OBJECTIVETo evaluate the clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) and minimally invasive reconstruction of posteromedial corner (PMC).

METHODSThere were 22 cases of ACL and PMC tear were performed with reconstruction from March 2012 to February 2014. The patients were 29.4 years old on average, including 8 males and 14 females. ACL reconstruction was performed under arthroscopy and PMC reconstruction was performed minimally invasively through the ACL incision. The stability of knee was assessed by anterior drawer test,Lachman test,vulgus stress test and Slocum test. The function of knee was assessed by Lysholm score and Tegner activity rating. MRI of knee was checked 12 months after operation.

RESULTSThe stability tests of all patients were negative at 2 and 6 months after operation, and there was one positive case in anterior drawer test and another positive case in vulgus stress test at 12 months after operation. Lysholm score of all patients 12 months after operation was 96.8 +/- 6.8, which was significantly better than 32.0 +/- 11.2 before operation. Tegner activity rating of all patients at 12 months postoperatively was 6.1 +/- 0.9, which was significantly better than 0.9 +/- 0.5 before operation. It showed the grafts were very well in the MRI 12 months postoperatively.

CONCLUSIONArthroscopic ACL reconstruction and minimally invasive PMC reconstruction can restore the stability of knee.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective:To assess the efficacy and safety of oncoplastic breast-conserving surgery (OBCS) in the treatment of early breast cancer. Methods:The clinicopathological data of breast cancer patients who were treated with OBCS (67 cases) and standard breast-conserving surgery (SBCS;117 cases) in Affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. Postop-erative complication, specimen weight, margins, and surgery re-excision rate between the two groups were compared. Results:Sero-ma (14.9%versus 48.7%, P<0.001), hematoma (4.5%versus 14.5%, P=0.035), and poor wound healing (3.0%versus 11.9%, P=0.036) were more common in the SBCS group than in the OBCS group. The patient satisfaction in the OBCS group was statistically higher than in the SBCS group (P<0.05). Compared with standard surgery, oncoplastic techniques can be employed for significantly larger tumors (25.04 mm versus 21.14 mm, P<0.001). OBCS resulted in higher mean specimen weights (92.24 g versus 57.44 g, P<0.001), wider clear nearest margins (12.04 mm versus 9.58 mm, P<0.001), and wider furthest margins (24.16 mm versus 15.24 mm, P<0.001). No statisti-cal increase was observed in further surgery re-excision of margins. Conclusion:OBCS is more successful than standard wide local exci-sion in treating larger tumors and obtaining wider radial margins. Oncoplastic approach showed no increase in postoperative complica-tion rate. The postoperative complication was excellent. OBCS is a safe and effective procedure for early breast cancer.

OBJECTIVETo explore a safe and effective scheme of analgesic for labor.

METHODSEighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied. In 5 min, 10 min and 60 min of acupuncture (the same time points in the control group) as well as at the end of the first and second stage labor, the analgesic effect was assessed for the primiparas of the two groups. The labor stages, adverse reactions, postpartum hemorrhage, postpartum urine retention, newborn asphyxia rate and usage rate of oxytocin were compared between the two groups.

RESULTSIn the observation group, in 5 min, 10 min and 60 min of acupuncture as well as at the end of the first and second stages, the visual analogue scale (VAS) was lower apparently as compared with the control group at the corresponding time points (all P < 0.05). The differences in the time limit in the active period, the second and third stages were not significant between the two groups (all P > 0.05). The incidence of adverse reactions and the usage rate of oxytocin were lower than those in the control group [2.4% (1/42) vs 31.0% (13/42); 2.4% (1/42) vs 23.8% (10/42), both P < 0.05]. The differences in postpartum hemorrhage, postpartum urine retention and newborn asphyxia rate were not significant between the two groups (all P > 0.05).

CONCLUSIONThe combination of acupoint injection and EA is the effective analgesic scheme for labor. This scheme effectively alleviates labor pain and has no maternal and child complications.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Labor Pain ; drug therapy ; therapy ; Labor, Obstetric ; Pregnancy ; Young Adult

The outpatient service system at Shanghai Sixth People's Hospital came into use since April 2009.Data from Jan.2010 to Oct.2010 and interviews with employees of department in question showed a rapid growth of outpatient appointments,a poor handling of outpatients absenteeism,and poor integration among the platforms of the appointments.The development of outpatient services depends on behavioral change of both medical workers and consumers.Some measures could be employed to improve outpatient appointment within the current mechanism.

