Objectives:To study the clinical results and feasibility of continuous brachial plexus nerve block and postoperative anagesia with catheters located by nerve stimulator in interscalene approach. Methods:60 ASAⅠ~Ⅱ patients receiving continuous interscalene brachial plexus block and postoperative analgesia for forearm,wrist or hand surgery were randomized into two groups.In group I,nerve blocks were performed using a normal venous needle located with traditional method which elicites numbness of the limb. Then a epidural catheter was passed and secured. Group Ⅱ were guided by nerve stimulator and special catheters were placed. Results:Compared with group I,time to perform the block,time to block and time to obtain satisfactory sensory and motor blockade in group II were shorter(P

Innovation team is an independent and open complex adaptive system, which provides new ideas for recognizing and understanding the inner operating mechanism of innovation teams. This article analyzed the mechanisms of communication and exchange, competition and cooperation, incentive and con-straint as well as the conflict management from the perspective of complex adaptive system.

BACKGROUND:Anterior cervical discectomy and bone graft fusion are effective method to treat cervical spondylosis. This method can provide firm fixation and the fusion rate is high. However, for cervical vertebra involved in more than two segments, the stability of fixator and bone graft is poor due to big bone graft span, which may easily cause fusion failure and pseudarthrosis, and impact curative effects. OBJECTIVE:To investigate biomechanical stability of anterior cervical pedicle screw implantation for osteoporosis in the vertebra. METHODS:A total of 12 human cervical vertebrae were col ected, including 6 vertebrae with normal bone density and 6 vertebrae with osteoporosis. Data of 60 vertebra specimens were analyzed. 30 osteoporotic specimens implanted in anterior cervical pedicle screw were set as anterior cervical pedicle screw group. 30 normal specimens implanted in anterior cervical pedicle screw were set as anterior vertebral screw group. According to bone density, 40 vertebrae were col ected in above two groups, and were considered as normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group (n=10). Bone mineral density of each vertebra was detected using dual-energy X-ray absorptiometry. Biomechanical index of two kinds of screws was detected using ElectroForce 3510 material testing machine. RESULTS AND CONCLUSION:Bone mineral content, vertebral screw pul-out strength, vertebral screw pul-out stiffness, pedicle screw pul-out strength, and pedicle screw pul-out stiffness were significantly higher in the anterior cervical pedicle screw group than in the anterior vertebral screw group (P<0.05). The maximum axial pul-out strength of normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group was significantly higher than in the anterior vertebral screw group (P<0.05). The results confirmed that osteoporotic vertebral biomechanical performance is more stable in anterior pedicle screws compared with the anterior vertebral screw.

Objective To observe the expression and the distribution of Netrin-1 in the spastic and normal segment of colon in patients with Hirschsprungs disease (HD) and investigate the relationship between Netrin-1 and development of HD.Methods Colon specimens of 36 cases with HD were selected for this study.Normal segment of colon served as the control group,while the spastic segments of colon as the lesion group.Immunohistochemical staining was applied to detecte the expression and the distribution of Netrin-1.Results Immunohistochemical staining showed that the expression of netrin-1 was positive in the intestinal muscular layers (longitudinal muscle,circular muscles),myenteric ganglias and mucosal layers in the control group.However,the expression of Netrin-1 was also positive in muscular layers and mucosal layer in the lesion group.There was no significant difference in the expression intensity of Netrin-1 between the two groups (P ＞0.05).Conclusion The expression of Netrin-1 in both the control group and the lesion group may indicate that netrin-1 have no significant correlation with genesis of HD.

The thesis,from the aspect of professional guidance of education,focuses on the outstanding problems that exist in the work of professional guidance,analyzes the main reasons that caused those outstanding problems,and gives the feasible suggestions to professional guidance in current university education.

Objective To discuss and summarize the effects of arthroscopic treatment of posterior ankle impingement syndrome.Methods The study enrolled 30 patients with posterior ankle impingement syndrome treated from January 2008 to November 2015.There were 18 males and 12 females,aged 19-58 years old (mean,37.6 years old).Right ankle injury was noted in 19 patients and left in 11 patients.A total of 27 patients had a history of obvious ankle injury (7 cases of acute sprains and 20 cases of chronic sprains).Arthroscopic surgery,including osteophyte removal,cartilage formation and joint clearance,was performed through the posterolateral and posteromedial approaches.Postoperative outcome was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores.Results All the patients were followed up for 8-27 months (mean,22 months).These patients got a good healing without nervous and vascular injuries.At the last follow up,the AOFAS score was (89.8 ± 3.8) points,significantly higher than before operation [(35.0 ± 10.1) points,t =-26.456,P =0.000].The VAS score was (2.5 ± 1.3) points,significantly lower than before operation [(6.6 ± 1.9) points,t =12.427,P =0.000].The ankle joint flexion angle was improved significantly from 29.4° ± 2.3° to 43.4° ± 1.4° as compared to preoperative status (t =-32.625,P =0.000).There were 21 cases of excellent result and 9 cases of good result,with an excellent and good rate of 100％.Conclusion Debridement and treatment of complications under arthroscopy is one of the effective methods for the posterior ankle impingement syndrome,which has advantages of minimal invasion,safety,targeted operation,and fast postoperative recovery.

