Objective To compare the efficacy of laparoscopic radical hysterectomy and open surgery with early stage cervical cancer in elderly patients.Methods Performed a retrospective study of 195 cases underwent surgical treatment of early stage cervical cancer in elderly patients.According to different approach,the patients were divided into laparoscopic group (66 cases) and open group (129 cases).The operation time,intraoperative blood loss,number of resected lymph nodes,bowel function recovery time,postoperative hospital stay and postoperative complications was compared between two groups.Results The operation time,intraoperative blood loss,bowel function recovery time,postoperative hospital stay in laparoscopic group were significantly shorter than those in open group [(237.6 ±46.9) min vs.(259.3 ± 76.7) min,(214.7 ± 104.8) ml vs.(283.4 ± 137.2) ml,(1.9 ± 1.2) d vs.(2.8 ± 1.5) d,(4.1 ± 3.5) d vs.(6.7 ± 1.4) d,P ＜ 0.05 or ＜ 0.01].There was no significant difference in number of resected lymph nodes and postoperative complications between laparoscopic group and open group (P ＞ 0.05).Conclusion Laparoscopic radical hysterectomy is both safe and effective in elderly patients with early stage cervical cancer.

[Objective]To investigate the characteristics of the distally based sural neurofasciocutaneous flap for repairing soft tissue defects in heel.[Method]From June 2002 to July 2008,58 cases of soft tissae defects in heal were repaired with distally based sural neurofasciocutaneous flaps.Among them,10 cases combined with a dead cavity,13 cases were innervated with the anastomosis of the sural nerve to the cutaneous nerve of recipient site.The size of the flaps ranged from 8 cm?4 cm to 20 cm?15 cm.The perforating barnches of peroneal artery in fascia pedicle were exposed first,and then the flaps were harvested.[Result]Forty-six flaps survived uneventfully.Necrosis took place in the distal part in 12 flaps,and the wounds healed after changing dressing daily,two-stage suture or skingrafting.Through 1 to 34 months of follow-up,all the survival flaps provided good contours.Infection was controlled and no recurrence,ulcer or pressure sore was found.Walk function was good.[Conclusion]Distally based sural neurofasciocutaneous flaps for reparing soft tissue defects have many advantages.It can offer abundant blood supply,large survival size,simple operation,high achievement rate,and re-establishment of protective sensation.The flaps can repair almost all defects in heel.

Along with the increasing medical image data,it is imperative to set up an effective system about medical image retrieval.Essentially,the image classification is crucial for medical image retrieval.As a distribution pattern of image gray scale,texture is an important character.Wavelet multi-scale decomposition is essentially multi-channel filtering and its multi-resolution analysis structure is identical with human visual system.So the extraction of texture feature under different resolutions after multi-band wavelets transform is of great benefit to image recognition and image retrieval.Consequently,this paper designs an image classification method based on eight-band wavelet.This method solves the key technology in the medical image retrieval,and it gains very high classification rate.

