ObjectiveTo evaluate the clinical effect of the percutaneous fixation for atlas-axis combined fractures in the elderly patients,especially with brain injury.MethodsFrom March 2006 to February 2011,a total of 7 cases with C1,2 combined fractures entered the study,including 5 males and 1 female with an average age of 72.4 years (range,64-84 years).Fracture combinations included two Jefferson/type Ⅱ odontoid,two anterior ring/type Ⅱ odontoid,two anterior and posterior ring/type Ⅱ odontoid,and one anterior and posterior ring+lateral mass/type Ⅲ odontoid.There were 5 patients with head injuries in varying degrees of coma.All patients underwent percutaneous placement of odontoid screw and anterior C1,2 transarticular screws (triple anterior screw fixation),and were immobilized in a hard collar for 3 months postoperatively.Results The average duration of the operation was 56 min(range,36-78 min).Satisfactory results were achieved in all patients,and all screws were in good position.There were no intraoperative surgery-related complications.The mean follow-up period was 10.7 months.During the follow-up,no pullout,loosening,distortion,or breakage of internal screws was observed.Radiographic union occurred in all odontoid fractures and C1,2 stable was found in all case.ConclusionFor elderly patients especially those with brain injury,the triple anterior screw fixation is reliable and effective in dealing with combined atlas-axis fractures.This percutaneous surgery has the advantages of less invasive,less blood loss,less pain and early recovery.

ObjectiveTo investigate the differences and the similarities of clinical presentations and CT features between type B3 thymoma ( atypical thymoma) and type C thymoma ( thymic carcinoma) in the WHO classification of thymic epithelial tumors.MethodsComplete CT findings of thirty cases of type B3 and seventeen cases of type C thymic epithelial tumors confirmed by histopathology according to WHO 2004 Classification System and clinical features including the prognosis of each case were reviewed retrospectively.Statistical analyses of the data for the age and the long diameter were performed with Independent-Samples t test between the two groups.Statistical analysis for gender,association with myasthenia gravis,method of the operation,contours,shapes,calcification,necrosis,enhancement pattern of the tumors on CT,presence of mediastinal lymphadenopathy,invasion of mediastinal fat,chest wall,pericardium,great vessel,pleural mediastinum,metastasis to the plural,pleural effusion,distant metastasis were performed with Fisher exact test.Kaplan-Meier method was employed for survival analysis.Results Clinical data:the average age of type B3 group was significantly younger ( t = - 2.905,P = 0.006).90.0％(27/30) of patients in type B3 group were complicated by myasthenia gravis,while only 5.9％ (1/17) of patients in type C group were complicated by myasthenia gravis.The difference between the two groups was statistically significant ( P = 0.000 ).The ratio of complete resection of type B3 group ( 80.0％ ) was significantly higher than that in type C group ( P = 0.001 ),70.6％ (12/17) of patients in type C group died within 2 years after surgical resection,while only 20.0％ (6/30) of patients in type B3 group died within one to nine years after surgical resection.Three years'survival ratio of C group was 29.4％,and five years'survival ratio of C group was lower than 14.7％,which was significantly lower than B3 group( five years'survival ratio was 94.7％ ),which was statistically significant (P =0.000).CT features:the average long diameter of tumor in type C group was ( 6.4 ± 2.1 ) cm,significantly longer than that in type B3 group,which was (4.6 ± 2.3) cm (t = - 2.778,P = 0.008 ),and the contour of tumor in type C group usually showed irregularity ( 13/17,76.5％ ),while it usually showed lobulated ( 18/30,60.0％ ) in type B3 group (P = 0.019 ),more necrosis found in C group ( 15/17,88.2％ ) than B3 group ( 17/30,56.7％ ),compared with type B3 group on enhanced CT,more tumor in type C group showed heterogeneous enhancement (P =0.042),and more great vessel invasion ( 15/17,88.2％,P =0.001 ) and more distant metastasis (8/17,47.0％,P = 0.028) occurred in type C group.ConclusionMost of type B3 and type C thymoma have a certain significant difference in clinical factor,prognosis and CT findings,which are helpful for differentiation.

Objective To summarize the characteristics of diagnosis and surgical treatment of the leiomyoma of cardia.Methods The clinical data of 18 cases of leiomyoma of cardia confirmed by pathological examination was retrospectively analysed.Results Dysphagia,chest or epigastric pain and gastric hemorrhage were the most common presenting symptoms.The average course of disease was 9 months.Two patients was misdiagnosed as carcinoma of cardia before operation.Seventeen patients received partial gastric resection,one patient proximal subtotal gastrectomy.No surgical death and severe complications occurred in all patients.Conclusion Leiomyoma of cardia is a rare benign tumor.The differential diagnosis is important because it may be misdiagnosed as malignancy.Surgery is the most effective therapy to this disease.

TLC scanning technique was, developed for the determination of matrine in Jieshenbao lotion. The method is simple, and highly sensitive, with an average recovery of 99.87%and a variation cofficient of 1.33%.

OBJECTIVE:To develop a RP-HPLC method for the simultaneous determination of Notoginsenoside R1 and Ginsenoside Rg1 in Danqi tablets. METHODS:The chromatographic separation was performed on a Kromasil C18(250mm?4.6mm,5?m) column with column temperature at room temperature. The mobile phase consisted of acetonitrile-water-H3PO4(20.5∶79.5∶0.02) at a flow rate of 1.0mL?min-1.The detection wavelength was set at 203nm. RESULTS:The linear range of Notoginsenoside R1 and Ginsenoside Rg1 were 4.67～46.68?g?mL-1 (r=0.999 0) and 4.62～115.50?g?mL-1 (r=0.999 9), respectively; with the average recover of Notoginsenoside R1 at 97.93% and that of Ginsenoside Rg1 at 97.98%, and RSD at 1.31%(n=6) and 1.38%(n=6), respectively. CONCLUSION:The method is simple, rapid and accurate, and suitable for the quality control of Danqi tablets.

