Cervical anterior decompression and fusion is currently used in the treatment of cervical spondylosis.This paper reviews the surgical complications and its prevention measures,so as to provide some references to reduce the complications and improve operative efficacy.

Objective To study the effect of trachea intubation and mechanical ventilation on the prognosis and discharge rate of patients with successful cardiac-pulmonary resuscitation.Method The clinical data of 389 patients,who were admitted from January 2005 to February 2007,were retrospectively analyzed.The relation between trachea intubation time and discharge rate was studied.According to the time from cardiac arrest to finishing trachea intubation,patients were divided into group A (within 3 minutes,n=209) and group B (over 3 minutes,n=143);according to the time from reaching emergency medicine department to finishing trachea intubation,the rest patients were divided into group C (within 5 minutes,n=9) and group D (over 5 minutes, n=38) minutes.The discharge rate was calculated between groups.The software of SPSS 11.0 was used for statistical analysis.Results The successful rate was 9.75% (389/3988),and 59 patients were discharged, with discharge rate 1.48% (59/3988).The discharge rate of group A was 19.62% (41/209),and was significantly higher than that of group B 6.99 % (10/143) (P

Objective To investigate treatment and prognosis of patients with osteosarcoma of the extremities.Methods A total of 311 patients with osteosarcoma of the extremities,who had undergone treatment in our institute from 1998 to 2008,were enrolled in this retrospective study.Kaplan-Meier survival curve and Cox regression model were used to analyze the correlation between survival rate and variables including patients' demographics,chemotherapy,surgery,complications,and tumor metastasis.Results Among 311 patients,there were 206 males and 105 females,aged from 5 to 56 years (average,18.6 years).A total of 282 patients underwent aggressive or radical surgery,including 149 cases of limb salvage surgery and 133 cases of amputation surgery.One hundred and five patients underwent standard chemotherapy and 206 patients underwent non-standard chemotherapy.The 5-year survival rate was 57.4％ in patients treated with standard chemotherapy,36.3％ in patients treated with non-standard chemotherapy,16.8％ in patients with lung metastasis,50.7％ in patients without lung metastasis,56.6％ in patients who underwent limb salvage surgery,31.8％ in patients who underwent amputation surgery,44.6％ in patients with Enneking stage Ⅱ B and 33.1％ in patients with Enneking stage Ⅲ.For patients treated by amputation surgery,because non-standard chemotherapy which was performed in most of them and other confounding factors,the 5-year survival rate of them was lower.The Cox regression analysis showed that lung metastasis and non-standard chemotherapy were associated with inferior outcomes.Conclusion Neoadjuvant chemotherapy combined with aggressive or radical surgery could cure about 60％ of patients with osteosarcoma of the extremities.Lung metastasis and non-standard chemotherapy are risk factors that severely affect prognosis.

Objective To explore the clinical outcome of using modified great toe wrap-around flap to reconstruct degloved thumb and fingers.Methods Eighteen patients were involved.Based on different types of injury,four procedures were carried on for reconstructing degloved thumb and fingers:①Unilateral modified great toe wrap-around flap to reconstruct 9 degloved thumbs of distal proximal level and 3 degloved fingers of proximal interphalangeal joint level.②Unilateral modified great toe wrap-around flap with second toe medial flap to reconstruct 2 total degloved fingers.③Bilateral modified great toe wrap-around flap to reconstruct 2 thumbs.④Bilateral modified great toe wrap-around flap and second toe medial flap with neurolized super thin anterolateral thigh flap to reconstruct 12 degloved fingers.This wrap-around flap carried with entire nail.A triangle flap was reserved at medial plantar of great toe.Results All free flaps were survived in one stage.Fifteen patients were followed up for 8 to 25 months.The contour of reconstructed digit was as same as contralateral digit with satisfactory motion arc and sensation.There was no extensive scar in donor toe.The width of medial plantar triangle flap increased significantly.All patients could walking,running,jumping without restricted.Conclusions With reconstructed by modified great toe wrap-around flap,degloved thumb or finger can be promised with excellent contour and function outcome.In the meantime,the loss of donor foot can be expected to minimal.This procedure is one of the best ways for reconstructing degloved thumb and finger.

