[Objective]To evaluate the effect of transepicondylar axis of different position on volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.[Method]Fifty-one dry humerus specimens were scanned with 16 slice spiral CT scanner,At top view the three-group humeral head retroversion angle decided by the transepicondylar axis of different position were measured by volume rendering technique,As to two-dimension CT method,the distal reference axis of the humeral head retroversion angle was defined by three sections of different levels,the total six-group data on humeral head retroversion angle were analyzed by Statistics.[Result]The humeral head retroversion angle ranged from 4? to 59.8?,the humeral head retroversion angle of six groups were(25.5?10.2)?,(25.0?10.8)?,(25.7?10.8)?,(27.3?10.3)?,(26.3?10.2)?,(25.8?10.4)? respectively.The Statistics showed that the results have no significant difference among them.The more distal the humerus was,the smaller humeral head retroversion angle defined by a line between the epicondyles on two-dimension CT method was.[Conclusion]The humeral head retroversion angle is markedly variable,the humeral head retroversion angle of shoulder joint prosthetic design should be individual.The transepicondylar axis of different position has no effect on volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.The top view at which lateral epicondyle of the humerus showing mini-triangulum and the anterior surface of the distal humerus articulation with the forearm being shaded is more simple,faster and precise for the volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.

Objective To investigate method of in vitro measurement of adult Chinese scapula glenoid version angle with MSCT postprocessing technique. Methods Fifty dry scapula specimens and 50 wet anticorrosive shoulder specimens of adult Chinese were scanned with Siemens Somatom Sensation 16 scanner. The scapula glenoid version angle was measured with postprocessing technique of thick or thin multiplanner reformation (MPR), and the data were analyzed statistically. Results The scapula glenoid version angle of dry scapula specimens and wet anticorrosive shoulder specimens was (-0.40±4.10)°, (-3.00±4.49)° with thick MPR, and (-0.34±4.21)°, (-2.70±4.54)° measured with thin MPR, respectively. There was significant difference of the scapula glenoid version angles between the dry scapula specimens and wet anticorrosive shoulder specimens (P<0.05), but not between thick or thin MPR measurement(P>0.05). Conclusion Measuring the scapula glenoid version angle with thick MPR of MSCT is simple and fast. The scapula glenoid version angle is markedly variable between the dry scapula specimens and wet anticorrosive shoulder specimens. The retroversion angle of scapula glenoid is about 3°, which should be considered in the design of shoulder prosthesis.

BACKGROUND:With the development of technology,electromagnetic irradiation has been applied in many fields;meanwhile,health of people could be threatened by electromagnetic exposure.Reproductive system of males is the major target of electromagnetic irradiation.But under the condition of electromagnetic exposure,the change of testosterone and its mechanism remain unknown. OBJECTIVE:To study the effect of electromagnetic irradiation on steroidogenic acute regulatory protein(StAR) and cytochrome P450 cholesterol side-chain cleavage(P450scc) in the tissues of the testis of the adult rats,and to preliminarily reveal the molecular mechanism of electromagnetic radiation that affects the synthesis of testosterone. DESIGN:A randomized controlled study. SETTING:Department of Nuclear Medicine and Staff Room of Labour Hygiene, Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA. PARTICIPANTS:The study was completed in the Department of Nuclear Medicine and Staff Room of Labour Hygiene, Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA from June 2003 to May 2004.A total of 75 male Wistar rats of clean degree II,weighing 180 to 220 g,were randomly divided into 5 groups:control group,and groups of 3,6,24,72 hours after electromagnetic irradiation with 15 rats in each group. INTERVENTIONS:The rats were exposed to microwave with the peak power of 90 W/cm2 for 15 minutes successively,and all the rats survived the irradiation.The serum contents of testosterone of rats in the groups of 3,6,24,72 hours after electromagnetic irradiation and control group were measured by using radioimmunoassay(RIA) respectively;meanwhile the levels of the StAR and P450scc mRNA in testis tissue were also determined with RT-PCR. MAIN OUTCOME MEASURES:Serum contents of testosterone in the groups of 3,6,24,72 hours after electromagnetic irradiation and control group;the expression levels of the StAR and P450scc mRNA in testis tissues. RESULTS:The serum contents of testosterone,the StAR and P450scc mRNA levels at the point of 3 hours after electromagnetic irradiation were significantly lower than those in the control group,and they were decreased by 83.1% ,57.3% and 53.6% respectively(P< 0.01).At the point of 6 hours, although those were increased a little, but were still obviously lower than those of the control group, and they were decreased by 52.6%, 17.9% and 29.2% respectively(P< 0.01,0.05) compared with the control group, and were recovered to the normal level at the point of 24 hours, but the contents of testosterone, the StAR and P450scc mRNA levels were significantly reduced again after 72 hours, and they were decreased by 57.6% , 39.5% , 53.5% respectively compared with those in the control group(P< 0.01). CONCLUSION:Electromagnetic irradiation can affect the expression of StAR and P450scc mRNA in the Leydig's cells of the adult rats, thereby decreasing the synthesis of testosterone.

