Advances in finite element analysis of rotator cuff tears / 中华创伤骨科杂志

Rotator cuff tears are one of the three most prevalent musculoskeletal disorders, with the supraspinatus tendon as the most common lesion site. It may lead to chronic shoulder pain, weakness and limited joint motion, and eventually to secondary degeneration of the shoulder. As traditional biomechanical experiments are limited by measurement techniques and ethical issues, it is almost impossible to clarify the stress distributions at the rotator cuff under physiological and pathological conditions. Recently, advances in computer science, software development and image processing have rapidly improved finite element models of shoulder joint which promote the researches into pathogenesis of rotator cuff tears and their surgical techniques, making finite element analysis an indispensable means in the biomechanic research of rotator cuff. This paper reviews the recent literature available in China and abroad to expound on the element models of shoulder joint applied in the researches into pathogenesis and surgery of rotator cuff tear.

A prospective clinical study of endoscopic foam sclerotherapy combined with rubber band ligation in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids (with video) / 中华消化内镜杂志

Objective:To evaluate the safety and long-term effectiveness of endoscopic foam sclerotherapy (FS) combined with endoscopic rubber band ligation (ERBL)in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids.Methods:Consecutive patients diagnosed as having grade Ⅱ-Ⅲ internal hemorrhoids in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2020 were prospectively enrolled in the study, and randomly divided into ERBL group and FS combined with ERBL group. The 24 h visual analogue scale (VAS) for pain and 1-week degree of bleeding were evaluated after the treatment. After follow-up of 6 months, the effectiveness of treatment was evaluated.Results:A total of 84 patients with age of 54.4±7.9 years were enrolled, 57.1% (48/84) males, and 73.8% (62/84)grade Ⅱ internal hemorrhoids. Forty-three patients were assigned to the ERBL group and 41 to the FS combined with ERBL group. There was no significant difference between the two groups in baseline data ( P>0.05). In the FS combined with ERBL group, the mean amount of polidocanol foam was 13.8±2.5 mL, the mean number of injection site was 4.7±1.2, and the median scores of VAS was 0 (0, 3), which was significantly lower than that of ERBL group [2 (0, 4), Z=-2.116, P=0.034]. The bleeding rate 1 week after treatment in the ERBL and FS combined with ERBL group were 20.9% (9/43) and 29.3% (12/41), respectively, and mild bleeding was the main symptom. There was no significant difference between the two groups in the bleeding degree ( U=807.0, P=0.378). After 6 months of follow-up, the total effective rates in the ERBL group and the FS combined with ERBL group were 81.4% (35/43) and 90.2% (37/41), respectively ( U=684.5, P=0.044). Conclusion:FS combined with ERBL can effectively relieve post-treatment perianal pain, and improve the long-term effectiveness.

The correlation between posterior cruciate ligament avulsion fracture and intercondylar notch and tibial slope / 中华骨科杂志

Objective:To evaluate whether posterior cruciate ligament (PCL) avulsion fracture was correlated with intercondylar notch and tibial slope.Methods:A total of 48 patients with PCL avulsion fracture were compared with 48 age- and sex-matched healthy controls without PCL avulsion fracture from January 2012 to October 2018 in our hospital. There were 25 males and 23 females with an average age of 54.35±14.06 years (range 27-82 years) in PCL avulsion fracture group. MRI of the knee joint were acquired in the sagittal, coronal, and axial sequences. The measurements included intercondylar notch's angle, width, and height, medial/lateral condylar widths, condylar width, medial/lateral posterior tibial slopes and coronal tibial slope. Notch shape index and notch width index were also calculated to adjust for size variations. The predictive accuracy of Risk factors were analyzed using the area under the receiver operating characteristic curve (AUC). The differences of morphological measurements between the two groups were compared. The morphological measurements with statistical significance were included for further multivariate analysis. Risk factors of PCL avulsion fracture were determined by binary logistic regression analysis. The inter- and intra-observer reproducibility of the measurements was determined by the intraclass correlation coefficients (ICC).Results:Except for coronal intercondylar notch height (0.709), medial posterior tibial slope (0.699) and lateral posterior tibial slope (0.705), the other intra-observer ICC ranged from 0.802 to 0.980, which indicated that the parameters had desirable reproducibility. Similarly, except for coronal intercondylar notch height (0.700), the other intra-observer ICC ranged from 0.778 to 0.971. Parameters of patients with PCL avulsion fracture, including the axial notch angle (52.56°±6.56°), coronal notch angle (54.81°±7.29°), axial intercondylar notch width (19.62±2.32 mm), axial notch shape index (0.68±0.08) and medial posterior tibial slope (8.27°±3.53°), were all significantly larger than those of the control group. The binary logistic regression analysis showed that the coronal notch angle ( β=0.102, OR=1.108, P=0.030) and medial posterior tibial slope ( β=0.151, OR=1.163, P=0.046) were the risk factors or PCL avulsion fracture. The AUC for coronal notch angle (0.678) and medial posterior tibial slope (0.631) exhibited good predictive power for the occurrence of PCL avulsion fracture. Conclusion:The larger coronal notch angle and medial posterior tibial slope were positively correlated with the incidence of PCL avulsion fracture.

