Objective To evaluate the preliminary clinical outcome of the screw fixation of minimally displaced scaphoid fracture assisted by computerized imaging reconstruction and preoperative planning system.Methods From March 2013 to Feburary 2014,Five screws on five patients were treated.We calculated and designed the position of scaphoid screw guide wire and ensured the guide wire centrally placed in the scaphoid by using the computerized imaging reconstruction and preoperative planning system software.The appropriate length of the screw was measured too in the software.We also identified the entry and exit points of the guide wire on the custom orthoses splinting the wrist joint.Five patients with scaphoid fractures were treated with percutaneous screw fixation under the guidance of a C-arm fluoroscopy and a guide wire were inserted based on the entry and exit points calculated preoperatively.All of the scaphoid fracture was nondisplaced or less than 1 mm.The modified MAYO wrist scoring system was used to evaluate the pain,function and range of motion for the wrist joint during follow up.Results Total surgical time was 28.8 min (25-39 min)and Fluoroscopy time was 18.4 s (11-23 s).The fracture healing was observed at routine 8 weeks follow up.No complication such as infection or fixation failure was reported.Modified MAYO wrist score was 83.8 (81-88)at average followup at 15 months (6-12 months).Conclusion Computer assisted percutaneous screw fixation is an effective method for the treatment of nondisplaced scaphoid fractures.It leads to significantly reduced guidewire placement time and radiological exposure time while provides accurate placement of the screw.

Objective The purpose of this study is to study the clinical and pathological features of neurilemoma .Methods We observed the clinicopathologic features and immunohistochemical staining from eight patients with orbital neurilemoma between 2010.1~2012.12.Results Eight patients with classic neurilemoma were included in the study ,in which there were five males and three females ,aged between 21 and 63,mean age 35.The main symptom of the patients was exophthalmos ,including five cases of right eyes and three left eyes;2 cases of orbital floor and six above orbit ,lasting for one to ten years .The tumor diameter ranged between 1cm and 5 cm,an average of 3 cm,being pale and light yellow color .There were five cases of type Antoni A and one case of type was Antoni B among the six classic type neurilemoma .Two cases of ancient were neurilemoma ,in which one case was the histological structure of the classic type neurilemoma ,but there were more hypertrophy tumor cells , chromatin was coarse block atypia cells .The other one case with cells arranged disorderly ,which was mainly fine striated cells with scattered deeply stained atypia cells ,stromal transparent degeneration ,cystic degeneration .Im-munohistochemistry results showed that S -100(+),vimentin(+),ki67(-).Conclusion Antoni type B and ancient schwannoma are rare ,with complicated histologic characteristics .Combined with clinical features and im-munohistochemistry staining ,it can be diagnosed .

Objective To summarize the methods of diagnosis and results of surgical treatment of pancreatic insulinoma. Methods The clinical data of 137 patients with insulinoma treated in our hospital during the past twenty-six years were reviewed retrospectively.Results There were 77 males and 60 females. All of them were characterized by the Whipple′s triad. The sensitivity of ultrasonography, CT and MRI for localization was 35.1%, 67.9% and 58.1% respectively. One hundred and tweenty-six patients underwent operation. Of them, 102 cases had tumor enucleation, 4 cases had pancreaticoduodenectomy, 16 cases had distal panreatectomy, and the other 4 cases had only laparotomy. Of the 122 patients, who underwent resection, the tumor was benign in 118(96.7%) and malignant in 4(3.3%). The diameter of the tumor was less than 2cm in 86.9% of cases. In 98.4% of cases the tumors were single and in 1.6% of cases were multiple. 13.1% of the tumors located in the head, 46.7% in the body, and 40.2% in the tail.Conclusions Whipple′s triad and the measurement of fasting glucose, IRI, IGR, C-peptide, and proinsulin levels contribute to the diagnosis of insulinoma. However, the preoperative tumor localization is still difficult. Tumor enucleation is the technique of choice when feasible. Patients in whom tumor localization is unsuccessful at operation should be carefully evaluated to be certain of the diagnosis, and in general should not undergo blind resection.

