Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

BACKGROUND:With more and more research available,there are different classification systems for intertrochanteric fracture,from Evans and Boyd-Griffin classification to Evans-Jensen and AO/OTA classification,all providing guidance for choosing an appropriate treatment scheme.OBJECTIVE:To review the advance in the treatment of senile unstable intertrochanteric fractures.METHODS:PubMed,Web of Science,WanFang and CNKI databases were searched with the keywords of intertrochanteric fracture,intramedullary nail,hip arthroplasty in English and Chinese,respectively.1 535 literatures were retrieved firstly,and finally 47 articles were included in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION:The therapy conception of intertrochanteric fractures has been changed from conservative traction to early surgical treatment.With the development of technology,the internal fixators have been improved continuously.Screw-plate system has been developed from Jewett plate,AO/ASIF plate to dynamic hip screw.Intramedullary nails such as Gamma,proximal femoral and proximal femoral antirotation nails have been successfully applied in clinic.Senile patients with unstable intertrochanteric fractures also obtain favorable prognosis through active internal fixation,but the high incidence of complications appears because of osteoporosis,osteogenesis deficiency and accompanied by degenerative hip diseases.Thereafter,hip arthroplasty is recommended to treat senile unstable intertrochanteric fractures so as to achieve rapid functional recovery,desired efficacy and low incidence of complications.However,it still remains controversial to choose internal fixation or hip arthroplasty.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

BACKGROUND: The impact of obesity on total hip arthroplasty has been discussed. However, there is a lack of follow-up study on the patients with different body mass indexes using three-dimensional gait analysis. OBJECTIVE: To investigate the effect of body mass index on the early-term functional recovery after total hip arthroplasty by three-dimensional gait analysis. METHODS: Sixty patients who underwent total hip arthroplasty at Department of Joint Surgery of Affiliated Zhongshan Hospital of Dalian University from January 2017 to June 2018 were enrolled. According to the body mass index at admission, they were divided into overweight group (body mass index ≥ 25 kg/m2) and normal group (body mass index < 25 kg/m2), n=30/group. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. The clinical data such as surgical site, age, sex, height, body mass, and operating time were collected. At 6 months postoperatively, three-dimensional gait analysis was used to collect the time-distance parameters (stride length, stride frequency, mean velocity), kinetic parameters, and kinematic parameters to evaluate the hip joint function. RESULTS AND CONCLUSION: (1) There was no significant difference in the surgical site, sex proportion and age between two groups (P > 0.05). The operation time in the overweight group was significantly longer than that in the normal group (P=0.000). (2) In terms of time-distance parameters, there was no significant difference in the stride length, stride frequency and mean velocity between two groups. The stride length in the overweight group was smaller than that in the normal group (1.08±0.18 vs. 1.35±1.45 m). (3) The range of motion of each planes of hip joint in the overweight group was significantly less than that in the normal group (P < 0.05). (4) In terms of kinetic parameters, the peak torque of hip flexion in the overweight group was significantly less than in the normal group (P=0.011). There was no significant difference in the peak torque of hip extension between two groups (P=1.000). (5) To conclude, obesity has certain effect on the early functional recovery after total hip arthroplasty.

Objective: To study whether sodium-hydrogen exchange inhibitor(NHEI) can enhance the protective effect of hyperpolarized preservation solution containing potassium channel opener (PCO), and the effect was compared with that of Celsior solution. Methods: After equilibrated on a crystalloid-perfused Langendorff model for 30 min, rabbit hearts were divided into four groups: (1) Cel group: receiving another 30 min of equilibration, 8 h cold storage with Celsior solution and 1 h reperfusion; (2) Pin group: arrested and stored with pinacidil (a type of PCO) hyperpolarizing cardioplegia; (3) Cel+Car group: receiving the same treatment as Cel group except that 10 μmol/L cariporide (a type of NHEI) was administered during the second equilibration period and reperfusion; and (4) Pin+Car group: receiving cariporide treatment and hyperpolarized arrest and storage. Results: Recovery rate of systolic function in the Pin+Car group was significantly higher than that in the Pin group ([87.4±11.9]% vs [69.0±7.2]%, P<0.05) and comparable to that in the Cel group ([93.4±5.2]%, P>0.05). No significant differences were found in any parameters between Cel group and Cel+Car group. There were no differences in coronary flow among all groups. Conclusion: NHEI can greatly enhance the protective effect of PCO hperpolarized preservation solution on the donor heart, and the combination of them has a comparable protective effect to Celsior solution.

