Objective To evaluate the advantage of using computer navigation system in the resection of rib tumors.Methods We carried out rib tumor resection in 5 patients using computer navigation system.Preoperative CT of each patient was performed.The preoperation CT-based planning was made for every patient with the navigation system software including confirming the tumor surgical margin and designing resection margin.A C-arm scan was carried out intraoperatively.With image fusion of both data,tumor resection were performed under navigation image guidance.Results The mean time of image fusion was 58 minutes.Four tumor resection specimens showed safe and clear margins.Histological examination of all tumor specimens showed tumor-free margins.One patient who was suspected lung cancer with bone metastases was performed a biopsy under navigation image guidance and obtained a pathology diagnose successfully.Conclusion The computer navigation system helps surgeons determine the surgical margin,implement precision tumor resection and reduce surgical damage.

Objective To evaluate the changes of rectal morphology and its clinical value in internal rectal prolapse.Methods The rectal morphology of internal rectal prolapse in thirty-one patients with functional constipation and ten normal control subjects was analysed with defecography.The data were analysed with Mann-Whitney Unonparametric test and Fisher's exact test.Results 23 cases and 2 cases with rectal intussusception in patients group and control group respectively were found.Fisher's exact test was P=0.007.In patients group and control group,the thicknesses of anterior intussusception were(13.51 ±9.42)mm and(3.68±2.34)mm,and posterior intussusception were(5.36±3.92)mm and(2.82±0.99)mm respectively;the intussuscipiens diameters were (37.19±11.79)mm and(25.32±9.25)mm,the intussusceptum lumen diameters were(14.91±4.74)mm and(19.73±6.36)mm,the ratio of intussuscipiens diameters and lumen diameters were 2.82±1.64 and 1.28±0.12,the maximum rectal diameter were(48.97±9.55)mm and(39.84±8.45)mm at rest state.There were significant differences between patients group and control group in above varied values(P＜0.05).Conclusion Defecography can differentiate whole thickness rectal intussusception from rectal mucosal prolapse,which provides the scientific basis for choosing the reasonable treatment.However,caution is required when selecting patients for treatment interventions based on defecography.

ObjectiveTo discuss the effects of apoptosis and invasion of RBE cells caused by miRNA 21 suppression and further investigate the potential role of miRNA-21 plays on target mRNA regulation. MethodsThe RNAi technology was employed to suppress the expression of RBE cells.The changes in RECK mRNA and protein expressions were detected by RT-PCR and Western blotting respectively. Changes occurred in apoptosis was closely monitored by flow cytometry (FCM). The invasion of RBE cells was analyzed in vitro by invasion assay (transwell). ResultsThe expression of miRNA-21 was clearly suppressed while the RECK mRNA and protein were over-expressed. The rate of apoptosis was significantly accelerated and there was a dramatic decrease in RBE cells' ability to invade after miRNA-21 knockdown. ConclusionThrough miRNA-21 suppression, the rate of apoptosis of RBE cells was accelerated whereas their invasion ability was greatly reduced. RECK was found to be the target gene of miRNA-21 which participates in the regulation process of regulation.

OBJECTIVETo establish a modified plasma protamine paracoagulation test.

METHODSPlasma protamine paracoagulation, modified plasma protamine paracoagulation and D-dimer (D-D) tests were performed for the plasma samples collected from 98 cases of disseminated intravascular coagulation (DIC) and 156 normal subjects. The sensitivity and specificity of the 3 tests were analyzed. The plasma samples from 8 cases of suspected myocardial infarction were detected using modified plasma protamine paracoagulation for diagnostic purpose.

RESULTSThe sensitivity of plasma protamine paracoagulation, modified plasma protamine paracoagulation and D-D tests was 16.33%, 88.76% and 77.56%, and the specificity was 100%, 88.46% and 97.44%, respectively. Positive results occurred earlier in modified plasma protamine paracoagulation test than in plasma protamine paracoagulation and D-D tests in 5 cases of myocardial infarction.

