Objective To study the feasibility of fluoroscopically guided percutaneous internal fixation with the Universal Spine System(USS) in the treatment of thoracolumbar fractures.Methods A total of 8 patients with thoracolumbar fractures without the need of decompression of the spinal canal underwent posterior percutaneous pedicle screw fixation by using the USS from October 2002 to May 2004.A fixation rod was placed under the vertebrae muscle to complete the reduction and fixation.Results The operation time was 120~240 min(mean,140 min),and the intraoperative blood loss was 20~90 ml(mean,40 ml).The Cobb's angle decreased from 21.5??4.3? preoperatively to 2.7??1.5? postoperatively(t=17.541,P=0.001).The collapse of vertebra was 18.5%?4.1% preoperatively and 2.4%?1.0% postoperatively(t=16.504,P=0.001).All the patients got out of bed 3 weeks after operation with the assistance of girdle brace.Effects of treatment were evaluated according to the Frankel grade at the third postoperative week: 2 patients recovered from grade C to D,1 patient from D to E,1 patient remained in D, and 4 kept in E. Conclusions Percutaneous internal fixation by using the USS in the treatment of thoracolumbar fractures without the need of decompression of the spinal canal offers advantages of minimal invasion and quick recovery,though it has some technical difficulties and disadvantages of long-time exposure under X-ray.

OBJECTIVETo evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.

METHODSSeven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.

RESULTSAll patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.

CONCLUSIONTarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.

Adult ; Bone Plates ; Diabetes Complications ; surgery ; Diabetes Mellitus, Type 2 ; complications ; Female ; Foot Diseases ; etiology ; surgery ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Tarsal Joints ; surgery

Objective To discuss the clinical effects of internal fixation with pubic nails and sacroiliac screws aided by 3D navigation for pelvic fractures of Tile type B2 or B3. Methods A total of 27 patients with pelvic fracture of Tile type B2 or B3 received operative treatment in our hospital from De-cember 2013 to December 2016. They were 15 men and 12 women, aged from 20 to 68 years ( average, 39. 2 years ) . According to the Tile classification, 12 cases were type B2. 1, 8 type B2. 2, and 7 type B3. Of them, 20 were unilateral pubic rami fractures and 7 bilateral pubic rami fractures; there were 3 dislocations of the sacroiliac joint, 17 fractures of the sacral Denis regionⅠ, and 7 fractures of the sacral Denis regionⅡ. All the 27 cases were treated by internal fixation with retrograde pubic nails and sacroiliac screws aided by 3D navi-gation. Quality of fracture reduction, functional recovery of the pelvis and postoperative complications were recorded to evaluate the clinical effects. Results Totally 26 out of the 27 patients were followed up for 6 to 18 months ( average, 11. 4 months ) , with one lost to the follow-up. According to the Matta scoring, the pelvic reduction was evaluated as excellent in 20, as good in 4 and as fair in 2 cases, yielding an excellent and good rate of 92. 3％. All the fractures united after 12 to 20 weeks ( average, 13. 8 weeks ) . According to the Majeed scoring at the final follow-ups, the pelvic function was evaluated as excellent in 20, as good in 3 and as fair in 3 cases, giving an excellent and good rate of 88. 5％. Screw loosening happened in one patient who had ambulated too early. No permanent pain, wound infection, neurovascular injury, heterotopic ossification or thrombosis occurred. Conclusion For the treatment of pelvic fractures of Tile type B2 or B3, internal fixation with pubic nails and sacroiliac screws aided by 3D navigation can lead to satisfactory short-term outcomes due to advantages of limited operative invasion, short operation time and limited intraoperative blood loss.

OBJECTIVETo evaluate the clinical results of dorsal approach and Weil osteotomy in treating the injury of the plantar plate in second metatarsophalangeal joint.

METHODSEight feet with plantar plate tear in five cases were treated by plantar plate repairment through dorsal approach and Weil osteotomy from June 2012 to December 2013. The mean age of the patients was 52 years old. All the patients were followed up for 6 to 12 months. American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) were used to evaluate the clinical effect.

RESULTSThe second metatarsophalangeal joint stability recovered and the pain released in all patients. Postoperative VAS was lower and AOFAS was higher than preoperative.

CONCLUSIONCombined dorsal approach and Weil osteotomy can effectively release the pian of plantar plate, stabilize the metatarsophalangeal joint, decrease the incidence rate of postoperative subluxation and anchylosis in treating plantar plate tears in the second metatarsophalangeal joint.

Female ; Humans ; Joint Instability ; surgery ; Metatarsophalangeal Joint ; injuries ; surgery ; Middle Aged ; Osteotomy ; methods ; Plantar Plate ; injuries

Objective To study the characteristics of diffusion tensor imaging (DTI) in brain tumor and it's diagnosis and differential diagnosis value.Methods Thirty-nine patients with brain tumors proven by pathologically (10 meningioma,17 glioma,12 metastatic tumors) were enrolled,by using Philips Achieva 1.5 T MRI,conventional MRI and DTI were underwent on them,fractional anisotropy (FA) maps,apparent diffusion coefficient (ADC) maps and three dimensional white matter fiber bundle map were reconstructed in the workstation.The core substance of the tumor area and the contralateral mirror area were selected as the region of interest,and FA and ADC values of them were measured,and t test was performed.Results The FA values of meningioma,metastases tumors and gliomas were 0.36 ± 0.08,0.28 ± 0.03,0.18 ± 0.06,respectively,and the differences among them were significant( P ＜ 0.05).The ADC values of meningioma,metastases tumors and gliomas were 1.72 ± 0.10,1.52 ± 0.22,1.34 ± 0.14,respectively,and the differences among them were significant( P ＜ 0.05).Conclusion DTI has high clinical value in identification of meningiomas,metastatic tumors and glioma.

