a strong internal fixation of lumbar posterior dynamic screw rod fixation system, it has been gradual y applied in clinic, and has been one of patient’s treatment options. OBJECTIVE:To compare and analyze the clinical efficacy of Isobar non-fusion internal fixation system and traditional intervertebral fusion nail rod system internal fixation operation method in treatment of lumbar disc herniation. METHODS:From September 2011 to September 2012, 40 patients with lumbar disc herniation who were treated in the Department of Orthopedic, Changhai Hospital, the Second Military Medial University of Chinese PLA were enrol ed in this study. They were equal y assigned to the Isobar non-fusion internal fixation system group (Isobar group) and the traditional intervertebral fusion nail rod system internal fixation group (rigid internal fixation group) and subjected to corresponding treatments. RESULTS AND CONCLUSION:Surgery was successful y completed in patients of the two groups. These patients received at least 2 years of fol ow-up, no drop out. Compared with pre-fixation, low back pain Visual Analog Scale and Oswestry Disability Index were improved significantly after fixation in both groups. Compared with the rigid internal fixation group, range of motion of lumbar spine was larger in the Isobar group. Low back pain Visual Analog Scale and Oswestry Disability Index were similar between the two groups. These results indicated that posterior Isolbar non-fusion internal fixation obtained identical outcomes as traditional treatment, and showed more advantages in range of motion of lumbar spine.

Objective To investigate the outcomes of arthroscopic treatment of anterior cruciate ligament tibial eminence avul-sion fractures by using loop ligature fixation .Methods 26 patients with anterior cruciate ligament tibial eminence avulsion frac-tures .All the patients were fellowed up at least one year .Results The X-ray indicated that all the avulsion fractures of tibial anteri-or eminence were healed after 6 months of the operation .The mean Lysholm score improved from (50 .8 ± 6 .5) preoperatively to (92 .7 ± 4 .3)postoperatively(t=36 .7 ,P<0 .05) .The mean IKDC 2000 subject score improved from (55 .6 ± 7 .4)preoperatively to (90 .7 ± 4 .2) postoperatively(t=22 .5 ,P<0 .05) .Conclusion Arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fractures by using loop ligature fixation could provide satisfying reduction ,stable fixation and well healing of the avulsed fragment .This arthroscopic suture fixation method is a minimally invasive ,simple and effective treatment for patients with tibial eminence fracture .

Objective To explore the therapeutic effect of cerebrospinal fluid (CSF) replacement combined with intrathecal injection on tuberculous meningitis. Methods Fifty-five patients with tuberculous meningitis were randomly divided into treatment group and control group. The patients in the treatment group were treated with CSF replacement combined with intrathecal injection on the basis of routine anti-tuberculosis therapy. The curative effects between these two groups were analyzed after 8 weeks. Results The total effective rate was 95.7% in the treatment group,compared with that 61.9% in the control group (P < 0.01); the healing rate in the treatment group was 56.2% vs 28.6% in the control group. In addition,the decay rate for WBC and CSF pressure in the treatment group are more rapid than those in the control group(P < 0.05). Conclusion CSF replacement combined with intrathecal injection has better curative effect in patients with tuberculous meningitis.

The working principle and application characteristics of ECG machine were introduced in detail from such aspects as the development history,structure,classification,new usage and procurement principle.The objective is to direct new equipment procurement and facilitate clinical application.

Objective:To do intelligence test in neurotics.Method:30 neurotics were tested by WAIS-RC.Results:The sub-score of digit span in neurotics was lower than norm(p

Objective To investigate the effect of early nutritional support on the growth and immature retinal vessels of very low birth infants.Methods Total 360 infants, admitted to our hospital from January 2003 to December 2013, who were born with birth weight lower than 1500g, without congenital malformation, being hospitalized for at least two weeks and safely discharged, were recruited.They were divided into 2 groups according to their time of hospitalization.200 infants ad-mitted from January 2010 to December 2013 were involved as group A and were given amino acid [ initial dose 1.6g/( kg· d), increased at 1.0 g/(kg· d)]in 12 h after birth and fat emulsion [initial dose 1.0 g/(kg· d), increased at 1.0 g/(kg · d) ] in 24 h after birth.168 infants admitted from January 2003 to December 2009 were involved as group B and were giv-en amino acid [initial dose 0.5 g/(kg· d), increased at 0.5 g/(Kg· d)] in 12~24 h after birth and fat emulsion [initial dose 0.5 g/(kg.d), increased at 0.5 g/(kg· d)] in 24h after birth.General condition at birth, enteral and parenteral nu-trition intake, growth parameters, retinal vessels development and other complications between two groups were retrospectively compared.Results No statistically significant differences(p>0.05) were found in gestational age, gender, general condi-tions at birth, faster time, average growth rate of Length and heat circumference, occurrences of complications, such as re-spiratory distress syndrome (RDS), necrotising enterocolitis (NEC), periventricular-intraventricular hemorrhage(PVH -IVH), parenteral nutrition associated cholestasis, infection, and the duration of oxygen therapy and mechanical ventilation between the groups.Group A compared to Group B, had less weight decrease [(6.12 ±1.15) vs (8.85 ±2.35)%, p =0.032]) ] and less time to regain birth weight [(9.0 ±3.5 ) vs (12.5 ±4.5) d ]and to reach 120 kCal/(Kg· d)[(10.02 ±4.99) vs (14.79 ±6.04) d,p=0.029)], had higher average weight growth rate after regain birth weight[(20 ±5.2 ) vs (14.1 ±4.6) g/(Kg· d)], had shorter hospital stay[( 30.9 ±10.5 ) vs ( 40.5 ±13.5) d ] and lower rate of immature retina at gestational age 34 weeks and retinopathy of prematurity(ROP).These comparisons were all statistically significance ( p<0.05 ) .Conclusion Early nutritional support can improve the growth velocity and visual function of very low birth weight infants, and reduce the incidence of immature retina at gestational age 34 weeks and retinopathy of prematurity (ROP), shorten hospital stays, and had no influence on the occurrences of other complication.

Objective To investigate the changes of intestinal blood flow and motility and their effects on intestinal mucosa barrier in rats with acute cerebral ischemia. Methods 64 male Wistar rats were assigned randomly into cerebral ischemia group (n=32) and control group (n=32).The two groups were divided into four subgroups according to timepoints of 6 h,12 h,24 h and 48 h after operation (8 rats for each subgroup).The intestinal mucosa blood flow,intestinal transmit index and endotoxin level in porlal vein were detected.The displacement ratio of E.coli was marked and counted with fluorescent microscope in tissue homogenate from organs. Results The intestinal blood flow in cerebral ischemia group at 6 h,12 h,24 h and 48 h after operation [(34.5±3.2)PU,(22.7±1.9)PU,(26.2±4.3) PU and (30.5± 4.1) PU] were significantly lower than control group[(46.8 ±5.4) PU,(50.1±3.6) PU,(45.4±4.1) PU and (48.7±7.3) PU] (t=2.650,2.875,2.639 and 2.507,all P＜0.05).The intestinal transmit index in cerebral ischemia group at 6 h,12 h,24 h and 48h after operation[(0.59±0.07),(0.48±0.06),(0.50±0.08)and (0.57±0.04)] were decreaesd as compared with control group [(0.73±0.04),(0.75=0.02),(0.74±0.06) and (0.76±0.03)] (t=2.409,2.758,2.649 and 2.807,all P＜0.05). The levels of endotoxin in cerebral ischemia group started to increase at 6 h and arrived to peak at 24 h,and the levels at four timepoints were (0.382 ± 0.014) Eu/ml, (0.466 ± 0.018) Eu/ml,(0.478 ± 0.029) Eu/ml and (0.412±0.036)Eu/ml,respectively,that were higher than those in control group[(0.102±0.007)Eu/ml,(0.114±0.021)Eu/ml,(0.112±0.018)Eu/ml and (0.108±0.011)Eu/ml] (all P＜0.05).The total E.coli detection rates in multiple organs in cerebral ischemia group (11.4％,18.8 ％,25.0％and 12.5％) were higher than in control group (2.1％,4.2％,2.1％ and 0.0％) at four rime points (all P＜0.05). The level of endotoxin was negatively related with the intestinal blood flow and intestinal transmit index( r =- 0.861 and - 0.796,both P＜ 0.05). Conclusions The higher intestinal mucosa blood flow and intestinal motility play important roles in the increase of intestinal mucosa permeability at early stage after acute cerebral ischemia.

