Objective To evaluate the outcome of unconstrained shoulder arthroplasty for severe injury of proximal part of the humerus.Methods Twelve eases were all treated with unconstrained shoul- der arthroplasty.Six patients with complex fractures of proximal humerus and four with bone tumor in the proximal part of the humerus used hemiarthroplasty and two patients with osteoarthritis were managed with total shoulder arthroplasty.Cemented prostheses were used in all the cases.Results The average age was 65 years and the follow-up was 2.3 years.Two cases of complex fractures had light pain with limited external rotation of the shoulder.No pain or prosthetic stems loosening were found,and the range of motion and the function of the shoulder were satisfactory in other cases.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe technique for severe injury of proximal humerus.

Objective To compare the effect of allograft and autograft of bone-patellar tendon- bone (B-PT-B) under arthroscopy in reconstruction of anterior cruciate ligament (ACL).Methods The injured ACL was reconstructed under arthroscopy by using autograft of B-PT-B in 30 cases and al- lograft of B-PT-B in 28 cases from January 2000 to August 2003.After over twelve months follow up,a comparison was done on rehabilitation of quadriceps femoris,knee stability,the Lysholm's score of knee and the enlargement of tunnel in both groups.Results Both groups obtained marked improvement of knee stability and symptoms after operation.But in the early time,the rehabilitation of quadriceps femoris in the ailograft group is faster than that in the autograft group.The rehabilitation of quadriceps femoris, knee stability and the Lysholm's score of knee were similar at 12th month (P＞0.05).There could be seen enlargement of tunnel in both groups,with more in the allograft group (P＞0.05).Conclusion For arthroscopic reconstruction of anterior crucial ligament (ACL),allograft of B-PT-B is good substitute, for it is characterized by effectiveness,convenience and minor side effect.

Objective:To explore the central neurobiological mechanisms of pleasure effect on rats with neuralgia treated by tuina manipulations of An-pressing and Rou-kneading Huantiao (GB 30).Methods:A total of 64 male Sprague-Dawley (SD) rats were used in this study.Eighteen rats were randomly selected as a normal group,and the other 46 rats were used to duplicate the chronic constriction injury (CCI) model.Ten rats failed in modeling and 36 rats succeeded.These 36 rats were then randomly divided into a model group and a tuina group,with 18 rats in each group.The rats in the normal group and the model group did not receive any interventions,while those in the tuina group received An-pressing and Rou-kneading Huantiao (GB 30),1 min for each time,once a day,3 weeks in total.Heating tests were evaluated to observe the change of pain-sensitivity score before intervention,1 week after intervention,2 weeks after intervention,and 3 weeks after intervention.After 1 week of intervention,2 weeks of intervention,and 3 weeks of intervention,6 rats were randomly selected from each group respectively for brain extraction.The change of Nissl's body and β-endorphin in the accumbens nucleus as well as amygdaloid nucleus of pleasure circuits,and pro-opiomelanocortin (POMC) in the arcuate nucleus were analyzed by methods of histochemistry and molecular biology.Results:After modeling,the pain-sensitivity scores of the tuina group and the model group were statistically different from the score of the normal group (both P＜0.05).After An-pressing and Rou-kneading Huantiao (GB 30) for one week,the pain-sensitivity score of the tuina group had statistical difference compared with that of the model group (P＜0.05).At each different time point:the amounts of Nissl's body in accumbens nucleus and amygdaloid nucleus of the tuina group were significantly more than those of the model group (all P＜0.01).Besides,the numbers of β-endorphin immunoreactive cells in the accumbens nucleus and amygdaloid nucleus of the rats in the tuina group were significantly higher than those in the model group (all P＜0.01),and so was the expression of POMC in arcuate nucleus (all P＜0.01).Conclusion:An-pressing and Rou-kneading Huantiao (GB 30),where the sciatic nerve is ligated,can reduce pain-sensitivity score and increase pain tolerance value of rats with chronic neuralgia.It can increase the activity of neurons in accumbens nucleus and amygdaloid nucleus of pleasure circuits,which indicates that the analgesia effect of tuina therapy may correlate with pleasure effect,and also reveals a part of neurobiological mechanisms of neuralgia.

