Objective To establish a finite element model of rotator cuff which can be used to simulate the rotator cuff injury and to evaluate the biomechanical effects of rotator cuff surgery.Methods The Dicom CT images of the right shoulder of a Chinese healthy volunteer were used to establish models of the scapula,humerus and clavicle.The rotator cuff structures were separated and modeled based on the MRI images and anatomical knowledge.After the rotator cuff model was introduced into the finite element analysis software Abaqus 6.12,the anatomical positions were simulated when the shoulder was at 30° internal rotation,30° external rotation,30° abduction,30° adduction,30° flexion and 30° extension.Results When the shoulder was in 30° flexion,the average stress was 52.2 kPa on the supraspinatus,223.0 kPa on the inffaspinatus and the teres minor,and 90.4 kPa on the subscapularis.When the shoulder was in 30° extension,the average stress was 105.0 kPa on the supraspinatus,78.2 kPa on the infraspinatus and the teres minor,and 55.7 kPa on the subscapularis,indicating that the muscle and tendon of the supraspinatus was subjected to greater stress and the humerus and the scapula produced less stress compared with the shoulder in 30° flexion.Conclusion Since our finite element model of the rotator cuff can simulate common activities of the shoulder joint and obtain stress values of the corresponding rotator cuff muscles,it can be used in simulation of rotator cuff injury and its surgery.

Objective To explore the optimum flow shear stress and mass transport for the construction of tissue-engineered bone.Methods The β-tricalcium phosphate (β-TCP) scaffolds seeded with human bone marrow-derived mesenchymal stem cells (HBMMSCs) were cultured in perfusion bioreactor.When the same flow rate was applied,the flow shear stress was separately 1×,2× and 3×.When the same flow shear stress was applied,the flow rates were separately 3 ml/min,6 ml/min and 9 ml/min.Cell proliferation was measured by MTT method.The construction of tissue-engineered bone was evaluated by measuring alkaline phosphatase (AKP) activity,secretion of osteopontin (OP) and osteocalcin (OC),and the mineralization of extracellular matrix (ECM).The flow shear stress and the mass transport were obtained using computational fluid dynamics.Results When the flow rate was same,the most cell proliferation was found in 2× group.The AKP activity and secretion of OC was higher in 2× and 3× groups than in those in 1× group.After 28days,the highest amount of mineralization of ECM was found in 3× group.When the flow shear stress was same,the AKP activity was highest in 6 ml/min group.After 28 days,secretion of OC and formation of mineralized ECM was highest in 3 ml/min group.When the flow rate was same,the flow shear stress was separately 0.004-0.007 Pa,0.009-0.013 Pa and 0.013-0.018 Pa.When the flow shear stress was same,the flow rate was separately 0.267-0.384 mm/s,0.521-0.765 mm/s and 0.765-1.177 mm/s.Conclusion When the tissue-engineered bone was constructed,0.013-0.018 Pa flow shear stress and 0.267-0.384 mm/s mass transport velocity could improve the construction of the tissue-engineered bone in vitro.

Objective To analyse the dysfunction of immunity and clinical significance in patients with cardiac cancer.Methods The level of CD4+ CD25hi CD127low Treg cells were detected by flow cytometry (FCM),and serum IL-10 and TGF-β1 levels were determined by enzyme linked immunosorbent assay (ELISA) kit in 56 patients with cardiac cancer.15 healthy volunteers were tested as normal controls.The clinical data of each patient were collected and analyzed. Results There was a significantly higher percentage of CD4+ CD25hi CD127low Treg cells in patients with cardiac cancer (5.73±1.56)% than that (4.45±1.06)% of healthy volunteers (P<0.01).The IL-10 and TGF-β1 levels in the serum of patients with cardiac cancer were also significantly higher than that of healthy volunteers (P<0.05).There was a positive correlation between levels of IL-10.TGF-β1 and the levels of CD4+ CD25hi CD127low Treg cells.The number of CD4+ CD25hi CD127low regulatory T cells in the peripheral blood of cardiac cancer patients were significantly correlated with clinical stages and metastasis lymph node.Conclusion The CD4+ CD25hi CD127low Treg cells in the peripheral blood of cardiac cancer patients is significantly increased in comparison with that in healthy volunteers,and was also correlated with different stages.The abnormal levels of CD4+ CD25hi CD127low Treg cells may be related to tumor progression in patients with cardiac cancer.