CONCLUSIONThe modified plasma protamine paracoagulation test has a higher sensitivity than plasma protamine paracoagulation test and a higher specificity than D-D test, and can be helpful in early diagnosis of thrombosis and fibrinolysis.

Adult ; Blood Coagulation Tests ; methods ; Female ; Humans ; Male ; Middle Aged ; Protamines ; blood ; Sensitivity and Specificity ; Thrombosis ; blood ; diagnosis

OBJECTIVETo explore clinical effects of manipulative reduction with minimally invasive percutaneous plate osteosynthesis in treating distal tibiofibular fractures.

METHODSFrom 2009 to 2011, 60 patients with distal tibiofibular fractures were treated by manipulative reduction with minimally invasive percutaneous plate osteosynthesis. Among them, there were 32 males and 28 females aged from 14 to 70 years old with an average of 41.22 +/- 2.06. According to AO classification of fractures,5 cases were type A1, 22 cases were type A2,21 cases were type A3 and 12 cases were type C1. Operation time, blood loss,time of callus and fracture healing were observed, Mazur scoring of ankle joint were used to evaluate therapeutic.

RESULTSFifty-eight incisions were healed at stage I ,and 2 cases were infected at distal tibial. Operation time was with an average of (62.34 +/- 5.66) min ranged 45 to 90 min;blood loss was 30 to 150 ml with an average of (80.57 +/- 5.59) ml;formation of callus appeared from 4 to 12 weeks,with an average of (8.24 +/- 2.06) weeks, and fracture healing time was from 3 to 6 months, with an average of (4.50 +/- 1.13) months. According to Mazur scoring of ankle joint 40 cases got excellent results, 18 good, and 2 fair.

CONCLUSIONManipulative reduction with minimally invasive percutaneous plate osteosynthesis can obtain reliable fixation. It is a good choice of treating distal tibiofibular fractures by protecting blood supply of fractures.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective 3D printing has been used in the assistanceof surgical planning and the development of personal-ized prostheses.This study was to determine the feasibility of using a 3D printer for the purpose of producing personalized pros-theses for complex rib fracture fixation .Methods Using data from a high-resolution CT scan of 10 ribs of 3 cases with rib frac-ture, rib moldswere generated with computer software and fabricated with the 3D printer using the fused deposition modeling method.The 3D printing molds were used for custom-designed titanium plate.Results The average length of the 3D models of ribs is 8.45 cm.The mean time of fabricating models was 18.8 minutes and 4.6 gram polylactic acid was consuming on aver-age.The mean error of dimension of 3D models is less than 0.2 mm.Reshaping plates spends 3.3 minutes on average.Radio-logical follow-up for bothcases demonstrated successful fixation at 3 months.Conclusion These cases demonstrate the feasibili-ty of the use of 3D modeling and printing to develop personalizedplates and can ease the difficulty of complex rib fracture .

Objective To prepare a human meningococcal reference serum and standardize IgG concentrations to capsular polysaccharides and in vitro bactericidal activities of the reference serum against serogroup A, C, Y and W135 strains.Methods Twenty healthy adults were recruited and given one dose of immunization with tetravalent (serogroups A, C, Y and W135) meningococcal polysaccharide vaccine . Plasma samples were collected and gone through a series of process treatments including defibrination , filtra-tion, and lyophilization to prepare the meningococcal reference serum Men 10.The IgG concentrations of Men10 to capsular polysaccharides of serogroups A , C, Y and W135 were calibrated by using an internation-al reference serum CDC1992 as the standard in enzyme-linked immunosorbent assay (ELISA).Provisional IgG concentrations of Men10 were intensively validated by testing a panel of 12 calibration serum samples from Centers for Disease Control and Prevention , USA ( US CDC) and a panel of 56 serum samples immu-nized with A, C, Y and W135 meningococcal polysaccharide vaccine from Lanzhou Institute of Biological Products Co., Ltd.(LIBP) with the assays using Men10 and CDC1992 as the standard and/or test sam-ples, respectively.The bactericidal titers against serogroup A , C, Y and W135 strains were measured by se-rum bactericidal assay (SBA).Results Four thousand vials (0.5 ml/vial)of lyophilized human meningo-coccal reference serum Men10 were successfully prepared with 2.5%of residual moisture .Reference serum Men10 was sterile and free from contamination by hepatitis B virus , hepatitis C virus , human immunodefi-ciency virus and syphilis .Provisional IgG concentration of Men 10 to capsular polysaccharide of serogroups A, C, Y and W135 was calibrated by using CDC1992 as the standard.Furthermore, IgG concentrations of both panels of 12 CDC calibration serum samples and 56 LIBP serum samples calibrated by using Men 10 as the standard correlated well with those by using CDC1992 as the standard (r=0.99,P<0.05).The IgG concentrations of CDC1992 as calibrated by using Men10 as the standard showed significant correlation with its previously determined values with variation <10%.SBA titers for serotype A , C, Y and W135 strains were established as well .Conclusion A panel of new human meningococcal reference serum Men 10 with accurately calibrated IgG concentration against capsular polysaccharide of serogroups A , C, Y and W135 as well as SBA titers was successfully established .

