BACKGROUND:Recently,open reduction and internal fixation has become an important therapy for pelvic and acetabular fracture. However,screw penetration sometimes occurs,which damage vessels or nerves in the pelvic cavity. OBJECTIVE:To measure the best entry points,direction and length of screw in acetabular anterior column fracture lag screw internal fixation technique. DESIGN,TIME AND SETTING:Measurement experiment was performed at the Department of Anatomy,Medical School of Shandong University from June to October 2008. MATERIALS:A total of 20 semi-pelvic specimens of adult male cadavers were used to make serial cross-sections of the acetabular anterior column. METHODS:In single screw technique,the horizontal distance OP and vertical distance PQ from entry point O to apex of greater sciatic notch Q were measured,and screw length was measured. In double screw technique,the horizontal distance O1P1,O2P2 and vertical distance P1Q,P2Q from entry point O1 of the inner screw and entry point O2 of the outer screw,respectively to apex of greater sciatic notch Q were measured. The length of inner screw and outer screw were measured respectively. Angle ? on sagittal plane and the angle ? on coronal plane of the screw were determined. All data were put into software SPSS 10.0 for statistical analysis. MAIN OUTCOME MEASURES:The entry points,direction and length of screw in acetabular anterior column fracture lag screw internal fixation technique RESULTS:Single screw technique:the length of OP and PQ was (23.5?2.2) mm and (16.8?1.6) mm respectively; the length of lag screw was (84.9?4.7) mm. Double screw technique:the length of O1P1 and P1Q was (26.3?2.3) mm and (13.6?1.4) mm,respectively,and the length of medial lag screw was (69.8?4.1) mm; the length of O2P2 and P2Q was (20.7?2.1) mm and (20.1?1.8) mm,and the length of lateral lag screw was (61.2?3.7) mm. Angle ? was (123.4 ? 4.1)? and angle ? (62.2 ? 5.8)?. CONCLUSION:The entry point of single screw technique lies in the summit of greater sciatic notch 17 mm outward,vertical to the medial margin of the posterior column,24 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 85 mm. The entry point of medial screw in double screw technique lies in 14 mm outward,vertical to the medial margin of the posterior column,and 26 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 70 mm. The entry point of lateral screw in double screw technique lies in 20 mm outward,vertical to the medial margin of the posterior column,and 21 mm upward,parallel to the medial margin of the posterior column; the length of the screw is 61 mm. The angle of lag screw with respect to the parallel line of the medial margin of the posterior column is 123?,and the angle lag screw with respect to the vertical line of the medial margin of the posterior column is 62?. The position of the lag screw must be confined by intraoperative fluoroscopy in multiple projections.

[Objective] To study the effect of arthroscopic reconstruction of anterior cruciate ligament using RIGIDfix and Intraflx system with quadruple-strand hamstring tendons.[Method]Thirty-six cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with four strands of hamstring tendons,and the grafts were fixed with RIGIDfix and Intrafix system.Ptients were treated with systematic rehabilitation therapy and relevant complications were managed post-operatively.The patients were followed up for 6~12 months,ask the patients' subjective symptom,examine the knee range of motion,anterior drawer test,Lachman test and Pivot shift test,were managed to evaluate clinical result according to Lysholm rating.[Result]All patients had no serious complication,and were followed up for 6~12 months post-operatively.All patients had returned his post,knee range of flexion achieved 130?,extention achieved 0?.Three cases sometimes felt his knee soft and instabilization during exercise violently,the other patients had no sensation of soft and instabilization.When patients were followed up,anterior drawer test:negative 35 cases,positive 1 case;Lachman test:negative 33 cases,positive 3 cases;Pivot shift test of all patients were negative.The Lysholm score increased from 51.3?4.2 to 85.6?4.6,the difference was significant(P

Objective To explore the treatment of fractures of symphysiolysis /superior and inferior ramus of pubis and sacrum. Methods We treated 11 cases of fractures of symphysiolysis / superior and inferior ramus of pubis and sacrum with pubic symphysis double plate +sacrum rods, and analyzed the clinical results of the operation. Results All the 11 cases were followed up for a period of 6 months to 2 years. 2 cases had numbness of perineum and foot drop which were cured with posterior tibial muscle tendon translocation. 1 case had chronic pain in sacroiliac region, and needed antalgica occasionally. The others had a satisfactory recovery. Conclusion For fracture of symphysiolysis /superior and inferior ramus of pubis and sacrum, pubic symphysis double plate +sacrum rods can get a good clinical result.