Objective To investigate the expressions and clinical significance of the tumor supressor gene phosphatase and tensin homlog deleted on chromosome ten protein(PTEN) and oncogene phosphoserine/threonine protein kinase B(phospho-serine/threonine protein kinase Akt/PKB,pAkt) in hepatocellular carcinoma(HCC).Method The expressions of PTEN and pAkt in 65 cases of HCC and their pericarcinomatous tissues were detected by immunohistochemical staining with S-P method.Results The positive expression rate of PTEN in HCC was significantly lower than that in pericarcinomatous liver tissues,and the positive rate of pAkt was significantly higher than that in pericarcinomatous liver tissues(all P

Objective To evaluate the clinical value of 99Tcm-MIBI SPECT for the differential diagnosis of parotid tumors before treatment.Methods 99Tcm-MIBI SPECT imaging of the parotid region was obtained in 32 patients with parotid tumors before surgery.Early and delayed 99Tcm-MIBI imaging were performed in all patients and the diagnosis was confirmed by pathological results after surgery.The ratio of radioactivity between the tumor and opposite side of normal parotid tissue (T/N) was measured.Fisher exact probability test and t test were used for statistical analysis.Results The sensitivity,specificity and accuracy of 99Tcm-MIBI SPECT imaging for the differential diagnosis of parotid tumor were 90.00％ (9/10),86.36％ (19/22) and 87.50％ (28/32),respectively.Among 22 patients who had benign tumors,19(86.36％) showed negative findings,and the other 3 ( 13.64％ ) patients showed false positive results.In 10 patients with malignant tumors,1 ( 10.00％ ) had false negative findings,and all the other 9 (90.00％)patients showed positive results.The difference between the benign and malignant groups was statistically significant (P =0.00018 ).In the early images,the T/N ratios of benign and malignant parotid tumors were 1.45 ±0.38 and 1.65 ±0.63 (t =20.4,P＜0.01),respectively; and in the delayed images,the ratios were 1.43 ± 0.56 and 1.77 ± 0.59 ( t =2.4,P ＜ 0.05 ),respectively.Conclusion 99Tcm-MIBI SPECT imaging might be useful for the differential diagnosis of parotid tumors before surgery.

Objective To investigate the anti?OPN antibody′s protective effect towards the synovial membrane of rats with rheumatoid arthritis,in?cluding the mechanism of such protective action. Methods From a total of 40 SD rats,6 were randomly selected as the normal control group while the remaining 34 were used to establish the collagen induced arthritis model. A total of 24 rats with arthritis index higher than 2 were chosen(exclud?ing the rest 10 rats),and randomly divided into model group and groups being treated with low,medium and high dose of anti?OPN anti?body,re?spectively. Weight,arthritis index and the volume of the left hind leg toe of the rats were recorded. Then on day 35,the rats were killed and their joints were taken out to make HE colored sections for observation of the pathological changes. The synovial membrane of each rat was taken out and WB method was used to test the protein expression of OPN and TNF?αin such membrane. ELISA method was used to test the change of the content of OPN and TNF?αin each rat′s blood. Results The rats in treatment group gained weight steadily from day 16 and their swollen joints were gradu?ally relieved upon medication. Comparing with the control group,the differences in weight,toe volume and arthritis index of the rats in model group were statistically significant(P<0.05). Comparing with the model group,the differences in weight,toe volume and arthritis index of the rats in the treatment groups were also statistically significant(P<0.05). Pathologic change of synovial membrane:for rats in treatment groups,synovial cell hy?perplasia was visibly reduced with a little inflammatory cell infiltration and smooth articular cartilage surfaces with no visible damage. Expression of OPN and TNF?αin synovial membrane and blood serum of rats:Judging from the OPN measured in synovial membrane and blood serum,we could see that the expression of OPN in rats of the model group increased obviously if compared with the control group. Comparing with the model group, the expression of OPN in the treatment groups was reduced(P<0.05). Judging from the TNF?αmeasured in synovial membrane and blood serum, we could see that the expression of TNF?αin rats of the model group increased obviously if compared with the control group,thus such difference was statistically significant between different groups(P<0.05). Conclusion The anti?OPN anti?body could significantly reduce the articular symp?toms of the rats with collagen induced arthritis,restrain the synovial cell hyperplasia and alleviate the inflammatory reaction. In the process of protect?ing the joints of the rats with collagen induced arthritis,anti?OPN anti?body restrained only the expression of OPN in the synovial membrane and blood serum,leaving the expression of TNF?αunaffected.

Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

Aim To investigate the effects of CP1 54526,a corticotropin releasing hormone (CRH) receptor 1 antagonist,on the hippocampal neuron ap-optosis.Methods Rat hippocampal neurons were primarily cultured.Cell viability was estimated using MTT assays.Neurons were randomly divided into four groups:Normal cultures (Control);CRH-exposed cul-tures (CRH);CRH and CP1 54526 co-exposed cul-tures (CRH + CP ); CP1 54526-exposed cultures (CP).Cell apoptosis was examined by TUNEL or flow cytometry Annexin Ⅴ-PI staining.The protein levels of Bax,Bcl-2 and Caspase-3 were investigated by West-ern Blotting.Results 1 0 -8 mol·L -1 CRH decreased cell viability of cultured hippocampal neuron (P <0.05),while 50 mmol ·L -1 CP1 54526 significantly increased neuron viability (P <0.05).Compared with Control group,cell apoptotic rate,the ratio of Bax and Bcl-2 and the protein level of Caspase-3 were elevated in hippocampal neuron induced by CRH.Combined with CP1 54526 reversed the effects of CRH.Applica-tion of CP1 54526 alone had no obvious effects on cell apoptosis.Conclusions A certain concentration of CRH can induce hippocampal neuron apoptosis,and its receptor 1 antagonist CP1 54526 can effectively re-duce the apoptosis and play a neuroprotective role.

Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.