Abstact:Objective To explore the effect of different arrangement of hollow screws in treatment of femoral neck fracture.Methods The clinical data of 160 cases with femoral neck fracture from March 2010 to May 2014 in our hospital were collected.They were randomly di-vided into triangle group and inverted triangle group according to arrangement of hollow screws.The operation time,intraoperative blood loss, fluoroscopy frequency in operation,length of stay,time of fracture healing,postoperative complications,Harris score and functional recovery of two groups were recorded and compared.Results The operation time and intraoperative blood loss in inverted triangle group were lower than those in triangle group,the difference was significant(P <0.05).The shortening rate of inverted triangle group and triangle group were 10%and 26.3% respectively.The shortening rate of inverted triangle group was lower than those of triangle group,the difference was significant (P <0.05).For the fluoroscopy frequency in operation,average hospitalization time,fracture healing time,rate of nonunion and femoral head necrosis,Harris score and functional recovery,there was no statistical significance between two groups(P >0.05).Conclusion Inverted tri-angle hollow screws treating femoral neck fracture makes surgery operation easier,operative time shorter and blood loss smaller.

Objective To evaluate the effect of asymptomatic hyperuricemia on the postoperative functional recovery in osteoarthritis (OA)patients with knee joint replacement.Methods Among the 294 patients who recieved knee joint replacement in our hospital from Feb-ruary 2013 to September 2015,a total of 187 patients were included in this study with 79 cases in the hyperuricemia group and the other 108 cases in the control group.The WOMAC index of the two groups were analyzed before the surgery,2 weeks,3 months,and 6 months after the knee joint replacement surgery.Multivariable linear regression was performed to test the effect of impact factors on the variation of WOMAC index.Results The WOMAC index of the two groups significantly increased 2 weeks after surgery,and the difference was statistically signifi-cant(P <0.05).And the WOMAC index of the control group was higher than that in the hyperuricemia group 2 weeks and 3 months after sur-gery with statistically significant difference(P <0.05).Conclusion The uric acid level before surgery was a influence factor of WOMAC index, and high uric acid level before knee joint replacement has negatively impact for the postoperative functional recovery in the osteoarthritis patients.

Objective The aim of this study was to compare recent clinical efficacy between a novel guidance method for percutaneous pedicle screw placement and the conventional fluoroscopic method for long segments thoracolumbar vertebral fracture without nerve injury. Methods A total of 38 patients with thoracolumbar vertebral fracture in our hospital from September 2010 to December 2012 were divided into group A and group B.Eighteen patients in group A underwent 200 percutaneous pedicle screw fixation by conventional fluoroscopic meth-od.Twenty patients in group B underwent 210 percutaneous pedicle screw fixation by a novel guidance method.All the operation for 38 cases were performed by the same surgeon.The time of insertion,radiation exposure,and accuracy of the screw placement between the two groups were compared.The accuracy of screws was evaluated and graded by two consecutive postoperative CT of operation segment for two groups. Results The mean time for a single pedicle screw placement was (13.11 ±2.32)minutes in group A and (10.35 ±1.92)minutes in group B,respectively.The average radiation exposure was (8.11 ±1.15)s in group B and (13.07 ±2.06)s in group A respectively.The differ-ences were statistically significant for both screw placement and radiation exposure times (P <0.05).A total of 172 screws (86.00%)in group A and 185 screws (88.09%)in group B were perfectly located within the pedicle.The statistical difference of grade A between two groups was not significant(P >0.05).Conclusion The novel guidance system can significantly reduce the insertion time and radiation expo-sure for long segments percutaneous pedicle screw placement,which provides the same accuracy for screw placement compared with the con-ventional method.

Objective The aim of this study was to provide methods for predicting ideal trajectory and position of C1 lateral mass screw (C1 LMS)from plain radiographs.Methods A total of 40 consecutive subjects (with 79 screws)who had undergone C1 LMS placement were enrolled.To evaluate the C1 LMS position,the positions of screw head and tips on anteroposterior radiographs,screw length,and height on lateral radiograph were graded as 0°,Ⅰ°,and Ⅱ°,respectively.On the postoperative computed tomography images,the lateral mass (LM) perforation,screw-thread engagement percent(%),bicortical fixation,extruded screw length,and violation of adjacent joints were analyzed. Results Screws with tip located medial to LM(tip 0)showed LMperforation in all cases.Polyaxial head located within the LM(head 0)or crossing the lateral margin of the LM(head Ⅰ)showed no LMperforation.Screw-thread engagement percent was the highest with head Ⅰ-tip Ⅰ (medial half of LM)position (97.6%),followed by head 0-tip Ⅰ (90.5%)and head Ⅰ-tip Ⅱ (lateral half of LM)(86.4%). Screws longer than the posterior half of C1 anterior arch (AA)showed bicortical fixation in all cases with mean extruded screw length of 1.9 mm.Adjacent joint was not violated in 98%,with the screw height below half of C1 AA.Conclusion On an anteroposterior radiograph, a C1 LMS with the screw head located on the lateral margin of the LMand with the screw tip in the medial half of the LMresulted in the safest and longest trajectory.On lateral radiograph,a screw tip that is placed within the anterior-inferior quadrant of the C1 AA results in safe bicorti-cal fixation without injury to the adjacent structures.These plain radiographic findings may be helpful bothpostoperatively and intraoperatively for assessing the trajectory and length of the screw.

Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.

