There were 12 patients who were all type C1 or C3 epipod comminuted fracture.By means of the internal fixation,all patients were transplanted with the nanometer artificial bones,comprising hydroxyapatite and ?-tricalcium phosphate.The 12 patients used the bacteriophages preoperation,during operation and 3 days postoperation.They were free from pressure dressing and started to take exercises 48 hours postoperatively.Followed up for 6-12 months,all of the 12 patients healed well.So nanometer artificial bone is an effective method for the epipodite comminuted fracture,without any severe toxicity or complications.

Objective To summarize the clinical characters,diagnosis and surgical treatment of primary hyperparathyoidism (PHPT).Methods The diagnosis,treatment and efficacy of 35 cases of PHPT were retrospectively reviewed.Results PHPT presented a variety of clinical manifestations,and occoured to different age groups without significant gender differences.All the 35 cases had elevated blood calcium and PTH.All patients underwent preoperative ultrasonography and 99Tcm-MIB imaging,and the positive rates were 68.6％ and 97.1％ respectively.34 patients received surgical treatment,among whom 30 cases had parathyroid adenoma,1 case had parathyroid hyperplasia and 3 cases had parathyroid carcinoma.Through operation,31 cases were cured,2 cases improved,and 1 case of parathyroid carcinoma suffered from lung metastasls.Conclusions PHPT can be diagnosed according to co-elevated serum calcium and PTH.Ultrasonography combined with 99Tcm-MIB imaging should be recommend for preoperative localization.The main cause of PHPT is solitary parathyroid adenoma.PTPT can be cured by surgery.Minimally invasive parathyroidectomy with accurate location is an efficient surgical strategy,and the prognosis is favorable.

Objective To explore the surgical techniques and clinical indication of laparoscopic splenectomy combined with cholecystectomy.Methods The clinical data from two patients underwent laparoscopic splenectomy combined with cholecystectomy were retrospectively analyzed.Results Two patients have been performed splenectomy with cholecystectomy successfully under laparoscopy.The operation time of laparoscopic splenectomy was 90 min and 100min.Blood loss was 700ml and 800ml.Two patients were discharged 5 days postoperatively without any complications of bleeding,infection,pancreatic leakage.Conclusion The key surgical technique in the laparoscopic splenectomy combined with cholecystectomy was to control the splenic artery and vein according 1o different spleen anatomy.Non-acute inflammatory gallstone with surgical splenic diseases was considerel the clinical indications and the aseptic techniques and the sequence should be taken seriously during LS + LC.

ObjectiveTo analyze the relationship between the patients' psychological factors and esthetics satisfaction of all-ceramic restoration of anterior teeth.MethodsThe N scales of Eysenck personality questionnaires (EPQ) were filled at the first visit,and the total scores of N scales were calculated.After restorative treatments,the satisfaction questionnaire was used to evaluate the patients' aesthetic satisfaction on material quality,color,geometry,profile,self-confidence,etc,and to analyze the relation between psychological factors and satisfaction of the patients.ResultsThe scores of EPQ N scale of the patients in this study were as follows:Nmax=23,Nmin =3,Navg =9.35±5.714.The patients had high satisfaction with restoration.Aesthetic satisfaction,color and self-confidence were in relation to the N scales scores,satisfaction of color was in relation to sickness suspicion,satisfaction of profile was in relation to enthrallment extent and guilty consciousness,and satisfaction of self-confidence improvement was in relation to anxiety and self-determination.Conclusions The psychologic factor of the patients has some influence on the esthetics satisfaction of all-ceramic restoration of anterior teeth.