Effectiveness of Prophylactic Use of Carbapenems for Severe Acute Pancreatitis ：A Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate effectiveness of prophylactic application of carbapenems for severe acute pancreatitis （SAP）， and to provide evidence-based reference in clinic. METHODS： Retrieved from PubMed， Embase， Medline， Cochrane Library， CNKI and VIP database，randomized controlled trials （RCTs） about effectiveness of prophylactic application of carbapenems （trial group） versus placebo or non-prophylactic use of antibiotics （control group） for SAP were included， and the retrieval time was from establishment to Dec. 2018. After extracting data from clinical studies that met the inclusion criteria， methodological quality of included studies were evaluated by using Cochrane bias risk assessment tool 5.1.0 and modified Jadad scoring scale， and Meta-analysis was performed for pancreatic infection rate， extrapancreatic infection rate， surgical intervention rate and mortality rate by using Rev Man 5.3 statistical software. RESULTS： A total of 8 RCTs were included， involving 544 patients. Meta-analysis showed that there was no statistical significance in the pancreatic infection rate [RR＝0.84， 95％CI （0.58， 1.22）， P＝0.36]， extra-pancreatic infection rate [RR＝0.76， 95％CI （0.43， 1.35）， P＝0.35] and surgical intervention rate [RR＝0.93， 95％CI （0.65， 1.32）， P＝0.68] or mortality rate [RR＝0.99， 95％CI（0.59，1.65）， P＝0.97] between 2 groups. CONCLUSIONS： The prophylactic use of carbapenems can not reduce pancreatic or extra-pancreatic infection rate， surgical intervention rate and mortality rate.

Progression on finite element modeling method in scoliosis / 中国骨伤

Scoliosis is a complex spinal three-dimensional malformation with complicated pathogenesis, often associated with complications as thoracic deformity and shoulder imbalance. Because the acquisition of specimen or animal models are difficult, the biomechanical study of scoliosis is limited. In recent years, along with the development of the computer technology, software and image, the technology of establishing a finite element model of human spine is maturing and it has been providing strong support for the research of pathogenesis of scoliosis, the design and application of brace, and the selection of surgical methods. The finite element model method is gradually becoming an important tool in the biomechanical study of scoliosis. Establishing a high quality finite element model is the basis of analysis and future study. However, the finite element modeling process can be complex and modeling methods are greatly varied. Choosing the appropriate modeling method according to research objectives has become researchers' primary task. In this paper, the author reviews the national and international literature in recent years and concludes the finite element modeling methods in scoliosis, including data acquisition, establishment of the geometric model, the material properties, parameters setting, the validity of the finite element model validation and so on.

