Classification pattern of overseas medical services at Grenada station during Mission Harmony-2015 / 军事医学

Objective To summarize the characteristics of medical service patterns at Grenada station of Mission Harmony-2015 so as to provide reference for future overseas services in similar island countries .Methods After detailed analysis of actual conditions of the countries visited and efficient communication with host country health organizations , we made an appropriate adjustment of the medical service pattern , which involved multi-site screening of general patients , followed by intensive checkups and treatment aboard the hospital ship .Results The procedure of diagnosis and treatment was streamlined and the efficacy of medical services was significantly enhanced to meet the maximum medical demand of local residents.Grenada became a station with the largest number of patients who received top-quality fee-free healthcare during Mission Harmony-2015 .Conclusion Adjustment of medical service patterns according to the actual conditions could deliver a desired effect during overseas missions .

Assessment of the learning curve for lumbar microendoscopic discectomy / 中国矫形外科杂志

0.05).The operating time in group A was 106?22.3 min,94.1?29.3 min in group B and 81.6?22.3 min in group C.There were no significant differences between group A and B,or between group B and group C,but there was significant difference(P=0.009) between group A and group C.The was Two cases of dura tear occurred at operatiom and one case was converted to open discectomy in group A.There were three cases of reoperation in group B.There were no intra-and postoperation complications in group C.[Conclusion]From the learning curve of lumbar microendoscopic discectomy,surgeons can master such skill only after performing 30 or more cases of lumbar microendoscopic disecetomy.

Roentgenographic Techniques by Digital Radiography and Diagnosis for Subluxation of Patella / 医疗卫生装备

Objective To evaluate the reliability of axial view of patella with the knee joint flexed at 60 and 90 degrees on imaging diagnosis of patellar subluxation with DR (digital radiography). Methods 60 cases confirmed patella subluxation were reviewed retrospectively. In addition to routine anteroposterior and lateral DR views, axial DR views of patella with the knee flexed at 60 degrees and 90 degrees were taken meanwhile. Results Of the 60 cases, 45 failed to provide any patellar problems, while the other 15 cases revealed suspicious imaging view of patella subluxation in their normal AP and lateral DR views. In the axial DR views of patella with the knee flexed at 60 degrees and 90 degrees, 50, 4 and 6 cases revealed subluxation, suspicious subluxation and normal alignment of patella. Conclusion Axial DR view of patella with the knee joint flexed at 60 and 90 degrees could provide helpful roentgenographic information in determining the existence of patella subluxation.

Compliance variation following the change of longitudinal stretch ratio. A study on femoral artery and vein in a rabbit model / 生物医学工程学杂志

This study was aimed to establish a rabbit model of bridging artery defect with autogenous vein under equal arterial and venous compliances by selecting an appropriate anastomosing tension based on assessing the influence of vessel's longitudinal strain on compliance. The exponential form P = M1 x [eM2(v-v0)-1] was employed to fit the blood pressure-unit volume curves under different stretch ratios(lambda) obtained from real curves on 13 femoral arteries and 12 veins whose uniaxial loading tests at longitudinal directions had been performed, then the quantic M = a1 lambda 5 + a2 lambda 4 + a3 lambda 3 + a lambda 2 + a5 lambda + a6 was done to fit M-lambda data. Results showed the differential form dv/dp = 1/(M1 x M2 + 11.78 M2) derived from P = M1 x [eM2(v-v0)-1], and lambda reflected the relationship between compliance and stretch ratio (or longitudinal tension) under average artery pressure 11.78 KPa well. It was found that under longitudinal tension 1.19 g, the arterial and venous compliances were equal(0.031 microliter/KPa) while the respective stretch ratios were 1.32 and 1.67.

Direct transpedicular osteosynthesis with lag screw in the treatment for indicated Hangmans Fracture / 中华骨科杂志

Objective To define the indications of direct transpedicular lag screw to treat traumatic spondylolisthesis of axis (Hangmans fracure) and to evaluate the result of the technique. Methods From February 1998 to December 2000, 22 patients with acute traumatic spondylolisthesis of axis were treated. Ten of them achieved anatomic reduction by skull traction but no acceptable stability was ensured by traction alone. Among the ten patients, eight had integral and normal shaped C2 vertebral bodies (6 male, 2 female; age ranged from 18 to 42 years with an average of 28.2 years; 5, 2 and 1 patients classified as type Ⅰ, Ⅱ and Ⅱa injuries respectively according to Levine-Edwards classification and graded as D spinal injury in 2 cases and E in 6 cases according to Frankel scale) were further fixed with transpedicular lag screw. Under general anesthesia, the patients were laid in prostrate decubitus in a prepared head-neck-chest ventral plaster plate with skull traction in place to maintain reduction and lateral image intensification was applied to confirm the reduction. A posterior midline incision from C1-C3 was performed, and soft tissue was released to expose clearly the lamina, lateral mass, superior and medial aspect of the C2 pars interarticularis (isthmus plus pedicle). Points of entry for screw insertion were located at the entrance at the posterior aspect of lateral mass. The drill bit is parallel to both of the medial and superior border of C2 pars interarticularis (usually 25?-30? cephalad to the transverse plane and 30?-35? medial to the sagittal plane). The screw hole in the posterior cortex was overdrilled with a 3.5 mm drill bit for interfragmentary compression. 3.5 mm screws (25-30 mm, determined by depth gauge) were drived in after the cortex being tapped with a 3.5 mm tap. The whole procedure was done under monitoring of "C" arm fluoroscopy for safety and accuracy. Results It costs an average of 70 minutes to finish the procedure with mean blood loss of 250 ml. Hospital stay was about 18 days. A mean follow up time of 14 months (11 to 18 months) didnt confirm any early or late postoperative complications, all cases gained bony union 3 months later with complete neurological function recovery. The range of neck rotation was restored normal with no C2,3 instability or screw loosing found. Conclusion With appropriate indications, transpedicular lag screw fixation provides good reduction and stability to Hangmans fracture. This technique can only be applied to the fractures which are reductable.