Objective To investigate the effect of different bone cement volume injected after vertebroplasty on stress distribution of the upper and lower endplates of the injured vertebra in the flexion and extension positions by finite element analysis.Methods Two patients with osteoporotic compression fractures of L2 vertebral body were chosen.Bone cement volumes of 25％ and 50％ were respectively injected into the fractured vertebral body bilaterally.Pre-and post-operative finite element models of fractured and adjacent vertebral bodies were developed after extracting the CT data.Stress changes at L2 superior-and inferior-vertebral endplates were observed in the vertical,flexion,and extension loading.Results Stress at the upper and lower endplates of the fractured vertebra increased after bone cement injection and more increase was observed in 50％ bone cement group than in 25％ bone cement group.In the neutral position,the stress mainly concentrated at posterior vertebral body,with stress of the upper endplate improving from 0.91 × 106 N · mm to 0.93 × 106 N · mm and stress of the lower endplate from 0.98 × 106 N ·mm to 1.03 × 106 N · mm.In the anterior flexion,the stress mainly concentrated at anterior vertebral body,with stress of the upper endplate improving from 4.44 × 106 N · mm to 5.55 × 106 N · mm.In the posterior extension,the stress mainly concentrated at medial vertebral body,with stress of the upper endplate improving from 21.95 × 106 N · mm to 22.10 × 106 N · mm and stress of the lower endplate from 30.60 ×106 N · mm to 30.88 × 106 N · mm.The finite element model revealed stress at the upper and lower endplates was higher in the anterior flexion and posterior extension than in the neutral position,while in the anterior flexion the stress was comparatively higher.Conclusions A small amount of implanted bone cement act no evident effect on stress distribution of the upper and lower vertebral endplates.However,the stress changes are significant as cement volume reached up to 50％,especially in the flexion position,as may suggest an enhanced risk of adjacent intervertebral disc degeneration and adjacent vertebral body fractures.

Objective To explore the early-term efficacy of the reconstruction ot acetabular bone loss with porous tantalum acetabular components in total hip arthroplasty.Methods Twenty-one patients (21 hips) were included in this study,which had an acetabular replacement with tantalum acetabular components from August 2009 to April 2012.There were 6 males and 15 females,with the mean age of 55.7±16.2 years (range from 24 years to 78 years).The primary total hip arthroplasty in 5 cases,the revision in 16 cases.The acetabular bone defects were classified as Paprosky classification,which included,type Ⅰ in 9 cases,type Ⅱain 4,type Ⅱb in 5,type Ⅱcin 1,type Ⅲa in 1 and type Ⅲb in 1 case.Results The mean follow-up time was 20.1 months (range,6-40 months).In Paprosky Ⅰ,the Harris hip score was 87.2±7.4 postoperatively,which was significant higher than the preoperative score 41.1±6.3.In Paprosky Ⅱ,the Harris hip postoperative score (79.8±11.8) was significant higher than the preoperative score (38.4±12.5).In Paprosky Ⅲ,the Harris hip postoperative score (79) was significant higher than the preoperative score (24).21 Tantalum components were well fixed by the radiograph imaging.No cases suffered aseptic loosening and migration.Bone ingrowths was obviously performed in 21 hips.But 2 hips had a radiolucent line,1 case occurred in zone 3 and the line was filled 4 months later,the other case still existed at last follow-up without any more widen.No infections or mechanical failures.The survivorship of the tantalum acetabular components was 100％.Conclusion Our short-term results suggest this implants may enhance biological fixation in acetabular defect cases.Porous tantalum cup appears to be an ideal material to facilitate biologic ingrowths in these cases.Long-term follow-up still needs to be confirmed.

