Objective To investigate the situation of sports participation and the unmet needs of services for 6-12 years old children with intellectual disabilities. Methods 420 children with intellectual disabilities in areas of minority nationalities in Hubei province aged 6-12 years were surveyed with a questionnaire. Statistics had been conducted for situation and unmet needs of services. Results 72.6%respon-dents wanted to participate in sport, 70%respondents participated in sport at least once a week, maining for rehabilitation;the unmet needs of services mainly focused on the special education, medical rehabilitation, functional training and the non-barrier transformation for kitchen and toilets. Conclusion Comprehensive rehabilitation and services are needed in 6-12 years old children with intellectual disabilities in areas of minority nationalities in Hubei Province. The diversity of unmet needs needed to be attend.

Objective To investigate whether intervention with two different dosage of atorvastatin may benefit to plasma level of fibrinogen (Fg) in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were randomly assigned into three groups:the control group (33 cases) treated without lipid-lowering drugs, 10 rag (30 cases) and 20 mg (39 cases) atorvastatin group with 3 days of treatment. Before and after the treatment, the plasma levels of Fg and lipids were detected.Results The treatment of 10 mg atorvastatin did not significantly decrease the level of Fg. Compared to the control group, the level of Fg was markedly reduced by 20 mg atorvastatin (21.6% vs 3.2%,P< 0.05). No changes of lipid levels were observed in any group before and after the treatment, whilst there was no relation between the decreasing percentage of Fg and that of TC(r = 0.125 ,P= 0.618), TG(r = 0.147,P = 0.573) or LDL- C (r = -0.279, P = 0.235 ), HDL-C (r = -0.021, P = 0.157). Conclusion Treatment with high dose atorvastatin (20 mg) for 3 days could reduce the level of Fg, and improve the function of vascular endothehum,which may promote the stabilization of atherosclerotic plaque.

The left clavicle of a healthy female was scanned by CT and serial sections were obtained. The CT images were fed into the Mimics and Ansys 10.0 software to construction a three-dimensional and finite element modeling of clavicle. Through meshing, assigning the material attribution, restricting the freedom and stimulating loading which effect to the vertical area of the acromion surface of clavicle, the result of stress and strain distribution and response of the model was obtained. Under the loading, the stress and strain mainly concentrated within the middle 1/3 part of the clavicle, and the stress on the superior surface was obviously highter than inferior surface. But the highest strain concentrated within the inferior surface of the middle 1/3 part of clavicle. The stress on superior surface of the middle 1/3 part of the clavicel was mainly tensile stress,or the inferior surface was compression stress. The stress and strain distribution didn't changed when the coracoclaviculare ligamenta was constructed. The result of finite element analysis of clavicle explains the reason why the middle 1/3 part of clavicle is prone to fracture, and the stress and strain distribution didn't changed when the coracoclaviculare ligamenta was constructed. Also, finite element analysis can be used to effectively understand the biomechanical characteristics of clavicle.