Objective To analyze the current situation of domestic research on fetal surgery by the method of literature measurement, and analyze the development trend.Methods The key words of ‘fetal surgery’or ‘fetal surgery’were searched respectively as the theme, keyword and Title Retrieval in CHKD Database,Wanfang Data knowledge service platform (Wanfang Data),VIP Chinese Journal database (CQVIP)and Chinese biomedical literature database (CBM).Results The result showed that the literature of fetal surgery increased obvi-ously by NoteExpress,especially after 2013.Some hot words of literature about fetal surgery included prenatal diagnosis,ultrasound,fetal sur-gery,prognosis and complications.The major authors’units located in Guangdong,Liaoning,Shanghai,Zhejiang,Sichuan and other regions. The affiliated Shengjing Hospital of China Medical University,Maternal and Child health Hospital of Foshan City in Guangdong Province,the First Affiliated Hospital of Zhongshan University were as the main research institutions.The literatures were classified by the subject of the ob-stetrics and gynecology,surgery,clinical medicine,pediatrics,oncology,the two accounted for more than 50%.The distribution of journals published this type of literature were more broad,and the content was more dispersed.Conclusion The development of the fetus is still in the early stage of development,which need for more accurate positioning and development of the fund to support its development.

Objective Based on protein-protein interaction network,gene modules were identified to provide new targets for molecular therapy of nasopharyngeal carcinoma.Methods GEO dataset (GSE12452)and SAMsoftware were employed to screen the differentially ex-pressed gene in nasopharyngeal carcinoma.Protein-protein interaction network was established by using String database.Based on the net-work,the gene modules were identified by using bioinformatics gene module analysis method.GO analysis was used to analyze the function of gene modules.Results In this study,2 634 differentially expressed genes were identified in nasopharyngeal carcinoma.There were 4 729 protein-protein interaction pairs among the differentially expressed genes according to the String database.We established the protein-protein interaction network based on these pairs.Seven gene modules were identified by bioinformatics methods.GO analysis results showed that the function of the gene modules including regulation of cell cycle,glycosylation,cell adhesion,oxidation reduction and so on.Conclusion There are 7 gene modules in protein-protein interaction network in nasopharyngeal carcinoma.These modules may play important roles in the progression and development of nasopharyngeal carcinoma.Our finding can provide a new sight for molecular diagnose and therapy of nasopharyngeal carcinoma.

Objective To investigate the clinical effects of autologous tumor immune cells (DC-CIK)assisted interventional therapy in the treatment of advanced primary liver cancer.Methods Totally 76 patients with advanced primary liver cancer were divided into 2 groups with 38 cases in each group by random number table method.The control group were merely treated with interventional therapy while the ob-servation group were treated with autologous DC-CIK cell assisted interventional therapy.The short-term curative effect,adverse reactions,liver function indexes before and after treatment,alpha fetal protein (AFP)and changes of immune function were compared between the 2 groups. Results There was no statistically significant difference in short-term curative effect and incidence of adverse reactions between the 2 groups (P >0.05).After treatment,the levels of AST,ALT and AFP in the observation group [(30.4 ±6.0)u/L,(45.2 ±3.8)u/L,(168.5 ± 49.3)mg/L]were significantly lower than those in the control group [(65.1 ±6.3)u/L,(61.8 ±5.3)u/L,(315.2 ±39.5)mg/L],and the differences were statistically significant (P <0.05).After treatment,CD3 +,CD4 + and CD4 +/CD8 + in the observation group were significantly higher than those in the control group (P <0.05).Conclusion Autologous DC-CIK cell assisted interventional therapy can sig-nificantly improve the liver function of patients with advanced primary liver cancer,and it can reduce the level of tumor marker AFP and sig-nificantly improve the immune function of patients.

Objective To evaluate the efficiency of dezocine combined with sufentanil on postoertive analgesia for spinal deformity sur-gery.Methods Divided the 90 patients who were admitted into our hospital from January 2013 to September 2015 into three groups by ran-dom single blind method,namely the dezocine group,the sufentanil group and the combined group,with 30 cases in each group.All the pa-tients underwnet propofol and sevoflurane static absorption compound anesthesia,and they were given continuous intravenous analgesia with different drugs after the surgery.Their visual analogue scale (VAS)score,sedation scale (SS)score,adverse reaction,total PCIA times,ef-fective PCIA times,respiratory rate and arterial blood gas were measured at 2,6,24,48 hours after operation.Results The VAS score of the combined group was lower than that of the dezocine group (P <0.05).The combined group was significantly superior to the dezocine group and the sufentanil group in SS score and adverse reactions.At 24 and 48 hours after surgery,SaO2 and PaO2 in the combined group were higher than those in sufentanil group (P <0.05).PaCO2 in the combined group was lower than that in the dezocine group and the sufentanil group(P <0.05).Conclusion Dezocine combined with sufentanil is a more efficiency way with less adverse reaction on postoperative anal-gesia for spinal deformity surgery,and it is an ideal way of analgesia.

Objective To investigate the selection of flaps for the reconstruction of facial skin defects.Methods A total of 40 patients with facial skin defects were treated from February 2011 to February 2015 in our hospital,and they were given different surgery methods ac-cording to the different facial skin defect sizes.Minor defects were primarily treated by direct suturing;medium-sized defects were treated by local skin flap transposition or island skin flap;and larger defects were treated by expanded skin flap.Results All patients were followed up for 1 to 2 years.All the flaps survived with good color and texture match.All the scars healed well which were almost invisible.There was no obvious deformity in the donor and recipient sites.In addition,there was no lesion recurred.Conclusion Select suitable flaps for the recon-struction of facial skin defects according to the face defect area could get reliable blood supply of the flap,inapparent incision scar and a high level of satisfaction.