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 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.

The incidence of cervical neoplasms complicated with pregnancy is rising,with delaying of reproouctive age.Because of the prevalence of cytology in pregnancy.eervical neoplasnis complicated with pregnancy are mostly detected early. All patients with cytological abnormalities should undergo colposcopy, and when necessary,they should undergo cervical biopsy.Conization is reserved for patients with suspected invasion.In cases of invasive carcinoma detected up to the 12th week of pregnancy,immediate treatment is prioritized.Regarding diagnoses made during the second trimester,in early-stage invasive cancers,delay of therapy seems to be safe.fetal pulmonary maturity can be awaited.And the use of neoadjuvant chemotherapy to stabilize the disease until the time of delivery appears to be viable.Doctors should draw up personalized program for the patients with cervical neoplasms complicated with pregnancy according to stage of disease, gestational weeks and the patient's desire for continued pregnancy.Cervical neoplasms complicated with pregnancy are mostly early-stageinvasive cancers, so prognosis is good.

Objective To detect the expression of HSPA2 mRNA and protein in pancreatic cancer and corresponding adjacent nontumorous tissues, and investigate the expression of HSPA2 protein in pancreatic cancer and its association with clinicopathological characteristics.Methods Western blot and qPCR (real-time quantitative PCR) was used to evaluate HSPA2 expression in pancreatic cancer and corresponding adjacent nontumorous tissues.Immunohistochemistry was used to investigate the HSPA2 expression in pancreatic cancer and its association with clinicopathological characteristics.Results Both the mRNA and protein levels of HSPA2 were significant higher in pancreatic cancer tissues than those in their paired adjacent nontumorous tissues.High HSPA2 expression was detected in 68.8% (55/80) of pancreatic cancer tissues.HSPA2 protein expression was significantly associated with tumor differentiation, vascular invasion, and status of metastasis (P=0.011,0.005,0.012).Conclusion HSPA2 expression is elevated in pancreatic cancer, and positively correlated the process of invasion, metastasis and progression of pancreatic cancer.

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 changes of clinical symptoms and liver or lung functions after inferior vena cava stent implantation in Budd Chiari syndrome patients. Methods 35 cases of Budd Chiari syndrome patients were enrolled and retrospective analysized, such as ascites, edema of lower limbs, abdomen wall of varicose veins and serum total bilirubin, serum albumin, prothrombin time, FVC, MVV, PEF, FEV1.0, FEV1.0/FVC and other pulmonary functional changes were analyzed before and 1 months after inferior vena cava stent implantation. Results Ascites, edema of lower limbs, abdominal varicose veins and other clinical symptoms were significantly reduced or disappeared, the total serum bilirubin significantly decreased, serum albumin significantly increased, and prothrombin time significantly reduced 1 month after surgery in patients with Budd Chiari syndrome, (t = 1.95, 2.31, 2.07, P < 0.01). FVC, MVV, PEF, FEV1, the indexes of FEV1/FVC improved obviously after surgery (t = 1.83, 2.69, 1.47, 1.69, 1, 97, P = 0.041, 0.029,0.046, 0.043, 0.043, 0.038). Conclusion Inferior vena cava stent implantation could effectively improve the clinical symptoms of patients with Budd Chiari syndrome.

Objective To explore the clinical application of function-preserving pancreatic surgery for treating pancreatic neuroendocrine neoplasms (pNENs).Methods Twenty-eight patients with pNENs treated by the function-preserving pancreatic surgery at Anhui Province Hospital from January 2002 to December 2015 were analyzed retrospectively.Results Among the 28 patients, enucleation surgery was performed in 18 cases, distal pancreatectomy was performed in 8 cases, and middle pancreatectomy was performed in 2 patients.Total average operation time was (197±68) min, and the blood loss was (106±99) ml.The postoperative pancreatic fistula was observed in 7 patients, seroperitoneum was in 4 patients, incisional infection was in 1 patient, pulmonary infection was in 2 patients, and all the patients were cured by conservative treatment.There was no death during perioperative period.The postoperative hospital stay was (13±6)d.Analysis of pathological examination and clinical symptoms showed that 24 cases were diagnosed as functional pNENs (including 23 with insulinoma and 1 with gastrinoma), and 4 cases were as non-functional pNENs.The tumor grade G1 was categorized in 19 cases, G2 was in 9 cases.The TNM was I stage in all patients.There were no vascular or nerve invasion or lymph node metastasis.The follow-up period ranged from 4 to 144 months.2 patients were lost, and other patients were all alive.No diabetes or hypoglycemia occurred.Conclusions The function-preserving surgery for pNENs was safe and feasible, especially for well-differentiated functional pNENs.

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.