Objective To evaluate the application value of real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for the risk assessment of unusual atrial septal defect (ASD) in clinic therapy.Methods Accurate assessment before operation was conducted in 57 cases of patients with unusual ASD by two-dimensional transthoracic echocardiography (2DTTE),two-dimensional transesophageal echocardiography (2DTEE) and RT-3DTEE.The ultrasound manifestations were observed.And the guidance in clinic therapy were compared.Results The shape and number can be displayed clearly by 2D-TTE and 2D-TEE in 46 of 57 eases.Another 11 cases were diagnosed as irregular or two holes possibly.RT-3DTEE can help to observe the morphology and quantity of ASD visually and comprehensively in all cases.There was no statistical difference among 2DTTE,2DTEE and RT-3DTEE for the measurement of right atrium end-systolic transverse diameter (RATD),left atrium end-systolic transverse diameter (LATD),right ventricular end-diastolic diameter (RVDD) and left ventricular end-diastolic diameter (LVDD;all P＞0.05).The statistic difference for the diameter of atrial septal defect (ASDD) was found between 2D-TEE and 2D-TTE (P＜0.05) and RT-3DTEE and 2D-TTE (P＜0.05).There was no statistical difference among 2D-TEE,2DTTE and RT-3DTEE for the measurement of residual boundary condition of superior vena cava,aorta side and the top side of the atrium (all P＞0.05),whereas significant difference was found in measuring the residual boundary condition of inferior vena cava (F=50.39,P＜0.001).There were statistic differences between 2DTEE and 2DTTE,RT-3DTEE and 2DTTE,RT-3DTEE and 2DTEE (all P＜0.05).The clinic therapy can be directed by RT-3DTEE in all 57 cases.The diagnosis of 5 cases was failed by 2D-TTE,and 2 cases was failed by 2D-TEE.Conclusion Abundant image information can be offered by RT-3DTEE which plays an important role in the risk assessment of unusual atrial septal defect.

Objective To study the efficacy and safety of four surgical techniques of tuberculosis of lumbosacral junction retrospectively. Methods Between Jul 2001 and Jan 2013, 79 patients with lumbosacral spinal tuberculosis underwent surgery. Antituberculous chemotherapy and nutrition support prior to surgery were used for at least two weeks. 45 patients underwent single stage radical debridement, fusion and anterior instrumentation (A group). 18 patients underwent combined anterior and posterior spinal surgery (AP group), 10 patients underwent transpedicular drainage, posterior instrumentation, and fusion (P group), and 6 patients underwent anterior radical debridement (D group). All the patients were treated by antituberculous chemotherapy for 18 months and followed regularly. The operation duration, blood loss, clinical status, ESR, VAS, ODI, roentgenogram and 3D?CT were concerned to estimate the progress of tuberculosis. Radiographs were analyzed before surgery, immediately after surgery, and at the final follow?up examination to assess the result of anterior fusion and maintenance of correction. Results There was no inju?ry of blood vessel, ureter or cauda equina during surgery. The mean follow?up period was 23 months (range 18-42 months). No obvious loss of deformity correction was observed. There was no recurrence, no tuberculous peritonitis, and no incidence of im?potence or retrograde ejaculation in any of these patients. The average operating duration(min) were 144.31 ± 23.18, 444.72 ± 141.63, 351.50 ± 85.25, 90.00 ± 29.66, respectively; The average blood loss(ml)were 266.67 ± 104.45, 988.99 ± 488.26, 890.00 ± 306.23, 200.00±104.88, respectively; The average Pre?op VAS were 4.71±1.79, 5.22±1.48, 3.30±1.64, 2.50±1.52, respectively;The average last follow?up VAS were 0.89±0.68, 0.90±0.74, 1.00±0.63, respectively; The average Pre?op ODI(%)were 29.64± 7.85, 32.17±7.59, 28.20±4.26, 20.67±4.63, respectively; The average last follow?up ODI(%)were 5.09±3.59, 4.78±3.78, 4.80± 3.39, 4.00 ± 1.18, respectively; The average Pre?op lumbosacral angle(°)were 20.61 ± 4.92, 23.78 ± 5.84, 25.10 ± 4.28, 21.67 ± 4.27, respectively; The average Post?op lumbosacral angle were 27.17±3.66, 30.56±5.31, 32.10±4.01, 24.83±2.32, respectively;The average last follow?up lumbosacral angle were 23.89 ± 3.12, 27.00 ± 5.46, 29.00 ± 4.85, 23.33 ± 2.50, respectively. Conclu?sion Single stage anterior interbody fusion with anterior instrumentation worked effectively to stabilize lumbosacral junction (less invasive, short surgical duration, no injury of posterior column). Anterior interbody fusion combined with posterior instrumentation was recommended for patients with extensive bone defect and low iliocava junction.