Objective To investigate the role of Stathmin in pancreatic cancer invasion and metastasis and its relationship with DNA methylation. Methods Immunohistochemical detection of MBDI and Stathmin protein expression in 40 cases of pancreatic cancer and 15 cases ot normal pancreatic tissue were performed,followed by analysis of their clinical and pathological relationship with pancreatic cancer; Human pancreatic cancer cell line BxPC-3 was treated with 5-Aza-2-dC (AZA).Both qRT-PCR and Western blot analysis of Stathmin expression were used before and after AZA treatment; Stathmin-siRNA transfected BxPC-3 cells were divided into the Stathmi-siRNA group and the empty vector control group.Transwell chamber invasion assay and animal experiment were performed to measure the changes in cell invasion and metastatic capability. Results lmmunohistochemistry showed positive MBDI and Stathmin expressions in 28 (70％) and 24 (60％) out of 40 cases of pancreatic cancer,respectively,which were significantly higher than that in the normal pancreatic tissue (P＜ 0.05); MBDI and Stathmin protein expressions were positively correlated (r =0.356,P =0.037),so were MBDI expression and lymph node metastasis (P=0.023).Stathmin expression was significantly correlated with clinical staging and lymph node metastasis (P =0.002,and P =0.001,respectively).After AZA treatment,both Stathmin mRNA and protein expression in BxPC-3 were significantly decreased.Transwell chamber invasion assay showed that compared with the control group,the cell invasion capability of the Stathmin-siRNA group was significantly decreased (P＜0.05).Animal experiment showed that the incidence of liver metastasis was significantly lower in the Stathmin-siRNA transfected group than the empty vector control group (P＜0.05).Conclusion Demethylation may contribute to the reduction of Stathmin expression in pancreatic cancer and further improve the prognosis of pancreatic cancer patients.

OBJECTIVETo evaluate the reliability and diagnosis accuracy of 5 special tests used for the diagnosis of subacromial impingement syndrome (SAIS).

METHODSA prospective blinded cohort study was taken,in which 105 patients with shoulder pain were reviewed. All the patients took 5 special syndrome tests including Neer syndrome, Hawkins-Kennedy syndrome, painful arc empty can test and external rotation resistance test, also underwent arthroscopic surgical examination. The Nikolaus's criterion was regarded as a golden standard for SAIS. Data accuracy analysis was calculated through a receiver operating characteristic (ROC) curve, sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (-LR). The binary Logistic regression analysis was used to find out the best test combination for ruling in or out SAIS. The interrater reliability was assessed by the Kappa coefficient and percent agreement.

RESULTSThe ROC analysis indicated a significant area under the curve (AUC) (AUC=0.62 to 0.73, P<0.05) for all tests except the Hawkins-Kennedy. Tests with a +LR greater or equal to 2.0 were the painful arc,empty can,external rotation resistance, Tests with a-LR less than 0.5 were Neer,painful are ,external rotation resistance. The regression analysis found the painful arc, empty can and external rotation resistance made the best combination for diagnosis SAIS,while the painful are and external rotation resistance made the best combination for ruling out SAIS. The difference of ROC analysis was significant with a cut-off of 3 positive tests out of 5 tests. All tests had moderate to good agreement (Kappa=0.42 to 0.71).

CONCLUSIONThe single test of painful arc, empty can and external rotation resistance, as well as 3 or more positive tests of the 5 tests can help confirm the diagnosis of SAIS, while the single test of Neer, painful arc and external rotation resistance are help rule out the diagnisis of SAIS. The tests of painful arc, empty can and ex ternal rotation resistance are the best combination for the diagnosis of SAIS (when 2 or more are positive), while the tests of painful arc and external rotation resistance are the best combination for ruling out SAIS (when both are negative)

Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Physical Examination ; methods ; Prospective Studies ; Reproducibility of Results ; Shoulder Impingement Syndrome ; diagnosis

In view of the limitation of the traditional integration solutions in the hospital information construction, this paper proposes an integration solution based on a uniform application integration platform, and analyzes the system integration architecture and the integration frame. Using this frame, we can realize the integration of the hetero structural sub-systems within the hospital.
Hospital Information Systems ; Medical Records Systems, Computerized ; Systems Integration

Jin's three-needle technique is named after Professor JIN Rui. The connotation of Jin's three-needle technique is summarized by his followers through long-term teaching and clinical practice. His principle and method of point combination are based on syndrome differentiation of acupuncture. And his unique needling technique and treating principle of mental tranquilization also play an important role in his clinical practice.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles

Objective To discuss the histology change,apoptosis state and Bcl-2,Bax expression after the bone cement leakage into the intervertebral disc in vertebroplasty.Methods Eight majority canis familiaris were studied.Three lumbar intervertebral discs(L2 to L5)in each dog were randomly classified into three groups(control group,PMMA group,and CPC group),the canine discs were stabbed by 18-gauge needle,and 0.1 ml cement was injected into them.Control discs were only stabbed and injected with nothing.Histology of all discs was studied 24 weeks after the operation.Terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL)and immunohistochemisty were used to detect apoptosis and Bcl-2,Bax expression in the discs.The data were statistically analyzed by SPSS 12.0.Results Intervertebral disc degeneration was not found in control groups.In bone cement groups,however,ruptured or serpentine patterned fibers,decreased cellularity of the nucleus pulposus and condensed matrix of the nucleus pulposus were found in histologic results.The Bax protein decreased in the order of control group, CPC group,and PMMA group.However,the Bcl-2 protein increased in the order of control group,CPC group,and PMMA group.The histology grade was significantly different among the three groups under ANOVA analysis(P