ObjectiveTo observe the functional recovery of shoulder joint and the reduction of posterior dislocated humeral head in children with shoulder joint internal rotation contracture and humeral head posterior dislocation secondary to brachial plexus birth palsy treated by a modified surgical procedure through the anterior combined posterior approach of the shoulder. MethodsNinteen patients,ranging in age from 2.5 to 8.5 years (average 5 years),suffered posterior dislocation of the shoulder joint secondary to internal rotation contracture in brachial plexus birth palsy. The gleno-humeral joint deformity was confirmed by X-ray and CT examination and classified as type Ⅳ in 15 eases and typeⅤin 4 cases according to the modified water's criteria.The surgical procedure was as follows:the contracture soft tissue around the anterior of shoulder joint was released firstly through the anterior approach, and the posterior-inferior capsule of the shoulder was exposed and separated with the pseudoglenoid through the posterior approach,the humeral head was reduced by external rotation the arm,then the posterior-inferior capsule was retighten.A plaster cast was used to fix the shoulder at the neutral position of 0° for 4 weeks. ResultsAfter 12 to 36 months follow up(average of 20 months), the Mallet score of the shoulder was from 11.4 ± 1.7 (range 7-16)preoperative to 15.5 ± 1.8(range 13-19) postoperative,the difference was significantly (P ＜ 0.05).The central relocation of humeral head was achieved in 16 patients, but the humeral head was still dislocated to posterior in 3 cases.ConclusionsThe posterior-inferior capsule was separated with the pseudo-glenoid and retighten through the posterior approach,and reduction of the humeral head by soft tissue releaseing through the anterior approach can recover the concentric relationship of gleno-humeral joint and improve the function of shoulder joint with posterior dislocation secondary to internal rotated contracture deformity in brachial plexus birth palsy.

Objective To evaluate the alteration of labial bone mass one year after immediate implant or delayed implant placement in esthetic zone.Methods From June 2009 to June 2012,22 patients with 11 immediate implant and 11 delayed implant in the maxillary anterior region were followed up.CBCT images were obtained immediately after surgery and one year after implant placement,the horizontal and vertical alterations of the labial bone were evaluated by image analysis software.Results The 1-year vertical reduction of labial bone after immediate implant placement was statistically significant (P＜0.05),and no significant difference in delayed implant (P＞0.05).The 1-year horizontal reduction of labial bone was statistically significant at coronal and middle of implant,without significant difference at apical of implant.Conclusions Immediate implant can not stop the physical absorption of labial alveolar ridge,and the study can provide reference to achieve esthetics in the anterior region.

Objective To observe the effect of connect meridians inducing Yin from Yang on muscle-tension after cerebral infarction. Methods 82 patients with cerebral infarction in Second Hospital of Harbin from 2010 to 2014 were divided into observation group (n=41) and control group (n=41) according to hospitalization order. The observation group accepted acupuncture of connecting meridians inducing Yin from Yang, and the control group accepted the traditional acupuncture method for 2 weeks. The situation of spasticity, the motor limb function of limbs, and activities of daily living were evaluated with modified Ashworth Scale (MAS), Clinic Spasticity Index (CSI), Fugl-Meyer Assessment (FMA) and Barthel index (BI), respectively. Results Compared with the control group, the score of MAS decreased (t=2.212, P=0.030), the score of CSI decreased (t=2.514, P=0.014), the score of FMA increased (t=4.288, P<0.001), and the score of BI in-creased (t=2.970, P=0.004) in the observation group after treatment. Conclusion The acupuncture of connecting meridians inducing Yin from Yang can reduce the muscle-tension of limbs, improve the motor function and increase the activities of daily living.

