ObjectiveTo explore the magnitude of the deformation of Durom cup after press-fit implantation in cadaver models and to investigate which part of the cup would deform the most.Methods Three fresh adult cadaver pelves were harvested and were cleaned of soft tissue,preserving the sacrospinous and sacrotuberous ligaments.Bilateral acetabular replacements in all cadaver pelves were performed by a senior surgeon.All acetabulums were reamed with corresponding reamers,and the direction of reaming was 40°to 45° of abduction and 15° to 20° of anteversion.Larger reamers were used sequentially until the anterior and posterior walls were firmly engaged.Six Durom cups were implanted.The deformation of each cup was detected by 3D Digital Image Correlation (3D DIC) method,and the magnitude and the parts of the deformation were recorded.ResultsThe diameters of cups were 50 mm in 2,52 mm in 2 and 54 mm in 2,respectively.All cups generated different degree of deformation,which were mostly located in the posterior-superior quadrant and the areas of the ramus of ischium.After measuring the maximum deformed areas for three times,it was found that the localized depression deformation occurred in all cups.The average deformation value was (41.73±8.86) μm (range,29.91-49.43 μm).There was no significant change in deformation value 24 hours after press-fit implantation and 7 days after removing the cups.ConclusionDurom large diameter metal acetabular component will generate deformation during the press-fit implantation.And the deformation may play an important role in more wear and more ions release.

Objective To explore the finger closed artery damage crisis the diagnosis and the treatment.Methods The clinical manifestation and the method of treatment of 30 examples 36 figure of closed arteries were summarized.Results 26 examples 30 figure of surgeries treatments wound showed the blood circulation good function restoration.After 4 examples 6 figure gave up surgeries treat,the wound showed the partial necroses and were operated amputation.Conclusion The finger closed artery damage crisis should remove the factor of inducing the vasospasm.The surgery treatment should be immediately done if the symptom of ischernia doesn't improve.The pathological changes blood vessel excision tallies or the venula transplant is the first-chosen method of treatment.

Objective To analyze the characteristics of spontaneous otoacoustic emission in full-term newbo‐rns .Methods The Capella OAE equipment (Madsen ,Denmark) was used to test Spontaneous Otoacoustic Emission (SOAE) in 147 cases (236ears) who have passed the newborn hearing screening with TEOAE(Transient Evoked Otoacoustic Emissions) .Results The SOAE incidence was 56 .77% (male 41 .51% ,female 69 .23% ;left ear 49 .14% ,right ear 64 .17% ) .It was significantly higher in females (P<0 .05) and in right ear (P<0 .05) .The av‐erage amplitude was 11 .78 ± 8 .36 dB SPL( 11 .73 ± 8 .25 dB in male ,11 .81 ± 8 .43 dB SPL in female;11 .97 ± 8 .56 dB SPL in the left ear ,11 .65 ± 8 .22 dB SPL in the right ear) .There were significant differences in genders(P<0 .01) .The frequency of SOAE focused on 3 .2~ 3 .7 kHz(2 .9~3 .4 kHz in males ,3 .4~3 .9 kHz in females ;3 .2~3 .7 kHz in the left ears ,3 .2~3 .6 kHz in the right ears) .There were significant differences in genders(P<0 .01) .The average peak of SOAE was 3 .70 ± 2 .75(3 .86 ± 2 .87 in males ,3 .62 ± 2 .70 in females;3 .70 ± 3 .02 in the left ears ,3 .70 ± 2 .55 in the right ears) .There were no significant differences in genders and laterality .Conclusion The characteristics of SOAE in full-term newborns include higher incidences ,multiple peaks and high frequency distribution .

AIM:To compare the effects of remifentanil and fentanyl for posterior scoliosis correction and the influences on postoperative pain.METHODS:Forty patients scheduled for posterior scoliosis correction(ASAⅠ-Ⅱ,aged 11-18 years)were randomly divided into group remifentanil(group R)and group fentanyl(group F).Anesthesia was maintained with propofol,vecuronium bromide and sevoflurane.Intravenous remifentanil(0.2 ?g?kg-1?min-1)and fentanyl(1 ?g?kg-1?h-1)were continuously administered for analgesia.Vecuronium bromide and analgesics were discontinued around 30 min before the wake-up test.The wake up time from propofol and sevoflurane discontinuation to movement of the patient's toe were recorded.In group R,once remifentanil infusion was stopped before surgery ended,the patients were injected with fentanyl 2 ?g/kg.All of the patients received intravenous fentanyl(10 ?g?kg-1?min-1)for postoperative analgesia and were interviewed for pain degree during the first 24 h after surgery.RESULTS:The wake-up time were(12.3?5.7)min in group R and(21.6?6.5)min in group F(P

