BACKGROUND: How to design and manufacture sophisticated artificial knee joint that meets the needs of patients after knee joint replacement rely on the precise design and manufacturing technology, which ensure the prosthesis match the body and make a coordinated movement with maintained soft tissues. OBJECTIVE: To design personalized knee joint utilize of computer-aided design technology.METHODS: The human knee joint was scanned by three-dimensional laser scanning and output of the point cloud data were processed by computer-aided design technology. After that, the three-dimensional solid model of the knee was reconstructed by Geomagic and UG software.RESULTS AND CONCLUSION: A very precise three-dimensional knee model was constructed. It provides an accurate model basis for the digital manufacture of biomimetic artificial knee, virtual assembly, stress analysis, motion analysis, and surgical simulation.

High-frequency surgical equipment electrical safety is analyzed based on safety testing standards for GB9706.4,and high-frequency leakage current of GD350-Btype high-frequency surgical equipment is tested by QA-ES.The safety of high-frequency surgical equipment is discussed.

Objective To analyze the clinical features of patients with IgG4-associated biliary and pancreatic diseases,and to improve the understanding of these diseases.Methods Nine cases of patients with IgG4-associated pancreatitis and cholangitis were analyzed retrospectively,which included clinical manifestations,serological examination,imaging test,pathology,treatment and prognosis.Results Of the 9 patients,8 were male,1 was female,the average age was 61 years old.Four cases were presented with jaundice,2 cases with jaundice and abdominal pain,2 cases with abdominal pain,and 1 case with diabetes.Serum IgG4 levels were 3.46-21.3 g/L (mean 9.743 g/L) in 6 cases,and which were higher than normal value,3 patients did not undergo blood test of IgG4.Nineteen auto-antibodies (including ANCA) were all negative in 9 cases.CA19-9 was increased in 4 cases.CT manifestations showed 5 cases with low density pancreas mass (2 cases with biliary tract dilatation);1 case had pancreas swelling with dilatation of bile duct,and 2 cases with bile duct dilatation only,and CT findings in 1 case were negative.Four patients underwent EUS-FNA,and EUS features included hypoechoic lesions without peripancreatic lymph nodes.FNA results indicated 2 cases with IgG4 related chronic inflammation,2 cases with chronic inflammation with negative IgG4.Seven cases were confirmed to have IgG4 related pancreatitis,and 2 cases with IgG4 related cholangitis.Six patients received glucocorticoid treatment,and the dose ranged from 8-40 mg;3 patients underwent surgery and the surgical pathology indicated IgG4 positive plasma cell.Follow-up showed the serum IgG4 returned to normal,clinical symptoms improved remarkably,and pancreatic mass decreased.Conclusions IgG4 positive plasma cell infiltration is the main feature of IgG4-associated cholangitis and pancreatitis.The diagnosis should combine image,serology with pathology.Glucocorticoid is an effective treatment.

Objective To compare the efficacy of stents 7 F and 10 F in drainage of pancreatic pseudocyst via EUS-FNA.Methods A retrospective analysis of patients with pancreatic pseudocyst who received endoscopic ultrasonography guided puncture drainage by using 7 F and 10 F double pigtail plastic stent respectively in Drum Tower Hospital of Nanjing University Medical School from 2010 to 2014 was conducted.Patients' hospitalization period, the time for 50％ cyst reduction, removal time, infection rate, and recurrence rate were compared.Results Twenty three patients with pancreatic pseudocyst were included, among whom 14 were male and 9 were female.The age ranged from 13 to 70 with an average of 45.1 years.Eleven patients were treated with 7 F pigtail plastic stents whereas 12 patients with 10 F pigtail plastic stents.All patients were treated with additional 8.5 F joint nose cyst drainage.Four cases in 7 F group got fever, 3 of whom were successful in anti-infection and 1 failed, having to change the stent.One case (9.1％) relapsed without symptoms after 52 months during the follow-up and received no intervention.Five cases in 10 F group got fever, 4 of whom were successful in anti-infection and 1 failed, having to change the stent.One case (8.3％) was identified as mild hemorrhage, and replantation needed to be performed in 1 case (8.3％) because stent was found to slip after 12 days.Two cases (16.7％) relapsed without symptoms after 11 and 24 months respectively and no intervention was received.There was no significant difference in patients' age, cyst size, removal time, infection rate and recurrence rate between the two groups.However, patients in group 10 F had a markedly shorter hospitalization period and time for cyst reduction by at least 50％ than those in group 7 F (P ＜ 0.05).Conclusion 10 F double pigtail plastic stents can drain the cyst faster, shorten the hospital stay, but there is no significant difference in infection or recurrence rate of cyst compared with 7 F stents.

