Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome.Intra-articular and extra-atticular tumor resection produced similar local recurrence rate in the present study,which suggested intra-articular resection may be an altemafive procedure.

Objective To review the long-term oncologic and functional outcomes of surgical treatment for pelvic chondrosarcoma at a single institution to further delineate surgical strategy of resection and function reconstruction.Methods All of 165 patients with pelvic chondrosarcoma that had been surgically treated between July 2000 and Dec 2013 were reviewed retrospectively.There were 102 male and 63 female patients who had a mean age of 43.5 (range,13 to 75) years.The resection type included Type T 16,type Ⅱ 18,type Ⅲ 11,type Ⅰ+Ⅱ 19,type Ⅱ+Ⅲ 63,type Ⅰ+Ⅳ 15,type Ⅰ+Ⅱ+Ⅲ 10 and type Ⅰ+Ⅱ+Ⅳ 13 cases.The pathology diagnosis was grade Ⅰ in 15,grade Ⅱ in 88,grade Ⅲ in 20,dedifferentiated in 28,mesenchymal in 12 and clear cell chondrosarcoma in 2 patients.Nine cases were secondary lesion following multiple exostoses.114 patients received no previous treatment while others were referred due to recurrent tumor.En bloc resection was achieved in 142 patients and intralesional resection in 23 cases.Twelve patients had a hemipelvectomy to achieve local tumor control,whereas 153 patients underwent a limb-salvage procedure.Spinal screw-rod system was used to reconstruct anterior pelvic ring after ilium resection.Modular hemipelvic endoprosthesis was utilized to reconstruct periacetabular defect after tumor resection while no reconstruction was performed after ischium and pubis resection.Results The median duration of follow-up was 54.1 (range,l0 to 159) months.147 (89.1％) patients were alive at the final follow-up,seven of which were alive with tumor.The estimated 5-year survival was 81.5％.Thirty-three patients (20％) had local recurrence,and twenty (12.1％) had lung metastasis.Recurrent case,sacroiliac joint involvement and intralesional resction were three risk factors for postoperative recurrence.Patients who received type Ⅱ+Ⅲ resection and reconstruction had a mean functional score of 23 according to MSTS 93.The mean MSTS 93 for patients with type Ⅰ+Ⅱ and type Ⅰ+Ⅱ+Ⅳ resection and reconstruction was 18.The wound complication rate was 15.8％.Two aseptic loosening and 2 pubic connection plate breakage were observed in hemipelvic endoprosthesis reconstruction.Conclusion Tumor grade correlates with overall or disease-free survival.For low-grade chondrosarcoma,adequate surgical margin can provide long-term local control while for high-grade cases,distant metastasis is the main case of treatment failure.Adequate surgical margin can be achieved in cases with acetabulum involved.However,aggressive surgical resection of pelvic chondrosarcoma still remains as a challenge for orthopaedic oncologists when the tumor invades the iliosacral joint,which necessitates careful preoperative plan and skilled surgical techniques.

Adult ; Female ; Humans ; Insecticides ; poisoning ; Ivermectin ; analogs & derivatives ; poisoning ; Male ; Middle Aged

Objective To explore the association between infant breastfeeding and cognition and behavior development in school age children.Methods Five hundred and eighty-one children aged 7-11 years old from two schools in Ningyang of Tai′an.Their cognition and beha-vior development during school age were assessed by Ravin's standard progressive matrices and child behavior check list(CBCL).Their feeding conditions during infant period,family environment,education level of parents,et al,were investigated with self-made inventory questionnaire.Association between infant breastfeeding types,duration of breastfeeding and cognition,behavior development were analyzed.Results The single factor analysis showed the scores of perceptual distinction,similarity,and Abstract thought in children who were only breast fed before 4 months were higher than those of controls for male children(Pa

Adolescent ; Child ; Cleft Palate ; pathology ; Eustachian Tube ; anatomy & histology ; pathology ; Female ; Humans ; Male ; Nasopharynx ; anatomy & histology ; pathology ; Young Adult

