1. 400 isolated skulls, 56 skulls from the integral human skeletons, and skulls of10 cadavers (5 adults and 5 juveniles) collected skulls from Shanghai and its vicinity werestudied for the characteristics of foramen magnum and the surrounding structures. 2. The shape of the foramen can be grouped into six types i.e. (1) oval, (2) rhom-boid, (3) ellipsoid, (4) round, (5) mushroom-like, and (6) hexogonal. 3. The percentages of the presence of the posterior condyloid canal were found tobe both sides present, 51%; right side alone 18%; left side alone 18% and both sidesabsent, 13%. The result was almost identical with that of Loh found from the skulls ofWestern China, and not far from that of Wood-Jones found from Northern China. Itis found that the anterior end of the posterior condyloid canal does not always open intothe sigmoid sulcus, but may sometimes lead into the jugular foramen, and in those casesthe vein passing through this canal can not be considered as an emissary vein. 4. Regarding the bony process situated around the anterior margin of the foramenmagnum, it can be classified into three categories according to their positions, i.e. (1)preoccipital spine, i.e. those on the anterior margin of the froman magnum, (2) precondyloidtubercle, i.e. those in front of the occipital tubercle and (3) postclival spine, i.e. thosearound the lower part of the clivus. 5. From the studies of the integral skeletons and the regional dissections, the au-thors found that the appearance of the bony processes may be due to traction and ossifi-cation of end of the ligaments related with the corresponding regions. It is therefore, nota homologous structure of the occipital condyle of the reptiles and birds; it is not athird condyle.

1. 50 heart specimens (30 ABS cast and 20 dissected specimens) were used to study the origin, course and diameter of the branches of the atrial artery. And some measurements were made. 2. Most of the S-A node artery are the first or second anterior atrial branch. In 26 cases (52%), it arises from the right coronary artery, with a diameter of 1.2～ 2.2mm; and in 24 cases (48%)from the left coronary artery, with a diameter of 1.1～ 2.0mm. Their courses are closely related with the anterior interatrial sulcus and the interatrial muscular bundle. Most of the right and left S-A node arteries take a counter-clockwise course and end at the orifice of the superior vena cava. During their course around the orifice of the superior vena cava, a descending loop is present in the posterior interatrial sulcus, only in two cases which is different from McAlpine's observation. Only in 6 cases the origin of the S-A node artery is at the other site, i. e. 4 from left circumflex atrial artery, and 2 from the extension of the terminal branch of the right coronary artery. 3. Kugel's artery usually arises from these branches of the promixal part of the right or left coronary artery, i. e. from the left or right S-A node artery, or from the left or right anterior atrial artery. It usually penetrates into the septum at the anterior interatrial sulcus, with a diameter of 0.1～1.2mm, during penetration. In the septum it has a constant course around the inferior border of the fossa ovalis and may be anastomosed with the branches of the right and left coronary artery at the posterior wall of the atrium. This is an important collteral circulation of the coronary artery. 4. A-V node artery usually arises from the right coronary artery, 94%; and only a small portion, 6%, from the left coronary artery. Its diameter is around 0.4～1.9 mm. Usually only one A-V node artery is present. Double A-V node artery is observedonly in 2 cases both of them are arising from the right coronary artery. In 2 cases, A-V node artery arises from the posterior ventricular branches, penetrates into the posterior wall of the left ventricule, runs between the right and left atrioventricular foramin and reaches the A-V node. In 44.23% of the 50 specimens, A-V node artery take its origin from the top of the "U" turn of the coronary artery at the crux. In 36.5% of the specimen the artery originates from the plain straight type of coronary artery; in the other 19.24% though the "U-turn" is present, but the artery does not originate from the top of the turn. The course of the artery is generally along the midline between the right and left atrio-ventricular foramina, and rarely along the borders of the left or right afrioventricular foramina. 5. The clinical importances of the topographical characteristics are discussed.