BACKGROUND: There are many advantages in treatment of deglovinginjury in hand with compatible grafting of temporoparietal fascial flaps(TFFs), while there are few relevant reports in China.OBJECTIVE: To evaluate function and appearance of hands after restora-tion of soft tissue defects with compatible grafting of TFFs.DESIGN: Case retrospective analysis.SETTING: Department of Maxillofacial Surgery, Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Sciences.PARTICIPANTS: Eleven patients with hand injuries received compatiblegrafting of TFFs in the Department of Maxillofacial Surgery of PlasticSurgery Hospital, Peking Union Medical College, Chinese Academy ofMedical Sciences from January 2001 to May 2005 were selected including8 males and 3 females with a mean age of 30 years. All subjects participat-ed in the observation and analysis voluntarily. All patients presented expo-sures of tendon, bone or joint.METHODS: Preoperative location was done with Doppler or palpation methods and the orientation of temporal vascular nerve tracts were labelled. Re-cutization of surface of fascial flap was achieved through fullthickness skin transplantation. Sizes of fascial flaps were limited between 10 cm×9 cm and 4 cm×6 cm. Follow-up was 8 months (6-11 months),the items of which included postoperative functional inspection and satisfactory degree of appearance. Ratio of total active range of motion (AROM) with joints injured and corresponding uninjured joints were used for functional evaluation, and the meso was zero. Functional rehabilitation was divided into 3 grades according to the ratio: Good as the ratio above 0.75, fair as the ratio between 0.5 and 0.75, poor as the ratio below 0.5. Evaluation on appearances of hands contained satifactions of both patients and doctor including whether there were fat and clumsy or visible scars.MAIN OUTCOME MEASURES: Postoperative functional recovery of hand after compatible grafting of TFFs.RESULTS: Eleven patients with hand injury were included and 4 patients withdrew from the study. ①Fascial flaps of 9 patients completely survived,one patient got partial necrosis due to venous injury during flap harvesting,and wounds spontaneously healed by exchanging dressing. Venous crisis was found in the 3rd day of postoperation in one patient during operation research (OR) and there were thromboses in anastomosed veins due to the folding of overlong vein, which was unobstructed after reanastomosis, while there were sporadical scars in the raw surfaces. ②Functional recovery of hands were good in 4 cases and better in 3 cases, 4 cases withdrew from the study. Both doctors and patients were satisfied with the recovery status of appearance of hands.CONCLUSION: It is better to simultaneously adapt compatible grafting of TFFs and re-cutization in restoration of tissue defects in hands such as exposures of bone and tendon. Better aesthetic results can be achieved with out second flap restoration. Most of all, the supple texture of fascial tissues provides a good gliding environment for functional recovery of tendon and joint, moreover, scars in donor sites are well camouflaged without functional lesions.

Objective To investigate the clinical characteristics,treatment and prognosis of myocardial damage presented with abdominal pain in children.Methods The clinical data of 33 children with myocardial damage presented with abdominal pain in Beijing Anzhen Hospital during the past 4 years were analyzed.Emergency conditions were ruled out in all cases.Results Among 33 cases with myocardial damage presented with abdominal pain,there were 10 cases of pneumonia,9 cases of acute bronchitis,7 cases of upper respiratory tract infection,1 case of allergic purpura,1 case of myocarditis and 5 cases of unknown causes.The duration of abdominal pain lasted 2 days to 3 months.The characteristics and the duration of abdominal pain were irregular.Mycoplasma antibodies positive were 5 cases (2 cases of bronchitis,3 cases of pneumonia).Coxvirus antibodies were 2 cases.There were different symptoms and signs of myocardial damage.Holter:there were ST-T changes in 23 children and 17 frequent premature ventricular complex(pattern of bigeminy and trigeminy in 7 children,premature atrial complex in 4 children).Creatine kinase isoenzyme-MB were high in 21 children(30-124 U?L-1).Cardiac troponin I were high in 19 children(0.8-1.2 ng?L-1).Chest X-ray:cardiomegaly was noted in 7 children,and the ratio of cardiac and chest were 0.55-0.58.Echocardiography:the left ventricular end-diastolic diameter was enlarged in 5 children,the right atrium was enlarged in 1 child.Most abdominal pain was relieved with treatment in 5 to 7 days,and 14 days was the longest.Total treatment course was 2 weeks to 1 month,and 3 months was the longest.But 1 case with myocarditis was recurrent abdominal pain treated nearly 3 months,and lasted to 6 months for recovery.Conclusions It is important to pay attention to cardial examination early,when a child becomes inconsolable from abdominal pain but emergency conditions should be ruled out.

