[Objective]To investigated the clinical result of transpedicle fixation combined with injectable calcium sulfate vertebroplasty in patients with thoracolumbar fractures.[Method]From April 2005 to June 2007,43 patients with thoracolumbar fractures were treated with vertebroplasty reinforced by calcium sulfate injection and short-segment pedicle screw fixation.The symptom improvement was observed.Plain X-rays were taken at pre-operation and post-operation and final follow-up to determine the improvement of the injured vertebral height and Cobb′s angle.[Result]All the patients underwent surgery uneventfully.Thirty-eight patients were followed up for an average of 22 months.After operation Frankel Grading System improved to Grade E.The loss rates of anterior,mid and posterior height were 51.4%,41.5%,3.5% before operation but 11.7%,14.3%,1.7% after operation.The Cobb′s angles were improved from 16.3?preoperatively to 0.8?postoperatively.The loss rates of vertebral height between pre-operation and post-operation were significantly different(P0.05).There was no breakage of pedicle screw or loosening of instrument.Pain score by visual analog scale(VAS) reduced from 8.5 to 1.0.[Conclusion]The surgery of transpedicle fixation combined with injectable calcium sulfate vertebroplasty is a mini-invasive and effective method for the treatment of patients with thoracolumbar fracture.It can achieve and maintain kyphosis correction,decrease the instrument failure rate,and provide better postoperative outcomes.

0.05).Conclusion The V allele in exon24 of A2M might be one of the susceptible factors in PD in Shanghai Hans.

ObjectiveTo analyze the perioperative risk factors of right heart failure (RHF) in human heart transplantation, and to summarize the efficacy of targeted agent especially on pulmonary hypertension.Methods Patients underwent heart transplantation were selected by exclusion criteria : (1) acute heart or other organ failure, or supported by mechanical assist device ; (2) the difference between the body weight of donor and recipient was ＞ 20％ ; (3) the ischemic time of donor was＞ 6 h; (4) acute rejection episode after transplantation; (5) perioperative death.The clinical data of 96 patients were collected, including gender, age, body weight, protopathy, history of heart failure, preoperative systolic pulmonary arterial pressure (SPAP), left ventricle end diastolic diameter (LVEDD), preoperative ejection fraction(LVEF), preoperative blood creatinine, donor ischemic time and preoperative application of 5-PDEs.The diagnosis standard of RHF was established.The risk factors were analyzed through Logistic Regression.Patients were divided into two groups according to the systolic pulmonary arterial pressure (SPAP).In group A, SPAP was ＜40 mm Hg, and in group B with SPAP≥40 mm Hg.The correlation between two groups was tested byχ2 test.ResultsIn the multivariable analysis, age, history of valve disease, length of heart failure,and preoperative SPAP were the risk factors of RHF with the coefficient of 1.051, 1.351, 1.712 and 6.725, respectively.SPAP seems to be the most important risk factor.Coronary artery disease and preoperative application of 5-PDEs-I were the favorable factors with the coefficient of 0.056 and 0.034, respectively.Parameters regarding age, history of valve disease, length of heart failure between the two groups were significantly different.There were no significant differences in gender, body weight, diagnosed as dilated cardiomyopathy or coronary artery disease and other etiologies, preoperative LVEDD, preoperative EF, preoperative blood creatinine, isehemic time and RHF, though the incidence of RHF in group B was higher than in group A (67.6％ vs 45.8％).There was also no statistic difference in using of ECMO and the mortality rate between two groups.ConclusionPreoperative PAP was the main risk factor of the RHF after heart transplantation.Although there was no statistic difference, the incidence of RHF in patients with SPAP≥40 mm Hg was higher than in patients with SPAP ＜40 mm Hg .The application of targeted agent therapy and ECMO may be helpful in treating RHF after heart transplantation.

Identifying the similarity and differences of malpractice,medical negligence and medical error has realistic meaning to deal with medical disputes efficiently.They are all subjective negligence and belong to the category of medical behavior.This paper mainly discussed the criteria and civil liability of their differences.

The management of national defence science and technology reports was described from their compila-tion, submission, review, communication and use, taking The Scientific Research and Training Center of China Astronauts as an example. The problems in the management of national defence science and technology reports were pointed out, with measures and suggestions put forward for strengthening their management.

ObjectiveTo observe the curative effect of Xiangshaliujunzi decoction on critically ill patients with gastrointestinal dysfunction accompanied by spleen deficiency syndrome of traditional Chinese medicine (TCM) and its influence on tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6).Methods Forty-eight critically ill patients admitted to Department of Emergency Intensive Care Unit (EICU) in Zhejiang Provincal Hospital of Traditional Chinese Medicine Xiasha Campus from February to December 2015 were enrolled, and they were randomly divided into observation group (26 cases) and control group (22 cases) by random number table method. The patients in both groups were given routine emergency western therapy, and in the observation group, additionally, Xiangshaliujunzi decoction (ingredients: codonopsis pilosula 20 g, atractylodes macrocephala koidz 12 g, poria cocos 12 g, radix glycyrrhizae preparata 4 g, rhizoma pinelliae preparatum 6 g, pericarpium citri reticulatae 5 g, fructus amomi villosi 5 g, radix aucklandiae 4 g, rhizoma zingiberis recens 3 pieces) 80 mL was prepared and divided into two parts for nasal feeding, once 40 mL, twice a day, while the patients in the control group received the nasal feeding with the same amount of warm boiled water. Before treatment and 3 days and 5 days after treatment, the gastrointestinal function scores were assessed, and the changes of the levels of plasma TNF-α, IL-6 were recorded.Results There were no statistical significant differences in gastrointestinal function scores, the levels of TNF-α and IL-6 between the two groups before treatment and 3 days after treatment (allP ﹥ 0.05). But 5 days after the treatment, the gastrointestinal function scores, the levels of TNF-α and IL-6 were obviously decreased in two groups, and the degree of decrease in observation group was more significant [gastrointestinal function score: 0.92±0.85 vs. 2.27±0.77, TNF-α (ng/L): 17.7±2.4 vs. 25.0±4.2, IL-6 (ng/L): 16.9±2.4 vs. 25.0±3.4, allP < 0.01].Conclusion Xiangshaliujunzi decoction has therapeutic effect on critically ill patients with gastrointestinal dysfunction and accompanied by spleen deficiency in TCM, the mechanism may be related to decreasing the levels of TNF-α and IL-6, thereby depressing the inflammation.

