OBJECTIVETo evaluate the clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) and minimally invasive reconstruction of posteromedial corner (PMC).

METHODSThere were 22 cases of ACL and PMC tear were performed with reconstruction from March 2012 to February 2014. The patients were 29.4 years old on average, including 8 males and 14 females. ACL reconstruction was performed under arthroscopy and PMC reconstruction was performed minimally invasively through the ACL incision. The stability of knee was assessed by anterior drawer test,Lachman test,vulgus stress test and Slocum test. The function of knee was assessed by Lysholm score and Tegner activity rating. MRI of knee was checked 12 months after operation.

RESULTSThe stability tests of all patients were negative at 2 and 6 months after operation, and there was one positive case in anterior drawer test and another positive case in vulgus stress test at 12 months after operation. Lysholm score of all patients 12 months after operation was 96.8 +/- 6.8, which was significantly better than 32.0 +/- 11.2 before operation. Tegner activity rating of all patients at 12 months postoperatively was 6.1 +/- 0.9, which was significantly better than 0.9 +/- 0.5 before operation. It showed the grafts were very well in the MRI 12 months postoperatively.

CONCLUSIONArthroscopic ACL reconstruction and minimally invasive PMC reconstruction can restore the stability of knee.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective:To assess the efficacy and safety of oncoplastic breast-conserving surgery (OBCS) in the treatment of early breast cancer. Methods:The clinicopathological data of breast cancer patients who were treated with OBCS (67 cases) and standard breast-conserving surgery (SBCS;117 cases) in Affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. Postop-erative complication, specimen weight, margins, and surgery re-excision rate between the two groups were compared. Results:Sero-ma (14.9%versus 48.7%, P<0.001), hematoma (4.5%versus 14.5%, P=0.035), and poor wound healing (3.0%versus 11.9%, P=0.036) were more common in the SBCS group than in the OBCS group. The patient satisfaction in the OBCS group was statistically higher than in the SBCS group (P<0.05). Compared with standard surgery, oncoplastic techniques can be employed for significantly larger tumors (25.04 mm versus 21.14 mm, P<0.001). OBCS resulted in higher mean specimen weights (92.24 g versus 57.44 g, P<0.001), wider clear nearest margins (12.04 mm versus 9.58 mm, P<0.001), and wider furthest margins (24.16 mm versus 15.24 mm, P<0.001). No statisti-cal increase was observed in further surgery re-excision of margins. Conclusion:OBCS is more successful than standard wide local exci-sion in treating larger tumors and obtaining wider radial margins. Oncoplastic approach showed no increase in postoperative complica-tion rate. The postoperative complication was excellent. OBCS is a safe and effective procedure for early breast cancer.

OBJECTIVETo explore a safe and effective scheme of analgesic for labor.

METHODSEighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied. In 5 min, 10 min and 60 min of acupuncture (the same time points in the control group) as well as at the end of the first and second stage labor, the analgesic effect was assessed for the primiparas of the two groups. The labor stages, adverse reactions, postpartum hemorrhage, postpartum urine retention, newborn asphyxia rate and usage rate of oxytocin were compared between the two groups.

RESULTSIn the observation group, in 5 min, 10 min and 60 min of acupuncture as well as at the end of the first and second stages, the visual analogue scale (VAS) was lower apparently as compared with the control group at the corresponding time points (all P < 0.05). The differences in the time limit in the active period, the second and third stages were not significant between the two groups (all P > 0.05). The incidence of adverse reactions and the usage rate of oxytocin were lower than those in the control group [2.4% (1/42) vs 31.0% (13/42); 2.4% (1/42) vs 23.8% (10/42), both P < 0.05]. The differences in postpartum hemorrhage, postpartum urine retention and newborn asphyxia rate were not significant between the two groups (all P > 0.05).

CONCLUSIONThe combination of acupoint injection and EA is the effective analgesic scheme for labor. This scheme effectively alleviates labor pain and has no maternal and child complications.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Labor Pain ; drug therapy ; therapy ; Labor, Obstetric ; Pregnancy ; Young Adult