Pituitary adenoma is a serious disease that affects human health through interfering hypothalamus-pituitary-target organ axis systems.Proteomics is an effective approach to elucidate molecular mechanisms of a pituitary adenoma and discover effective biomarkers for a pituitary adenoma.A great progress has been made in the field of pituitary adenoma proteomics in the past ten years:(1) the use of laser capture microdissection,(2) functional pituitary adenoma proteomics (such as prolactinoma),(3) proteomics analysis of invasive characteristics of nonfunctional pituitary adenoma,(4) protein post-translational modifications including phosphorylation and tyrosine nitration,(5) the use of protein antibody array,(6) proteomics analysis of hormone isoforms,(7) serum proteomics and peptidomics,(8) integration of proteomics and other omics data,and (9) proposal of multi-parameter systematic strategy for a pituitary adenoma.

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

BACKGROUND: A large amount of cell dies of apoptosis in secondary injury stage after spinal cord injury.OBJECTIVE: To probe into the influence of local intraspinal infusion with danshen injection on necrosis and apoptosis of spinal cell after acute spinal cord injury.DESIGN: Randomized controlled experiment was designed.SETTING: Clinical Medical Trial Center of People' s Hospital Affiliated to Yunyang Medical College.MATERIALS: Forty-four Chinese white rabbits of first grade were employed, aged varied from 4 to 5 months, of either sex, mass weighted varied from 2.0 to 2.5 kg.INTERVENTIONS: The experiment was performed in Clinical Medical Trial Center of People' s Hospital Affiliated to Yunyang Medical College from June 2002 to July 2003. Two groups were randomized, named danshen group and the control group, 22 rabbits for each. In both groups, modified Allen method was used to prepare the model of incomplete spinal cord injury. In danshen group, danshen injection was infused from subdural catheter for 4times at 0. 3 mL/kg per day of the total amount (once every 6 hours). In the control group, physiological saline of same dose was injected. The animals were sacrificed at the 8th, 24th and 72nd hours successively after injection for pathological and histomorphologic observation, peroxide dismutase and malondialdehyde determination and determination of positive cell count of B-cell lymphoma-2 (Bcl-2), the apoptosis-inhibition gene.MAIN OUTCOME MEASURES: Cell apoptotic index and cell apoptotic rate in the region of spinal cord injury.RESULTS: Forty-four rabbits entered result analysis for all. ① Results of cell apoptosis: Apoptotic index in danshen group was less remarkably than that in the control group(13.10 ± 1. 38, 20.39±2.96, 4.101, P ＜0.01); cell apoptotic rate was lower remarkably than the control group[ (9.67 ± 1.09)%,(14.68±2.81)%, t=4.072, P ＜0.01] and Bcl-2 expression was more than that in the control group[ (19. 12 ± 4.74) /mm2, ( 13.37 ± 3.68) /mm2,t = 2. 347, P ＜ 0.01 ]. ② POD content: The result in danshen group was higher thanthe control group[ (136.20 ± 13.64) NU/mL, (101.70 ± 15.24) NU/mL,t = 4. 132, P ＜ 0.01 ]. ③ Malondialdehyde content: The result in danshen group was lower than the control group[ (1.27 ± 0. 22) nmol/mL,(2.54±0.69) nmol/mL, t=4.309, P ＜0.01] . ④Degeneration and necrosis of neuron and neural fiber: The result in danshen group was milder than the control group.CONCLUSION: After local infusion with danshen(Radix Salviae Miltiorrhizae), cell apoptosis was decreased in local spinal cord injury and cell necrosis was inhibited and alleviated after acute spinal cord injury.

Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones.Among them, 65 patients were males, 39 females and their age was 46.6 years (ranging from 23 to 76 years) .And 29 of them underwent bilateral hip operations and 75 unilateral ones.Seventy-six cases of aseptic necrosis of the femoral head in the terminal stage, 28 cases of hip dysplasia and osteoarthritis.Surgical approach: of all the operations, 103 hips were operated on with hardinge approach, 30 with posterolateral approach.During the operation, first of all, the femoral medullary cavity was broached and then the anteversion of intramedullary broacher was measured.After that, the anteversion of the acetabular cup was calculated as 37° minus the anteversion of the broacher, and the acetabular cup was implanted at that angle.The patients′ prosthesis combined anteversion, range of motion of the hip joint, operation time, hemorrhage amount, and complications had been kept record.One, three, and six months respectively after the operation, all the patients received outpatient review, and took anteroposterior and lateral position X-ray examination.Harris hip score had been applied to evaluate their hip function before the operation and six months after the operation. Results: All the patients had been operated on smoothly, with the operation time of(57.6±14.5)minutes(36-115 minutes)and hemorrhage amount of (336.5±50.8)ml(180-620 ml). The operation finding showed that the combined anteversion by employing "femur first" principle and combined anteversion techniqueis was (36.6±6.8)°. Also, range of motion of the patients′ hip conforms to the D′Lima criterion and no patients had experienced dislocation and some other serious complications.The follow-up ended at August 2017, which lasted for 12.2 months(6-18 months), and 88 cases(119 hips) were interviewed. The Harris hip score for the affected sides of the hip joints 6 months after the surgery was 94.6(86-100). Compared with the score of 29.8(12-43) before surgery, the t-test had proven its statistical significance(t=12.82, P=0.003). Conclusion Based upon the "femoral first" principle and "combined anteversion technique" during total hip arthroplasty, these operations has been carried out well enough to meet the patients′ needs of performing normal daily activities.

Objective:To investigate the malignant imaging characteristics of non-palpable Breast Imaging-Reporting and Data System 3 breast lesions (NPBL BI-RADS 3 breast lesions) with ultrasound-guided core needle biopsy.Methods:From February 2016 to February 2018, the ultrasound characteristics of 161 NPBL BI-RADS 3 breast lesions in Beijing Friendship Hospital, Capital Medical University were retrospectively collected with ultrasound-guided core needle biopsy and pathological examination. According to the pathological results, the patients were divided into two groups: benign group (153 cases) and malignant group (8 cases). Associated risk factors were analyzed retrospectively according to general characteristics and characteristics of the ultrasound report. The Fisher exact probability test was used for single-factor comparative analysis. Significant variables based on univariate analysis were included in multivariate regression analysis, and then logistic regression was used to search for clinical risk parameters and ultrasound malignant signs. The receiver operating characteristic (ROC) curve was plotted with statistically significant factors to evaluate the diagnostic efficacy. In combination with the area under the curve (AUC), the parameter integral critical value, sensitivity and specificity were analyzed.Results:The age≥45 years ( OR=35.036, P=0.012), the maximum lesion diameter of 1-1.3 cm ( OR=25.047, P=0.008) and a aspect ratio of the lesion of 0.56-0.72 ( OR=19.860, P=0.013) could significantly affect the benign and malignant nature of the lesions, could be independent risk factors. The AUCs for constructing ROC curves to assess the diagnostic values of the above-mentioned indices were 0.732, 0.724 and 0.751, respectively; the sensitivity was 87.5%, 62.5% and 75%; the specificity was 58.8%, 82.4% and 75.2%; the positive predictive values was 10.0%, 15.6% and 13.6%; the negative predictive values was 98.9%, 97.7% and 98.3%, respectively. Conclusion:Of the NPBL BI-RADS 3 breast lesions, the malignant risk of lesions with an age≥45 years, maximum diameter of 1-1.3 cm and aspect ratio of 0.56-0.72 is high.

Objective: To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer. Methods: A patient with early breast cancer enrolled in Beijing Friendship Hospital, Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green. The axillary status accessed by these two methods were compared. Results: Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography. Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery. All of these sentinel lymph nodes were negative. The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery. Conclusions Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy. More related researches should be carry out to further compare these two methods.