OBJECTIVE:To study the stability of baicalin magnesium salt. METHODS:The stability of baicalin magnesium salt at high temperature(60 ℃),high humidity(90%),strong illumination(4000 lx),different temperatures(20,37,50,60 ℃) and pHs(6.80,5.70,4.60,4.30,3.90,3.60,3.20) was investigated,and HPLC was used to detect the drug contents. RESULTS:High humidity test indicated that the quality of baicalin magnesium salt was increased by (6.17 ± 0.12)% in the 5th day and in-creased by(6.92±0.05)% in the 10th day. Drug contents in the 10th day were respectively(94.78±0.12)%,(94.79±0.20)%, (94.66±0.15)% in the high temperature,high humidity,strong illumination tests(n=3). In phosphate buffer solution(pH 6.80), baicalin magnesium salt was stable only when the temperature was below 20 ℃;and it was yet stable in pure water(pH 6.76)at 37 ℃. pH stability test showed that the most stable pH was 4.30. CONCLUSIONS:Baicalin magnesium salt has hygroscopicity to some extent. Strong illumination affects the stability more seriously than high temperature and high humidity. The stability of ba-icalin magnesium salt in pure water is superior to in phosphate buffer solution,and the salt is stable in weak acid solution.

Objective To study the differences in the inclination of lower incisors among the female patients with beautiful profiles in different vertical skeletal types so as to provide the clinical treatment design for a certain guiding. Methods 137 cephalometric films of female patients with beautiful profiles were selected and divided into three groups based on the vertical facial types(∠SNMP):small degree(n = 31),average degree(n = 89) and larger degree groups(n=17). The angles of∠L1/MP and∠L1/A-Pog were measured and treated with covari-ance analysis for detecting the differences between the groups. Results The index of L1-MP(°)was the smallest in the larger degree group,the largest in the small degree group and average in the average group,with significant differences between the three groups(F = 17.38,P < 0.001). There was no significant differences in ∠L1/A-Pog (°)(F=2.61,P>0.05). Conclusion Lower incisors have compensatory inclined lingually in the group of higher mandible angle,but labially in the group of lower mandible angle.

Objective To investigate the effect of the application of tranexamic acid in unilateral total knee arthroplasty (TKA)with different methods .Methods Totally 120 cases of primary unilateral TKA patients admitted from June 2013 to May 2012 were studied ,including 33 males and 97 females ,with the average age of (65 ± 9) years (31 to 81 years) .Patients were divided into intravenous tranexamic acid group (group V ) ,topical tranexamic acid group (group T ) and irrigation using tranexamic acid group (group I) ,and control group (group C) .There were 30 cases in each group .Four groups of patients had no differences in age ,gender ,body mass index and disease diagnosis ,operative time ,preoperative hemoglobin ,preoperative hematocrit differences sta‐tistically(P>0 .05) .Postoperative blood loss and blood transfusion were observed .Groups were compared using one‐way ANOVA analysis .Results The total blood loss of group V was (368 ± 95)mL ,total blood loss of group T was (407 ± 118)mL ,both were less than the control group (509 ± 96)mL ,the difference was statistically significant (P<0 .05) .The differences between the blood loss of group I (491 ± 122) mL and the control group was not statistically significant (P=0 .924) .Group V showed the least a‐mount of hidden blood loss .Group T showed the least amount of visible blood loss .There were not deep vein thrombosis ,infections and other complications in any groups .Conclusion Intravenous and topical application of tranexamic acid can significantly reduce postoperative blood loss in TKA .Irrigation with tranexamic acid can not reduce the blood loss effectively .

Objective To understand and analyse the epidemic status of human intestinal nematode infection in Jiangsu Province, so as to provide basis for making control measures. Methods The typical thirty-nine spots in thirteen counties among the sampling spots of National Investigation on Distribution of Human Parasites in 1990 were selected and investigated according to the Methods of National Investigation Scheme on Human Principal Parasites in 2004. Results The total prevalence was 3.88%, which decreased by 46.92% compared with the investigation in 2002 (7.31%). The infection rates of hookworm, Ascaris and Trichuris were 1.14%, 1.06% and 1.73%, respectively, and the proportion of light infection was 91.75%. The rate of multiple infections was 9.40%. The proportion of hookworm infection was 78.06% in Southern Jiangsu and the proportion of Ascaris or Trichuris was 89.03% in Northern Jiangsu. The infection rate of Enterobius was 3.72% among children aged less than 12 years. Conclusions The prevalence of intestinal nematodes has decreased to lower level in Jiangsu Province. The difference of prevalence in different regions has a relationship with the disease control and social-economic, culture and health levels. The principal control work should be still put in the northern part of Jiangsu Province. The preschool children and the middle and old age peasants are high-risk population. The different control measures should be taken in accordance with the situation of different regions in the future.