Amblyopia greatly affects the physical and mental development of children. Acupuncture is effective for amblyopia, though its mechanism remains unclear. This article summarized the mechanism of acupuncture treatment of amblyopia from the perspectives of morphology of neurons in visual cortex, visual electrophysiology, and molecular biology, etc. It was found that acupuncture may treat amblyopia through repairing the morphological and ultrastructural damages of neurons in visual cortex, promoting the electrical activities in visual pathway and visual cortical neurons, and modulating the synthesis and expression levels of factors involved in visual system. Nevertheless, further studies are required to unveil the mechanism of acupuncture treatment of amblyopia.

Objective To explore the mechanism of SH?SY5Y mitochondrial dysfunction treated by manganese to find a new potential therapeutic target. Methods Transmission Electron Microscopy(TEM)to observe the morphology of mitochondria. Cell treated with 250μmol/L for periods of time(2 h, 4 h, 6 h)while mitochondrial membrane potential(MMP)and ROS can be detected by FCM and fluorescence microplate reader. Results After treating with MnCl2 in 6 h, TEM images showed early vacuoles, lamellar structures of SH?SY5Y cells. Then test the mitochondrial membrane potential and showed that MMP would be decreased gradually. Meanwhile, analysis showed that in comparison with control, treatment group had a higher ROS level respectively (P < 0.05). Conclusion MnCl2 can cause mitochondrial damage through a mechanism closely related to disrupt the MMP or generate abundant ROS.

ObjectiveTo investigate the effects of lipopolysaccharide (LPS) on mRNA expression of iron metabolism related genes. Methods Ten male mice (2 months) were injected intraperitoneally with lipopolysaccharide(0.5 μg/g). After 6 hours, mice were sacrificed and then sera, liver and spleen were collected. The mice blood routine was measured. The serum iron and total iron binding capacity (TIBC) were determined with reagent kit. The quasi-quantitative reverse transcription polymerase chain reaction (RT-PCR) was performed for mRNA of hepatic hepcidin(HP), ferroportin1(Fpn1), transferrin receptor 1(TfR1) and spleenic HP, Fpn1 and interleukin-6(IL-6). Results The serum iron and TIBC were reduced in mice injected LPS, which exhibited mild anemia(P＜0.05) . LPS can increase the expression of hepatic hepcidin and decrease Fpn1 and TfR1 in liver after LPS administration 6 hours(P＜0.05). In spleen, IL-6 was upregulated and Fpn1 downregulated(P＜0.05). Conclusion LPS can influence serum iron through regulating the mRNA expression of hepatic and spleenic iron metabolism related genes, such as HP, Fpn1 and TfR1.

BACKGROUND: Talomerase activity inhibitor inhibits or kills renal carcinoma cells, and also affects stem cells that play importan roles in occurrence and development of renal carcinoma.OBJECTIVE: To observe renal carcinoma stem cell surface marker CD133 and telomerase activity expression in serum-free suspension culture, and to compare with renal carcinoma cells in serum suspension culture.DESIGN, TIME AND SETTING: The in vitro cytological study was performed at the Jiangsu University from June 2008 to Februar 2009.WIATERIALS: Fresh normal renal tissue surrounding renal carcinoma was obtained from Affiliated Hospital, Jiangsu University.Renal carcinoma stem cell line OS-RC-2 was supplied by Cell Bank, Chinese Academy of Sciences Shanghai Branch.METHODS: OS-RC-2 in logarithmic phase, digested by trypsin, and centrifuged. Supematant was removed. OS-RC-2 cell line in serum-free DMEM/F12 supplemented with epidermal growth factor and basic fibroblast growth factor was incubated at 2×105/L in 5% CO2 incubator at 37℃. Renal carcinoma cultured in serum and normal renal tissue served as controls.MAIN OUTCOME MEASURES: Cell growth was observed under an inverted microscope. Expression of CD133 and CD34 was detected using flow cytometry. Reel-time quantitative TRAP assay was applied to evaluate telomerase activity in renal carcinoma stem cells.RESULTS: After incubated in serum-free medium, renal carcinoma stem cells were round and suspended. Two days later, cell mass generated. Each cell mass contained 3-8 cells, with strong refraction. Seven days later, cell mass became more, presented big body that was regular, round or elliptical. CD133+CD34- rate in renal carcinoma stern cell mass was significantly greater in serum-free suspension culture compared with in serum suspension culture. CD133 and CD34 expression was not determined in normal renal tissue. There were significant differences among groups (F=328.25, P < 0.05). Telomerase activity was greater in renal carcinoma stem cells and renal carcinoma cells compared with normal renal ceils (F=-278.74, P < 0.05). No significant difference was detected between renal carcinoma stem cells and renal carcinoma cells.CONCLUSION: Compared with serum cultured renal carcinoma cells, serum-free cultured renal carcinoma cell surface marker CD133 presents high expression. Moreover, talomerase activity is high in renal carcinoma stem cells and renal carcinoma cells compared with normal renal tissue.

