[Objective]To retrospectively analyze 39 cases of surgical treatment of fibrous dysplasia of proximal femur,in order to propose a partition method which can be used to guide the surgical treatment,and probe the surgical treatment strategy according to the partition method of fibrous dysplasia of proximal femur. [Methods]The data on 39 cases of fibrous dysplasia of proximal femoral from 1998 to 2009 were retrospectively analyzed.The study determined extent of the lesion according to preoperative X-ray film and proposed partitioning method in accordance with the scope of proximal femoral involvement,analyzed the relation of partition type and surgical treatment,and evaluated the effect of surgical treatment through the postoperative localized lesions control and functional score(MSTS 93).[Results]According to the scope of 39 cases of lesions,combined with characteristics of proximal femoral anatomy,proximal femur was divided into four zones: area I,femoral shaft(below small protuberance);area II,intertrochanteric(small rotor to the neck base division);area III,femoral neck;area IV,the femoral head.Based on the above partition,lesions were divided into 7 types,type I,type II,type III,type I + II,type II + III,type II + III + IV,type I + II + III,type I + II + III + IV.Surgical treatment was performed mainly with curettage of bone lesions,bone grafting and fixation.Internal fixation included DHS,intramedullary nails,and artificial joint replacement,DHS was most common in area II involvement(57.58%),followed by area III involvement(24.24%).Intramedullary nail was most common in area I involvement(64.70%) and area II involvement(35.30%).For lesions involving ≥3 zones,joint replacement was carried out.The patients were all followed up,with a median time of 6.3 years(0.5-11 years).Local recurrence rate was12.82%(5 / 39),local deformity was not found deterious.The followed up results were satisfactory.The selected treatment was reasonable.[Conclusion]When making a surgical treatment regimen for fibrous dysplasia of the proximal femur,Surgeons should consider lesion characteristics,and choose a reasonable internal fixation to achieve better surgical results.Partition method proposed in this paper can be formulated as one of preoperative surgical treatment options.

Objective T o understand the assessm ent on the criminal responsibility of drug-induced m ental disorders and judicial experts’ opinions. Methods T he judicial experts from institutes of forensic psychi-atry in Shanghai were selected. T hey were asked to finish a self-m ade questionnaire of assessm ent on the criminal responsibility of drug-induced m ental disorders by letters and visits. Results Most of experts knewthe special regulation,“not suitable for evaluation” towards the criminal responsibility of drug-in-duced m ental disorders of the guideline prom ulgated by Ministry of Justice. B efore and after the guide-line was issued, no expert m ade a no-responsibility opinion in such cases. After the guideline was issued, som e experts m ade a full-responsibility or lim ited-responsibility opinion in such cases. T here was a little disagreem ent am ong the experts in the case that the crime was unrelated with m ental sym ptom s or the criminals used drugs even though he knewit could induced insanity. B ut there were still m any obvious disagreem ents am ong experts in the case that crime was related to such sym ptom s and person was no ability to debate. Most experts agreed to settle the disagreem ents with im proved legislative perfection. Conclusion Most experts are not strictly com plying with the assessm ent guidelines during their practice, and there is still an obvious disagreem ent towards the criminal responsibility of drug-induced m ental disorders.

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.

Objective To investigate the value of differential diagnosis of the configuration of QRS complex in lead aVR in patients with inferior wall myocardial infarction. Methods The configuration of QRS in 52 patients with pathological Q-wave both in lead Ⅲ and aVF were analyzed and the result of selective coronary arteriography was compared. Results 13 patients with the configuration of QRS in lead aVR appeared rS ( s), while 10 patients appeared QS(qs) and 29 Q(q)r,correlated with 12,4 and 0 patients with coronary arteriography showed stenosis or occlusion lesion in fight coronary artery or left circumflex artery (χ2 = 35.56, P = 0.000). Conclusions The con-figuration of QRS in lead aVR is helpful to differential diagnosis of the patients with pathological Q-wave both in lead Ⅲ and aVF. Patients with the configuration of QRS in lead aVR appear rS(s) could be diagnosed as old myocardial infarction,but excluded from old myocardial infarction while appearing Q(q)r.

An actinomycete B37 was isolated from an intertidal marine sponge Hymeniacidon perleve, which has strong activity against Gram positive bacteria and moderate activity against tumor cells. The mycelium and spore morphology, physiological properties and 16SrDNA sequence suggested that B37 is Streptomyces pseudogriseolus. The fermentation conditions of this strain were investigated for the biosynthesis of bioactive metabolites.

