Objective To observe the clinical effect of procedure for prolapse and hemorrhoids (PPH) in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale(WHOQOL-BREF) was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale (VAS) at postoperative six hours was (7.6 ± 2.1),which reduced to (1.3 ± 1.1) at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains (t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05).There was modest improvement in environmental domain,while no change was found in social domain (P ＞ 0.05).Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.

Objective To investigate the value of endoscopic papillosphincterotomy (EST) in the management of common bile duct stone and constrictive papillitis. MethodsFrom July 1987 to May 2001 746 cases treated with EST were analyzed retrospectively. ResultsThe rates of success in constrictive papillitis and functional disturbance of Oddi′s sphincter were 94.8% and 94.1% respectively. Forty patients (88.9%) with chronic obstructive pancreatitis caused by constrictive papillitis were alleviated and common bile duct stone were removed in 538(94.1%) out of 572 patients after EST. The incidence of complications (severe pancreatitis and hemorrhage) after EST was 2.2% and the mortality was nil. ConclusionEndoscopy is effective and minimally invasive treatment for common bile duct stone and constrictive papillitis.

Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.

10.3969/j.issn.2095-4344.2013.25.023

BACKGROUND: Compared to other preparation method, chemical extraction can almost removed all cellular components,reduce the possibility of immunological rejection, and remain the integrality of nerve graft. However, there are still problems need to be explored.OBJECTIVE: To investigate the optimal condition of acellular nerve graft using Trito X-100 and sodium deoxycholate as extracting agent.DESIGN, TIME AND SETTING: Randomized grouping, controlled cytology observation. The experiment was performed at the Department of Stomatology, Affiliated Hospital of Binzhou Medical University, from February to June 2009.MATERIALS: Fifteen New Zealand white rabbits, aged 3-4 months, weighing 2.5-3.0 kg. Triton X-100 and sodium deoxycholate were provided by Sigma Company, USA.METHODS: The bilateral facial nerve were obtained from rabbits, and removed the adipose tissue and epineurium of the nerve surface under the surgery microscope, then divided these nerves into 66 segments, with each length of 10 mm. The 66 neurons were randomly divided into 11 groups, with 6 neurons in each group. Except the control group, all neurons were placed into Petri dish for 12 hours bathing using distilled water at room temperature, then 5 groups of which were cultured with Triton X-100 for 12,24, 36, 48, and 60 hours, oscillation at room temperature; the remained 5 groups were cultured with 3% Triton X-100 for 12 hours,followed by 4% sodium deoxycholate for 12 hours, repeated for 1-5 cycles.MAIN OUTCOME MEASURES: Haematoxylin-eosin staining; degrees of decellularization and integrality of fiber pipe.RESULTS: Only use Triton X-100 to deal with the nerve of New Zealand white rabbits, even if 60 hours, could not to remove all the cellular components, and the basement membrane of Schwann cells were greatly destroyed. After 2 cycles treatment of Trito X-100 combined with sodium deoxycholate, cellular components and myelin sheath of nerve fibers and axons were removed effectively, and basement membrane of Schwann cell was remained, with epineurium and perineurium could be seen.CONCLUSION: Oscillation accompanied by 2 cycles treatment of Trito X-100 and sodium deoxycholate can obtain acellular nerve graft by removing cellular components completely, and reserving integrated basement membrane of Schwann cells.

BACKGROUND:The microvolt T-wave alternans (MTWA) is an important index for ventricular arrhythmias prediction and is a promising tool to evaluate non-invasively malignant ventricular arrhythmia and risk of sudden death.OBJECTIVE:To introduce a algorithm for detecting TWA using Poincare mapping method (PM),which is a technique for dynamics systems to display periodic behavior.METHODS:Samples series of beat to beat cycles were selected to prepare Poincare mapping to describe TWA distdbution.D_(twa),which denoted the sum distances between the origin to even and odd series,was used to present the presence and absence of TWA.RESULTS AND CONCLUSION:This algorithm was applied in MIT/BIH Arrhythmia database and European ECG ST-T database,and D_(twa) used for correlation analysis with V_(twa),which denoted TWA amplitude of Spectrum Method.The cross-correlation coefficient was γ= 0.984.The algorithm can identify the absence and presence of TWA accurately and provide idea for further study of TWA-PM.

