Objective To evaluate spiral CT diagnosis of gastrointestinal stromal tumors (GIST).Methods The CT findings and clinicopathological data of 32 GIST cases were retrospectively analyzed. Results Of the 32 GIST cases, 1 located in the esophagus, 22 in the stomach, 1 in the mesentery, 6 in the small intestine and 2 in the colon. There were 4 benign and 28 malignant cases. Expression of CD117 and CD34 was 75% and 81% respectively. The lesions were exogenous in 56% cases. The average size of the benign and malignant masses was 4. 75cm and 6.78cm respectively. Conclusions Spiral CT could provide important information for the diagnosis and localization of GIST, but the final diagnosis still relies on pathology.

This article introduces how to use debate in clinical teaching and explains the organization,training,choosing the debate topics,making the rule and implementation of debate.Debate is advantageous to raise and enhance the medical students' abilities of study independent,clinical thought,consult,analysis and application literatures,oral expression,team cooperation and so on.

1. 40 cadavers were dissected in order to observe the position and formation of the osteo-fibrous canal (384 canals) of the medial division of posterior ramus of lumbar nerves together with the occurrence of the articulo-accessory (process) ligament.2. The form of the external opening of the osteo-fibrous canal may be classified into three groups; nearly circular 35.1% (151); approximately ellipsoid 32.3% (124); crack detector 28.4% (109).3. The osteo-fibrous canal consists of four walls, bounded by mammillary process, accessory process, bony wall and superior articular process ligament respectively. According to the constitution of the anterior and posterior walls of the canal, it may be divided into three categories; osteo-aponeuroticoligamentous type 29.4% (113); osteo-membranous type 66.4% (255) and bony type 4.2% (16).4. The length and width of the superior articular process ligament were measured. The sexual difference of the lengths of L_(1～5) lumbar is significant.5. The sulcus between the superior articular process and the alar portion of the sacrum was observed and measured.6. The ligament on the posterior wall of the canal is nominated as the ligament of the superior articular process.7. Based on the anatomical structures thus studied, some clinical significances were discussed.

Objective To explore the correlation of chemosensitivity in vitro of anti-cancer drugs between peripheral blood lymphocytes and tumor cells in non-small cell lung cancer of elderly patients.Methods The MTT method was used to test the sensitivity of the peripheral blood lymphocyte and the tumor cells of 52 patients with nonsmall cell lung cancer to 13 kinds of anti-cancer drugs.Results The sensitivity test in eleven drugs include CDDP,CBP,LOHP,PTX,CTX,ICTX,THP,VP-16,GEM,VCR and NVB in the peripheral blood lymphocyte were associated with that in the tumor cells.But no dependablity in two drugs,ADM and HCPT.Conclusion The peripheral blood lymphocytes could be replace tumor cells to test the chemosensitivity of anti-cancer drugs in patients with non-small cell lung cancer.

Objective To probe the precision of the magnetic resonance spectroscopy (MRS)in assessing the fat content in the vertebral bone marrow and the changes at different vertebrae.Methods A total of 46 female volunteers were recruited in this study. After routine MRI examination,single voxel (SV)was chosen for the 1 H-MRS acquisition at L1 -L4 vertebral body.Thirty subjects were scanned twice to evaluate the precision of MRS.The fat fraction (FF%),unsaturation index (UI)and coefficients of variation (CV) were calculated by amplitude and area under the peak respectively.The changes of fat content in marrow at L1 -L4 vertebrae was further evaluated.Results The CV related to peak amplitude was 1.7% in quantification of vertebral FF%,while the CV related to peak area was 6.3%.In quantification of vertebral UI,the CV related to amplitude and area was 2.4% and 7.8% respectively.The FF% was ascended from L1 to L4,while UI of bone marrow declined.A significant correlation was observed between FF% and UI (r=-0.714,P <0.01).The correlation of FF% among L1 -L4 were also significantly observed (r =0.612 -0.923,P <0.01). Conclusion MRS at 3.0 T provides reliable measurement for marrow fat content with a good precision associated with amplitude. Meanwhile,there is a preferential increase in saturated lipids compared to unsaturated lipids from L1 to L4.There is a high correlation of FF%among L1-L4.MRS is a valuable tool for providing complementary information on osteoporosis research.

The article introduces the training of basic skill,renovating of the experiment contents,the diversifi cation and abundance in interest of experiment teaching methods of the students of medical laboratory speciality of higher profession.

1. 40 cadavers were dissected in order to observe the position, formation and morphology of the osteo-fibrous canal (400 canals) of the posterior rami of the lumbar spinal nerves.2. The average lengths of the osteo-fibrous canals for the posterior ramus of the lumbar nerves in both sexes are: L_1 4.88mm, L_2 4.71 mm, L_3 4.61 mm, L_4 4.57mm, L_5 4.39 mm.3. The average longitudinal diameter of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 6.38mm, L_2 6.73 mm, L_3 6.34mm, L_4 5.75mm, L_5 2.61mm.The average transverse diameters of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 2.69mm, L_2 2.66mm, L_3 2.68mm, L_4 3.14mm, L_5 2.06mm.4. The shapes of the outlets of the osteo-fibrous canals of the posterior rami of lumbar nerves may be classified into four types: nearly circular 64.75% (259 sides); approximately ellipsoid 30.25% (121 sides); nearly triangular 3.00% (12 sides); nearly oblate 2.00% (8 sides).5. 320 inter-transverse ligaments were observed and measured.6. There was always an iliolumbar ligament interposed between L_5 and S_1.7. Further more, the authors discussed the relationship between the morphology of the nerves and the osteo-fibrous canals in connection with the possible causes of low back pain.