An imaging study on effect of total artificial disc replacement on lumbar sagittal alignment / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate effect of Activ L total lumbar disc replacement on lumbar sagittal alignment.</p><p><b>METHODS</b>The imaging data of patients with degenerative disc disease received Activ L total lumbar disc replacement at Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University from March 2009 to March 2013 were retrospectively analyzed. The average age was 45.6 years(range, 35-60 years)and the surgery levels were as follows: L3-4 2 cases, L4-5 15 cases, L5/S1 5 cases, L3-4+ L4-5 3 cases, L4-5+ L5/S1 7 cases. All patients were followed up for 15 to 63 months(average, 32 months). Radiographic parameters such as lumbar lordosis angle(LL), segment lordosis angle(SL) and sacral slope angle(SS) were recorded. All the radiographic parameters were compared using one-way ANOVA at different stage. Lumbar lordosis angle of the two-level was compared with the one of one-level by using independent sample t-test before and after the operation. A partial correction test was carried out to determine the corrections between the parameters preoperatively, one month after the operation and at final follow-up.</p><p><b>RESULTS</b>One month after the operation, the lumbar lordosis angle decreased by an average of 1.8°, but there was no statistically significant(P>0.05). Compared with one month postoperation, the lumbar lordosis angle increased by an average of 6.8°(P<0.05), which also increased a lot compared with preoperation(P<0.05). The value of segment lordosis angle was rising up from preoperation to the final follow-up(P<0.05), so was the value of sacral slope angle, but there was no statistically significant between different stage(P>0.05). The lumbar lordosis angle showed no significant difference between double-level ones and single-level ones at different stage(P<0.05). The lumbar lordosis angle showed positive correlation with the sacral slope(P<0.001), however, the lumbar lordosis angle showed no corrected with the segment angle all the time(P>0.05).</p><p><b>CONCLUSIONS</b>The total lumbar disc replacement with Activ L prosthesis had contributed to maintain and improve the lumbar alignment in the short and medium term. Double- or single-level total lumbar disc replacement had no significant effect on the value of lumbar lordosis angle. The lumbar lordosis angle showed positive correlation with the sacral slope all the time with no correlation between lumbar lordosis angle and sacral slope.</p>

Role of eukaryotic translation initiation factor 4G in tumor / 生理学报

Eukaryotic translation initiation factor 4G (eIF4G) is a scaffold component of eukaryotic translation initiation factor 4F (eIF4F) complex, which takes principal part in the initiating of protein synthesis. Both two subtypes (eIF4G1 and eIF4G2) of eIF4G were found to be closely related with various tumors. The eIF4G1 expression is significantly up-regulated in breast cancer, cervical cancer, nasopharyngeal carcinoma, lung squamous cell carcinoma, prostatic carcinoma and other malignant tumors, compared with those in adjacent tissues; and the eIF4G2 is obviously over-expressed in diffuse large B cell lymphoma and acute myeloid leukemia, but low-expressed in bladder transitional cell carcinoma. This paper reviews the progress in the study of the role of eIF4G in tumor genesis, development, diagnosis and prognosis.

Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi meth-od / 中华骨科杂志

Objective Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi method. Methods Use document retrieval method to review information and articles about the treatment guidelines and articles of cervical radiculopathy including domestic and international areas, established a protocol about clini?cal consensus of the treatments for cervical radiculopathy. This protocol included 23 questions (the effective proportion of non?operating therapy, neck immobilization, physiotherapy, pharmacologic treatment, surgical indications, contraindications, anteri?or surgical decompression, anterior surgical implants). We performed a modified Delphi survey in which current professional opinions from experienced experts, representing from almost all of the Chinese provinces, were gathered. And then we modi?fied the protocol according to those professional opinions. Three rounds were performed and finally we established consensus. Consensus was achieved with ≥70% agreement. Results The panel included 30 experienced experts. The recycling question?naire's quantity of three rounds were 30(100%), 24(80%) and 16(53.3%) respectively. After three expert assessments, there were 18 questions which achieved with≥70%agreement and these questions accounted for 64.3%(18/28) of all the questions. Consen?sus of the treatments for cervical radiculopathy was reached on 7 aspects, including:the effective proportion of non?operating thera?py (1 question), neck immobilization (1 question), physiotherapy (1 question), pharmacologic treatment (5 questions), surgical indi?cations (3 questions), contraindications (4 questions), surgery (3 questions). Conclusion This modified Delphi study had reached a consensus concerning several treatment issues on cervical radiculopathy which had strong representativeness of experts and good convergence of opinions. In the absence of high?level evidence, at present, these experts' opinion findings will guide health care providers to define appropriate treatment in their regions. Areas with no consensus provide excellent insight for future research.

