Objective To analyze the manifestation,reason,the processing method of the steel wire implantation with the sereotactic mammography to improve the accuracy of the preoperative positioning.Methods Seventy-nine cases which got the stereotactic steel wire implantation.In 96 lesions, 13 had steel wire displacement.Among them,5 cases got steel wire displacement during the sereotactic process,5 cases got steel wire displacement after the stereotactic process,2 cases got steel wire displacement during the operation,one case did not show the calcification on the postoperative radiography.Results The steel wire displacement occurred in 5 cases during the stereotactic process came from the patients and doctors respectively and the repositioning was needed.The steel wire displacement after the stereoscopic positioning was attributed to the overdose injection of local anesthesia,which led to the mismatch between the depth of Z axis of the mammary gland and the actual depth the computer given,the incorrect method for needle placement,and,neglecting whether the steel wire have got the lesion anchored when pulling out the needle set of steel wire hood,besides,these three kinds of instances above were all exaggerated by the accordion effect.For the displacement within 2 cm,the lesion can be excised toward the pathological change direction according to the position that steel wire prompted and re-place the second steel wire,putting the J-shaped steel wire into the needle hood and taking it out of the body.After repositioning,2 cases had the steel wire prolapse during operation,which resulted from the over-lifting of the steel wire.After placing the steel wire, the radiologist should give an accurate description on the depth and direction to the surgeon and the notch should be taken for incision from the steel wire head end which is proximate to skin.The postoperative specimen from one case had no calcification,which might be related to the condition that the calcification was located in the gland body,which got destruction from the surgical electrical electrotome.The excisionscope should be extended and the short term reexamination is recommended to make sure the complete excision of the calcification.Conclusion It is the gold standard method that implanting the steel wire with the stereotactic mammography to guide the surgical dissecting technique to diagnose non-palpable breast lesion(NPBL).Thorough understanding of the displacement manifestation of implanting steel wire with stereotactic technique and the treatment methods will be helpful in the surgical dissecting guidance.

Wolff law was an adaptable principle of bone, Tension-Stress Principle was equal to Distraction Osteogenesis or Distraction Tissue Regeneration, The Natural Reconstruction theory was a new orthopedic perspective proposed by Prof. QIN after deformity correction using Ilizarov technology. The thought about their relationship originated from a social phenomena, that the crowds and the confusion about export choice in Beijing's subway. Ilizarov technology and Wolff law were one concept related to Mechanics, and the former is completely in line with the latter. In other words, Ilizarov technology is an extension of Wolff law, is a repeated process of micro-trauma and continuous repair of bone trabecular initiated by moden engineering, just trabecular formed along the tension-stress direction. With adjustment of mechanical force,doctor can control the process of fracture healing and bone remolding to a certain extent. Natural Reconstruction theory enlarged the defined range of Wolff law obviously. Not only guided orthopedics clinical and basic research,but also related to the dialectical thinking of the doctor-patient relationship in sociology. There was an inevitable connection among Wolff law, Ilizarov technology and Natural Reconstruction theory. The history of discovery and understanding was a continuous process of thinking,practice and integration.
Humans ; Ilizarov Technique ; Reconstructive Surgical Procedures

OBJECTIVETo evaluate the effectiveness of unilateral versus bilateral pedicle screw fixation in lumbar spinal fusion.

METHODSStudies on comparison between unilateral and bilateral pedicle screw fixation in lumbar spinal fusion were identified from Medline, EMBASE, Cochrane CENTRAL (Third Quarter 2011), ScienceDirect, OVID, SpringerLink and The China Biological Medicine Database, and searched several related journals by hand. The included trials were screened out according to the criterion of inclusion and exclusion. The quality of included trials was evaluated. Data were extracted by two reviewers independently. RevMan 5.1.1 was used for data analysis.

RESULTSSeven studies involving 480 patients were included, 246 in unilateral group, and 234 in bilateral group. The results of meta-analysis indicated that statistically significant difference were observed between the two fixation procedures in mean operation time (MD = -24.39, 95%CI: -33.16 to 15.61, P < 0.01), the amount of bleeding (MD = -118.73, 95%CI: -143.43 to -94.03, P < 0.01). There were no difference in inpatient stay, fusion rate, complication rate and excellent and good rate.

CONCLUSIONSBoth unilateral and bilateral pedicle screw fixation are effective in lumbar spinal fusion. To compare with bilateral fixation, unilateral fixation can shorten operation time, reduce amount of bleeding and medical expenses. And there is a similar effect of inpatient stay, fusion rate, complication rate and excellent and good rate.