Objective To estimate the value of confocal laser endomicroscopy (CLE)for differential diagnosis of gastric ulcer. Methods Patients diagnosed as gastric ulcer by conventional endoscopic mode of CLE were enrolled. The eonfocal endoscopic mode of CLE was used to observe the borderline and/or the surface of the ulcers. Biopsy specimen was taken for histopathological examination and the result of CLE was compared with histopathological finding. Results A total of 12 769 CLE images were obtained from 150 sites of 43 patients. The sensitivity and specificity of CLE for phlegmonosis process were 83.54% and 85.92%, respectively, with positive predictive value of 86.84% and negative predictive value of 82.43%. Whereas the sensitivity and specificity of CLE for intraepithelial neoplasia were 53.57% and 88.52%, respectively, with positive predictive value of 51.72% and negative predictive value of 89.26%. As for diagnosis of gastric cancer, the sensitivity and specificity of CLE were 88.37% and 93.46%, respectively, with positive predictive value of 84.44 % and negative predictive value of 95.24%. The kappa values for agreement of histopathological findings and CLE for diagnosis of phlegmonosis process, intraepithelial neoplasia and gastric cancer were 0.69,0.42 and 0.81, respectively. Conclusions CLE can provide a real-time histopathological diagnosis of the gastrointestinal tract with high sensitivity, specificity, positive and negative predictive values. Targeted biopsy can be done under CLE and the detective rates of precancerous lesions and tumors will be increased.

Objective To compare the difference of the clinical efficacy on post-stroke shoulder-hand syndrome treated by acupuncture at stellate ganglion and by conventional acupuncture. Methods Ninety cases of post-stroke shoulder-hand syndrome ( at stageⅠ or stageⅡ) were randomized into treatment group and control group, 45 cases in each group. Both groups received basic rehabilitation training. Additionally, the treatment group received acupuncture at the bilateral stellate ganglions of the neck, with reducing acupuncture by rotating the needles. The control group received the conventional acupuncture on Jiquan ( HT 1) , Chize ( LU 5) , Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), with reducing acupuncture by lifting and thrusting the needle on Jiquan ( HT 1) and Chize ( LU 5) , and with mild reinforcing and reducong acupuncture on the other acupoints. The treatment for both groups was given once every day, and 14 times in total. The total syndrome scores, visual analogue scale (VAS) scores, modified Fugl-Meyer Assessment of motor function scale (FMA) scores, and modified Barthel index (MBI) were observed to evaluate the changes of symptoms, pain and motor function of the upper limbs, and activity of daily life before and after treatment in the two groups. The clinical efficacy was also compared between the two groups. Results The total syndrome scores, VAS scores, FMA scores and the modified Barthel index were improved apparently after treatment in the two groups (all P<0.01), and the improvement in the treatment group as more obvious (all P<0.01) . The total effective rate was 93.33% (42/45) in the treatment group, which was better than 73.33% (33/45) in the control group ( P<0.05) . During the treatment, patients of both groups had good compliance, and all completed the trial. No obvious adverse reaction was found in the two groups. Conclusion Acupuncture at stellate ganglion is effective and safe for the treatment of post-stroke shoulder-hand syndrome, and it has higher efficiency than the conventional acupuncture.

Objective To investigate the expression of Gli1 protein in colorectal cancer (CRC) tissues,and evaluate its association with the prognoses of the patients.Methods A total of 106 patients were enrolled and their clinicopathological characteristics were analyzed.The expression of Gli1 proteins were detected by immunohistochemical staining,and its association with time to recurrence/metastasis (TTR) and overall survival (OS) of the patients were analyzed.Results The positive rate and expression intensity of Gli1 protein in recurrent or metastatic tumor tissues were higher than those in non-recurrent and non-metastatic tumor tissues [86.84 ％ (33/38) vs.58.82 ％ (40/68),1.32 scores vs.0.71 scores,both P ＜ 0.01),while the positive rate and expression intensity of Ki-67 protein remained no difference between both groups [97.37 ％ (37/38) vs.91.18 ％ (62/68),1.89 scores vs.1.75 scores,both P ＞ 0.05).The positive rates and expression intensities of Gli1 and Ki-67 proteins in CRC tissues were higher than those in adjacent tissues [26.42 ％ (28/106) and 0.27 scores;4.72 ％(5/106),0.05 scores] and normal tissues [3.33 ％ (1/106),0.03 scores;0,0.00 scores] (all P ＜ 0.01).Results of univariate analysis showed that the expression of Gli1 protein,tumor grade and lymph node involvement were significantly associated with TTR,but all of the clinicopathological factors had no obvious association with OS.The association remained significant between the expression of Gli1 protein and TTR in multivariate analysis (P ＜ 0.01).Conclusion The expression of Gli1 protein is an independent prognostic marker of recurrence or metastasis in CRC patients,its high expression implicates a high risk of CRC recurrence or metastasis.

