The present preliminary study was to observe the feasibility of the use of polylactic acid gel (PLA-G) in modified radical mastectomy and the ability of the PLA-G in the prevention of flap adhesion after operation. Sixty-eight patients were diagnosed with breast cancer, and received modified radical mastectomy from Jan. 2004 to Dec. 2006. The patients were divided randomly into a treatment group and a control group (with 34 cases each). The PLA-G was used under the surface of the auxiliary operative wound in the treatment group, and nothing was used in the control group. The wound healing, the wound complication, the amount of drainage solution, the indwelling time of the drainage tube and the auxiliary skin adhesion were evaluated after operation in both groups. There were no statistical difference on wound healing between the first intension (29:27) and the second intention (5:7), and the wound dehiscence after taking the stitches out (0:0) between the two intensions, the hematoma (0:1) and the effusion of the wound (5:6), and the flap necrosis (1:2) between two groups. There were also no statistical difference on the amount of drainage solution per day (6 +/- 3) and indwelling time of the drainage tube (6 +/- 4) after operation between the two groups (P > 0.5). After the operation, the case load with no flap adhesion in the treatment group was significant higher compared with the control group (22:8). The case load with complete acquired skin flap adhesion in the treatment group was visibly lower than in the control group (3:19), which proved that there was a significant statistical difference between the two groups (P < 0.05). This study suggested that the using of PLA-G in the breast cancer modified radical mastectomy could prevent skin flap adhesion without any harmful effects in the wound healing.
Breast Neoplasms ; surgery ; Drainage ; Female ; Gels ; therapeutic use ; Humans ; Lactic Acid ; therapeutic use ; Mastectomy, Modified Radical ; Necrosis ; Polyesters ; Polymers ; therapeutic use ; Surgical Flaps ; Tissue Adhesions ; prevention & control ; Wound Healing

Prolactin-inducible protein(PIP)is regarded as a kind of specific tumor marker,and detecting the expression of PIP from breast cancer tissues,metastatic lymph nodes and peripheral blood can find breast cancer micro-metastasis effectively.Some technologies such as immunohistochemistry,reverse transcription polymerase chain reaction and so on can detect PIP sensitivily.Recently,these technologies have been used in some clinical and basic studies.Detection rate of breast cancer micro-metastasis is improved effectively when PIP is combined with other tumor makers,especially mammag-lobin and cytokeratin 19.

Objective To investigate the relationship between different behavior types with classification of TCM and emotional disturbance in coronary artery disease (CAD) patients. Methods Two hundred and forty-two CAD patients were investigated and grouped to A or B type behavior with type A behavior pattern questionnaire (TABPQ) and symptom check-list 90 (SCL-90). To analysis the emotional disturbance in two groups and investigate their relations with syndrome classification of TCM. Results SCL-90 factor score of anxiety and depression in CAD patients was obviously higher than Chinese norm. Factor score of depression, anxiety, hostility, phobia, paranoid and psychotic state in A-type behavior group was obviously higher than that in B-type group, with statistical significance (P

Diabetes is a kind of metabolic syndrome, always hap-pening in the case of insufficient secretion of insulin or insulin resistance, inducing the increase of blood glucose. While, dia-betic osteoporosis is a kind of chronic diabetic complications, which happens when insulin secretion is absolutely or relatively insufficient and then the insufficiency induces imbalance of hor-mone, calcium phosphorus metabolic disorders, thus leading to the decline of bone mineral density and change of bone micro-structure. The overnutrition, less exercise and the environment change lead to the increased incidence of diabetes. For all the diabetes, type 2 diabetes accounts for about 90%. Patients with type 2 diabetes show the increasing risk of fracture. This review summarizes the recent advances in the influence of type 2 diabe-tes on bones.