Objective To investigate the effect of Aidi injection combined with chemotherapy on CD+4CDhi25CDlow127regulatory T (Treg) cells in peripheral blood of advanced non-small-cell lung cancer (NSCLC).Methods Sixty patients with advanced NSCLC were randomly divided into the study group (treated with Aidi injection combined with chemotherapy) and the control group (treated with chemotherapy).The levels of CD+4CDhi25CDlow127Treg cells were detected by flow cytometry (FCM), and TGF-β1 and IL-10 levels were determined by enzyme linked immunosorbent assay (ELISA) before and after chemotherapy. A group consisted of 20 healthy persons was set up meanwhile.Results There was a significantly higher percentage of CD+4CDhi25CDlow127Treg cells in patients with NSCLC (5.77±1.50) % than that(3.84±0.96) % of healthy volunteers (P=0.000).The IL-10 and TGF-β1 levels[(24.09±6.74), (197.76±43.76) ng/ml]in the serum of patients with NSCLC were also significantly higher than that[(19.39±5.73), (141.13±32.17) ng/ml]of healthy volunteers (P =0.006,P =0.002). In control group, levels of CD+4CDhi25CDlow127 Treg cells were obviously lower than that before chemotherapy (P =0.048).Levels of TGF-β1 and IL-10[(22.25±6.79), (184.85±49.11) ng/ml]were slightly decreased, which showed no significant difference contrast to pretherapy[(24.37±8.10), (197.16±44.57) ng/ml](P =0.276, P =0.314).In study group, levels of CD+4CDhi25CDlow127Treg cells and TGF-β1, IL-10[(4.36±1.19) %,(20.16±4.73), (165.42±39.57) ng/ml]were obviously lower than that before chemotherapy[(5.78±1.50) %,(23.81±5.15), (198.35±43.68) ng/ml](P=0.000, P=0.003, P =0.006).Conclusion The CD+4CDhi25CDlow127 Treg cells in the peripheral blood of advanced NSCLC patients is significantly increased. Aidi injection combined with chemotherapy can obviously reduce the level of CD+4CDhi25CDlow127 Treg cells in patients with advanced NSCLC, and the combined therapy could improve the immune function of patients.

Objective To evaluate the clinical diagnostic application and operative efficacy of the expression of NKG2D in peripheral blood CD+8 NKT cell and its ligand sMICA in patients with esophageal or cardiac carcinoma.Methods The peripheral blood NKG2D positive CD+8 NKT cell percentage was concomitantly determined by flow cytometry in 53 preoperative patients including 29 postoperative patients with esophageal or cardiac carcinoma and 30 healthy controls.The serum sMICA was determined by ELISA.Results The peripheral blood NKG2D positive CD+8 NKT cell percentage in patients was significantly lower than that in controls [(77.632±8.972) % vs (89.053±6.515) %] (t = -6.113,P ＜0.05); with stage Ⅱ,Ⅲ,Ⅳ,it decreased significantly in order (F = 99.251,P ＜0.01);with lymph node metastasis lower than that without lymph node metastasis (t = -10.384,P ＜0.01); squamous carcinoma was higher than adenocarcinoma (t =9.899,P ＜0.01); postoperative was significantly higher than preoperative (t =-4.319,P ＜0.01).The level of serum sMICA in patients was significantly higher than that in controls [(326.28±85.407) pg/ml vs (210.00±92.560) pg/ml](t =7.292,P ＜0.01); with stage Ⅱ,Ⅲ,Ⅳ,it increased significautly in order (F =63.355,P ＜0.01); with lymph node metastasis higher than that without lymph node metastasis (t =7.770,P ＜0.01); squamous carcinoma was lower than adenocarcinoma (t =-7.593,P＜0.01); postoperative was significantly lower than preoperative (t =7.027,P ＜0.01).Serum sMICA could inhibit peripheral blood CD+8 NKT cell activation receptor NKG2D (F =142.773,P ＜0.05),determination coefficient R2 = 0.7368.Conclusion The level of peripheral blood CD+8NKT cell activation receptor NKG2D and serum sMICA in patients could be an assistant indicator for

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. Methods From 2006 to 2004,four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town,Heqing County,two villages each type,and the comprehensive control measures were implemented,including the examination and treatment of schistosomiasis,Oncomela?nia hupensis snail survey and control,health education,improving drinking water and lavatories,banning grazing,constructing sanitary pen of livestock,replacing cattle with machine,etc. The schistosome infection state and snail status in 2006 were treat?ed as the baseline information,and the effect of the comprehensive measures were evaluated. Results The infection rate of hu?man in plateau canyon areas decreased from 4.94%in 2006 to 0.06%in 2014,and that of livestock decreased from 1.11%to 0. In plateau basin areas,there was only 1 case of schistosomiasis found in Xiaolian Village in 2007,and no any other cases found in the other years,the infection rates of livestock dropped from 7.38%to 0. Compared with 2006,the snail areas in the two type areas decreased by 74.89%and 75.30%,respectively,meanwhile,the percentage of snail area,the occurrence rate of frames with snails,as well as the average density of living snails also decreased,and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009,and Xiao?lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. Conclusions The comprehen?sive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistoso? miasis in plateau areas of Yunnan Province. In the future,we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.

