[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 study the coping strategies of patients with mood disorders and explore the corresponding nursing strategies.Methods A survey,using the coping strategies questionnaire,was conducted among 32 patients with unipolar disorder and 55 patients with bipolar disorder including 34 with current depressive episode,14 with current manic episode and 7 with mixed episode.Results As for coping strategies,no difference was found between unipolar depression and bipolar disorder with current depressive episode or mixed episode(P>0.05);while significant difference was found between bipolar depression and bipolar mania on problem solving(t=-2.869,P=0.006),help seeking(t=-2.443,P=0.018),self accusation(t=2.461,P=0.018)and withdrawing(t=2.870,P=0.006).The patients with unipolar disorder,bipolar depressive or mixed episode tended to use mixed coping strategies,with the percentages of 50.00%,41.18%and 42.86%respectively and 64.29%of the patients with bipolar mania tended to use mature coping strategies.Conclusions Coping strategies of patients with mood disorder are associated with the status of the diseases but independent of the categories of the diseases.Therefore,the corresponding nursing strategies include setting aside the problems,encouraging family member to make decisions and conducting active guidance.

Objective To evaluate clinical results of arthroplasty with the UNIVERS 3-D prosthesis in unstable shoulder arthritis. Methods 16 cases, which were 10 males and 6 females aging from 35 to 79 years (mean, 56.3 years), underwent shoulder arthroplasty with the UNIVERS 3-D prosthesis because of unstable arthritis. The patients were evaluated before surgery, at 12 months and the most recent follow-up with an average follow-up of 30.8 months(mean, 12-50 months) by Constant and normalised Constant score, and reviewed by the radiological analysis on preoperative and postoperative X-rays including AP, scapular and axillary views. Constant and normalised Constant score improvements at 12 months and the most recent follow-up evaluation were compared with the preoperative scores using paired-samples t test. Results 1) 8 out of 11(72.7%) cases with mild inferior humeral or glenoid exostosis. 2) The Constant score improved from 43.8?13(normalized Constant score, 51.36%?15.40% ) to 70.6?17.69(normalized Constant score, 86.44%?22.12%). The pain, activity, mobility and strength scores had been improved obviously. 3)Only one case had the radiolucent line around the uncemented humeral component with radiolucent index of less than 1. No any periglenoid component radiolucency, no shift or subsidence in humeral component, no migration and tilt in glenoid component, no change and loosening in the junction bolt between humeral stem and head. 4) Two cases were experienced postoperative complications including impingement of prosthesis with osteophytes, and PE-inlay loosening received revision surgery. Conclusion Excellent clinical results can be obtained by the shoulder arthroplasty using the UNIVERS 3-D prosthesis with low incidence of radiolucency and postoperative complication.

Objective To investigate the clinical experiment of arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis. Methods From January 2001 to April 2005, 6 patients (4 males and 2 females), with a mean age of 33 years old (range, 28 to 44 years old) and mean duration of 13 months, received arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator. All patients had received at least 3 weeks standard drug treatment for tuberculosis before the operation. After thoroughly debridement under arthroscopy using anterolateral and anteromedial approaches, a half-ring sulcated external fixator was used to fix the ankle joint at the neutral position. 4 days (2-7 days) after the operation, patients could walk with partially weight bearing. All patients replied to our questionnaire and the average follow-up was 21.3 months, with a range of 6-42 months. Patients returned for a clinical and radiolographic evaluation every week before the tibiotalar joints union. The external fixator apparatus were removed after the joint fused. Results Fusion occurred in all patients, the average time to clinical and radiographic union was 12.5 weeks (9-17 weeks). 3 patients were graded as excellent: no pain with a stable fusion. The others were graded as good: mild pain, occasional limp with a stable fusion. There were no sinus or other complications occurred. Conclusion There are considerable advantages using arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis without serious bone defect, include: limited invasion, quickly recovery, thoroughly debriding the tuberculose focus. And the half-ring sulcated external compression fixator could achieve stable and elastic fixation with adjustable rigidity. And patients can walk earlier to promote ankle fusion and decrease related complications.

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.