1.There were 80 heart specimens(age:17～95,with no marked pathological chauges) used to observe the origin,course and the site of anastomosis of the atrial arteries. 2.Within the 80 specimens there are 34 hearts with anastomoses,and the frequen- cies of the anastomoses are 53,including one case of anastomosis between an artery of extracorary origin and the atrial artery. 3.The commonest site of the anastomosis is the posterior wall of the left atrium, there are 23 cases(43.40%)within the 53.The other sites are the base of interatrial septum,13 cases(24.53%);anterior wall of the atrium,13 cases(24.53%);the lateral wall of the right atrium and the orifice the superior vena cava being 2 cases respecti- vely(3.77%). 4.The diameters of the anastomosis are as follows:In the A.B.S.casts:We have measured the anastomotic diameter in 38 cases.Most of them are within the range of 100～200?m in 20 cases(52.6%),200～300?m in 9 cases(23.6%). In dissecting specimens:Within the measured 19 cases,50～100?m in 8 cases (42.1%),100～200?m in 5 cases(26.3%),200～300?m in 3 cases(15.8%),300～ 500?m in 3 cases(15.8%).Among the adult hearts,it seems that the diameter of the anastomosis and the site of the anastomosis are not increased by advancement of the age. 5.The origin of the anastomotic branch of the A-V node artery is near the A-V node.This is very important for the blood supply of A-V node,when there is patholo- gical changes of the coronary artery. 6.Since there is a great range of variation in the diameter of the anastomosis and the formation of the anastomosis,such as two-branches-form,three-branches-form, four-branches-form,or network-like anastomosis,perhaps,the morphological charact- eristics of the anastomosis is closely related with the pathogensis of coronary artery. 7.In this set of specimen,we have observed three cases in which the ventricular branches of the coronary artery joined the anastomosis on the wall of the atrium.

Specimens of skin, skeletal muscle, adipose tissue, brain, peripheral nerve and catilage were taken from 6 cadavers (divided into 2 groups) perfused and embalmed with formalin. 90 pieces of the above-mentioned tissues were taken in different times and the paraffin sections were stained by routine HE. Electron microscopic observation was made from some skin and skeletal muscle specimens, and histochemical methods were used to demonstrate DNA, RNA, keratin(-SH, -SS), fatty acids and calcium in some skin materials. Loyez stain method for myelin sheath was applied to some brain and nerve sections.1. Skin tissue: In both group A and B, 83.3% and 78.9% of skin materials were appraised as grade I and II (excellent and good) respectively. The morphological changes appeared mainly as karyopyknosis of the epidermal cells and shrinkage of the secretory part of the sweat glands. Most of the skin tissues of the corpses perfused 3～4 hrs after death were well preserved, only 8.3% being in grade Ⅲ (moderate). On the other hand, 43% of skin materials taken from those perfused 30 hrs after death were in grade Ⅲ. Ultrastructurally, the shape of the epidermal cells and their adhensions still remained intact, but karyopyknosis or chromolysis and autolysis of most of the cytoplasmic membraneous structures were found. In those cadavers preserved for less than one year, there was no evidence of progressive changes in microscopic and submicroscopic structures of the skin. The tonofillaments and desmosomes were still kept well in those specimens preserved for many years, and their presence may be the cause of maintaining cell integrity. Histochemically, mercapto-reaction of keratin was kept stable and found to be well shown even in old samples of skin, but the disulfide reaction usually showed marked fading with time, probably due to exofolition of the stratum corneum. However, this reaction was well shown in the hairs and not weakened for many years.2. Fat tissue: Hydrolysis of lipid substances of subcutancous fat and sebaceous gland, as shown by the presence of fatty acid, was found in the corpses preserved even as short as half a year.3. Skeletal muscle: The preservation state of the skeletal muscle was also dependent on the complete perfusion in time. The structure of the muscle fibers was generally worse preserved than that of the skin as shown in severe myolysis. Since stagnation of the small blood vessels frequently accompanied myolysis, obstruction of microcirculation which prevented the permeation of fomalin into the muscle tissues may be the cause of rapid myolysis. The ultrastructural changes of the muscle fibers were the same as those of the epidermal cells. In all specimens even as old as 30 years, two types of myofillaments were well preserved, and bands could be seen distinctly.4. Nervous tissue: The brain tissues were well preserved in those corpses that were perfused shortly after death, but the peripheral nerves usually showed severe autolysis, obviously it is due to the same reasons as those for myolysis.5. Cartilage: The structural changes of cartilage after death were slow and all specimens of cartilage were well preserved.

