BACKGROUND:A selection of treatment for thoracolumbar fracture is very important.OBJECTIVE:To develop and validate three-dimensional finite element models of human thoracolumbar fracture using varying fixation methods,and to compare biomechanical characteristics of fixation method.DESIGN TIME AND SETTING:A contrast observation was performed at the Mechanical Experiment Center of Tongji University from August to October 2008.MATERIALS:64-slice spiral CT (Siemens,Germany) was used to scan T_(11)-L_1 segments of an adult male,and the slice thickness was 0.6 mm.based on Boolean operation,the lower half of T_(12) segment was resected,and the structure of posterior part was reserved to establish finite element model of thoracolumbar fracture.METHODS:There were five groups in this study,including 4 pedicle screws+2 rods (group 1),5 pedicle screws+2 rods at one side (group 2),6 pedicle screws+2 rods at both sides (group 3),anterior fixation (group 4),and anterior plus posterior fixation (group 5).Forces of axial compressive,anterior bending,posterior extension,left bending,and right rotation were loaded to compare the biochemical characteristics.MAIN OUTCOM MEASURES:vonMises stress and displacement at different directions.RESULTS:The stresses of all the fixation screws increased from the anterior part to posterior part in all movement tests,and the strongest stress was measured in the joint position.The stress of proximal screw was stronger than that of the distal screw.Additionally,the stress in group 1 was significantly stronger than in groups 2,3,and 5 (P<0.01).The group 5 was the most stable,but the group 1 was the poorest.CONCLUSION:T_(12) bursting fracture models were established using varying fixation methods,and the results verified that short segment plus fracture vertebral segmental fixation has more superior biomechanics.

With the development of the prenatal medicine, the survival rate of the premature has im-proved obviously. However,doctors should focus on the ethics problem whether treat the extreme survival and critical diseased premature is necessary. During the process,the attitude of parents and the medical care personnel impact the premature survival rate. Therefore, the role excellent communication skills and the hospital ethics committee to improve the premature rate and avoid the medical conflict should not be ignored.

Objective To compare the value of MRI and CT in the diagnosis of rectal cancer staging.Methods This study performed a retrospective survey and analyzed the data of 98 cases of preoperative imaging,including MRI and CT images,and the results were compared with the postoperative pathological examination,to evaluate the value of preoperative diagnosis of the two methods.Results The diagnostic accuracy of MRI in T1,T2,T3 (92.1％,74.4％,80.0％) were higher than those of CT (79.4％,29.2％),the diagnostic accuracy of MRI in N0,N1,N2 on (77.6％,83.3％) were higher than those of CT(49.0％,46.2％,30.0％),the difference was statistically significant (x2 =9.55,P ＜ 0.05).In the lymph node metastasis,MRI misdiagnosis rate (20.0％,3/15) was slightly lower than that of CT (26.7％,4/15).Conclusion For patients with rectal cancer,MRI in the diagnosis of T1-T3,N staging were is better than CT,it is an ideal preoperative diagnosis method,it is and is worthy of clinical application for reference.

Objective To evaluate the physical functions of community-dwelling older adults, and analyze the related factors. Methods From September to October, 2016, 80 adults over 55-year-old in one community in Wuhan, Hubei, China were selected with convenience sampling. General situation was collected through questionnaires. Physical functions were measured by tests of grip strength, Five-Times-Sit-to-Stand Test (FTSST), modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and TimedUp and GoTest (TUGT). Their correlation was analyzed. Results The average grip strength of the participants was (27.46 ± 9.66) kg; the average time of FTSST was (11.58 ± 4.03) s;there was only one (1.25%) participant observed with an impairment in mCTSIB;the average time of TUGT was (9.05±3.47) s. Grip strength was correlated with gender (r=-0.669), education level (r=0.238), the score of Mini-Mental State Examina-tion (MMSE) (r=-0.302) and activities of daily living (ADL) (r=-0.344) (P<0.05). The time of FTSST was correlated to gender (r=0.274), the score of MMSE (r=0.243) and ADL (r=0.321) (P<0.05). The time of TUGT was correlated to gender (r=0.255), education level (r=-0.362), income level (r=-0.245), the score of Self-rating Depression Scale (r=0.223), the score of MMSE (r=0.328) and ADL (r=0.354) (P<0.05). Conclusion The levels of grip strength, FTSST and TUGT are related to the demographic characters in community-dwell-ing older adults. Little abnormity has been found in mCTSIB.

