Objective　To investigate the effect of surgical management of phacoemulsification and implantation of artificial lens for traumatic cataract.Methods　The surgery was performed on 19 patients.Results　Post-operatively, the visual acuities were 0.5 or better in 57.9% and 1.0 or better in 15.8% in one week; 0.5 or better in 78.9% and 1.0 or better in 21.0% in one month.Conclusion　It can have better effect to perform phacoemulsification and implantation of artificial lens in different conditions with surgery skill and better equipment.

Objective To evaluate the value of low concentration of isotonic contrast agent combined with 80 kV and adaptive statistical itera-tive reconstruction (ASiR)technique for bronchial artery with CT angiography (CTA).Methods 40 patients (18.5 kg/m2 ≤ body mass index(BMI)≤25 kg/m2 )with lung cancer were randomly divided into two groups and performed enhanced chest CT examina-tion.20 patients (low concentration group)were scanned with Visipaque 270mg I/mL,scanning protocol of (80 kV,260 mA)and other 20 patients (high concentration group)were scanned with Ultravist 370 mg I/mL,scanning protocol of (120 kV,1 50 mA). The CT value,signal noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)and effective dose (ED)of the two groups were compared and analyzed statistically.Differences between the two groups were determined with t test(P <0.05).Results The mean CT value of the low concentration group (31 7.33 HU±70.44 HU)was higher than that of the high concentration group (256.39 HU±37.38 HU)(P <0.05).SD,ED and dose length product (DLP)of the low concentration group (SD:7.55 ±1.51 HU;ED:1.74±0.14 mSv;DLP:124.94±9.9 mGy/cm)were lower than those of the high concentration group (SD:9.36±1.26 HU;ED:3.20±0.35 mSv;DLP:228.82±25.13 mGy/cm)(P <0.05).CNR and SNR of the low concentration group (CNR:59.71± 17.36;SNR:44.01±14.71)were higher than those of the high concentration group (CNR:37.61±6.16;SNR:27.75±4.72)(P <0.05).The subjective scores of the two groups were (3.73±0.66)and (3.81±0.59),respectively,with no statistical difference.Conclusion For the patients with normal body mass index ,it can reduce 47% radiation dose and 27% iodine dosage using low concentration of isotonic contrast agent combined with 80kV and ASiR technique for bronchial artery CTA,while maintaining similar excellent image quality.

Objective:To study the clinico-pathologic characteristics, molecular phenotypes, and prognosis of young breast can-cer patients. Methods:Data from 133 low-age (age≤30 years) young breast cancer patients and 117 young (31 years≤age≤35 years) breast cancer patients who underwent surgery between January 2002 and December 2009 were reviewed. Cases of the middle and old-age elderly (age>35 years) breast cancer patients during the corresponding period were randomly selected as matched controls. The clinico-pathologic characteristics, molecular phenotypes, and prognosis were retrospectively analyzed. Results:The low-age young and young breast cancer patients significantly differed from the elderly patients in terms of tumor size, lymph node metastasis, histological grading, molecular phenotype, and relapse (P<0.05). The low-age young patients are more vulnerable to have triple-negative breast can-cer, recurrence, and distant metastasis (P<0.001). Moreover, the low-age young patients have lower overall survival and disease-free survival than the other groups (P<0.05). Conclusion:Young breast cancer patients have poor prognosis compared with the elderly. Ear-ly screening and prompt treatment are necessary for young breast cancer patients.

OBJECTIVE:To investigate the writing quality of Chinese traditional medicine prescriptions and the medication status in our hospital to promote standard prescription writing and rational administration.METHODS:A total of 11 018 Chinese traditional medicine prescriptions were randomly sampled from outpatient dispensary of traditional Chinese medicine in our hospital in 2006 to find out the non-standard and irrational prescriptions with age and sex,clinical diagnosis,dosage form,specification,usage,and the consumption sum of drugs as main indexes.RESULTS:Of the total Chinese traditional medicine prescriptions,27.85%(3 068)were non-standard in writing,of which,0.47% were without items of age and sex,5.59% without clinical diagnosis,2.72% without dosage form,1.39% without usage,23.64% were unclear in specification and dosage;the prescriptions in which only one drug was prescribed accounted for 90.86%;30.51% were prescriptions for special group;and 5.92% had a prescription consumption sum of no less than 200 yuan(≥200 yuan).CONCLUSION:The quality of Chinese traditional medicine prescriptions in our hospital remains to be further improved.