Objective To investigate the incidence of heterotopic ossification in cervical artificial disc replacement in Chinese mainland population by meta-analysis.Methods The related literatures published between 1997 and June 2012 were collected from both English databases,including Pubmed,Ovid,Cochrane library and Embase,and Chinese databases including Chinese Biomedical Literature Database,China National Knowledge Infrastructure,VIP database and Wanfang database.Literatures were selected in strict accordance with the inclusion and exclusion criteria.Studies providing data of prevalence of heterotopic ossification after cervical artificial disc replacement in Chinese mainland population were included.The information of literatures was extracted by excerpts questionnaire,and recorded by two independent researchers.I2 was calculated to test heterogeneity among studies.A random effects model was used if I2 ≥25％.Subgroup analysis was done according to the number of levels of disc replacement,brands of implants and duration of follow-up.Sensitivity analysis was done according to the sample size.The Meta-Analyst software was used for statistical analysis.Results A total of forty studies (1822 cases) were included in this study.The pooled incidence of heterotopic ossification was 7.3％ (95％CI:4.7％ to 11.0％).For single and mixed level disc replacement,the incidence was 11.6％ and 5.8％,respectively.For single and mixed level disc replacement using Bryan disc,the incidence was 13.8％ and 5.4％,respectively,and the total incidence was 7.2％.No matter the single or mixed level disc replacement,the incidence of heterotopic ossification increased with follow-up.Conclusion The incidence of heterotopic ossification in cervical artificial disc replacement is high in Chinese mainland population,while it is lower than in foreigners.However,it is necessary to monitor its long-term incidence due to its increase with follow-up.

Cartilage ; diagnostic imaging ; Ectodermal Dysplasia ; diagnosis ; Humans ; Radiography

OBJECTIVETo develop and evaluate the application of the facial minimally invasive fat granules injection device with controlled pressure and quantity.

METHODSDue to the requirement of facial fat grafting (small volume, precision, high pressure), we developed the integrated device with handheld controller and motor. From Nov. 2013 to Mar. 2015, 50 cases who underwent facial fat transplantation were selected to receive facial fat grafting with the device on the right side and with conventional syringe on the left side as control. The clinical effect was assessed by patients, surgeon and one from the third party. The intraoperative pain, injection difficulty, postoperative swelling and hruising, complications and overall satisfactory were recorded. Pain intensity was assessed using digital classification method ( NRS). Therapeutic effect was evaluated using Likert 5 points scoring method. Chi-square test, Wilcoxon test and one-way ANOVA were used for statistical analysis.

RESULTSThe device has the advantages of minimal designed and easily handling. The injection speed is 7.2 mm/s with the fat injection volume as precise as 0.04 ml/s (0.0056 m/mm). Among the 50 cases, the excellent and good effect were achieved in 90% (45/50) on the right face, and 78% (39/50) on the left face (Z = -4.285, P < 0.01). Local nodes happened in 7 cases on left face, while none on the right face (χ² = 6.57, P < 0.05). Petechiae occurred in 21 cases on right face and 45 cases on left face (χ² = 5.37, P < 0.05). Pain was assessed as 3.7 ± 1.1 points on the right sides, and 5.2 ± 0.7 points on the left sides (F = 17.405, P < 0.01).

CONCLUSIONSThe facial minimally invasive fat granules injection device with controlled pressure and quantity has the advantages of easily handling, precisely controlled quantity with hotter effect, less pain and complication.

Adipose Tissue ; transplantation ; Analysis of Variance ; Chi-Square Distribution ; Face ; surgery ; Humans ; Injections ; instrumentation ; Pain Measurement ; Statistics, Nonparametric

Objective To improve the teaching quality of Sex and Reproductive Health for college students.Methods From February 2008 to June 2010,the general elective course of SeX and reproductive health were offered for students from all the majors in Shanghai Jiao Tong University.The lessons were conducted in the form of lectures,group discussions,role-plays and debates.The self-designed questionnaires were respectively given out after the first class and at the end of the last class in order to have an understanding of the rate of the relevant knowledge known by the students and their suggestions.Results The rate of the relevant knowledge known by the students significantly increased.Some suggestions about the educational reform were received through questionnaire and educational feedback.Conclusion The reproductive health service is needed for college students.Group discussions and role-plays are ideal methods for interactive teaching.