The arrangement of fascicles of musculocutaneous nerve at different levels in brachial plexus were studied in 22 adult cadavers. The nerve fascicles were dissociated and traced under operative microscope. At the distal end of the musculocutaneous nerve, the muscular and cutaneous fascicles are separated.The muscular fascicles are situated at the latero-anterior quadrant of the cross-section of the nerve.The mixed fascicle are become predominated proximally. The muscular and the muscular predominated mixed fascicles are still situated at latero-anterior quadrant. At the level 1 cm below the clevicle, 1cm and 1.5 cm above the clevicle,the fascicles of the nerve are situated at the lateral superio-anterior quadrant of the crosssection of relative parts of brachial plexus. The fascicles of the nerve are situated at the anterior quadrant of the crosssection of superior trunks. The fibers of musculocutaneous nerve are originate from C5, C6 and C7, being 31.6,％, 64.6％ and 3.8％,respectively.

Objective To evaluate the indications and clinical efficacy of the different surgical methods for lumbosacral tuberculosis.Methods 112 patients suffering from lumbosacral tuberculosis from January 1998 to October 2011 were reviewed retrospectively.Based on American Spinal Injury Association (ASIA) grading system,31 case was classified as grade C,32 as grade D and 49 as grade E.The affected locations were L5,S1 in 66 cases,L4-S1 in 32,and L5-S2in 14 cases.41 cases (posterior group) underwent posterior pedicle screw instrumentation,debridement and allograft; and 38 cases (anterior group) underwent one-stage anterolateral debridement plus allograft and internal fixation.33 (posterior-anterior group) cases experienced posterior pedicle screw instrumentation and anterior debridement and allograft.All cases underwent routine support and anti-tuberculosis treatment before and after operation.The change of erythrocyte sedimentation rate (ESR),signs of tuberculosis activity,graft fusion,neurological recovery and correction of deformity were evaluated in follow-up and compared among three groups.Results The average operating time in posterior,anterior and posterior-anterior group was (150±22) m in,(140± 18) min,(180± 1 8) min respectively.ESR and C-reactive protein (CRP) were recovered to normal 3 months post surgery.The quality of life total score of lumbosacral tuberculosis patients was very low (55.54 ± 9.23).After surgery and drug treatment,the total score and each dimension scores of the SF-36 were significantly improved.Postoperative ASIA classification and 1umbosacral angle were significantly improved.Tuberculosis recurrence occurred in three cases,fixation loosening in two cases,fixation fracture in one case,and all above cases were cured after revision surgery.The others all were cured and bone graft fusion was determined.Conclusion The quality of life of lumbosacral tuberculosis patients were impacted seriously,and which could be significantly improved with surgical intervention.According to the patient MRI,CT characteristics,surgical approach selection was based on lesion location.Effective internal fixation was based on the extent of damage in bone structure and anatomical characteristics.Following above principles,satisfactory clinical results could be achieved.

