BACKGROUND: The incidence rate of spondylolysis of lumbar vertebral arch in recruits is higher during the training, and it affects the normal training. OBJECTIVE: To analyze the correlation of the incidence rate of spondy lolysis of lumbar vertebral arch with training and the original lesions at waist in recruits. DESIGN: A randomized sampling survey. SETTING: Department of Orthopaedics, the 97 Hospital of Chinese PLA. PARTICIPANTS: Totally 100 male recruits aged 18.7 years averagely en rolled in 2003 were involved in the survey. METHODS: The 100 recruits were followed up for the whole course, the X-ray examination at lumbar vertebrae of right, lateral and two-slope positions were observed before training and after 100-day reinforced training. MAIN OUTCOME MEASURES: The incidence rates of spondylolysis of vertebral arch, and whether there was slippage and other aggravations in those with spondylolysis before were mainly observed. RESULTS: All the 100 recruits entered the analysis of results. ① The in cidence rate of spondylolysis of vertebral arch before and after training: Be fore training, 5 cases had spondylolysis of L5 vertebral arch, and the incidence rate was 5%. At the end of the 100-day training, 8 cases had spondylolysis of lumbar vertebral arch, and the incidence rate increased to 8%. ② The results of X-ray examination before and after training: The Xray examination showed that isthmus narrowing of left and L5 vertebral arch occurred in 2 cases and 1 case respect ively, and spondylolysis of bilateral L5 vertebral arches occurred in 5 cases, including 1 case of degree I slip page before training. At the end of the 100-day training, the degree I slip page and below occurred in 3 of the 5 cases with spondylolysis of bilateral L5 vertebral arches before, another 3 cases with original narrowing of lumbar vertebral arch all had breakage. CONCLUSION: The incidence rate of spondylolysis of vertebral arch is associated with the training intensity. It suggestes that the examination of spinal cord should be reinforced in enrolled recruits, and the items of Xray examination at lumbar vertebrae of right, lateral and two-slope positions should be added.

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) show good efficacy for the lung cancer patients with EGFR mutations.Chemotherapy drugs are the first choices for the lung cancer patients with EGFR wild-type.In basic research,EGFR-TKIs combination with chemotherapy drugs show good synergy.But in clinical research,the timing of EGFR-TKIs combination with chemotherapy drugs is related to the efficacy.

Anemia is commonly observed in lung cancer patients,and it is mainly caused by chemotherapy.Anemia can cause several debilitating symptoms such as fatigue and tachycardia which will not only influence the patients' quality of life and therapy effect,but also short the survival time.So anemia has been regarded as a poor independent prognostic indicator of the disease.Transfusion the erythrocytes and using the erythropoiesis stimulating agents is the main treatments of the disease.Using the erythropoiesis stimulating agents is the main treatment before the hemoglobin decreasing significantly in order to reduce the times of transfusion.Keeping the hemoglobin between 10.0-12.0 g/dl can improve the patients' quality of life and avoid the adverse events such as thrombus formation at the same time.

Objective Through observing the changes of serum creatinine (Scr),blood urea nitrogen (BUN),and Cystatin C (Cys C) to prove whether the treatment of patients of diabetic nephropathy (DN) in V period with Jiawei-qidan-tangshen decoction is really effective.Methods 60 patients of DN in V period were randomly divided into a treatment group and a control group by random number table method,with 30 patients in each group.Glycated hemoglobin (HbA1c),serum creatinine (Scr),blood urea nitrogen (BUN),and Cystatin C (Cys C) were detected before and after the treatment.Results 12 weeks after treatment,Scr,Cys C (19.19±37.06) μmol/L,(1.81 ±0.69)mg/L had significantly declined in the treatment group (P＜0.001),and had no significant change (147.25±62.70)μmol/L,(2.04± 1.20)mg/L in the control group (P＞0.05).Total effective rate of Scr and Cys C was 73.33％ and 83.33％ in the treatment group and 40％ and 53.33％ in the control group respectively,both showing significant difference (P＜0.05).Conclusion It is effective to treat patients of DN in V period with,Jiawei-qidan-tangshen decoction,and have no obvious side effects.

[Objective]To explore the method of rehabilitation for serious open injury below knee.[Method]A fotal of 153 cases with serious open injury below knee were treated.In which 106 cases were primary repair,47cases were second repair,treated with 7 kinds of internal fixation methods,11 kinds of flap.[Result]A fotal of 132 cases were followed up from 6 months to 5 years after operation,the average time was 17 months,the postoperative satisfaction rate was 85.7%,the flap survival rate was good 25 cases with local necrosis,4 cases with non-union,8 cases with chronic infection,3 cases with osteomyelitis.[Conclusion]The improvement of the flaps enlarge the application and reduce the complication of the flaps.The study offer a reasonable method to repair serious open injury below knee.The proficiency microsurgical scissors and reasonable application of various tissue flaps was the key to repair the injury successfully.

Having its long-term development in mind, our hospital has attached great importance to the cultivation of personnel with high academic degrees and marked effects have been achieved in this aspect. Major ways adopted include: ①improvement in an all-round way of the overall quality of personnel with high academic degrees, with emphasis put on the enhancement of their clinical skills through practice, enhancement of their research capabilities, and cultivation of a sense of independence and innovative abilities; ②instillation of three senses in personnel with high academic degrees, viz. sense of dedication, sense of orienting medical service towards the needs of patients, and sense of dynamic enterprise; ③optimization of the environment so as to encourage personnel with high academic degrees to display their abilities; ④dynamic supervision of personnel with high academic degrees through selecting the superior and eliminating the inferior.

