[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation.[Method]A total of 18 cases(28 feet) of hallux valgus were treated with modified Mitchell operation from Apr.2000 to Oct.2003.The average preoperative hallux valgus angle(HVA) was 30.5 according to the X-ray images,while the average intermetatarso-phalangeal angle(IMA) was 13.5.The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge left.The distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mm.Absorbable screws were used for fixation.[Result]All 28 feet were followed up for 10~32 months.It showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 92.9%.According to the postoperative weight-loading X-ray checking result,the average HVA was 15.5,with an average improving of 15;the average IMA was 8.5,with an average improving of 5.[Conclusion]The modified Mitchell operation can correct the metatarso-varus without destroying the biomechanical status.The loading function of great toe could be resumed by the removing of the first metatarso head.

Objective:To investigate the clinical efficacy of every 3-week regimen of oxaliplatin (OXA) plus 5-fluorouracil (5-FU)/leucovorin(CF)as postoperative adjuvant chemotherapy for colorectal cancer.Methods:Ninety eight patients with stage Ⅱ to stage Ⅲ colorectal cancer received every 3-week OXA plus 5-FU/CF adjuvant chemotherapy for six cycles after resection surgery. All the patients received a complete reexamination every 3 months after the end of adjuvant chemotherapy. The disease-free survival period and 1- and 2-year disease-free survival rates were observed.Results:The total 2-year disease-free survival rate was 74.5%. It was 87.0% for stageⅡpatients and 63.5% for stage Ⅲ patients. The main adverse reaction included peripheral neurotoxicity, neutropenia and diarrhea at grades Ⅰ to Ⅱ. Grades Ⅲ to Ⅳ adverse reactions occurred rarely.Conclusion:The every 3-week OXA combined with 5-FU/CF adjuvant chemotherapy regimen had definite efficacy and good tolerance, which was a rational choice of postoperative adjuvant chemotherapy for colorectal cancer.

Objective For drinking water deep treatment,this study compared the abilities of several common domestic products of activated carbon in virus removal from water through adsorption. Methods This study compared the abilities in virus removal of two types of granular activated carbon (GAC) materials (domestic product made of coconut shell) and one type of activated carbon fiber (ACF) material (domestic product made of mucilage glue-based ACF felt) under a fixed condition (phosphate buffered saline-PBS solution,pH =7.3,25 ℃) and the abilities of one of the above two GAC types under various conditions (before and after pretreatment,15-35 ℃,pH= 6.0-8.4,concentration of Ca2+ 0-500 mg/L,ionic strength 0-0.1 mol/L). The tested virus was the indicator phages obtained from sewage with an enterobacterium (Escherichia coli 285). Results The removal process with the GACs followed the first order kinetic model (R2: 0.83-0.99),whereas that of the ACF did not (R2: 0.44-0.64),with the rate constants of 0.505 3-2.606 8 (GACs) and 0.219 2-0.413 8 (ACF). Pretreatment (boiling for 2 h and then washing in deionized water) could both increase and decrease the removal effects,depending on the GAC sources. Different abilities in virus removal were found between the two GACs with their comparative outcomes depending on if they were subject to the pretreatment; higher levels of temperature,Ca2+ concentration,and ionic strength,and slight acidic and alkaline conditions favored virus removal. Calculation from the first order kinetic simulation showed that: the removal percentage within 15 min was around 30% with the highest 40% and the lowest 5%; and the maximum removal during the experimental period of 5 h reached 5-log. Although the amount (1 g) of the GACs used was ten times of that of the ACF (0.1 g),the measured values showed that the latter had faster initial removal rates than the former. Conclusion The three domestic products of activated carbon showed a large difference in their abilities to remove the viruses from water through adsorption with their comparative outcomes depending on the experimental conditions. If the short duration (about 15 min) currently employed in activated carbon treatment process is considered,it will be necessary to study the ways in promoting virus removal through adsorption onto the activated carbon materials of domestic products used in this experiment.

