OBJECTIVE:To observe the effects of preoperative application of tirofiban on related indexes of patients with acute myocardial infarction. METHODS:In retrospective analysis,128 patients with acute myocardial infarction selected from our hospital during Jan. 2015-Jun. 2016 were divided into observation group (76 cases) and control group (52 cases) according to whether or not the tirofiban was used before PCI. Control group was given Aspirin enteric-coated tablets 300 mg,po+ Clopidogrel sulfate tablets 600 mg,po,before PCI,and given Heparin sodium injection 100 U/kg ,iv,during PCI. Observation group was ad-ditionally given Tirofiban hydrochloride injection 0.2 μg/(kg·min),iv,before PCI,on the basis of control group. ST-segment depres-sion and chest pain remission of 2 groups were observed after PCI. CK-MB level before surgery,CK-MB peak value,the time of CK-MB reaching the peak value,duration after surgery as well as TIMI blood flow grading after surgery were also observed in 2 groups. The levels of von Willebrand factor(vWF),ET-1 and NO were observed before and after surgery;the occurrence of ADR was recorded. RESULTS:After PCI,ST-segment depression rate(89.74%)of observation group was significantly higher than that (67.31%)of control group,the chest pain remission rate(89.47%)was significantly higher than that of control group(75.00%), the patients with TIMI blood flow grading grade 2-3 in observation group was more than control group,with statistical significance (P<0.05). Before PCI,there was no statistical significance in the levels of CK-MB,vWF,ET-1 and NO between 2 groups(P>0.05). After PCI,CK-MB peak value,the time of CK-MB reaching the peak value,duration in observation group were significant-ly lower or shorter than control group;the levels of vWF and ET-1 significantly decreased,while NO levels increased;the improve-ment of vWF,ET-1 and NO in observation group was significantly better than control group,with statistical significance (P<0.05). The incidence of mild bleeding in observation group was significantly lower than control group,while the incidence of mod-erate bleeding was significantly higher than control group,with statistical significance (P<0.05). There was no statistical signifi-cance in the incidence of death between 2 groups(P>0.05). CONCLUSIONS:The application of tirofiban before PCI can relieve clinical symptom,improve cardiac function,protect vascular endothelial and restore coronary artery perfusion. The attention should be paid to the risk of bleeding.

Gestational diabetes refers to the first occurrence or discovery of different degrees of abnormal glucose tolerance during pregnancy, which is one of the most common complications during pregnancy. As the incidence rate increased year by year, the complications of mother and child increased significantly. In recent years, gestational diabetes mellitus has been paid more and more attention. Most of the current researches are about the diagnosis and treatment of gestational diabetes 24 weeks and later, and the theoretical basis for the screening method and treatment of early gestational diabetes is still lacking. With the further understanding of early gestational diabetes mellitus and its adverse maternal and infant pregnancy outcomes, it is imperative to actively carry out the research on the screening and treatment of early gestational diabetes mellitus.

Objective To establish a method for the determination of aluminium in drinking water by flow injection analysis instrument.Methods In a hexamine buffer solution(pH=6.0),phenanthroline solution and ascorbic acid as the anti-interference agent,aluminium could react with chromazurol S solution and form a compound,of which maximum absorption was at 550 nm.Results The linear range for this method was 5-200 ?g/L.The correlation coefficient was 0.999 3,the detection limit of this method was 2.0 ?g/L,the recovery rates were in the range of 92.2%-108% and RSD were in the range of 2.5%-8.2%.Conclusion The flow injection method is simple,rapid,accurate and is applicable to the determination of aluminium in drinking water.

60 cases(aged 18-40 years) underwent orthodontic treatment were divided into 2 groups.30 patients in group A were treated with invisible aligners,while 30 in group B with fixed orthodontic appliance.Periodontal indices (PI,GI,SBI,PD)were examined before treatment,6 weekes,6 months and 12 months after treatment.Before and 6 weeks after treatment the indices were not statistically different between groups,6 and 12 months after treatment the indices of group A were lower than those of group B (P ＜ 0.05).The invisalign appliance is more propitious to periodontal health than the fixed orthodontic appliance.

BACKGROUND: Scoliosis is a complex three-dimensional plane deformity, including lateral bending on the coronal plane, before physiological kyphosis reduction or increase in the sagittal plane, the rotational deformity of the spine in the axial plane. The method of ful decompression, maximum reconstruction of spinal balance in coronal and sagittal plane, long-segmental fixation and short-segmental fusion is the more ideal orthopedic method for degenerative scoliosis. OBJECTIVE: To analyze the characteristics of scoliosis fixation system. METHODS: The articles about scoliosis fixation system were retrieved from PubMed database, Chinese Journal Ful -text database from 1999 to 2015 by the first author using computer. “Scoliosis, Internal Fixation, Three-dimensional Correction” were taken as the search terms in English and Chinese. Total y 163 relevant articles were retrieved, and eventual y 34 articles met the inclusion criteria. RESULTS AND CONCLUSION: With the development of fixation materials, the spinal fixation system which was designed based on three-dimensional orthopedic concept of spine is a dynamical y developed system. The goal is to restore the balance of spine in three dimensions as comprehensive as possible. At present, the general spinal system within very broad application includes TSRH spinal fixation system, ISOLA spinal internal fixation system, Moss Miami spinal fixation system, CD Horizon spinal internal system and China Great Wal spinal fixation system. Spinal fixation system possesses three-dimensional orthopedic capability, and can correct the spinal deformity in coronal and sagittal plane, and biomechanics is reasonable, fixed and reliable. Bone grafting material is the key factor of preventing breakage of internal fixation, screw extraction and other complications. Compared with such bone grafting materials made of autologous bone, al ograft bone and xenograft bone, artificial bone can shorten the orthopedic time and reduce the risk of concurrent diseases because of bone grafting, which is the future trend of bone grafting material. Meanwhile, three-dimensional reconstruction has been used in clinical practice, and can develop programs for scoliosis orthopedic treatment, provide imaging reference to ensure the security of internal fixation and also has played a huge role in improving the comprehensive efficacy of spinal internal fixation system.