Objective To evaluate double microcatheter technique for detachable coil treatment of wide-necked intracranial aneurysms. Methods Routine endovascular coil occlusion was not achieved in 6 cases of wide-necked intracranial aneurysms. A second femoral arterial sheath was inserted on the opposite side . A second microcatheter was positioned within the aneurysm. The detachable coils were introduced via double microcatheter simultaneously or successively till the aneurysm were compactly embolized. The coils were detached after satisfactorily positioned. Results Total 6 cases of wide-necked aneurysms were successfully embolized with detachable coil. Aneurysmal sacs were 100% embolized in 2 cases, over 90% in 4 cases. 1 case suffered moderate disablement as a result of complication of. Angiographic follow-up in 5 cases revealed no recurrent or rerupture.Conclusions The double microcathter technique may be an optional method during embolization of some complicated wide-necked aneurysms.

BACKGROUND: Titanium alloy implant has been widely used in the clinic. But there are few reports addressing on corrosion performance of medical titanium alloy dental implant, in particular in different physiological electrolytes. OBJECTIVE: To investigate the corrosion behaviors of medical titanium alloys in physiological saline, simulated saliva, and simulated body fluid. DESIGN, TIME AND SETTING: A randomized grouping, controlled observation was performed at the School of Stomatology, Lanzhou University and State Key Laboratory of Solid Lubdcation, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences between November 2008 and March 2009. MATERIALS: Medical titanium alloys (Ti-6Al-4V) were cut into 10 mm×10 min×1 mm sheets and were randomly divided into 3 groups, with 10 sheets in each group. METHODS: Corrosion performance of titanium alloys in physiological saline, simulated saliva, and simulated body fluid was investigated using electrochemical measurements. Following electrochemical corrosion, surface morphologies and wettability of samples were also observed using scanning electron microscope and CA-A type contact angle tester. MAIN OUTCOME MEASURES: Tafel curve, surface morphology, and contact angle of medical titanium alloys in three physiological electrolytes after 4 days of electrochemical corrosion. RESULTS: The corrosion of titanium alloys was most severe in simulated saliva, followed by simulated body fluid, and mildest in physiological saline. Scanning electron microscope results demonstrated that medical titanium alloy surface exhibited many holes after corrosion by physiological saline, showed rough surface with a slightly changed number of holes after corrosion by simulated body fluid, and presented with an increased number of holes, with aperture greatly increased in some holes after corrosion by simulated saliva. The contact angles of titanium alloys were all reduced after corrosion of three electrolytes. CONCLUSION: The corrosion of titanium alloy was most serious in simulated saliva. Thus, corresponding protection measures should be given in clinical application.

Objective To investigate the expressions of EphA2 and EphrinA1 in bladder carcinomas and their clinical significance. Method The expressions of EphA2 and EphrinA1 were detected on bladder carcinomas (75 cases ) by immunohistochemistry S-P method. Results ( 1 ) The positive rates of expression of EphA2 and EphrinA1 were 61.3%(46/75) and 46.7%(35/75) respectively. (2) The expression of EphA2 was related to tumor size, lymphatic metastasis and TNM staging(P＜ 0.05),but not to gender,age and pathology type (P ＞ 0.05 ). ( 3 )The expression of EphrinA1 was related to tumor size and lymphatic metastasis (P ＜ 0.05 ), but not to gender, age, pathology type and TNM staging (P ＞ 0.05 ). (4)There was significantly positive correlation between the expression of EphA2 and EphrinA1 (P ＜ 0.05).Conclusions EphA2 and EphrinA1 are related to the occurrence and development of bladder carcinoma.The combined detection of EphA2 and EphrinA1 can help to predict the clinical and pathologic characteristics of bladder carcinoma. It is an important index to assist treatment, they are predictive factors for bladder carcinoma.

Objective To understand the syphilis infection status of high-risk population in Yangdu district of Yancheng city so as to provide a scientific basis for preventive and intervention measures.Methods Serum anti-TP antibody was detected by the en-zyme-linked immunosorbent assays(ELISA).Treponema pallidum particle agglutination(TPPA)assay was carried out on the posi-tive samples of anti-TP antibody,then rapid plasma regain(RPR)was conducted on the positive ones.Results The syphilis antibody positive rate of high-risk population was 14.30%,among them the positive rate of RPR in the syphilis infected persons was 58.18%;the positive rate of syphilis had statistically significant difference between genders in different crowds and different age groups(P <0.05).Conclusion The syphilis infection rate of high-risk population in Yandu district is high.The infection rates of STD clinic clients and the people subjected to reeducation were higher than those of the person accepting voluntary counseling and testing(VCT);the infection rate of 21-40 years old females is significantly higher than that of males.The high-risk population mo-nitoring should be strengthened and the publicity and education and behavior intervention should be carried out to effectively re-strain the spread of syphilis in crowds.