The authors explained in the first place the challenges facing hospitals in the new century. These include: impact of the reform of the social security system on hospitals; impact of China's accession to the WTO on domestic hospitals; and impact of people's diversified needs on the construction of hospitals. Then the authors set forth some development strategies for hospitals in the new century. These include: ①establishment of new concepts; ②reinforcement of awareness in four aspects, viz. management awareness, competition awareness, service awareness, and innovation awareness; ③stress on the systematic nature of hospital construction, viz. market-and battlefield-oriented adjustment of the layout of disciplines, construction of the contingent of talents in accordance with the needs of the market, and enhancement of medical quality in light of new quality concepts; ④establishment of a flexible and highly efficient management mechanism, viz. setting up a speedy and highly efficient decision-making procedure and an individual-centered management mechanism, reforming the distribution mechanism in line with the rules of the market economy, and finding ways for the government to solve the problem of funds compensation for non-profit hospitals.

BACKGROUND: There exists insufficient study with specific applicability regarding vascular distribution characteristics of sural nerve nutrient vessels of the distally based flap.OBJECTIVE: To investigate the distribution of sural nerve nutrient vessels of the distally based flap and provide an anatomical evidence for the design of operation on repair of foot injury.DESIGN: A single sample study.SETTING: Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA, and Department of Orthopaedics, the 97 Hospital of Chinese PLA.PARTICIPANTS: Thirty-two samples of lower extremities whose blood vessels were perfused with red emulsion were provided by Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: The origin of the blood vessels of distally based flap and deep communicating branches of the lesser saphenous vein in the samples were dissected and observed.MAIN OUTCOME MEASURES: ①The nutrient vessels of sural nerve of distally basde flap.②The nutrient vessels of lesser saphenous vein of distally based flap.③The superficial and deep communicating branches of lesser saphenous vein of distally based flap.RESULTS: There were 2 to 5 nutrient vessels in the distally based flap:one originating from the perforating branch of the lateral calcaneal artery was (0. 6 ± 0.2) mm in diameter and one from the terminal perforating branch of the peroneal artery was(0.8±0. 2) mm in diameter and they were (1.0 ± 1.3) and(2. 8 ± 1.0) cm, respectively, away from the lateral malleolus. The incidence of intermuscular septum perforating branches (0 to 3) was 96. 7%, 66.7% and 20. 0%, respectively, and their diameter was (0.9 ±0. 3), (1.0 ±0. 2) and (0. 8 ±0. 4) mm and their distance to lateral malleolus was(5.3 ±2. 1), (6. 8 ±2.8) and (7.0 ±4.0) cm, respectively. There were 2 types of nutrient vessels of the lesser saphenous vein of distally based flap, the nutrient vessels of nerve-vein and the ones of vein-nerve. The superficial and deep communicating branches of the lesser saphenous vein were(1.7 ±0. 5) mm in diameter and(3.4 ±0. 9) cm away from the lateral malleolus. They ended at the peroneal veins.CONCLUSION: The perforating branches of heel lateral artery, the terminal perforating branches and intermuscular septum perforating branches of the peroneal artery have sub-branches to deep fascia, skin, nerves and parenteral nutrient vessels. These sub-branches communicate and form vascular chain of lesser saphenous vein to sural nerve and vascular network of superficial and deep fascia. The superficial and deep communicating branches end at the peroneal veins.

Objective To explore clinical value of the single-hale video-assisted thoracoscope surgery in lung surgery.Methods In our hospital from January 2015 to June 2015, a total of 60 patients was performed with lung partial resection line thoracoscope surgery, 28 routine puckering traditional video-assisted thoracoscope treatment, in the same period 32 underwent video-assisted thoracoscope surgery.Intraoperative blood loss, operating time, postoperative pain degree, and postoperative chest such as flow rate were compared between two groups.Results Two groups of patients had no perioperative death and severe complications.Intraoperative blood loss and operating time were no significant significance between single-and double-hole operation groups.The degree of postoperative pain score was (0.8 ± 0.5) in puckering thoracoscope group, and (1.2 ± 0.6) in traditional thoracoscope group, with significant difference (P =0.009).Conclusions Single-hole thoracoscope surgery in the treatment of lung diseases is feasible and reliable compared to traditional thoracoscope surgery, and patients can effectively reduce postoperative pain, and improve the quality of life.

Objective To analyze the CT signs and the clinical relevant factors of degenerative osteoarthritis of athnto-odontoid joint.Methods The CT signs and the clinical information of 214 patients received CT scans of skull from June 2011 to April 2012 were analyzed retrospectively.Results One hundred and twenty patients were diagnosed with degenerative osteoarthritis of atlanto-odontoid joint,while 67 of them having subaxial degenerative osteoarthritis at the same time.Forty-three patients had a history of chronic cervical and occipital pain.95.83％ (115/120) patients showed osteophytes in CT scans,while 44.17％ (53/1 20) showed calcification around dens and 24.17％ (29/120) showed joint space obliteration.The incidence rate increased with age.Seventy-seven patients [64.17％(77/120)] appeared cervical and occipital pain.Conclusions Degenerative osteoarthritis of atlanto-odontoid joint shows hyperostosis,osteophytes at the edge of joint,joint space obliteration and calcification around dens in the CT scans.The incidence rate is increased with age and correlated with cervical and occipital pain.