BACKGROUND:There are many methods to treat thoracolumbar fractures However,it remains unclear whether a simple operation to treat a thoracolumbar burst fracture can decrease the trauma and obtain better effect to avoid the enlargement of operation.OBJECTIVE:To investigate the clinical outcome of posterior short-segmental transpedicular screw system internal fixation in treatment of single-level thoracolumbar burst fracture without nerologic deficit.METHODS:A total of 186 patients with single.level thoracolumbar burst fracture but without nerologic deficit treated in the First Affiliated Hospital of Soochow University between September 2003 and January 2008,including 152 males and 34 females,aged18 10 65 years.were treated by posterior pedicle screw The intraspinal bone fragments were treated with indirect decompression.All patients were checked with radiography and CT scan before/after operation as well as before implant removal.The correction of anterior vertebral body height and the ratio of bone fragment to cross section area of spinal canal were measured.RESULT AND CONCLUSION:Compared with normal.the anterior vertebral body height was 42%before operation,98%after operation,and 98%before implant removal The ratio of bone fragment to cross section area of spinal canal was 34%before operation,13%after operation.and 8%before implant removal.Internal posterior short-segmental transpedicular screw fixation treating single-level thoracolumbar burst fracture without nerologic deficit can obtain stability of spinal column,and it is beneficial to recovery of body height,physiologic postu ral contour and canal volumn .

OBJECTIVE To explore the characteristics of cochlear hair cell injuries in guinea pigs exposed to blast underpressure(BUP). METHODS The guinea pigs were killed 14 days after exposure to experimental BUP. Their basilar membranes were stained by silver nitrate and the hair cell injuries were quantitatively assessed using the light microscope. RESULTS The outer hair cells(OHCs) of the guinea pigs clearly appeared to be injured following exposure to the experimental BUP at a peak underpressure varying between -22.4kPa and -63.3kPa. The most obvious injury was in the second turn and OHC loss was smallest in the first row and more severe in the second and third rows. OHC loss was seen in all of three experimental groups of animals following exposure to BUP. Furthermore, the higher the peak of underpressure, the more obvious the injury of OHCs. Quantitative morphological analysis of cochlear hair cells showed that the total OHC loss rates in all the experimental groups of guinea pigs exposed to BUP were significantly higher than that of control group animals(P

Objective:To understand the status of sedation and analgesia treatment and management in pediatric intensive care unit(PICU) in Shandong Province, and to provide the basis for the improvement of sedation and analgesia treatment plan.Methods:This study was a multi-center retrospective study.The PICUs of 6 tertiary hospitals in Shandong Province participated in this study.The data of 1 340 children admitted to these 6 PICUs from January 2016 to December 2018 were collected.The age, gender, the pediatric risk of mortality score Ⅲ at 24 hours after admission, whether they received mechanical ventilation, whether they received sedation and(or) analgesia, whether they were monitored sedation and(or) analgesia, and in-hospital mortality were analyzed.The children were divided into the simple sedation group( n=798), the sedation + analgesia group( n=120) and the non-sedation analgesia group( n=422) according to whether they received sedation and(or) analgesia.The diseases, proportion of mechanical ventilation, incidence of hypotension, average length of stay in PICU and in-hospital mortality were compared among the three groups. Results:The median age of the 1 340 children was (13.3±6.4) months, including 786 males(58.7%). Sedation therapy had been carried out in 6 PICUs, of which 5 PICUs had routine sedation assessment; 4 PICUs had carried out analgesic therapy, of which only 2 had routine pain assessment.A total of 918 children(68.5%)received sedation and(or) analgesia, midazolam was the most commonly used sedative drug, followed by dexmedetomidine, and 526 children(57.3%)were monitored for sedation assessment, the most commonly used assessment method was the Richmond agitation sedation score.One hundred and twenty(9.0%)cases received sedation combined with analgesia, fentanyl was the most commonly used analgesic, and 38 children(31.7%) underwent routine pain assessment.There was no significant difference in age and sex among the three groups.The proportion of surgical diseases and patients received mechanical ventilation(100.0%, 120/120) were the highest in the sedation + analgesia group.The proportion of mechanically ventilated patients was the lowest in the non-sedation analgesia group(11.4%, 48/422). The mean duration of mechanical ventilation in the sedation + analgesia group was slightly shorter than that in the simple sedation group( P>0.05). The incidence of hypotension was highest in the sedation + analgesia group, and lowest in the non-sedation analgesia group[21.7%(26/120) vs.2.1%(9/422), P<0.01]. There was no significant difference in in-hospital mortality and mean PICU stay among three groups. Conclusion:Benzodiazepines are still the main sedative drugs used in PICUs in Shandong Province.In recent years, the usage of dexmedetomidine has gradually increased, but the proportion of analgesic use is very low.At present, analgesic and sedative therapy is mainly used for children after surgery and receiving mechanical ventilation.Although analgesic and sedative therapy does not increase the in-hospital mortality and average length of stay in PICU, it increases the incidence of hypotension.The sedative and analgesic treatment and assessment in the PICU of Shandong Province are still not standardized, mainly reflected in infrequently analgesic treatment and the assessment of sedation and pain, which need to be further improved.

Objective: To investigate the clinical effect and safety of entecavir capsules in the treatment of treatment-naïve HBeAg-positive patients with chronic hepatitis B (CHB). Methods: A total of 158 HBeAg-positive CHB patients were given oral entecavir capsules at a dose of 0.5 mg/time once a day for 144 weeks. Clinical outcome and safety were evaluated at baseline and at 24, 48, 72, 96, 120, and 144 weeks of treatment respectively. The Fisher’s exact test was used for the analysis of categorical data. Results: After 144 weeks of treatment, 90.91% of all patients achieved virologic response (< 69 IU/ml), the normalization rate of alanine aminotransferase was 88.18%, the clearance rate of HBeAg was 33.33%, and the seroconversion rate of HBeAg was 24.07%. Of all patients, 2 dropped out due to adverse events and 5 experienced serious adverse reactions. Conclusion Entecavir capsules can inhibit viral replication and have good safety in treatment-naïve HBeAg-positive CHB patients.

ObjectiveTo explore the status of mild cognitive impairment （MCI） among the elderly in Shanghai communities， and to identify the factors associated with MCI. MethodsThe Montreal Cognitive Assessment-Basic （MoCA-B） was used to screen for MCI in elderly adults. Logistic regression analysis was conducted to identify the factors associated with MCI. ResultsAmong 629 participants， 226 （35.90%） were positive for MCI. Older age （OR=1.04， 95%CI： 1.01-1.07）， lower family income （average OR=2.20， 95%CI： 1.01-4.80； poor OR=2.59， 95%CI： 1.03-6.50）， hearing impairment affecting daily life （OR=1.86， 95%CI： 1.19-2.91）， and anxiety symptoms （OR=1.58， 95%CI： 1.02-2.44） were associated with the positive for MCI. Living in central urban area （OR=0.57， 95%CI： 0.37-0.89） and having higher social support （OR=0.97， 95%CI： 0.94-1.00） were protective factors for MCI. ConclusionThe current status of MCI among the elderly in Shanghai communities is not optimistic. It is important and necessary to establish the cognitive-friendly community for the elderly.