OBJECTIVE:To systematically review the efficacy and safety of reinforcing kidney and invigorating spleen princi-ple in the treatment of primary osteoporosis (POP) in middle and elderly aged patients,and provide evidence-based reference for clinic. METHODS:Retrieved from VIP,Wanfang Database,CJFD,Medline,PubMed,Elsevier,Springer,Web of Science and Ovid,randomized control trials (RCT) about reinforcing kidney and invigorating spleen principle (test group) versus other meth-ods(no reinforcing kidney and invigorating spleen principle,control group)in the treatment of POP were collected. Meta-analysis was performed by using Rev Man 5.3 software provided by Cochrane after data extraction and quality evaluation modified by Jadad scale. RESULTS:Totally 28 RCTs were enrolled,involving 2849 patients. Results of Meta-analysis showed,the total effective rate [OR=3.80,95%CI(2.76,5.23),P<0.001],BGP level [MD=2.23,95%CI(1.80,2.66),P<0.001],BMD level of femoral neck [MD=0.04,95%CI(0.00,0.08),P=0.05] and BMD level of lumbar spine [MD=0.07,95%CI(0.03,0.11),P=0.001] in test group were significantly higher than control group,ALP level [MD=-5.59,95%CI(-10.51,-0.66),P=0.03] and VAS score [MD=-1.38,95%CI(-1.87,-0.89),P<0.001] were significantly lower than control group,with statistical significance. There were no significant differences in U-Ca/Cr [MD=-0.07,95%CI(-0.17,0.02),P=0.12] and serum Ca2+ level [MD=0.16,95%CI (-0.07,0.39),P=0.17] in 2 groups. CONCLUSIONS:Reinforcing kidney and invigorating spleen principle can improve patients' osteogenesis during bone metabolism,reduce the activity of the osteoclastic process and relief patients'pain in the treatment of POP.

Objective To explore the clinical results and operation experiences for benign breast mass by ultrasound guided mammotome minimally invasive biopsy system (MMIBS). Methods 212 benign breast masses in 186 patients were resected by ultrasound guided MMIBS. Clinical data of 186 patients were retrospectively analyzed. Results Needle position in 186 patients was visualized. Lesions were completely removed in 134 cases of 186 (72%) patients. The complete resection rate for tumors on major pectoral muscle or near areola were 31.5% (6/19) and 33.3% (4/12) respectively. Identified by postoperative ultrasound, 118 out of 134 patients (88.0%) with tumor sizes 0.5 to 2.5 cm and 16 out of 38 patients (42.1% ) with sizes 2.5 to 3.0 cm were completely removed. No lesions larger than 3.0 cm were completely removed. All 52 cases in which the tumors were not completely removed by MMIBS were converted to open surgery. Ultrasound follow-up after 4 weeks showed that all the 134 cases that had had masses completely removed had no residual masses, whereas 6 months after operation, 16 out of the 112 cases proved tumor recurrent necessitating open reoperation in 6 cases and second MMIBS operation in 10 cases, among them one case recurred after six months and received open operation. Conclusions For small benign breast mass, MMIBS has therapeutic effect with significantly minimal invasion.

Objective To study the risk factors of intracranial hemorrhage after endovascular therapy of cere-bral arteriovenous malformations embolization.Methods the clinical records and images of 230 patients with cAVMs were retrospectively reviewed.Patients with intracranial hemorrhage after endovascular therapy in 3 days were recorded and the risk factors of hemorrthage by using multivariate logistic regression for guiding the treatment strategy were studied.Results There were 15 patients occurred intracerebral hemorrhages.After treatment the area of cAVMs was significantly smaller than that before treatment[(2.18 ±0.91)cm vs (6.67 ±1.56)cm],the difference lvas a statis-tically significant (t =9.627,P <0.05).A partial AVM reduction of ≥36.5%(P =0.031)and hypertension(P =0.025)were considered as risk factors for hemorrhage after endovascular therapy of cAVWs.Conclusion Patients receives a partial AVMreduction of ≥36.5% or with hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.It's helpful for preventing intracerebral hemorrhage if the arterial blood pressure maintains after endovascular therapy.