Mirror therapy has been widely used in practice as an effective rehabilitaiton method. Mirror integrated therapy combined mirror therapy with some other technologies, such as virtual reality, functional electrical stimulation, augmented reality, etc., to enhance the task orientation, and improve the efficiency of treatment.

Obstacles in pharyngoesophageal function are characterized clinically by dysphagia.At present,the treatment for dysphagia is broadly divided into two ways:balloon expansion therapy and electrical stimulation therapy.Balloon dilatation device for achalasia of cricopharyngeal muscle is design based on the principle of expansion treatment to stimulate cricopharyngeal muscle contraction and dilatation through the pressure of balloon dilation.At work,the water was filled in balloon catheter through the electronic charge pump to pressurize to reach a certain pressure of the balloon dilatation,and the drain valve drained water at prescriptive speed until it reaches a certain contraction of the balloon pressure,followed by water filling in the balloon catheter.This operation was repeated operation,resulting in a compression cycle to cricopharyngeal muscle,promote its contraction and dilatation.Patients can gradually restore autonomy of swallowing.The device is easy to operate,safe and reliable.The doctor can fill water in the balloon catheter at certain time and quantity to achieve the treatment of achalasia of cricopharyngeal muscle.

Objective To study the impact of active control of the trajectory of the center of gravity on the effectiveness of balance training and balance assessment. Methods Two groups of subjects ( group 1 30-45 years old, group 2 45-60 years old ) were evaluated and trained using both active center of gravity trajectory control and static balance methods. Results The percentages of success in controlling the center of gravity were the same when both groups were trained using static balance. Group 1's success percentage was higher than that of group 2 after active center of gravity trajectory training. Their affected lower limbs performed better in wave trace training than after static balance training, and performance improved with increased wave trace amplitude. Conclusions Wave tracing can stimulate the lower limbs of patients with active control force and improve their balance. The wave assessment is superior to static assessment, as it can objectively reflect ability in active center of gravity control and adjust the lower limbs of subjects whose static balance ability is at the same level.

ObjectiveTo investigate the clinicopathologic features,therapy,and prognosis of primary small cell carcinoma of the pancreas.MethodsDatabases including Chinese Journal Full-text Database,VIP Database for Chinese Technical Periodicals,Medline/Pubmed,and OVID were searched electronically up to April 2012.A systematic review was performed together with one case in our hospital.ResultsTwenty-eight articles fulfilling the criteria consisting of 46 patients with pathologically confirmed diagnosis of primary small cell carcinoma of the pancreas were studied,together with 1 patient in our Drum Tower Hospital,finally 47patients were included.The results of this systematic review showed:( 1 ) Primary small cell carcinoma of the pancreas was more common in men with a median age of 62.The most common clinical presentations were abdominal pain,jaundice and weight loss.Para-neoplastic syndrome was rarely observed.(2)Most cases were found to have abnormally elevated serum levels of neuron-specific enolase.CT displayed heterogeneous,and marked enhancing masses in most cases.The conclusive diagnosis depended on histological confirmation.(3)63.8％ of the cases were found to be associated with metastasis at the time of diagnosis.The overall median survival time was 28 weeks.(4) There was no consensus on the treatment of primary small cell carcinoma of the pancreas. Chemotherapy was currently considered as the treatment of choice among the systematic management for these patients.ConclusionsPrimary small cell carcinoma of the pancreas was a rare and aggressive neuroendocrine tumor with a poor prognosis.

The function theory of an anesthesia vaporizer was studied and the geometry configuration was measured in this study. The internal gas flow and mixing process in the anesthesia vaporizer were simulated using CFD method. Applying tracking in turbulent flow to stochastic particle, for the droplet of anesthesia drug, the moving track of droplet was traced. Based on the results, the internal gas flow variation, the concentration distribution of anesthesia drug volatilization process and mixing process with gas were ascertained. Numerical simulation results showed that, the diluted gas velocity reduction of internal flow in the anesthesia vaporizer was higher. Because of the anesthesia vaporizer geometry, the mixing process between anesthesia drug vapor and diluting gas was not homogeneous. This also influenced the stability and accuracy of anesthesia drug concentration. The optimization precept of anesthesia vaporizer is ascertained.
Anesthesia, Inhalation ; instrumentation ; Computer Simulation ; Humans ; Imaging, Three-Dimensional ; Nebulizers and Vaporizers ; standards ; Numerical Analysis, Computer-Assisted