Objective: To investigate the undergraduate's sand play themes and the symbol interpretation Method: The sample included 36 subjects, 16 male students, 20 female students A 72?50?7 6cm sand stray and an assortment of miniatures were provided Each subject made two sand plays in one week interval Result: The themes in sand play of students were almost outdoor activities and family problem, which appeared in 56 of the total 72 trays (78%) Themes of traumatic childhood experiences that were prominent in results of western research did not appear Fences were used in 54 of the 72 trays (72%), the subjects interpreted the meaning of fences as boundary of self, safety, space for self, etc

[Summary] This paper reported a case of 4-year-old boy suffered with medial meniscus tear treated by arthroscopic repair in our hospital.After the boy injured his knee , plaster was applied for 4 weeks.Without any symptomatic progress , he was hospitalized with the diagnosis of medial meniscus tear .We performed arthroscopic meniscus repair , using 4.0-mm arthroscopy.At 3-month follow-up, the boy could full-bearing walk with no pain or discomfort , with a range of motion of 0°-135°.The post-operational MRI at the fourth month showed preliminary healing of repaired meniscus .We believe that regular arthroscopic instruments can accomplish meniscus repair in young children .

Objective To investigate the technique and efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament(ACL) from the tibial eminence with stainless steel wire guided by meniscal stitching needle.Methods Fifteen cases of avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle from December 1999 to August 2005.The Lysholm scoring scale system was used to evaluate knee functions before and after surgery.Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments.Results The operation was completed within 30 min.No complications of intraarticular infection,iatrogenic injury,fibroarthritis,or non-union of fracture were found.The 15 cases were followed for 6～54 months(mean,20.9?15.0 months).X-ray films revealed good bone union in all the 15 cases.The Lysholm scores were improved from 19.1?15.2(range,10～56) preoperatively to 97.5?3.7(range,91～100) postoperatively,with significant statistical difference by the student-t test(t=18.483,P=0.000).Wire breakage was found in 2 cases at 8 and 14 months after operation,respectively.But the bone union in the 2 cases was not affected.Conclusions Arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle in the treatment of avulsion fracture of the anterior cruciate ligament from the tibial eminence has advantages of simplicity,broad indications(from type Ⅱ to Ⅳ injuries),minimal invasion,and rapid postoperative recovery.

Objective To observe histologically the effect of exogenous application of bFGF (basic fibroblast growth factor) combined to freeze- dried tendon on angiogenic enhancement in early ACL (anterior cruciate ligament) reconstruction. Methods 14 dogs were used in the experiment. 100 ng/mL bFGF was combined to freeze- dried tendon and then transplanted into one side knee to substitute the original ACL, while only freeze- dried tendon was used in the transplantation at the other side as control. The ACLs were harvested each week from 1 to 6 weeks from the 14 dogs respectively. The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. Results Neovascularization occurred at 2nd to 3rd week and reached the peak at 4th to 5th week postoperatively at the experimental sides. By contrast, the neovascularization occurred at 4th to 5th week postoperatively at the control sides. Conclusion The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze- dried tendon are superior to those in the control group.

Purpose:To analyse the dosimetric parameters measured by the silicon diode, and to describe the features of the dose distributions for small fields.Materials and Methods:P-type silicon diode with small volune and high sensitivity was chosen to measure the PDD,OAR and Sc,p at isocenter for circular fields of 5mm ～50mm in diameter used for stereotactic irradiation .The dosimetric data measured are evaluated by comparising with ones by other methods, such as ionization chamber and films,and ones in literature.Results:The values PDD of 10 and 30 fields at depth from 5cm～20cm are almost the same as those in reference 7 within ?0.6; The effective linear attenuation coefficient extrapolated to zero fiels size is 0.0510cm -1 for 6MV-X rays. The Sc,p value measured by diode and chamber(NE2571) are agread each other within variations of ?0.4% for large field size, but a great difference appears when the field size is 2 times smaller than the diameter of chamber. The Sc,p values by diode for field size of 12.5mm～27.5mm are agreed well with the results by Monte Carlo calculations. The OARs measured by diode are ageed well within 1mm with ones by films developed by ourself. The penumbras(90%～10%) measured by diode are coincidence with the results published.Conclusion:Due to the high dose gradients at the beam edge and the absence of lateral electron equilibrium for the smaller fields, the detector size and positioning are the most impostant factors influenced the measured results. Our practice shows that the silicon diode with diameter of 2mm or smaller is the best choice for the dosimetric date collection for beams used in X-ray stereotactic irradiation.

[Objective]To summarize the middle-term results of unicompartment knee arthroplasty(UKA),and postulate a new specific assessment score.[Method]From March 2004 to September 2006,unicompartment knee arthroplasty had been proformed in 22 patients(22 knees)with unicompartment osteoarthritis.The mean follow-up period was 34 months(range from 14 to 49 months).The HSS score、KSS score and WOMAC score were used to evaluate the outcomes of UKA at the time of preoperation and follow-up respectively.A new unicompartment knee arthroplasty specific score was postulated to evaluate the results of UKA.[Result]At the time of the final follow-up,pain relief was significant in all patients,and the range of motion and quality of living were improved.The HSS score,KSS score and WOMAC score were significantly improved compared with pre-operation(P

