Objective To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women.Methods From May 2007 to Sep.2008,30 infertile patients underwent THLPA.The dye-test,hysteroscopy,and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time.Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985).The adhesions were graded as mild (score 1-9),moderate (10-19),and severe (≥20).Twenty-four cases were in mild adhesions,5 moderate adhesions,and 1 severe adhesion.The duration of the operation and discharge,pelvic adhesions score,tubal patency,complications,and pregnancy rate were investigated.Results (1) THPLA:the majority of pelvic adhesions in all patients were successfully performed adhesiolysis.Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis.(2) Tubal patency:35 tubes were of proximal occlusion by dye-test,of which 21 (60%,21/35) were unobstructed and 4 (11%,4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy.(3) The duration of operation:the overall operative time were (32±6) minutes in mild adhesion,(52± 6) minutes in moderate adhesion,and 83 minutes in severe adhesion.Of which the time of THLPA were (11±5) minutes in mild adhesion,(35±7)minutes in moderate adhesion,and 62 minutes in severe adhesion,respectively.(4)The duration of discharge:the postoperative discharge time was 120-175 minutes.No complications occurred.(5)The rate of pregnancy:in the (15.8±4.3) months' follow-up,the rate of pregnancy was 45% (13/29),which one patient lost follow-up.Conclusions THLPA is safe,efficacious and not being hospitalized management.When compared with laparoscopy,it is simpler,more economic,and less minimally invasive approach.The appropriate indication of THLPA is to treat filmy,especially mild pelvic adhesions.It could partly avoid transabdominal operative laparoscopy for the infertile women.

[Objective]To evaluate the outcomes of treating thoracolumbar burst fractures in young adults with posterior short-segment pedicle screw fixation without fusion by analyzing the clinical and radiographic parameters.[Method]Fifty-four patients with thoracolumbar burst fractures from June 2002 to April 2006 were investigated retrospectively.Thirty-one patients were male and 23 were female.The mean age was 31 years.All patients underwent open reduction and posterior short-segment pedicle screw fixation without bone graft fusion,and had their implants removed at 12 to 20 months post-operatively.Pain status was evaluated using the visual analog scale(VAS).Changes in the anterior vertebral height ratio,Cobb′s angle,and vertebral wedge angle were measured preoperatively,postoperatively,before implant removal,and at 2 years after implant removal.[Result]Thirty-two patients were available to follow-up,with an average period of 43 months(range,36-56 months).A good correction was gained and pain was released significantly after surgery.The loss of correction was statistically significant and there were 4 patients suffering from screw broken before the instrumentation removal,however.A progressive kyphotic deformity (Cobb′s angle increased while vertebral wedge angle unchanged) was caused by the collapse of the intervertebral disc space while the reduced vertebral height was stable after the implant removal.No significant correlation was found between the final kyphosis and pain scale.[Conclusion]Short-segment pedicle screw fixation without fusion can provide good reduction and sustained corrective height if adequat indication of thoracolumbar burst fractures has been choosen.Earlier implant removal can regain local segmental motion.

Objective To investigate epidemiological characteristics and differences in anklebrachial index (ABI) among the natural population in Shanghai and Inner Mongolia,and to observe the prevalence of lower extremity peripheral arterial disease (PAD).Methods A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample.ABI was measured and related data were collected.Results The A BI value in Shanghai was 1.074 ± 0.095,while it was 1.062 ±0.075 in Inner Mongolia (P ＜ 0.001).The prevalence of lower extremity PAD in Shanghai was 4.2％,while it was 1.9％ in Inner Mongolia (P ＜ 0.01).For males,the ABI value in Shanghai was 1.078 ±0.105,and it was 1.075 ± 0.080 in Inner Mongolia (P ＞ 0.05).For females,the ABI value in Shanghai was 1.073 ±0.089,while it was 1.052 ±0.070 in Inner Mongolia (P ＜0.001).For males,the prevalence of lower extremity PAD of the in Shanghai was 4.7％,while it was 2.0％ in Inuer Mongolia (P ＜ 0.05).For females,the prevalence of lower extremity PAD of in Shanghai was 4.0％,while it was 1.8％ in Inner Mongolia (P ＜ 0.05).The ABI values in age group of ＜ 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068,respectively (P ＜ 0.05).The prevalences of lower extremity PAD in age group of ＜50 years in Shanghai and Inner Mongolia were 7.6％ and 1.2％,respectively (P ＜0.001).There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50-69 years and ≥70 years (all P values ＞ 0.05).Conclusions The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia.But they are lower than the level of western countries.In different age groups,the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of ＜ 50 years,which may be related to the limited sample size.The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