objective To understand the baseline data of mortality from malignant tumor from 2006 to 2009 around Hongyanhe Nuclear Power Plant in Wafangdian City,Liaoning Province,so as to provide scientific basis for evaluating the impact of normal operation of nuclear power plant on the health of the residents nearby.Methods Thirty small towns near Hongyanhe Nuclear Power Plant were divided into 5 investigated areas according to the distances away therefrom(0.,10.,20-,30-,and 40-km).The data about from malignant tumor were obtained from the Center for Disease Control and Prevention of Wafangdian.The mortality distribution of difierent malignant tumors was analyzed,including the radiosensitive malignant tumors,especially leukemia,breast cancer,and thyroid gland cancer in different area,gender,and age groups.Results The mortality from malignant tumor was 151.97/105,and the standardized mortality rate(SMR)was 97.76/105.The mortality from malignant tumor among the males was 188.28/105(with the SMR of 116.76/105),and that among the females was 113.47/105(with the SMR of 75.89/105).with a sex ratio of 1.71.The first five cancers in the rank of death causes were lung,liver,stomach,colorectal,and esophageal cancers with mortality of 46.19/105,23.51/105,20.30/105,8.06/105 and 5.45/105,respectively.The mortality from mal.ignant tumor in the areas around the nuclear power plant from the near to the distant were 99.85/105, 137.40/105,138.73/105,156.30/105,and 154.16/105,respectively.The mortality from radiosensitive malignant tumors,leukemia,breast cancer,and thyroid gland cancer were 4.57/105,4.06/105,and 0.26/105,respectively.Conclusions Lung cancer and digestive tract malignant tumors are the main causes of death from malignant tumors in Wafangdian area before the nuclear power plant began to operate.There are no significant differences in the mortality distribution of malignant tumors among different areas,genders,and age groups.There are not significant differences in the mortality distribution of leukemia and breast cancer among different areas and age groups.

Objective To explore the application scope of small splint in the treatment of type-C distal radius fractures. Methods According to CT scan data from the right forearm of a healthy male volunteer, the three-dimensional model of normal distal radius was established. According to AO classification, the fracture line based on normal model was divided to establish nine kinds of high-order tetrahedral mesh models of the upper forearm with C-type fracture. Finite element analysis on nine kinds of fracture models was conducted in ANSYS 15.0 software to obtain the corresponding stress values, and then the stress distribution contours were generated. Results As soft tissues of the wrist were thin with more fracture blocks, after the splint was fixed, the stress on the wrist under 100 N maximum physiological axial load was significantly larger compared with that on the other parts, and the compressive stress was mainly concentrated on the wrist joint. The fixed effect of C2.2, C2.3, C3.2, C3.3-type fracture by small splint was relatively poor, as such comminuted fracture would cause too many and too small fracture blocks, while the fixed effect of C1.1, C1.2, C1.3, C2.1 and C3.1-type fracture was better. Conclusions Through the related finite element study on the treatment of C-type fracture distal radius with small splint, the application scope of small splint was preliminarily determined, which could provide some reference for clinical work.

Objective To quantitatively study the pressure of residual lateral displacement in distal radius AO C3.1 fracture after manual reduction corrected by dynamic airbag pad using finite element analysis and to verify its effectiveness for correcting the residual displacement of fractures. Methods Imageware 13.0, Mimics 15.0 and ANSYS Workbench were used to simulate 1 cm residual lateral displacement after manual reduction of distal radius fracture corrected by dynamic airbag pad. Then the correlation between the distance of residual lateral displacement and the adjustment of dynamic airbag pad pressure were quantitatively analyzed. Results In the case of constant load restrained by airbag ribbon, during the process of pressure adjustment by splint pad, the stress was mainly distributed in the fracture end where the airbag pad was located. About 2.4 kPa pressure was needed to correct 1 mm displacement on radial side, while about 1.3 kPa pressure was needed to correct 1 mm displacement on dorsal side. The dynamic airbag pad was depressurized after the restoration of residual shift. At this time, displacement could be effectively prevented due to the constant load of airbag ribbon and the frictional load at the fracture end. Conclusions In the case of constant load constrained by airbag ribbon, intelligent airbag splint can effectively correct the residual lateral displacement after the manual reduction of the distal radius AO C3.1 fracture and prevent it from being displaced by adjusting pressure of the dynamic airbag pad.

Objective To observe the correlations of subchondral insufficiency fracture(SIF)of medial femoral condyle with medial meniscus injury pattern and medial meniscus extrusion(MME).Methods Data of 36 patients with clinically confirmed unilateral medial femoral condyle SIF were retrospectively analyzed.The patients were divided into low-grade and high-grade groups according to SIF grade.Cartilage injury,medial meniscus injury and MME were compared between groups,and the correlations of SIF grade with cartilage injury,osteonecrosis volume(OV)and MME were analyzed.Cartilage injury grade,OV and MME were compared between groups,and the correlations were explored.Results There were 18 cases in each group.The percentage of cartilage injury grade Ⅲ-Ⅳ,OV and MME value(the distance between the vertical line of medial meniscus and the vertical line of tibial plateau cartilage)in high-grade group were greater than those in low-grade group(all P＜0.05).Significant difference of injury grades of meniscus posterior horn was found between groups(P=0.007).SIF grade was positively correlated with cartilage injury grade,OV and MME value(rs=0.710,0.765,0.540,all P≤0.01).MME value was positively correlated with meniscal injury degree and tear range(rs=0.502,0.520,both P＜0.01).There were 4,19 and 13 cases with 0,1 and 2 grade MME,respectively,and significant differences of cartilage injury grades,OV and MME values were found among different MME grades(all P＜0.05).MME value was positively correlated with cartilage injury grade and OV(rs=0.451,0.579,both P＜0.01).Conclusion In SIF patients,OV and cartilage injury were both correlated with medial meniscus injury pattern and MME.