Preparation of human meniscus acellular matrix / 中国骨伤

<p><b>OBJECTIVE</b>To investigate development of a cell extraction process for preparing human meniscus acellular matrix, and morphology and biomechanical properties.</p><p><b>METHODS</b>Human meniscus were subjected to modified eight-step detergent, then, the specimens were assessed by staining with haematoxylin-eosin, toluidine blue, sirius red, saffron O, alcain blue and hoechst-33258, et al. The ultrastructure of the specimens was observed with scanning electron microscope. Transient recovery rate of deformation, maximal recovery rate of deformation and maximal compressive strength were tested to determine the biomechanical properties of the scaffold.</p><p><b>RESULTS</b>Every stain confirmed that the celluar constituents of the specimens were removed. The specimens stained positively by staining with sirius red. Lacuna were found irregularly not only on the surface of the meniscus,but also in the meniscus with scanning electron microscope. Pores in the specinmens were large, the diameter of pores was 80 to 760 microm, porosity was over 67%. The transient recovery rate of deformation was (89.62 +/- 1.04)%, the maximal recovery rate of deformation was 100% and the maximal compressive strength was (3.04 +/- 0.13)N, when the specimens were compressed 30%.</p><p><b>CONCLUSION</b>The modified eight-step detergent can remove the immunogenic cell components from human meniscus, in addition, 3D extracellular matrix can be retained. The scaffold has good biomechanical properties. This scaffold stands a good chance to be an implant for future tissue engineering of the human meniscus.</p>

Perioperative management and risk factors affecting the prognosis of hip fracture surgery in elderly patients / 中华老年医学杂志

Objective To analyze perioperative management and risk factors for the prognosis of hip fracture surgery in elderly patients.Methods The present study included 112 elderly patients (aged ≥65 years) who received hip fracture surgery from January 2009 to January 2013 in our department,and their clinical data were retrospectively analyzed.Results The percentage of cases with concomitant diseases before operation was 91.0 ％,and the postoperative complications rates were 35.7％.One-year mortality after operation was 21.4％.The percentage of survival cases with daily living activities fully restored to pre injury status was 47.6％.Logistic regression analysis revealed that independent risk factors for the one-year mortality included general health before injury (OR=13.36,P =0.047),pulmonary disease (OR =18.33,P =0.007),number of postoperative complications (OR=15.14,P=0.025),and renal failure (OR=11.26,P=0.034).Conclusions Elderly hip fracture patients have many different concomitant diseases.By applying the qualified levels of perioperative management,anesthetic and operative methods,and postoperative rehabilitation measures according to the conditions of the patient,the incidence of perioperative complications and one year mortality can be decreased,and qualified surgical outcomes can be obtained.The independent risk factors for the one-year mortality include general health before injury,pulmonary disease,number of postoperative complications and renal failure.

Device related complications of the Coflex interspinous process implant for the lumbar spine / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coflex, a type of interspinous process implant, can provide intervertebral dynamic stability for surgical segments and effectively relieve lumbocrural pain. However, few studies have described therapeutic strategies and the avoidance of Coflex implant complications.</p><p><b>METHODS</b>Coflex implant complications in this study included intraoperative or postoperative spinous process fracture, aggravated postoperative lumbocrural pain, dislodgment and malposition. The complications were analyzed, and therapeutic strategies were applied according to the specific complication. The Visual Analogue Scale and Oswestry Disability Index scores were evaluated by using the paired-samples test from SPSS 12.0.</p><p><b>RESULTS</b>Conservative treatment was provided to seven patients who experienced aggravated lumbocrural pain even though their devices remained in the correct position, and pedicle screw treatment was used as an alternative in four cases. The Visual Analogue Scale and Oswestry Disability Index scores showed evident improvement in these patients. The Visual Analogue Scale and Oswestry Disability Index scores of two patients who underwent revision were also improved.</p><p><b>CONCLUSIONS</b>Coflex implants should be avoided in patients with osteoporosis, a narrow interspinous space and intervertebral coronal spondylolysis, or sagittal instability. Furthermore the device choice, depth of implantation, and clamping intensity should be appropriate. Conservative treatment can be provided to patients with symptoms if the device remains in the correct position; however, revisions and salvages should be undertaken with internal fixation of pedicle screws for patients with device malposition, intraoperative implantation failure, or device intolerance.</p>

Device implanted complications of Coflex interspinous dynamic stabilization / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate device implanted complications and corresponding therapeutic strategies of Coflex interspinous dynamic stabilization system for lumbar spine intraoperatively and postoperatively.</p><p><b>METHODS</b>From September 2008 to August 2010, 133 cases of degenerative disease of lumbar spine including 62 males and 71 females, ranging from 35 to 81 years of age (mean 60.8 years), underwent or planed to be underwent decompression with Coflex interspinous dynamic stabilization system were reviewed retrospectively, and 13 cases including 6 males and 7 females, ranging from 41 to 71 years of age (mean 58.6 years), occurred device implanted complications. The Coflex implanted complications were analyzed, and therapeutic strategies according to different character were carried out, scores of visual analogue scale (VAS), Oswestry disability index(ODI) and effect-related data preoperatively, postoperatively, after conservative treatment and in final follow-up were evaluated with paired-samples t test.</p><p><b>RESULTS</b>Thirteen cases of Coflex implanted complications and treatment applied included: 3 cases occurred fracture of spinous processes intraoperatively were treated by pedicle screws instead; 2 cases occurred fracture of spinous processes postoperatively or during follow-up, including 1 case underwent revision with pedicle screws, another 1 case treated with conservative treatment; 4 cases with degenerative coronal spondylolysis in surgical segments, 1 case with sagittal instability preoperatively, and 1 case with device dislodgment in follow-up all suffered aggravated pain and received conservative treatment; 1 case suffered implanted malposition intraoperatively was underwent internal fixation with pedicle screws instead; at length, 1 case with aggravated pain postoperatively and without definite reason received revision with internal fixation of pedicle screws demolishing the Coflex. The follow-up time of 13 cases ranged from 20 to 38 months (mean 27.6 months); and 7 cases implanted Coflex with aggravated pain of lumbar and lower limb, but the position of device can still maintained, were received conservative treatment, and whose score of VAS and ODI in the final follow-up were 1.9 ± 0.7 and 23.2 ± 3.4, and comparing to 6.1 ± 1.1 and 58.1 ± 3.0 preoperatively, evident improvement was got finally (t = 8.2 and 18.2, P < 0.01). Scores of VAS and ODI of 2 cases with Coflex implanted complications underwent revision with pedicle screws were also improved correspondingly.</p><p><b>CONCLUSIONS</b>Coflex interspinous dynamic stabilization system implanted should be avoided to cases who suffered with osteoporosis, too narrow interspinous space and intervertebral coronal spondylolysis or sagittal instability; and choice of device, depth of implantation and intensity of clumping should be appropriate. For patients with symptom but device still in right position, conservative treatment can be carried out; but for patients subjected to malposition of device, failure of implantation intraoperatively or intolerance to device, revisions and salvages should be underwent with internal fixation of pedicle screws.</p>

Cervical spinal cord injuries without radiographic abnormality: classification and surgical treatment / 中华骨科杂志

Objective To investigate the traumatic characters, the causative factors and the outcomes of surgical treatments of cervical spinal cord injuries without radiographic abnormality(SCIWORA).Methods From March 2000 to July 2004, 81 patients of cervical SCIWORA undergone surgery were evaluated retrospectively. There were 55 males and 26 females, with a mean age of 57.3 years. According to the mechanisms of injuries and pathological changes of the cervical spine, the causative factors were divided into 3 groups: hyper-flexion type of injury (1 or 2 segments) with protrusion or prolapse of the cervical intervertebral discs (19 cases), hyper-extension type injury with multiple (≥3 segments) cervical spinal stenosis (41cases), and whiplash injury with multiple cervical spinal stenosis and segmental intervertebral instability or anterior protrusion of the cervical intervertebral discs (21 cases). A variety of surgeries as anterior discectomy with interbody fusion, multiple posterior decompressions with cervical laminoplasty, and multiple posterior decompressions with internal fixation at the facet joints were performed based the classification. Results The average follow-up period was 78.5 month (54-118 months). During the follow-up of 1 month, 3 months,1 year and last visit post-operatively, the rate of JOA improvement were 25.1%, 41.3%, 63.6% and 60.9%respectively. In the long-term follow-up, the good ratio of neurological function was obtained with 80.2%.Conclusion SCIWORA is considered as a course of acute, dynamic and limited injury. In spite of common clinical manifestation, its traumatic characters and causative factors are different indeed. The distinct improvement of neurological function can also be achieved with proper classification and surgery.

Notch signaling in human breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the role of Notch signaling in human breast cancers, the expression of Notch1 and its ligand JAG1 in human breast cancers and their relationships with clinical stages of breast cancers were analyzed.</p><p><b>METHODS</b>RT-PCR was used to detect the expression of Notch1 and JAG1 in 62 breast cancer specimens and 22 normal breast tissues at the margin of tumor sections, and the statistical difference of expression rates and standardized coefficient between the two groups were analyzed. To compare the expression intensity of Notch1 and JAG1 at different development stages of the illness and at different stages with or without axillary node metastasis.</p><p><b>RESULTS</b>The expression rate and standardized coefficient of Notch1 in human breast cancers were significantly higher than those of normal breast tissues at the margin of tumor sections. The expression rate of JAG1 in human breast cancers was 15%, while JAG1 was not detected in normal breast tissues at the margin of tumor sections. The standardized coefficient of Notch1 in cases with axillary node metastasis was significantly higher than that in cases without axillary node metastasis. The standardized coefficient of Notch1 at stage I was significantly lower than that at stage II, and stage II was significantly higher than stage III. There was no statistically significant difference between stage I and stage III.</p><p><b>CONCLUSION</b>Notch1 and JAG1 are highly expressed in human breast cancers, indicating that the aberrant expression and activation of Notch1 may be related with tumorigenesis of human breast cancer. Notch1 may play different roles at different developmentl stages of human breast cancer.</p>

Reversal of multi-drug resistance in K562/A02 cells by two short hairpin RNAs (shRNA) of mdr1 / 中华血液学杂志

<p><b>OBJECTIVE</b>To construct two recombinant plasmids of mdr1 and mcl1 shRNA, and to investigate their reversal effect on drug resistance in K562 adriamycin resistant cell lines (K562/A02).</p><p><b>METHODS</b>Two oligonucleotides of mdr1 and mcl1 gene were designed referring to that of GenBank, double-stranded DNA was derived through annealing, and cloned into pRNAT vector digested by two restricted endoenzymes. K562/A02 cells were transfected with the recombinant plasmids. The mdr1 mRNA expression and its protein product P-glycoprotein (P-gp) were detected by RT-PCR and flow cytometry. The expression of mcl1 gene was detected by RT-PCR. 50% inhibition concentration (IC50) of adriamycin (ADM) on K562/A02 cells was determined by MTT method. Cells apoptosis was analyzed by flow cytometry.</p><p><b>RESULTS</b>Comparing with K562/A02 cells, the shRNA of mdrl or mcl1 gene in vitro can remarkably increase the sensitivity of K562/A02 to adriamycin, down-regulate mdr1 or mcl1 gene expression, increase the K562/A02 cells apoptosis rates induced by adriamycin. Cotransfection of mdrl and mcl1 genes shRNA can also down-regulate the expression of their gene, more remarkably increase the sensitivity and apoptosis of K562/ A02 to adriamycin.</p><p><b>CONCLUSION</b>Transfection of mdrl or mcl1 gene shRNA can promote the sensitivity of K562/A02 to adriamycin and cotransfection of the two shRNA can more remarkably do so. The mel1 gene might be involved in adriamycin resistant in K562/A02 cells.</p>

Effect of Synthesized Rehabilitation on Detoxification Addicts / 中国康复理论与实践

@#ObjectiveTo explore the effect of synthesized rehabilitation on detoxification addicts.Methods100 detoxification addicts were randomly divided into the rehabilitation group and control group with 50 cases in each group. Cases of the rehabilitation group were treated with "ten-step" rehabilitation treatment, but that of the control group did not. The rehabilitating treatment included cognitive psychotherapy, behavioral therapy, family treatment, social skill training and etc. The effects of two groups were evaluate with Symptom Checklist-90 (SCL-90) scale.ResultsExcept hostility, other factorial scores of the rehabilitation group including positive items, somatization, obsession, interpersonal sensitivity, depression, phobia, paranoid and psychotic factors were significantly higher than that of the control group (P<0.05～0.01).ConclusionThe synthesized rehabilitation can obviously improve the psychology of detoxification addicts.

Classification and treatment of cervical spinal cord injuries without fracture or dislocation / 中华创伤骨科杂志

Objective To evaluate retrospectively the causative factors and corresponding surgical treatments of cervical spinal cord injuries without fracture or dislocation. Methods 29 cases of cervical spinal cord injury without fracture or dislocation were studied to analyze their imaging manifestation, features and causative factors of the injury, and pathological elements. Different surgical operations were performed accordingly, and their short-term outcomes were evaluated. Results The analysis indicated that there were chiefly 3 groups of causative factors. About 24% of the patients were typical cervical disc protrusion or prolapse, about 52% of them suffered from obvious decrease or even disappearance of the storing space of spinal canal, and about 24% suffered from decrease of the storing space of spinal canal combined with segmental instability among the vertebras, or with cervical disc prolapse. The postoperative short follow-ups (a mean period of 8.5 months) for the 29 surgical treatments showed that their spinal cord functions had been improved significantly, with the recovery rate being 52.8% by Japanese Orthopaedic Association (JOA) scoring. Conclusions Despite some common features, the causative factors for the cervical spinal cord injury without fracture or dislocation are quite different. Consequently, in order to achieve satisfactory outcomes, corresponding surgical operations with different approaches should be performed, and proper internal fixation should be applied according to the specific indications.

Anti-apoptosis effect of ligustrazine on the apoptosis of PC12 cells induced by dopamine / 第三军医大学学报

Objective To explore the protective effect of ligustrazine on the apoptosis of PC12 cells induced by dopamine(DA) and its mechanisms. Methods Apoptosis of PC12 cell was induced by dopamine at the concentrations of 0, 0.30, 0.60 mM. Ligustrazine at the concentrations of 0, 30, 60, 90 ?g/ml was added to defect the effect of ligustrazine on apotosis. The subdiploid peaks showing cell apoptosis rate were detected by flow cytometry. The cell activity was determined by MTT. Concentration of nitric oxide(NO) was determined by the Griess reaction. Results Compared with those of the control, the apoptosis rate and the level of NO induced by 0.30 or 0.60 mmol/L DA were higher, but the activity of PC12 cells was lower. Compared with those of the groups without ligustrazine, the apoptosis rate and the level of NO increased, but the cell activity decreased in a dose dependent manner. Conclusion Ligustrazine can inhibit the apoptosis induced by DA, which might be correlated with the decrease of NO production.

Evaluation of Dispensers' Performance in Outpatient Dispensary and Effects / 中国药房

OBJECTIVE: To work out scientific computation and evaluation method for the working performance of dispensers so as to improve the service quality and motivate the enthusiasm of the dispensers.METHODS: The performance of each dispenser consisted of the coefficient of dispensing prescriptions and coefficient of colligation(weight ratio: 80%∶20%).The coefficient of dispensed prescriptions was derived from the number of prescriptions in the foreground(counter),the quantity of drugs dispensed and the number of dispensed prescriptions in the background;and coefficient of colligation was derived from the service quality and work performance of dispensers.The individual bonus was decided by his performance coefficient.RESULTS: The monthly quantitative evaluation indicators and evaluation results of the work performance and service quality of each pharmacist became available.As compared without this evaluation system,the differences among dispensers in performance coefficient and in dispensing error were markedly decreased after the practice of performance evaluation,and the irrational prescriptions were able to be corrected in time.CONCLUSIONS: The quantitative evaluation method has motivated the working enthusiasm of the dispensers and enhanced both the working efficiency and service quality.Besides,this system can be modified based on the practical situation to be generally approved.