BACKGROUND: The anterior thoracolumbar internal fixation devices can be divided into two main categories: the stick system such as kaneda,and the plate system such as Z-plate. Both categories have satisfactory biomechanical properties, but the devices of these types are all imported and so expensive that they exceed the affordability of domestic patients:Based on various anterior throacolumbar internal fixation devices and the spinal characteristics of the Chinese people, the author designed a new brand of anterior thoracolumbar internal fixation device for Chinese people:New Ti-plate (NTP).OBJECTIVE: Biomechanical properties of three anterior thoracolumbar internal fixation devices were compared in an attempt to provide a scientific and theoretical basis for clinical applications.DESIGN: A sampling investigation.SETTING: The Department of Orthopaedics of the Second Affiliated Hospital of Soochow University and Department of Radiology of Nantong Hongqiao Hospital.PARTICIPANTS: This study was carried out at the Biomechanical Engineering Research Institute of Shanghai University between May and August 2003. Fifteen fresh spinal samples from the healthy adults (T12-S1) were used in this study.METHODS: Fifteen spinal (T12-S1) specimens were obtained from fresh bodies to induce injuries to anterior and middle columns, which were fixed with Dunn Ⅲ, NTP and Z-plate respectively to compare the strength, rigidity, and the stability of the spine.MAIN OUTCOME MEASURES: Changes of load-straining and loaddisplacement of the three groups of specimens under the conditions of axial decompression, anteflection, post-extention, and lateral flexion.RESULTS: Fifteen fresh adult spinal specimens were involved in this study and all entered the stage of result analysis. Under the maximal load of 500 N,the average straining for Z-plate, NTP and Dunn Ⅲ was 410 uε,430 uε, 477 uε respectively. The average longitude displacement for the above three devices was 2.23 mm, 2.38 mm and 2.85 mm respectively.The thoracolumbar fracture was fixed with three anterior internal fixation devices and it was proved that Z-plate and NTP fixations were better than fixation with Dunn Ⅲ in respect of spinal strength, rigidity and stability (P ＜ 0.05), but the difference between Z-plate and NTP had no statistical significance (P ＞ 0.05).CONCLUSION: NTP and Z-plate devices are conformed to the spinal biomechanical principles and were capable of reconstructing spinal biomechanical stability effectively, and it is a preferable anterior spinal internal fixation device.

This paper introduces the low-power design of a portable wireless ECG monitor which adopts MC35 GPRS module.At first,it presents the hardware and software system.Secondly,according to the principle of low-power design,it describes the low-power design methods from the aspects of hardware and software respectively.Finally,this paper discusses how to improve this power management system.In practice,this design efficiently reduces the power-consuming,and prolongs the working time of the monitor.

Objective To investigate the effects of remote preconditioning on inflammatory cytokines and respiratory index of rabbit lung injured by ischemia/reperfusion.Methods Eighteen rabbits were randomly divided into three groups(6 each):control group(C),ischemia-reperfusion group(I/R)and remote preconditioning group(R).The plasma concentrations of interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and interleukin-10(IL-10)were measured before ischemia and 60,120 and 180 min after reperfusion.Respiratory index(A-aO2/PaO2)was calculated before ischemia and 15,30,60,120 and 180 min after reperfusion.The animals were sacrificed after reperfusion,and the left lung was removed for calculation of wet/dry(W/D)ratio and lung permeability index,histological examination was done with light microscope,and diffuse alveolar damage(DAD)scores was estimated.Results The plasma concentrations of IL-6 and TNF-? were significantly higher in I/R group than in C group(P

Objective:To explore the role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma (HNSCC).Methods:The expression of CXCR2 in HNSCC tissues of 105 cases was detected by immunohistochemical staining,the correlation between CXCR2 expression and cervical lymph node metastases of HNSCC was analysed.Then,3 stable HNSCC cell lines with CXCR2 interference were established,the effects of CXCR2 silencing on cell migration and invasion were observed by in vitro tests.Results:CXCR2 was positively expressed in 51.43% of HNSCC specimens and was statistically associated with the cervical lymph node metastases of HNSCC.CXCR2 silencing markedly inhibited the migration and invasion of HNSCC cells in vitro.Conclu-sion:CXCR2 may play a key role in the invasion and metastases of HNSCC.

ObjectiveTo study the role and mechanism of low-dose aspirin with IFN-α in inhibiting growth and metastasis of hepatocellular carcinoma (HCC).MethodsMHCC97L cells were cultured and a metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude (nu/nu) mice.After administration of different doses of Aspirin and IFN-α for 40 days,the mice bearing xenografts in liver were killed,and the tumor volume and lung metastasis were evaluated.Cell proliferation and MMP-2 activity were measured by MTT and gelatin zymography,respectively.The expressions of VEGF and MMP-2 were measured by western blot and ELISA.ResultsCompared to the control group,there were no significant differences in the high-dose Aspirin [45 mg/(kg · d)] treated group regarding tumor volume [(1.89 ±0.88) cm3 vs (3.12±0.85) cm3,P＞0.05] and incidence of lung metastases (58.3％ vs 66.7％,P＞0.05),but the tumor volume and incidence of lung metastasis were significantly inhibited in the highdose IFN-α group [1.5 × 107/(kg · d)],the high-dose IFN-α combined with high-dose Aspirin group,and the low-dose IFN-α [7.5 × 106 / (kg · d) ] combined with low-dose Aspirin [15 mg/(kg · d] group (P＜0.05).2 mmol/L Aspirin did not inhibit the proliferation of MHCC97 cells (P＞0.05),but inhibited the activities and expressions of MMP-2 and VEGF.Low-dose IFN-α combined with low-dose Aspirin significantly decreased the expressions of MMP-2 and VEGF in nude mice (P＜0.05).ConclusionLow-dose Aspirin combined with low-dose IFN-α significantly inhibited the growth and metastasis of HCC through suppressing the expressions of MMP-2 and VEGF.