Objective To explore the effect of looming cognitive style and negative evaluation on anxiety in college students.Methods A total of 300 college students were assessed with looming maladaptive style questionnaire(LMSQ),Beck anxiety inventory(BAI) and fear of negative evaluation scale (FNE).Results (1)There was significant gender difference in fear of negative evaluation in college students (90.16±11.69 vs 97.63± 11.69,t=-2.770,P＜0.05),and there was no significant gender difference in looming cognitive style and anxiety(50.49± 11.59 vs 53.67± 11.65,t=-2.770,P＞0.05;29.82±7.89 vs 28.84±7.22,t=0.813,P＞0.05).(2) LCS were positively correlated with fear of negative evaluation and anxiety (P＜ 0.01).(3) Looming cognitive style could forecast anxiety in college students (β=0.257).Looming cognitive style and fear of negative evaluation could forecast anxiety in college students together (β1 =0.137,β 2 =0.247).(4) The meditation effects of fear of negative evaluation in total effect were 0.468.Conclusion Looming cognitive style and fear of negative evaluation are important factors influencing the anxiety of college students,fear of negative evaluation plays an important mediation role between looming cognitive style and anxiety of college students.

Objective To analyze the mediating effect of coping style on the relationship between Looming Cognitive Style (LCS) and anxiety and depression of university students.Methods 281 university students were investigated with looming maladaptive style questionnaire (LMSQ),simplified coping style questionnaire (SCSQ),Beck anxiety inventory (BAI) and Beck depression inventory (BDI).Results ① The differences between positive group and negative group in anxiety were significant in LCS ((62.67 ± 16.42) vs (52.56±11.23)) and physical threat of LCS((32.58±8.90) vs (26.14±6.40)) (t=2.97,P＜ 0.05;t=3.34,P＜0.05);and the differences were not significant in social threat of LCS(t=1.86,P＞0.05).The differences of the people in different degree of depression were significant in LCS and physical threat and social threat of LCS (F=11.635,P＜0.05;F=10.357,P＜0.05;F=4.774,P＜0.05).(②)LCS were positively correlated with anxiety and depression(r=0.257,P＜0.01;r=0.343,P＜0.01).Negative coping style was positively correlated with anxiety and depression(r=0.286,P＜0.01;r=0.299,P＜0.01),and positive coping style was negatively correlated with anxiety and depression(r=-0.176,P＜0.01;r=-0.248,P＜0.01).③ Positive and negative coping style partly mediated the relationship between LCS and anxiety and depression,and the proportions of mediating effects in total effects were 9.5％-21.8％,the variation for mediation explained the variance of the dependent variable were 9.5％-23.0％.Conclusion Coping style mediates LCS and anxiety and depression,and coping style are needed to be considered during intervening anxiety and depression of university students.

Objective To compare the clinical effects of open kinetic chain (OKC) exercises with those of closed kinetic chain (CKC) exercises and limited open kinetic chain combined with closed kinetic chain exercises on rehabilitation after the anterior cruciate ligament reconstruction.Methods Ninety-four patients recovering from single-bundle anterior ligament reconstructions were enrolled and randomly divided into an OKC group (n =33),a CKC group (n =30) or a limited open kinetic chain combined with closed kinetic chain group (combined group) (n =31).Lysholm score,International Knee Documentation Committee (IKDC) score,KT-1000,and active and passive range of motion were evaluated for the 3 groups three and six months after the surgery.Results Three months after surgery,significant differences were found among the 3 groups in Lysholm scores [(87.00±4.79),(83.67± 3.55) and (86.71±3.62) respectively],IKDC scores [(89.45±4.79),(86.40±3.76) and (88.58±3.60) respectively],KT-1000[(1.99±0.30),(1.05±0.26) and (1.02±0.24) mm],as well as active and passive range of motion [(10.06±2.06),(7.73±1.41) and (8.10±1.35) mm;(9.76±2.26),(7.87±1.89) and (8.39±1.62) mm] (P＜ 0.05).Six months after surgery,no significant differences were found in Lysholm scores and IKDC scores(P＞0.05),but significant differences were found in KT-1000,and active and passive range of motion(P＜0.05) compared to those at 3 months after surgery.Moreover,there were no significant differences between the OKC and combined groups in Lysholm scores and IKDC scores(P＞0.05),but significant differences between them in active and passive range of motion (P＜0.05).There were no significant differences between the CKC and combined groups in Lysholm scores,IKDC scores,KT-1000,and active and passive range of motion(P＜0.05).Conclusion Combining limited open kinetic chain exercise with closed kinetic chain exercise is safe and reliable in the rehabilitation after anterior cruciate ligament reconstruction.