Objective:To investigate the metal artifact reduction effect of orthopedic metal artifact reduction (O-MAR) techonology and its improvement effect on the image quality in CT examination in the patients with arthroplasty, and to elaborate the significance of the technology in clinical diagnosis and treatment of arthroplasty.Methods:The CT data of 20patients with hip or knee prostheses was collected.There were two tube voltages in each group of CT data:120and 140Kev.There were also two groups of CT data in each tube voltage group:nonO-MAR group and O-MAR group;there were four subgroups of CT data of each case:120 Kev/-O-MAR, 120Kev/+O-MAR, 140Kev/-O-MAR, 140Kev/+O-MAR.After data collection, Mimics software was applied to conduct three-dimensional (3D) reconstruction for purpose of the qualitative and quantitative analysis of CT data.Qualitative analysis mainly included the grade of severity of metal artifact and quality of data.Quantitative analysis included the volume of metal artifact, the average CT value and standard deviation (SD) in region of interest (ROI) .ROI 1and ROI 2were chosen at the location of beam hardening artifact (radial high-density metal artifact) and photon starvation artifact (band low-density metal artifact) , respectively.Results:According to the result of3D measurement, the volumes of artifact had no significant difference between 120 Kev/-O-MAR group and140Kev/-O-MAR group (P=0.062) , but there were siginificant differences in the volumes of artifact between other groups (P＜0.05) ;O-MAR technology decreased the volume of beam-hardening artifact obviously (P＜0.05) .According to the results of two-dimensional (2D) measurement, there was no significant difference in the average CT values in ROI 2between 120Kev/-O-MAR group and 140Kev/-O-MAR group (P=0.069) , but there were significant differences in the average CT values between other groups (P＜0.05) ;O-MAR technology decreased the high-density beam-hardening metal artifact and the low-density photon-starvation metal artifact in 2D measurement.Conclusion:O-MAR technology could significantly reduce the CT metal artifact of hip and knee prostheses and increase the clinical value of CT data.

In April 2022,an epidemic occurred in Gongshu District,Hangzhou,where Zhejiang Cancer Hospital is loca-ted.And the hospital was confronted with the most extensive,the most unusual and the most urgent public health emergency crisis since its establishment.Taking patients as the core and proceeding from the public perspective,an authoritative voice of a hospital was conveyed in a timely and accurate manner,which demonstrated the hospital's resolution and executive power in the crisis.Based on Malcolm Gladwell's"tipping point"theory,the paper reveals the situation of online public opinion caused by the sudden epidemic and its response,discusses the hospital's communication practices in handling public health emergencies and provides hospitals with practical reference for brand promotion and operation.

Objective:To discuss the accuracy of stereolithography (SLA)-3D printing model in orthopedics and maxillofacial surgery,and to clarify the reliability of its clinical application.Methods:A total of 33 cases of SLA-3D printing models were randomly included (10 long bones,13 irregular bones and 10 prostheses),and the CT scanning and three-dimensional reconstruction were performed.According to the clinical application characteristics of the models,the max height (MH),max length (ML),max width (MW),width of the trochlear (WT),length of the trochlear (LT),length of the glenoid cavity (LGC),width of the glenoid cavity (WGC),distance of pubic tubercle-anterior superior iliac spine (DPI),diameter of the acetabulum (DA),diameter of the marrow cavity (DMC),anterior height of right ramus (AHRR) and posterior height of right ramus (PHRR) were selected to measure the original data and model data,respectively.The absolute / relative errors were calculated.Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the data.The three-dimensional error analysis of the prosthesis model was carried out.Results:There were no significant differences in the anatomical parameters except MW of irregular bone (P＞0.05) in 33 cases of SLA-3D printing model.The values of ICC were all greater than 0.950;the maximum values of absolute / relative errors were-0.58 mm and-1.37％,respectively;the maximum 3D error of prosthesis model was 0.237 mm,and the average value was 0.132 mm.Conclusion:The CT data of SLA-3D model is highly consistent with the original data,and it is accurate and reliable in the diagnosis and treatment of the diseases in orthopedics and maxillofacial surgery.

Objective:To evaluate the effects of individual extralevator abdominoperineal excision (ELAPE) of rectal neoplasms in the low posterior wall on the pelvic floor by finite element analysis. Methods:MIMICS 10.01, Geo Magic Studio 12, and ANSYS Workbench 14.0 were used to analyze the magnetic resonance data obtained from the pelvic region of 27 healthy nulliparous volunteers. Three types of finite element models (intact model, ELAPE model, and individual ELAPE model) were developed. The maximal stress on non levator ani tissues were analyzed using the three models, while the maximal stress on levator ani tissues were analyzed using the in-tact model and the individual ELAPE model. Their stress distributions under the same pressure were analyzed and compared. Results:The maximal stress on non levator ani tissues obtained using the intact model, ELAPE model, and individual ELAPE model were (1.963± 0.061), (5.127 ± 0.070), and (3.667 ± 0.126) MPa, respectively, with P<0.01. High-stress zones were obtained at the joints with pelvic walls on both sides using the three models, while the maximal stresses were obtained at the joints with pubis on both sides. The maxi-mal stress on levator ani tissues obtained using the intact model and individual ELAPE model were (0.812 ± 0.042) MPa and (1.437 ± 0.043) MPa, respectively. Thus, the individual ELAPE model yielded higher values of maximal stress compared to the intact model. Both models generated high-stress zones at the joints with tendinous arch of levator ani tissues on both sides, and maximum stresses at the joints with pubis on both sides. Conclusion:Individual ELAPE decreases the stress on non levator ani tissues. This suggests that the risk of postoperative pelvic floor hernia is relatively reduced.