Endoscopy ; instrumentation ; methods ; trends ; General Surgery ; methods ; Humans

[Objective]To evaluate the effectiveness of biopsy of bone lesions.The factors that might effect on the clinical utility were analyzed in order to find out the independent factor for clinical effectiveness.Also we evaluated the effects of these factors on the open biopsy with needle biopsy previously done.[Method]We retrospectively reviewed 206 cases performed at our institute between June 2003 and Oct 2006,including percutaneous core-needle biopsy or open biopsy.The biopsy result was classified as correct,nondiagnostic,or incorrect.The biopsy results were considered clinical useful if they were correct and not useful if they were nondiagnostic or incorrect.We identified the independent risk factor by analyzing whether the characteristics including biopsy methods,lesion position,myxoid,lesion type reduced the effect on the clinical utility and increased the probability of proceeding to subsequent open biopsy.[Result]In 206 patients,one hundred and forty-seven cases(71.4%)underwent core-needle biopsy.Forty-seven cases(22.8%)underwent open biopsy and twelve cases(5.8%)had open biopsy with needle biopsy first.One hundred and seventy-six cases(85.4%)patients had clinical useful results.Eighteen cases(8.7%)were nondiagnostic,and twelve cases(5.8%)were incorrect.Myxoid histology was identified of independent risk factor on the clinical utility by logistic regression(P=0.02).[Conclusion]Most cases of bone lesions can be diagnosed by core-needle biopsy or open biopsy.The myxoid histology is associated with decrease clinical accuracy;No single characteristic cause increase probability of open biopsy.Correct diagnose of bone lesions requires combining biopsy,radiology and clinical data.

[Objective]To retrospectively analyze 39 cases of surgical treatment of fibrous dysplasia of proximal femur,in order to propose a partition method which can be used to guide the surgical treatment,and probe the surgical treatment strategy according to the partition method of fibrous dysplasia of proximal femur. [Methods]The data on 39 cases of fibrous dysplasia of proximal femoral from 1998 to 2009 were retrospectively analyzed.The study determined extent of the lesion according to preoperative X-ray film and proposed partitioning method in accordance with the scope of proximal femoral involvement,analyzed the relation of partition type and surgical treatment,and evaluated the effect of surgical treatment through the postoperative localized lesions control and functional score(MSTS 93).[Results]According to the scope of 39 cases of lesions,combined with characteristics of proximal femoral anatomy,proximal femur was divided into four zones: area I,femoral shaft(below small protuberance);area II,intertrochanteric(small rotor to the neck base division);area III,femoral neck;area IV,the femoral head.Based on the above partition,lesions were divided into 7 types,type I,type II,type III,type I + II,type II + III,type II + III + IV,type I + II + III,type I + II + III + IV.Surgical treatment was performed mainly with curettage of bone lesions,bone grafting and fixation.Internal fixation included DHS,intramedullary nails,and artificial joint replacement,DHS was most common in area II involvement(57.58%),followed by area III involvement(24.24%).Intramedullary nail was most common in area I involvement(64.70%) and area II involvement(35.30%).For lesions involving ≥3 zones,joint replacement was carried out.The patients were all followed up,with a median time of 6.3 years(0.5-11 years).Local recurrence rate was12.82%(5 / 39),local deformity was not found deterious.The followed up results were satisfactory.The selected treatment was reasonable.[Conclusion]When making a surgical treatment regimen for fibrous dysplasia of the proximal femur,Surgeons should consider lesion characteristics,and choose a reasonable internal fixation to achieve better surgical results.Partition method proposed in this paper can be formulated as one of preoperative surgical treatment options.

Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome.Intra-articular and extra-atticular tumor resection produced similar local recurrence rate in the present study,which suggested intra-articular resection may be an altemafive procedure.

Grounding impedance measurement is a traditional proficiency testing programs, 2014 proficiency testing program on the basis of original ability to verify, combined with actual detection need, innovation introduced two verification point of the power input socket and metal plane testing. This paper analyzes and discusses the results of the ability verification in 2014, and puts forward the points of attention and the recommended method of metal plane test.
Laboratories ; standards ; Laboratory Proficiency Testing

BJECTIVE: To explore the effect of different convergent conditions on accuracy of simulation results from a three dimensional finite element model of the pelvic ring.METHODS: A first-order linear load of 600 was applied on the S_1 vertebral endplate in an established three-dimensional finite element model. The step length was set to 0.1 s. The boundary condition was set as constraint of 6 degrees of freedom in the proximal femur. Static and dynamic explicit convergences with 6 different weight scale factors were calculated retrospectively,and all the simulated results were compared with the experimental results in order to verify the accuracy. RESULTS: The static convergence predicted most accurate with the linear regression coefficient 0.88. With the increase of weight scale factor, the time cost decreased. However, the accuracy of the predicted results decreased. There was statistically difference between the simulation results and experimental results when the weight scale factor achieved 3 000 (P<0.05) and the coefficient of linear regression was lower than 0.8.CONCLUSION: It suggested that as for the complex finite element model, especially when the model contains complex contact conditions, dynamic explicit convergence can be an alternative solution to static convergence if the latter failed. Also proper weight scale factor should be used to decrease the time cost under the condition that the error was in the limited.

Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Carcinoma, Squamous Cell ; therapy ; Chemoradiotherapy ; Diarrhea ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Humans ; Leukopenia ; chemically induced ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; therapeutic use ; Radiotherapy, Conformal ; Thrombocytopenia ; chemically induced ; Uterine Cervical Neoplasms ; therapy ; Vomiting ; chemically induced

Mucosal adjuvants play important roles in vaccine development. By now, the common used mucosal adjuvants can be divided into three categories: the bacterial derivatives, cytokines and chemokines, and antigen delivery systems. Progresses of the three kinds of adjuvants were reviewed to give a reference to novel vaccine research.

Objective To explore the clinical effect of autogenous bone,allograft bone and BMP synthetic bone in the treatment of lum-bar spondylolisthesis,and provide more basis to choose transplant material.Methods A total of 96 patients with lumbar spondylolisthesis were chosen as research subjects,who were cured in our hospital from January 2014 to January 2015.They were divided into group A(who were treated with autogenous bone),group B(who were treated with allograft bone)and group C(who were treated with BMP synthetic bone), according to prospective study method.The indicators of the operation,postoperative adverse reactions,change of intervertebral disc height and bone graft fusion rate of three groups were compared.Results Difference of the operation indexes of three groups had no statistical sig-nificance(P >0.05).The incidences of adverse reactions in group A and group C had no statistically significant difference(P >0.05),but both less than that in group B,with statistically significant difference(P <0.05).The intervertebral disc height after 6,9,12 and 18 months in group A and group C had no statistically significant difference(P >0.05),but both more than that in group B,with statistically significant difference(P <0.05).Bone graft fusion rate of group C was faster than that of group A and goup B,and the graft fusion rate in 18 month in group A and C had no statistically significant difference(P >0.05).And the fusion rates of group A and C in each period were significantly higher than that of group B,with statistically significant difference(P <0.05).Total effective rate of neurologic improvement in group A and group C had no statistically significant difference(P >0.05),but both better than that of group B,with statistically significant difference (P <0.05).Conclusion BMP synthetic bone used in lumbar spondylolisthesis has the same clinical effect as autologous bone.But BMP synthetic bone has faster bone graft fusion rate than autologous bone.And it is beneficial to patients’recovery.

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.