Objective: To report a newly designed method for treating supracondylar fracture of the humerus,and to inquire into the problems of cubitus varus deformity and joint stiff.Methods:Based on a review of anatomy,a new method which called tension band with sphenoid-shaped osteotomy through posterior approach was designed and applied for 46 cases of patients in clinic.The clinical effect was compared with effect of crossing Kirchner's wire.Results:The tension band with sphenoid-shaped osteotomy was a better method and can abide by anatomical and biomechanical principles.After follow-up for 12-36 months,curative effect was estimated as follow:30 cases were excellent,14 cases good and 2 cases poor according to Home's evaluation.Conclusions:It is a better methods in treating supracondylar fracture of the humerus following advantages including simple,reliable fixation and early mobilization etc.

Objective To discuss the indication, the prevention and treatment of complications of the esophagectomy through left thoracic and neck approach. Methods 2?058 cases of esophageal carcinoma were analyzed retrospectively. Results The success rate of this procedure was 98.40%, and 33 cases died postoperatively, the mortality was 1.60%(33/2?058). Lymph node metastases were presenting 895 cases. The gross rate of lymph node metastasis was 43.49%(895/2?058), the rates of 1ymph nodes metastasis in neck, chest and abdomen were 5.12%(107/2?058), 42.50%(875/2?058) and 21.19%(436/2?058), respective1y. The occurrence rate of residual carcinoma was 1.51%(31/2?058). The complication rate was 15.74%(324/2?058). 1?870 cases were followed-up (90.86%). The overall 3-, 5-year survival rates were 61.22%(895/1?462) and 36.45%(384/1?053), respectively. Conclusion The advantages of this approach were relatively radical resection, 1ow incidence of residual carcinoma, less severe complications.

Objective Wether preoperative freezing plus traditional operative resection would improve 5 year survival of patient with esophageal cancer was studied. Methods 50 patients admitted for esophageal cancer were divided equally at random.The treatment group (n=25) received cryotherapy before traditional surgery.The rest,without pretreatment,had surgery as controls.Their 1,3,5 year survival rates were contrasted. Results With pretreatment the 1,3,5 year survival rate reached 92,76,56 percent respectively,while that of the controls attained 80,40,and 28 percent accordingly.Statistically significant difference in survival did exist between groups by the end of 3 and 5 years after the combined therapy, yet no difference was detected within 1 year. Conclusion Preoperative cryotherapy could reduce the possibility of lymphatic metastasis,iatrogenic spread during operation and improve patient’ s immunological functions and life span.

Objective To observe the changes of calcitonin gene-related peptide(CGRP) -immunoreactive positive nerve fibers innervation in bone tissue of femoral heads during the pathological process of early steroid-induced avascular necrosis of the femoral head (SANFH), and explore its significance.Methpathological group of SANFH was induced.Immunohistochemical technique was used and the changes of CGRP-immunoreactive positive nerve fibers innervation in weight bearing area of the femoral heads during the pathological process of early SANFH were observed.Result The number of CGRP-immunoreactive nerves increased first and then decreased ( Peaked at 6 weeks, 10.28 ± 0.66 ), but it was more than that ofnormal control group.There was significant difference between two groups ( P ＜ 0.01 ).Conclusion There were changes in the distribution of CGRP-immunoreactive positive nerves fiber during the process of bone repair after SANFH.CGRP-immunoreactive positive nerves fiber might take part in the process of bone repair in SANFH.

Objective:To investigate the diagnostic efficacy and clinical application value of 99Tc m-diethylene triamine pentaacetic acid (DTPA) SPECT/CT imaging in cerebrospinal fluid leakage (CSFL). Methods:A total of 23 patients (11 males, 12 females; age (44.2±15.1) years) who underwent endoscopic repair surgery for suspected CSFL in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital between April 2018 and January 2020 were retrospectively reviewed. All patients performed 99Tc m-DTPA SPECT/CT imaging, paranasal sinus high resolution CT (HRCT) and MRI before surgery. The diagnostic efficacies of 3 imaging techniques were calculated according to the result of surgery regarded as the golden standard. χ2 test was used to compare the qualitative and localized diagnostic efficacies of 3 imaging techniques for CSFL. Results:Of 23 patients, 21 were finally confirmed with CSFL and 24 leak locations were identified according to the results of surgery; the other 2 patients had no obvious CSFL and no leak location was found during the operation. The sensitivity and accuracy of 99Tc m-DTPA SPECT/CT, MRI and HRCT for the diagnosis of CSFL were 100%(21/21) and 95.7%(22/23), 85.7%(18/21) and 82.6%(19/23), 76.2%(16/21) and 69.6%(16/23), respectively. The accuracy of 99Tc m-DTPA SPECT/CT, MRI and HRCT for the diagnosis of leak location was 79.2%(19/24), 50.0%(12/24) and 45.8%(11/24), respectively. There was no statistically significant difference of diagnostic efficacies for CSFL among 3 imaging techniques ( χ2 values: 0.451-3.453, all P>0.05). For leak location, the diagnostic efficacy of 99Tc m-DTPA SPECT/CT was significantly better than that of MRI and HRCT ( χ2 values: 4.463, 5.689, both P<0.05). Conclusion:99Tc m-DTPA SPECT/CT imaging shows an excellent diagnosis efficacy not only for CSFL but also for leak location, which is helpful for guiding surgery.

Fracture is a common physical injury. Its healing process involves complex biological activities at tissue, cellular and molecular levels and is affected by mechanical and biological factors. Over recent years, numerical simulation methods have been widely used to explore the mechanisms of fracture healing, design fixators and develop novel treatment strategies, etc. This paper mainly recommend the numerical methods used for simulating fracture healing and their latest research progress, which helps people better understand the mechanism of fracture healing, and also provides direction and guidance for the numerical simulation research of fracture healing in the future. First, the fracture healing process and its relationship with mechanical stimulation and biological factors are described. Then, the numerical models used for simulating fracture healing (including mechano-regulatory model, biological regulatory model and mechano-biological regulatory model) and corresponding modeling techniques (mainly including agent-based techniques and fuzzy logic controlling method) were summarized in particular. Finally, the future research directions in numerical simulation of fracture healing were preliminarily prospected.
Computer Simulation ; Fracture Healing ; Fractures, Bone ; Humans ; Models, Biological ; Stress, Mechanical

Objective To systematically explore the change of fixator stiffness (0.05-7.50 kN/mm) on healing effects of seven different types of fractures (A1: simple spiral, A2: simple oblique, A3: simple transverse; B2: wedge spiral, B3: wedge fragmented; C2: complex segment, C3: complex irregular) under the OTA/AO fracture classification. Methods Taking intramedullary nail fixation of long bone fracture as research objective, based on strain-regulated tissue differentiation theory, and combined with fuzzy logic algorithm and finite element analysis, the process of fracture healing was numerically simulated. Results Moderate fixator stiffness (1.5-2.5 kN/mm) shortened the healing time while ensuring recovery of biomechanical performance of the fractured bone. However, the appropriate fixator stiffness corresponding to each fracture type was different. The sensitivity of healing effects to change of fixator stiffness was also different. For type A fracture, when fixator stiffness was 1.5 kN/mm, optimal biomechanical recovery of the fractured site could be obtained, while the change in fixator stiffness had a large impact on healing effect. For type B and C fractures, when fixator stiffness was above 1.5 kN/mm, the change in fixator stiffness had no significant effects on recovery of biomechanical performance. Conclusions Fracture healing is affected by both fixator stiffness and fracture types. For treating fractures in clinic, the selection of fixators should carefully take fracture types into account.