BACKGROUND:Klinefelter nails and external fixation were commonly used treatment methods for Bennett fracture, but study about biomechanics of two methods was little. OBJECTIVE:To establish three-dimensional finite element models of Bennett fracture by Klinefelter nails and external fixation, and analyze its biomechanics. METHODS:Three-dimensional models of Bennett fracture were established by smal external fixation and Kirschner nail treatment. The Bennett fracture models established by smal external fixation treatment were considered as model A. Bennett fracture models established by Kirschner nail treatment were considered as model B. 120 N load was applied to the first metacarpal X-axis direction. The X-direction displacement and total displacement of model A and model B, and the fracture fragments stress of model A and model B were observed. RESULTS AND CONCLUSION:(1) In the X direction, the absolute values of maximum displacement and minimum displacement of model A at proximal fragment and distal fragment were less than model B;the maximum relative displacement, minimum relative displacement and average relative displacement of model A were less than model B. The differences of the average displacement of the proximal fracture fragment and the distal fragment, and the relative mean displacement in two models were statistical y significant (P<0.05). (2) In total displacement, absolute values of the maximum displacement and minimum displacement of model A at proximal fragment were less than model B;absolute values of the maximum displacement and minimum displacement of model A at distal fragment were less than model B;the maximum relative displacement, minimum relative displacement and average relative displacement of model A were less than model B. The differences of the average displacement of the proximal fracture fragment and the distal fragment, and the relative mean displacement in two models were statistical y significant (P<0.05). (3) The maximum stress value, a minimum stress value and the average stress values of fracture fragments of model A were significantly smal er than model B. The difference of the mean stress value in two models was statistical y significant (P<0.05). (4) These findings showed that the X-direction displacement and the total displacement were smal er, and the fracture fragments stress was uniform in smal external fixation and Kirschner nail treatment for Bennett fracture, indicating that smal external fixation for Bennett fracture has more advantages compared with Klinefelter nail.

Objective To evaluate the diagnostic value of sonohysterography (SHG)in uterine cavity diseases. Methods 48 patients suspected to suffer from uterine cavity diseases on the basis of transvaginal sonography underwent sonohysterography,hysteroscopy and biopsy.The results of sonohysterography were compared with those from hysteroscopy and biopsy. Results The diagnostic accuracy,sensitivity,specificity of SHG in detecting abnormal uterine cavities were 93.8%(45/48),91.4%(32/35),100%(13/13) and respectively. Conclusions SHG is a simple,effective and cheap method in the detectiou of uterine cavity diseases.

As a treatment of noninvasive,safe,effective,and easy to operate,external counterpulsation has been widely used in the treatment of ischemic heart disease.The treatment mechanism of external counterpulsation may improve collateral circulation and hemodynamics.Therefore,it can provide a new measure for the treatment of cerebrovascular disease.However,the efficacy and safety of external counterpulsation in the treatment of ischemic stroke still need to be confirmed by a large sample clinical trial.

Background and purpose:Cisplatin-based concurrent chemoradiotherapy(CCRT) has become the standard treatment for locally advanced cervical cancer(LACC) . But no marked survival benefi t was found for stage Ⅲ-ⅣA patients,and the high toxicity of cisplatin warrants evaluation of other chemotherapeutic agents to increase effi cacy and decrease toxicity. This study was done to evaluate the effi cacy and toxicity of paclitaxel(TXL) and nedaplatin(NDP) administered concurrently with radiotherapy followed by consolidation chemotherapy in the treatment of locally advanced squamous cell cervical carcinoma(LASCC) . Methods:29 Patients with LASCC(FIGO stage ⅡB-ⅢB) were enrolled into this study from February 5,2007 through December 10,2007. The median age was 48 years old(35-64) . Radiotherapy included external beam radiotherapy to pelvic(stageⅡB 45Gy,stage Ⅲ 50 Gy) and 192Ir brachytherapy(stageⅡB 50 Gy,stage Ⅲ 35Gy) . TXL 35 mg/m2 and NDP 20 mg/m2 were given every week for 6 weeks concurrently with radiotherapy. After one month of CCRT,TXL 135 mg/m2 and NDP 60mg/m2 were administered every 3 weeks for 4 cycles. Results:All patients completed CCRT. For the consolidation chemotherapy,25 patients received 4 cycles,2 patients 3 cycles and 2 patients 2 cycles. The clinical complete response rate was 89.7%(95%CI,78.6%-100%) ,partial response rate 10.3%(95%CI,0-21.4%) After a median follow-up of 14 months(range,8.7-18.8 months) ,the disease-free and overall survival rates were 86.2%(95% CI,73.7%-98.7%) and 96.7%(95% CI 90.2%-100%) ,respectively. One patient died due to disease progression.During CCRT,Grade 3 leukopenia occurred in 3.6%(6/169) of the cycles,Grade 3 diarrhea 0.6%(1/169) ;During consolidation chemotherapy,Grade 3 leukopenia and neutropenia occurred in 8.7%(9/104) of the cycles. There were 2 patients who developed Grade 3 late rectum toxicity. Conclusion:CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with LASCC. A prospective randomized trial to compare this treatment strategy with standard CCRT seems to be worthwhile.

