ObjectiveTo describe the use of endoscopic technique for exposure of the mandibular ramus-condyle unit(RCU) to facilitate reduction and rigid fixation of the fractures.MethodsSixteen patients ( 18 sides) with diagnosis of subcondylar fracture ( 11 sides),condylar neck fracture ( 2 sides ),and mandibular ramus fracture (5 sides ),who underwent endoscopic exposure of the RCU and fixation with miniplates by an extraoral or transoral approach.Six sides were no displacement,10 sides were obvious displacement,and 2 sides were dislocation.ResultsAll patients had successful treatment of fractures of the mandibular RCU,all patients showed quick recovery to preinjury occlusion.Followed up 12-36 months,normal temporomandibular joint function was noted in all patients.No patient had marginal mandibular nerve weakness or other complications.ConclusionsIt demonstrates the feasibility of endoscopic access to the RCU for treatment of the fractures.The procedures can be performed with minimal morbidity and functional impairment.

ObjectiveTo determine the role of low-field magnetic resonance angiography(MRA) in diagnosis of intracranial artery steno-occlusive disease in patients with cerebral infarction.Methods67 cases with cerebral infarction were given low-field MRA and DSA examination.Results62 cases of cerebral infarction MRA diagnosis and DSA agree,diagnostic accuracy was 92.5％.ConclusionLow-field MRA has a good reliability in diagnosis of intracranial artery steno-occlusive disease with the advantages of safe,reliable and convenient,can provide effective instruction for treatment of cerebral infarction.

OBJECTIVE: To explore clinical efficacy of dorsal plate assisted fixation of dorsal lunate fossa fracture block of distal radius. METHODS: From January 2019 to January 2022, 30 patients were treated with dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius, including 13 males and 17 females, aged from 42 to 68 years old with an average of (48.7±5.6) years old;According to Doi fracture classification, 24 patients were type 3 blocks and 6 patients were type 4 blocks. The degree of palmar angle of anterior and posterior distal radius was fixed by dorsal steel plate during operation. Fracture healing and functional recovery of wrist were observed after operation. Functional evaluation was performed by Gartland and Werley scoring system at 12 months after operation. RESULTS: All patients were followed up from 12 to 13 months with an average of (11.3±0.9) months. All fractures healed for 4 to 5 months with an average of(4.7±0.8) months. Median palpal inclination of anterior and posterior distal radius fixed by dorsal plate was 5.30°(4.85°, 6.03°), 12.45°(11.98°, 13.43°) respectively, and had statistical difference( P<0.01). Gartland and Werley scores was (1.1±0.4) at 12 months afteropertaion, and 27 patients got excellent result and 3 good. CONCLUSION Dorsal plate assisted fixation of dorsal lunate fossa fractures is beneficial to reduction and stabilization of displaced dorsal fractures and restoration of palmar inclination.
Female ; Male ; Humans ; Adult ; Middle Aged ; Aged ; Radius/surgery* ; Lunate Bone/surgery* ; Upper Extremity ; Wrist Joint ; Wrist ; Fractures, Bone

Objective To study the effects of miR-200b on proliferation and migration of sw620 colon cancer cells,and its regulation effect on E-cadherin expression.Methods The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection were detected by real-time PCR (RT-PCR).The change of the expression level of E-cadherin after miR-200b transfection was detected using the methods of RT-PCR and Western blot.The proliferation and migration abilities were measured by MTT and scratch test after miR-200b transfection.Results The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection raised significantly compared to the control group (t =11.579,P ＜ 0.01 ; t =11.579,P ＜0.01).MiR-200b transfection inhibited the proliferation abilities of sw620 cells.It is the most significant of the inhibitory effect on the third day and the inhibition rate was 55.34％.MiR-200b transfection markedly inhibited the migration abilities of sw620 cells.The two groups had significant difference in the migration distance of 24,48,72 h (t =11.579,P ＜0.01 ; t =10.419,P ＜0.01 ; t =6.955,P ＜0.01).The mRNA and protein expressions of E-cadherin gene increased significantly by transfecting miR-200b gene in sw620 cells (t =10.432,P ＜ 0.01 ; t =8.325,P ＜ 0.O1).Conclusion Up-regulated expression of miR-200b could inhibite the proliferation and migration abilities of sw620 colon cancer cells.The involved molecular mechanism is probably related to the change of E-cadherin expression.

Objective To explore the role of 256 CT iterative reconstruction in improving image quality and reducing radiation dose of carotid artery into cranial segment.Methods Sixty patients underwent head and neck CTA on a 256 CT scanner.Conventional dose scanning was performed in 30 patients using a filtered back projection (FBP) reconstruction (group A) and iterative iDose4 reconstruction (group B).Low dose scanning was performed in the other 30 patients using FBP reconstruction (group C) and iDose4 reconstruction (group D).The noise,SNR,CNR,score of image quality and effective radiation dose were evaluated in four groups.One-way ANOVA was used to analyze the image quality index between groups.Independent sample of Kruskal-Wallis test of ranked data was used to compare image quality score between groups.Paired t test was used to compare the effective radiation doses between the low dose group and conventional dose group.Results The image noise of four groups were 8.21 ±0.88,7.31 ± 0.33,11.17 ± 2.02 and 6.50 ± 0.49 respectively.SNR were 43.21 ± 4.49,5 1.83 ± 3.64,42.88 ± 9.19 and 53.47 ± 4.88,respectively.CNR were 37.88 ± 4.02,61.21 ± 6.31,36.63 ± 8.20 and 62.99 ±5.90,respectively.There were statistic differences (F =112.786,97.041 and 86.098,P ＜0.01).The differences of image noise between group A and B had no statistic significance,which was statistic different between group A and C (P ＜ 0.01).Except that the differences of SNR and CNR between group A and C,B and D had no statistic significance,the differences between other two groups had statistic significance (P ＜ 0.01).In case of image quality score of 1,2 and 3,there were 2,13 and 15 patients in group A; 0,7 and 23 patients in group B; 5,15 and 10 patients in group C; and 0,5 and 25 patients in group D.There was statistic differences of image quality score between each group (H =22.575,P ＜0.01).The effective radiation dose was (2.31 ±0.13) mSv in conventional dose group and (0.84 ±0.04) mSv in low dose group.There was statistic difference between the two groups (t =60.682,P ＜ 0.05).Conclusion Compared with conventional dose,iDose4 iterative reconstruction algorithms can obtain excellent images of CTA for carotid artery into the cranial segment with more than 50％ radiation dose decrease.