Objective To analyse the phenotypes of the drug?resistant tuberculosis, and investigate the outcomes of the individualize surgery and chemotherapy for these patients. Methods From January 2009 to June 2012, we retrospectively ana?lyzed 49 patients with drug?resistant tuberculosis spondylitis admitted in Southwest Hospital. 33 were initial cases and 16 were re?curring cases. All the 49 patients received individualized open operation or CT?guided percutaneous drainage and local chemother?apy depending on the characteristics of the focus. Individualized chemotherapy regimens were tailored for all patients according to the drug?resistant spectrum and all patients were followed up successfully at least 24 months. All the clinical data were collected and analyzed by statistical methods. Results Among the 49 patients, 14 were monoresistance tuberculosis, 11 were polyresis?tance tuberculosis, and 24 cases were multi?drug resistant tuberculosis. Frequence of the drug?restistance from high to low was Iso?niazid, Rifampicin, Streptomycin, Levofloxacin, Dipasic/Rifapentine, Ethambutol, Protionamide, Capreomycin, Paza?aminosalicy?late, and Amikacin. 43 patients received open operation and 6 patients received CT?guided percutaneous drainage and local che?motherapy. Time of the percutaneous drainage was (48±11) days (39-60 days), and all patients received Individualized chemother?apy with an average of (29.5±2.5) months (24-36 months) postoperatively. At the last follow?up, all patients had remarkable pain remission, 44 patients with paraplegia got slight or remarkable recovery and 17 patients with kyphosis got significant correction. Conclusion The main drug?resistant spectrums are Isoniazid、Rifampicin、Streptomycin、Levofloxacin. The individualized sur?gery combined with individualized chemotherapy made according to the drug?resistance is a feasible treatment for the drug?resis?tant tuberculosis especially the multi?drug resistant tuberculosis.

Objective To set the criteria of mild spinal tuberculosis and investigate the ettect of standard chemotherapy regimen for further establishing the clinical classification of spinal tuberculosis and standardizing management.Methods According to the criterion,a total of 89 patients with mild spinal tuberculosis were enrolled for outpatient conservative management and follow-up.Ambulant treatments were carried out in all patients,including nutrition support and standard chemotherapy regimen.The regimen was consisting of four first-line antituberculosis drugs (rifampicin,isoniazid,ethambutol and pyrazinamide).All patients were followed up one month later,then every 3 months for the following 12 months,and subsequently at intervals of half a year.The clinical manifestations,kyphosis progression,neurological status,erythrocyte sedimentation rate and liver function were analyzed.Results A mean of 30.62± 13.20 (range,18-46) months' follow-up was achieved in 85 patients,whose tuberculosis lesions were cured completely.Another 4 patients,who were diagnosed with drug-resistant tuberculosis later,had underwent surgery for progressive bone destruction and no response to chemotherapy.The mean visual analogue scale score and Cobb's angle was 5.6± 1.6 and 6.25°±3.11° before chemotherapy,and 2.1 ± 1.1 and 12.36° ±6.31 °at the last follow-up time,respectively.Signals of vertebral body and intervertebral disc returned to normal in 6 patients,while solid bony fusion of adjacent segment was achieved in 79 patients.Asymptomatic mild kyphosis was observed in 69 patients.2 patients with sinus before treatment all healed.No neurological deficit was found.Conculusion For patients early diagnosed with mild spinal tuberuclosis,standard chemotherapy regimen could work safely and effectively for healing the tuberculous lesion,avoiding surgery as well as preventing kyphosis,vertebral instability and neurological deficit.Mild spinal tuberculosis that was early diagnosed could be considered as a subtype of spinal tuberculosis.

