Objective To detect serum bone specific alkaline phosphatase(BAP) and osteocalcin(OC) in children with idiopathic short stature(ISS),and explore the status of osteoblast.Methods Thirty-six cases of ISS in this study were divided into two groups(preaddescence group and adolescence group),50 healthy children as control group.The height,weight and body mass index in every group were measured.Left hand and wrist were measured with CHN way for bone age.Serum BAP and OC were measured by enzyme linked immunosorbent assay(ELISA).Results BAP and OC in ISS group of preadolescence were(79.90?25.96) U/L,(60.96?18.46)?g/L,and(152.17?35.36)U/L,(76.16?28.03)?g/L in normal children.In the ISS group of adolescence BAP and OC were(108.33?35.20)U/L,(63.82?24.81)?g/L,and(156.30?35.29)U/L,(104.92?28.26)?g/L in normal group.There was significant difference between ISS and control group in both age in the levels of BAP and OC(Pa

Objective Stress radiography provides an objective tool to measure posterior knee instability.This study was conducted to evaluate the intraobserver and interobserver reliability of measurements using Telos device to quantify posterior knee instability,compared wim KT-1000 and PDT test for consistency analysis.Methods From October 2008 to June 2009,68 stress radiographs in 34 patients with posterior knee instability were taken using Telos device.The amount of posterior displacement on the radiographs was measured independently by 2 surgeons on 2 separate occasions.Changes in intraclass correlation coefficients(ICCs)were examined to assess the intraobserver and interobserver reliability of the measurement,and were compared with those from KT-1000 and PDT test for consistency analysis.Results Intraobserver ICC was 0.992,while interobserver ICC Was 0.991.There was no significant difierence between Telos and KT-1000 in pair-t test.The data from Telos device was consistent with KT-1000.The coincident ratio Of PDT test was 20% while the posterior displacement of the tibia calculated on stress radiography was 5-10 mm.The coincident ratio of the PDT was 71.4% while the posterior displacement of the tibia calculatcd from stress radiography was 10-15 mm.Conclusion Using Telos device for stress radiograph provides a reproducible method to quantify posterior knee instability,and the consistency between Telos divece and KT-1000 was reliable.The coincident ratio of the PDT test with stress radiography increased when the posterior displacement of the tibia from stress view became more severe.

Objective To explore the clinical significance of dynamic determination of serum procalcitonin(PCT)levels in judgment of infection and prognosis in patients with severe craniocerebral injury.Methods A total of 80 patients with severe craniocerebral injury were selected and they were divided into infection group and non-infection group.Infection group was divided into improved group and non-improved group.Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score and Glasgow coma scale(GCS)score was compared between infection group and non-infection group.The level of serum PCT,white blood cell count(WBC),C-reactive protein(CRP)and interleukin(IL)-6 was compared on the first,third,fifth day of admission in intensive care unit among these groups.Results Infection group in 48 patients,and non-infection group in 32 patients.There was no significant difference in age,sex and GCS score between two groups(P ＞0.05).APACHE Ⅱ score in infection group was higher than that in non-infection group [(21.71 ± 7.13)scores vs.(15.32 ± 6.17)scores],and there was significant difference (P＜ 0.05).The level of serum PCT on the first day of admission in intensive care unit in infection group was higher than that in non-infection group[(2.15 ± 1.79)ng/L vs.(0.56 ± 0.47)ng/L],and there was significant difference(P＜ 0.05).There was no significant difference in WBC,CRP and IL-6 between two groups(P＞0.05).The level of serum PCT,WBC,CRP,IL-6 on the third day of admission in intensive care unit in infection group was higher than that in non-infection group,and there was significant difference(P＜ 0.05).The level of serum PCT on the fifth day of admission in intensive care unit in infection group was higher than that in non-infection group [(3.09 ± 1.98)ng/L vs.(1.06 ± 0.63)ng/L],and there was significant difference (P＜0.05).WBC,CRP,IL-6 on the fifth day of admission in intensive care unit was(15.13 ±6.32)×109/L,(103.56 ±40.62)mg/L,(230.41 ± 121.83)ng/L in improved group(38 cases),and (18.62 ±8.89)× 109/L,(134.38 ± 34.16)mg/L,(268.73 ± 138.12)ng/L in non-improved group(10 cases),and there were significant differences between two groups(P ＜ 0.05).The level of serum PCT on the first,third,fifth day of admission in intensive care unit in improved group was lower than that in non-improved group,and there was significant difference(P ＜ 0.05).Conclusion The alteration of serum PCT level may be used as one of the effective predictors for infection in patients with severe craniocerebral injury and for their prognosis.

