Adenolymphoma ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Metaplasia ; pathology ; Middle Aged ; Parotid Neoplasms ; metabolism ; pathology ; surgery

BACKGROUND: The clinical application of one-level osteotomy and multilevel osteotomy has been well documented, but currently few studies were reported to compare their biomechanical characteristics.OBJECTIVE: To investigate the biomechanical characteristics of one-level osteotomy with Dick screw fixation and multilevel osteotomy with Luque instrumentation in the treatment of kyphosis.DESIGN: Randomized comparative experiment.SETTING: Laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: Fresh specimens of thoracic and lumbar spinal segments obtained from 12 3 or 4-year-old calves.METHODS: The experiment was conducted in the laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University between September 2002 and September 2003. Fresh spinal segments T8-L5 from 12 calves were randomized into an intact group, Dick screw group with one-level osteotomy with Dick screw fixation and Luque group with multilevel osteotomy with Luque instrumentation, with 4 spesimens in each group. Lateral bending test of the specimens was performed to examine the physiological overload using an Instron 5 500 universal material testing machine at the constant speed of 10 mm/minute until fracture or dislocation was induced. Changes in the loading were recorded and the induced injuries observed to obtain the load-displacement curve of the injury test.MAIN OUTCOME MEASURES: The load-displacement curve of the destructive right bending test in each group.RESULTS:All the data of 12 canines were involved in the result analysis.The spinal segments of the intact group yielded to the force of 3 600 N with a flat and smooth load-displacement curve, and those of Dick screw group yielded to a load of 2 800 N with also a relatively flat curve, while in Luque group, the segments did not yield until a load of 7 160 N, followed by drastic decrease of the resistance to less than 4 000 N, generating a flat and smooth curve afterwards.CONCLUSION: Luque instrumentation is a little more preferable than Dick screw in terms of the maximum resistance, but this difference does not justify the clinical decision of their superiority. Both techniques benefit postoperative recovery of spinal function with strong stability.

Objective To investigate morphosis of the epiphyseal plate and the expression of vascular endothelial growth factor (VEGF) in the epiphyseal plate during healing of injured epiphysis.Methods Thirty SD rats aged 4-5 weeks were used to make models of proximal tibia epiphysis injury.These models were equally divided into 5 groups in random,with 6 rats in each group,and these groups of rats were killed separately at 2,4,6,10,21 days postoperatively to harvest the proximal tibia epiphysis,in order to explore the morphosis of the epiphyseal plate and VEGF expression pattern in the epiphyseal plate at different healing phase.The structure of the epiphyseal plate was evaluated by measuring the length of the limb and radiographic examination of the limb.The ratio of length of injured tibia and that of the other side was used to describe the tibia length discrepancy.The micro structure of the epiphyseal plate and situation of the bone bridge in the epiphyseal plate were measured by using Micro CT.By using HE stain and VEGF immunohistochemistry,the changing of chondrocyte and VEGF expression pattern in the epiphyseal plate were observed at different healing phase.Results The limb discrepancy appeared at 4 days postoperatively,became biggest at 10 days postoperatively,and tended to decrease at 21 days postoperatively.Micro CT demonstrated the fibrous bone tissue formation in the epiphyseal plate at about 6 days postoperatively,which became bone bridge finally.HE stain showed chondrocyte in the rest zone had the tendency to aggregate after injury,and the highly ordered structure of chondrocyte in the epiphyseal plate no longer existed,chondrocyte differentiation was accelerated.VEGF immunohistochemistry stain showed the high reaction of VEGF in the epiphyseal plate appeared after surgery,and the positive zone of VEGF expanded through the physis with time,which finally led to angiogenesis and ossification.Conclusion A serial alteration of morphosis of the epiphyseal plate occurred during the healing process.Fibrous bone tissue formation in the epiphyseaL plate could be observed in the early and mid-term of the healing process.With progress of healing,VEGF expression zone gradually expanded across the epiphyseal plate,which is related to the formation of bone bridge.

Objective To evaluate the diagnostic value of the 10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex in the diagnosis of diabetic peripheral neuropathy (DPN)and to search an exact diagnostic method of DPN not only economical but also easy to handle.Methods To carry out the measurements of the NCV,10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex on the patients who have been diagnosed with diabetes (DM)between April 2014 and June 2014 in the endocrinology department of our hospital.The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value serve as assessments of the diagnostic efficiency of clinically diagnostic criteria. Results The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value of the ankle reflex are 66.04%,95.56%,97.22%,54.43%,61.60%,and 0.5 1 in mediate accordance with the diagnostic criteria and it is the best one among the five methods.While the sensitivity and accordance of the pressure sense are of the least accordance with the diagnostic criteria.The correspondent value of the combination of vibration threshold sense,temperature sense and ankle reflex are respectively 86.79%,91.11%,95.83%,74.55%, 77.90% and 0.73,in positive accordance with the diagnostic criteria.Conclusion Among the five methods the consistency between the combination of vibration threshold sense,temperature sense and ankle reflect and diagnostic criteria is of positive accordance and can be applied in screening DPN clinically.