Objective: To evaluate the impact of the number of negative lymph nodes on disease free survival (DFS) of patients with locally advanced gastric cancer. Methods: A total of 485 patients who underwent surgery for gastric cancer were enrolled in this study. We analyzed the data of these patients including complete information of follow-up and definite postoperative pathological results. The disease free survival of all patients was more than 6 months and was analyzed according to the pathological stage respectively. COX regression analysis was performed to screen the independent prognostic factors. Kaplan-Meier method was used to draw the disease free survival curve and the disease free survival rate was compared among subgroups. Results: Cox regression analysis showed that the disease free survival rate of gastric cancer patients with pathological stage T_3N_(0～2)M_0 was significantly associated with age, degree of tumor differentiation, tumor location as well as the number of negative lymph nodes. In the T_3N_0M_0 subgroup, when the number of negative lymph nodes was 1 to 4 and 5 or more, the 2-year disease free survival rate was 8.3% and 55.6%, respectively, and the 3-year disease free survival rate was 0 and 24.9%, respectively (P=0.025).In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 3 or less, 4 to 9, and 10 or more, the 2-year disease free survival rate was 17.3%, 39.1%, and 52.6%, respectively, and the 3-year disease free survival rate was 4.2%, 6.0%, and 17.1%, respectively (P<0.001). In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 7 or less and 8 or more, the 2-year disease free survival rate was 11.5% and 35%, respectively, and the 3-year disease free survival rate was 0.8% and 5%, respectively (P=0.015).Conclusion: For gastric cancer patients with pathological stage T_3N_(0～2)M_0, the number of negative nodes could reflect the level of regional lymph node dissection. The number of negative nodes can be an index for evaluation of the accuracy of pathological staging and is considered as an independent prognostic factor for disease free survival of gastric cancer patients.

BACKGROUND: Nitric oxide (NO) is synthesized by catalysis of nitric oxide synthase (NOS). Three distinct isoforms of NOS have been detected in different structures of the guinea pig cochlea. However, there are still rather controversies about the definite localization and expression of NOS isoforms in guinea pig cochlea.OBJECTIVE: To investigate localization and expression of three NOS isoforms in the cochlea of guinea pigs, and to explore the effect of NO on auditory physiology and pathophysiology of inner ear.DESIGN: An observed and controlled study.SETTING: Department of Physiology, Jinzhou Medical College; Department of Orthopedics, the Second Affiliated Hospital of Jinzhou; Department of Otorhinolaryngology, Jinzhou Central Hospital.MATERIALS: The study was performed in Hearing Research Laboratory of China Medical University from May to November 2000. Ten healthy male albino guinea pigs, with body mass of 250-300 g, with sensitive Preyer's reflexes and normal drum membrane and external auditory canal,were selected.METHODS: After anesthesia, guinea pigs were decapitated and the temporal bones were removed immediately. The round and oval windows were opened, perfused with 40 g/L paraformaldehyde, and the specimens were immersed in the same fixative solution for 2 hours. Decalcification of the cochleae was performed in 100 g/L EDTA solution for 1 week. Then the specimens were placed in 250 g/L sucrose solution overnight and embedded in OCT. Cryostat (20 μm) sections were prepared for immunohistochemistry.MAIN OUTCOME MEASURES: Localization and expression of three NOS isoforms in the cochlea of guinea pigs.RESULTS: All data of ten guinea pigs was entered the final analysis without any loss. [1] Neuronal-type nNOS and endothelial-type eNOS immunoreactivity were localized in inner and outer hair cells of the organ of Corti, as well as in spiral ganglion cells. In addition, staining for nNOS and eNOS were also seen in the marginal cells of stria vascularis, spiral ligament cells, and in nerve fibers. [2] Inducible-type iNOS immunoreactivity was also detected in above each structure of the guinea pig cochlea under physiological conditions.CONCLUSION:NO may play an important role in neurotransmission,blood flow regulation, and cytotoxicity.

OBJECTIVETo observe the effects of electroacupuncture (EA) with branch-foundation acupoint combination on the indices regarding pituitary-target gland axis in aging rats with yang deficiency, so as to explore its regulating mechanism on aging rats with yang deficiency.

