BACKGROUND:With the development of medical instruments, more and more traditional surgical operations are replaced by minimal y invasive surgeries. In minimal y invasive surgery, cutting and sealing tissue is a conventional procedure;however, due to the limitation of space and vision, the ordinary methods are not suitable for minimal y invasive surgery. OBJECTIVE:To develop high frequency electrosurgical generator that has a constant power output and ability for tissue cutting and closing. METHODS:In order to improve the efficiency of tissue cutting and sealing in surgical, a kind of high-frequency energy generator was developed for tissue cutting and sealing. The instrument consisted of switching power supply with adjustable amplitude, high-frequency power amplifier, impedance monitor and microcontrol er. The energy converter composed of switching power supply and high-frequency power amplifier converted the 220 V, 50 Hz utility powers to a kind of high-frequency energy with 450 kHz and applied on tissues. Impedance monitor would real-timely detect the electrical parameter impacting on tissue that was provide the amount of feedback to microcontrol er in order to complete constant power control and bioimpedance determination by the control er. RESULTS AND CONCLUSION:The experimental results indicated that the instrument could rapidly and stably provide high-frequency energy, and could detect the biological impedance in real-time, achieve constant power output through feedback control, and could cut and close the biological tissue efficiently.

Objective To study the etiological effect between the spatial variation of lumbar facet orientation and the degenerative lumbar spondylolisthesis(DLS)in axial,sagittal and coronal plane.Methods 85 patients with DLS at L4 and 110 controlsreceived X-ray and CT scanning.The facet angle at L4-L5 was measured in axial,sagittal and coronal plane.Results Compared with the control group, the DLS-angles were lesser and the difference between the left and right was greater in axial,coronal plane(P <0.05).But were greater in sagittal plane(P <0.05).Conclusion The DLS-angles are more sagittal in axial plane,more level in sagittal plane and more erect in coronal plane.The change of spatial orientation in the facet joint is one of etiological factors of degenerative lumbar spondylolisthesis.

Objective To investigate the relationship between daily physical activities determined by walking-steps and the obesity indices including body weight，Body Mass Index (BMI)，waist and hip circumference and their ratio in adults. Methods 125 individuals who participated in routine physical examinations of health were measured with body weight, BMI, waist and hip circumference/ratio, daily physical activities determined by walking steps. Results For males, daily physical activities correlated negatively with body weight （r=-0.397，P＜0.01）, BMI （r=-0.499，P＜0.01）, waist circumference （r=-0.490, P＜0.01） and the ratio of waist vs. hip circumference （r=-0.478，P＜0.01）, whereas body weight（r=-0.342，P＜0.01）, BMI （r=-0.249，P＜0.05）, and hip circumference （r=-0.303，P＜0.05） for females. Daily walking-steps were significantly different among the groups of normal weight (11491±6100) steps/d, overweight (9314±5722) steps/d, and obesity (6141±2985) steps/d (P＜0.01). Conclusion Daily physical activities determined by walking steps correlated significantly with obesity indices.

Objective To investigate the relationship between daily walking-steps and serum lipids.Methods 120 individuals who participated in routine physical examinations of health were investigated, objective measurements included triacylglycerol (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL), and daily walking-steps were determined by pedometer.Results The daily walking-steps were correlated negatively to TG ( r=-0.351, P＜0.01), and positively to HDL ( r=0.284, P＜0.05) for male after adjustment for age.Conclusion Daily walking-steps determined by pedometer are correlated negatively to TG levels, and positively to HDL levels for male. No correlations are found between daily walking-steps and levels of TC, LDL for male. No correlations are found between daily walking-steps and serum lipids for female.

Objective To investigate the relationship between objectively determined daily physical activities and blood pressure levels in Chinese adults. Methods 125 individuals who participated in routine physical examinations of health were investigated, include systolic pressure, diastolic pressure, pulse pressure, and daily walking steps determined by pedometer. Results The daily walking steps correlated negatively with systolic pressure（Male r=－0.613, P＜0.01; Female r=－0.430, P＜0.01） and diastolic pressure (male r=－0.686, P＜0.01; female r=－0.388,P＜0.01). Daily walking steps of normotensive, pre-hypertensive, and hypertensive groups were (18249±6066) step/d, (10395±3788) step/d, (6232±3967) step/d for males, and (12564±6927) step/d, (11458±5084) step/d, (6153±3569) step/d for females respectively （P＜0.05）. Conclusion The daily physical activity determined by walking steps correlated negatively with blood pressure in Chinese adults. Hypertensives often live in low active or sedentary lifestyle. Active lifestyle （≥10000 step/d） may help keep normal blood pressure for Chinese adults.

Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.

Collagen is the building component of temporomandibular joint (TMJ) discs and is often affected by inflammation in temporomandibular disorders.The macromechanical properties of collagen are deteriorated by chronic inflammation.However,the mechanism by which inflammation influences disc function remains unknown.The relationship between the ultrastructure and nanomechanical properties of collagen in inflamed discs should be clarified.Seven-week-old female Sprague-Dawley rats were randomly divided into two groups.Chronic TMJ inflammation was induced by intra-articular injection of complete Freund's adjuvant,and samples were harvested after 5 weeks.Picrosirius staining revealed multiple colours under polarized light,which represented alternative collagen bundles in inflamed discs.Using atomic force microscopy scanning,the magnitude of Young's modulus was reduced significantly accompanied with disordered collagen fibril arrangement with porous architecture of inflamed discs.Transmission electron microscopy scanning revealed a non-uniform distribution of collagen fibres,and oversized collagen fibrils were observed in inflamed discs.Fourier transform infrared microspectroscopy revealed a decrease in 1 338 cm-1/amide Ⅱ area ratio of collagen in different regions.The peak positions of amide Ⅰ and amide Ⅱ bands were altered in inflamed discs,indicating collagen unfolding.Our results suggest that sustained inflammation deteriorates collagen structures,resulting in thedeterioration of the ultrastructure and nanomechanical properties of rat TMJ discs.

OBJECTIVETo evaluate the clinical value of T lymphocyte subsets in prediction of chemotherapy responses of patients with pulmonary adenocarcinoma.

METHODSFifty-five chemotherapy-naive patients with pathologically or cytologically confirmed pulmonary adenocarcinoma were examined for peripheral blood T lymphocyte subsets using flow cytometry, including CD3(+) T cells, CD3(+)CD4(+) T cells, CD3(+)CD8(+) T cells, CD45RO(+) T cells and CD45RA(+) T cells.

RESULTSPatients who responded favorably to chemotherapy (CR(+)PR) showed a significantly lower percentage of CD45RA(+) T cells than those who failed to respond to chemotherapy (P=0.04). CD45RO(+) T cell percentage were slightly higher in the response group than in the non-response group, but this difference was not statistically significant (P=0.25). The other T cell subsets, namely CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) T cells showed no significant differences between the two groups.

CONCLUSIONA high percentage of peripheral blood CD45RA(+) T cells is associated with a poor short-term outcome of chemotherapy in patients with advanced pulmonary adenocarcinoma. Peripheral blood CD45RA(+) T cell level can be a reliable index for predicting chemotherapy efficacy in these patients.

Adenocarcinoma ; blood ; immunology ; Adult ; Aged ; Female ; Humans ; Leukocyte Common Antigens ; metabolism ; Lung Neoplasms ; blood ; immunology ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocyte Subsets ; immunology

ObjectiveTo investigate the relationship between high-sensitivity C reactive protein （hs-CRP） and oxygen uptake efficiency slope (OUES) in patents with cardiovascular disease. MethodsExercise tests, following a symptom-limited standard Bruce protocol with simultaneous respiratory gas-exchange measurements, were performed on a treadmill in 17 post-PCI patients, 21 stable angina pectoris and 24 patients with essential hypertension (EH). The oxygen uptake (VO2), minute ventilation (VE) were determined. The OUES was derived from the relation between VO2 (ml/min) and VE (L/min) during incremental exercise and was determined by VO2=a×lgVE+b, where a = OUES. The OUES was calculated from data of the first 75% (OUES75) and 100% (OUES100) of exercise duration. The serum hs-CRP was measured by immunoassays, and the left ventricular ejection fraction (LVEF) was measured with echocardiography. ResultsOUES75 （r=-0.506,P＜0.001）, OUES100 （r=-0.567,P＜0.001） and LVEF （r=-0.286,P＜0.01） were correlated with lg(hs-CRP). In stepwise multivariable linear regression models, lg(hs-CRP) （β=-0.374，P=0.006）, body height （β=-1.854，P=0.036）, body weight （β=-5.033，P=0.034）were independent risk factors of lower OUES75. lg(hs-CRP) （β=-0.396，P=0.003）, body height （β=-2.157，P=0.013）, body weight （β=-5.912，P=0.011） were independent risk factors of lower OUES100. ConclusionThe serum leveles of hs-CRP may be the useful marker that reflecting cardiopulmonary functional reserve and left ventricular function.

Objective To explore clinical effect of double plates in the treatment of com-minuted fracture of tibial plateau.Methods Patients with double plates in the treatment of com-minuted fracture of tibial plateau were systematically analyzed.Bone grafting was applied to the area of cancellous bone defect under cartilage surface.The T-shaped supported plate was placed in medial tibial condyle after pre-bending and the lateral was fixed by the small anti-slip plate.And functional exercise of knees after operation was taken.Results All patients were healed and there were no knee valgus deformity,break of plate and screw,deep infection,internal and external fix-ation failures after the operation.The excellence rate reached to 84.2%.Conclusion From the clinical perspective,double plates could effectively treat comminuted fracture of tibial plateau.