Objective To summarize the methods of diagnosis and results of surgical treatment of pancreatic insulinoma. Methods The clinical data of 137 patients with insulinoma treated in our hospital during the past twenty-six years were reviewed retrospectively.Results There were 77 males and 60 females. All of them were characterized by the Whipple′s triad. The sensitivity of ultrasonography, CT and MRI for localization was 35.1%, 67.9% and 58.1% respectively. One hundred and tweenty-six patients underwent operation. Of them, 102 cases had tumor enucleation, 4 cases had pancreaticoduodenectomy, 16 cases had distal panreatectomy, and the other 4 cases had only laparotomy. Of the 122 patients, who underwent resection, the tumor was benign in 118(96.7%) and malignant in 4(3.3%). The diameter of the tumor was less than 2cm in 86.9% of cases. In 98.4% of cases the tumors were single and in 1.6% of cases were multiple. 13.1% of the tumors located in the head, 46.7% in the body, and 40.2% in the tail.Conclusions Whipple′s triad and the measurement of fasting glucose, IRI, IGR, C-peptide, and proinsulin levels contribute to the diagnosis of insulinoma. However, the preoperative tumor localization is still difficult. Tumor enucleation is the technique of choice when feasible. Patients in whom tumor localization is unsuccessful at operation should be carefully evaluated to be certain of the diagnosis, and in general should not undergo blind resection.

Background and purpose: Langerhans cell histiocytosis (LCH) is a rare complex reticulocndotheliai disease that often invades the head and neck. There in no consensus of treatment. Radiation is one of the treatment options for the localized lesions. Our aim in the study was to analyze the radiotherapeutic efficacy for LCH in the head and neck region. Methods: 8 patients with eosinophilic granuloma (EG) and 1 case with Hand-Schuller-Christian disease (HSC) were treated with radiotherapy in our hospital from July 2000 to May 2007. Their clinical data were retrospectively analyzed. Results: 5 cases of EG were treated with tumor partial excision and radiation, while the other 3 cases of EG were given radiation alone after biopsy. The HSC was administered with radiation and endocrine therapy. All the patients were followed up for 1.5-8 years. The response rate was 89%. Conclusion: Radiotherapy of LCH is an effective modality, but the optimal dose needs to be further studied.

OBJECTIVETo investigate the clinical outcomes of cannulated screw combined with buttress plate in treating transarticular shear fractures of the distal humerus.

METHODSFrom July 2008 to December 2011, 17 patients with shear fractures of the distal humerus were treated with cannulated screw combined with buttress plate. Among them, included 10 males and 7 females aged from 20 to 59 years old (mean 36.5). All the fractures were classified into type I (8 cases), type II (1 case), type III (3 cases) and type IV (5 cases) according to Bryan-Morrey and McKee classification. According to AO/ASIF classification, 10 cases were type 13B3.1, 7 cases were type 13B3.3; according to Dubberley classification, 5 cases with type 1A, 2 cases with type 1B, 2 cases with type 2A, 2 cases with type 2B, 4 cases with type 3A, 2 cases with type 3B. There were 12 cases with fresh injuries, 4 cases with old injuries. All fractures were closed injuries. Complications and range of motion of elbow were observed, and clinical efficacy were evaluated by Broberg-Morrey standard.

RESULTSAll patients were followed up with a mean time of 21.3 months (ranged, 18 to 24). All fractures obtained bone healing from 10 to 15 weeks with a mean of 12.5 weeks. No malunion or delayed healing occurred. Two cases occurred ossification in lateral collateral ligament attachment. 2 cases occurred heterotopic ossification in the capitellum in front of capsule joint. The range of elbow extension was (16 +/- 7) degrees, flexion was (115 +/- 9) degrees, the average are of pronation and supination was (65 +/- 5) degrees and (60 +/- 5) degrees respectively. According to Broberg-Morrey standard, there were excellent in 7 cases, good in 8 cases, fair in 2 cases, and average score was 92.44 +/- 4.64.

CONCLUSIONFor transarticular shear fractures of the distal humerus, classification should be performed according to preoperative X-ray and CT, cannulated screw and buttress plate combined and early function rehabilitation could recover elbow function.

Adult ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVETo investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures.

METHODSFrom March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect.

RESULTSAll patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%.

CONCLUSIONBone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has relevant scientific basis and practical value, it can effectively reduce complications, promote patients early recovery.

Adult ; Aged ; Exercise Therapy ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Movement ; Splints

Objective To study the relationship between the expression of cytochrome c ( Cyt c) and programmed cell death 4 (PDCD4) in pancreatic cancer, and investigate the pathway of PDCD4 inducing the apoptosis of pancreatic cancer cells. Methods Pancreatic cancer specimens from 69 patients who received pancreatic resection from 1990 to 2002 in First Affiliated Hospital of China Medical University were collected. The expression of Cyt c in the 69 paraffin specimens of pancreatic cancer was detected by immunohistochemistry, and the expression of Cyt c in 8 samples of cold-preserved fresh pancreatic cancer and normal pancreatic tissues were detected by Western blot. The expression of PDCD4 and Cyt c in pancreatic cancer was analyzed by paired t test and chi-square test. Results Compared with normal pancreatic tissues, the expression of Cyt c in pancreatic cancer was significantly decreased. The positive expression rate of Cyt c in 69 samples of pancreatic cancer was 41% (28/69). The expression of Cyt c was positive in most patients with positive expression of PDCD4, and the expression of PDCD4 was negative in most patients with negative expression of Cyt c. The expression of PDCD4 and Cyt c was closely correlated with each other (χ2= 10.52, P < 0.05). Conclusions There is a close relationship between the expression of PDCD4 and Cyt c in pancreatic cancer. PDCD4 may induce the apoptosis of pancreatic cancer cells through mitochondrial pathway.

AIM:To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.
METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time ( BUT) , the Schirmer I test ( SⅠt) and tear ferning test ( TFT ) were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.
RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium (P<0. 05); However, no obvious difference was detected in the results of SⅠt (P>0. 05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk (P<0. 05), while no significant difference compared with 2mo (P>0. 05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group (P<0. 05) and there was no significant difference at 1, 2mo after surgery (P all>0. 05). SⅠt results did not differ between the different examination times(P>0. 05).
CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.