Objective To improve the diagnosis and treatment based on the retrospective clinical analysis of 86 patients with leishmaniasis, an endemic disease caused by various species of Leishmania. Methods The data of 86 consecutive patients with visceral leishmaniasis and lymph node leishmaniasis were retrospectively reviewed, including epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and prognosis. Results There were specific endemic zones of leishmaniasis in Sichuan province. The main clinical symptoms and signs in the initial evaluation were: fever (100%), splenomegaly (100%), enlarged lymph nodes with hepatosplenomegaly (58.1%). All patients were treated with sodium pentavalent antimony gluconate (SPAG). About 95.3% (82/86) of the patients were cured, 3.5% (3/86) improved, and 1.2% (1/86) relapsed. Splenotomy was carried out for 2.3% (2/86) of the patients. The misdiagnosis rate was 30.2%.Conclusions Visceral leishmaniasis has no specific manifestations and is easily misdiagnosed. If leishmaniasis is suspected, bone marrow biopsy and smear examination, lymph node biopsy, rk-39 strip test for visceral leishmaniasis pathogen should be done to improve the outcome. SPAG is the first choice for leishmaniasis chemotherapy.

Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate.

Objective:To observe the hemodynamic change and inhibitory effect on stress response of oxycodone during induction, maintenance and resuscitation period of general anesthesia in patients undergoing gastric cancer surgery.Methods:60 patients with general anesthesia undergoing elective gastric cancer from March 2018-March 2019 in No.904 Hospital were selected. According to the random number table method, they were randomly divided into two groups ( n=30): Oxycodone group (group O) and Fentanyl group (group F). The anesthesia was induced by intravenous oxycodone 0.3 mg/kg (group O) or fentanyl 3 μg/kg (group F), propofol 2 mg/kg and cisatracurium 0.25 mg/kg. Oxycodone (group O) or fentanyl (group F) with sevoflurane were used for maintenance of general anesthesia. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T 0), immediately intubation (T 1), 1 min (T 2) and 5 min (T 3) after intubation, immediately skin incision (T 4), surgery for 1 h (T 5), the end of operation (T 6) and 1 min (T 7) and 5 min (T 8) after extubation. The concentration of glucose (Glu), cortisol (Cor), epinephrine (E) and norepinephrine (NE) were detected in time T 0,T 2, T 4,T 5 and T 7. The time of extubation and the visual analogue scale (VAS) scores after extubation and 30 min after entering postanesthesia care unit (PACU) were recorded. The incidence of cough during induction, dysphoria during extubation and the adverse effects such as nausea, vomit and respiratory depression during PACU were also observed. Results:There were no significant difference between two groups in MAP and HR at the time point from T 0 to T 8 ( P>0.05); there were no significant difference about concentrations of Glu, Cor, E and NE at the time point of T 0,T 2,T 4,T 5 and T 7 ( P>0.05). Extubation time and VAS scores of 30 min after entering PACU in group O were significantly lower than those of group F ( P<0.05). Meanwhile, the incidences of cough during induction, dysphoria during extubation and respiratory depression in group O were significantly lower than in group F ( P<0.05). There was no significant difference in the incidence of nausea and vomiting ( P>0.05). Conclusions:Oxycodone can be safely and effectively used for induction and maintenance of general anesthesia in gastric cancer surgery, inhibit intraoperative stress response, and improve the quality of recovery period.