ObjectiveTo observe the synergistic action of lower He-sea and Front-mu points in treating functional dyspepsia by adopting electroacupuncture at the lower He-sea and Frong-mu points of stomach.MethodSixty patients with functional dyspepsia were randomized into a lower He-sea group, a Front-mu group, and a combining group of lower He-sea and Front-mu points, to receive treatment once daily, 5 sessions a week, totally for 4 weeks. Nepean Dyspepsia Index (NDI) was tested before and after intervention, and the general therapeutic efficacy was evaluated.ResultThe total effective rate was 100.0% in the combining group, versus 90.0% in the Front-mu group and 90.0% in the lower He-sea group, and the differences were statistically significant (P<0.05). The follow-up study showed that the total effective rate was 100.0% in the combining group, versus 90.0% in the Front-mu group and 85.0% in the lower He-sea group, and the differences were statistically significant (P<0.05). Before treatment, therewere no significant inter-group differences in comparing Nepean Dyspepsia Symptom Index (NDSI) and Nepean Dyspepsia Life Quality Index (NDLQI)(P>0.05), while there were significant differences in comparing NDSI and NDLQI after treatment (P<0.05). ConclusionIt can improve the functional dyspepsia symptoms by using the lower He-sea point and Front-mu point together or using them separately, while the combining use can produce a more significant efficacy.

BACKGROUND:Basic research demonstrated that type Ⅰ collagen exhibited prominent effect on osteogenesis,bone mass and bone fracture,which also participated in the bone fusion.However,few reports concerning the polymorphism of type Ⅰ collagen gene and spinal fusion.OBJECTIVE:To investigate the polymorphism of type Ⅰ collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation.METHODS:A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected,including 102 cases received anterior cervical subcorpectomy combined with lilac bone implantation fusion following decompression,and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion.Meantime,223 normal adults were served as the control group.The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells.The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR),with length of 293 bp.The genotypes of Pcol2 site in type Ⅰ collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method.The PCR product was digested with restriction endonuclease Eco311 and the result was observed by agarose gel electrophoresis.The G gene represented for the presence of the restriction endonuclease site,while the T gene for the absence of the restriction endonuclease site.The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3,6 and 12 after operation,and the results were compared by stages including quick (＜3 months),middle (3-6 months) and slow (6-12 months).RESULT AND CONCLUSION:There were the-1997G/T polymorphisms of the type Ⅰ collagen gene in 423 cases,including 166cases with GG,232 cases with GT,and 25 cases with TT,in addition,there was some correlation between the GG genotype and the lilac bone implantation fusion (P =0.004).The GG genotype accounted for 50% in the fast group,which was obviously greater than that of the middle and slow groups (33.3% and 16.7%,respectively).However,the-1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831).The GG genotype in the-1997G/T polymophsim of the type Ⅰ collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion.

Objective To compare the epidemiological characteristics and differences in brachialankle pulse wave velocity (baPWV)among middle-aged residents between Shanghai and Inner Mongolia autonomous region (Inner Mongolia),and to observe the prevalence of arterial stiffness in the two populations.Methods A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method.BaPWV was measured and related data were collected.Results A total of 903 cases were enrolled in this study,including 441 from Shanghai and 462 from Inner Mongolia.The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s,P ＜ 0.001].The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5 ％ (312) and 57.4％ (253),P ＜0.001].The baPWV value of middle-aged men in Inner Mongolia was (1 568 ±299) cm/s,while it was (1 508 ± 260) cm/s in Shanghai,no statistical difference was found (P ＞ 0.05).The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s,which was higher than that of Shanghai [(1 468 ±252)cm/s,P ＜0.01].The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0％ (126/188) and 60.8％ (59/97),respectively (P ＞ 0.05).The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9％ (186/274) and 56.4％(194/344),respectively.Conclusions The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists.Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