Objective To explore the possibility of minimally invasive resection of chest wall tumor by video-assisted tho-racoscopic surgery( VATS) .Methods Retrospective analysis of 24 cases of chest wall tumors with minimally invasive resec-tion by VATS from June 2013 to May 2017, including 13 cases of bone fibrous dysplasia, 7 cases of rib abnormal hyperplasia of fiber, 2 cases of cartilaginous tumor, 1 case of Langerhans histiocytosis and 1 case of extramedullary single plasma cell tumor.3 cases with C arm positioning in operation and 4 cases with computer navigation and positioning .Results 24 cases of rib tumors were successfully removed .No surgical death and serious complications occurred in this group .All patients followed up 1-3 years, there is no recurrence.Conclusion Resection of rib tumors with VATS can bring precise resection and lead to minimally invasive.

Background: Chemotherapy-induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization (TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active-acupuncture (n= 72) or placebo-acupuncture (n= 70) groups using a covariate-adaptive randomization at a ratio of 1:1. The acupoints Hegu (LI4), Neiguan (P6), and Zusanli (ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory (MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored. Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not signiffcant (allP > 0.05). From the second day after TACE, anorexia scores were signiffcantly lower in the active-acupuncture group than in the placebo-acupuncture group and continued to decrease over time with treat-ment (allP values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active-acupuncture group were slightly lower than those for the placebo-acupuncture group, but the differences were not statistically signiffcant (all P > 0.05). No signiffcant differences were found between the two groups in the occurrence rate of any adverse event (P > 0.05). Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.

Objective: To detect the expression of the plateau adaptablity gene (EPAS1, EGLN1 and PPARα) and proteins ( HIF-2, PHD2 and PPARα) in rats blood, heart, liver, lung and kidney tissue after the rats exposed to high altitude . Methods:The Wistar rats were randomly divided into plain group ( Shanghai , 55 m) , acute exposure to high altitude 3400 m group, acute exposure to high altitude 4300 m group.Blood and organs of rats were collected in 1, 3, 5 days after arrival.Real time PCR and ELISA were used to compare the expression of plateau adaptablity gene and related protein between plain group and high altitude exposure groups .Results: The count of red blood cells , hemoglobin and HCT in high altitude 4300 m were higher than those in plain group .Compared with plain group , the expression of EPAS1 gene in blood, heart, liver and kidney tissue of rats at high altitude increased obviously (all P<0.05);the expression of EGLN1 in the heart, liver, brain and kidney increased , and PPARαgene in the heart, liver and kidney increased (all P<0.05).Compared with plain group , the expression of HIF-2 protein increased significantly at high altitudes in the liver, brain and kidney tissues .PHD2 and PPARαincreased in the heart , liver and kidney.Conclusion: Plateau adaptive genes ( EPAS1, EGLN1 and PPARα) and protein ( HIF-2, PHD2 and PPARα) differed in different altitude and different organizations .They might be used as target markers of plateau hypoxia .