Objective To evaluate correlations between CT features and clinical activity index of Crohn’s disease(CD).Methods The CTE datasets from 37 patients with moderate active,severe active and remission stages CD were retrospectively analyzed.To ob-serve imaging features of intestinal wall,parenteral and complications.And analyze whether there was an association between imaging findings and clinical activity.Results A total of 147 bowel segments in 37 cases were involved.Wall thickening (intestinal wall≥4 mm)were observed in 121 segments.An average thickness was (12.1±3.2)mm.There are 42 bowel segments of trilaminar mural stratifica-tion,71 of the double-layed stratification and 34 of non-stratification.Enlarged mesenteric lymph nodes were observed in 20 patients. Comb sign was observed in 27 patients.Higher density of surrounding fat appeared in 22 cases.The other 37 cases inluced 4 cases with abdominal abscess,7 cases with fistula,1 6 cases with intestinal obstruction or stenosis and 1 7 cases of perianal disease.The in-testinal stratification,wall thickening,comb sign,mesenteric fat density increased,abdominal abscess,intestinal stenosis and obstruc-tion were closely associated with clinical activity.Conclusion CTE images could provide information about intestinal wall,parenteral changes and complications of Crohn’s disease,and effectively help identifying remission and active stages of Crohn’s disease.

[Objective]To find an effective method of surgical treatment of fibrous dysplasia of bone involving the femur associated with severe varus deformity.[Method]Thirteen patients with fibrous dysplasia of bone involving 14 femurs with severe varus deformity were reviewed from Feb 2002 and Jul 2005.Medial displacement of valgus or valgus osteotomies,curettage and allograft,reconstructional nail have been adolted to treat fibrous dysplasia of bone involving the femur with severe varus deformity.[Result]All patients were followed up from 8 months to 41 months with an average of 21 months.Forteen femoral mechanical alignments(axis)had been corrected completely rdiologically;the preoperative average neck-shaft angle of 75?(range,55?~100?),corrected to the average 120?(range,95 ?~135?)of postoperative,the average shortening of the femur was 3.4 cm(range,2.0~4.5 cm)preoperatively,then enlongthened by 2.8 cm(range,1.8~3.6 cm)in postoperation.Ninteen location of osteotomies showed good union in 14 femur.All bone grafts were absorbed slightly beginning at 3 months and markedly at 10 to 14 months postoperatively.Preoperation,4 patients walked with bilateral crutches,2 used unilateral cane,5 can't walk due to pathological fracture,2 without support;after operation,11 patients walk without support,2 ambulated with the aid of unilateracane.Eleven patients were painless,2 moderate pain.All had no infections and recurrent fracture and progression of the deformity.[Conclusion](1)This method can correct varus deformity,improve function,as well as restore biomechanical axis of femur.(2)It is able to effectively eradicate lesions and prevent recurrence.(3)Impaction allograft is the key of prompting allograft incorporating fully and preventing pathological fracture.

BACKGROUND:Problems can occur at the donor site where the autologous tendon graft is taken. Alogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament.
OBJECTIVE: To study the clinical curative effect and immune rejection of arthroscopic reconstruction of the anterior cruciate ligament by alogeneic tendon graft.
METHODS:The 120 included patients with anterior cruciate ligament injury were randomized into autologous tendon graft and alogeneic tendon graft groups, respectively, with 60 patients in each group. The autologous semitendinosus-gracilis graft at the affected side or the alogeneic anterior cruciate ligament was implanted into the knee joint in autologous tendon graft group or alogeneic tendon graft group, respectively. Lachman test results, Lysholm and Larson scores of joint function, and postoperative immune rejection were observed and assessed during 2-year folow-up.
RESULTS AND CONCLUSION: Lysholm and Larson scores in autologous tendon graft and alogeneic tendon graft groups were significantly increased after the reconstruction compared with before the reconstruction; however, there was no difference in the scores between both two groups at 2 years after the reconstruction (P > 0.05). At the end of the folow-up, the normal function of the knee joint was restored, and no lag and flexion constraint of the knee joint were observed. No significant differences were observed in Lachman test results between both groups (P> 0.05). Compared with the autologous tendon graft group, immune rejection rates were higher in the alogeneic tendon graft group; however, no significant differences were observed between both groups (P > 0.05). In summary, the alogeneic tendon graft may be a candidate for the reconstruction of the anterior cruciate ligament due to its similar clinical curative effect to the autologous tendon graft and low immune rejection rates.

