Currently,the number of abdominal surgery has gradually increased,accompanied by the increasing of ventral hernia and parastomal hernia patients.The main reason is abdominal incision or abdominal stoma destroying the normal abdominal muscle fascia,as well as obesity,malnutrition,ascites,diabetes,infections leading to poor wound healing.The incidence of abdominal wall incisional hernia after abdominal surgery accounts for about 80％ of ventral hernia.These incisional hernias and some other ventral hernias may easily become large ventral hernia without the standard treatment.Surgery is the only effective treatment for large ventral hernia.However,such hernia repair for surgeons is a great challenge.In clinical practice,after removing the huge sac and completely resetting the contents of the hernia sac can lead to decreasing of intraperitoneal volume and increasing of intra-abdominal pressure,or even lead to occurrence of abdominal compartment syndrome (ACS).The increasing of intra-abdominal pressure and occurrence of ACS has aroused the attention of clinicians after large ventral hernia operation.Some content reduction operation in the process of large ventral hernia surgery can effectively reduce postoperative intra-abdominal pressure,occurrence of intra-abdominal hypertension and ACS.More and more patients with large ventral hernia underwent the abdominal content reduction surgery combined with hernia repair.But there is still lack of evidencebased medical researches on large simples.Therefore,it still needs multi-center prospective clinical study on large samples to provide clinical treatment strategies for the volume reduction surgery and more base for further researches and clinical applications.

One hundred Chinese adult humeral heads (50 of either side) were studied with laser. The radius, height, angle as well as the surface area of each were anteriorly, laterally and obliquely measured in two-dimensions.The main results are as follows:1) The mean angle of the articular area was 144.48?11.9?.2) The average radius and height of the humeral head were 2.15?0.16 cm and 1.56?0.24 cm respectively. The articular surface height occupied 36.05 per cent of the diameter of the approximate spherical body.3) The mean articular surface area of the humeral head was 21.02?4.03cm~2. According to the radius of the humeral head and the articular surface angle, the curvature of the articular surface can be estimated and drawn out. That will offer the theoretical data of Chinese adult humeral head for the design and manufacture of artificial joint and artificial humeral head.

10.3969/j.issn.2095-4344.2013.26.024

1. The upper tributaries of great saphenous veins were divided into 15 types. TypeⅥ, in which the superficial iliac circumflex vein, the superficial epigastric vein and thelateral superficial femoral vein together constituted a pattern of the common trunk, wasthe most frequent one, comprising 53 sides, amounting to 25.61 per cent. 2. The average length of 156 sides of great saphenous veins was 76 cm, the longestwas 85 cm. and the shortest 65 cm. 3. With reference to the bone landmarks of lower limbs, the saphenous vein wason average 0.8 cm. from the infero-anterior margin of malleolus medialis of tibia, 5.5 cm.from the anterior middle one third of the crista of the tibia, and 1.95 cm. from the pos-terior aspect of the medial epicondylus of the femur. 4. The distance between the lower margin of the saphenous femoral junction andthe lower margin of the inguinal ligament was on the average 4.3 cm. 5. The average number of valves of the great saphenous veins was 8. The highestincidence ranged from 5--10 valves, comprising 83.58 per cent of all the cases. 6. The authors suggested that the commonly designated terms medial and lateralacessory saphenous veins should be replaced by medial and lateral superficial femoral veinsrespectively, according to their receptive scopes and the rule of anatomical nomenclature.

The cervical spinal canal at C_3-C_7 (200 in total) of 40 adult cervical spinal columns were measured on the axis radiograph. The diameter and area of spinal canal and corresponding spinal cord were investigated with vernier calipers and planimeter.The average values of the measurements are reported as follows:1. The sagittal and transverse diameter of the cervical spinal canal at C_3-C_7 are 13.71?1.31mm and 24.15?1.91mm, while those of the corresponding segment of spinal cord are 7.99?1.01mm and 13.35?1.64mm, respectively.2. The total area of the spinal canal and spinal cord at C_3-C_7 are 239.35?41.78 mm~1 and 106.6?9.9 mm~2, respectively. These data were studied with computer using multiple linear regression analysis program and a calculating formula of cervical spinal canal and the corresponding segment of spinal cord were inferred.Since sagittal and transverse diameters of vertebral canal and cervical spinal cord are measured, we may calculate the both area by using above mentioned formula. This will offer a new method for diagnosis of spinal canal stenosis and spondylosis.

BACKGROUND:Odontoid fracture is very common in cervical spine injuries, the special position of odontoid process, which is adjacent to important anatomic structure, makes screw placement difficult, and a slight discrepancy in position and orientation of the inserted screw leads to a decrease in intensity of internal fixation, even invalid internal fixation. Therefore, it is very necessary to develop an individualized treatment protocol by which screws can be precisely and safely placed and which is worthy of clinical popularization. OBJECTIVE:To study the navigation of Mimics software and three dimensional (3D)-printed module in anterior odontoid cannulated screw fixation and to investigate its feasibility and accuracy. METHODS:Sixteen human cadaveric cervical spines were scanned by a continuous thin-slice CT scanner. Original DICOM CT images were three-dimensional y reconstructed using Mimics software. The screw channel and support column were designed for C2 vertebra odontoid cannulated screw fixation for odontoid fracture. Segmentation of bone surface was performed. Navigation modules with screw channel were built using 3D printing technique. Navigation modules were used to aid screw placement. Screw fitting and placement were evaluated using X-ray and CT scan. RESULTS AND CONCLUSION:Total y 16 navigation modules were built and 22 screws were implanted. During and after screw placement, the cortical bone along screw channel and surrounding the vertebral body was not cracked. Postoperative X-ray and CT scans showed that some factors regarding screw placement such as entry point, orientation and depth of placement were consistent with those ideal factors simulated by Mimics software. The navigation modules were closely attached to the corresponding bony structure in front of the vertebral body, with a satisfactory gomphosis. Screw fitting and stability were good during application. These results verify that with the aid of navigation module, anterior odontoid cannulated screw fixation is reliable for treatment of odontoid fracture, which provides insights into the popularization of 3D printing-based digital navigation technique in orthopedic implantation.