Objective To investigate the clinical characteristics of acute inhalational metallic nickel poisoning and its treatment effect.Methods Data including epidemiology,clinical features,laboratory tests,imaging examinations,therapy protocol as well as prognosis were collected and analyzed.Results Thoracic CT scan of all patients demonstrated as bilateral diffuse infiltration.Nickel concentration in both blood and urine were high in all patients and the concentration was positively associated with poisoning severity.All 4 patients received glucocorticoid treatment,2 of whom with acute respiratory distress syndrome were admitted to ICU to initiate mechanical ventilation and were given sodium dimercaptopropanesulfonate.All patients survived to hospital discharge.Conclusions Acute inhalational metallic nickel poisoning is uncommon and early symptoms are inconclusive.The blood and urine nickel concentration is helpful to judge the severity of the disease.Pulmonary diffuse infiltration is the main clinical feature.Glucocorticoid,chelation therapy as well as symptomatic treatment are effective therapies to relief disease severity.

italic>Bupleurum L. (Apiaceae) is an economically important genus, in which many species are of medicinal value. In this study, the complete plastid genomes (plastomes) of B. chinense DC. and B. boissieuanum H. Wolff were sequenced and their characteristics were investigated. Comparative and phylogenetic analyses were conducted with other published Bupleurum plastomes. The complete plastomes of B. chinense and B. boissieuanum were 155 458 and 155 800 bp in length, and both exhibited the typical quadripartite circular structure consisting of a large single copy region (LSC, 85 343 and 85 804 bp), a small single copy region (SSC, 17 495 and 17 410 bp), and a pair of inverted repeat regions (IRa/b, 26 310 and 26 293 bp), respectively. A total of 129 genes, including 84 protein-coding genes, 37 transfer RNA (tRNA) genes, and eight ribosomal RNA (rRNA) genes were identified from each of the two plastomes. Repeat sequences detected were similar in types and distribution patterns, but the numbers were slightly different. Comparative analyses revealed that the Bupleurum plastomes were highly conserved in length, structure, the guanine and cytosine (GC) content, and gene content and order, both intraspecifically and interspecifically, and no obvious expansion or contraction of the inverted repeat regions occurred. Sequence variation was lower within the same species than among different species, noncoding sequences (including intergenic regions and introns) showed a higher divergence than the protein-coding sequences, and sequences in the LSC and SSC regions were more divergent than those in the IR regions. In addition, 11 sequences with higher nucleotide diversity among species were detected in the LSC and SSC regions. All studied Bupleurum species were inferred forming a monophyletic group with a 100% bootstrap value. Bupleurum chinense and B. boissieuanum were phylogenetically closest to B. commelynoideum and B. falcatum, separately, with all three B. chinense accessions clustered into a distinct clade. These results provide genetic information for further species identification, phylogenetic resolution, and will assist in exploration and utilization of medicinal Bupleurum species.

OBJECTIVETo introduce exponent curve model methods in the study of the hepatitis B vaccine antibody level.

METHODSAfter the China made vaccine of hepatitis B DNA recombinant yeast derived vaccine (YDV) had been carried out for 5 years, data on the anti-HBsAg's titer were used to construct an exponent curve model. When the vaccination program had been carried out for 8 years, the predicating results of the model were further tested by observed number.

RESULTSThe exponent curve model was Y = 165.67 exp (-0.019X) and the R(2) was 0.98. After 8 years, the practical observed number became 35 mIU/ml, and the predicating result of the model was 27 mIU/ml, 8 mIU/ml lower than the observed number. When the vaccine had been carried out for 12 years, the predicating results of the model became 10.74 mIU/ml, still higher than 10 mIU/ml but was still in the effective range.

CONCLUSIONAn exponent curve model could be constructed, as long as the data of the antibody's titer was in accordance with the tendency of exponent curve. The model could be used to predict the persistence lever of vaccine antibody under certain conditions. The results showed that after 8 years, the predicting results of the model were reliably lower than the observed number.

Follow-Up Studies ; Hepatitis B ; immunology ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Models, Biological ; Saccharomyces cerevisiae ; genetics ; Vaccination ; Vaccines, DNA ; immunology ; Vaccines, Synthetic ; immunology

BACKGROUNDNominal atrioventricular (AV) interval in dual chamber pacemaker (DDD) is not the best AV delay in the majority of patients with atrioventricular block. To find a simple method for optimizing AV delay adjustment, we assessed surface electrocardiography (ECG) for optimizing AV delay during dual chamber pacing.