Objective To probe into the clinical features, ways of diagnosis and treatment measures of concurrent paratyphoid fever A after renal transplantation. Methods The 5 patients were all town or village people under the county level. After the operation, the immunosuppressive scheme of ciclosporin A (or Tacrolimus) + mycophenolate mofetil (MMF) + prednisone acetate was adopted. One case was caused by catching cold and the rest 4 had no any distinct inducement. Five patients fell ill respectively at the 5th, 7th, 7th, 9th and 14th month after the operation. On the admission, the 5 patients suffered from gastrointestinal symptoms such as vomiting and diarrhea to varying degrees; 3 from toxic symptoms such as fever, intolerance of cold, hypodynamia and headache; 3 from symptoms of the respiratory system such as stuffy nose and congestion of throat; 1 from elevation of blood pressure; 1 from relative slow pulse. In 3 patients with decrease of urine volume, 1 suffered from gross hematuria, swelling of transplanted area of the kidney, pain on pressure and rise of blood pressure. Only 1 patient's paratyphoid fever A antibody in the Widal's test gastroenteritis or untoward reaction of MMF and the curative effect was bad. After definite diagnoses,the combined treatment of the third-generation cephalosporin and FQNS were given to all of them.After treatment for 7-10 days, the symptoms in all patients all disappeared. During the treatment, 1 patient was diagnosed as acute rejection and given the methylprednisolone shock for 3 days. After that, the patient's graft function was improved; 3 patients suffered from relatively great fluctuation of blood concentration of immunosuppressive agent and toxic symptoms such as decrease of the graft function, etc. After adjustment of dosage, their indicators of renal function became normal. Conclusion Early symptoms and accessory examinations of paratyphoid fever A after renal transplantation lack specificities. Diagnosis of paratyphoid fever A after renal transplantation mainly depends on blood culture. Drugs of first choice include FQNS and the third-generation cephalosporin. During the treatment, the doctor should closely monitor blood concentration of the immunosuppressive agent.

Objective To observe the outcomes of the modified multiple nerve transfer s combined with the late hand function reconstruction to restore the active pick-up function of the paralyzed upper extremity in patients with total brachial plexus avulsion injuries (TBPAI).Methods 33 patients suffered with TBPAI firstly underwent multiple nerve transfers,which including accessory nerve transfers to neurotize the suprascapular nerve to recover the shoulder abduction,contralateral C7 (CC7) nerve transfers via the modified pre-spinal route with direct coaptation to restore lower trunk function and the musculocutaneous nerve was also neurotized by the transferred CC7 nerve via a cutaneous nerve graft to restore the function of elbow flexion,as well as the phrenic nerve transfers to neurotize the posterior division of lower trunk to restore the function of elbow and finger extension.The patients with muscle recovery were selected to perform the hand function reconstruction at the second stage for restoring the active pick-up function.The patients were chosen as followcriterias:the degree of shoulder abduction attained 30°or more,the motor power of elbow,wrist,and finger flexion attained grade M4 or more,elbow and finger extension attained M3 or more.The methods of hand function reconstruction included wrist fusion and flexor carpal ulnaris opponensplasty,in addition to palmar capsulodesis of the metacarpophalangeal joint.Results The mean follow up was 41±7.7 (range,36-73 months) after the first procedure of multiple nerve transfers,the muscle strength of elbow and finger and wrist flexion attained M 4 as well as the elbow and finger extension achieved M3 or more in 10 patients,all of 10 patients achieved 40°-80°shoulder abduction.8 out of 10 patients had performed the second surgical procedure for hand functional reconstruction.6 of them had successfully recovered the active pick-up function.Conclusions The newly designed procedure of multiple nerve transfers could effectively restore the function of shoulder abduction,elbow,wrist,and finger flexion,as well as elbows and finger extension in patients with TBPAI,combined with the hand functional reconstruction,active pick-up function could be successfully reconstructed.