Objective To compare the clinical outcomes of arthroscopy versus mini-incision surgery for the treatment of avulsion fracture of the tibial attachment of the posterior cruciate ligament (PCL).Methods From March 2001 to September 2009,84 patients with acute displaced avulsion fracture of the tibial PCL attachment were treated operatively in our department.Thirty-five patients were treated with arthroscopic reduction and suture fixation (Group 1); 49 patients were treated with open reduction through a mini-incision and internal fixation with cannulated screw(s) and washer(s) (Group 2).There were 27 males and 8 females in group 1,with a mean age of 29.6 ± 5.6 years old,and 40 males and 9 females in group 2,with a mean age of 32.2 ± 7.6 years old.Based on the Meyers & Mckeever classification,there were 24 type Ⅱ fractures and 11 type Ⅲ fractures in group 1,and 31 type Ⅱ fractures and 18 type Ⅲ fractures in group 2.The 2 groups were compared in terms of range of motion,posterior drawer test (PDT),Lysholm score,International Knee Documentation Committee (IKDC) grading,and clinical results.Results All the patients obtained an average follow-up of 21.5 months (range,13 to 34 months).Primary union was achieved in all the fractures 3 months postoperatively.There were no significant differences between group 1 and group 2 regarding the PDT negative rate [82.9％ (29/35) versus 91.8％ (45/49)],the Lysholm score (95.1 ± 5.6 versus 96.1 ±4.7),therate ofIKDC grade A [88.6％ (31/35) versus91.8％ (45/49)],or the rate of normal range of motion [94.3％ (33/35) versus 93.9％ (46/49)] (P ＞ 0.05).On average,group 1 used significantly longer operative time (92.4 ± 15.9 minutes) than group 2 (53.8 ± 14.3 minutes).Conclusions Both arthroscopy and mini-incision surgery can achieve satisfactory clinical outcomes in the treatment of PCL tibial avulsion fracture.Although the 2 methods make no significant differences in stability of the knee joint and clinical scores,mini-incision surgery can result in much shorter operative time and thus permit an early postoperative rehabilitation.

Objective To establish a quantitative biomechanical relationship between the anterior cruciate ligament deficiency and the posterior horn of medial meniscus. Methods 10 human cadaveric knees were examined using an in vitro knee-testing apparatus. In response to a combined 134 N anterior and 200 N axial compressive tibial load, the in situ forces in the posterior horn of medial meniscus were measured. Testing was performed on 10 knees at multiple angles of flexion (30?, 60?, 90?) before and after resection of anterior cruciate ligament. Results The resultant forces on the posterior horn of medial meniscus were as follows: intact ACL knees, (22.8?11.5) N in 30? flexion, (27.1?16.3) N in 60? flexion, (26.7?14.5) N in 90? flexion. ACL deficiency knees, (87.3?43.9) N in 30? flexion, (77.7?43.3) N in 60? flexion, (66.2?40.1) N in 90? flexion. The resultant forces significantly increased as a result of ACL deficiency(P

Objective To describe the arthroscopic reductions and fixation of tibial intercondylar eminence fracture with cannulated screws. Methods During February 2003 to September 2005, 40 patients were treated arthroscopically for fracture of the tibial intercondylar eminence. The average age was 29.5 years (11-58 years), with a mean follow-up time of 20.1 months(6-37 months). Among the 40 patients, there were 4 type Ⅱ fractures (10%), 24 type Ⅲ fractures (60%) and 12 type Ⅳ fractures (30%). The fragments were reduced and fixed with cannulated screws. All-arthroscopic technique was adopted in all cases. The hematoma and the fragment were debrided, and the bony fragment was reduced and temporarily fixed with 2-3 guide wires through the portal superomedial to the patella. Intra-operative X-ray was taken to prove the reduction. One or two cannulated screws were used to fix the fragment as the definite fixation. Results The fracture healed completely in all but 1 patient. Lachman test were negative in all patients postoperatively. The average postoperative KT-1000 manual maximum displacement(MMD) was 0.625 mm(?蛳1-2 mm) and average Lysholm score was 98.3 points(87-100 points). The range of motion was normal in 34 patients. Flexion deficit was found in 5 cases, but within 10?. Knee joint stiffness was found in 1 case with range of extension and flexion 0?-30?-45?. A secondary operation with arthroscopic release was performed. The range of extension and flexion was improved to 0?-10?-80? postoperatively. Mild anterior knee pains were found in 8 patients. For 4 young patients with open epiphysis, the cannulated screws were removed 10-12 weeks post operation. No growth disturbance was detected for these 4 patients at final follow-up. Conclusion Arthroscopic fixation of fracture of the tibial intercondylar eminence with cannulated screw is a simple, safe and effective procedure suitable for both children and adult patients.