BACKGROUND:It is a very difficult task to transfer from the animal model of cervical spondylosis to clinical treatment. However, the pathology of cervical spondylosis is not very clear, and the main reason is the lack of an ideal animal model of the experiment.
OBJECTIVE:To review the commonly used modeling methods and evaluate the advantages and disadvantages of different modeling methods through consulting literatures.
METHODS:The key words were“cervical spondylosis, cervical spondylotic myelopathy, cervical spondylotic radiculopathy, vertebroarterial type of cervical spondylosis, animal model”. The first author retrieved Medline and CNKI for studies published from 1991 to 2015 concerning animal experiments or clinical studies on the construction of animal model of cervical spondylosis. Final y, 41 studies were included for reviewing.
RESULTS AND CONCLUSION:There are many methods for the modeling of cervical spondylosis at the present stage, including implantation method, screw insertion method, bal oon compression method, mechanical compression, injection method, spinal suture method and mechanical imbalance method. Each has its advantages and disadvantages. In the study of cervical spondylosis, we should choose the appropriate animal model according to the research purpose. Further research and the establishment of a comprehensive animal model are stil the goal of efforts.

BACKGROUND:With the development of atlantoaxial morphology, applied anatomy and biomechanics, pathogenesis, diagnosis and treatment of atlantoaxial instability have attracted more and more attention. However, the development of effective fixation for atlantoaxial instability is relatively late, so scholars al over the world have made numerous studies. OBJECTIVE:To compare biomechanical functions of different fixations through atlantoaxial posterior approach, and to assess its stability. METHODS:We retrieved recent studies on comparative biomechanical evaluation and its primary clinical application of different posterior approaches in repair of atlantoaxial instability, and conducted a retrospective analysis by measuring the three-dimensional range of movement in normal atlantoaxial complex and atlantoaxial instability models. This analysis evaluated the stability of different fixations under normal three-dimensional atlantoaxial movement, and provided a biomechanical basis for reasonable fixator selection.
RESULTS AND CONCLUSION:Atlantoaxial posterior fixation included Gal ie wire fixation, Brooks fixation, Apofix and Halifax vertebral plate hook fixation, screw fixation through joint and atlantoaxial pedicle nail/rod fixation. Gal ie technique contributes to the reduction of anterior semiluxation, but its mechanical stability is poor. Brooks technique has strong rotation and stretch forces. Apofix and Halifix vertebral plate hook device provides strong anti-rotation and anti-antelocation strength, and is more stable than Gal ie technique in mechanics. The biomechanics of screw fixation through joint was better than wire technique and Halifax. The screw fixation avoids occipitocervical fusion, and has a high requirement to instal ation. When an internal fixator was selected, immediate cervical vertebra stability should be provided to protect spinal cord functions. Upper neck functions should be maintained to reach reduction and maintenance of occipital bone, atlas and axis. A suitable fixation method should be selected for each patient.

Ventilator associated pneumonia (VAP) is a challenging complication of critical illness.Aerosolized antibiotic is an option for the management of VAP currently,as it is reported that it could increase levels of drug in alveolar without increasing systemic toxicity.The articles that focused on the aerosolized antibiotics in the treatment of VAP and its influence factors were reviewed,and it was found that to achieve maximum drug delivery efficiency and reduce the influence of nebulization method,some factors,such as ventilation modes,tidal volume,nebulizer type,should be adjusted and monitored during the treatment.

Objective To summarize the theoretic evidence of Shenmen (HT7) Point in the treatment of insomnia and its action mechanism, for guiding clinical application. Method The reasons and evidences for using acupuncture at Shenmen to treat insomnia were summarized from the following 3 aspects: records in the ancient literatures, clinical application, and modern medical studies. Result Acupuncture at Shenmen can produce a calming and sedative effect, and it should be one of the optimal choices for treating insomnia due to its significant efficacy; it calms the mind and improves sleep quality via activating the nervous center for regulating sleep and promoting the secretion of neurotransmitters such as 5-hydroxytryptamine (5-HT) in brain. Conclusion Acupuncture at Shenmen is an effective method is treating insomnia.

Early esophageal cancer is derived from mucosa and submucosa without lymph node metastasis. They are detected generally during endoscopy or physical examination without clinical symptoms. Main treatment of early esophageal cancer is endoscopic resection,and the 5-year survival rate is over 90% . Once symptoms occur,local lymph node metastasis is often present and the prognosis is poor with a markedly reduced 5-year survival rate. Thus it is vital to diagnose and treat esophageal cancer at an early stage. With the development of endoscopic techniques,especially the proficiency of endoscopic ultrasonography(EUS),the detection rate of early esophageal cancer has been increased greatly. EUS also plays an important role in the staging of early esophageal cancer. This article reviewed the application of EUS in diagnosis and treatment of early esophageal cancer.