Objective To observe the effects of basic fibroblast growth factor on c-fos gene expression in spinal cord neurons of rats after tractive spinal cord injury. Methods The animal model of SD rats with tractive spinal cord injury was established through tracting T_ 13-L_2 spine longitudinally with a special spinal tractor that was put on parapophysis of T_ 12-L_3 vertebrae after exposing T_ 13-L_2 spinal cord via dual laminectomy, meanwhile spinal cord function was monitored by cortical somatosensory evoked potential (CSEP). Forty model rats were randomly divided into 2 groups, the bFGF treatment group (n=20) with bFGF injection into the subarachnoid cavity and the control group (n=20) with saline injection. Five SD rats without any treatment served as normal control. The c-fos gene expression was detected with immunohistochemistry and analyzed quantitatively with image system of computer. Results The c-fos gene expression in tractive spinal cord injury was higher than that in normal control group, especially increased markedly in damaged neurons. The peak value of c-fos gene appeared in 2 h after the injury, but c-fos level in the bFGF treatment group was lower evidently than that in the control group at the different sacrificed time (P

Objective To observe the effect of basic fibroblast growth factor on ChAT expression in neurons after tractive spinal cord injury in rats.Methods The animal model of tractive spinal cord injury in 36 SD rats was established.The bFGF-treated rats(n=18) received 20 ?l bFGF solution containing 20 ?g bFGF into subarachnoid cavity immediately,or at 1,2,3,4,8,12 and 24 h after animal model establishment,while the saline-treated rats(n=18) received the equal volume of normal saline at the same time.Another 6 normal SD rats underwent no treatment as normal controls.All rats were killed on postoperative day 4,7,14.The choline acetyltransferase(ChAT) were detected by immunohistochemistry preoperatively and on day 4,7,14 after spinal cord injury.Results The number of neurons positive of ChAT decreased gradually after tractive spinal cord injury.After bFGF treatment,positive neurons of ChAT increased in number,with significant difference between the bFGF-treated group and saline-treated group(P

Objective To evaluate clinical results of arthroplasty with the UNIVERS 3-D shoulder prosthesis in post-traumatic gleno-humeral arthritis. Methods A total of 54 cases (age range of 31-84 years, mean 67.07 years) with post-traumatic gleno-humeral arthritis were treated by the arthroplasty with the UNIVERS 3-D prosthesis. Constant score and normalised Constant score were used to strictly evaluate the preoperative function of 45 cases, of which 30 cases were reviewed by Constant score and normalised Constant score postoperatively with an average follow-up of 12-68 months. Of all, 44 cases were strictly followed up in respect of preoperative and postoperative X-ray including anteroposterior, axial and Y-shaped positions. Results Compared with the pre-operation, there was a significant increase in post-operative pain, activity, mobility and strength as well as the postoperative Constant score and normalized Constant score. Total shoulder arthroplasty (TSA) provided better score for daily life and mobility than hemiarthroplasty, with a significant difference (P

Objective To evaluate the clinical results of arthroplasty with the UNIVERS 3 D prosthesis in shoulder rheumatoid arthritis (RA). Methods Six cases of shoulder RA underwent the arthroplasty with the UNIVERS 3 D prosthesis. Five cases were strictly reviewed by Constant score and normalized Constant score after operation with an average follow up of 26 months, ranging from 12 to 45 months. Five cases were reviewed by the radiological analysis on preoperative and postoperative X ray including three AP views, scapular view, and axillary view. The radiographic forms were classified by two different criteria according to Levigne. Results The postoperative Constant score (mean, 55.06) and normalized Constant score (mean, 72.2%) were improved more than one time in all cases except one. Complication of anterior superior subluxation occurred in glenohumeral joint of one case and no surgical treatment performed. The radiographic forms were classified by Levigne on humeral head wear (including 2 cases of microgeodes, 1 case for notch in the greater tuberosity, and 3 cases for spherical form loss) and on the sphericity and upward migration of the humeral head (1 case for ascending form, 1 case for centered form, and 4 cases for destructive form) according to the clinical results. Conclusion The arthroplasty with the UNIVERS 3 D prosthesis results with excellent clinical function results in shoulder RA without any radiolucent line and with very low complication. Radiological classification on the sphericity and upward migration of the humeral head, and humeral head wear may be useful element in operation choice and its prognosis.

Objective To retrospectively analyze the clinical results of peroneal tendon insertion and reconstruction with suture anchors in the treatment of avulsion fractures of the fifth metatarsal base.Methods Five patients (three males and two females) with the fifth metatarsal base fractures were in zone 1, with average seven days of duration before surgery. The result of radiological examination confirmed that all fractures were in zone 1 of the fifth metatarsal base, with some small, comminuted and obviously displaced pieces. After removal of the small comminuted fracture pieces, the peroneal tendon insertion was dissociated and sutured to the fifth metatarsal base by suture anchors (5 mm in diameter) with line. The feet were immobilized by plaster in the vagus position. The patients began to walk with weightbearing six weeks after operation. Results All patients were followed up for at least six months, which showed no deformity of the feet. The function of forefoot valgus and abduction restored to normal. There was no any loss in muscle force compared with the normal side. Conclusions Peroneal tendon insertion and reconstruction by suture anchors is very helpful to solve the problem in the fixation of the small fracture fragments. The function of the peroneal tendon recovers very well. The surgery has the advantages of easy manipulation and small area of dissection, without requirement of secondary surgery.