Abstract On March 12, 2022, a case with Plasmodium vivax malaria was reported in the First Hospital of Jiaxing City. The case sought healthcare services due to persist, sharp distending pain of the brain and fever on February 25, 2022, and the symptoms showed no improvements following symptomatic treatment. Microscopy identified malaria parasites on March 12, and the case was definitively diagnosed as P. vivax malaria on March 13. The case was discharged from hospital on March 16 and relapsed on June 15. The case was a veteran from the China-Myanmar border, where malaria is highly prevalent, and had no history of travel after returning to Jiaxing City on October 2021. Based on epidemiological history and laboratory tests, the case was diagnosed as a cross-border mosquito-borne imported case of P. vivax malaria. The case was given treatment with mosquito vector isolation, and the case's family members, neighbors and colleagues were all tested negative for malaria parasites. There was no Anopheles sinensis detected in the case' residence; however, Anopheles was detected in the neighboring areas, indicating a risk of re-establishment. Returners from high-risk regions including borders and labor exporters are recommended to be included in malaria surveillance, and the sensitivity of malaria surveillance requires to be maintained and the diagnostic and treatment capability of malaria requires to be improved in medical institutions.

Objective To investigate the value of fluorescin-aided confocal laser endomicroscopy (CLE) for diagnosis of helicobacter pylori (Hp) infection. Methods From June 2009 to November 2009, patients undergone gastric endoscope examination with upper gastrointestinal symptoms (upper abdominal discomfort, abdominal distension, satiation, acid reflux and eructation) or screened for gastric cancer were enrolled. The gastric mucosa CLE image data of twenty diagnosed Hp positive patients and 10 Hp negative patients was analyzed retrospectively. By comparing with histological image of targeted biopsy tissue, the CLE diagnostic criteria for Hp infection were established. In the prospective study, CLE diagnose result was compared with Hp tested result. The consistency of CLE diagnostic criteria in different observers was also analyzed. The CLE image data with histopathology result were compared accordingly. Results Total 72 patients were enrolled in the prospective study,of 34 Hp positive patients, 31 patients were correctly diagnosed by CLE. The accuracy, sensitivity and specificity of CLE diagnosis were 88.9%, 91.2 and 86.8% respectively. CLE image displaying fluorescin leakage and cell shedding was the highest specificity for Hp infection diagnosis, (97.4 %);fluorescin leakage plus gastric pits distortion and cell edema was the highest sensitivity (88. 2%). The consistency of CLE diagnostic criteria in different observers was high (Kappa value 0. 72, 0.87). The CLE image of Hp infection was highly correlated with inflammation activity (P＜0. 001). Conclusion CLE can accurately distinguish normal mucosa from Hp infected mucosa at the cellular level. The diagnostic value for Hp infection was reliable.

Objective To assess the value of confocal laser endomieroscopy (CLE) in diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Methods CLE examination was performed in 41 patients who needed further examination because of lesions in esophagus during July 2008 to April 2009. The diagnosis was made based on the features of esophageal squamous cells which was defined as low grade intraepithelial neoplasia(LGIN), high grade intraepithelial neoplasia (HGIN) and early esophageal squamous cell carcinoma (EC). Biopsy specimens were taken precisely matched to the CLE imaging sites. The result was compared with that of histopathology. Results There were 7281 eonfocal images obtained from 60 target lesions in 41 patients. The sensitivity, specificity and accuracy of CLE were 75.0%, 88.6% and 85.0% in diagnosis of LGIN, respectively, 85.7% ,92.3% and 90.0% in diagnosis of HGIN, respectively,and 88.9% ,96.1% and 95.0%, in diagnosis of EC,respectively. Conclusions It is an effective method for diagnosis of esophageal neoplastic lesions using CLE, which has high accuracy in diagnosis of HGIN and early esophageal cancer.