Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery

Condoms ; standards ; supply & distribution ; Humans ; Quality Control ; Sexually Transmitted Diseases ; prevention & control

Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation.
Bone Neoplasms ; diagnosis ; surgery ; Chondroblastoma ; diagnosis ; surgery ; Humans ; Patella ; surgery

The incidence of cervical neoplasms complicated with pregnancy is rising,with delaying of reproouctive age.Because of the prevalence of cytology in pregnancy.eervical neoplasnis complicated with pregnancy are mostly detected early. All patients with cytological abnormalities should undergo colposcopy, and when necessary,they should undergo cervical biopsy.Conization is reserved for patients with suspected invasion.In cases of invasive carcinoma detected up to the 12th week of pregnancy,immediate treatment is prioritized.Regarding diagnoses made during the second trimester,in early-stage invasive cancers,delay of therapy seems to be safe.fetal pulmonary maturity can be awaited.And the use of neoadjuvant chemotherapy to stabilize the disease until the time of delivery appears to be viable.Doctors should draw up personalized program for the patients with cervical neoplasms complicated with pregnancy according to stage of disease, gestational weeks and the patient's desire for continued pregnancy.Cervical neoplasms complicated with pregnancy are mostly early-stageinvasive cancers, so prognosis is good.

Epithelial-mesenchymal transition (EMT) not only can endow cells migration and invasion characteristics,but also can make tumor cells obtain self-renewal ability and have the characteristics of stem cells,which might result in cancer stem cell (CSCs).There are the same molecular mechanism and microenvironment between EMT and CSCs,which have great clinic significances for the diagnosis and treatment of the aggressive cancers.Moreover,many studies show that miR-200 could regulate EMT and CSC,participate in the tumor invasion and metastasi,and promote the research of targeted cancer therapy.

Objective To explore the best minimal invasive method in treating renal pelvic stones less than 1.5 cm.Methods A total of 90 patients with renal pelvic stone less than 1.5 cm were enrolled, including 47 cases of retrograde intrarenal surgery(RIRS)by rigid and flexible ureteroscopy with holmium laser lithotripsy,and 43 cases of percutaneous nephrolithotomy(PCNL)by holmium laser lithotripsy.Opera-tion time,stonefree rate(SFR),hospitalization,and complications were analyzed for comparison.Results The average sizes of stone in the RIRS group and PCNL group were 1.2 cm(range 1.0 ~1.5 cm)and 1.3 cm (1.0 ~1.5 cm),respectively.In the RIRS group,45(95.74%)patients out of 47 had complete clearance and 32 patients needed combination of flexible ureteroscopy to fragmentate the stones falling into the renal calices.The operation time was 44 min(range 27 ~70 min)with postoperative fever in 2 cases.The decrea-sing in hemoglobin and hematocrit was(0.18 ±0.06)g/L and 0.11%,respectively.No major complication was recorded.In PCNL group,the mean operation time was 70min(range 45 ~90 min)with a stone-free rate of 95.35%(41 /43).The decreasing in hemoglobin and hematocrit was(17.25 ±6.70)g/L and 5. 62%,respectively.The complications in PCNL group were postoperative fever in two cases and bleeding in two cases.Conclusion RIRS has the advantages of natural orifice endoscopic surgery in shortening opera-tion time,reducing blood transfusion requirements,and decreasing postoperative complications.For renal pelvic stone less than 1.5 cm,RIRS can be the primary choice.

Objective To detect the expression of HSPA2 mRNA and protein in pancreatic cancer and corresponding adjacent nontumorous tissues, and investigate the expression of HSPA2 protein in pancreatic cancer and its association with clinicopathological characteristics.Methods Western blot and qPCR (real-time quantitative PCR) was used to evaluate HSPA2 expression in pancreatic cancer and corresponding adjacent nontumorous tissues.Immunohistochemistry was used to investigate the HSPA2 expression in pancreatic cancer and its association with clinicopathological characteristics.Results Both the mRNA and protein levels of HSPA2 were significant higher in pancreatic cancer tissues than those in their paired adjacent nontumorous tissues.High HSPA2 expression was detected in 68.8% (55/80) of pancreatic cancer tissues.HSPA2 protein expression was significantly associated with tumor differentiation, vascular invasion, and status of metastasis (P=0.011,0.005,0.012).Conclusion HSPA2 expression is elevated in pancreatic cancer, and positively correlated the process of invasion, metastasis and progression of pancreatic cancer.

Objective To explore the clinical application of function-preserving pancreatic surgery for treating pancreatic neuroendocrine neoplasms (pNENs).Methods Twenty-eight patients with pNENs treated by the function-preserving pancreatic surgery at Anhui Province Hospital from January 2002 to December 2015 were analyzed retrospectively.Results Among the 28 patients, enucleation surgery was performed in 18 cases, distal pancreatectomy was performed in 8 cases, and middle pancreatectomy was performed in 2 patients.Total average operation time was (197±68) min, and the blood loss was (106±99) ml.The postoperative pancreatic fistula was observed in 7 patients, seroperitoneum was in 4 patients, incisional infection was in 1 patient, pulmonary infection was in 2 patients, and all the patients were cured by conservative treatment.There was no death during perioperative period.The postoperative hospital stay was (13±6)d.Analysis of pathological examination and clinical symptoms showed that 24 cases were diagnosed as functional pNENs (including 23 with insulinoma and 1 with gastrinoma), and 4 cases were as non-functional pNENs.The tumor grade G1 was categorized in 19 cases, G2 was in 9 cases.The TNM was I stage in all patients.There were no vascular or nerve invasion or lymph node metastasis.The follow-up period ranged from 4 to 144 months.2 patients were lost, and other patients were all alive.No diabetes or hypoglycemia occurred.Conclusions The function-preserving surgery for pNENs was safe and feasible, especially for well-differentiated functional pNENs.

In the medical field, the innovation education is to cultivate residents in China, which is an important way to senior medical elite. By analyzing competency-based neurosurgery residency training mode, the training methods for innovative ability of competency-based neurosurgeon are further discussed, for the purpose of reforming the training mode of neurosurgeon, improving creative ability and scientific clinical thinking ability.

Objective To explore the effect of gamma-aminobutyric acid (GABA) on the growth, apoptosis and telomerase activity of Cholangiocarcinoma cell line QBC939. Methods Cholangiocarcinoma cell line QBC939 was cultured by routine method, and then treated with different concentrations of GABA (1-1000 μmmol/L). The proliferation, apoptosis and cell cycle of QBC939 cells was investigated by MTT, Flow cytometry and transmission electron microscopy. The telomer-ase activity of QBC939 cells was examined by modified PCR-ELISA assay. Radioimmunoassay was used to measure the intracellular cyclic adenosine monophosphate(cAMP) content. Results The dif-ferent concentrations of GABA inhibited the growth of QBC939 cells and promoted the apoptosis. The apop-totic rate of QBC939 cells was increased from 4. 8% to 28. 03%, which had significant difference (P<0.05). It had no effect for distribution of cell cycle. Cell nuclear condensation and apoptotic bodies were seen by transmission electron microscopy. Telomerase activity was inhibited by GABA(0. 82±0. 048 vs 0.56±0. 054, P<0.05). The content of intracellular cAMP was increased with the increase of GABA concentration in a dose-dependent manner [(0. 59±0. 049) nmol/L vs (0. 82±0. 033)nmol/L, P<0. 05]. Conclusion GABA can inhibit the proliferation of QBC939 cells by promoting apoptosis and inhibiting telomerase activi-ty, which may be mediated by the information transmission of post-receptor.