Objective To investigate the relationship between cleftpalate and secretory otitis media so that the secretory otitis media resulted from cleftpalate was treated and prevented effectively. Methods 116 children with cleftpalate and 73 normal children were investigated by tympanogram, hearing threshold and auditory brain response. Results The incidence of secretory otitis media and hearing loss had significant difference between the two groups. Conclusions Children with cleftpalate had high incidence of secretory otitis media and hearing loss. We should pay more attention to the treatment and prevention of secretory otitis media in children with cleftpalate. It is necessary for the cleftpalate children to insert the tympanal pressure equalization tubes while palatal surgery is performed.

Objective To observe the effect of different energy levels of pulsed Nd∶YAG laser irradiation on the changes of NO and NOS levels in ulcer tissue of oral ulcer model.Methods Forty-eight Sprague-Dawley rats were inflicted with oral ulcer,and then randomly and equally assigned to 6 groups,that is,oral ulcer group,1% iodine glycerin group and the rest 4 groups receiving pulsed Nd∶YAG laser irradiation at 1.5 W 40 mJ,1.5 W 60 mJ,1.5 W 80 mJ or 1.5 W 100 mJ(once per day,for 3 consecutive days).The other 8 rats served as normal control.In 24 h after last treatment,4 rats from each group were sacrificed and their cheek pouches were taken out for NO and NOS levels in the mucosal tissue by spectrophotomentry.Ulcer healing were observed 24 h after the last treatment for 8 consecutive days.The efficiency of Nd∶YAG laser irradiation at different powers were evaluated.Results Irradiation groups had significantly shorter healing time compared with iodine glycerin group.Level of NO and NOS activity in 1.5 W 60 mJ and 1.5 W 80 mJ groups was evidently lower than the ulcer group(P

Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Objective To investigate the treatment effects and toxicities of extended-field intensity modulated radiation therapy (EF-IMRT) and intra-cavitary brachytherapy combined with chemotherapy for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.Methods A total of 46 stage Ⅰ b1-Ⅳa cervical cancer patients with positive para-aortic lymph nodes treated at Fudan University Shanghai Cancer Center between 2009 and 2011 were reviewed.Neoadjuvant,concomitant and adjuvant chemotherapy with paclitaxel and carboplatin were administrated for one cycle before radiation therapy,two cycles during radiation therapy or three cycles after radiation therapy.All patients received EF-IMRT and intra-cavitary brachytherapy.The positive lymph nodes received an additional boost dose.Results All patients received EF-IMRT to 50.4 Gy (1.8 Gy per fraction).Twenty-six patients was treated with boost dose of 6.0-8.0 Gy in 2.0 Gy per fraction to positive para-aortic lymph nodes.Thirty-seven patients received a positive paraaortic lymph nodes boost or(and) parametrial boost.All patient also received a high-dose-rate intra-cavitary brachytherapy at the point A dose of 20.0-30.0 Gy in 5.0 Gy per fraction.Total chemotherapy cycles were 189,and the average patient received 4.1 courses.Two cases (4％,2/46) experienced grade Ⅲ gastrointestinal toxicities,no patients suffered grade Ⅳ gastrointestinal toxicities.Fifteen cases (33％,15/46) experienced grade Ⅲ hematological toxicities,and 3 (7％,3/46) experienced grade Ⅳ hematological toxicities.Late grade Ⅲ-Ⅳ toxicity was seen in 3 cases (7％,3/46).The 3 year progressionfree survival rate was 46.2％,and the 3 years overall survival rate was 61.2％.Conclusion EF-IMRT and intra-cavitary brachytherapy combined with chemotherapy is safe and effective for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.

To explore the clinical significance of changes in maximal expiratory flow in 50％ and 25％ vital capacity (Vmax50％ & Vmax25％) before and after bronchodilator reversibility testing in patients with asthma.Forced expiratory volume in one second (FEV1),Vmax50％ and Vmax25％ were measured before and after bronchodilator reversibility testing in 118 patients with asthma and 82 with chronic obstructive pulmonary disease (COPD).The rate of positive reversibility in Vmax50％ was significantly higher than that in FEV1 in 118 asthmatics (x2 =7.995,P =0.007).The rates of positive reversibility in Vmax50％ and Vmax25％ were significantly higher in asthmatics than those in COPD patients (x2 =9.335,P =0.009).

Objective To research the relationship between high temperature and population death in cardio-cerebrovascular diseases in Shijiazhuang.Methods The time series of maximum daily temperature and daily death number of cardio-cerebrovascular diseases were described,and the relationship between daily maximum temperature and daily mortality of cardio-cerebrovascular diseases in summer was analyzed.The impact of daily highest temperature in summer from 2009 to 2011 on daily death of cardio-cerebrovascular diseases was analyzed.Results In summer,the highest temperature which could reach to 41.7℃ emerged mostly in July and August,and when the highest temperaiure was higher than 34℃,cardio-cerebrovascular diseases death increased obviously as the temperature increasing.The relative humidity was more than 70％ in most time of the year round.The excessive death in hot days accounted for 10.9％ in which the old people occupied the majority.Conclusion The extreme high temperature may obviously increase the cardio-cerebrovascular death in Shijiazhuang.