Objective To Discuss the Clinical Recognition of Acute Myocardial Infarction(AMI) caused by aortic valve incompetence.Methods Data of 275 AMI patients in our hospital recent two years,7 of them were caused by aortic valve incompetence; all of patients(7 AMI) were received coronary artery angioplasty,ultrasound,left ventricular angiography examination,its clinical feature was analyzed.Results All of 7AMI patients have normal coronary without limited constriction or plaque and with aortic valve incompetence.

BACKGROUND:In recent years, a single-door laminoplasty for cervical spondylotic myelopathy was performed in the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University. This surgery achieved spinal decompression while remaining the important structure of cervical vertebra.
OBJECTIVE:To comparatively analyze the therapeutic effects of minimal y invasive cervical laminoplasty and single-door laminoplasty on cervical spondylotic myelopathy.
METHODS:A total of 78 cases of cervical spondylotic myelopathy were randomly divided into two groups, which respectively received minimal y invasive cervical laminoplasty and single-door laminoplasty.
RESULTS AND CONCLUSION:Al cases were fol owed-up for 3-36 months. No significant difference in excellent and good rate of Japanese Orthopaedic Association score was detected between the two groups in final fol ow-up (P>0.05). The apparent rate of axial symptoms was significantly lower in the minimal y invasive cervical laminoplasty group than that in the single-door laminoplasty group after treatment (P<0.05). Cervical curvature loss was significantly lower in the minimal y invasive cervical laminoplasty group than that in the single-door laminoplasty group (P<0.05). In final fol ow-up, in the minimal y invasive cervical laminoplasty group, two titanium screws of one patient were slightly loose, and no abnormal symptom was observed. In the single-door laminoplasty group, hinge breakage was visible in six patients. The broken vertebral plate was excised. Artificial spinal dura mater was coated on the surface of spinal cord for protection. Results suggested that the effect of two surgical methods in promoting functional recovery of spinal cord is identical. However, complications in the minimal y invasive cervical laminoplasty group are further fewer than those in the single-door laminoplasty group.

Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia.Methods Sixty children (1ys≤ age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV,n =20],group B [pressure control ventilation (PCV) + VCV,n =20] and group C (PCV + PCV,n =20) randomly.The P mean,Pmax,and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored.The SpO2,PaO2,and PaCO2 after mechanical ventilation 1.5 hours were recorded.Results Compared to group A,groups B and C had lower P max and P mean (P ＜ 0.05) during the FOB procedures.Compared to groups A and B,group C had a lower P max and P mean (P ＜0.01) after the FOB procedures.At the 1.5 hours after the procedure,all the children showed significant increase in SpO2 and PaO2 (P ＜ 0.05) and decrease in PaCO2 (P ＜ 0.05) in groups A,B,and C.Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia,the pressure control ventilation (VCV) mode can decrease the pressure of airway (Paw) and PaCO2 than volume control mode during procedure.

Objective To explore the significance of treadmill exercise test (TET) in identifying left main coronary artery(LMD) obstruction from proximal left anterior descending(LAD) obstruction.Methods Patients with positive in the TET of the Central Hospital of Dalian from Jan.2008 to Dec.2013 were enrolled in this study and they were divided into LMD group with 21 cases and LAD group with 35 cases according to the results of coronary angiography.Retrospectively study was conducted to analyze the exercise time,the start time of ST segment change,the lead of ST segment between groups.Results Lead aVR ST segment elevation(≥0.10 mV) was 85.7％ (18/21) in the LMD group and 62.9％ (22/35) in the LAD group.Lead aVR ST segment elevation in the LM group was ((0.16 ± 0.07) mV,higher than in the LAD group ((0.11 ± 0.07) mV ; t =2.614,P ＜ 0.05).Accompany ST segment depression of leads and cumulative ST segment depression were (5.7 ±1.7) pcs and (1.13 ±0.42) mV in LMD group,significantly higher than those of LAD group((4.6 ± ± 1.8) pcs and (0.87 ± 0.32) mV ; t =2.314,2.634,P ＜ 0.05).The occurrence rate of ST segment depression (≥0.10 mV) in leads V2 and V6 were 33.3％ (7/21) and 90.5％ (19/21) in LM group,significantly higher than that in LAD group (11.4％ (4/35) and 62.9 ％ (22/35) ; x2 =3.990,5.105 ;P ＜ 0..05).The start time of ST segment deviation of LM group was significantly earlier than that of LAD group ((199.8 ± 70.8) s vs.(273.7 ± 127.3) s;t =-2.787,P ＜ 0.01).The differences were not statistically significant in terms of the exercise time between groups ((315.0 ± 120.0) s vs.(376.1 ± 110.0) s;t =-1.948;P ＞ 0.05),the rate for achieving target heart rate(33.3％ (7/21) vs.48.6％ (17/35) ; x2 =1.244 ; P ＞ 0.05) and the Duke score ((-11.8 ±7.2) vs.(-8.4 ±6.8) ;t =-1:772;P＞0.05).Conclusion Compare with patients with the LAD disease,ST segment elevation of lead aVR is significantly higher induced by treadmill exercise test in patients with left main disease.Meanwhile,the lead accompanied with ST segment depression is significantly higher,and the start time of ST segment deviation is significantly earlier.