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.

OBJECTIVE:To explore effective pharmaceutical administration measures for the rational adjunctive drugs. METH-ODS:The effective pharmaceutical administration of adjunctive drugs in medical institutions of Sichuan province was introduced, including establishing key monitoring management system of adjunctive drugs (establishing and implementing prescription review system,rational drug use training,strict supervision and examination) and playing promotion effect of provincial pharmaceutical quality management control center on medical institutions,etc. The effects of pharmaceutical administration in 18 third-grade class-A medical institutions were evaluated through statistically analyzing rational utilization ratio,drug ratio,consumption sum of ad-junctive drugs. RESULTS:Up to May 2016,key monitoring management system of hospital adjunctive drugs had been established and improved in medical institutions over Sichuan province. The rational utilization ratio of adjunctive drugs in 18 medical institu-tions increased from 69.41% in Jan. 2016 to 79.05% in May 2016;drug ratio decreased from 29.22% to 27.93%. The monthly consumption sum of adjunctive drugs decreased from 22 970 000 yuan in Apr. 2015 to 17 380 000 yuan in Apr. 2016(decreasing by 20.49%). CONCLUSIONS:Medical institutions of Sichuan province conduct effective pharmaceutical administration of adjunc-tive drugs through establishing the key monitoring management system for medical institutions and playing the role of the provincial pharmaceutical quality management control center for the supervision.

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.

Objective To explore the relationship between mdr1 gene expression of hepatocellular carcinoma (HCC) and pathological characteristics,chemotherapy and prognosis. Methods The mdr1 gene expression of HCC in 56 patients with the methods of immunohistochemistry was studied. The results were analysed with the pathological data by statistic methods. Results The positive expression of mdr1 gene in cancer tissues and pericancerous tissues of HCC were 30/56(53.6%) and 19/56 (33.9%) respectively. The difference was statistically significant (? 2=4.39, P

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

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 observe the hypotensive effect of Urapidil in operation on patients with fundus oculi disease accompanying hypertension.METHODS:Urapidil was injected iv first and then dripped.The SP,DP and heart rate were ob?served at given times and ECG was monitored.RESULTS:The total effective rate was95.1%,average SP decreased43.97mmHg(P

Objective:The one-way communication between traditional LIS system and equipment has been unable to meet the needs of business development of medical laboratory in our hospital, we need to upgrade our equipment and to develop the bidirectional communication interface between LIS and equipment.Methods: Our hospital has invested a lot of money to upgrade previous One-way communication interface based on ASTM, the new instrument specifications conform to HL7 standard, and develop bidirectional transmission program based on HL7.Results: After the implementation of the bidirectional communication, testing equipment can automatically identify bar code to get the test request information, after the completion of the test instrument, the inspection unit can automatically send sample results to LIS.Conclusion: Bidirectional transmission improves the work efficiency, transmission based on HL7 is not only fast, but also conducive to the sharing of data between heterogeneous medical information systems, and it is a general tendency.

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.

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.