METHODSDDD pacemakers were implanted in 46 patients with complete, or almost complete, AV block. Optimal AV delay was achieved by programming an additional delay of 100 ms, to the width of intrinsic P wave or to the interval between pacing spike to the end of P wave on surface ECG. Left ventricular (LV) end diastolic and end systolic volumes, ejection fraction and diastolic parameters were measured by Doppler echocardiography during both nominal and optimal AV delay pacing.

RESULTSCompared to nominal AV delay setting, LV end diastolic volume increased [to (53.2 +/- 11.3) ml from (50.2 +/- 10.2) ml, P < 0.05], end systolic volume decreased [to (26.1 +/- 9.0) ml from (27.9 +/- 8.2) ml, P < 0.05] during adjusted AV delay pacing, resulting in an increase in LV ejection fraction [to (68.2 +/- 5.3)% from (64.5 +/- 4.3)%, P < 0.05]. LV diastolic filling and isovolumic relaxation time were not significantly changed.

CONCLUSIONOptimization of AV delay by surface ECG is a simple method to improve LV systolic function during dual chamber pacing.

Adult ; Aged ; Aged, 80 and over ; Atrioventricular Node ; physiopathology ; Cardiac Pacing, Artificial ; methods ; Electrocardiography ; methods ; Female ; Heart Block ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Time Factors

OBJECTIVETo identify the relationship between amino acid mutations in Neisseria gonorrhoeae isolates and their antibiotic resistance.

METHODSPI gene fragments of Neisseria gonorrhoeae from 17 clinical isolates were obtained with PCR amplification. They were cloned into the PCR cloning vector pBS-T to form pBS-T-PI and sequenced. The sequences of PI genes were analyzed. At the same time, minimum inhibitory concentration (MIC) of penicillin and tetracycline to these 17 isolates were measured and contrasted with the corresponding PI sequence.

RESULTSThe recombinants of PI gene from 17 clinical isolates of Neisseria gonorrhoeae were successfully constructed and sequenced. They were divided into PIA and PIB subtypes according to the results from blastn software by comparing the sequences with the GenBank. Mutations were found at the sites of 120 and 121. There were only some of the sequences having an aspartic acid (D) mutation on 120 and 121 sites, which was not the same as reported. On the other hand,there were two PI sequences,5-9 and 6-1, whose mutations on No. 120 were lysine, similar to those documented.

CONCLUSIONSome relationship between PI amino acids mutations at sites 120 and 121 in Neisseria gonorrhoeae isolates from Chengdu, China and their resistance to penicillin and tetracycline were found. However,further studies need to be done in the future to confirm this hypothesis.

Amino Acid Sequence ; Anti-Bacterial Agents ; pharmacology ; DNA Mutational Analysis ; DNA, Bacterial ; Drug Resistance, Bacterial ; Mutation ; Neisseria gonorrhoeae ; drug effects ; genetics ; isolation & purification ; Polymerase Chain Reaction

OBJECTIVETo develop the method and investigate the value of the application of multislice helical computed tomography (CT) in the maxillofacial distraction osteogenesis.

METHODSTwelve cases of maxillofacial distraction osteogenesis (3 in zygoma, 2 in maxilla, and 7 in mandible) were scanned by the multislice helical CT, then the reconstruction of three dimensional and fault image and the relative measurement were carried out to study the effect of distraction and osteogenesis.

RESULTSThe three dimensional image provided clear and high resolution stereoscopic view that the effect of distraction osteogenesis could be evaluated easily and exactly. The fault image could be set up in private computer by Mimics and the measurements, such as distance, thickness and density, could be performed as expected. The effect of 12 cases was satisfied, and the average distracted distance was 16.73 mm.

CONCLUSIONBasing on multislice helical CT scanning, the high resolution image reconstruction and relative measurement data could be obtained which could meet the need of clear and direct observation. Its application in the maxillofacial distraction osteogenesis is expecting and promising.

Humans ; Imaging, Three-Dimensional ; Mandible ; Maxilla ; Osteogenesis, Distraction ; Tomography, Spiral Computed ; Tomography, X-Ray Computed