Objective To assess effects and security of the insertion of sacroiliac screws by the bi-planar navigation robot system. Methods In a simulated surgical setup, 12 AO cannulated screws were placed into the S1 vertebral bodies of 4 human pelvic bone under the guidance of the bi-planar navigation robot system which was developed jointly by Beijing Aeronautics and Space University and our hospital. To compare this new technique with the conventional technique, another 12 cannulated screws were placed into 4 Synbone pelvic models under fluoroscopic control. The fluoroscopic times, the radiation exposure time and operation time between image acquisition and guide-wire insertion were recorded. Results With the guidance of the bi-planar navigation robot system, the average fluoroscopic times were 2.5, the average radiation exposure time was 1.5 seconds, and the average operation time was 253 seconds. All the screws were in the safe area. Under the fluoroscopic control, the average fluoroscopic times were 20.3, the average radiation exposure time was 13.7 seconds, and the average operation time was 246 seconds. Two screws (16.7%) were misplaced. The fluoroscopic times and the radiation exposure time were reduced significantly when the bi-planar navigation robot system was used (P0.05). Conclusions The bi-planar navigation robot system can provide precise navigation for insertion of sacroiliac screws within several minutes, and reduce the radiation exposure to the patient and the staff significantly. The results of this prospectively controlled experimental study are encouraging for further clinical trials.

Objective:To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodon-tic treatment by Johnston analysis and the regular cephalomatric analysis.Methods:Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study.Lateral cephalometric radiographs were taken before and after treatments.All the radiographs were traced and analyzed by the method of Johnston analysis.Other measurements were evaluated using a series of 1 3 li-near and angular measurements including SNA,SNB,ANB,U1 -SN,U1 -NA,U1 /NA,L1 -NB, U1 /NB,L1 /MP,U1 -L1 ,(U1 +L1 )/2-AB,MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre-and post-treatments,which clarify the dental and skeletal changes by Johnston analysis.The effect of orthodontic correction was de-termined using the non-parameters test.Results:The maxillary moved backforward by 1 .3 mm according to the stable skull base,while the mandible moved forward by 2.1 2 mm.The relative position between the maxillary and mandible (ABCH)changed 3.42 mm.The upper and lower incisors retracted signifi-cantly.The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively.After treatment,the parameters of ANB、U1 -NA、U1 /NA、U1 -SN、L1 -NB、L1 /NB and L1 -M were reduced by -(1 .98 ± 1 .55)°(P =0.01 2),-(5.08 ±4.6)mm (P =0.002),-(1 1 .79 ±1 .21 )°(P =0.004),-(1 3.55 ±6.32)°(P =0.047), -(3.1 7 ±3.07)mm (P =0.01 0), -(6.84 ±2.55)°(P =0.038)and-(4.1 3 ±2.24)°(P =0.048)on average,whose changes had the statistically significant effects.Con-clusion:Tweed-Merrifield technique (directional force technique)can stabilize anchorage molar,retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protru-sion,and make a good vertical control which means this technique is applicable to the patients who need strong anchorage.Even for the severe bimaxillary protrusion adult patients,the Tweed-Merrifield tech-nique can control the anchoragewell and make the profiles improved greatly.

[Objective]To evaluate the surgical technique and effectiveness of extra-articular arthroscopic debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment.[Methods]Arthroscopic debridement was performed in 18 patients(5 males,13 females;mean age 56.4,range 34 to 78) in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis.Arthroscopy was inserted into subacromial interspace and bursectomy was done.Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroscopy.VAS pain score,Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 9 months(6 to 15 months)[KG-58x].Pain and functional disturbance of the shoulder disappeared or obviously improved.The average VAS pain score was(7.8?0.6) preoperatively and(1.7?0.4) postoperatively.The average Constant-Murley score was(61?7)preoperatively and(91?4)at the last follow-up.Radiograph showed little residual deposits in 2 cases but without preoperative symptoms.No case need rotator cuff repair.[Conclusion]Extra-articular arthroscopic removal of calcium deposits together with bursectomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.