Since the reform of the supply side has been put forward by General Secretary Xi Jinping,the research and practice of the health industry has been strengthened for the reform of the supply side,and the beneficial exploration has been carried out on the supply side structure reform.The various forms of medical alliance are the feasible way to solve the problem of supply side.Through such a reform,it can make full use of medical resources to meet the needs of the people's medical treatment.The construction of medical alliance practice in Beijing Chaoyang Hospital is analyzed,and on this basis,proposals of the medical alliance construction are put forward.

[Objective] Aneurysmal bone cyst of the ealeaneus is an uncommon entity. The purpose of the report is to describe aneurysmal bone cyst of the ealcaneus seen in a child.[ Methods] The clinical, radiological and histopathologic findings of a boy with aneurysmal bone cyst of the calcaneus were retrospectively analyzed with reference to literature. [ Results ]The tumor mainly involved the right calcaneus. He was treated successfully after the curettage and bone grafting. Histopathological examination revealed an aneurysmal bone cyst of the right calcaneus. He is now disease-free for 2 years, and no sign of recurrence was found. [ Conclusion] Aneurysmal bone cyst of the calcaneus is an uncommon entiy. To simple aneurysmal bone cyst,curettage and bone grafting are effective therapic method.

AIM: To establish quality standard for prepared pieces of Rhizoma Panacis Majoris. METHODS: Traditional identification and TLC were used for qualitative analysis of prepared pieces. The contents of ginsenoside Ro and chikusetsusaponin IVa were determined by HPLC. Water,ash and acid-insoluble ash were also detected. RESULTS: The average content of ginsenoside Ro was 7. 19% ,chikusetsusaponin IVa was 3. 16% from different habitants. CONCLUSION: The established method has been proved to be simple,stable,accurate,and can be applied to the determination of ginsenoside Ro and chikusetsusaponin IVa in Rhizoma Panacis Majoris. The quality control standards for Rhizoma Panacis Majoris is normative and the result is accurate.

Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.

[Objective]To study the possibility of drug inhibition of wear particle induced osteolysis and aseptic prosthesis loosening in vivo.[Methods]4?8 mm transverse holes were made in femur condyle and tibia plateau of 12 adult rabbits bilaterally.One milligram of CoCr alloy(mean 5.38 ?m),Ti-6Al-4V(mean 3.21 ?m) and UHMWPE(12～200 ?m) particles were implanted into the holes separately.The animals were divided into 4 groups and each group had the same particles combination.Oral drug therapy twice a day was adopted with non-selective COX inhibitor(indomethacin,0.5 mg/kg BW),membrane Ca2+ channel inhibitor(nitrendipine,0.1 mg/kg BW),osteoclast inhibitor(alendronate sodium,0.1mg/kg BW) and blank control(0.9% saline) to the 4 groups separately and randomly according to the double blind principle,which started on the 2nd day postoperatively until 12 weeks at the time of sacrifice.Routine histological observation and calculation of the ratio of bone area(BA) to total tissue area(TTA) were done under the computerized analysis system.[Results]CoCr and Ti alloy particles could seldom be seen in the slices of the groups which showed normal cancellous bone.There were obvious macrophage infiltration and fibroblast proliferation round the particulate UHMWPE in the group of blank controls.It was similar in the groups of indomethacin and nitrendipine though the histological reaction was a little bit weaker and osteotoid tissue could occasionally be seen.UHMWPE particles were totally enclosed in the cancellous bone with little fibrous tissue proliferation in the group of alendronate sodium and the BA/TTA ratio was significantly higher than those at the other groups(P0.05).[Conclusion]This indicates the possibility of inhibition or prevention of osteolysis induced by wear particles by drug therapy especially when alendronate sodium is adopted,and it has significant clinical implications for controlling the most common cause of implant failure.

AIM: To study the processing principle of Fructus Schisandrae Sphenantherae steamed with wine. METHODS: The content of volatile oil was measured by means of volatile oil measuring method and identified by TLC. The total lignans was determined by spectrophotometry and the water-soluble extractive was measured by determination of extractive method. RESULTS: The volatile oil content in Fruetus Schisandrae Sphenantherae by steaming with wine decreased by 35.3%, TLC showed that a new spot was added; the lignans content had an increase of 28.9% and the water extractive was 2% less than in crude drug. CONCLUSION: Tranditional process is reasonable.