Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery

Condoms ; standards ; supply & distribution ; Humans ; Quality Control ; Sexually Transmitted Diseases ; prevention & control

Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation.
Bone Neoplasms ; diagnosis ; surgery ; Chondroblastoma ; diagnosis ; surgery ; Humans ; Patella ; surgery

Objective To explore the effect of gamma-aminobutyric acid (GABA) on the growth, apoptosis and telomerase activity of Cholangiocarcinoma cell line QBC939. Methods Cholangiocarcinoma cell line QBC939 was cultured by routine method, and then treated with different concentrations of GABA (1-1000 μmmol/L). The proliferation, apoptosis and cell cycle of QBC939 cells was investigated by MTT, Flow cytometry and transmission electron microscopy. The telomer-ase activity of QBC939 cells was examined by modified PCR-ELISA assay. Radioimmunoassay was used to measure the intracellular cyclic adenosine monophosphate(cAMP) content. Results The dif-ferent concentrations of GABA inhibited the growth of QBC939 cells and promoted the apoptosis. The apop-totic rate of QBC939 cells was increased from 4. 8% to 28. 03%, which had significant difference (P<0.05). It had no effect for distribution of cell cycle. Cell nuclear condensation and apoptotic bodies were seen by transmission electron microscopy. Telomerase activity was inhibited by GABA(0. 82±0. 048 vs 0.56±0. 054, P<0.05). The content of intracellular cAMP was increased with the increase of GABA concentration in a dose-dependent manner [(0. 59±0. 049) nmol/L vs (0. 82±0. 033)nmol/L, P<0. 05]. Conclusion GABA can inhibit the proliferation of QBC939 cells by promoting apoptosis and inhibiting telomerase activi-ty, which may be mediated by the information transmission of post-receptor.

Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

In the medical field, the innovation education is to cultivate residents in China, which is an important way to senior medical elite. By analyzing competency-based neurosurgery residency training mode, the training methods for innovative ability of competency-based neurosurgeon are further discussed, for the purpose of reforming the training mode of neurosurgeon, improving creative ability and scientific clinical thinking ability.

Objective To investigate the significance of myelography for selecting operation methods in microendoscopic discectomy(MED).Methods A total of 196 patients with lumbar disc herniation diagnosed by CT/MRI received a myelography before MED.According to their clinical manifestations,signs,and outcomes of myelography,the patients were given three different operation methods.①Simple discectomy was performed in 105 patients with patent spinal canal,lateral impression at intervertebral level,and shift of the nerve root sleeve;②Discectomy with spinal decompression was performed in 70 patients with patent spinal canal and compression of the nerve root sleeve;③Discectomy with semilaminectomy was performed in 21 patients with patent spinal canal,semispherical compression of the nerve root sleeve,and 7-shaped nerve root.Results The operation time was 30~90 min(mean,50 min) and the intraoperative blood loss was 30~120 ml(mean,50 ml).No intraoperative complications occurred.Conversions to open surgery were required in 21 patients,including partial spinal stenosis in 16 patients and thickened vertebral plate in 5 patients.Follow-ups were carried out in 196 patients for 3~58 months(mean,34 months).According to the Japanese Orthopedic Association(JOA) scoring system,the final scores significantly increased postoperatively(25.86?2.96) than preoperatively(13.21?4.96)((t=)38.24,P=0.00).According to the Macnab and Watts standard,the rate of excellent or good results was 93.7%(164/175).Conclusions Myelography has an important reference value for selecting operation methods of microendoscopic discectomy in patients with lumbar disc herniation.

Intervetional therapy as an important therapeutic method for malignant biliary obstruction has been used extensively,but there still remain some problems worthy for our emphasis and research. We retrospectively reviewed more than 800 patients with malignant obstructive jaundice during 12 years. Indications,contraindications,complications and corresponding treatment methods were studied. Furthermore,discussion including methods of biliary drainage,proper time of stent implantation,methods of anesthesia,usage of antibiotics and haemostat were also carried out. Use of analgesics (pain-suppressal)pre-and post procedure,development of acute pancreatitis and its management,and peri-operative mortality were further investigated in detail. We hope our experiences and lessons would give interventional doctors some help in their career.(J Intervent Radiol,2007,16: 649-651)

Objective:To investigate the recent and forward effects of different operation patterns on recurrent calculus of intrahepatic duct.Methods:A analysis was made on previous history and operation patterns,distribution,effect and follow-up visit in 76 reoperation patients with recrudescent hepatolith between Jan,2000 and Feb,2008 in Affiliated Provincial Hospital of Anhui Medical University,retrospectively.The situation after operation was confirmed as the short-term curative effects and the follow-up results as long-term curative effects.Results:The average hospital stay was 10.4 days and the incidence rate of postoperative complications was 14.5%.The follow-up which lasted from 8 months to 8 years showed that the average recurernce rate was 38.2%.Besides,the rate of joint-type operation was lower than single-type operation (P

Objective To explore the best minimal invasive method in treating renal pelvic stones less than 1.5 cm.Methods A total of 90 patients with renal pelvic stone less than 1.5 cm were enrolled, including 47 cases of retrograde intrarenal surgery(RIRS)by rigid and flexible ureteroscopy with holmium laser lithotripsy,and 43 cases of percutaneous nephrolithotomy(PCNL)by holmium laser lithotripsy.Opera-tion time,stonefree rate(SFR),hospitalization,and complications were analyzed for comparison.Results The average sizes of stone in the RIRS group and PCNL group were 1.2 cm(range 1.0 ~1.5 cm)and 1.3 cm (1.0 ~1.5 cm),respectively.In the RIRS group,45(95.74%)patients out of 47 had complete clearance and 32 patients needed combination of flexible ureteroscopy to fragmentate the stones falling into the renal calices.The operation time was 44 min(range 27 ~70 min)with postoperative fever in 2 cases.The decrea-sing in hemoglobin and hematocrit was(0.18 ±0.06)g/L and 0.11%,respectively.No major complication was recorded.In PCNL group,the mean operation time was 70min(range 45 ~90 min)with a stone-free rate of 95.35%(41 /43).The decreasing in hemoglobin and hematocrit was(17.25 ±6.70)g/L and 5. 62%,respectively.The complications in PCNL group were postoperative fever in two cases and bleeding in two cases.Conclusion RIRS has the advantages of natural orifice endoscopic surgery in shortening opera-tion time,reducing blood transfusion requirements,and decreasing postoperative complications.For renal pelvic stone less than 1.5 cm,RIRS can be the primary choice.