Objective To explore the applicationof minimally invasive arthroscopy in the knee joint injuries caused by longitudinal impact of military training.Methods A total of 538 consecutive soldier outpatients diagnosed as knee joint injuries caused by longitudinal impact of daily military training in our hospital from January 2006 to January 2015 were retrospectively analyzed.According to the Principles about Diagnosis and Treatment of Military Training Injury,the general condition,injuries types and injury subject were performed the statistical analysis.The grading diagnosis and treatment strategy of impact injuries was proposed at first time according to the MRI examination results,injury type and severity.The patients needing operative therapy were screened out for conducting the arthroscopic operation according to this strategy.All the patients receiving surgeries were evaluated by the Lysholm scoring before and after operation.The subjective evaluation satisfaction investigation was performed.Results Seventy six cases received the arthroscopic surgeries,and all the cases were followed up successfully.The duration of following-up ranged 12-35 months.The Lysholm scores before operation was[46.3 ± 5.3]which were lower than [83.7±3.8] after operation,the difference was statistically significant(P＜0.01).The wounds healed at the first stage,and no complications of nerve and blood vessel injury,infections,etc.occurred.The patients subjectively felt that the knee joint function was significantly improved,71 cases satisfied with the arthroscopic operation effect,the satisfactory rate was 93.4％.All the cases went back to the normal training life after surgeries.Conclusion For the knee joint injuries caused by longitudinal impact of military training,the prevention is the key role.On the basis of preliminary diagnosis by the physical examination and imaging examination,the treatment should be combined with the grading diagnosis.and treatment strategy.In the operation therapy,the minimally invasive arthroscopy as an examination and treatment means can more comprehensively evaluate the knee injury condition,timely repair injured meniscus and conduct the ligament reconstruction,which has small trauma and recovers rapidly,the patient can recover the routinemilitary training as soon as possible.The arthroscopy is the first choice of treatment scheme for the patients with grade Ⅲ or more injury.

Objective To evaluate the clinical outcome associated with the core decompression in combination with the nano-hydroxyapatite/collagen composite rod combined with decalcified bone matrix in a consecutive series of patients with osteonecrosis of femoral head,especially the prevention of collapse of femoral head and its predisposing factors.Methods From August,2012 to May,2013,46 pationts (50 hips) who had undergone core decompression in combination with nano-hydroxyapatite/collagen composite rod insertion in corporated with decalcified bone matrix in our hospital were involved in this study.Postoperative care consisted of prophylactic intravenous antibiotic and anticoagulation therapy.Patients were instructed to be non-weight-bearing for 3 weeks,to partial weight-bear for the next 3 weeks,and to weight bear as tolerated thereafter.All patients were evaluated both clinically and radiographically.The primary clinical outcome of this study was functional improvement assessed with the Harris hip score.Serial radiograms of the pelvis were taken at 1,3,6,12 months post-operatively to analyze the process of osteonecrosis.Results All patients followed up for 12 months,no one suffer complications.The mean Harris score pre-operation was 65.6 ± 10.6,post-operation score was 87.5 ± 15.3,with a mean improvement of 21.8 ± 13.2 (P ＜ 0.05).According to Harris hip score system,excellent for 30 hips,good for 14 hips,fair for 2 hip and poor for 4 hips.Refer to the Kaplan-Meier survivorship curve,the success rate at 12 months post-operatively was 92％.Radiological changes coincided with clinical changes.Conclusion Core decompressionin combination with nano-hydroxyapatite/ collagen composite rod insertion in corporated with decalcified bone matrix provided a minimally invasive surgical treatment option to treat early stage osteonecrotic hips(stage Ⅰ and Ⅱ) and to prevent femoral heads from collapsing,with clinical outcomes and success rates priorto other commonly used surgical procedures.

Objective To evaluate the clinical efficacy of total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe Ⅳ developmental dysplasia of the hip.Methods From September 2003 to September 2012,21 patients (24 hips) underwent total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe Ⅳ developmental dysplasia of the hip in our hospital.There were 3 males and 18 females,aged from 28 to 71 years (average,54±10 years).The ceramicpolyethylene articulation was used in 17 patients (20 hips),and metal-polyethylene articulation in 4 patients (4 hips).The osteotomy site was treated with autologous bone graft in 18 patients (21 hips) and allogeneic bone graft in 3 patients (3 hips).The Harris hip score was used to assess the clinical results.Results A total of 18 patients were followed up for 0.5 to 9 years (average,3.5 years).The Harris hip score was improved from preoperative 47.9±9.1 to 88.4±3.5 at 6 months postoperatively.For most patients,hip pain relieved significantly; range of motion of the hip was improved,and the gait returned to normal.Sciatic nerve palsy occurred in 1 patient.There was no wound infection.X-rays 6 months after operation showed that the position of prostheses was satisfactory,without loosening of prostheses and bone block resorption.Conclusion Total hip arthroplasty with subtrochanteric femoral shortening osteotomy can achieve good clinical effect in Crowe Ⅳ developmental dysplasia of the hip.Moreover,it can improve leg length discrepancy and decrease the risk of sciatic nerve injury.