Objective To evaluate the clinical value of 99Tcm-MIBI SPECT for the differential diagnosis of parotid tumors before treatment.Methods 99Tcm-MIBI SPECT imaging of the parotid region was obtained in 32 patients with parotid tumors before surgery.Early and delayed 99Tcm-MIBI imaging were performed in all patients and the diagnosis was confirmed by pathological results after surgery.The ratio of radioactivity between the tumor and opposite side of normal parotid tissue (T/N) was measured.Fisher exact probability test and t test were used for statistical analysis.Results The sensitivity,specificity and accuracy of 99Tcm-MIBI SPECT imaging for the differential diagnosis of parotid tumor were 90.00％ (9/10),86.36％ (19/22) and 87.50％ (28/32),respectively.Among 22 patients who had benign tumors,19(86.36％) showed negative findings,and the other 3 ( 13.64％ ) patients showed false positive results.In 10 patients with malignant tumors,1 ( 10.00％ ) had false negative findings,and all the other 9 (90.00％)patients showed positive results.The difference between the benign and malignant groups was statistically significant (P =0.00018 ).In the early images,the T/N ratios of benign and malignant parotid tumors were 1.45 ±0.38 and 1.65 ±0.63 (t =20.4,P＜0.01),respectively; and in the delayed images,the ratios were 1.43 ± 0.56 and 1.77 ± 0.59 ( t =2.4,P ＜ 0.05 ),respectively.Conclusion 99Tcm-MIBI SPECT imaging might be useful for the differential diagnosis of parotid tumors before surgery.

0.05),but the proportion of NRDS,the rate of mechanical ventilation dependence,and mortality had significant diffe-rences(Pa

Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

Aim To investigate the effects of CP1 54526,a corticotropin releasing hormone (CRH) receptor 1 antagonist,on the hippocampal neuron ap-optosis.Methods Rat hippocampal neurons were primarily cultured.Cell viability was estimated using MTT assays.Neurons were randomly divided into four groups:Normal cultures (Control);CRH-exposed cul-tures (CRH);CRH and CP1 54526 co-exposed cul-tures (CRH + CP ); CP1 54526-exposed cultures (CP).Cell apoptosis was examined by TUNEL or flow cytometry Annexin Ⅴ-PI staining.The protein levels of Bax,Bcl-2 and Caspase-3 were investigated by West-ern Blotting.Results 1 0 -8 mol·L -1 CRH decreased cell viability of cultured hippocampal neuron (P <0.05),while 50 mmol ·L -1 CP1 54526 significantly increased neuron viability (P <0.05).Compared with Control group,cell apoptotic rate,the ratio of Bax and Bcl-2 and the protein level of Caspase-3 were elevated in hippocampal neuron induced by CRH.Combined with CP1 54526 reversed the effects of CRH.Applica-tion of CP1 54526 alone had no obvious effects on cell apoptosis.Conclusions A certain concentration of CRH can induce hippocampal neuron apoptosis,and its receptor 1 antagonist CP1 54526 can effectively re-duce the apoptosis and play a neuroprotective role.

Objective To analyze MRI manifestations of cerebral sparganosis and the diagnostic value of MRI.Methods MRI findings in 8 patients with proven cerebral sparganosis by pathological examination were reviewed.Results The lesions were hypointense on T1WI and hyperintense on T2WI with edema of brain around the lesions.Most of the lesions were markedly enhanced with ring-type,nodules,tortous beaded shape or tortuous linear like worm past-enhanced scans.The location and shape of the lesions in 3 cases were changed on followed-up MRI.Conclusion There are some specific pathological findings in cerebral sparganosis.MRI is of important clinical value in diagnosis and differential diagnosis of cerebral sparganosis.

It is now clear that both endogenous and exogenous sources of nitric oxide(NO) exert important modulatory effects on cardiac mitochondrial function.There is also growing evidence that NO can be produced within the mitochondria themselves.NO can influence respiratory activity,both through direct effects on the respiratory chain or indirectly via modulation of mitochondrial calcium accumulation.At pathological concentrations,NO causes irreversible alterations in respiratory function and also interacts with reactive oxygen species(ROS) to form reactive nitrogen species(RNS),which may further impair mitochondrial respiration and even lead to open the mitochondrial permeability transition pore and induce cell death.Diabetes,aging,myocardial ischemia,and heart failure are all associated with altered ROS generation,which can alter the delicate regulatory balance of effects of NO in the mitochondria.

Hospital business process optimization and reengineering is an effective method and channel for hospitals to enhance medical and management quality, realize cost minimization, improve efficiency, and increase benefits. The paper gives an account of the theories, methods, steps, relevant techniques, and tools of hospital business process optimization and reengineering, discusses the systematic framework for hospital business process improvement and key success factors and obstacles for hospital business process reengineering, analyzes the relationship of business process reengineering with hospital organizational structures and hospital information systems, and puts forward assessment criteria for hospital business process optimization and reengineering.