Objective To OxplorO thO rOlationship bOtwOOn diffOrOnt vOntilation modO and hypocapnia in prOtOrm infants.Methods From April 2014 to OctobOr 2017,a total of 302 prOtOrm infants with rOspiratory distrOss syndromO in Suining COntral Hospital who rOcOivOd diffOrOnt assistOd vOntilation wOrO sOlOctOd in this rOsOarch. According diffOrOnt vOntilation modO, thOy wOrO dividOd into convOntional mOchanical vOntilation(CMV) group( n=66),thO mOchanical vOntilation modO was CMV, continuous positivO airway prOssurO(CPAP) group(n=149),thO mOchanical vOntilation modO was CPAP, high frOquOncy vOntilation(HFOV) group(n=87),thO mOchanical vOntila-tion modO was HFOV. ThO morbidity of hypocapnia in diffOrOnt groups and prOvOntion mOthods wOrO analyzOd. Results Among 302 childrOn,52casOs had hypocarbonOmia,thO total morbidity of hypocapnia was 17.2%. ThO morbidity of hypocapnia in thO HFOV group was 37.9% (33/87),which in thO CMV group was 21.2% (14/66), which in thO CPAP group was 3.4% (5/149),thO diffOrOncO among thO thrOO groups was statistically significant(χ2 =47.013,P=0.000).Conclusion ThO incidOncO of invasivO vOntilation should bO carOfully considOrOd in prOtOrm infants, OspOcially high frOquOncy vOntilation. To prOvOnt and trOatmOnt of hypocapnia, timOly adjustmOnt of vOntilator paramOtOrs according to blood gas during diffOrOnt vOntilation modO should bO donO.

Objective To study the natural history of mild cognitive impairment (MCI) progress to dementia and to evaluate the efficacy of acetylcholinesterase inhibitor (AChEI) donepezil on MCI.Methods Ninty-eight patients with MCI including amnestic MCI and non-amnestic MCI were retrospectively analyzed. The patients with donepezil or not were separately divided to two groups while they were matched by sex, age,degree of MCI and possession of the ApoE?4 allele.The rate of conversion from MCI to dementia, measured with the Mini-Mental State Examination (MMSE),Alzheimer's Disease Assessment Scale- Cognitive section(ADAS-Cog) and Wechsler Memory Scale-Revised (WMS-R),was compared between the two groups.Results In aMCI group,the rate of conversion dropped by 15.1% and 8.3% (P0.05).Conclusion Donepezil could postpone the conversion of MCI to dementia.

Adult ; Crown Lengthening ; Dental Restoration, Permanent ; Esthetics, Dental ; Female ; Humans ; Incisor ; Malocclusion ; therapy

Objective To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-Ⅱ) in the treatment of intertrochanteric fractures in elderly people.Methods From July 2009 to December 2011,127 elderly patients with intertrochanteric fracture were treated by PFNA-Ⅱ.They were 49 cases of male and 78 cases of female,with a mean age of (74.3±15) years.127 elderly patients were classified by modified Evans:type Ⅰ (n=37),typeⅡ (n=42),type Ⅲ (n=26),type Ⅳ (n=15),type V (n=7).We made the statistics on the intraoperative bleeding volume,operation time,incision length,X-light exposure times,and made evaluation of the efficacy of postoperative follow-up and complications by the Harris hip score.Results The average operation time was 42.5 min (35-90) min,the average intraoperative bleeding volume was 107.5 ml (65-410)ml,X-light exposure times were (2.5±1.4) times (2-4) times and the average total incision length was (6.5± 1.8) cm (5.5-11.0) cm.No serious complications or original complications were found during perioperative period.All patients received a 6 to 24 month follow-up (mean 12.5 months in average).The X ray examination showed that the average neck shaft angle was (134±13)° (120°-150°).The average fracture healing time was (14.0±2.5) weeks (11 to 19 weeks).The average hip Harris score was (86.5± 19.5) points (65-100 points).Among them,29 cases (22.83％) were excellent,76 cases (59.8％) were good,20 cases (15.7％) were moderate,2 cases (1.6％) were poor.Totally,excellent and good rate was 82.7％.No complications including hip varus deformity,screw cut-out and femoral shaft fractures were found.There were 14 patients (11.0％) with thigh pain and 5 patients (3.9％) with inner thigh pain.The heavier pain in 4 patients were improved by physical therapy.Conclusions Asian PFNA-Ⅱ has advantages including simple operation,fewer complications,and better clinical efficacy for the treatment of intertrochanteric fractures,but its longterm efficacy and complications still need a large sample and multi-center observation.