Since 1949 , the linkage of environment and health in China has been mainly reflected in the is-sues, knowledge, policy and laws, organizations and the interactions between domestic and external factors, featuring the increasing expansion and complexity. The weak and inefficient environment and health governance institutions and the poor environment and health problems coping ability are the two major challenges that face the current environ-ment and health governance in China.

BACKGROUND:Bioglass has good biocompatibility and biological activity, which can be combined with calcium phosphate bone cement to form an absorbable bioglass that has the advantages of both materials and is expected to have a better use of space. OBJECTIVE:To explore the mechamism of the new type of absorbable bioglass injection for vertebral body supporting and osteogenic induction in osteoporosis rats. METHODS:Twenty-seven female Sprague-Dawley rats were selected to make osteoporosis models by bilateral ovariectomy, and after 1 month, the rats were randomized into three groups. Bone defect models were established in the lumbar L4 segment of al the rats. Rats in the experimental group were subjected to absorbable bioglass injection; rats in the control group 1 underwent polymethylmethacrylate bone cement injection; and rats in the control group 2 were given injectable calcium phosphate. Twelve weeks after implantation, the compressive strength, degradation and osteogenesis of the implant materials were detected, and levels of serum bone morphogenetic protein-2 and transforming growth factor-β were measured. RESULTSAND CONCLUSION: The compressive strength, hydroxyapatite deposition amount, and weight loss ratio in the experimental group were significantly higher than those in the two control groups (P < 0.05); the relative volume, thickness and number of bone trabeculae in the experimental group were significantly higher than those in the control groups (P < 0.05); the bone morphogenetic protein-2 and transforming growth factor-β protein levels in the experimental group were significantly higher than those in the two control groups (P < 0.05). These findings indicate that the new-type absorbable bioglass can greatly strengthen the vertebral body supporting and promote osteogenic effect in osteoporosis by enhancing the bone morphogenetic protein-2 and transforming growth factor-β protein levels.

[Objective]To establish animal model of avascular necrosis of the femoral head in rabbits induced by glucocorti-coid, to further investigate the pathogenesis of glucocorticoid-induced osteonecrosis.[Method]Twenty NewZealand white rabbitswere used and randomly divided into two groups.Group A was injected with horse serum and prednisone. Group B was used asthe control.The concentration of TNF-?was measured by ELISA in rabbits serum of group A and group B.Femoral head speci-mens were studied by histopathologic examination and the expression of VEGF by immunohistochemical examination.[Result]The concentration of TNF-?in rabbits serum of group A was higher than that of group B(P

[Objective]To explore a new method for the therapy of avaseular necrosis of the femoral head with vascular endothelial growth factor(VEGF).[Method]Thirty New Zealand white rabbits were chosen as experimental animals and avascularnecrosis of the femoral head model of 22 rabbits were established.Animals were egually divided into three groups:VEGF group,natural repair group,normal group.The medicament was injected to the femoral head by percutaneous injection in group A and normal saline in group B.The repairing process of bone necrosis of femoral head were studied.[Result]Compared to the untreated model group(group C),the femoral head of VEGF groups showed significant new vessel formation,number of empty bone lacunae decreased and hematopoietic tissue improving in marrow cavity.X-ray film and CT revealed evident that veGF could enhance repairing of the femoral head.[Conclusion]Pereutaneous injection of VEGF to the necro femoral head could significantly enhance bone tissue angiogenesis and ameliorated repair of osteonecrosis,thus providing a potential method for the treatment of the femoral head necrosis.

Objective To investigate the clinical value of uterine artery embolization on the treatment of cesarean scar pregnancy(CSP).Methods Clinical data of 112 cases of CSP patient underwent uterine artery embolization in Ningbo Women and Children's Hospital from January to December 2012 were enrolled for retrospectively analysis.Results All 112 patients underwent transvaginal ultrasound examination before admitted to hospital and among them 101 cases were diagnosed as CSP and 11 cases were suspected of CSP.Ninety-four cases were checked by magnetic resonance imaging (MRI) to measure the muscular thickness of uterine scar and the size of pregnant bursa.All patients received bilateral uterine artery embolization successfully,50-100 mg Methotrexat (MTX) were injected into uterine artery during this procedure.After uterine artery embolization,95 cases received curettage under ultrasound guidance,while 17 cases received curettage under hysteroscopy.All patients recovered as schedule.During the follow-up,no serious complication was found.Conclusion The use of uterine artery embolization in the treatment of CSP is safe and effective,and it can preserve patients' fertile ability.It is worthy recommended in the clinical application.