Objective:To establish an HPLC method for the determination of patulin in health foods containing hawthorn to im-prove the quality control of patulin in related health foods. Methods:An Agilent TC-C18(2)(250 mm ×4.6 mm, 5 μm) column was used with the temperature of 30℃. The mobile phase consisted of 0. 8% tetrahydrofuran and the flow rate was 1. 0 ml·min-1 . The detection wavelength was set at 276nm. Results:The calibration curve of patulin was linear within the range of 1-20ng(r=1. 000 0), the average recovery was 92. 1% and RSD was 2. 2%(n=6). Conclusion:The method is simple, reliable and accurate, which can be used in the content determination of patulin in health foods containing hawthorn.

Objective To discuss the application value and improvement of principle of multi-echelon medical care in emergent rescue of the injured in Chinese Wenchuau earthquake. Methods The author analyzed and evaluated the medical rescue that was done at disaster site, in the front line hospital and higher level hospitals during earthquake. Results A total of 4 689 patients were treated at disaster site, including 413 patients with severe injury, of whom 3 died. Different kinds of operations including debridement were performed at disaster site, with infection incidence of open wound was nearly 80%. In the front hne hospital, 1 400 patients were treated, with 200 operations done. Of all, 110 patients with severe trauma were treated emergenfly, with an amputation rate of 3.0% and postoperative infection incidence of 66.8%. In the station hospitals, 125 patients received definite surgeries, with 1-5 surgeries per injury site. There was no postoperative cross infection, amputation or death. Conclusions The multi-echelon medical care is the basic mode for medical rescue of large number of patients in natural disaster rescue. First aid at disaster site should be performed as early as possible. Transportation is crucial for successful rescue and an improved patient grading system can help increase the efficiency of rescue. The front line hospitals should mainly provide life support, debridement and fixation of simple fracture, while the specific treatment and definite surgery should be carried out in the station hospitals.

This study sought to producte alginate sodium microsphere for controlled release bovine serum albumin(BSA) and to investigate the protein release profile of the BSA-alginate sodium microsphere in vitro, which threw some light on the angiogenesis of tissue engineering bone with vascular endothelial growth factor (VEGF) controlled release under stress. The BSA-alginate sodium microsphere was fabricated with W/O emulsification and ion cross-linking method using alginate sodium. The appearance, microsphere diameter and envelopment rate were detected, and the release characteristics of the BSA-alginate sodium microsphere in vitro was investigated. The alginate microsphere was found to be spherical in shape and evenly distributed. Its mean grain diameter was determined to be 230 +/- 60 microm, carrying capacity 80.3 microg/mg and envelopment rate 61%. Smooth controlled release in BSA-alginate sodium microsphere was shown to last more than 2 weeks. Alginate sodium proved an excellent biodegradable material for protein or polypeptide controlled release. The emulsification and ion cross-linking method was noted to be simple; it was propitious to the structural and functional stablility of protein or polypeptide, thus leading to the prolonged efficacious time of the microsphere.
Alginates ; administration & dosage ; chemistry ; Animals ; Cattle ; Delayed-Action Preparations ; chemical synthesis ; Drug Carriers ; Glucuronic Acid ; administration & dosage ; chemistry ; Hexuronic Acids ; administration & dosage ; chemistry ; Microspheres ; Serum Albumin, Bovine ; administration & dosage

OBJECTIVE To investigate the bacterial distribution and sensitivity to antibiotics isolated from infected patients in emergency department. METHODS The antimicrobial susceptibility tests to commonly used antibiotics were performed to the specimen send by the emergency and respiratory departments in our hospital in 2007.The data were analyzed respectively. RESULTS Totally 340 strains were isolated in emergency department and 366 strains were isolated in respiratory department.The main bacteria isolated were similar in the two departments such as Acinetobacter baumannii,Pseudomonas aeruginosa,Staphylococcus aureus and Escherichia coli,but their sensitivities to antibiotics were different. CONCLUSIONS Bacterial distribution of the infected patients in emergency department is similar to respiratory departments,but their sensitivities to antibiotics are different.