Minimally Invasive Surgical Procedures ; Philosophy, Medical

Objective To find out households consumption of iodized salt in Xinjian county, and to provide scientific basis for prevention and treatment of iodine deficiency disorders(IDD). Methods From 2006 - 2010 in Jiangxi province, according to the direction of east, west, south, and north, nine townships(streets) were selected,in each township (street), 4 administrative villages (committees) were selected, in each administrative village(committee) 8 households were selected to collect their edible salt each year, direct titration method was adopted to detect salt iodine. Results From 2006 - 2010 a total of 1440 salt samples were collected, of which 1379 were qualified iodized salt, 34 unqualified, 27 non-iodized salt; iodized salt coverage rate, qualified iodized salt and iodized salt consumption rates were 98.13% (1413/1440), 97.59% (1379/1413) and 95.76% (1379/1440),respectively, and the rate of non-iodized salt was 1.88% (27/1440). Conclusions The intake rate of qualified iodized salt in Xinjian county have reached the standards of eliminating IDD. The quality of iodized salt should be improved in few counties. In the future, we should also increase the use of various forms advocacy of IDD prevention and treatment, and educate the masses to enhance self-protection awareness, so that they can consciously resist the salt smuggling, and refuse to buy non-iodized salt.

According to the characteristic of the practice in the outpatient dentofacial surgery,we analyzed the prominent contradiction in the process.With the progress of the medical service law and the innovation of the medical treatment mode,we must pay more attention to the ethics problems on the medical education.Before practice,we must strengthen the students' training in stimulator,the concept of legal,ethics,communication skill and so on.Teachers and hospitals should take the responsibility.The relevant laws and regulations ought to be modified step by step to ensure the practice.

Objective To explore the clinical characteristics,diagnosis,treatment,and prognosis of male breast cancer.Methods The clinical data of 38 cases of male breast cancer,who were treated in the two hospital during the past 10 years,were analyzed retrospectively.The diagnosis was mainly based on preoperative B-ultrasound,radiography with molybdenum target tube and fine needle aspiration.Among the 38 cases,radical mastectomy was conducted in 3 cases,modified radical mastectomy in 27 cases,simple mastectomy in 5 cases,and operation was refused in 3 cases.Postoperatively,radiotherapy was adopted in 4 cases,simple endocrinotherapy in 7 cases,radiotherapy plus chemotherapy in 9 cases,and chemotherapy plus endocrinotherapy in 8 cases.Results Median age at treatment was 58.5(53-82)years.TNM staging included stageⅠin 13 cases,stageⅡ in 19 cases,stageⅢ in 4 cases,and stageⅣ in 2 cases.Median follow-up was 73.8 months(2 months-10 years),and follow-up rate was 73.6%(28/38).During the follow-up,13 cases died including 8 cases died of local recurrence and metastasis,and 5 cases died of heart and brain disease.The 5-and 10-year overall survival rate was 71.6% and 55.3% respectively;5-and 10-year disease-specific survival of stageⅠ,Ⅱ was 92.6% and 78.9% respeoively;among 6 cases of stageⅢ,Ⅳ 4 were followed,and all 4 cases died with in 3 years.Conclusions Male breast cancer has a long course,poor prognosis and low survival rate.Combined therapy with modified radical mastectomy,as its basis,is the treatment of choice for male breast cancer.There is a certain correlation between the prognosis of male breast cancer and clinical stage of the disease.