Objective To characterize the changes of retinal structure and visual field mean defects (MD) in early Parkinson's disease (PD) and the related factors.Methods Twenty-five patients with early stage PD and 33 normal controls were enrolled in this study.PD patients were evaluated by unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H-Y) stage in off period.All subjects undertook retina of retinal nerve fiber layer (RNFL) and macular examinations by optical coherence tomography (OCT),and MD by automatic visual field analyzer.Results (1) The average thicknesses of RNFL and C11 quadrant RNFL were thinner in PD group [(96.2 ±7.6) μm and (124.4 ± 18.4) μm] than in healthy controls [(102.6 ± 5.0) μm and (135.4 ± 21.8) μm,respectively,P =0.000 and P =0.047].Moreover,PD patients had a thinner average thickness of macular[(277.2 ±9.6) μm vs (285.8 ± 12.6)μm,P=0.006],and smaller macular volume compared with controls [(10.0 ± 0.3) mm3 vs (10.3 ±0.4) mm3,P =0.006].However,there was no significant difference in MD between PD and control subjects [(0.43 ± 2.75) dB vs (-0.18 ± 1.41) dB,P =0.322].(2) Pearson's correlation analysis showed that H-Y stage was negative correlated with the average RNFL thickness (r =-0.569),average macular thickness and volume (r=-0.501 and r=-0.417) in PD patients (all P＜0.05).Conclusions PD patients have thinner average thicknesses of RNFL,C11 quadrant RNFL and macular,smaller macular volume than those in normal controls.There were no significant differences in MD between two groups.There were negative relationships between H-Y stage,and retinal thickness and volume of PD patients.

Background Dry eye syndrome is a frequent postoperative complication of laser in situ keratomileusis (LASIK).Some studies reported that the hinge location of corneal flap has influence on dry eye syndrome following LASIK,but others showed inverse views.Objective This systematic review was to evaluate and compare the effects of a superior-and nasal/temporal-hinge location on dry eye syndrome after LASIK.Methods A systematic literature retrieval was conducted in the Medline,Embase,Cochrane Library and CNKI from 1990 to 2011 according to designed searching strategy and relevant words.Published randomized-controlled clinical trial (RCT) data of the effect of superior-and nasal/temporal-hinge location on dry eye syndrome were extracted by two researchers separately.The outcome parameters,such as tear film breakup time (BUT),Schirmer Ⅰ test and corneal sensation were analyzed 1 week,3 months and 6-12 months postoperatively.The statistical analysis was performed using a RevMan 5.0 software and the quality of included literatures were graded according to the Jadad scale.Fixedeffect model was used for the inhomogeneity multiple studies (P≥0.1,homogeneity test I2 ＜50％),and random-effect model was used for the homogeneity studies.Results Ten pieces RCT papers were searched and 3 of them were rejected because of the lack of outcome data.In 7 included studies,652 eyes of 331 patients were involved in the Meta analysis,with the Jadad scores ≥ 3.BUT assessment was performed in 5 trials (530 eyes),Schirmer Ⅰ test evaluation was in 7 trials (652 eyes) and corneal sensation observation was in 4 trials (320 eyes),without significant homogeneity among the relevant literature(I2＜50％).Meta analysis revealed that BUT in the eyes with superior-hinge group was obvious shorter than that in the eyes nasal/temporal-hinge group at 1 week (WMD =-0.42,95％ CI:-0.79 to-0.06,P=0.020),but there was no signifieant difference in 3 months and 6-12 months duration postoperatively.Better corneal sensation was found at postoperative 3 months (WMD=-0.62,95％CI:-l.09 to-0.19,P=0.005) in the nasal/temporal-hinge group,but there was no difference in 1 week and 6-12 months duration postoperatively.No significant difference was seen between the two groups in Schirmer Ⅰ test during the follow-up period (P＞0.05).Conclusions LASIK with nasal/temporal-hinge corneal flap can improve the corneal sensation and relief the dry eye syndrome after LASIK to some extent.More high-quality evidence-based studies are still needed for the further clinical evaluation.

