Objective:To determine the three-dimensional stability of atlantoaxial reconstruction with anterior approach screw fixation through C2 vertebral body to C1 lateral mass and Gallie’s technique for C1~2 instability.Methods:25 human cadaveric specimens were randomly divided into 5 groups.The three-dimensional range of motion C1 relatively C2 was measured under five different conditions,the intact state(intact group),odontoid tape Ⅱ fracture(group OTF),fixation with posterior C1~2 transar- ticular screw(group PTS),anterior approach screw fixation through C2 vertebral body to C1 lateral mass(group ASM),ASM and Gallie’s technique(group ASMG). The obtained data were statistically analyzed. Results:The range of motion in all directions group ASMG,ASM and PTS was significantly decreased.There was significant difference among group ASMG,ASM and PTS in flexion/extension and lateral bendings by statistical analysis(P0.05). Conclusion:In vivo biomechanics studies showed that ASMG had unique superiority in the reconstruction of the atlantoaxial stability,especially in controlling the instability of flexion/extension and lateral bendings.It was one kind of reli- able surgical choice for the treatment of the obsolete insta- bility or dislocation of C1~2 joint.

BACKGROUND: Senile hip fracture is a common disease, and its high disability and lethality severely affect the lifetime and quality of life of the elderly.OBJECTIVE: To summarize the research progress of senile osteoporotic hip fractures.METHODS: A computer-based search of CNKI, CqVip, WanFang and PubMed databases was performed for relevant basic research published from January 1995 to September 2016 using the keywords of osteoporosis,hip fracture, epidemiology in Chinese and English, respectively. Meanwhile, references in the searched articles were retrieved, finally 27 eligible articles were enrolled for analysis.RESULTS AND CONCLUSION: (1) The occurrence of senile osteoporotic hip fractures is closely related to the bone mineral density, proximal femur geometry, and fall-strain. (2) The preventions of osteoporotic fractures include primary prevention aiming at risk factors for osteoporosis and secondary prevention for osteoporotic patients. (3) The surgical treatment of femoral neck fracture is divided into open/closed reduction and internal fixation, femoral head arthroplasty and total hip arthroplasty. (4) Sliding hip screw fixation, proximal femoral intramedullary nail, external fixator and femoral head arthroplasty are used to treat intertrochanteric fracture. (5) There are various drugs used for hip fracture, such as calcium, vitamin D, estrogens, calcitonin and bisphosphonates. Indeed, individual treatment contributes to postoperative rehabilitation.

Objective To evaluate the clinical efficacy of laparoscopy combined with colonoscopy for small colorectal space occupying lesions (equal or less than 3 cm). Methods From January 2010 to January 2015,a total of 41 cases of small colorectal space occupying lesions (equal or less than 3 cm)were treated under general anesthesia with laparoscopic surgery combined with colonoscopy.The patients were placed at the lithotomy position.After the establishment of pneumoperitoneum,injection of methylene blue for staining was carried out under colonoscopy. Laparoscopic titanium clipping positioning was conducted, and then the colonoscope was withdrawn.According to the intraoperative frozen pathological results,bowel resection surgery or colorectal surgical resection was selected. Results All the 41 cases of laparoscopic combined with colonoscopic surgery were successfully completed, with no conversion to laparotomy.There were 9 cases of preoperative diagnosis of precancerous lesions,6 of which were found neoplasia in the colon epithelium with intraoperative pathological diagnosis,with 3 cases of Tis adenocarcinoma.Among 32 cases of preoperative diagnosis of stage 0 -Ⅰ colorectal cancer,there were 29 cases of intraoperative and postoperative diagnosis of stage Ⅰ (23 cases of T1 N 0 M0 adenocarcinoma and 6 cases of T2 N 0 M0 adenocarcinoma)and 3 cases of stage Ⅲ (T2 N 1 M0 adenocarcinoma).Two cases were multiple lesions.Bowel resection was performed in colon intraepithelial neoplasia and Tis lesions of colorectal cancer,while resection of colorectal cancer was conducted in stage T1 -T2 colorectal cancer.Two patients with colonic epithelial neoplasia were followed up for 9 and 12 months,without recurrence.The remaining 39 cases were followed up for 24 -49 months,with a median of 38.6 months. Among the 35 cases of colorectal cancer,colonoscopy detected local recurrence in 1 case of T2 N 1 M0 adenocarcinoma (stage Ⅲ)after 34 postoperative months.No metastasis was found in all the patients. Conclusion Laparoscopy combined with colonoscopy for small diameter (equal or less than 3 cm)benign tumor or stage Tis -T2 malignant colorectal cancer has advantages of both endoscopy,especially suitable for difficultly located or removed lesions,which can improve the positioning precision and surgical safety.

Animals ; Arbovirus Infections ; prevention & control ; virology ; Arboviruses ; growth & development ; Biomedical Research ; methods ; standards ; trends ; China ; Humans ; Insect Vectors ; virology

In this paper, we describe mismatch, chaos, and disorder behavior during healthcare seeking. Such structural imbalances, scarcity and surplus make healthcare services less efficient. We give reasons for such phenomena in terms of long-term effects of health resource allocation policy-making and implementation, inherent de-fects within healthcare insurance, incomplete market development, and cultural issues. We then propose four policy strategies, including rational price mechanism, strict referral healthcare system, confidence in basic healthcare facili-ties, and proper healthcare cultures. These will restore orderly healthcare behavior and help realize expectations for the current healthcare reform in China.

Objective To seek a operation method of quality control of biochemical tests in peacekeeping mission via perspective of evidence-based laboratory medicine .Methods Literatures related to quality control of biochemical tests in international peace-keeping were referred ,compared and discriminated .Combined with 5-year peacekeeping laboratory experience ,a set of feasible ap-proaches were worked out and a practice evaluation was performed in a task period .Results Under the supervision of the quality control system ,providing accurate and reliable test results to the clinical ,developing and implementing quality control of biochemical tests were economical ,practical and reliable ,and could guarantee the effectiveness of reports of biochemical test in peacekeeping medical institutions .Conclusion Evidence-based laboratory medicine is important for quality control of biochemical tests in peace-keeping medical institutions .

BACKGROUND:Internal fixation has been shown to decrease intertrochanteric fracture complications in the clinic and to improve quality of life of patients. The major method widely used in the clinic is the fixation of proximal femoral nail and dynamic hip screw. ＜br> OBJECTIVE:To observe the clinical effects of proximal femoral nail and dynamic hip screw in treatment of intertrochanteric fracture in the elderly. ＜br> METHODS:A total of 60 patients with intertrochanteric fracture were randomly divided into proximal femoral nail and dynamic hip screw groups (n=30), and they respectively received proximal femoral nail and dynamic hip screw fixation. ＜br> RESULTS AND CONCLUSION:Compared with the dynamic hip screw group, operative time, blood loss, the incidence of complications one year after repair, fracture healing time and complications were lower in the proximal femoral nail group (P＜0.05). After repair, the excellent and good rate of Harris hip scores was higher (P＜0.05). No significant difference was detected in healing time of wound between the two groups (P>0.05). Results verified that compared with the dynamic hip screw fixation, the clinical effects of proximal femoral nail fixation were better, more safe and reliable in the treatment of intertrochanteric fracture in the elderly.

Animals ; China ; Culex ; Insect Vectors ; Longitudinal Studies

Angioplasty, Balloon, Coronary ; Humans

The paper introduces microcosmic control model for medical morals construction.The function of the model includes explanation,operation and evaluation.The author holds that the key to the morals construction is scientific management,and the decision maker should have the social responsibility and the love-patient consciousness.