OBJECTIVE:To analyze the differences of drug instructions between hospital directory and OTC standard model in-structions,and to provide reference for enhancing instruction management and reducing the safety risk of clinical drug use. METH-ODS:1 324 drugs of hospital directory in a hospital in 2014 were compared with OTC directory from CFDA websites. The instruc-tion of drug types included in OTC directory were compared OTC model instruction. According to the degree of risks which the dif-ferences may bring,differences were divided into four levels for analysis as negligible,general,important and severe. RESULTS:244 drugs belonged to OTC,of which 32.38%were different from standard model instructions. The four risk levels rates of negligi-ble,general,important and severe accounted for 29.11%,34.18%,7.59% and 29.11%,respectively. Among important risk,the difference of“indication limit”occupied the highest proportion,being 50.00%. Among severe risk,the difference of“forbidden for special disease”and“forbidden for pregnant women”accounted for 43.48% and 39.13%. CONCLUSIONS:There are problems, such as the absence of important medication information,statement conflicts. The hospital and administration departments should en-hance the standard management of drug instruction to guarantee safe and rational drug use in the clinic.

BACKGROUND:Neural stem cel s with self-proliferation and differentiation potential are the ideal seed cel s for central nervous tissue engineering. Although col agen and silk fibroin as biological scaffold materials have been widely used, both of them used alone have certain shortcomings. Is it possible to combine the two materials to build a novel neural tissue-engineered scaffold? What is the effect of this novel scaffold on the growth and differentiation of neural stem cel s? OBJECTIVE:To observe the growth and differentiation of neural stem cel s seeded onto the novel composite scaffold. METHODS:The rat embryonic neural stem cells were inoculated onto new composite scaffolds, and then, their growth and differentiation were observed by light microscopy and scanning electron microscopy. Neural stem cells were cultured in conventional suspension culture as control group. Cell counting kit-8 assay was used to detect viability of neural stem cells in the two groups. Three-dimensional composite scaffolds carrying neural stem cells were slic ed into paraffin sections to observe the growth and differentiation of neural stem cells by hematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION:Neural stem cel s cultured on the new composite scaffold grew and differentiated wel , and interconnected synapses were observed. Cel counting kit-8 assay showed that neural stem cel s on the scaffold grew wel , and the cel viability was significantly higher in the composite scaffold group than that in the control group (P<0.05). Hematoxylin-eosin staining and immunofluorescence staining of paraffin sections further provided evidence for good growth and differentiation of neural stem cel s on the scaffold. These results indicate that the novel composite scaffold with good biocompatibility benefits the growth and differentiation of neural stem cel s, promising a favorable application prospect.

BACKGROUND:Col agen and silk fibroin materials for construction of spinal cord scaffolds have been proven to repair or partial y repair damaged spinal cord nerve function. OBJECTIVE:To introduce partial characteristics of the col agen and silk fibroin and to review the recent progress and application as scaffolds in spinal cord tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases (2003-01/2012-10) was performed for articles addressing the application of col agen and silk fibroin scaffolds in spinal cord injury with the keywords of“col agen, silk fibroin, scaffold, spinal cord injury”in Chinese and English, respectively. RESULTS AND CONCLUSION:Col agen has low antigenicity, good biocompatibility and biodegradability. Col agen and its degradation products can cause no inflammatory reactions in the body, but have the disadvantages of rapid degradation and poor mechanical properties. Silk fibroin has good biocompatibility and excellent mechanical properties, but its degradation is slow. The col agen and silk fibroin are compounded using an electrostatic spinning technology to improve the physical properties of the material on the basis of maintaining good biocompatibility. At present, fibroin or col agen materials in terms of nervous system repair have been studied, laying some foundation for spinal cord tissue engineering. Considering the similar characteristics and mechanics performance to the spinal cord tissue, col agen/silk fibroin composite materials are expected to become the ideal scaffold materials for spinal cord tissue engineering.