Objective To survey and analyze the factors that may affect the results of human-ities education about master degree postgraduates, and provide the basis and reference for traditional medical humanities education reform. Methods By using the self-made questionnalre, a survey was conducted among 100 medical postgraduates of a university. Questionnalre items included basic infor-mation of the postgraduates, humanities-related extracurricular experiences, whether there had been personal experiences corresponding to these options or these experiences affected the attitude of hu-manistic education options. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number. The differences between different gender, marriage and differ-ent specialty student satisfaction were analyzed by using chi-square test or Fisher's exact test, showing no statistical significance (P>0.05). Results Respondents believed that the highest rate of the top four which supported the experiences that promoted humanistic education were clinic volunteer activi-ties, interpersonal harmony, rescuing the patient experiences and illness experiences, accounting for 95.8%(91/95), 92.6%(88/95), 89.5%(85/95) and 88.4%(84/95), respectively. On the other hand, the highest rate of the top four that impeded humanities education-related experiences were academic stress, workload, limited communication and lack of humane care, accounting for 100.0% (95/95), 95.8%(91/95), 91.6% (87/95) and 84.2% (80/95) respectively. In addition, different types of students' attitude towards experiences that may have impact on the humanistic education were not statistically significant (P>0.05). Conclusion Humanities education in medical colleges should not be limited to classroom instruction form. We should broaden humanistic education approach, flexible assessment methods of humanities, to enhance the effect of humanities education.

Objective:To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes.Methods: A series of 100 consecutive,unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed.There were 50 male patients and 50 female patients.The average patient age was 51 years,and the average body mass index was 24.69 kg/m2.The preoperative diagnosis included avascular necrosis of femoral head,hip osteoarthritis,osteoarthritis se-condary to acetabular dysplasia,sequelae of hip old infection,ankylosing spondylitis,rheumatoid arthritis and avascular necrosis of femoral head after cannulated screws fixation of femoral neck fracture.There were 7 hips which had surgical history prior to the index hip arthroplasty,including 3 cases with bone graft treatment for avascular necrosis of femoral head through Smith-Peterson approach,2 cases with acetabular shelf procedures for acetabular dysplasia through Smith-Peterson approach,and 2 cases with cannulated screws fixation for femoral neck fracture (internal fixation residual).All were uncemented hips.The stems used in this study included 67 Triloc stems (DePuy company,USA),45 Corail stems (DePuy company,USA),2 Accolade stems (Stryker company,USA),1 Synergy stem (Smith-Nephew company,USA) and 1 Polarstem (Smith-Nephew company,USA).Results: The average follow up period was 8.5 months,the average incision scar length was 10 cm,and the average postoperative Harris score was 93.62.There was 95％ postoperative leg length discrepancy within 3 mm.The average cup inclination angle was 38.7°with 94.8％ in the range of 30° to 50°.The average cup anteversion angle was 14.3° with 94.2％ within the target range of 5° to 25°.The were 15 (12.9％) operative complications,including two femoral perforations (changing stem from Triloc to Corail),three calcar fractures (treated with cerclage wires),four greater trochanter fractures (2 were treated wire tension band,and 2 nondisplaced fractures untreated),one deep infection (debridement and retaining of the prothesis),one superficial infection (debridement),one hematoma and three wound healing complications (debridement).All the complications were successfully treated without any sequelae at the end of the latest follow-up.There was no postoperative dislocation.There was no major nerve and vascular injuries.There were 35 cases (30.2％) reporting symptoms of lateral femoral cutaneous nerve palsy.Conclusion: Direct anterior approach to total hip arthroplasty allows accurate and reproducible cup orientation positioning and leg length restoration and decreases the risk of postoperative dislocation,which is helpful for early rapid postoperative recovery.

Objective To investigate the clinical, biochemical and genetic features of a Chinese boy with early-onset glo-boid cell leukodystrophy (GLD). Methods The clinical and genetic data of a rare case of early-onset GLD were retrospectively analysed. Results At 2 months after birth, the boy showed progressive psychomotor regression. At 4 months of age when the boy was taken to a doctor, the pyramidal sign was positive. The cranial MRI showed that the body of the lateral cerebral ventri-cles was slightly enlarged and the brain ditch crack of frontal-temporal-parietal lobe was widened and deepened. On his brain CT scan, high signals in bilateral basal ganglia, thalami, cerebellar hemisphere were observed.β-galactosylceramidase (GALC) ac-tivity in the peripheral leucocytes was signiifcantly decreased (3.9 nmol/g protein.h). On his GALC gene, one homozygous novel mutation c.868C>T on exon 8 was found, which resulted in the amino acid change on p.R290C proteins. Conclutions Early-on-set GLD is a rare autosomal-recessive hereditary lysosomal storage disease with a terrible prognosis, in which beta-galactose glu-coside enzyme deifciency is induced by GALC gene mutation. The diagnosis of early-onset GLD is dififcult and should depend on enzyme assay and gene testing.