Purpose To compare the difference of CT coronary artery imaging quality under highflow oxygen uptake and normal breathing, and to investigate the effect of high flow oxygen uptake on the quality of CT coronary artery imaging.Materials and Methods 132 patients underwent coronary CTA examination using 256-slice CT (Philips), among them 71 patients were supplied with highflow oxygen, and the other 61 were asked to breathe normally. Coronary arteries were post-processed and reconstructed on AW 4.4 workstation. Scanning completion rate, signal to noise ratio (SNR), contrast to noise ratios(CNR) and image quality score ofcoronary segment using these two prospective ECG-gating techniques were compared.Results The scanning completion rate and image quality score of the highflow oxygen uptake group were significantly superior to those of the normal breathing group (P<0.05). However, there was no statistically significant difference of SNR and CNR between the two groups (P>0.05).Conclusion Imaging quality of coronary CTA can be improved using highflow oxygen uptake with reduced patient radiation dose, thus worth being used clinically as a simple and practicable method.

PurposeTo investigate the formation of neovascularization using dynamic contrast-enhanced MRI (DCE-MRI) in C6 glioma margin in rats, and to explore its utility.Materials and MethodsC6 glioma model was created in 24 SD rats. Routine and DCE-MRI was performed 4 days, 8 days, 12 days, 16 days, 20 days and 24 days after transplantation. Pathology and immunohistochemistry exams were also obtained to evaluate marginal tumor cells and neovascularization.ResultsNeovascularization was observed in C6 glioma margin within (257.658±53.663)μm range. Vessel co-option index difference was statistically significant (P<0.01). Tumor cells surrounding the co-opted vessels were strongly positive on proliferating cell nuclear antigen and matrix metallopeptidase 2 staining. Vessel co-option regression and transformation were observed on day 16 on Tenascin-C andα smooth muscle actin staining. For DCE-MRI analysis, Ktrans and Kep were higher on day 12 and 16 (P<0.05). There was significant negative correlation between co-option index and Ktrans (r=-0.9243 and-0.8347,P<0.05). Vp showed no statistically significant difference at all time points (P>0.05).Conclusion The neovascularization in tumor margin demonstrates vessel co-option. DCE-MRI parameters Ktrans and Kep are negatively correlated with co-option index, indicating that Ktrans and Kep could be a well-defined imaging-based biomarker for glioma neovascularization.

In order to preprocess mammograms for diagnosing the early cases of breast cancer and improving the computational efficiency in the computer-aided detection of micro-calcifications in mammograms, we have advanced a novel processing technique for the extraction of micro-calcification region of interest (MROI). The proposed method is based on a three-step procedure: (1) the mammogram is divided into sub-images of the same size; (2) the wavelet multi-resolution method is conducted on the sub-images, and the parameters related to wavelet transform and threshold T are discussed according to rho; (3) the classification of sub-images is determined by T. It is tested with 20 mammograms and the results show that the method can achieve a true positive rate as high as 89.7% with a false positive rate as low as 2.1%.
Breast Diseases ; diagnostic imaging ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; diagnostic imaging ; Diagnosis, Computer-Assisted ; Humans ; Mammography

The present study examined the role of Wnt/β-catenin signaling pathway in the degeneration of nucleus pulposus cells and the protective effect of DKK1 on nucleus pulposus cells. The model of nucleus pulposus cell degeneration was induced by intra-disc injection of TNF-α, and the expression of β-catenin protein was detected by Western blotting. The cultured rabbit nucleus pulposus cells were divided into 4 groups. In group A, the cells were cultured with normal medium and served as control group. In group B, the cells were cultured with TNF-α and acted as degeneration group. In group C, the cells were cultured with TNF-α and transfected with Adv-eGFP and was used as fluorescence control group. In group D, the cells were cultured with TNF-α and transfected with Adv-hDKK1-eGFP, serving as intervention group. The expression of type II collagen, proteoglycan, β-catenin, and MMP-13 in each group was detected by immunocytochemistry and RT-PCR. The result showed that TNF-α increased the expression of β-catenin and MMP-13, and significantly inhibited the synthesis of type II collagen and proteoglycan, which resulted in the degeneration of nucleus pulposus cells. This effect could be obviously reversed by DKK1. We are led to concluded that TNF-α could activate the Wnt/β-catenin signaling pathway, and increase the expression of MMP-13, thereby resulting in disc degeneration. Specifically blocking Wnt/β-catenin signaling pathway by DKK-1 could protect the normal metabolism of intervertebral disc tissue. The Wnt pathway plays an important role in the progression of the intervertebral disc degeneration.

Objective:To summarize the experience of radiation oncology residency training programs in western coutries, and provide evidence to improve the present Phase-I Radiation Oncology Residency Training Programs in China.Methods:An electronic questionnaire-based survey was conducted among residents and staffs in 6 top cancer centers in China and 5 centers from Europe and North America to collect their feedback regarding the description and comparison of different programs.Results:A total of 70 responses and 4 papers explaining relevant training programs from 26 residents and 23 teachers in Chinese hopsitals and 20 residents and 1 teacher from Europe and North America were received. The Radiation Oncology Residency Training Programs in China were designed into 2 phases, and the results in the current study were involved with the first phase. Program designs were similar in the following aspects: goal, clinical practice-based training, rotation curriculum, interim and final assessment. However, the total timeframe in the investigated Chinese Phase-I programs was shorter than that in western hospitals (2 to 3 years vs. 4 to 5 years). Chinese programs covered major common diseases, whereas rotation design was performed based on each individual disease in western programs. In Chinese programs, the working hours were mainly 40-60 h every week. Although the working hours were commensurate with local workforce regulations, the residents from MSK program had an outstanding longer working time of 60-80 h every week and treated more patients compared with other programs. Conclusions:The investigated Phase-I Radiation Oncology Residency Training Programs in 6 top cancer centers in China share common features in goals, training modes and assessments with western programs. However, our programs have shorter timeframe and less detailed requirements in individual disease than the western programs.