Objective To observe the effect of Sox9 gene overexpressian on chondrogenesis of esenchymal stem ceils (MSCs) in vitro. Methods Rabbit MSCs were obtained and purified by gradient centrifuge and adhesion culture in vitro. MSCs were transfected by recombinant Sox9 plasmid. RT-PCR and Western blot analysis were used for transfection confirmation. Chondrogenic molecules such as type I1 collagen,aggrecan and Sox9 were detected by immunohistology, RT-PCR and western blot. Cell proliferation was tested by MTT assay. Results MSCs were successfully transfected with Sox9 gene and verified by RT-PCR and Western blot analysis. The overexpression of Sox9 had no effect on the proliferation of MSCs. Transfeeted cells expressed more chondrogenic markers than the control groups. Conclusion Sox9 gene overexpression can enhance chondrogenic differentiation of MSCs.

Prof. LIN Ying-qiang,a famous bone-setting and massage doctor,is good at treating soft tissue injury. He emphasizes not only on 'treatment aiming at its pathogenesis' but also on application of anatomy and biomechanics in clinic. His bone-setting manipulations based on 'explosive force'manipulation and herbal get remarkable clinical effects on the treatment of neck-shoulder and lumbocrural pain.

Purpose To explore the feasibility of optimizing monochromatic images in reducing iodinated contrast dose in CT pulmonary angiography (CTPA). Materials and Methods Sixty-eight patients undergoing CTPA were randomly divided into two groups, with half in research group and half in conventional group to evaluate image quality. Research group underwent spectral CT imaging with the injection of 30 ml Omnipaque (300 mgI/ml) and optimal monochromatic images were postprocessed using the software of GSI viewer. Conventional group underwent conventional CTPA with the injection of 80 ml Ultravist (370 mgI/ml). The CT values were measured respectively in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery. The contrast noise ratio (CNR) in two groups were calculated, and image quality were subjectively assessed. Results The total iodine intake in research group (9000 mg) was significantly lower than that of conventional group (29 600 mg). CNR in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery in research group was significantly higher than that of conventional group (t=2.07-2.71, P<0.05). Subjective image quality scores in research group were also higher than that of conventional group but had no statistical difference (Z=-0.944, P>0.05), while there was a good agreement between the two readers (Kappa=0.8, P<0.05). Conclusion It is possible to reduce iodinated contrast dose using spectral CT imaging and improve the image quality of CTPA.

