To observe the relation between the course and therapeutic effect of electroacupuncture in treating prolapse of lumbar intervertebral discs, and the different effects improved by electroacupuncture between different clinical symptoms of lumbar intervertebral discs, according to the symptoms of lumbago, pain of leg or pains of both lower back and leg, the cases were divided into different therapeutic groups. Every group was treated for three courses of treatment. There was a significant difference between the therapeutic effect and the course of treatment (P＜0.01). There was a difference between the symptoms and the therapeutic effects (P＜0.05). Among the clinical symptoms of lumbar intervertebral disc improved by electroacupuncture,lumbago was most obvious, pain of leg was worst. The therapeutic effect of the second course of treatment was relatively marked.

Objective To investigate the development of rehabilitation medicine, the knowledge, ability and quality requirements of stu-dents in different professional positions, and the demand for rehabilitation industry personnel in Hunan, China, and to discuss the strategies for improving the quality of vocational education. Methods 87 directors of personnel management or rehabilitation department in all levels of hospitals and 100 rehabilitation therapists were included from May to Semptember 2014. The rehabilitation medical service, education background of employees, professional positions, and the demand for rehabilitation knowledge, ability, and industry personnel were sur-veyed. Results and Conclusion Rehabilitation medical service was not sufficiently carried out for insufficient number of employees, unbal-ance structure and other deficiencies. Rehabilitation personnel training schools and enterprises need to strengthen the depth of integration, and improve the professional quality and clinical ability.

Evoked potentials which can monitor spinal cord function in operation continuously and timely has been widely used in spinal orthopedics. However, intraoperative evoked potentials are affected by the technique in a variety of factors, how to improve the accuracy of intraoperative monitoring is still a problem to explore. In this paper, intraoperative nerve monitoring application and intraoperative potential reasons for the changes in the spine surgery orthopedic surgery were reviewed.

Objective: To evaluate the effect of core∶dentin thickness ratio on the flexure strength, fracture mode and origin of bilayered IPS Empress Ⅱceramic composite specimens. Methods: IPS EmpressⅡ core ceramic, dentin porcelain and bilayered composite specimens with core∶dentin thickness ratio of 2∶1 and 1∶1 were tested in three-point flexure strength. Mean strengths and standard deviations were determined. The optical microscopy was employed for identification of the fracture mode and origin. Results: The flexure strength of dentin porcelain was the smallest (62.7 MPa), and the strength of bilayered composite specimens was smaller than single-layered core ceramic(190.2 MPa). The core∶dentin ratio did not influence the strength of bilayered composite specimens. The frequency of occurrence of bilayered specimen delaminations was higher in the group of core∶dentin thickness ratio of 1∶1 than in the group of 2∶1. Conclusion: IPS Empress Ⅱcore ceramic was significantly stronger than veneering dentin porcelain. Core∶dentin thickness ratio could significantly influence the fracture mode and origin, and bilayered IPS Empress Ⅱceramic composite specimens showed little influence in the fracture strength.

Prostaglandin E1 ( PGE1) , derived from D-HLA and controlled by phospholipidase A2, is a kind of strong endogeneous vasodilator and platelet inhibitor. Its effects on vasculars and platelets are just inferior to prostacyclin only, which is the strongest physiological vasodilator and platelet inhibitor, and the common receptors exits.Now it is found that exogeneous PGE1 can central some kinds of paletet supra-activation in illnesses such as cardiovascular disease, renal disease and diabetes mellitus. So PGE1 may be benificial to those patients.

Objective To analyze the clinical characteristics,diagnosis,treatment and outcome of patients with cardiac amyloidosis (CA).Methods Clinical data from 18 patients diagnosed as CA by endomyocardial biopsy (EMB) from 1995 to 2005 were retrospectively analyzed.Results Among the 18 patients with CA,all patients had reduced diastolic dysfunction; 12 had mitral valve early diastolic blood flow peak velocity/late diastolic blood flow peak velocity (E/A) ＞ 2.0 and ventricular diastolic early filling deceleration time (DT) ＜ 150 ms; 12 had left ventricular ejection fraction (LVEF) ＜50％ ; and 13 had New York Heart Association (NYHA) classification Ⅲ or Ⅳ.The 1-year,3-year and 5-year survival rates of 18 patients with CA were 67％,44％ and 17％,respectively.Kaplan-Meier analysis showed,NYHA functional class ＞ Ⅱ,E/A ＞ 2.0 and DT ＜ 150 ms were associated with increased mortality (log-rank statistic P =0.026 and 0.001,respectively).CA patients with chemotherapy before heart failure were associated with decreased mortality and extend survival.Conclusions The mortality rate goes up and survival rate gradually descends as prolonged onset time.NYHA functional class ＞ Ⅱ and E/A ＞ 2.0 (DT ＜150 ms) are associated with mortality.