Objective To explore the mechanism of sulfotanshinone sodium injection in treatment of patients with sudden deafness (SD).Methods Sixty patients with SD admitted to the Department of Otorhinolaryngology of Wuxi Traditional Chinese and Western Medicine Hospital from January to December 2016 were enrolled, and they were randomly divided into a study group and a control group (each 30 cases). The same basic treatment was given in the two groups, the patients in the study group were treated with sulfotanshinone sodium 40 mg intravenous (IV) drip, while the patients in the control group were treated with vinpocetine sodium chloride 20 mg IV drip, once a day for consecutive 14 days to complete a therapeutic course, and two courses were carried out in bothgroups. Before and after treatment, the changes of hearing threshold, indexes of hemorheology and immune function were compared between the patients in the two groups, and the clinical efficacy and adverse reactions in the two groups were observed.Results After treatment, the hearing threshold, hemorheology indexes, immune function index of CD8+ were significantly lower than those before treatment, while the CD3+, CD4+, CD4+/CD8+ ratio were significantly higher than those before treatment in the two groups, and the above changes of indexes were more obvious in the study group than those in the control group hearing [threshold (dB): 16.63±2.04 vs. 17.15±1.88, plasma viscosity (PV, mPa·s): 1.27±0.14 vs. 1.31±0.11, whole blood middle shearing viscosity (mPa·s): 4.77±0.33 vs. 4.95±0.28, whole blood high shearing viscosity (mPa·s): 3.86±0.25 vs. 4.00±0.31, erythrocyte aggregation index (EAI): 1.57±0.29 vs. 1.72±0.34, CD3+: 0.70±0.05 vs. 0.64±0.05, CD4+: 0.43±0.04 vs 0.37±0.03, CD8+: 0.32±0.04 vs. 0.34±0.03, CD4+/CD8+: 1.36±0.32 vs. 1.18±0.27]; the degree of whole blood low shearing viscosity (mPa·s: 6.72±0.80 vs. 7.01±1.13) and hematocrit (HCT: 0.38±0.04 vs. 0.40±0.03) decreasing weremore significant in the control group than those in the study group. The total effective rate was higher in study group than that in the control group [86.67% (26/30) vs. 83.33% (25/30)], but the difference between the two groups was not statistically significant (P > 0.05); the incidence of adverse reactions in the study group was markedly lower than that in the control group [3.33% (1/30) vs. 20.00% (6/30),P < 0.05].Conclusions Sulfot anshinone sodium injection can effectively enhance the SD patients' hearing, and improve their hemorheology indexes and immune function; the therapeutic results of sulfotanshinone sodium injection in safety and improvement in immune function are superior to those of vinpocetine sodium chloride injection.

ObjectiveTo investigate the safety and early clinical efficiency of dynamic cervical implant (DCI) internal fixation to treat cervical disc herniation.Methods From September 2009 to December 2010,31 patients with herniation of cervical disc underwent DCI implantation.The operation time and blood loss were recorded and analyzed.Neck disability index (NDI),Japanese Orthopaedic Association (JOA) score,and visual analogue scale(VAS) score were used to evaluate neurofunctional recovery pre- and post-operation.Routinely,the patients accepted X-ray examination preoperatively and postoperatively.We used White's measurement to measure the range of motion(ROM) and height ratio of implant segment and the superior vertebra pre- and post-operation.ResultsThe average operation time and amount of bleeding were 45 (30-60) min and (100±30) ml respectively.The average postoperative follow-up was 14 months (range,6-20).The average NDI (50.5±16.2 vs.19.6±4.3,P＜0.05),JOA score (12.3±1.6 vs.13.9±1.8,P＜0.05) and VAS score (6.3±2.6 vs.3.1±2.2,P＜0.05) changed significantly at the last follow-up compared with those pre-operation.There were no significant differences in the average ROM of implant segment (9.6°±4.2° vs.6.9°±5.3°,P＞0.05),the height ratio of implant segment and the superior vertebra(2.6±0.1 vs.2.5±0.1,P＞0.05) and the angle of functional spine unit(2.6°±5.2° vs.1.7°±2.9°,P＞0.05) at last follow-up compared with those preoperation.ConclusionUsing DCI to treat cervical disc herniation had shorter operation time and less bleeding advantages,and the early clinical effect was satisfactory.It may retain the cervical biomechanical movement in some degree,maintain the cervical stability.