ObjectiveAim at the problems in the treatments of the children malignant bone tumor of distal femur,we put forward the concept of the dual mobility hemi-knee prosthesis and try to perform the motion parameters analysis and the pilot clinical trials.MethodsBase on the CT data from samples of knee joint in adult,we adopted the Mimics/Geomagic/Pro-E software and computer numerical control milling machine technology to design and produce the dual mobility hemi-knee artificial prosthesis,and then motion parameters was analyzed in vitro test,and at last pilot clinical trial was performed.ResultsIn vitro experiment showed that the displacement of the internal femoral condyle flexion facet center was(2.59±0.43) mm in normal knee group,(2.22±0.52) mm in dual mobility hemi-knee prosthesis group,and (1.18±0.43) mm in total knee arthroplasty group; the displacement of the external femoral condyle flexion facet center was (11.95±6.62) mm in normal group,(11.25±6.19) mm in dual mobility hemi-knee prosthesis group,and (1.26±0.42) mm in total knee arthroplasty group; the maximum relative rotation angle was 13.17°±7.58° in normal knee group,11.69°±6.49° in dual mobility hemi-knee prosthesis group,and 5.40°±1.29° in total knee arthroplasty group.After that,we accomplished the pilot clinical trials successfully for a patient with malignant bone tumor in distal femur.The patient recovered well and the treatment outcome was satisfactory.ConclusionThe motion parameters analysis showed that the motion mode of the dual mobility hemi-knee prosthesis is similar with that of the normal knee.The dual mobility hemi-knee prosthesis provides a whole new concept and method for the treatment of malignant bone tumor of distal femur in children,and the device and concept of ligament reattachment provide a solution to the reconstruction of knee ligament.

Objective To discuss the significance of the retrograde urethrography in diagnosis and treatment of urethraltrauma. Methods 78 cases with urethraltrauma treated by the retrograde urethrography were retrospectively analyzed. Results The location and extent of urethral injury was determined according to the place and speed of contrast medium overflow and the diffuse range. Among 78 cases ,29 cases were bulbar urethral trauma and other 49 cases were membranous urethral trauma.Conclusion Retrograde urethrography is simple, practical and easy to operate for determining the injured part of urethra and the extent of damage of urethraltrauma, and was instructional for the choice of operation method and incision.

Objective To provide an anatomic evidence for the double-bundle posterior cruciate ligament (PCL) reconstruction, the sizes and locations of the attachments of the PCL to the tibia and the femur were measured. Methods We studied 30 cadaveric knees. PCLs were divided into anterolateral and posteromedial bundles to the insertion footprint, and those locations were measured and described. Results The distances from the center of the femoral insertions of the anterolateral and posteromedial bundles to the anterior margin of the medial femoral condyle were (8.52±1.81)mm and (11.63±1.81)mm. The vertical distances from the center of the femoral insertions of the double-bundle to the intercondylar roof were (4.67±0.55)mm and (10.32±1.23) mm. The vertical distances from the tibial insertion of the center of the double-bundle to the plane of the tibial articular surface were (8.43±1.21)mm and (14.52±2.31)mm. The distances from the medial margin of the articular cartilage of the tibial plateau to the center of the tibial insertions of double-bundle were (47.44±6.23)mm and (45.95±6.32)mm. The areas of the insertions of the anterolateral and posteromedial bundles on the femur were (107.12±15.25)mm~2 and (65.35±10.27)mm~2. The areas of the insertions of the double-bundle on the tibia were (50.07±11.33)mm~2and (51.08±10.22)mm~2. Conclusion The anatomic characteristic of the attachment of the anterolateral and posteromedial bundles was revealed, providing anatomical bases for surgery.