Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

BACKGROUND:With more and more research available,there are different classification systems for intertrochanteric fracture,from Evans and Boyd-Griffin classification to Evans-Jensen and AO/OTA classification,all providing guidance for choosing an appropriate treatment scheme.OBJECTIVE:To review the advance in the treatment of senile unstable intertrochanteric fractures.METHODS:PubMed,Web of Science,WanFang and CNKI databases were searched with the keywords of intertrochanteric fracture,intramedullary nail,hip arthroplasty in English and Chinese,respectively.1 535 literatures were retrieved firstly,and finally 47 articles were included in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION:The therapy conception of intertrochanteric fractures has been changed from conservative traction to early surgical treatment.With the development of technology,the internal fixators have been improved continuously.Screw-plate system has been developed from Jewett plate,AO/ASIF plate to dynamic hip screw.Intramedullary nails such as Gamma,proximal femoral and proximal femoral antirotation nails have been successfully applied in clinic.Senile patients with unstable intertrochanteric fractures also obtain favorable prognosis through active internal fixation,but the high incidence of complications appears because of osteoporosis,osteogenesis deficiency and accompanied by degenerative hip diseases.Thereafter,hip arthroplasty is recommended to treat senile unstable intertrochanteric fractures so as to achieve rapid functional recovery,desired efficacy and low incidence of complications.However,it still remains controversial to choose internal fixation or hip arthroplasty.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

BACKGROUND:The region around the hip is a bone tumor predilection site. It is difficult to conduct tumor resection due to the involvement of weight loading area. Tumor resection requires high surgical technique. The pelvis and hip are often needed to be rebuilt.
OBJECTIVE:To compare the effects of three reconstruction methods after tumor resection around the hip.
METHODS:From January 2007 to December 2012, 20 patients with bone tumors around the hip were treated by surgery in the Zhongshan Hospital, Wuhan University, including 7 benign tumors, 13 borderline and malignant tumors. Eight patients received al ograft. Eight patients received arthroplasty. Four patients received saddle prosthesis.
RESULTS AND CONCLUSION:A total of 20 patients were fol owed up for 5 to 60 months (averagely 40 months). According to Enneking evaluation criterion, the operative outcome was evaluated as excellent in 8 cases, good in 5 cases, average in 4 cases, and poor in 3 cases. Excellent and good rate was 65%. Results suggested that after excision of bone tumors, al ograft, arthroplasty or saddle prosthesis can significantly elevate patient’s survival rate, improve patient’s living quality and is an effective therapy for treating tumors around the hip.

Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.

Purpose:To compare the survival rates of hyperf ractionated radiotherapy plus concurrent chemotherapy with hyperfractionated rad iotherapy alone in the treatment of stage Ⅲ/Ⅳ nasopharyngeal carcinoma (NPC) a nd analyze the prognostic factors. Methods:Between December 1992 and December 1995, 144 NPC patien ts were randomized into hyperfractionated radiotherapy plus concurrent chemother apy (R +C) and hyperfractionated radiotherapy alone (R alone).Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R + C patients before and during the course of radiotherapy. Results:The 5-year overall survival rates of the R + C and R alone groups were 63.3% and 50.7%,repectively . The factors influencing the resu lts were N stage,chemotherapy and the peripheral blood hemoglobin concentration . Conclusions:Hyperfractionated radiotherapy plus concurrent chem otherapy can improve the survival rate, especially for the patients with N2-N3 stage.The negative prognostic factors for Ⅲ/Ⅳ NPC are N2-N3 stage, radiothera py alone and the reduction of hemoglobin during treatment.

[Objective]To investigate the osteogenic ability in vivo of mesenchymal stem cells(MSCs).[Method]Ten-fifteen ml bone marrow aspirates were harvested from the iliac crest of sheep and enriched for MSCs by density gradient centrifugation over a Percoll cushion(1.073 g/ml).After cultured and proliferated,the tissue-engineered bones were constructed with these cells and seeded onto porous 13-tricalcium phosphate ceramics(13-TCP).Then,the constructs were implanted into left metatarsus defect(21 mm in length)of 8 sheep as an experimental group.Porous ?-TCP composed with bone marrow was implanted into defects of same size and position in 8 sheep as a control group.Sheep were sacrificed in the 6th,12th,and 24th week postoperatively,and the implanted samples were examined by radiograph,histology,and biomechanical analysis.[Result]New bone tissue was observed either radiographically or histologically at the defect area of experimental group as early as the 6th week postoperatively;but was not observed in the control group.Because of the new bone formed in a direct manner without progression through a cartilaginous process intermediately,osteoid tissue,woven bone and lamellar bone,occurred earlier in the experimental group than in the control group,in which the bone defects were repaired in a "creep substitution" manner.At the 24th week,radiographs and biomechanical tests revealed an almost complete repair of the defect in experimental group,but only a partial repair in the control group.[Conclusion]MSCs have good reproductive activity not only in vitro,but also in vivo.The new bone formed in a direct manner without progression through a cartilaginous process intermediately when MSCs were transplanted in vivo.The results demonstrated that MSCs was an excellent seed cells for bone tissue engineering.

The daily intake levels and trend of polychlorinated dibenzo-p-dioxins(PCDDs), polychlorinated dibenzofurans(PCDFs), polychlorinated biphenyls(PCBs) of general population of several developed countries are reviewed. Based on the data of China, PCDD-Fs levels in Chinese human milk and blood were less than that of other countries, in addition, a daily intake of PCDD-Fs for Chinese general population was estimated in the present paper, the tolerable daily intake of Chinese general population was less than that the World Health Organization proposed.

Objective: To study the relationship between the uncomfortable symptoms and psychological state of post CABG(Coronary Artery Bypass Grafting) patients.Methods: 65 post CABG patients answered the questionaires(Symptom Inventory,Self-Rating Anxiety Scale,Self-Rating Depressing Scale).Results: The Symptom Inventory has positive correlation with the total standard points of SAS and SDS.The higher the standard scores the worse the patient's psychological state.Conclusion: Use of proper health education,psychological care and drugs can release the patients of their uncomfortable symptoms.