Objective To investigate the clinical outcomes of interbody fusion with transpedicular screw fixation in the reoperation for lumbar spinal instability secondary to lumbar discectomy.Methods From May 1997 to Aug 2002, 23 patients underwent reoperation with posterior lumbar spinal decompression, removal of residual disc, transpedicular screw instrumentation and interbody fusion because of lumbar spinal instability after previous lumbar discectomy. There were 14 males and 9 females. The age of patients ranged from 28 to 64 years with an average age of 48.5 years. The time between the onset of the symptoms and the diagnosis was 18 months on average (range, 6 months to 36 years). The mean interval between the primary and revision surgery was 68 months (range, 24 months to 10 years). Lumbar discectomy had been performed in all patients as the primary surgery. All patients were evaluated by the conventional radiography, and CT or MRI if necessary. The low back pain was predominant in 8, and associated with radicular leg pain in 15. The instability of one segment was found in 17, and two segments in 6. The average follow-up was 3.6 years (range, 1 to 6.4 years). Results The lateral, AP, flexion and extension X-ray films were taken at 1, 3, 6 months and 1 year to evaluate the fusion, sliding between two vertebral bodies and internal fixation, and McGill pain questionnaire was adopted to determine the satisfaction of the patients. The intraoperative blood loss ranged from 550 to 800 ml (mean, 650 ml), and the total operative time ranged from 120 to 210 min (mean, 180 min). Based on Oswestry low back pain and disability scores, the clinical successful rate was 86.9%. The rate of patient satisfaction was 82.6%. 20 patients showed radiographic bony fusion. Pedicle screw breakage and loosening were found in 3 out of the 102 screws. 5 patients had nerve root irritation and recovered within 2 to 3 weeks. 5 patients had dural laceration. Bony nonunion was found in 3 patients. Conclusion Transpedicular screw instrumentation and interbody fusion is proved helpful in management of spinal instability secondary to decompression surgery, providing successful interbody fusion and restoration of the intervertebral stability.

BACKGROUND:Exchange nailing has been reported to be a very good method for metaphyseal nonunion after femoral shaft fracture treated with intramedul ary nail. However, the effect of intramedul ary nail exchanging is not ideal for the treatment of nonisthmal femoral shaft nonunions.
OBJECTIVE: To compare the clinical and imaging outcomes between intramedul ary nail exchanging and intramedul ary nail retention plus augmentation plating for the treatment of nonisthmal femoral shaft nonunions.
METHODS:The clinical data of 39 patients with nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nail were retrospectively analyzed, and 21 patients were treated with intramedul ary nail exchanging and 18 patients were treated with intramedul ary nail retention plus augmentation plating. Clinical therapeutic effect was evaluated by Tohner-Wrnch standard.
RESULTS AND CONCLUSION:Al cases were fol owed-up for more than 15 months. In the intramedul ary nail exchanging group, postoperative internal fixator loosening occurred in three cases who obtained bony union by intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft. The fixation time, blood loss, volume for suspended red blood cel s transfusion, hospitalization costs and re-operation rate in the intramedul ary nail retention plus augmentation plating group were lower than that in the intramedullary nail exchanging group (P<0.05). Al the patients in two groups obtained bony union, and the clinical and radiographic healing time in the intramedul ary nail exchanging group were longer than those in the intramedul ary nail retention plus augmentation plating group (P<0.05);according to Tohner-Wrnch standard at final fol ow-up, excel ent in 10 cases, good in six cases and poor in five cases in the intramedul ary nail exchanging group, and the excel ent and good rate was 76%;in the intramedul ary nail retention plus augmentation plating group, there were 11 cases of excel ent and seven cases of good, and the excel ent and good rate was 100%;there was significant difference between two groups (P<0.05). Due to relatively simpler manipulation, shorter fixation time, less intraoperative blood loss, slighter trauma, less hospitalization cost, lower re-operation rate and more satisfactory therapeutic effect, intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft has been a better method for the treatment of nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nailing when compared with intramedul ary nail exchanging.

This article was aimed to explore the intelligent integration of database as the core-data and application of data mining as the core of knowledge discovery. On the basis of the existed set of information-sharing platform, this article elaborated from aspects of formatting HER intelligent integration, data integration and multi-method combined data mining intelligent integration. With the demonstration study on syndrome distribution and syndrome diagnostic criteria of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), data integration and intelligence optimization of Crystal Reports and complex networks were applied to dig out the correlation between syndromes and symptoms, disease-syndromes-herb association analysis. Analysis mentioned above showed that based on the shared system, and in accordance to research programs, intelligent integration of data and data mining methods, the improvement of the sharing platform application is proved feasible.

Objective To summarize the experience chest small incision closure of atrial septal defects treatment,evaluation of the efficacy and safety of operation.Methods Eight patients with secondary pore pathogenesy,atrial septum defect size 16-45 mm,take right next to the sternum surgery incision between 3 or 4 ribs 3-4 cm,in the cardiac ultrasound guided into occluder.Results All successful surgery,no postoperative shunt and abnormal,1 huge successful closure of atrial septal defect in 45mm.Conclusion After transcatheter closure of atrial septal defect with small incision in the chest,easy,small trauma,recover fast,safe and reliable.

Objective To study a novel method for the high-dose-rate brachytherapy (HDR) CT image to the intensity modulated radiation therapy (IMRT) CT image deformable image registration and dose accumulation.Methods The applicator in the HDR CT image is first segmented and removed,then a deflation step is performed on the applicator-free HDR CT image by solving the Navier-Stokes equation.Demons algorithm is utilized to register the deflated HDR CT image to the IMRT CT image,along with the HDR dose.The deformed HDR dose is then added on the IMRT dose and yield the final accumulated dose.Results The HDR CT image and IMRT CT image,as well as the corresponding dose distribution,from five cervical cancer patients are used for evaluation of the proposed algorithm,the results show that the proposed method can effectively get rid of the influence of the applicator and produce an accurate accumulated dose.Conclusions Dose accumulation and supervision is an important step in adaptive radiotherapy for accurate dose delivery and treatment plan re-optimization.The proposed method in this study can effectively accumulate the HDR dose to the IMRT dose domain,and the accuracy is proved to be sufficient for clinical needs.