Objective To construct the mice pneumonia model with imipenem-resistant Acinetobacter baumannii and provide experimental model in anti-pan-resistant Acinetobacter baumannii therapy study. Methods A total number of 120 4-week-old BALB/C male mice were randomly selected and divided into three groups including micro-intratracheal injection, ultrasonic atomizing and nasal dripping. The mice were treated with methotrexate to induce hypo-immunity in every group. These BALB/C mice of normal immunity and hypo-immunity were infected through Imipenem-resistant Acinetobacter baumannii by microintratracheal injection, ultrasonic atomizing and nasal dripping, respectively. The morbidity, mortality,bacterial clearance rate and histopathology in lung were determined. Results The morbidities of BALB/C mice with hypo-immunity infected by micro-intratracheal injection and ultrasonic atomizing achieved 100%(30/30), while the mortalities were 100% (10/10) and 33.3% (3/10), respectively. Mice in two groups above displayed the influx of neutrophils, lymphocytes and macrophages in the peri-bronchial and alveolar interstitial space 12-24 h after pulmonary infection. In addtion, the mice in micro-intratracheal injection group displayed coUapse of partial alveolar walls, formation of abscesses and bacterial colonies in alveoli. While the lung pathology in mice of ultrasonic atomizing group was characterized by cell degeneration in some regions in the lungs, slight relaxation, congestion in alveolar wall vessels and normal of bronchial and alveolar tissue 24 h after inoculation. Degeneration in peri-tracheal and peri-bronchial areas was observed 24-48 h after inoculation, along with highly expanded pulmonary blood vessels and edems. The inflammation was reduced at 48 hours. There was no obvious pulmonary infection in BALB/C mice with hypo-immunity by nasal dripping with mortality of 0% (0/10) and no significant histopathologic change in lungs. Conclusions BALB/C mice with hypo-immunity pneumonia model with Imipenem-resistant Acinetobacter baumannii can be conducted by micro-intratracheal injection or ultrasonic atomizing, but the latter has the advantages of high-productivity, easy-operation, low-cost, time-saving and usefulness. Mice with normal immunity are not susceptible to imipenem-resistant Acinetobacter baumannii.

Objective To investigate the distribution of hepatitis B virus(HBV)genotypes in Zhejiang.Methods HBV genotyps were detected by fluorimetric real-time PCR in 240 HBVDNA positive patients who were born in Zhejiang(Hangzhou,Huzhou,Jinhua,Shaoxing,Taizhou,Ningbo each 40 positive patients).Results of the 240 HNBDNA positive patients,82(34.17%)were genotype B,and 140(58.33%)were genotype C,15(6.25%)were genotype B and C,3(1.25%)were genotype D.No genotype A、E and F found in the studied subjects.Conclusions HBV genotype B,genotype C,genotype B and C,genotype D existed in Zhejiang and there is no difference in ferms of the distribution of genotypes in six areas metioned above.

Objective To study the compatibility of TCM prescriptions of TCM practitioners of all dynasties of Alzheimer disease (AD). Methods Amnesia, forgetting, dementia, and idiot were set as search words to retrieve relevant literature in Encyclopadia of Traditional Chinese Medicine. Prescription information was screened and standardized to build database. Frequency analysis and association rules were used to mine TCM prescriptions and compatibility rules. Results Totally 449 AD related prescriptions were selected, involving 682 Chinese medicinal herbs. The individual herb with the highest frequency was Ginseng Radix Rhizoma (192);the herbal pair with the highest frequency was Ginseng Radix Rhizoma-Polyhalae Radix (182);the herbal combination with 3 Chinese medicinal herbs with the highest frequency was Poria with Hostwood-Ginseng Radix Rhizoma-Polyhalae Radix (79);the herbal combination with 4 Chinese medicinal herbs with the highest frequency was Polyhalae Radix-Ginseng Radix Rhizoma-Poria with Hostwood-Glycyrrhizae Radix et Rhizoma (37). The results of association rules showed that Ginseng Radix Rhizoma-Polyhalae Radix, Ginseng Radix Rhizoma-Glycyrrhizae Radix et Rhizoma, and Ginseng Radix Rhizoma-Poria with Hostwood were commonly used compatibilities in AD related prescriptions. Conclusion Treatment of TCM practitioners in all dynasties for AD mainly chooses Chinese medicinal herbs with the efficacy of tonifying qi and soothing nerves. The compatibilities and combinations are reasonable and with certain representativeness.