Bone Screws ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

Rotator cuff tears are one of the three most prevalent musculoskeletal disorders, with the supraspinatus tendon as the most common lesion site. It may lead to chronic shoulder pain, weakness and limited joint motion, and eventually to secondary degeneration of the shoulder. As traditional biomechanical experiments are limited by measurement techniques and ethical issues, it is almost impossible to clarify the stress distributions at the rotator cuff under physiological and pathological conditions. Recently, advances in computer science, software development and image processing have rapidly improved finite element models of shoulder joint which promote the researches into pathogenesis of rotator cuff tears and their surgical techniques, making finite element analysis an indispensable means in the biomechanic research of rotator cuff. This paper reviews the recent literature available in China and abroad to expound on the element models of shoulder joint applied in the researches into pathogenesis and surgery of rotator cuff tear.

Objective Through testing the expression of complement C3 fragment C3b and iC3b,C5b-9 as well as indexes of KKS before and after using kallikrein-kinin system inhibitor PKSI-527,observing the relevant between KKS and complement system,we preliminary study on the mechanism how KKS works on the renal injury of sensitized mice model induced by trichloroethylene.Methods Female BALB/c mice (6～8 weeks) were randomly divided into blank control group (5),TCE treated group (15),PKSI-527+TCE treated group (15).Mice were sensitized with TCE in the 1,3,7,10 days,the first and the last challenge were on day 17 and 19.24h before every challenge,mice in PKSI-527 +TCE group were treated with intraperitoneal injection of KKSinhibitor PKSI-527 inhibitor (50mg/kg).Mice were killed 72h after the last challenge.The function of kidney in mice were detected and kidney B1R,B2R expression were detected using real-time quantitative PCR,mice kidney complement C3 fragments C3b,iC3b and C5b-9 deposition were also detected by chemoimmunology.Results Compared with blank control group,all indexes expressions in the solvent control group have no significant change.Compared with the solvent control group,BUN、Cr level and B1R、B2R level have an significant increase (P＜ 0.05) in TCE sensitized group and PKSI-527+TCE sensitized group;There is a sharp decrease in PKSI-527+TCE sensitized group compared to TCE sensitized group (P＜ 0.05).Conclusion The renal damage in the TCE sensitization mouse model may aggravated by upregulate complement system followed by the activation of kallikrein-kinin system.

Objective:To analyze the clinical efficacy and safety of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma (HCC).Methods:Ninety-four cases with mid-and advanced-stage HCC who received camrelizumab combined with apatinib as second-line treatment were enrolled. Routine blood test, blood biochemical indexes, tumor stage, tumor imaging characteristics, previous treatment strategies and other clinical data before treatment were documented. Imaging examination follow-up results and adverse reactions during treatment were followed up until the end of follow-up or loss of follow-up or death. Kaplan-Meier method was used to analyze the clinical efficacy.Results:As of the last follow-up, 94 cases with mid-and advanced-stage HCC had received camrelizumab combined with apatinib as second-line treatment. Among them, 15 cases were lost to follow-up, 31 cases died, and 48 cases survived. The overall remission rate was 31.9%. The overall disease control rate was 71.3%. The median time to disease-free progression was 6.6 months. The median time to disease progression was not yet available. The 1-year cumulative survival rate was 62.3%. Grade 3 and above adverse reactions mainly included were thrombocytopenia (7.4%), abdominal pain (4.3%), active hepatitis (4.3%), leukopenia (4.3%), diarrhea (3.2%), hand-foot syndrome (3.2%). All adverse reactions were effectively controlled.Conclusion:Camrelizumab combined with apatinib can effectively prolong the survival period of patients with mid-and advanced-stage HCC, and it is well tolerated.

Objective To study the brain functional connectivity(FC)changes in patients with normal tension glau-coma(NTG)and healthy volunteers using FC technique of resting-state functional magnetic resonance imaging(rs-fMRI)based on V1 region seed point(ROI),so as to explore the pathogenesis and early diagnosis of NTG.Methods Fourteen NTG patients(NTG group)who met the inclusion criteria and 14 healthy controls(HCs group)were enrolled.The clinical data of all subjects were collected,and rs-fMRI was performed in both groups.The magnetic resonance data was pre-pro-cessed by software,and bilateral A1 regions were taken as the ROI to analyze their correction with the whole brain voxel time series and obtain the FC value between the ROI and the whole brain by comparison of FC values in resting state be-tween the groups.Pearson correlation analysis was used to explore the relationship between FC value in the brain regions with significant differences with the ROI and clinical variables in the NTG group.Results Compared with the subjects in the HCs group,there were no statistically significant differences in age,gender,body weight,cup-disc ratio and 24 h mean intraocular pressure of patients in the NTG group(all P＞0.05),and there were statistically significant differences in the best corrected visual acuity(BCVA)of both eyes and peripapillary retinal nerve fiber layer thickness(RNFLT)(all P＜0.05).The Pearson correlation analysis showed that FC value of the brain regions with abnormal FC to V1 region were cor-related with RNFLT in the NTG group(P＜0.05).ROI1-left superior frontal gyrus,ROI1-right superior frontal gyrus,ROI2-left cingulate gyrus and ROI2-right middle frontal gyrus were significantly positively correlated with RNFLT(all P＜0.05).Compared with the HCs group,the brain regions with reduced FC to the right ROI in the NTG group were the left superior frontal gyrus and right superior frontal gyrus;the brain regions with reduced FC to the left ROI were the left cingulate gyrus and right middle frontal gyrus.Conclusion Compared to healthy individuals,NTG patients have significant changes in the functional connections between certain specific brain regions and V1 region,including bilateral superior frontal gyrus,left cingulate gyrus,and middle frontal gyrus.The changes in brain functional activity may be caused by visual dysfunction caused by NTG,leading to functional impairment of the visual and cognitive emotion processing brain regions,which may be one of the potential neuropathological mechanisms in NTG patients.