Objective To exoplore the causes in healing difficulties of osteoporotic fracture, and to study the feasible approaches and methods for clinical treatment of osteoporotic fracture. Methods Forty female Sprague-Dawley rats, used as donor animals, were divided randomly into ovariectomized (OVX) group and control (CON) group, with each group of 20 animals. OVX group was subjected to bilateral ovariectomy and CON group was subjected to sham operation. Four months after surgery, the rats were sacrificed, and long bones of the extremities were harvested respectively for preparation of bone matrix gelatin (BMG) in terms of Urist's method. BMG implants obtained from OVX and CON rats were implanted into left and right femoral muscle pouches respectively of 17 female SD rats. The host rats were killed after 14-day feeding, and tissue block of BMG implants were removed for histologic study, alkaline phosphatase (ALP) activity, and calcium content (CA) determination, respectively. Results ALP activity of BMG tissue block from OVX group was (7.22? 2.59)U/g, and that from CON group was (12.01?6.18)U/g. Significant difference was found between the two groups (P

Objective To assess the clinical results of the treatment of the 211 cases of long bone shaft fractures at lower limbs with intramedullary interlocking nails. Methods 211 cases of femoral and tibial fractures were treated chiefly with unreamed intramedullary interlocking nails and postoperative functional exercises including continuous passive motion (CPM). Results 189 cases were followed up for an average of 9 months (ranging from 4 to 26 months). All the cases achieved bone union, and no nonunion occurred. Delayed union occurred in 7 cases and limited knee joint function in 4 cases. According to the Johner-wruhs criteria, 178 cases were assessed as excellent, 24 as good and 9 as fair. The total excellent and good rate was 95.6%. Conclusions The intramedullary interlocking nail is a good device for the treatment of long bone shaft fractures at lower limbs. Its indications have become wider. It is correct to pay equal attention to the blood supply of the fractured bone and the reduction of the fracture during the operation.

Objective To determine whether dopamine D5 receptor (D5R) regulates the development of dilated cardiomyopathy (DCM) by inhibiting oxidative stress.Methods We developed heart-specific hD5 mutant (α-MHC-hD5F173L) and wild type (α-MHC-hD5WT) transgenic mice.The NOX2 expression and ROS production were tested in the transgenic mice at three month of age.The α-MHC-hD5F173L mice were treated with either NADPH oxidase inhibitor Apocynin (1mmol/kg/day) or phosphate-buffered saline (PBS) as control by intraperitoneal injection for 4 weeks.After then, the indexes of heart function were measured.The hD5WT and hD5F173L were transfected respectively in rat H9C2 cells, in which ROS production and NOX2 expression were detected at basal level.Results The ROS production and NOX2 expression were higher in the heart of α-MHC-hD5F173L than α-MHC-hD5WT mice.Apocynin treatment improved the heart function of α-MHC-hD5F173L mice.NOX2 expression and ROS production were higher in hD5F173L than hD5WT transfected H9C2 cells.Conclusions Dopomine D5 receptor may prevent DCM development by inhibiting oxidative stress.

Objective To explore six-degree-of-freedom (6-DF) registration methods between planning and cone beam computed tomography (CBCT) during image-guided radiation therapy (IGRT) in esophageal cancer.Methods Thirty pairs of CBCT images acquired before radiation and the corresponding planning computed tomography (CT) images of esophageal cancer were selected for further investigation.Registration markers for 6-DF image registration were determined and contoured in those images.The results of registration as well as time cost were compared among different registration methods of bone match, gray value match, manual match, and bone plus manual match.Results Contouring bone and spinal canal posterior to the target volume of esophageal carcinoma as registration marker could make 6-DF registration quick and precise.Compared with manual match, set-up errors of v rotation in bone plus manual match (-0.55° vs.-0.88°, t=2.55, P=0.020), of x-axis and v rotation in bone match (0.12 mm vs.-2.33 mm, t=5.75, P=0.000; -0.35° vs.-0.88°, t=3.00, P=0.007), and of x-axis and w rotation in gray value match (7.20 mm vs.-2.33 mm, t=3.10, P=0.006; -0.10° vs.-0.59°, t=2.81, P =0.011) were significantly different.Compared with manual match, the coincidence rate of bone plus manual match was the highest (85.55%), followed by bone match and gray value match (74.45% and 74.45%).The time cost of each registration method from longest to shortest was:6.00 -10.00 minutes for manual match, 1.00 - 5.00 minutes for bone plus manual match, 0.75 - 1.50 minutes for gray value match, and 0.50 - 0.83 minutes for bone match.Conclusions Registration marker is useful for image registration of CBCT and planning CT in patients with esophageal cancer.Bone plus manual match may be the best registration method considering both registration time and accuracy.