Objective To explore the visual attention of mild cognitive impairment patients.Methods Basic cognitive ability test and oddball task event-related potentials(ERPs) were used to measure the visual attention of 16 mild cognitive impairment subjects( MCI group)and 17 health older adults(control group).Results came from Basic cognitive ability test, data of ERPs beheavior and the amplitude and latency of P3a( related to nonvoluntary attention )and P3b (related to voluntary attention)of the two said groups were compared and contrasted.Result The resuits of meaningless figures recognition and two-word recogniton of MCI group were lower than NC group significantly ( P < 0.05 ).The correct rate of MCI group was were lower than control group significantly( P < 0.01 ).The reaction time of MCI group was were longer than control group significantly( P < 0.01 ).The amplitude of P3a was lower than the health control( P < 0.01 )significantly.The latency of P3b was significantly prolonged compared to the control (P < 0.01 ).The correct number of meaningless figures recognition of MCI group and control group were respectively corrected with the amplitude of P3a of the groups ( MCI group R = 0.83, P < 0.01 ; control group R = 0.86, P <0.01 ).Conclusions The mild cognitive impairment patients had deficit on non-selective attention function.The selectiv attention function of MCI group was slower compared to conntrols.

ObjectiveTo explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. MethodsAfter analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. ResultsOf 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. ConclusionRPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.

Objective To analyze the effects of Cavity Preparation Skill Evaluation System (CPSES) in pre-clinical dental cavity preparation assessment.Methods Twenty one dental undergraduates in Medical School of Nankai University were chosen in this study.After cavity preparation training,students' cavity preparation skills were evaluated systematically.The outline form and depth of 21 left mandibular first molar class Ⅰ cavity preparation made by students were evaluated by CPSES system and evaluators' visual assessment.The evaluation results were analyzed using GraphPad InStat statistical software(V3.1) with paired t test (test level α=0.05) and correlation analysis to study the application effects of the CPSES system.Results The evaluation results generated from CPSES system and evaluators' visual assessment for class Ⅰ dental cavity preparation skill evaluation showed significant difference(two tailed P value 0.0050,t=3.156) and certain correlation on cavity preparation assessment(two tailed P value 0.0837,r=0.386 2).Conclusion Application of cavity preparation skill evaluation system in undergraduate endodontic teaching can deepen and strengthen the students' understanding of cavity preparation requirements and help students master cavity preparation knowledge and skills better.

ObjectiveTo classify the type of lumbosacral plexus nerve root injury.MethodsFrom November 2004 to August 2011,36 patients suffered with lumbarsacral plexus nerve root injury underwent surgical exploration in our department.There were 24 males and 12 females,aged from 7 to 49 years(average,29.5 years).By inductively analyzing the location and amount of nerve root injury,preoperative clinical manifestations and results of physical examination,the clinical typing of lumbarsacral plexus nerve root injury was made.ResultsLumbosacral plexus nerve root injury was classified into 6 types:total lumbosacral plexus nerve root injury (4 cases),lumbar plexus and upper sacral plexus nerve root injury (6 cases),sacral plexus nerve root injury (9 cases),upper sacral plexus nerve root injury (11 cases),lower sacral plexus nerve root injury(4 cases) and lumbar plexus injury(2 cases).There were 19 patients with total lumbosacral plexus nerve root injury,lumbar plexus and upper sacral plexus nerve root injury or sacral plexus nerve root injury,among which 73.7％(14/19) nerve root injury located in the spinal canal and all of them were nerve root avulsion or rupture.There were 17 patients with upper sacral plexus nerve root injury,lower sacral plexus nerve root injury or lumbar plexus nerve root injury,among which 64.7％ (11/17) nerve root injury located in intro-pelvic or pelvic sacral foramina,and all of them were distraction injury.ConclusionThis clinical typing is useful for the accurate diagnosis of lumbosacral plexus nerve root injury.In addition,it is also beneficial for judging the location and characteristics of nerve root injury.

Bone Neoplasms ; pathology ; Carcinoma, Neuroendocrine ; pathology ; Humans ; Osteosarcoma ; pathology ; Ureter ; pathology ; Ureteral Neoplasms ; pathology