Continuing medical education is one of major parts in medical education system of minimal invasive surgeon. Based on the characteristics of net continuing medical education such as freedom of learning, no regional restriction and abundant resource, combined with visualized teaching of minimal invasive surgery education, the novel training model of e-learning based on internet was applied to establish minimal invasive surgery continuing education system.

OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

Objective To investigate the clinical characteristic, surgical stage, operative approach, resection and stability reconstruction of dumbbell intra-extradural tumor of cervical spine. Methods From January 1999 to December 2005, 37 consecutive cases with cervical dumbbell intra-extradural tumor were retrospectively studied. 18 males and 19 females ranged from 18 to 80 years old were involved in this study, including 25 schwannomas, 3 neurofibromas, 5 multi-neurofibromas and 4 malignant schwannomas. According to tumor location and involved range, all tumors were divided into five stages: 8 cases in Ⅰ stage, 9 cases in Ⅱstage, 13 cases in Ⅲ stage, 5 cases in Ⅳ stage and 2 cases in Ⅴ stage. Resection and reconstruction were performed at 20 patients through posterior-lateral approach, 17 patients through anterior-lateral combined with posterior-lateral approach. Lateral mass screw internal fixation system were used in 26 cases, while anterior combined posterior fixation were performed in 5 cases and none fixation in 6 cases. Results The follow-up period was from 3 months to 7 years. 1 case developed a transient weakening of upper limb, 1 case developed anesthesia in posterior neck, and 1 case developed Horner's sign. Vertebral artery ligation was performed in 1 case because of vertebral artery injury. 2 cases with malignant schwannoma occurred local recurrence in 1-2 years postoperation and received second operation. The recent effects after operation were satisfactory in majority cases,with complete recovery of spinal cord function in 19 cases. 2 cases without fixation appeared recuration deformity in cervical spine in 1-2 years postoperation. Conclusion The surgical approach and operative methods must be selected according to the location, surgical staging, characters of tumors. Stability reconstruction plays important roles in maintaining stability of cervical spine. More care should be taken in procedure for protecting vertebral artery, cervical nerve and spinal cord.

Objective To develop a new method for the determination of trace manganese in water by flame atomic absorption after cloud point extraction. Methods The effect of experimental conditions such as pH value and concentration of reagents and equilibration temperature on cloud point extraction and determination sensitivity was discussed. The chemical variables affecting the separation phase and extraction recovery were optimized. Results Under the optimum conditions, pre-concentration of only 50 ml of sample in the presence of 0.05% Triton X-114 presented a detection limit of 0.28 ?g/L(3?) for manganese. The enhancement factor was 65 for manganese. The relative standard deviation was 2.17%. The calibration graph using the pre-concentration system for manganese was linear with a correlation coefficient of 0.999 at levels near the detection limits up to at least 120 ?g/L. The recovery rates were 98.0%-101.5%. Conclusion The method is rapid, accurate, simple and is suitable for determination of trace manganese in water samples.

Objective To observe the effect applicated of endoscopic sinus joint laryngoscope in laryngeal microsurgery.Methods 68 patients with laryngeal lesions were randomly divided into the multi-mirror combination group (34 cases) and the single laryngoscope group (34 cases).The multi-mirror combination group was taken with laryngeal microsurgery under endoscopic Joint laryngoscope.The single laryngoscope group was only taken with laryngeal microsurgery under laryngoscope.The efficacy and surgical situation of the two groups were compared.Results The total effective rate of the multi-mirror combination group was 97.06％,which was significantly higher than that of the single-laryngoscope group (85.30％) (x2 =4.031,P ＜ 0.05).Compared with the case of surgery and complications and recurrence rate,the multi-mirror combination group was superior to the single laryngoscope group (all P ＜ 0.05).Conclusion The endoscopic joint laryngoscope has the function of expanding the scope of the operative field and increasing the focus and clarity,and also has the advantages of small traumatic for patients,fewer complications,low recurrence rate,easy operation and high accuracy.

