Objective To investigate the ureteral injury in gynecological laparoscopies and discuss its diagnosis,treatment and prevention.Methods Six cases of ureteral injury were reviewed.The clinical features including the type of diseases,uterine size,pelvic adhesion and the methods of diagnosis,treatment were studied.Results Ureteral injuries happened during laparoscopically assisted vaginal hysterectomy(LAVH). The gynecological disorders included pelvic adhesions,endometriosis and leiomyoma in cervical.Patients presented flank pain,fever,increased volumes discharge.Conclusion Ureteral injury is an uncommon and sever complication in gynecological laparoscopies.Fever,flank pain and abnormal vaginal discharge should be paid attention to be ureteral injury.

OBJECTIVETo observe the effects of electroacupuncture at Neiguan (PC 6) and Jianshi (PC 5) com- bined with granisetron on nausea and vomiting as well as serum levels of 5-hydroxy tryptamine (5-HT) and dopamine (DA) in chemotherapy patients.

METHODSSeventy-two chemotherapy patients who met the inclusive criteria were randomly divided into an observation group (38 cases) and a control group (34 cases). The patients in the observation group were treated with electroacupuncture at Neiguan (PC 6) and Jianshi (PC 5) combined with granisetron injection; the patients in the control group were treated with electroacupuncture at sham-point 1 and sham- point 2, and the rest treatment was identical to the observation group. After 3-day treatment, the clinical indices including times of vomiting and severity of nausea, etc. were observed in the two groups.

RESULTS(1) At the acute stage within 24 h, the times of vomiting in the two groups were not significantly different (P>0.05); at the delay stage, the severity of nausea was significantly higher in the control group (P<0.05). (2) As for the comprehensive efficacy and rate of complete control, there was no obvious difference between the two groups at the acute stage (P>0.05); while in the delay stage, the rate of complete control in the observation group was superior to that in the control group (P<0.01). (3) Compared before and after the treatment, serum levels of 5-HT and DA were evidently reduced in the observation group (both P<0.05), while those in the control group were not significantly changed after treatment (both P>0.05).

CONCLUSIONElectroacupuncture at Neiguan (PC 6) and Jianshi (PC 5) combined with granisetron could obviously relieve the nausea in chemotherapy patients at the delay stage. The effect mechanism is possibly related to reducing the content of 5-HIT nndl nA

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Nausea ; etiology ; therapy ; Neoplasms ; drug therapy ; Vomiting ; etiology ; therapy ; Young Adult

Objective To explore the changes of asphyxial neonatal gastric juice pH values,and to provide data for making early intervention measures.Methods Eighty asphyxial neonates were divided into routine group(55 cases)and intervention group(25 cases).Twenty neonates who weren't asphyxial were set as a control group.Those neonates' gastric juice pH values were monitored dynamically.The newborns in intervention group were treated by giving smecta and cimetidine intravenously on the routine treatment.The impairment occurrence conditions of these newborns' gastrointestinal functions were observed.Results The gastric juice pH values of asphyxial neonates were obviously lower than those of the control group at their birth(Pa0.05).The occurrence rate of gastrointestinal functions impairment was lowered(?2=16.0 P

Anti-Bacterial Agents ; pharmacokinetics ; pharmacology ; Cell Membrane ; drug effects ; Microbial Sensitivity Tests

Objective To examine the distribution of flurbiprofen axetil in cerebral-spinal fluid (CSF) by determining the CSF concentration of flurbiprofen after iv administration. Methods Seventy-two ASA Ⅰ or Ⅱ patients of both sexes aged 18-75 yr weighing 54-82 kg undergoing spinal or combined spinal-epidural anesthesia for lower extremity or lower abdominal surgery were studied. Flurbiprofen axetil 1 mg/kg was injected intravenously.CSF 2 ml and venous blood 3 ml were obtained simultaneously every 5 min after iv injection for 45 min (T1-9 ) for determination of flurbiprofen concentration using high performance liquid chromatography, and the CSF/blood flurbiprofen concentration ratio was caculated. Results Flurbiprofen was not detected in CSF at T1,2 after iv injection in 3 and 4 patients. The CSF flurbiprofen concentration was significantly higher at T4-9, and CSF/blood flubiprofen concentration ratio higher at T5-9 than at T3 ( P ＜ 0.05). There was no significant difference in CSF flurbiprofen concentrations among T4-9 ( P ＞ 0.05 ) Conclusion Flurbiprofen is detected in CSF after iv injection, the CSF flurbiprofen concentration peaks at 20 min after iv injection and it lasts until 45 min after iv injection.