Objective Through testing the expression of complement C3 fragment C3b and iC3b,C5b-9 as well as indexes of KKS before and after using kallikrein-kinin system inhibitor PKSI-527,observing the relevant between KKS and complement system,we preliminary study on the mechanism how KKS works on the renal injury of sensitized mice model induced by trichloroethylene.Methods Female BALB/c mice (6～8 weeks) were randomly divided into blank control group (5),TCE treated group (15),PKSI-527+TCE treated group (15).Mice were sensitized with TCE in the 1,3,7,10 days,the first and the last challenge were on day 17 and 19.24h before every challenge,mice in PKSI-527 +TCE group were treated with intraperitoneal injection of KKSinhibitor PKSI-527 inhibitor (50mg/kg).Mice were killed 72h after the last challenge.The function of kidney in mice were detected and kidney B1R,B2R expression were detected using real-time quantitative PCR,mice kidney complement C3 fragments C3b,iC3b and C5b-9 deposition were also detected by chemoimmunology.Results Compared with blank control group,all indexes expressions in the solvent control group have no significant change.Compared with the solvent control group,BUN、Cr level and B1R、B2R level have an significant increase (P＜ 0.05) in TCE sensitized group and PKSI-527+TCE sensitized group;There is a sharp decrease in PKSI-527+TCE sensitized group compared to TCE sensitized group (P＜ 0.05).Conclusion The renal damage in the TCE sensitization mouse model may aggravated by upregulate complement system followed by the activation of kallikrein-kinin system.

OBJECTIVETo explore the mental health status of residents scattered living in Anxian after Wenchuan earthquake so as to provide scientific basis for further mental health intervention.

METHODSA face to face interview was conducted among the scattered residents with designed questionnaire, which had three parts of the physical and emotional reaction, the relax methods and the social care and supports expected. Two-stage probability proportional to size (PPS) sample method was performed to sample 2184 from 0.44 million scattered residents in Anxian. On the basis of statistical description, mental health of different characteristics groups was compared.

RESULTSThree main symptoms of posttraumatic stress disorders in 2184 residents (11.23+/-3.44) were higher than the 103 fire victims in Hunan in 2003 (10.06+/-3.26), three factor scores of SCL-90 (5.76+/-1.74) were higher than normal in 1998 repair mode (n=23 891) (4.72+/-1.44), and the statistical difference was observed (t=10.77, P<0.05; t=706.04, P<0.05). Comparing the mental health of different groups, some significant differences were found by age, gender and education background.

CONCLUSIONThe earthquake disaster brought prevalent physical and emotional reaction. Elderly people, female, junior students need mental intervention immediately. Therefore, strengthen the mental education and assistance (especially in high risk groups) would be of more significance.

Adolescent ; Adult ; Child ; Child, Preschool ; Disasters ; Earthquakes ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mental Health ; Middle Aged ; Sampling Studies ; Stress Disorders, Post-Traumatic ; epidemiology ; psychology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo explore the public health situation and needs in Anxian after Wenchuan earthquake so as to make an effective strategy for disease control and prevention.

METHODS69 concentrated settlements with 100 residents were investigated. Probability proportion to size was adopted for sampling of 2200 residents from 687 scattered households (about 440 000 scattered residents). The content of this survey included drinking water, food hygiene, environment sanitation, planning immunity and medical health service, disease surveillance and so on. SPSS 16.0 was used for data analysis, and statistical interpretation was used to describe the results.

RESULTS90.9% (31/66) resettled residents in Anxian lived in tents, 7.6% (5/66) lived in the movable-plate house, 93.3% (621/666) scattered households lived in tents and 71.9% (446/621) of them lived in tents which were built by residents themselves; the rate of drinking water disinfection in resettlement sites and scattered households were 97.1% (66/68) and 94.6% (650/687); 12.8% scattered residents had mouldy or food; 50% of resettlement sites raised animals; 43.6% (17/39) medical station didn't have bacterin inoculation service; 66.7% (10/15) lacked sufficient disinfection equipment; register rate was 50.0% (33/66) and report rate of symptoms and infectious diseases was 56.1% (37/66).

CONCLUSIONThere was still some risk of enteric and vector-borne diseases in Anxian, therefore, some tailored measures should be very important.

Disasters ; Earthquakes ; Environmental Monitoring ; Health Care Surveys ; Health Services ; Health Services Needs and Demand ; Humans ; Water Supply