Objective To observe the clinical effect of cardiopulmonary resuscitation (CPR) in the treatment of cardiac arrest. Methods A retrospective analysis was coducted, 137 patients with cardiac arrest admitted to Department of Emergency of Fuyang People's Hospital from January 2017 to December 2018 were enrolled, emergency rescue with CPR machine. There were 116 cases of CPR in emergency room, including 44 cases of cardiac arrest before hospital and 72 cases of cardiac arrest in hospital. There were CPR was 21 cases of CPR in EICU. The difference of return of spontaneous circulation (ROSC) rate and rescue time between Emergency Room and Emergency Intensive Care Unit (EICU) and ROSC rate in patients with cardiac arrest before and after emergency rescue room were compared. Results There were 45 cases of ROSC in 137 patients, the success rate of rescue was 32.85%, rescue time was 30.00 (20.00-40.00) minutes, and the maximum duration of times was 180 minutes. The ROSC rate of EICU was significantly higher than that of emergency room [66.67% (14/21) vs. 26.72% (31/116), P < 0.05], and the rescue time was significantly shorter than that of emergency room [minutes: 25.00 (10.00-30.00) vs. 30.00 (25.00-40.00), P < 0.05]. The ROSC rate of patients with cardiac arrest in emergency room was significantly higher than that before hospitalization [33.33% (24/72) vs. 15.91% (7/44), P < 0.05], there was no significant difference in rescue time between patients with cardiac arrest in emergency room and that before hospitalization [minutes: 30.00 (20.00-40.00) vs. 30.00 (26.25-40.00), P > 0.05]. Conclusions The function of CPR provides high quality extrathoracic compression, which effectively saves the labor cost of cardiac compression, especially in the case of shortage of medical and nursing staff. In the face of patients who need continuous CPR for a long time, it is a feasible choice to use CPR machine instead of unarmed CPR, which is worth popularizing in clinic.

OBJECTIVE: To explore the three-dimensional ultrasound locatization in endoscopic thyroidectomy for multinodular goiter (MG). METHOD: Thirty two patients with MG underwent ET via bilateral areolar approach. Preoperative ultrasonography were used to locate lesions and marked in the 3-D map designed by us. Dur ing ET procedure, surgery skills were adopted to expose inferior pole of thyroid, glands in the area of Berry ligament or (and) upper pole were retained according to the preoperative location map. RESULT: According to the preoperative ultrasonic orientation, 3 lobectomy were performed in 15 cases of unilateral lesions, 12 subtotal thyroidectomy were performed in 17 cases of bilateral lesions, and 5 patients performed unilateral lobectomy add partial thyroidectomy. All patients had successful ET using bilateral areola approach. No conversions to open surgery, no complication occurred, and no nodules were found missing in the postoperative ultrasonography examinations. CONCLUSION Preoperative ultrasonic orientation and intraoperative operating skills are contributing to a successful ET for MG.
Adolescent ; Adult ; Aged ; Endoscopy ; methods ; Female ; Goiter, Nodular ; diagnostic imaging ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Thyroidectomy ; methods ; Ultrasonography ; Young Adult

Objective Ticagrelor-related dyspnea may affect the medication adherence of patients with coronary artery disease.This study aims to assess the impact of ticagrelor adherence on 1-year cardiovascular outcomes in pateints with stable coronary artery diseases (SCAD).Methods This study includes the patients with SCAD from Fuwai hospital who discharged with ticagrelor between Jan.2015 to Jun.2015.We collected data of clinical characteristics and ticagrelor adherence from these patients by reviewing the electronic medical records and personnel interview.Follow-up was performed at 6 and 12 months by telephone interview or office visits.Results A total of 155 patients with SCAD were enrolled,of whom 122 (78.7％) were males with a mean age (57.0 ± 10.0) years.Among them,50 (32.3％) patients have a history of myocardial infraction and 106 (68.4％) patients had angiographic confirmed left main and/or multivessel disease.Forty-six patients (29.7％) with SCAD prematurely stopped ticagrelor within 12 months,while 25 (16.1％) patients switched from ticagrelor to clopidogrel.Hemorrhagic events and locally unavailable ticagrelor were the major reasons causes of the premature discontinuation of ticagrelor.Univariate analysis showed age,body mass index (BMI),hypertention and locally unavailable ticagrelor as relative factors for early ticagrelor discontinuation after discharge.Multivariate analysis revealed unavailable drug locally (OR 0.25,95％ CI 0.09-0.69) and elderly patients (OR 4.13,95％ CI 1.40-12.19) were risk factors for low persientence or premature ticagrelor discontinuation.Conclusion This study showed poor ticagrelor adherence in patients with SCAD after discharge.Locally unavailable ticagrelor and elderly patients were strong predictors of poor ticagrelor adherence.Discontinuation to ticagrelor prematurely may not have impact on adverse cardiovascular outcomes.

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures. Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳintra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group, 38 cases) or polyaxial locking plates (B group, 34 cases) between January 2012 and December 2016. Operation time, intraoperative bleeding, union time, radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups. Results There were no significant differences between the two groups in operation time, intraoperative bleeding, or union time (P>0.05). The patients in A group were followed up for (23.2 ± 5.4) months, and those in B group were followed up for (22.5 ± 4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6 ± 4.5)° vs. (27.6 ± 6.1)°, (30.7 ± 4.2)° vs.(27.0 ± 5.4)°] and Gissane angles [(109.2 ± 10.8)° vs. (96.8 ± 9.5)°, (107.3 ± 10.1)° vs. (95.4 ± 10.2)°] at 3 and 12 months after operation , compared with A group (P<0.05). Evaluated by the Maryland foot score, the excellent and good rate for the B group was 91.2％(31/34) , which was insignificantly higher than that for the A group (84.2％, 32/38) (P > 0.05). Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures, but polyaxial locking plates may be superior in stability and functional recovery.