Background Nowadays,keratoplasty is widely used in the treatment of keratoconus.Deep lamellar keratoplasty(DLKP)is one of the research hotspots.However,its effacacy and safety are still concerned.Objective This paper was to evaluate and compare the therapeutic outcomes between DLKP and penetrating keratoplasty(PKP) for keratoconus.Methods The peer-reviewed and published literature was searched from PubMed database,Cochrane Library,EMBase and CNKI to identify relevant trails comparing DLKP with PKP for keratoconus.Methodological quality and Meta-analysis were carried out according to the principle of evidence-based medicine.The statistical analysis was performed using Review Manager 5.0 software.Results Eleven studies with 2950 eyes were identified that compared the results of DLKP and PKP procedures for keratoconus directly.Of those studies reporting vision and refractive data,less patients underwent DLKP achieved a best corrected visual acuity (BCVA)of≥0.5 than DLKP(RR=0.91,95％ CI:0.84-0.99,P=0.030) ;patients with DALK had severer myopia that those with PKP(RR =-0.60,95％ CI:-1.43-0.23,P =0.150),but the astigmatism was comparative (WMD =0.21,95％ CI:-0.48-0.91,P =0.550).Endothelial cell density values were higher in the DLKP group and the differences were significant.Endothelial immune graft rejection did not occur after DALK,and PKP had a higher overall graft rejection rate than DLKP(RR=0.06,95％ CI:0.01-0.31,P=0.001).Conclusions According to the available data,PKP can imporve the BCVA and refractive results,but DLKP can avoid the risk of endothelial rejection and reduce the risk of late endothelial failure for keratconus.

There has always been no lack of discussion on Biaoben and Genjie theory in traditional Chinese medical acupuncture circles, but many questions still exist. This article expounds the original meaning of Biaoben and Genjie, traces the origin of the theory and sorts out the questions in Biaoben and Genjie theory, e.g. the difference in the position between Biaoben and Genjie, no record of the location of Genjie of six hand meridians, regularities in meridional qi circulation, understanding and valuing, and application and development to confirm the importance of Biaoben and Genjie theory and to give reference.

Objective To evaluate the clinical and functional outcome of biological reconstruction by using pasteurized autograft and massive allograft after en-bloc resection of primary femoral diaphyseal sarcomas.Methods Retrospectively reviewed 19 consecutive patients with primary femoral diaphyseal sarcomas between Feb.2005 and Dec.2013.There were 11 males and 8 females with the mean age of 18 (2-38) years old.Thirteen patients were diagnosed as osteogenic sarcoma (OS),while five Ewing' s sarcoma (EWS) and one malignant fibrous histocytoma (MFH).All patients were treated with wide local excision,and 9patients were reconstructed by intercalary femur segmental allograft and 10 by pasteurized autograft.The median length of the resected bone was 16.9 (9-24) cm.15 segmental grafts were fixed by using plates including 10 intramedullary free vascularised fibular graft constructs,the other 4 segmental grafts were fixed by intramedullary nails.The average operation time for pasteurized autograft construct was 5.1 hours,while the time for intercalary allograft construct was 4.22 hours.Of 38 host-donor junctions,there are 28 diaphyseal junctions and 10 metaphyseal junctions.Results The average operation time for pausterized autograft construct tended to be longer than intercalary allograft (5.1h Vs 4.22h),although the difference did not reach the significance.Bone union occurred at a median of 10.3 months and 7.25 months at diaphyseal and metaphyseal junction for pasteurized autograft-host construct; 13.8 months at the diapyhseal junction and 11.5 months at the metaphyseal junction for allograft-host construct.Bone healing time of diaphyseal junction and metaphyseal junction between these two constructs were significant difference.Eight of 19patients (42.1％) developed complications:5 bone unnunion/fracture (including 1 subsequently developed local recurrence),1deep infection and 2 local recurrence (including 1 soft tissue recurrence).The mean overall follow-up was 33.5 months (3-107),five patients died of lung metastases,the cumulative patient survival was 76.5％ at 2 years and 61.2％ at 5 years determined by Kaplan-Meier method.All living patients except the MFH patients who received amputation,had a mean MSTS score of 83.7％ (70％-95％).Conclusion Although the reconstructive procedure with pasteurized autograft is more complicated and needs longer operation time than allograft reconstruction,the bone healing time with autograft is significant shorter than allograft.Our observations suggest the pausterized autograft shell with intramedullary free fibular graft is strongly recommeded.