METHODSForty healthy Sprague-Dawley female rats were randomly divided into a normal control group, a model group, an EA group and an EA control group, 10 rats in each group. Except the normal control group, the rats in the rest 3 groups were all treated with subcutaneous injection of D-galactose for 40 d, followed by intramuscular injection of hydrocortisone for 7 d to establish aging model with yang deficiency. After the successful establishment of model, the EA group was treated with EA at "Guanyuan" (CV 4), "Housanli" (ST 36) and "Baihui "(GV 20) while the EA control group was treated with EA at "Zhongji" (CV 3) "Yinlingquan" (SP 9) and "Yintang" (GV 29); the rats in the normal control group and model group were immobilized and fixed during the same time period. The treatments were given 6 times per week totally for 4 weeks. With radiation immunity analysis method, the 8 biological indices of pituitary-target gland axis, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine-4 (T4), adrenocorticotropic hormone (ACTH), corticosterone (CORT), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were detected to observe the changes of their content.

RESULTSCompared with the normal control group, the serum level of TSH, T3, T4 and E2 were reduced in the model group (P<0.05, P< 0.01) while those of ACTH, CORT, FSH and LH were increased (P<0.05, P<0.01). Compared with the model group, the serum level of TSH, T3, T4 and E2 were increased in the EA group (P<0.05, P<0.01) while those of ACTH, CORT, FSH and LH were significantly reduced (P<0.05, P<0.01). Compared with the EA control group, the content of TSH was increased in the EA group without statistical significance (P>0.05), that of T3, T4 and E2 was increased (all P<0.05) and that of ACTH, CORT, FSH and LH was significantly reduced (all P<0.05).

CONCLUSIONThe electroacupuncture with branch-foundation acupoint combination has benign regulating effects on the key hormones of pituitary-target gland axis, which could effectively improve the dysfunction of pituitary-target gland axis that is caused by aging with yang deficiency; the efficacy of electroacupuncture with branch-foundation acupoint combination is superior to that of adjacent control acupoint combination.

Acupuncture Points ; Adrenocorticotropic Hormone ; blood ; secretion ; Aging ; blood ; metabolism ; Animals ; Disease Models, Animal ; Electroacupuncture ; Estradiol ; blood ; secretion ; Female ; Follicle Stimulating Hormone ; blood ; secretion ; Humans ; Pituitary Gland ; secretion ; Rats ; Rats, Sprague-Dawley ; Thyroid Hormones ; blood ; secretion ; Yang Deficiency ; blood ; metabolism ; therapy

Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cystic Fibrosis ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

Objective To evaluate the dosimetric impact from collimator angles during the VMAT planning for upper thoracic esophageal carcinoma.Methods VMAT plans for 8 cases of upper thoracic esophageal were studied.Ten different plans with respective collimator angles (0,5,10,15,20,25,30,35,40,45 degrees) were determined for each case,and the treatment planning parameters were compared.Results The 20 degree group represented with best performance,and 0 and 45 degree group were most frequently used in clinical practice.Statistical analysis shown that among these groups,V10,V15 and V30of total lung were significantly different (F =5.328,8.033,28.424,P ＜ 0.05),and differences of maximal dose of spinal cord and total MU were also significant (F =9.608,4.464,P ＜ 0.05).Conclusions A proper collimator angle is important in VMAT planning for upper thoracic esophageal and may lead to optimal results.

Physical training induces beneficial adaptations,but long excessive exercise may lead to severe damage to the skeletal muscles,liver,heart,kidneys and immune functions. Over the past few decades,health scholars have been searching for natural components that can prevent or improve the damage induced by hyperkinesis. The mechanisms of organ damage induced by long overtraining include immunosuppression,metabolism disorder,hormone disturbance,oxidative damage, etc. Natural poly-saccharides have interventional effects on these injuries,possibly by improving immunity,regulating metabolism and ameliorating free radical damage.

Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications