Objective To explore the diagnosis and treatment of the hypoxicisehemic encephalopathy of newborn in improving the healing rate and reducing the morbidity and mortality.Methods 56 cases from 2004 July to 2008 June were treated,all the clinical manifestations,diagnosis and treatment methods,causos and exmination were analyzed.Results Of 56 cases,clinical grading is mild 24cases;midrange 21cases;severe 11 cases;CT grading is mild 16 cases ;midrange 26 cases ;severe 14 cases;in this group,healing 34 cases,improving 16 cases,not healing 4 cases,death 2 cases,the total effective rate is 89.3%.Conclusion The causes of hypoxic-isehemic encephalopathy of newborn were complex and the clinical manifestations were veriform,the prognosis has intimate relations to the degree and commence of diagnosis and treatment.The morbidity,disable rate and mortality would be descended if proper diagnosis and prevention and cure means were given in the early period.

Objective To observe the branches and distribution of the tibial nerve and analyze the compressed position of it.Methods Twenty sides of adult cadavers were anatomized and the tibial nerve branches in ankle,foot,the internal and external plantar tunnel were observed.Correlated data was measured and recorded.Results ① The tendinous part of abductor hallucis muscle that was located under the muscle and consisted the surface of the internal and external plantar tunnel was(8.62?0.79)cm in length,(3.01?0.30)cm in width,and the thickness of it was about(0.24?0.02)cm.The internal and external nerves were located in the internal and external tunnel.The length of the internal tunnel was about(4.58?0.41)cm,and the diameter was(1.11?0.10)cm.The length of the external tunnel was about(2.58?0.23)cm,the diameter was about(0.96?0.08)cm.② Internal hell nerve was in an isolated tunnel interior the hell,which was the hell tunnel.The length of the hell tunnel was about(3.03?0.21)cm,the diameter was(1.07?0.09)cm.Conclusion The tibial nerve branches can be compressed at internal,external plantar tunnel or the heel tunnel.When making neurolysis of the tibial nerve for tarsal tunnel syndrome patients,except for the flexor retinaculum,the internal and external plantar tunnel and the hell tunnel should also be decompressed especially for the patients with the symptom of compressed single branch.

The small-for-size syndrome (SFSS) is widely recognized as one of the most serious clinical complications. It substantially contributes to a poor prognosis after adult living donor liver transplantation. Currently, there is still no consensus on the exact definition and pathogenesis of SFSS. We reviewed the progress on research of pathogenesis of SFSS and put forward some relevant preventive and treatment measures, including donor selection, graft assessment, reduction of high portal vein perfusion, dual grafts technology, advanced molecular medicine and other innovative approaches. Also, we offered some relevant insights into the future research directions of SFSS.

BACKGROUND:Traditional studies on foot and ankle biomechanics have limitation. Ankle joint was complicated and had big range of motion, so it is difficult to establish finite element models and to analyze the type of fracture.
OBJECTIVE: To construct the finite element models of distal tibial fractures and analyze the stability.
METHODS: CT data of ankle were colected from a normal male volunteer and the three-dimensional reconstruction of volunteer was made by Mimics software, and the effectiveness was verified. The ratio of different joint involvement and height of fracture block were assumed with Solidwork software, and finite element models of distal tibial fractures were established. Fracture stability was analyzed by ANSYS software using finite element method.
RESULTS AND CONCLUSION:The distal tibia fracture model was consistent with the relevant literature data, and finite element analysis could be further conducted. The ratio of articular surface involved was positively associated with fragment height and fracture displacement, and negatively associated with fracture stability. These results indicate that the three-dimensional finite element models of distal tibial fractures were successfuly established. Fracture stability was associated with the ratio of articular surface involved and fragment height.

【Objective】To compare the fingerprint spectrum of amino acids(AA)of Lignum Santali Albi(LSA)from Indonesia,India and Australia.【Methods】Free AA and hydrolytic AA of LSA from Indonesia,India and Australia were analyzed by amino acid automatic analyzer.The detection wavelength was 570nm and 440nm.【Results】There were obvious differences among the free AA from three kinds of LSA.2S,4S-4-hydroxyproline(Hyp)was detected in Indonesian LSA in 11.77min(?=440nm)with the content of 1.431?7%,and became proline after hydrolysis.The peak of Hyp was not obvious or even undetectable in Indian LAS and Australian LSA.【Conclusion】There exist obvious differences among free AA from three kinds of LSA and 2S,4S-4-Hyp can be used as the specific compounds for the identification of LSA from Indonesia,India and Australia.