Objective To investigate the effects of exogenous wild DCC gene stably transfection on growth of colorectal carcinoma cell line SW1116 in vitro. Methods DCC gene domain was amplified from human normal colon tissue by reverse transcript-polymerase chain reaction(RT-PCR). At first,a recombinant expression plasmid pcDNA3. 1( + )-DCC was constructed. Human colorectal carcinoma cell line SW1116 with-out DCC gene was transfected with pcDNA3. 1-DCC. Cell viability was tested by methyl thiazolyl tetrazolium (MTT)assay. Immunofluorescence staining was used to determine the effects of pcDNA3. 1-DCC and expres-sion of carcino-embryonic antigen(CEA)in human colorectal carcinoma cell line SW1116 which was transfect-ed with pcDNA3. 1-DCC. Results The population of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )-DCC plasmid and normal cells(t = 3. 645,P ﹤ 0. 05;t = 3. 132,P ﹤0. 05)at 3 ~ 6 days after transfection,and the proliferation rate of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )plasmid and normal cells(t = 2. 134,P ﹤ 0. 05;t = 2. 736, P ﹤ 0. 05). Cell line SW1116 transfected with pcDNA3. 1( + )-DCC plasmid total viability was lower than nor-mal cells(t = 3. 053 ,P ﹤ 0. 05)at 2 ~ 6 days after transfection. Cell line SW1116 transfected with pcDNA3. 1 ( + )-DCC plasmid total viability was lower than those with pcDNA3. 1( + )plasmid(t = 2. 816,P ﹤ 0. 05)at 2,4,5,6 days after transfection. The population of flavo-green colour cells transfected with pcDNA3. 1( + )-DCC plasmid and the fluorescent intensity of these cells were lower than those with pcDNA3. 1( + )plasmid and normal control cells. Conclusion Transfected DCC gene can suppress the cell proliferation and make CEA expression of cell line SW1116 down regulation to weaken its infiltration and metastasis abilities.

In the present study, a three dimensional finite-element model of the human pelvic was reconstructed, and then, under different acetabular component position (the abduction angle ranges from 30 degrees to 70 degrees and the anteversion ranges from 5 degrees to 30degrees) the load distribution around the acetabular was evaluated by the computer biomechanical analysis program (Solidworks). Through the obtained load distribution results, the most even and reasonable range of the distribution was selected; therefore the safe range of the acetabular component implantation can be validated from the biomechanics aspect.
Acetabulum ; diagnostic imaging ; Arthroplasty, Replacement, Hip ; Biomechanical Phenomena ; Cadaver ; Computer Simulation ; Computer-Aided Design ; Finite Element Analysis ; Hip Prosthesis ; Humans ; Imaging, Three-Dimensional ; Models, Biological ; Pelvis ; diagnostic imaging ; Range of Motion, Articular ; physiology ; Stress, Mechanical ; Tomography, Spiral Computed

BACKGROUND: Adult acetabular dysplasia in advanced stage combined with hip joint osteoarthritis should undergo total hip replacement. The severity of acetabular lesion is various in different patients, which leads to significantly increased difficulty in reestablishing acetabulum. Acetabular medial wall displacement osteotomy can solve the component of acetabular prosthesis, but the displacement range of the acetabular medial wall following osteotomy is controversial.OBJECTIVE: To look for a suitable displacement range of acetabular medial wall following osteotomy by computer-aided design finite element analysis.METHODS: SolidWorks 2008 software was used to establish three-dimensional models of acetabular dysplasia pelvis. Acetabular medial wall displacement osteotomy was simulated to make acetabular medial wall bone displace from 2 mm bone contact to 7 mm bone contact in the pelvic cavity. One experimental group was set at 1 mm intervals, totally 10 experimental groups. The acetabulum in each group was split into four quadrants. The prosthesis acetabulum-bone interface in each group was analyzed by computer simulation contrast mechanics experiment. The Mises stress and shear stress values were measured between acetabular prosthesis and bone interface.RESULTS AND CONCLUSION: In groups 1, 5, 6, 9 and 10, the Mises stress was unevenly distributed in posterior inferior, anterior superior and anterior inferior quadrants. In groups 2, 3, 4, 7 and 8, the Mises stress was evenly distributed in posterior inferior,anterior superior and anterior inferior quadrants. Of them, the stress was most even in the group 4. In groups 2, 3, 4, 7 and 8, the shear stress was evenly distributed in the above-mentioned three quadrants. The shear stress was lowest in the groups 7 and 8.These indicate that joint force in the acetabulum mainly focused in the posterior superior quadrant. With the displacement of acetabular cup, the contact area of acetabular cup and bone would gradually increase, which finally increased the Mises stress in the contact surface. However, shear stress decreased with displacement of acetabular medial wall. Therefore, the suitable displacement range of acetabular medial wall osteotomy is 1 mm away from the pelvic cavity and 1 mm complete embolism in the pelvic cavity. The optimal position was 1 mm complete embolism in the pelvic cavity.

Objective This study aims to explore the characteristics of gender and age in six different suicide methods in urban area of China. Methods We collected 548 suicides from Shanghai, Jinhua, Wuhan, Loudi and Duyun, and then analyzed the age and gender characteristics in each suicide method. Results In the age characteristics, the mean age for jumping and hanging was oldest (about 55 years old), followed by drowning and hanging (about 49 years old), oral intake poisoning was much younger (about 49 years old), while carbon monoxide poisoning was youngest (about 37 years old). In the gender differences, male were more than females in suicides by sharp object (52:24), hanging (67:33) and jumping (55:45), while females were more than males in suicides by drowning (58:42). Conclusion The age and gender difference was eminent in different suicide methods. Carbon monoxide poisoning was the youngest age group in suicides and males involved more than females in suicides by mechanical methods.