Objective To summarize the clinical characteristics of neonatal asplenia syndrome to improve the understanding of the disorder. Methods Newborns with neonatal asplenia syndrome admitted to the neonatal department of our Hospital from June 2008 to July 2015 were recruited and their gender, birth weight, gestational age, clinical manifestations, imaging features, laboratory examinations, treatments and prognosis were analyzed. Results A total of 8 newborns with asplenia syndrome were studied. All the patients presented with cyanosis at birth, 5 of them with heart murmur, 3 with apical impulse in the right ( dextrocardia) thorax and complex congenital heart diseases were found in all of them by echocardiogram examinations. 2 of them were diagnosed congenital heart diseases before birth by the fetal ultrasound. 2 cases combined with congenital imperforate anus and cutaneous fistulas. 1 case was found right renal agenesis and Howell-Jolly was seen in another case. All the 8 patientsˊ parents refused medical advices about continuing treatments and left hospital. Among them, 4 patients died in the neonatal period, 2 lost in follow-up and only 2 survived, one for 19 months and the other for 4 years. Conclusions Patients with asplenia syndrome presented absence of spleen, visceral inversion, severe cardiovascular malformations and other malformations. When the cyanosis, heart murmur and abnormal position of apical impulse were found in the newborns, asplenia syndrome should be considered and imaging examinations such as chest X-ray, ultrasound, visceral angiography and more should be ordered immediately, in order to make an early diagnosis of the disease.

?-(1,3)-D-glucan is a core structure of many bioactive fungal polysaccharides. It has drawn intensive attentions in recent because of its multiple bioactivities, particularly the immunomodulatory and antitumorous actions. In this review, we introduced the studies of structure-activity correlation of these ?-(1,3)-D-glucans, particularly the contributions of main backbone, branch degree and residues, molecular weight and conformation to the activities. We also summarized the recent progress in the detective methods for both quantitation and qualification using limulus G factor assay,galactosyl ceramide ELISA and etc.

Objective To investigate the protective effect of Xinan granule on viral myocarditis in mice. Methods Viral myocarditis model was made by intraperitoneal inoculation with Coxsackie virus B3 in BALB/C mice. Mice were randomly devided into six groups:the normal control group, the model control group, the Xinan granule10、20、40 g/(kg?d) groups and the Binduzuo 0.1 g/(kg?d) group.After CVB3 infection 2 h, one set of mice were given drugs for 7 d.Blood and heart samples were obtained on the 8th day after CVB3 infection.The myocardial histopathologic changes were observed. The serum cardiac enzyme (LDH) were measured.The others were given drugs for 2 d before CVB3 infection, and for 7ds after CVB3 infection. The survival time were recorded for 20 ds. Results The myocardial histopathologic damage, LDH, cardiac index, punctate hemorrhage on heart surface in Xinan group reduced more significantly than that of the model control group. The survival time in Xinan group were longer than that of the model control group. Conclusion Xinan granule may have the preventional and therapeutic effect on viral myocarditis in mice.

Objective To realize intelligent and refined management of medical war storage materials by designing a management platform based on context awareness.Methods The conditions of medical war storage materials and its storage environment were monitored dynamically,and technologies of context awareness,radio frequency identification,temperature and humidity sensing and etc were used to establish the platform.Results The platform improved the traditional medical war storage materials management system in intelligence and refinement,and implemented auto update and intelligent alarm for the information on medical war storage materials.Conlusion The platform fulfills automatic and intelligent medical war storage materials management,and thus has practical values for medical service support.

Objective To investigate the clinical value of the intervertebral disc morphous in patients with thoracolumbar vertebral compression fracture. Methods The MRI, X-ray and CT data of 75 patients with thoracolumbar vertebral compression fracture were retrospectively analyzed. The intervertebral disc damage degree was observed, and its correlation with vertebral fracture degree and endplate damage degree was studied. The vertebral body leading edge height, intervertebral space height and back convex Cobb angle in patients with different intervertebral disc damage degree were measured. Results The intervertebral disc damage degree height was positively correlated with endplate damage degree (P<0.01), and the intervertebral disc damage degree was positively correlated with fracture degree (P<0.01). With the increase of the intervertebral disc damage degree in patients with Ⅰ - Ⅳtype intervertebral disc damage, the vertebral body leading edge height and intervertebral space height gradually became smaller: (0.68 ± 0.05), (0.61 ± 0.03), (0.58 ± 0.03), (0.42 ± 0.05) mm, and (0.31 ± 0.06), (0.29 ± 0.03), (0.24 ± 0.06), (0.22 ± 0.02) mm, and there were statistical differences (P<0.05). There was no statistical difference in back convex Cobb angle in patients with different intervertebral disc damage degree (P>0.05). Conclusions It is more important to observe the morphological changes of the intervertebral disc in patients with thoracolumbar vertebral compression fracture, and the damage degree is closely related with the vertebral fracture degree and endplate damage degree.