Objective The role of testis-sparing surgery in children with benign testicular tumors were emphasized by this retrospective survey. Methods Sixteen patients who undergo testis-sparing surgery between the years 1996 to 2003 were reviewed. Intraoperative frozen section histopathology had been done in all of patients. The period of follow-up ranged from 6 months to 7 years. Results In our series, as well as in the literature there was no differenle between frozen section and definitive histology.Ten cases were teratomas, 4 cases were epidermoid cysts and 2 cases were mucus cysts.Follow-up of 6 months to 7 years has shown no recurrence,and on examination,testicular volume is normal in all cases.Conclusion Testis-sparing surgery is a positive method in the management of benign testicular tumors in children.It preserves testicular volume,which is important for both cosmetic and functional roles.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion plus medications on senile osteoporosis (SOP), and to explore the related mechanisms. Methods: A total of 70 elderly participants with osteoporosis were randomly divided into an observation group and control group, with 35 cases in each group. The control group was treated with conventional drugs, and the observation group was treated with heat-sensitive moxibustion on the basis of the conventional drugs. Both groups were treated for 3 months. Before and after treatment, assessed the visual analog scale (VAS) and Oswestry disability index (ODI) scores, determined the bone mineral density of the participants' lumbar spine (L2-L4) and left femoral neck, and detected the participants' serum bone morphogenetic protein-2 (BMP-2) and osteoprotegerin (OPG) levels. Results: After treatment, the VAS scores of both groups were lower than before treatment (both P<0.05), and the VAS score of the observation group was significantly lower than that of the control group (P<0.05). After treatment, the bone mineral density values of the lumbar spine and left femoral neck in both groups were significantly higher than before treatment (both P<0.05), and the bone mineral density values of the observation group were higher than those of the control group (P<0.05). After treatment, the ODI scores of the two groups were lower than those before treatment (both P<0.05), and the ODI score of the observation group was lower than that of the control group (P<0.05). After treatment, the serum BMP-2 and OPG levels in the observation group were significantly higher than those in the control group (both P<0.05). Conclusion: Heat-sensitive moxibustion plus medications for SOP can significantly relieve patients' pain, improve dysfunction, and increase bone density, which may be related to the improvement of the serum BMP-2 and OPG levels.

Objective To investigate methods and effect of preventing hemorrhoea when superior position sacral tumor was resected.Methods 36 patients with superior position sacral tumor were operated by excision of presacral tumor from May 2000 to May 2007.14 cases were performed with double hypogastric artery ligation.Hy- pogastric arteries were embolismed temporarily through intervention in 7 cases and permanently in 10 cases.Distal end of abdominal aorta was placed with sacculus in advance in 5 cases.Average volume of blood was calculated ac- cording to different methods of preventing blood.Results Blood loss was 500～2000ml(average 1100ml)by hy- pogastric artery ligation.Blood loss was 600～2100ml(average 1200ml)by temporary double hypogastric arterial em- bolism while blood loss was 550～1900ml(average 1150ml)by temporary embolism.Blood loss was 200～1000ml (average 560ml)by placing sacculus in advance at distal end of abdominal aorta.Conclusion Hemorrhoea may be prevented completely through temporarily or temporarily reducing blood supply of pars sacralis when sacral tumor was resected.Especially,it is a best method when distal end of abdominal aorta was placed with sacculus in advance.

Purpose: To study the expression of VEGF, VEGF-C, fit-4 in breast cancer and its relationship with lymph node metastasis and explore the significance of lymphangiogenesis on metastasis via lymphtics. Methods: Paraffin-embedded specimens from 82 patients with primary breast cancer who had undergone radical mastectomy with lymph node dissection were studied. VEGF, VEGF-C, flt-4 expression were investigated by immunohistochemical staining. Results: Positive staining for VEGF, VEGF-C, flt-4 were observed in some breast cancer cells. Furthermore, the expression of VEGF-C, flt-4 were significantly higher in lymph node-positive group than in node-negative group. Correlation was found within the expression of VEGF-C, flt4 also. Conclusions: Clinical significance was found between VEGF-C, flt-4 expression and lymph-node metastasis in breast cancer, and may be involved in the metastatic process.