Objective To investigate the clinical presentations, pathologic features, and the di-agnosis and treatment of prostate sarcomatoid carcinoma. Methods Two cases of prostate sarcoma-told carcinoma were analyzed with review of the relevant literature. Case 1, a 51-year-old man com-plained of dysuria and perineal discomfort for 2 months, was admitted because of acute urinary reten-tion. His serum PSA was 2.31 ng/ml. Heterogeneous density of the prostate left lobe and bladder neck involvement was shown on CT scan. Prostate sarcomatoid carcinoma was confirmed by transrec-tal prostate biopsy, and patient accepted radical cystoprostatectomy and ideal conduit followed with lo-cal radiotherapy and hormonal therapy. Case 2 was a 54-year-old male. This ease was admitted with a history of dysuria and intermittent gross hematuria for 1 month. Hypoechoic lesion was found by ul-trasonography,and heterogeneous density of the prostate was shown on CT scan. His serum PSA was 2.61 ng/ml. The prostate biopsy result showed prostate sarcoma. Radical cystoprostatectomy and ide-al conduit was performed on this case. Results The diagnosis of prostate sarcomatoid carcinoma in the 2 cases was confirmed by postoperative pathology. Under microscope, the neoplasm was mainly composed of epithelial and sarcomatoid mesenchymal cells,with a transitional region of these cells. Im-munohistochemical staining showed that the cells were positive for cytokeratin and epithelial membrane antigen. Vimentin was negative in the epithelial cells, but was positive in the majority of sarcomatoid cell. Both patients died of multi-metastasis at 43 and 19 months after surgery respectively. Conclu-sions Sarcomatoid carcinoma of the prostate is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features and immunohistochemical studies. Radical resection combined with endocrine therapy and radiotherapy is considered to be the most relia-ble treatment so far.

BACKGROUND: Due to individual characteristics of human body, it is difficult to well match between standard prosthesis and patient skeleton. Computer-assisted design and manufacture of individualized prosthesis can effectively prolong artificial joint lifespan and quality and reduce revision rate. However, related studies are few in China.OBJECTIVE: To explore computer-assisted design for individualized femoral head prosthesis according to three-dimensional (3D)reconstruction of CT images for improving prosthesis and affected skeleton matching.METHODS: The CT scanning image of one healthy male volunteer, with no hip joint disease, was used. His femur was scanned with GE Speed Light CT with 3.0 mm thick cross-section slices. CT 2D images were transmitted to a computer. The medical image format was translated from DICOM into bmp. Inner and external bone contours were drawn automatically or by hand and processed digitally, and then these data were downloaded into 3D Mimics8.1, and Rapidform2004 software. The 3D femoral canal model was rendered. Femur canal contours curve was downloaded into the Solidworks2004 software in the form of dxf. Femoral prosthesis was designed on the base of femoral canal contours curve.RESULTS AND CONCLUSION: The CT image was transmitted in the form of vector by a set of self-made medical image processing software. The accurate 3D femoral internal/external outline model was obtained by CT 2D image and reverse technique. Suitable femoral prosthesis was designed by means of image reverse engineering and norientation CAD. Reverse engineering and CAD provide an effective way to develop individualized prosthesis, improve the matching of prosthesis and affected skeleton, prevent prosthesis loosening and improve long-term stability.