BACKGROUND: Compared with the metal screws, absorbable screws have more obvious advantages, such as does not have to conduct internal fixation removal, non-metal ic components, no influence on the magnetic resonance imaging of patients after implantation, relatively simple operations, namely dril ing-tapping-screws fixation, more in line with the principles of minimal y invasive in orthopedics. OBJECTIVE: To investigate the biomechanical characteristics of absorbable screw fixation in repair of simple lateral mal eolus fractures by means of finite element technology. METHODS: The three-dimensional model of simple lateral mal eolus fractures and absorbable screw model were established, and then fixed according to standard orthopedic surgical techniques. The reference load when the load bearing of fibulotalar joint reaching the peak value in a normal adult gait cycle was loaded. The stress distribution and displacement of fibula and absorbable screws were analyzed. RESULTS AND CONCLUSION: There were total y 38 542 units, 8 790 nodes in the single screw fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 89.35 MPa, the maximum displacement was 0.5 mm, the maximum displacement of the distal fracture was 0.5 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 152.58 MPa, the maximum displacement was 0.59 mm, the maximum displacement of the distal fracture was 0.77 mm. There were total y 43 115 units, 9 496 nodes in the double screws fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 38 MPa, the maximum displacement was 0.44 mm, the maximum displacement of the distal fracture was 0.44 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 66.68 MPa, the maximum displacement was 0.48 mm, the maximum displacement of the distal fracture was 0.49 mm. The experiment verified the biomechanical feasibility of absorbable screw fixation in repair of simple lateral mal eolus fractures. For simple involving only the lower lateral fibular fracture, absorbable screw fixation is entirely feasible, and usual y requires at least two screws to maintain the stability of the articular surface of the reset.

BACKGROUND:For unstable intertrochanteric fracture repair, there are two views:extramedul ary fixation or intramedul ary fixation. Theoretical y, intramedul ary fixation is in line with the principles of minimal y invasive, more mechanical and biological advantages. However, evidence-based medicine and related studies have shown that compared with the extramedul ary fixation, intramedul ary fixation did not reflect the proper theoretical advantage. OBJECTIVE:To compare the biomechanical performance of two kinds of internal fixation systems:dynamic hip screw and Gamma nail which commonly used in repair of intertrochanteric fractures by finite element method, and to evaluate the advantages and disadvantages of dynamic hip screw and Gamma nail in treatment of unstable intertrochanteric fracture. METHODS:Three-dimensional finite element model of human femur unstable intertrochanteric fractures (31-A2;AO fracture classification), and the three-dimensional finite element models of dynamic hip screw and Gamma nail were established respectively, and were fixed according to the requirement of orthopedic surgery. The reference load which the joint bearing was at the peak time in adult step state period with the body mass of 700 N was stimulated. The stress distribution of bone, bone-internal fixation model, nail or screw, the strain and deformation of fracture location on the surface of the bone and bone-internal fixation model, the stress distribution along the femur and the loading transfer condition along the internal fixator and the like were analyzed. RESULTS AND CONCLUSION:Dynamic hip screw and Gamma nail have good sliding compression features which could make the continuous and dynamical y axial compression of the fractured section. Under the load conditions, the displacement value of dynamic hip screw was larger. In the treatment of unstable intertrochanteric fracture, Gamma nail was stronger than dynamic hip screw. Two kinds of internal fixations al make the bearing load of the proximal femur reduce. In the treatment of 31-A2 type unstable intertrochanteric fractures, we should choose dynamic hip screw for fixation if the femoral calcar was not seriously crushed, little defect or no defects and can immediately rebuild the stability of femoral calcar during operation, otherwise, stronger internal fixation, namely Gamma nail fixation should be chosen.

Objective To discuss the clinical effect of different surgery in the treatment of shunt-dependent hydrocephalus by comparing the postoperative complications of ventriculoperitoneal(V-P) shunt surgery with different incidence of eminence puncture or the triangle puncture.Methods 98 patients with shunt-dependent hydrocephalus who underwent V-P shunt were analyzed.According to different operation methods,they were divided into eminence puncture group (63 cases) and triangle puncture group (35 cases).The operation time and postoperative complications were compared between the two groups,and the clinical efficacy was compared by Glasgow Coma Scale (GCS) score at the end of 12 months follow-up.Results The operation time of the eminence puncture group [(53.35 ± 5.72) rain] was longer than (35.52 ± 9.18) min of the the triangle puncture group (t =6.024,P ＜ 0.05).The incidence rate of complication in the eminence puncture group was lower than that in the the triangle puncture group at postoperative 12 months (x2 =4.395,P ＜ 0.05).Postoperative CT examination found that the ventricle width of the two groups was decreased in different degree.The improvement of Evan's index(t =40.86,P ＜0.05) and GCS score(U =4.50,P ＜ 0.05) in preoperative of the eminence puncture group were greater than those of the triangle puncture group after 12 months.Conclusion The clinical efficacy of V-P shunt of the frontal lateral ventricle puncture may be superior to the triangle puncture in the treatment of shunt-dependent hydrocephalus.