OBJECTIVE: To understand the assessment on the criminal responsibility of drug-induced mental disorders and judicial experts' opinions. METHODS: The judicial experts from institutes of forensic psychiatry in Shanghai were selected. They were asked to finish a self-made questionnaire of assessment on the criminal responsibility of drug-induced mental disorders by letters and visits. RESULTS: Most of experts knew the special regulation, "not suitable for evaluation" towards the criminal responsibility of drug-induced mental disorders of the guideline promulgated by Ministry of Justice. Before and after the guideline was issued, no expert made a no-responsibility opinion in such cases. After the guideline was issued, some experts made a full-responsibility or limited-responsibility opinion in such cases. There was a little disagreement among the experts in the case that the crime was unrelated with mental symptoms or the criminals used drugs even though he knew it could induced insanity. But there were still many obvious disagreements among experts in the case that crime was related to such symptoms and person was no ability to debate. Most experts agreed to settle the disagreements with improved legislative perfection. CONCLUSION Most experts are not strictly complying with the assessment guidelines during their practice, and there is still an obvious disagreement towards the criminal responsibility of drug-induced mental disorders.
China ; Crime/psychology* ; Criminals/psychology* ; Data Collection ; Expert Testimony ; Forensic Psychiatry ; Humans ; Liability, Legal ; Male ; Mental Competency ; Mental Disorders/psychology* ; Psychotic Disorders ; Surveys and Questionnaires

Six kinds of saponins (I, II, VII, PA, H) content of 22 samples of Paris polyphylla var. yunnanensis collected from different regions of Yunnan province were determined by HPLC, data was analyzed by SPSS 17. The results showed that the effect of altitude on saponin content was not significant, and the effect of growth area of saponins in P. polyphylla var. yunnanensis was significant, saponin content in sample from west Yunnan was significantly higher than that of samples from other regions.
Altitude ; China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Liliaceae ; chemistry ; Saponins ; analysis

Anesthesia, General ; Animals ; Central Venous Pressure ; physiology ; Heart Function Tests ; Hemodynamics ; physiology ; Respiration, Artificial ; Shock, Septic ; pathology ; Swine ; physiology ; Venae Cavae ; physiology

OBJECTIVETo summarize the complications and the early clinical effect of less invasive stabilization system and the femoral condylar support plates in the treatment of AO type C distal femoral fractures.

METHODSFrom September 2007 to February 2012, 46 patients with AO type C distal femoral fractures were retrospectively studied. Of all patients 25 were treated with less invasive stabilization system including 14 males and 11 females with a mean age of (56.3±4.2) years old; according to AO classification, there were 14 cases of C1, 8 cases of C2 and 3 cases of C3 with a mean hospital stay of (15.6±1.7) days. While 21 cases were treated with femoral condylar support plates fixation including 12 males and 9 females with a mean age of (53.8±5.1) years old;there were 13 cases of C1, 6 cases of C2 and 2 cases of C3 with a mean hospital stay of (17.8±2.2) days. Comparative analysis was performed from the operation related index,postoperative complications and Evanich score of the knee joint function between the two groups at follow-up.

RESULTSAll 46 patients were followed up from 13 to 38 months with a mean time of 19.6 months after surgery. Complications included 1 case with infection,3 cases with internal fixation failure, 1 case with nonunion and 1 case with activity limitation of the affected knee. The differences in the incision length, blood loss, fracture healing time were significant between two groups (P<0.05), while there was no significant difference in the duration of operations, hospital stays and the incidence of postoperative complications between two groups (P>0.05). The statistical significance was also found in the Evanich score at last follow-up between two groups (P<0.05).

CONCLUSIONPatients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time and better functional recovery. Less invasive stabilization system had became one of the ideal internal fixations in the treatment of AO type C distal femoral fractures.

Adult ; Aged ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; Fracture Healing ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; epidemiology

OBJECTIVETo observe the expression of Ginkgo biloba Tablet (GbT) on scavenger receptor A (SRA) of the aortic wall and changes of serum inflammatory factors in atherosclerotic rats, and to explore its new mechanism for fighting against atherosclerosis (AS).

METHODSTotally 45 male Wistar rats were randomly divided into the control group, the model group, the GbT group, 15 rats in each group. Levels of blood glucose, blood lipids, blood calcium, serum C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (slCAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in all rats. The expression of SRA in the aortic wall of atherosclerotic rats was observed by immunohistochemical assay. The correlation between the expression of SRA and levels of in-flammatory factors was also observed.

RESULTSCompared with the control group, blood glucose and blood calcium obviously increased (P < 0.05); levels of TG, TC, and LDL-C were significantly elevated (P < 0.01); neointimal areas were significantly thickened, increased intima percentage was significantly enlarged, narrowed lumen index was significantly reduced; levels of CRP, sICAM-1, and sVCAM-1 were significantly elevated in the model group (all P < 0.01). Compared with the model group, blood glucose and blood calcium obviously decreased (P < 0.05); levels of TG, TC, and LDL-C significantly decreased (P < 0.01) in the GbT group. Aortic lumens were obviously narrower in the model group than in the GbT group (P < 0.05). SRA expressed at the aortic wall. The aforesaid 3 indices were significantly improved in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were significantly decreased in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were positively correlated with the percentage of SRA positive expression area (r = 0.701, 0.604, 0.581, all P < 0.01).

CONCLUSIONSSerum levels of inflammatory factors in atherosclerotic rats were elevated, and the expression of SRA in the aortic wall was enhanced. The expression of SRA was closely correlated with serum levels of inflammatory factors. GbT could decrease serum levels of inflammatory factors and inhibit the expression of SRA.

Animals ; Aorta ; drug effects ; metabolism ; Atherosclerosis ; drug therapy ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Calcium ; blood ; Drugs, Chinese Herbal ; pharmacology ; Ginkgo biloba ; chemistry ; Intercellular Adhesion Molecule-1 ; blood ; Lipids ; blood ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Scavenger Receptors, Class A ; metabolism ; Tablets ; Vascular Cell Adhesion Molecule-1 ; blood