Background The objective of this study was to assess the clinical safety and efficacy of vena cava filter (VCF) placement,with particular emphasis on the incidence and risk factors of inferior vena cava thrombosis (VCT) after VCF placement.Methods Clinical data of patients with venous thromboembolism (VTE),with or without placement of VCF,were analyzed in a retrospective single-center audit of medical records from January 2005 to June 2009.The collected data included demographics,procedural details,filter type,indications,and complications.Results A total of 168 cases of VTE (82 with VCF; 86 without VCF) were examined.Over a median follow-up of 24.2months,VCT occurred in 18 of 82 patients with VCFs (11 males,7 females,mean age 55.4 years).In 86 patients without VCFs,VCT occurred in only 6 individuals (4 males,2 females) during the study period.VCT was observed more frequently in patients fitted with VCFs than in those without VCFs (22% vs.7.0%).Conclusions The incidence of VCT in patients with VTE after VCF implantation was 22% approximately.Anticoagulation therapy should be continued for all patients with VCF placement,unless there is a specific contraindication.Almost all instances of VCT in patients with VCF implants in our study occurred after stopping anticoagulation treetment.The use of VCFs is increasing,and more trials are needed to confirm their benefit and accurately assess their safety.

Objective To evaluate the reliability and validity of the Chinese Version of Communication and Sharing of Information Scale(CSI) in the the assessment of the efficacy and quality of collaboration of the physician and nursing related staffs.Methods All the sample enrolled from 10 hospitals of Tianjin,all the subjects voluntarily signed the informed consent.Totally 600 subjects were tested by CSI.Exploration and confirmation factor analysis were used to examine the construct validity.Cronbaeh' s α was applied for examining internal consistency of the scales,the correlation analysis was used to examining the test-retest reliability of the scales.Results Exploratory Factor Analysis revealed that Communication and Sharing of Information Scale included 3 factors:Communication with nursing related staff,Communication with physician,Medical information sharing.Confirmation Factor analysis revealed that x2/dfwas 5.760,NNFI 0.900,GFI 0.945,AGFI 0.923,REMEA was 0.06,all reached the correction criteria of the scale,indicated that this scale had good construction validity.Cronbach' sαof the total scale was 0.870,the Cronbach' s α of the 3 factors were 0.780,0.788,0.815 respectively,indicated this scale had good inner-consistency.The total scale test-retest reliability was 0.870 after 1 week in 100 subjects randomly enrolled from all the previous subjects,indicated this scale had good reliability.Conclusion CSI has good reliability and validity and is suitable to assess the efficacy and quality of the collaboration of the physician and nursing related staffs.

To propose an equipment and technology package for oxygen preparation and supply under hypoxia conditions in order to meet the requirements of populations on the plateau .Different populations were analyzed in terms of their oxygen supply requirements, and the modes, schemes and equipment for oxygen supply were explored accordingly and then applied.Efforts in the past 20 years have resulted in the advances in the equipment for centralized, mobile and portable oxygen preparation and supply, though the equipment for individual use hads to be improved and the diffused oxygen supply scheme also needs to be further evaluated .