BACKGROUND: There is no any mature and complete system to repair nerve tissue after segmental injury due to particularity of nerve tissue regeneration. Using tissue-engineering technique to solve this problem is difficult and challenged.OBJECTIVE: To research an artificial nerve bridging substance in application of repairing nerve injury on clinic and obverse its microcosmic spatial structure at the same time.DESIGN: Open experiment.SETTING: Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERTALS: The experiment was carried out in the Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA from November 2001 to January 2003. CollagenⅠ, collagen Ⅳ and gelatin were provided by Sigma-aldrich Company, USA.METHODS: Establishment of bridging substance: Collagen Ⅰ (65.53%) and collagen Ⅳ (32.77%) were added into 0.05 mol/L acetic acid solution, respectively; and then, two suspensions were mixed together and stirred at 4℃. The suspension of collagen and heparin sulfate was pumped, held still and poured into silica gel tube with bore of 3 mm.Continuously, two ends of tube were enclosed and suffered from cold drench and mold at five various speeds. General observation was done. Composites were intercepted cross section, vertical section and 45° section for observation by optic microscope at different speeds of 10×10-5 m/s, 5×10-5 m/s, 2.5×10-5 m/s, 1.0×10-5 m/s and 1.0×10-6 m/s; meanwhile, interior structure of microtubule was observed with scanning electron microscope. Interior diameter of microtubule was calculated as the following formula: actual aperture = (magnification × area of microtubule) ÷ (length of guage × perimeter of aperture).MAIN OUTCOME MEASURES: ① General observation; ② observation with microscope; ③ observation with scanning electron microscope and interior diameter of microtubule.RESULTS: ① General observation: Models were regular cylinders and had symmetrical features. Flexility was wonderful,texture was well-proportioned, and elasticity was strong. ② Results of optic microscope: Structure of external surface was completely blocking without any poricidal dehiscence. Surface was smooth and had good continuity. ③ Results of electron microscope: External surface shaped like terrace tile; asides, interior structure of microtubule was average and its courser was coincident and parallel to each other. Microtubules with longitudinal courser were independence on each other. The structure was blocking and did not connect to each other. This was as the same as courser of nerve fibrous bands of organis. Cross section of interior microtubule was general round and regular, and the diameter was average. Interior microtubule had groat continuity without breaks or transection. Trabeculae of microtubule also had groat continuity,and its surface was smooth. Interior diameter of microtubule ranged from 197.3 μm to 258.8 μm.CONCLUSION: Nerve bridging substance is made of collagen and gelatin which are characterized by groat compatibility and degradation after mixture, lysis and cold drench, It has singly longitudinal microtubule and microstructure of high imitation by normal nerves, so nerve bridging substance can be used in basic researches and repair nerve injury on clinic.

Objective To discuss the efficacy of a modified single posterior fixation of complicated acetabular fractures with a percutaneous cannulated screw and a reconstruction plate in comparison with traditional bilateral approaches (ilioinguinal and Kocher-Langerbeek). Methods From April 2004 to May 2007, 48 cases of complicated acetabular fracture were treated surgically. By Letoumel classification, 22 were transverse and posterior wall fractures, 16 fractures of both columns, 3 fractures of anterior column and posterior wall, 3 T shape fractures and 4 anterior column and posterior hemi-transverse fractures. Of them, 22 cases were treated through the bilateral approaches and 26 cases through the modified single posterior approach by which a percutuneous cannulated screw was applied, going askew through skin and ischial tuberosity, to fix the anterior column and a reconstruction plate to fix the posterior column. Results Forty patients were followed up for 6 to 37 months(average, 18 months) . There was no statistical difference between the 2 groups as fax as the following factors were concerned: anatomic reduction rate and functional good-to-excellent rate. But there were significant differences in operation time and volume of hemorrhage during operation. Conclusion In treatment of complicated acetabular fractures, the modified singl eposterior approach simplifies traditional bilateral approaches so that surgery procedures, perioperative bleeding and postoperative complications can be reduced without sacrificing the treatment efficacy.

Objective To study the efficacy of chitosan on rehabilitation treatment after sinuses open surgery .Methods Fifty-six cases patients after sinuses open surgery were collected during June 2013 to October 2014 and divided into experimental group and control group by random sampling method, 28 cases in each group.The experimental group were smeared with chitosan on surface after cleaning by normal saline, while control group cleaned by normal saline alone.The efficacy, adhesion of nasal mucosa and time of mucosa complete epithelialization in two groups at three and six months were analysed while out-patient review.ResuIts After three and six months, the total effective rate of experimental group was significantly higher than that of control group[85.71% vs.60.71%(χ2 =4.46,P<0.05);92.86% vs.67.86%(χ2 =5.54,P<0.05)].The time of mucosa complete epithelialization in experimental group was (50.4 ±6.5)d, which was shorter than (62.3 ±7.5)d of control group (t=6.34,P<0.05).After three and six months, the nasal mucosa without adhesion in experimental group was better than that in control group (χ2 =5.60, χ2 =5.49;P<0.05). ConcIusion Chitosan can promote nasal mucosa epithelialization, reduce adhesion of nasal mucosa, improve the postoperative curative effect of chronic nasal-sinusitis.