Objective:To explore the ability of osteo-articular allograft of variant deproteinized bone combining calcium phosphate cement with recombinant human vascular endothelial growth factor and bone morphogenetic protein-2 in repairing osteo-articular defect.Methods:36 adult mixtus dogs were constructed as semi-articular defect models through resecting 30mm right femur inferior extremity near articular facet,and they were randomly divided into 3 groups.In group A,material CPC/rh VEGF/rh BMP-2/DBP was transplanted into the semi-articular defect.In group B,material rhVEGF/rhBMP-2/DBP was transplanted there.In group C,simple material DPB was transplanted there.At 4,8,12 and 16 weeks after operation,the effects were as- sessed by macro-morphology observation,X-ray examination,histologic examination as well as collagen type I immunohistochem- istry analysis transmission electron microscope examination and vitodynamic tests in order to observe bone reparation matter. Results:The new bone formation observed by vitodynamic tests,macro-morphology observation,X-ray examination,histologic ex- amination and transmission electron microscope examination in group A was significantly superior to that in group B and C.The results of collagen type I immunohistochemistry analysis and vitodynamic tests were significantly superior to that in group B and C(P0.05).Conclusion:The mate- rials CPC/rh VEGF/rh BMP-2 can promote the new bone formation,achieve bone healing and make them become autologous tissue at last.

The vascular endothelial cells (VECs) are not only a mechanical barrier of blood cycle cells and vascular smooth muscle cells, but also largest and most important type of endocrine organs.Because of its mechanical barrier action It is highly susceptible to in vitro and in vivo a variety of physical and chemical factors in the injury; damaged VECsvascular endothelial cells, especially the disordered endocrine function, the inevitable imbalance to a variety of active substances secreted or related active substances, finally result in dysfunction of cardiovascular system.This article reviews many mechanisms underlying VECsvascular endothelial cell injury, investigates VECsvascular endothelial cell repair mechanisms, and study ways to protect and repair the injured VECsvascular endothelial cells, and improve the prognosis of vascular disease.

BACKGROUND: Electromyography is a non-stationary and non-Gaussian physiological signal. Currently, the high-order spectral technique, which based on higher-order cumulant, has been widely used in solving problems such as non-Gaussian, non-stationary and nonlinearity. OBJECTIVE: To propose a feature extraction method for surface electromyography (SEMG) signals based on a non-Gaussian AR model parameterized bispectrum estimation and fisher linear discriminant analysis. METHODS: Aim at features of SEMG, from point of high statistics, and based on a non-Gaussian AR model, bispectrum analysis was performed to extract effective features, followed by constructing characteristic vector by fisher linear discriminant analysis dimension reduction, then the support vector machine was used to classify the movement patterns. The differences of recognition rates between AR+BIS+LDA and other features extracted by different methods were compared. RESULTS AND CONCLUSION: Experimental results showed that the eight forearm movement patterns could be well identified after training by multi-class support vector machine and its average recognition rate reached above 97.6%. For short data sets, bispectrum's feature had a better pattern recognition rate than other features such as AR model coefficients, wavelet packet transformation coefficients. That improved the performance of real-time control of prosthesis.

Sagittal spinal deformity is one of the common reasons of sagittal disequilibrium which can cause torso forward,cardiopulmonary dysfunction,fiat back syndrome,intractable low back pain and a series of cases,affecting the patients' life quality and increasing huge economic burden on society.The treatment of sagittal spinal deformity has been a hot spot in the field of clinical spinal surgery and its main purpose is to reconstruct the overall balance of the body,which would relieve pain and improve life quality.Pedicle subtraction osteotomy is considered to be one of the most effective and safe method for correcting spinal deformity with excellent reconstruction of sagittal plane balance.However,the calculation of the angle required during surgery is still a problem,because insufficient or excessive correction will lead to the secondary sagittal disequilibrium.Therefore,an accurate calculation of the angle required during pedicle subtraction osteotomy is particularly important.In recent years,scholars believe that the sagittal equilibrium depends on a fragile balance among spinal curvature,pelvic shape and position of the lower limbs.Scholars have developed a standard of sagittal equilibrium based on their own research,and proposed a variety of quantitative analysis methods to calculate the angle required during pedicle subtraction osteotomy:trigonometric method,exact angle calculation method,overall balance method,spine femoral angle measurement method,digital virtual method,graphic method,acoustic meati to hip axis method and hilus pulmonis to hip axis method,which provide important theoretical bases for the treatment of sagittal spinal deformity.

The special environmental features of high altitude, such as hypobaric hypoxia, low temperature, arid, high solar radiation, variable climate and geochemical anomaly, cause great effects on human physiology and health. It will provide valuable references and new ideas to study drug's metabolism in special environment of high altitude hypoxia, and give the guidance to clinical reasonable medication, avoiding adverse reactions and personalized medicine in plateau areas. This article reviewed the effect of high altitude hypoxia on drug metabolism, elaborated metabolic characteristics of some drugs and the activity and expression of drug metabolism enzymes under hypoxia environment at high altitude, and discussed related mechanism.