Objective To investigate the treatment methods for primary gastric lymphoma (PGL) and analyze the prognostic factors.Methods The clinical data of 55 patients with PGL who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2002 to December 2007 were retrospectively analyzed.Operation,medication or operation combined with medication were applied to patients according to the pathological type,clinical staging,infection of helicobacter pylori and complications.Patients were followed up via phone call till February 2013,and the location,diameter,pathological type,clinical stage of the PGL and the treatment methods were recorded for prognostic analysis.The survival rate was calculated by Kaplan-Meier method,and the univariate analysis of survival was done by Log-rank test.Multivariate analysis was done by COX regression model.Results The PGL located at the gastric antrum in 26 cases,body of the stomach in 17 cases,fundus of the stomach in 5 cases,gastric cardia in 3 cases,body and antrum of the stomach in 4 cases.There were 46 patients with ulcerous PGL,5 with nodular PGL and 4 with diffused and infiltrated PGL.There were 53 B cell lympboma,1 T cell lymphoma and 1 undefined tumor.Of the 53 patients with B cell lymphoma,36 were with mucosa-associated lymphoid tissue lymphoma (MALTL) and 17 with diffuse large B-cell lymphoma (DLBCL).There were 23 patients in stage Ⅰ,23 in stage Ⅱ,4 in stage Ⅲ and 3 in stage Ⅳ.Of the 55 patients,23 received operation,14 received medication,17 received operation + medication,and 1 left untreated.Fifty-three patients had complete follow-up data.The median time of follow-up was 60 months (range,7-132 months).The 1-,3-,5-year cumulative survival rates were 91％,79％ and 72％.The results of univariate analysis showed that tumor diameter,pathological type and clinical staging were risk factors influencing the prognosis of PGL patients (x2 =9.34,6.59,88.01,P ＜ 0.05),while the treatment methods did not influence the prognosis of PGL patients (x2 =3.63,P ＞ 0.05).The results of multivariate analysis showed that DLBCL,clinical stages Ⅲ and Ⅳ were independent risk factors influencing the prognosis of PGL patients (OR =5.758,2.231,95％ confidence interval:2.536-13.073,1.370-3.625,P ＜ 0.05).Conclusion Multi-disciplinary team treatment should be recommended for PGL patients.Pathological type (DLBCL) and clinical stages (stage Ⅲ and Ⅳ) are the independent risk factors influencing the prognosis of PGL patients.

Objective To analyze the relation between lamivudine-resistant mutation types and HBV genotypes.Methods 95 cases with YMDD mutation were selected from out-patient clinic and sickroom in our hospital.Restriction endonuclease MboⅠand EarⅠwere used to identify HBV genotypes of PCR product, farther a phylogenesis tree was applied to check it.Results We could divide 95 cases into two parts, 75 cases(78.95%) were HBV C genotype and 20 cases(21.05%) were B genotype, these were verified by phylogenesis tree.With regard to the types of YVDD mutation、YIDD mutation and YMDD+YVDD+YIDD mutation, there were 11 cases, 5 cases, 4 cases in genotype B, respectively, but 35 cases, 27 cases, 13 cases in genotype C.We made the cha-test to check genotypes and types of YMDD mutation, ?2= 0.856, P=0.710. There were no significant differences.Conclusions Using MboⅠand EarⅠcan genotype HBV PCR product easily and reliably. It is no statistical significance between HBV B or C genotype and the types of YMDD mutation.

Objective To study the clinical, radiologic and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma for further improving the diagnostic ability.Methods The data of 10 patients with histologically proved telangiectatic osteosarcomas were retrospectively reviewed, and the clinical, radiologic and pathologic characteristics were further analysed in combination with the literature.All 10 patients were examined with X-ray and MRI, and 2 patients with CT.Results Telangiectatie osteosarcomas originated from inferior femur in 5 patients, femur neck in 1 patients, superior humerus in 2 patients and superior segment of tibia in 2 patients.The lesions showed osteolytic bone destruction on X-ray films (n = 10) and CT images ( n = 2), with mild bone expansion in 4 patients.The majority of the edge of the destroyed bone areas was unclear but without sclerotic rim.There were Codman's triangle and soft tissue mass in each patient but no obvious neoplastic bone forming.On MRI, all the lesions were mostly or completely constituted by the multiple cysts with periostnal reaction, and several scatteredly smaller liquid-liquid levels were found within cystic cavity in 7 patients.In all 10 cases, there were pathologic hemocoele similar to aneurysmal bone cysts (ABC), but malignant tumor cells and some neoplastic bones were found in cystic walls or septations.Only a small number of neoplastic bone tissue were seen by microscopy in 6 patients.Conclusions The radio-pathologic characteristics of telangiectatic osteosarcoma include the similar imaging findings of ABC, the common growth patterns of malignant tumors,and the pathologic hemocoele, malignant tumor cells within cystic wails or septations.The comprehensive analysis of clinical, radiologic and pathological data may help clinicans to make a correct diagnosis for telangiectatic nsteosareoma.