[Objective]To compare the neurological improvement of the patients with spinal cord injury without radiographic abnormality (SCIWORA)after primary treatment including operation via anterior/posterior approach and conservative management,and to discuss about evaluating standard for this kind of patients.[Method]Eighty adult cervical SCIWORA patients,72 males and 8 females with an average age of 52.7 years(34 to 74 years)and a follow up period of 53 weeks (48 to 60 weeks),were retrospectively studied. They were divided into the anterior operated,posterior operated and conservative treated groups. The motor and sensory scores and impairment scale of each patient were obtained at least three times by international standard for the neurological classification of spinal cord injury (ASIA standard),and those of their first and final visits to the hospital were retrieved and analyzed. Mann-Whitney U Test and Wilcoxon Rank Sum Test were used in statistic study.[Result]All the patients achieved an average increase of 2 to 5 points of motor scores (P

Objective To investigate the medial-lateral tilting of patella in two different coordinate systems before and after total knee arthroplasty (TKA). Methods Six fresh-frozen left low limbs from cadaver were tested using a modified Oxford Rig. Anatomically based multiple loading of the quadriceps mechanism was applied(Vastus medialis 24.5 N, Vastus intermedius/rectus femoris 29.4 N, Vastus lateralis 19.6 N). In a three dimensional coordinate system, patellar tilting was tracked using a custom-made Laser tracking device. The femoral trochlea was used as the other coodinate system in skyline view of patellar-femoral joint. Total knee arthroplasty was performed using PFC? posterior cruciate ligament substituting knee system. The tilting angles of patellar were measured before and after TKA. Results In three dimensional coordinate system, when knee flexed 30?,60?,90?,120?,150?, the patella titled :-3.10??2.25?,2.50??1.07?,5.46??2.60?,6.32??2.16?,-2.10??1.90? respectively before total knee arthroplasty was undertaken. After total knee arthroplasty, the patella tilted 3.24??0.35?,2.30??1.39?,1.65??1.17?,1.29??1.03?,-0.86??1.42? respectively. When femoral trochlea was taken as coordinate, the patella tilted 0??0?,0??0?,0??0?,0.24??0.35?,-3.21??1.80?; 0??0?,0??0?,0??0?,0??0?,-1.12??1.20? respectively both before and after TKA (Lateral patella tilting was defined as positive and medial patella tilting, negative). Conclusion Even the relationship between patella and femoral trochlea remains normal, the mode and magnitude of patellar tilting changes significantly after TKA. In early flexion of knee joint, patella tilts medially before TKA while it tilts laterally after TKA. After TKA, patella tilts less laterally than it does before TKA when a knee flexes from 60 to 120 degrees.

10 points or if the progressing osteoarthritis was proved by the T nnis grade.And the remaining patients would join in the satisfied group.The differences of preoperative clinical and radiographic factors between unsatisfied group and satisfied group were identified.[Result]Ten hips in the unsatisfied group had significantly more WOMAC pain score(t=3.969,P

[Objective]To analyze the clinical characteristics and treatment methods of upper-middle thoracic fractures with spinal cord injury.[Method]Forty patients with upper-middle thoracic fracture were retrospectively reviewed.Hanley-Eskay classification was used:compression fractures in 4,burst fractures in 11,fracture-dislocations in 23,and burst dislocation in 2 cases.Neurologicall function(according to the ASIA classification):A in 29,B in 3,C in 4,D in 0,and E for 4 cases.Four cases without spinal cord injury received conservative treatment.Thity-six cases with spinal cord injury underwent laminectomy and reduction followed by posterior fusion with bone graft and pedicular screw instrumentation.All 36 cases received early rehabilitation.[Result]All 40 cases were evaluated clinically,radiographically,and functionally during the follow-up(mean,32 months).Conservative group:one case developed delayed kyphosis deformity with neurological deficit and underwent anterior-posterior surgical treatment 16 months tater.Surgical group:the correction in 3 patients was not complete on radiographs after operation.No loose screw or breakage was found,and the grafted bone was completely fused.Among the patients with spinal cord injury,one case in ASIA A improved to ASIA B,one case in ASIA B improved to ASIA C,two cases in ASIA C improved to ASIA D.All of the 4 cases with hemorrhage less than 4 mm(MIRI) increased 1 grade of ASIA.Activities of daily living(ADL)scores were increased (average,22.53?6.25)at early rehabilitation in all cases.[Conclusion]The upper-middle thoracic fractures are involved in multipla spine vertebral levels,high dislocation incidence,serious spinal cord injury(most cases were complete injury),poor prognosis.Presence of hemorrhage less than 4 mm (MRI) was associated with good prognosis.Posterior approach decompression and reduction followed by fusion with bone grafting and pedicle screws instrumentation are ideal surgical methods for patients with fresh fractures.Early rehabilitation may improve daily life ability and prevent complications.

Objective To assess the value of myelography and CTM for the diagnosis of lumbar disc herniation.Methods 200 patients diagnosed as lumbar disc heriniation based on clinical findings were reported.They were all examined with myelography and CTM prior to operation.Results Based on the operative findings the accuracy was 86% in myelography and 98.5% in CTM.Conclusion CTM is more accurate than myelography in the diagnosis of lumbar disk heriniation.