[Objective]To evaluate the long-term results of recurrent lumbar disc herniation between different kinds of reoperation.[Method]Seventy-four patients of recurrent lumbar disc herniation after discectomy alone were treated surgically from May 2001 to Augest 2005.They were divided into three groups:nonfusion,posterolateral fusion and intervertebral fusion.After a long term follow-up(≥2y),their clinical data were reviewed to compared their improvement rate of lower back pain,JOA score,subside rate of disc height and chang rate of superior intervertebral space angle.[Result]The long-term results revealed that the improvement rates of lower back pain JOA score in the three groups were increased in sequence.The differences in subside rate of disc height and change rate of superior intervertebral space angle between discectomy and posterolateral fusion groups were insignificant,but much higher than those of posterior lumbar interbody fusion group.[Conclusion]Posterior lumbar interbody fusion is effective in increasing the improvement rates of lower back pain JOA score and maintaining the disc height and the superior intervertebral space angle.

ObjectiveTo investigate the feasibility and influence factors of a new silver salt method for determination of arsenic in drinking water. Methods Arsenic was determined at different reaction temperature,acidity, specification and addition of zinc granular, fill weight of lead acetate cotton, and the effect of these factors on assay results was observed. Arsenic in drinking water was determined in accordance with standard test methods (GB/T 5750.6) of the new silver method. Results The recoveries of the arsenic were 75.3％ - 93.6％(F =9.21,P ＜ 0.01 ) with reaction temperature at 10 - 30 ℃, and the best reaction temperature was 25 ℃. The recoveries of the arsenic ranged from 80.3％ - 91.6％(F =4.67, P＜ 0.05) when sulfuric acid was 3.0 - 6.0 ml and the best value was 5.0 ml. The recoveries of the honeycomb structural zinc granular(diameter 0.2 - 0.3, 0.3 - 0.4 mm) and button zinc granular were 87.2％, 90.7％ and 83.0％, respectively; the best specification was 0.3 - 0.4 mm. The recoveries of zinc granular weight(3 - 5 g ) were 74.6％ - 91.7％, respectively; the best was 5 g. The recoveries ranged from 79.6％ - 91.3％ with fill weight of lead acetate cotton at 25 - 100 mg, the best fill weight was 50 mg.The recoveries of the arsenic were 90.7％, 92.5％, 81.5％ and 74.2％ with lead acetate cotton length at 0.5 - 2.0 cm,and the best loose-tight degree was 1.0 cm. The stability time of arsine solution was 5.0, 4.0, 2.5 h with corresponding temperature at 20, 25, 30 ℃, respectively. ConclusionsIn order to ensure precision and accuracy of the measurement, it is necessary to control reaction temperature, acidity, specification and addition of zinc granular free from arsenic, fill weight of lead acetate cotton and loose-tight degree in the reaction system.

Objective To prevent the occurrence of violence in the emergency department,to reduce the damage to medical personnel,and to maintain the normal medical order in emergency department.Methods A retrospective analysis of medical incidents of violence in the emergency department has been made.A root cause analysis (RCA) group has been established to explore the root cause of the incident and to make the violence emergency preplan of emergency department.Results Medical personnel have been trained according to the plan.It has improved the awareness of health care workers.The incidence of violent injury incidents decreased.Conclusions The establishment and training of emergency preplan can improve the awareness and prevention ability of emergency medical staff to violence injury.The safety of medical staff in emergency department can be guaranteed.

Objective To compare the dosimetry and toxicities between postoperative fixed-field intensity-modulated radiotherapy (FF-IMRT) and image-guided radiation therapy/volumetric modulated arc therapy (IGRT-VMAT) for cervical cancer.Methods A total of seventy patients with stage I b-Ⅱa postoperative cervical cancer who had high risk factors,were divided into FF-IMRT (FF-IMRT group,n =35)and IGRT-VMAT (IGRT-VMAT group,n =35),to compare the difference of target dose and adverse reaction between the two groups.Results In the IGRT-VMAT group,the interfractional setup errors in the x,y,and z axes were (0.25±0.14) cm,(0.26±0.16) cm,and (0.24±0.18) cm,respectively;the intrafractional setup errors in the x,y,and z axes were (0.1±0.09) cm,(0.12±0.09) cm,and (0.11±0.09) cm,respectively;the margins in the x,y,and z axes were 0.75 cm,0.84 cm,and 0.78 cm,respectively.Under the same dosimetric conditions,the IGRT-VMAT group was superior to the FF-IMRT group in terms of conformity index,treatment time,and number of monitor units (P=0.000).The Dmean and volume receiving high-dose irradiation for the bladder,rectum,and small intestine were significantly lower in the IGRT-VMAT group than in the FF-IMRT group (P=0.000).Compared with the FF-IMRT group,the IGRT-VMAT group had a significantly reduced incidence of acute and chronic gastrointestinal,urinary,and hematologic toxicities (P＜ 0.05).Conclusions IGRT-VMAT can correct setup error online,shorten the treatment time,reduce the dose to organs at risk,and alleviate acute and chronic toxicities,and is especially suitable for patients with postoperative small bowel position changes.