Objective To investigate the changes of platelet aggregation rate and platelet surface CD 41+CD62P+ expression af-ter clopidogrel discontinuation in the patients with percutaneous coronary interventions (PCI)) .Methods The platelet aggregation rates and platelet surface CD41+CD62P+ in 52 PCI patients with oral clopidogrel for near 12 months and discontinuation soon were measured before clopidogrel therapy(T0 ) ,in 1 week after clopidogrel therapy(T1 ) ,1 week before clopidogrel discontinuation(T2 ) , 1 week(T3 ) and 1 month after clopidogrel discontinuation (T4 ) .Results Compared with T0 ,the platelet aggregation rate and the expression of platelet CD41+CD62P+ at T1 were significantly decreased ,the difference showing statistical significance (P<0 .05) , which at T2 maintained the lower levels ;which at T3 were increased ,which at T4 were recovered to those at T0 .The platelet aggre-gation rates at various time points were (44 .20 ± 18 .36)% ,(25 .38 ± 12 .10)% ,(23 .74 ± 8 .15)% ,(51 .79 ± 10 .55)% and(45 .97 ± 16 .42)% respectively ,and the positive rates of CD41+ CD62P+ were(12 .96 ± 11 .48)% ,(3 .93 ± 3 .33)% ,(4 .72 ± 3 .14)% , (13 .90 ± 10 .38)% and(10 .84 ± 8 .13)% ,respectively .Conclusion In the patients treated with 12-month clopidogrel after PCI ,the platelet aggregation rate and the CD41+CD62P+ positive rate are mildly increased at 1 week after clopidogrel discontinuation and gradually returned to the level before discontinuation at 1 month after clopidogrel discontinuation .

Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .

Objective:To investigate the structural alterations of mitochondria and its role in neutrophil death induced by ONO-AE-248.Methods:Human neutrophils were cultured in vitro with ONO-AE-248(5?10-5 mol/L)and medium alone. Transmission electron microscopy(TEM) was used to detect the structural alterations of mitochondria and the level of mitochondria membrane potential by flow cytometry using mitocapture dying.Results:ONO-AE-248 resulted in extremely swollen mitochondria within 6 hours. Meanwhile, a rapid loss of mitochondrial membrane potential of neutrophils occurred, especially in 3 hours and 6 hours. There were obviously differences between spontaneous apoptosis and non-apoptosis programmed cell death induced by ONO-AE-248.Conclusion:The experiment results suggest that changes of mitochondrial structure and function be typically morphological, physiological and biochemical features in this unique form of neutrophil death, and that the mitochondrial pathway might play a more important role in ONO-AE-248-induced death of neutrophils.

This paper designs a heart sound processing analog circuit, in which the amplification circuit, the filter circuit and the lifting of electrical level circuit are involved. It also gives a safety design problem analysis using an electret capacitor microphone to pick-up the heart sound signals. It is proved that the circuit is reliable and effective.

Sacral fractures are usually caused by high-energy violence,often complicated with injury to the lumbosacral plexus.In severe cases,they may cause instability of the posterior pelvic ring or of the lumbosacral junction.Their classifications commonly used in clinic are Denis,Tile,Isler and refined Denis type Ⅲ ones proposed by Roy-Camille and Gibbons.Recently,classifications of the lumbosacral lesions and scoring systems of the injury severity have often been used clinically.At present,internal instrumentation of sacral fractures is developing along the direction of high efficiency,safety and minimal invasion,but different methods of internal fixation have their own indications which should be strictly followed.This review summarizes the classifications of sacral fractures and their treatment advances.

Objective To investigate the clinical features of patients with recurrent epithelial ovarian cancer (EOC),and explore the factors that can prolong the disease-free interval(DFI) after primary treatment.Methods We retrospectively reviewed the medical records of 54 patients with recurrent EOC and analyzed the clinical stage,histological subtypes,primary treatments,DFI,recurrent site,secondary treatment,and the response after secondary treatment.By Mann-Whitney test and T test,factors influent the DFI were analyzed,the relationship between DFI and the response after secondary treatment were analyzed also.Results The mean DFI for all 54 patients was 19.07 months.The DFI of patients received optimal cytoreductive surgery was longer than those received non-optimal cytoreductive surgery [(32 ± 19.10) months vs (18.77 ± 7.80) months,P ＜ 0.01];The DFI of patients with serous,mucous and clear cell tumor was [(20.16 ± 14.63) months,(14.00 ± 4.73) months and (16.67 ± 13.03) months,respectively],suggesting patients with mucous tumor might have shorter DFI.The DFI of patients with low tumor grade was longer than those with high tumor grade [(28.18 ± 16.97) months vs (16.52 ±9.46) months,respectively];The DFI of patients with stage Ⅰ and Ⅱ disease was [(19.60 ± 12.89)months],was compared to the DFI of patients with stage Ⅲ,stage Ⅳ disease,which was [(19.22 ± 12.38) months] and [(11.67 ±5.39) months],respectively.When disease recurred,the most frequent recurrent site was pelvic (50％,n =27),with upper abdominal (29.6％) and lymph node(29.6％) followed.When recurrence was found in lymph node,the most frequent site was pelvic and para-arotic lymph node.In our study,when disease recurred,response of the tumor after the secondary treatment has no relationship with the DFI.Conclusions Patients received optimal cytoreductive surgery,patients with low tumor grade and early stage have longer DFI.Retroperitoneal lymphadenectomy might be chosen during the primary cytoreductive surgery in some selected patients.

