As a main cellular organelle for bioenergy production , the mitochondrion plays a pivotal role in aerobic respiration , substance metabolism , oxidative stress , apoptosis and calcium homeostasis .Increasingly studies have shown a close relationship between mitochondrial dysfunction and cancer .Mitochondrial metabolic disturbance , reactive oxygen species ( ROS ) increase, mitochondrial gene mutation , calcium overload and abnormal apoptosis can influence tumorigenesis , growth, invasiveness and metastasis of multiple tumors .We aimed to summarize the mechanisms and influences of mitochondrial dysfunction on cancer .

It is very frequent that patients undergoing total knee arthroplasty ( TKA) suffer a severe pain from the bone cutting and soft tissue balance procedures postoperatively .In addition , pain control is the key point of the rehabilitation after surgery . Therefore, establishing an effective method to decrease the pain should be considered as a priority .Femoral nerve block (FNB), as a common and effective peripheral nerve block after TKA , affects the strength of quadriceps femoris and the postoperative recovery . Adductor canal block (ACB), targeting at the saphenous nerve , is proved to be as effective as FNB in pain control , and has less influence on the quadriceps strength .However , considering about the short time following up , the expansion of local anesthesia drug and few reports in China , the application of ACB in TKA needs further study .

Objective To explore the home-made U-shaped retractor ’ s effect on reducing the traction injury of recurrent laryngeal nerve in the video-assistance thyroidectomy . Methods The patients with unilateral and unifocal papillary thyroid microcarcinoma , which were diagnosed by ultrasound preparation and by pathological postoperation , were enrolled .They all underwent the ipdilateral lobectomy , isthmus resection and the clearance of central lymph nodes with video-assistance technology .From January 2013 to June 2014, 79 cases ( control group ) were received conventional method , by which the thyroid lobe was elevated onto the trachea surface.From January 2015 to March 2016, 71 cases (U-shaped group) accepted the procedure which adopted home-made U-shaped retractor to pull the thyroid lobe to carotid artery horizontally .The operations were completed by the same surgeon .There were no significant differences between the two groups in age , gender and lesion size , which is comparable .The incidence rate of hoarseness was compared postoperation . Results Postoperative hoarseness of the U-shaped group occurred in 6 cases (8.5%) and the control group in 17 cases (21.5%), which show a significantly statistical difference (χ2 =4.919, P=0.027).And there was no significant difference in voice recovery time [median:16.5 d (8-31 d) vs.18 d (4-50 d), Z=-0.246, P=0.806]. Conclusion In the video-assisted thyroidectomy , using the U-shaped retractor to pull the thyroid lobe laterally and horizontally will be beneficial to reduce the recurrent laryngeal nerve tension and the incidence of the retract injury .

Open surgery was the main treatment for abdominal aortic diseases in the past .However , with the development of endovascular instruments , endovascular repair technique has become the main option for abdominal aortic diseases .Unibody bifurcated stent-graft and modular bifurcated stent-graft are often used to treat abdominal aortic diseases .Unibody bifurcated stent-graft has its own features in endovascular repair of abdominal aortic diseases .We made a literature summary on application of unibody bifurcated stent-graft in abdominal aortic diseases .

[Summary] With an increasing higher failure rate from 50%to 70%after simple sutured surgery for rotator cuff tears , scholars have put forward the patch augmented biomechanics for healing massive tears .Research hotspots lie in the material structural and physiological properties .There are two types of rotator cuff patches , which are synthetic materials ( non-degradable and degradable type ) and biological rotator cuff patch ( autologous or allogeneic tissue , xenogeneic material ) .The synthetic materials rotator cuff patch is able to provide powerful biomechanics but has severe immune rejection , and the biomaterials patch provides excellent histological reconstruction in rotator cuff and accurate regulation of biological activity of metabolic degradation but lower biomechanical maximum tensile strength .This article reviewed the current common problems and progress in the application of the rotator cuff patches .