Objective To assess the effects of combined application of thrombolytic therapy and aspiration thrombectomy on no-reflow phenomenon in patients with ST-segment elevation acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). Methods Five hundred and thirty four patients with ST-segment elevation AMI,admitted from 2007 to 2010 and successfully treated with primary angioplasty within 24 hours after the onset of AMI,were divided into 4 groups:A group (without thrombolytic therapy combined with aspiration thrombectomy treatment),B group (only thrombolytic therapy),C group (only aspiration thrombectomy) and D group (treated with thrombolytic therapy and aspiration thrombectomy). All clinical,angiographic and procedural data were collected. Multiple logistic regression analysis was used to identify the related predictors of the no-reflow phenomenon. Results The no-reflow phenomenon was found in 138 (25.8%) of 534 patients. The incidence of no-reflow phenomenon in A,B,C,and D group was 32.7% (85/260),20.8% (20/96),21.7% (31/143) and 5.7% (2/35) (P=0.009),respectively. Conclusion Combined application of thrombolytic therapy and aspiration thrombectomy may significantly decrease the incidence of no-reflow phenomenon in patients with ST-segment elevation AMI and treated with primary PCI.

Objective To investigate the effects of p38 MAPK inhibitor on glutamate (Glu), glutamine (Gln), taurine amino acid (Tau), glycine (Gly) and gamma aminobutyric acid (GABA) in hippocampus of rats with vascular dementia (VD).Methods Twenty-four healthy male SD rats were randomly divided into sham operation group, VD model group and inhibitor group. VD model was established by permanent ligation of bilateral carotid artery method, and the sham operation group stripping bilateral carotid artery but not ligation. Rats of the inhibitor group were injected p38 MAPK inhibitor SB202190 after the establishment of VD model. Morris water maze was used to evaluate the learning and memory function of rats. The samples of DG region of hippocampus were collected by microdialysis, and the contents of amino acids were detected. Results The learning and memory abilities were significantly better in sham operation group and p38 MAPK inhibitor group than those of VD model group. The latency time was significantly shorter in p38 MAPK group than that of VD model group. The time of locating the platform quadrant and the number of crossing the original platform were significantly higher in sham operation group and p38 MAPK inhibitor group than those of VD model group (P <0.05). Compared with sham group, the levels of Glu, Gln and Tau were significantly lower, and Gly and GABA were significantly higher, in VD group and p38 MAPK inhibitor group (P<0.05). Compared with VD group, Glu, Gln and Tau were significantly increased, Gly and GABA were significantly decreased in p38 MAPK inhibitor group (P<0.05). Conclusion p38 MAPK inhibitor has protective effect on VD hippocampal injury, which may be related to its ability to inhibit VD-induced abnormal secretion of amino acids and regulate the secretion of various amino acids.

Objective To evaluate the value of digital tomosynthesis (TOMOS)in diagnosis of odontogenic cystic lesions of the jaws with oral fixed metal dentures, and compared with multi-slice spiral CT (MSCT). Methods The imaging findings of 40 cases with fixed metal dentures pathologically proved odontogenic cystic lesions of the jaws jn retrospective were retrospectively analyzed.All cases were performed by MSCT and TOMOS scanning,and 13 cases enhanced at the same time. The characteristics of the imaging findings in TOMOS and MSCT were compared. The diagnosis merits and disadvantages, especially their ability to detect the lesions and adjacent structures,were assessed. Results There were no significant difference (consistency check Kappa value>0.4) in evaluating the structure characteristics of the lesions, the relationgship between the lesions and cortex ,and the relationship between the lesions and surrounding organs. TOMOS is superior to MSCT in displaying apical change, the same in pure cystic and cystic-solid lesions interfered by artifacts.However, it is inferior to MSCT in detection of soft tissue invasion. Conclusion There is similar assessment value of TOMOS and MSCT in displaying odontogenic cystic lesions of the jaws. TOMOS can be chosen when the imaging findings of the lesions are interfered by metal artifacts.

Objective To observe the dynamic distribution of the extravasated Evans Blue (EB) dye points (neurogenic inflammatory response) at the skin after acute gastric mucosal injury (AGMI) and its relation to the related regular acupoints in the locations in rats. Methods A total of 70 Wistar rats were randomized into normal control (n=10),normal saline (n=10),and AGMI (n=50) groups. The AGMI group was further divided into 5 h,2 d,3 d,4 d and 5 d subgroups with 10 rats in each. AGMI model was duplicated by intragastric perfusion of diluted hydrochloric acid (HCl,0.5 mol/L). Evans Blue Dye (50 mg/kg,50 mg/mL in 0.9% saline) was given to the rats before AGMI modeling. The plasma extravasated EB points at the skin of the whole body were observed after removal of the hair. Results The extravasated EB points presented a nerve-segmental distribution,with the proportion of the points in the location being 47.5% for "Geshu" (BL 17),58.82% for "Jizhong" (GV 6),88.23% for "Pishu" (BL 20),82.35% for "Weishu" (BL 21),17.64% for "Zhongwan" (CV 12),and 5.88% for "Shangwan" (CV 13),respectively. The plasma extravasation of EB seldom appeared in normal rats and only fewer points were found in rats accepted administration of 0.9% saline. Significant differences were found between model and normal control groups,and between model and normal saline groups in the numbers of the extravasated EB points (P