Objective To determine the efficacy of hysteroscopy and laparoscopy in differential diagnosis of pregnancy-related diseases,including gestational trophoblastic neoplasia(GTN),incomplete abortion and ectopic pregnancy.Methods Twenty-seven patients with a suspected diagnosis of GTN were transferred to Peking Union Medical College Hospital from September 2003 to March 2006,and underwent hysteroscopy and laparoseopy.Clinical data of patients were reviewed retrospectively.Most patients had abnormal vaginal bleeding and persistently elevated plasma beta human chorionic gonadotropin(?-hCG) level for a median(53?37)days(range,15-125 days)after evacuation.Ultrasound revealed a lesion with affluent blood flow in intrauterine,unilateral horn of uterus,or myometrium.No positive findings were revealed by computerized tomography or X-ray of the chest in all patients.Eleven patients underwent evacuation under hysteroscope,10 patients were diagnosed and treated by laparoscopy,and 6 by hysteruscopy and laparoseopy.Results Choriocarcinoma was diagnosed in 4 patients,who achieved complete remission by chemotherapy later.The diagnosis of GTN was ruled out in the other 23 patients, including cornual pregnancy in 12,pregnancy in rudimentary horn in 1,and incomplete abortion in 10,who were cured by hysteroscopic and laparoscopic surgery and postoperative adjuvant single dose methotrexate.Conclusions The major causes of pregnancy-related abnormal bleeding include incomplete abortion,eetopic pregnancy,and GTN.Hysteroscopy and laparoseopy are effective alternative of diagnosis for differentiation of GTN from non-GTN and can also offer therapeutic treatment.

Objective:To explore the related risk factors of antepartum depression and anxiety,and to provide the theoretical support for early screening,clinical intervention and prevention of antepartum depression and anxiety.Methods:At the time of 28 weeks of prenatal examination,the Edinburgh Postnatal Depression Scale (EP-DS),Self-Rating Anxiety Scale (SAS)were used to survey 2112 pregnant women who were selected from Maternal and Child Health Hospital of Kunming City.Non conditional logistic regression analysis was used to explore the re-lated risk factors of prenatal depression and anxiety.Results:At the 28 weeks of pregnancy,the detection rate of de-pression symptoms and anxiety symptoms were 25.4% and 6.6%.Logistic regression analysis showed that the risk factors for perinatal depression symptoms were younger age (OR =0.80,95%CI:0.68 -0.94),not stick to work during pregnancy (OR =1.18,95%CI:1.02 -1.36),not satisfied with the living environment (OR =1.50,95%CI:1.23 -1.83),expectations for boys (OR =0.86,95%CI:0.77 -0.96),not only daughter (OR =1.37,95%CI:1.06 -1.76),unplanned pregnancy (OR =1.38,95%CI:1.10 -1.72).The risk factors for perinatal anxiety symp-toms were being not satisfied with the living environment (OR =1.64,95%CI:1.19 -2.26),not harmonious with her husband (OR =2.01,95%CI:1.20 -3.37),unplanned pregnancy (OR =1.50,95%CI:1.05 -2.14).Conclu-sion:It suggests that the pregnant women with younger age,less working during pregnancy,being not satisfied with the living environment,having more expectations for boys,being not only daughter,with unplanned pregnancy are more likely to suffer from antepartum depression;those being not satisfied with living environment,having harmoni-ous relation with her husband,and with unplanned pregnancy are more likely to suffer from antepartum anxiety.