Objective To study the optimal timing of tracheotomy in patients with acute cervical spinal cord injury who need ventilation for a long time . Methods A retrospective research on seventy-nine patients with acute cervical spinal cord injury who underwent tracheostomy in our hospital from January 2011 to December 2015 was conducted .The 79 patients were divided into two groups.The patients with a duration from intubation to tracheostomy less than or equal to 10 days were enrolled in group A , and the duration more than 10 days, group B.The duration of ventilation , the length of ICU stay , and the incidence rate of lung infection were compared between the two groups . Results The duration of ventilation in the group A (192 ±58) h was less than that in the group B (348 ±53) h (t=-12.490, P=0.000).The length of ICU stay in the group A (9.8 ±2.7) d was less than that in the group B (15.9 ±2.2) d (t=-11.058, P=0.000).The incidence of pneumonia in the group A (16.2%, 6/37) was lower than that in the group B (38.1%, 16/42,χ2 =4.686, P=0.030).Mechanical ventilation was successfully withdrawn in 34 and 38 cases of group A and B, without significant difference (χ2 =0.000, P=1.000). Conclusion Early tracheostomy in patients with acute cervical spinal cord injury who need ventilation for a long time could shorten the duration of ventilation and the length of ICU stay , and decrease the incidence of pneumonia .

Objective To investigate the clinical characteristics of postmenopausal patients with cervical intraepithelial neoplasia ( CIN) gradeⅡ/Ⅲand cervical cancer . Methods A retrospective analysis was made on the clinical characteristics of 57 cases of postmenopausal patients who were diagnosed as CIN grade Ⅱor above from January 2014 to September 2015.Their age ranged from 49 to 77 (58.2 ±5.6) years old, and the time of menopause ranged from 1 to 36 (9.4 ±6.9) years. Results ①In postmenopausal women with CIN Ⅱ/Ⅲ and cervical cancer, only about 1/5 (11/57, 19.3%) had clinical complaints, and nearly 2/3 (36/57, 63.2%) had smooth cervical appearance .②There were 36 cases of high-risk human papillomavirus ( HPV) (36/39, 92.3%), 20 cases of single HPV16 infection (20/36, 55.6%), 7 cases of HPV16 type and other high-risk HPV infection (7/36, 19.4%), and 9 cases of other types of high-risk HPV infection (9/36, 25.0%).③The positive rate of high-risk HPV was 92.3%(36/39) and the HPV16 positive rate was 69.2% (27/39).TCT examination showed a positive rate of high grade squamous intraepithelial lesion (HSIL) of only 29.6% (16/54), with significant difference (χ2 =6.686 and 14.286, P =0.010 and 0.000, respectively). Conclusions Postmenopausal women with cervical lesions usually have no obvious clinical symptoms . Gynecological examination alone is difficult to judge whether the cervical lesions exist .Strict cervical lesions screening is particularly important .

[Summary] Gender difference study of meniscus injury shows certain clinical significance in understanding epidemiologic characteristics of meniscus injury .Several large amount case studies demonstrated that the risk of meniscus tears was significantly higher in male than in female .However , in certain kinds of sports and special types or locations of meniscus tears , especially in medial meniscus posterior root tear ( MMPRT ) , there were more females than males .Further large amount case studies were needed for a deeper understanding of meniscus tears .In this paper,we reviewed the current situation and progress of gender difference of menisus tear .

Stress response is an organism's defense mechanism against various stimulations, and involves nervous, endocrine, cardiovascular and immune systems.This review summarized the clinical research progress of adjuvant anesthetics and methods for reducing stress response and future trends of investigation.

Objective To explore the clinical diagnosis and treatment of cesarean scar pregnancy (CSP).Methods The clinical data of 83 CSP patients who first visited to our hospital during the period from January 2014 to December 2016 were collected for a retrospective analysis.Among the 83 cases, 79 were diagnosed by ultrasound, 2 were diagnosed by MRI, and 2 were misdiagnosed (2.4%).Curettage under ultrasound monitoring was used in 11 cases, including 10 cases of type Ⅰ and 1 case of type Ⅱ according to the 2016 classification standard of Chinese Medical Association.Curettage under ultrasound monitoring after methotrexate(MTX) was used in 34 cases, including 30 cases of type Ⅰ and 4 cases of type Ⅱ.Curettage under ultrasound monitoring after uterine artery embolization (UAE) was used in 37 cases, including 3 cases of type Ⅰ, 30 cases of type Ⅱ, and 4 cases of type Ⅲ.Besides, 1 case of type Ⅲ was treated with curettage under laparoscopic monitoring after UAE.Results All the operations were successful, without hysterectomy or conversion to open surgery.No persistent pregnancy was occurred.A total of 65 cases were followed up and 18 cases were lost.The β-hCG was decreased to normal after 2-5 weeks.After 4-9 weeks, menstruation was recovered.Conclusion According to different clinical types of CSP and gestational weeks, curettage under ultrasound or laparoscopic monitoring after different pretreatement is simple, safe and effective in primary hospitals.