Objective To analyse the experience and treatment of early phase severe acute pancreatitis (SAP) in intensive care units (ICU).Methods A multicenter retrospective study was done on patients with SAP treated in three major teaching hospitals (Beijing Hospital,Peking University First Hospital and Peking University Shenzhen Hospital) in China from Jan.2001 to Dec.2011.Results There were 188 patients who were enrolled in the study,including 121 males and 67 females.The age ranged from 19 to 104 (51.0±18.2) years.The mean APACHE Ⅱ score was (22.2±4.6).84.0％ of patients survived,the mortality was 10.1％ in the early phase and 5.9％ in the late phase.The most common systemic complications were acute renal injury (46.3 ％),acute respiratory distress syndrome (35.6％),and septic shock (17.6％).The local complication rate was 47.3％,which included acute peripancreatic fluid collections (32.8％),acute necrotic collection and walled-off necrosis (48.4 ％) and pseudocyst (18.8 ％).The conservative treatments included intensive care,fluid resuscitation,mechanical ventilation,continuous renal replacement therapy,antibiotics,glucose control,inhibition of pancreatic enzyme activity and secretion,and nutritional support.Surgical intervention included endoscopic retrospective cholangio-pancreatography and endoscopic sphincterectomy,B ultrasound or CT guided puncture and drainage,and surgical drainage and debridement of necrosis.Conclusions The early phase of SAP was characterized by systemic inflammatory response syndrome and multiple organ dysfunction syndrome which accounted for the first peak in mortality.Intensive care therapy and multi disciplinary comprehensive combined strategy were very important for these patients with systemic and local complications.ICU treatment in the early phase was preferred for patients with SAP.

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

Objective To discuss the setting problem of control limit for quality control chart during the statistical quality con-trol procedure of clinical laboratory quantitative measurement.Methods The normality test of the monthly quality control data for 3 items of albumin (ALB),alanine aminotransferase (ALT)and creatinine (Cr)was performed by using the SPSS 14.0 statistical software and which was compared with the cumulated data.Results Among 30 groups of data,the normality test was inconformity in 18 groups,among 30 groups of mean t test,the differences in 20 groups showed statistical significance(P <0.05).Therefore,the calculated means and standard deviation(SD)in short term could not be directly set as the control limit of the quality control chart. Conclusion Setting the control limit of internal quality control in clinical laboratory quantitative measurement should be according to the guidance of C24-A3 document in CLSI.The SD estimated value obtained from large amount stable quality control data or the 6-month cumulative values is recommended to be used as SD of the new batch number,which should be regularly assessed.

Objective To analyze the correlation of carotid artery stenosis(CAS)with postoperative cognitive dysfunc?tion(POCD)in patients who underwent off-pump coronary artery bypass grafting(OPCABG). Methods Between March 2014 and October 2014, a total of 157 patients who underwent OPCABG in our hospital were enrolled and divided into POCD group and non-POCD group according to their performance respondent to MMSE questionnaire survey conducted 5 days before operation. LOTCA questionnaire survey was conducted at the first day and 7th days pre-and post-operation re?spectively in order to investigate the influence of CAS on POCD in patients. Results The incidence of POCD was 30.6%(48 out of 157). Advanced age, diabetes,cultural level,carotid artery stenosis, Hb level after operation, score of LOTCA question?naire survey conducted before surgery,time of respirator and the time spend in ICU were significant predictive factors for POCD. However, multivariate logistic regression analysis showed that age, CAS and the time spend in ICU were independent risk factors for POCD, especially CAS(OR=5.078,95%CI:2.211-11.662, P<0.001). Patients with severe CAS suffer from a significant decline in cognitive function on space, time, action and ideation. Conclusion CAS is a predominant risk factor for POCD in patients undergoing OPCABG.

Objective To explore the surgical treatments through anterior and posterior approaches for anterior and posterior compression of cervical spinal cord. Methods The clinical data of 25 cases of anterior and posterior compression of cervical spinal cord from June 1999 to November 2003 were summarized retrospectively. There were 18 males and seven females with age range of 28-56 years (average 36.4 years). Of all,18 cases were with tricolumnae fractures of cervical spine caused by traffic injury,five with cervical herniation and two with malignant macrophage tumor in vertebral body and annex and vertebral lamina. Results All 25 cases underwent internal fixation decompression with I-stage combination operation of anterior and posterior approaches. Of 18 cases with tricolumnae fractures,one died and 17 recovered in various degrees. In five cases with cervical herniation,the positive sign disappeared basically. Two cases of malignant giant-cell tumor appeared metastatic carcinoma in the lungs 10 months after operation. Conclusions The I-stage combination operation of anterior and posterior approaches is an ideal way for the patients suffering from anteropsterospinal compression in cervical spinal cord. It can not only decompress completely the cervical spinal cord,stabilize the wounded cervical vertebra,but also facilitate nursing and function training and be beneficial to the recovery of spinal cord function.