Objective To present the preoperative planning protocol and surgical procedures of computerized navigation technique in arthroscopic anterior cruciate ligament (ACL) reconstruction, and the comparative study results of tibial and femoral bone tunnel positions between navigation and arthroscopy technique. Methods The proper placement of femoral and tibial tunnels were planned preoperatively in standard AP and lateral X-ray view. Intraoperative fluoroscopic images were taken and inputed into navigation computer system to form the virtual interactive working fields. After placement and registration, signals from patient trackers being fixed into distal femur and tibia respectively, and tool trackers being attached with ACL tibial and femoral guide, were identified and captured by the optic navigation camera and so, the navigation computer system could pursued the real-time position of the ACL guide tools and the virtual tunnel positions were projeted into the working fields to help precise placement of femoral and tibial tunnels. From December 2005 to April 2006, 46 patients underwent fluoroscopy assisted anterior cruciate ligament reconstruction. Of them, 40 cases were evaluated with the postoperative X-ray lateral view to measure the placement of both femoral and tibial tunnels, and compared with the group of 40 cases of arthroscopy assisted ACL reconstruction in the same study period. Results For the navigation group, the average position of tibial tunnel was 45.35%?3.827% (37% to 53%) and 62.25%?5.610% (52% to 73%) for femoral tunnel. For the arthroscopic group, the average tunnel positions was 41.05%?6.008% (25% to 54%) for the tibia, and 56.62%?7.316% (46% to 77%) for the femur. With reduced SD, the average positions for both of the 2 tunnels in the navigation group were significantly more posterior than the arthroscopic group(P

Contemporary management ideas and social movements have impelled governments and service providers to value healthcare consumers' opinions and experiences. Patient satisfaction surveys have been used as a routine tool to measure a hospital's service quality from the patient's angle and patients' fidelity towards service providers. Quality improvement measures and service development strategies are consequently formulated. However, there still exist many problems in the research on and use of satisfaction surveys as a measurement tool, including lack of strategies for scientific tool selection and development, lack of standardization and analysis benchmarking, emphasis on nursing service at the expense of a hospital's overall service quality, lack of psychological surveying and research on applicability and practicability, artificially introduced bias factors in conducting the surveys, oversimplified presentation of survey results, and limited use of information, It is suggested that guidelines for tool selection and development be formulated, regional or nationwide benchmarking be established, plan designs in conducting the surveys be perfected, presentation of survey results be improved, and rational use of information be promoted.

Objective To detect plasma K-ras gene mutation by using CED-RFLP/PCR to diagnose pancreatic cancer. Methods CED-RFLP/PCR technique was used to detect K-ras gene mutation in the plasma specimens of pancreatic cancer patients, patients with benign pancreatic diseases and healthy subjects. Results In pancreatic cancer patients the positive rate of plasma K-ras gene mutation was 73%, without false positivity, and higher than that in the pancreatic juice and duodenal juice, but lower than that in the fine-needle aspirates. Plasma K-ras gene mutation was not found in patients with benign pancreatic disease and healthy subjects. Conclusion The detection of plasma K-ras gene mutation by CED-RFLP/PCR is simple and effective, and could avoid the faults of other detection methods. It is helpful for the diagnosis and identification of pancreatic cancer.

BACKGROUND:Eucommia ulmoides gum has good thermoplastics, liquidity, bondability and antimicrobial properties. However, the application of Eucommia ulmoides gum as a root canal filing material is rarely reported. OBJECTIVE: To compare the different contents of gas phase nano-silica on mechanical performance of composite material taking the gutta-percha as the matrix, and observe the effect of the root canal filing. METHODS:Four kind of root canal filing materials were prepared through adding barium sulfate (20%), nano-hydroxyapatite (10%) and different contents of gutta-percha and gas phase nano-silica (40% and 15%, 45% and 20%, 50% and 25%, 55% and 30%). PureEucommia ulmoidesgum served as the blank control. The mechanical properties (hardness, tensile strength and rupture elongation rate) of those five materials were detected. Furthermore, four kinds of composite materials, pureEucommia ulmoidesgum and Gutta-Percha Pelets were filed into the fresh extracted premolar root canal by using Obtura II technology. The effect of root canal filing was observed under X-ray and scanning electron microscopy.RESULTS AND CONCLUSION: Along with the increase of the content of gas phase nano-silica, the hardness of Eucommia ulmoides gum composite material increased, tensile strength increased firstly and then decreased, and rupture elongation rate decreased. PureEucommia ulmoides gum was transmitted to the X-ray and no image of filing material was obtained. Four kinds of composite materials were resistant to X-ray, and images showed that al composite materials were equaly filed into the root canal, without cacuole, and were in contact with the root canal inner wal, showing good filing effect. Scanning electron microscopy showed that, fingerlike projections were the longest at the surface of pureEucommia ulmoides gum; as the content of gas phase nano-silica increased, fingerlike projection length reduced at the surface of composite materials.Eucommia ulmoides gum composite materials could be developed as a canal filing material under heat flow condition.