Objective To observe the positive rate of serum anti-cardiac troponin Ⅰ autoantibodies (anti-cTnI) in the patients with coronary atherosclerotic heart disease(CHD) and its clinical significance.Methods A total of 200 CHD patients and 200 healthy controls from the Department of Cardiology,Drum Tower Hospital of Nanjing University Medical School during September 2015 and May 2016 were collected in the case-control study.Serum anti-cTnI was detected with an indirect ELISA method.Meanwhile,the general data,chnical biochemical parameters and coronary vascular lesion from the two groups were analyzed.Results The positive rate of anti-cTnI in CHD patients(21/200,10.5％) was significantly higher than that in healthy controls(4/200,2.0％,P ＜ 0.01).According to the detection results of serum anti-cTnI,the participants were divided into three groups,including anti-cTnI positive group with CHD,anti-cTnd negative group with CHD and anti-cTnI positive group in healthy controls.The median age and serum Glu level in the anti-cTnI positive group with CHD were significantly higher than those in the anti-cTnI positive group in healthy controls (P ＜ 0.05),while the levels of serum HDL-C and apoA I were inverse (P ＜ 0.01).The median age and Gensini score in the anti-cTnⅠ positive group with CHD were significantly higher than those in the anti-cTnI negative group with CHD,while the level of serum HDL-C was inverse (P ＜ 0.05).Conclusion Anti-cTnI may be more likely to occur in old CHD patients with severe coronary artery lesions,and the low levels of serum HDL-C and apoA Ⅰ may correlate to the production of anti-cTnⅠ.

Objective To study the clinical efficacy of cell block yielded by ultrasound-guided fine needle aspiration in the early diagnosis of thyroid cancer and differential diagnosis of thyroid follicular tumor.Methods Cytological smears were performed in 864 thyroid nodules by ultrasound-guided fine needle aspiration.Then the residual specimens were made as cell blocks.Diagnosis was made by observation of the organization structure of the cell block.Cell block sections from 78 nodules with diagnosis of follicular tumors were applied to the detection of immunocytochemical staining for minichromosome maintenance protein (MCM2), growth arrest and DNA damage-induced nuclear protein 153 (GADD153), and Ki-67.Results Satisfaction rate of cytological smear combined with cell block specimen was 94.3 ％ (815/864) and accuracy rate of the diagnosis was 94.0％ (766/815), which were higher than in cytological smear group (P＜0.01).The false negative rate of cytological smear combined with cell block specimen was 16.6％ (41/247)in diagnosis of thyroid cancer.Positive rate of M CM2 and GADD153 in thyroid follicular neoplasia were lower than that of follicular carcinoma (P ＜ 0.01).There was no significant difference between thyroid follicular neoplasia and follicular carcinoma in regard to positive rate of Ki-67 (P ＞ 0.05).Conclusions The combination of ultrasound-guided fine needle aspiration-yielded cell block and molecular markers has great significance in early diagnosis of thyroid cancer and differentially diagnosis of thyroid follicular tumor.

Objective To investigate the imaging differentiation between high-grade and low-grade limb of long bone chon-drosarcoma.Methods The MRI imaging features in 23 cases of pathologically proven limb long bone chondrosarcomas were retro-spectively analyzed,including 13 cases of low-grade and 10 cases of high-grade.The MRI imaging features including endosteal scal-loping lesion,cortical thickening,cortical destruction,bone expansion,soft tissue mass,bone marrow edema,soft tissue edema,calci-fication,hemorrhage,tumour maximal radial line and enhancing features were performed the statistical analysis.Results 13 cases were the low-grade chondrosarcomas,including atypical cartilaginous tumour and grade 1 chondrosarcomas,10 cases were high-grade chondrosarcomas (8 cases of grade Ⅱ chondrosarcomas,1 case of gradeⅢ chondrosarcomas and 1 case of dedifferentiated chondrosarcomas).Cortical destruction,soft tissue mass and soft tissue oedema had statistical differences between the low-grade and high-grade.Bone marrow had statistically significant difference.Calcification +(SC<1/3ST)had statistical difference between the low-grade and the high-grade.Calcification ++(1/3 ST

本文对当前我国残疾人用品用具总体工作的状况进行了扼要介绍和评述，包括政策与政府的主导作用、对用品用具的需求、产品开发生产与供应服务、专业人员教育与培训、国际交往与合作等。本文认为，残疾人用品用具作为一个行业在我国已初步形成，指出了该行业目前存在的几个问题。