[Objective]To report the treatment and outcome of treatment of discoid lateral meniscal tear by arthroscopic surgery.[Method]During the period between Jan.1999 and Jun.2005,77 patients suffered from discoid lateral meniscal tear have been treated by arthroscopic surgery in Xijing Hospital. The standard arthroscopic portals (anteromedial and anterolateral)were used.Lateral menisci were totally removed in the 21 patients (29.2%) of total 77 cases,whereas lateral menisci of 13 patients (18.1%) were removed partially and meniscus-plasty was applied in 38 patients (52.8%).Thirty-nine (54.2%) of 77 patients were males,and 33 (45.8%) females.Their average age was 29.4?10.9 years (range 8~51 year).Five patients were lost in follow-up.The mean follow-up period of the rest 72 patients was 26.2 ?9.3 months (range 12~44 months).The patients were assessed pre-operationally and post-operationally by the Lysholm score.Moreover,the results of Lysholm score were analyzed by student-t test.[Result]All patients had progress in pain,swelling,range of motion and knee function. No complication,which included intraarticular infection,iatrogenic injury,fibroarthritis or loss of range of motion,was found.Lysholm score was 66.8?5.2 in average (range from 50 to 78) before operation,whereas it improved to 96.4?3.6 in average (range from 85 to 100) after operation.According to student-t analysis,very significant statistical difference was found between the pre-operative and post-operative results (t=34.7,P

[Objective]To introduce the treatment and result of meniscal cyst by arthroscopic surgery.[Method]During the period between 1997 and 2005,20 patients suffered from meniscal cysts have been treated by arthroscopic surgery in Xijing Hospital.Meniscal cysts were excised in all cases with shaver under arthroscopic visualization,whereas outside-in suture repair of meniscus was undergone in 8 cases to close the lacuna and repair the meniscal peripheral free which were resulted from remoral of cyst.The patients were followed up from 3 to 42 months with an average of(18.7?12.2)months.The patients were assessed pre-and post-operatively by the Lysholm score and Glasgow Assessment.[Result]Sixteen of total 20 patients were followed up.Meniscal cyst recurred in a patient one year after operation.Lysholm score of the 16 patients showed a significant improvement from(71.2?8.7)pre-operation to(97.1?2.9)post-operation(t=32.948,P

Objective To reconstruct three-dimensional femoral footprint of the anterior cruciate ligament(ACL) by dual-source CT(DSCT),which can provide a novel positioning system particularly applicable in the anatomic ACL reconstruction under arthroscopy. Methods DSCT scanning was performed for the bilateral knees of 30 healthy volunteers.Three-dimensional reconstruction of the lateral wall of the intercondylar notch was done with 64-slice spiral CT workstation(GE,Volume Share2-AW 4.4 version).Double-bundle footprints of the ACL femoral insertions were identified, outlined and marked on the three-dimensional models.The over-the-top junction of the distal femur and the trochlea of femoral lateral condyle was dotted as a reference point O.The femoral footprint long and short axes,the footprint angle between the line passing through 2 centers of anteromedial and posterolateral bundles and the femoral shaft,the distance between 2 bundle centers,the shortest distance from the footprint edge to the distal femoral cartilage,and the shortest distance from the footprint edge to the posterior margin of the femoral cartilage were measured on the models with a standardized scale. Results All the ACL femoral footprints were successfully reconstructed by DSCT in the 60 knee joints.They were relatively protruding,plain,irregular in shape but identical in grey scale,distinct areas on the image. On the three-dimensional models of femoral lateral condyle,a 3-point-2-angle positioning system applicable in arthroscopic anatomic ACL reconstruction was successfully established and used to define and describe the double-bundle insertions of ACL.The mean long and short axes of ACL femoral footprint were respectively 16.5 ± 1.8 mm and 8.0 ± 1.3 mm; the mean ACL footprint angle was 8.3° ±4.9°; the mean distance between 2 bundle centers was 7.8 ± 1.0 mm; the mean shortest distance from the footprint edge to the distal femoral cartilage was 1.6 ± 1.5 mm; the mean shortest distance from the footprint edge to the posterior margin of the femoral cartilage was 1.7 ± 0.9 mm. Conclusions Three-dimensional ACL femoral footprints can be clearly reconstructed with DSCT.Natural ACL femoral footprints vary from person to person,which indicates a need of individualized reconstruction in order to restore the anatomy in maximum.The 3-point-2-angle positioning system we have developed is just suitable for arthroscopic ACL reconstruction.

Objective To evaluate the results and side effects in three dimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods From December 1996 to December 1998,67 patients with esophageal carcinoma were treated with 3DCRT(3DCRT group),in which all were treated once every other day to a total dose of 40 42 ?Gy in 13 15 days at 5 6?Gy per fraction totally 7 8 fractions, and during the same interval, another 112 patients treated by conventional fractionation radiotherapy(CF group) to a total dose of 64 68?Gy over 44 48 days at 2.0?Gy per fraction 5 days per week were analyzed and compared. Results The 1 ,2 ,3 and 4 year local control rates in 3DCRT group were 71.6% ,62.7%,49.3% and 43.3% ,compared to 53.6%, 43.8% ,33.9% and 25.9% in CF group (P = 0.011). And the survival rates in 1 ,2 ,3 and 4 years in 3DCRT group were 62.7%,52.2%,43.3% and 38.8%, as compared with 49.1%, 41.1% ,30.4% and 22.3% in CF group (P = 0.027). However, in the 3DCRT group, the incidence of acute radiation esophagitis was higher (P=0.003) and those of hematogenous side effects and B symptom were lower(P=0.007,0.021). Conclusion Compared with conventional fractionation radiotherapy,3DCRT is able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.