Objective:To explore a new method of the cultivation of adoptive immunotherapy cells.Methods: Mononuclear cells was isoplated by density gradient centrifugation and then proliferated by using CD 40-agonist monoclonal antibody 5C11、cytokine of IFN-αand IL-7(CD40 group)in vitro.During the culturing procedure ,the cell morphology was obersved by optical microscope.The percentage of T-lymphocytes, NK-T cells, Treg cells and the cell proliferation, which were compared with CIK group CD3mAb activated,was detected on the 9th day.Results:There was no significant difference of CD 4+/CD8+T cells percentage between the two groups.But the Treg cells percentage of CIK group was far higher than that of CD 40 group,while the percentage of CD3+CD56+NK-T cells was lower than that of CD 40 group.And a group of Mo-NK-DC cells were observed in the CD 40 group.Conclusion: The new method of adoptive immunity therapy has been established in this study could increase the percentage of NK -T cells which had the ability to kill tumor cells.Simultaneously ,it is reduced the amount of Treg cells significantly.

Objective:To explore the scheme of accurate pelvic osteotomy parameters and to analyze the feasibility and efficacy of 3D printing navigation plate in developmental dysplasia of the hip surgery.Methods:From January 2015 to December 2017, a total of 18 children with DDH underwent computer-assisted Salter pelvic osteotomy (computer-assisted osteotomy group) and 25 children with DDH who underwent conventional Salter pelvic osteotomy (conventional osteotomy group) were selected for retrospective analysis. There were 11 males and 32 females with an average age of 3.2±2.5 (range 1-11) years. According to International Hip Dysplasia Institute (IHDI) classification, there were 20 cases of type 1, 9 of type 2, 12 of type 3 and 2 of type 4. All patients were unilateral dislocation, including 18 cases on the left and 25 on the right. All children underwent pelvic CT examination before operation. Further, the proximal femur was surgically corrected during the operation. According to the acetabular rotation angle (ATA) and bony acetabular index (BAI), the computer-assisted osteotomy group simulated the operation with Mimics software made 3D printing navigation plate through which an accurate osteotomy scheme was developed. The two groups were compared in operative duration, intraoperative blood loss, Japanese Orthopaedic Association (JOA) hip joint score. Acetabular index (AI), central edge (CE) angle, and acetabulum head index (AHI) were compared between the two groups by using postoperative X-ray. The acetabular tilt angle (ATA) changes before and after operation in the computer-assisted osteotomy group were compared through 3D CT.Results:The follow-up duration was 2.3±0.2 (2.0 to 2.5) years in the computer-assisted osteotomy group and 2.8±0.15 (2.5 to 3.0) years in the conventional osteotomy group. The operative duration in the computer-assisted osteotomy group was 127±20.6 min, which was significantly longer ( t=4.657, P<0.001) than that in the conventional osteotomy group (103±13.2 min). Intraoperative bleeding was 157±17.5 ml in the computer-assisted osteotomy group and 151±15.3 ml in the conventional osteotomy group without significant difference between the two groups ( t=1.195, P=0.239). At 2 years after surgery, the JOA score of the hip joint in the computer-assisted osteotomy group (86.7±8.5 points) was like that (84.8±10.0 points) in the conventional osteotomy group ( t=0.628, P=0.533). At the last follow-up, the CE angle in the computer-assisted osteotomy group (36.8°±5.2°) was significantly larger than that (31.8°±4.4°) in the conventional osteotomy group ( t=3.414, P<0.001). There was statistically significant difference in term of AHI between the computer-assisted osteotomy group (85.8%±6.6%) and the conventional osteotomy group (80.4%±8.3%, t=2.284, P=0.028). AI was 23.5°±5.5° in the computer-assisted osteotomy group and 25.2°±4.2° in the conventional osteotomy group without significant difference ( t=-1.150, P=0.257). The ATA of the affected side was 12.3°±1.4° in the computer-assisted osteotomy group which was similar ( t=0.614, P=0.547) to that of the healthy side (11.8°±2.8°). Conclusion:Based on specific anatomical parameters, computer-assisted preoperative planning can not only directly simulate the process of osteotomy, but also produce individualized 3D printed guide plates. Compared with conventional Salter pelvic osteotomy, computer-assisted osteotomy can achieve accurate radiographic correction of the hip joint in children with DDH, resulting in a better matching relationship between the femoral head and acetabulum.