Objective To evaluate the preliminary clinical efficacy of bevacizumab for cerebral radiation necrosis (CRN). Methods Nineteen patients with CRN for whom the treatment with steroids and mannitol failed were retrospectively analyzed with a total of 22 lesions. Except for 5 lesions confirmed by pathological evidence, all lesions were confirmed by the following imaging evidence:1. computed tomography (CT)?or magnetic resonance imaging (MRI)?enhanced lesions showed loss of tension and were accompanied by substantial edema;2. CT?or MRI?enhanced lesions had a low perfusion pressure;3. magnetic resonance spectroscopy indicated that the enhanced areas had a decreased choline peak; 4. positron emission tomography showed that the fluorodeoxyglucose uptake was substantially reduced in the enhanced areas. All patients were given 5 mg/ kg bevacizumab at an interval of 14 days for 2?6 cycles. MRI examination was performed in each cycle before treatment, and the enhanced lesions on T1?weighted images ( T1 WI) and edema on T2?weighted images (T2 WI) were compared before and after treatment. The clinical symptoms, Karnofsky Performance Status ( KPS), and adverse reactions in all patients were evaluated. Comparison before and after treatment was performed by paired t test. Results All 19 patients completed the treatment successfully and there were no severe adverse reactions. The clinical symptoms of patients were substantially improved after the second cycle of treatment, and the KPS score increased by 26?? 8 on average. The visible volume of enhanced lesions on MRI T1 WI was significantly reduced by 54?? 8% after treatment (P= 0?? 000), while the visible volume of edema on MRI T2 WI was reduced by 80?? 7% after treatment (P= 0?? 000). The follow?up time ranged from 3 to 12 months with a mean value of 5?? 6 months. Eleven patients kept clinical improvement in CRN, four patients had recurrence, and four patients died from tumor progression. Conclusions Bevacizumab is preliminarily confirmed to substantially improve the clinical symptoms and quality of life in patients with CRN.

Objective To evaluate the clinical efficacy and safety of stereotactic radiotherapy (SRT) combined with bevacizumab for brain metastases in patients with lung adenocarcinoma.MethodsThe clinical data of 95 patients with brain metastases of lung adenocarcinoma were retrospectively analyzed, including 36 patients treated with SRT and bevacizumab (bevacizumab group) and 59 patients treated with SRT, corticosteroids, and mannitol (traditional drug group).The tumor response rate, peritumoral edema control rate, improvement in Karnofsky Performance Scale (KPS) score, and adverse reactions were analyzed.Results Compared with the traditional drug group, the bevacizumab group had significantly higher tumor response rate (P=0.033) and peritumoral edema control rate (P=0.000) at 1-4 weeks after treatment, as well as an obvious improvement in KPS score and reduced doses of corticosteroids and mannitol.In addition, the adverse reactions in the bevacizumab group were mild and controllable.Conclusions SRT combined with bevacizumab for brain metastases in patients with lung adenocarcinoma can achieve higher short-term tumor response rate and peritumoral edema control rate and improve patients' quality of life.

ObjectiveTo retrospectively analyze the treatment of odontoid fractures using percutaneous and open anterior screw fixation,and compare the clinical and radiographic results of the two techniques.MethodsFrom March 2003 to May 2010,115 patients with odontoid fracture were treated with anterior screw fixation,and all patients were followed up.The mean age of the patients was 43.5 years (range,16-71).Forty-seven patients who underwent percutaneous anterior screw fixation were set as the percutaneous fixation group,including 42 cases of type Ⅱ odontoid fracture and 5 of rostral type Ⅲ fracture.Sixtyeight patients who received open anterior screw fixation were set as the open fixation group,composing of 61cases of type Ⅱ odontoid fracture and 7 of rostral type Ⅲ fracture.We compared the operative time,intraoperative blood loss,X-ray exposure time,fracture union and complications between the two groups.Results The average follow-up duration was 37.6 months with a range of 12-70 months.The gender,age,classification of odontoid fractures,time after the injuries and concomitant spinal injuries showed a similar pattern in both groups.The operating time and intra-operative blood loss in percutaneous fixation group were (40.3±9.5)min and (5.6±4.1) ml respectively,and in open fixation group were (62.9±15.3) min and (47.1±28.6) ml respectively,both of them were significantly superior in percutaneous fixation group than in open fixation group (P＜0.05).There was no statistical difference in radiation exposure time,fracture union and incidence of complication between the two groups.ConclusionComparing with open screw fixation,percutaneous anterior screw fixation is a safe and reliable procedure for treatment of type Ⅱ and rostral type Ⅲ odontoid fractures with potential advantages.