Objective To analyze the possible prognostic factors of thoracic-esophageal cancer patients with lymph node (LN) metastasis after esophagectomy plus three-field lymphadenectomy.Methods 590 esophageal cancer patients with LN metastasis after esophagectomy plus three-field lymphadenectomy were recruited from Jan.1993 to Mar.2007,and the prognostic factors and causes of postoperative failure were analyzed.Results Five-year survival in the whole sample was 29.6％.While the 5-year survival in different subgroups with 1-2,3-6 or ＞ 7 metastatic LNs were 41.2％,22.2％ and 7.0％ (x2 =62.158,P ＜0.0001),respectively.Univariate analysis showed that tumor site,disease length,T stage,number of metastatic LN and the seventh edition of AJCC staging system were prognostic factors.Multivariate analysis indicated that tumor site and number of metastatic LN were two independent prognostic factors.Conclusion Tumor site and number of metastatic LN were independent prognostic factors influencing the outcome of esophageal cancer.

Objective To explore the finger closed artery damage crisis the diagnosis and the treatment.Methods The clinical manifestation and the method of treatment of 30 examples 36 figure of closed arteries were summarized.Results 26 examples 30 figure of surgeries treatments wound showed the blood circulation good function restoration.After 4 examples 6 figure gave up surgeries treat,the wound showed the partial necroses and were operated amputation.Conclusion The finger closed artery damage crisis should remove the factor of inducing the vasospasm.The surgery treatment should be immediately done if the symptom of ischernia doesn't improve.The pathological changes blood vessel excision tallies or the venula transplant is the first-chosen method of treatment.

Objective To assess the effects of medicated permeation with traditional Chinese medicine Shujin-Zhitong liquid combined with ion tophoresis on osteoarthritis(OA) of rabbit knee joint in vivo.Methods The modified Hulth OA model was prepared with rabbits by anterior cruciate ligament desmotomy plus medial meniscus resection.Twenty-four model rabbits were randomly divided into three groups: Chinese medicine group: treated with Chinese medicine Shujin-Zhitong liquid by ion tophoresis for 20 minutes per day;positive control group: glucosamine hydrochloride was administered orally per day;blank control group: no treatment was administered to the model rabbits.Serum nitrogen monoxidum(NO) concentration was determined at the time points of prior model making,prior treatment,and 4 and 8 weeks of treatment.At 4 and 8 weeks of treatment,the apoptotic rate of chondrocytes was determined by flow cytometry,and the gene expressions of collagen Ⅱand aggrecan were determined by reverse transcription polymerase chain reaction(RT-PCR).Results The contents of serum NO in Chinese medicine group and positive control group were lower than that in blank control group at 4 weeks after treatment,and the content of serum NO in Chinese medicine group was lower than those in positive control group and blank control group at 8 weeks after treatment.The apoptotic rates in Chinese medicine group and positive control group were lower than that in blank control group at 4 and 8 weeks after treatment.Gene expression levels of collagen Ⅱ and aggrecan in Chinese medicine group and positive control group were higher than that in blank control group at 4 weeks after treatment,while the gene expression level in Chinese medicine group was higher than those in positive and blank control groups at 8 weeks after treatment.Conclusions The treatment of medicated permeation with traditional Chinese medicine Shujin-Zhitong liquid combined with ion tophoresis has shown good therapeutic effect on osteoarthritis(OA) of rabbit knee joint,the mechanism might be the inhibition of chondrocytes apoptosis and reduced secretion of inflammatory factors,and the improvement of cartilage repair by up-regulating related gene expression of chondrocyte.

Objective: To investigate the infection state of hepatitis C virus genotype 6a in China.Methods: Three(95,126,150)HCV genotype 6a serum samples were identified by digesting 5′NCR with compound enzyme method.Then,HCV 5′NCR and NS5B fragments were amplified from these samples by RT-PCR assay and sequenced.The phylogenetic trees of the samples were analyzed and compared with 24 HCV complete gene sequences from GenBank.Results: The sequencing reports on 5′NCR showed "CA" bases in 3 serum samples(95,126,150) were inserted into-145 site,and the sequences of 3 serum samples had the highest homology with sequence Y12083(0.934,0.930,and 0.926,respectively).The results of the phylogenetic trees suggested these 3 serum samples belonged to HCV genotype 6a.The sequencing reports on NS5B showed the 3 serum samples also had the highest homology with HC-J4(0.934,0.930,and 0.926,respectively),and the results of the phylogenetic trees suggested these 3 serum samples belonged to HCV genotype 1b.To exclude the influence of amplification efficiency of primers,NS5B fragments were amplified by HCV genotype 6a specific primers and no amplification products appeared.Conclusion: There are different results of HCV genotype by analyzing 5′NCR and NS5B in 3 samples infected with HCV genotype 6a.It may be related with gene recombination.It suggests HCV genotype should be analyzed on more than two regions.