Objective Recently, the role of TREK-1 in anti-depression and neuroprotection was demonstrated definitely.In this paper,a systematic review about the functional structure of TREK-1 as well as the underlying mechanisms which involved in depression resistance and nerve protection was made for purpose of providing new ideas for the treatment of clinical diseases.Methods The electronic search of Medline/PubMed,CNKI,CBM and Wanfang Data were performed to collect the introduction of TREK-1 and the studies of depression and nerve protection in which TREK-1 participated from inception of each database to October 2015 ,besides the relevant references of the included studies were also retrieved.Results 30 studies were included in this paper.14 studies were about the interpretation of TREK-1's structure, distribution and the regulatory factors, and the number of researches regarding the involvement of TREK-1 in anti-depression and neuroprotection was 13 and 7 respectively.Based on these studies,it was easily to conclude that inhibition or blocking of TREK-1 channels can produce obvious antidepressant effect, however, activation of TREK-1 channels will induce the dilation of local cerebral vascular and silence hyperactive neurons.Conclusion Some achievements about the antidepressant and neuroprotective effect of TREK-1 channels in vivo have been made gratifyingly,thus future research should focus on exploring the best TREK-lactivation ratio in different brain regions to gain the best balance between anti-depression and neuroprotection.

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

OBJECTIVE To explore occurrence, distribution,and resistance profile of ?-lactamases in clinical isolates of Enterobacter cloacae for rational use of antibiotics in clinic. METHODS Susceptibility test to 13 antibiotics was also performed through disk diffusion test.ESBLs were conformed according to NCCLS.DIDST test was adopted to detect AmpC ?-lactamases in E.cloacae isolates. RESULTS Among 78 isolates collected,13(14.9%) produced AmpC ?-lactamases,24(27.6%) produced ESBLs,10(11.5%) produced both ?-lactamases.These produced(?-lactamases) strains resisted to almost all ?-lactams,except for imipenem.The ?-lactamases producers possessed seriously multi-and cross-drug resistance. CONCLUSIONS ESBLs and AmpC ?-lactams are the main mechanism of E.cloacae resistance to antibiotic.

Objective To investigate the correlation between single nucleotide polymorphism rs13146124 of interferon regu‐latory factor2(IRF2) on type Ⅰ interferon pathway and systemic lupus erythematosus(SLE) in a population from Guizhou Prov‐ince .Methods The polymorphism IRF2(rs13146124) was detected by using Taqman‐PCR in 366 cases of patients with SLE and 218 healthy controls .The genotype and allele frequencies were calculated and analyzed .Results The genotype frequencies of AA , AG and GG in IRF2 rs13142164 site in patients with SLE were 0 .011 ,0 .246 and 0 .743 respectively ,compared with the control group ,the difference was not statistically significant (χ2 =0 .093 ,0 .205 ,0 .136 ;P=0 .761 ,0 .651 ,0 .712) .The allele frequencies of A and G in IRF2 rs13146124 site in SLE patients were 0 .13 ,0 .87 respectively ,compared with the control group ,the difference was not statistically significant(χ2 =0 .071 ,P=0 .790) .There was no significant difference between the allele frequencies of A and G in IRF2 rs13146124 site in SLE and ANA ,dsDNA and other specific antibodies .There was no correlation between the allele frequen‐cies of A and G in IRF2 rs13146124 site in SLE and clinical features such as arthritis ,kidney damage ,etc .Conclusion The poly‐morphism of rs13146124 in IRF2 may not be associated with SLE in the population from Guizhou Province .

Objective:To investigate the IRF5 rs2004640,rs10954213,rs4728142 loci gene polymorphisms in the progress of Systemic lupus erythematosus(SLE),and explore the influence of the IRF5 gene polymorphisms to the SLE.Methods:218 patients with SLE and 200 health controls were analyzed by using TaqMan-PCR.And all allele frequencies were calculated.The risk factors were compared between cases and controls.At the same time,antinuclear antibodies and double-stranded DNA antibody of 218 SLE cases were analysed with indirect immunefluorescence method,specific autoantibodies in plasma spectrometry were determined using linear immunoassay in plasma.Results:T allele frequency of IRF5 rs2004640 loci in SLE was higher than the controls,allele frequency of the G/T distribution differences in two groups were statistically significant(χ2=6.809,P=0.009).The GG/TT genotype frequencies between the control and the SLE were statistically significant(χ2=5.111,5.035;P=0.024,0.025).Compared control group with SLE group,G allele frequency of IRF5 rs10954213 loci in SLE group was higher than the controls,the difference was statistically significant(χ2=4.332,P=0.037).And GG genotype distribution had significant difference in the two groups(χ2=5.805,P=0.016).SLE group AA/AG/GG genotype distribution of IRF5 rs4728142 loci,compared with control group,there were no statistically difference(χ2=1.273,0.902,1.853;P=0.259,0.342,0.173).And allele frequency A/G also were not statistically differences in two groups(χ2=2.651,P=0.104).The T allele frequency of IRF5 rs2004640 and autoantibodies(anti-Sm,anti-Rib-P)significant associations were found with SLE patient.There were no statistically significant difference between IRF5 rs10954213 with autoantibodies.Compared with SLE remission patients,ANA,ds-DNA increased obviously.Anti-NUC,anti-His,anti-Rib-P were higher,there were statistically significant differences betwen two groups.Conclusion:The GG/GT/TT polymorphism of IRF5 rs2004640,GG/GA/AA polymorphism of rs10954213 were related to SLE.But the GG/GA/AA polymorphism of IRF5 rs4728142 were not significant difference.IRF5 rs2004640 T comtributed to the anti-Sm,anti-Rib-P.In active SLE patients,anti-ds-DNA,anti-NUC,anti-His,anti-Rib-P were higher than the other group.

Objective To explore the change of serum sIL-2R and IL-6 levels in patients with Kawasaki disease (KD) and its role in the pathogenesis. Methods The serum slL-2R and IL-6 were detected by sandwich ELISA. The serum hs-CRP level was measured by DADE BEHRING BN ProSpec. Results The serum levels of sIL-2R and hs-CRP in KD before and after high-dose intravenous gama globulin(IVIg) were significantly higher than in healthy controls (P