Objective To retrospectively analyze the distribution percentage points of molecular subtypes of breast cancer and investigate its guiding significance in the prognosis and personalized therapy in patients with breast cancer aged over 60 years.Methods A retrospective analysis of all patients with invasive breast cancer aged over 60 years from January 2009 to June 2014 in Breast Center of Beijing Hospital was performed.Based on the immunohistochemical methods recommended in the St.Gallen International Expert Consensus Report 2013,the molecular subtypes of breast cancer in these patients were identified.All patients were followed up every 6 months after operation until December 2014.Clinical pathological characteristics and prognosis indexes in different molecular subtypes of breast cancer were evaluated.Results Totally 770 patients aged over 60 years with invasive breast cancer met the criterion.The luminal A,luminal B,human epidermal growth factor receptor 2 (HER2) over-expression,triple-negative subtypes accounted for 29.1％ (224 cases),47.5 ％ (366 cases),6.5 ％ (50 cases) and 16.9 ％ (130 cases)of patients,respectively.The luminal A subtype of breast cancer had larger tumor size,more lymph node metastasis and more late TNM stage as compared with other subtypes(all P＜0.01).Univariate and multivariate analysis showed that aged ≥ 80 years and the triple-negative molecular subtype were the independent poor prognostic factors for breast cancer(both P＜0.05).The luminal A subtype of breast cancer had relatively good prognosis,while the triple-negative subtype had relatively poor prognosis.Conclusions Molecular subtypes have a significant prognostic effect on breast cancer in patients aged over 60 years,which suggests molecular subtype can be considered as a reference indicator in personalized therapy.Patients aged over 80 years has poor prognosis due to less rational treatment.The reasonable and target treatment based on the molecular subtype of breast cancer should be provided for patients aged over 80 years in clinical medicine.

Objective To provide the oxygen supply apparatus when the civil aviator and airforce pilot are inspected the hypoxia tolerance and altitude tolerance in the hypobaric environment.Methods Demand oxygen and contstant flow oxygen were supplied.Results The portable hypobaric oxygen supply apparatus can supply mixed oxygen below the altitude 8 000 m,and the oxygenous concentration of mixed oxygen was adjusted according to the altitude.The pure oxygen was supplied when the altitude was at 8 000～12 000 m.Conclusion The normal and emergency oxygen supply performance can fulfill the system physiological requirements.The portable hypobaric oxygen supply apparatus may be used by the persons engaging in special task on plateau also.

Abstract?AIM:To evaluate the efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy ( RR) .?METHODS: There were 43 patients ( 43 eyes ) with RR were collected at the Fifth Affiliated Hospital Sun Yet-Sen University between Jan.2009 and Jan.2014.Twenty-one patients received the photocoagulation treatment combined with intravitreal bevacizumab and 22 patients received the treatment of photocoagulation alone.All the patients would complete ophthalmologic examinations, including best -corrected visual acuity ( BCVA ) , intraocular pressure, optical coherence tomography, fundus fluorescein angiography before and after the treatment.?RESULTS:BCVA:In monotherapy group, there were no statistically difference about BCVA before and after treatment ( P>0.05).In combined therapy group, the BCVA had been increasing gradually in 2wk, 1, 3, 6mo after treatment ( P <0.05 ). There was no significant difference about BCVA before and 1a after treatment ( P>0.05).In the comparison of BCVA in these two groups in 2wk, 1, 3, 6mo after treatment, the combined therapy group were better than monotherapy group in each time point (P<0.05), but no statistically significant difference was observed in these two groups at 1a after treatment (P>0.05).Central macular thickness (CMT):in monotherapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P <0.05 ). There was no significant difference about CMT before and after 1a treatment ( P>0.05).In combined therapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P<0.05 ). There was no significant difference about CMT before and 1a after treatment ( P>0.05).In the comparison of CMT between these two groups in the 2wk, 1, 3, 6mo after treatment, those of combined therapy group were thinner and difference were statistically significant ( P <0.05 ), but no statistically significant difference was observed in two groups at 1a after treatment (P>0.05).? CONCLUSION: Photocoagulation combined with intravitreal bevacizumab for the treatment of radiation retinopathy both have an effect on reducing the macular edema in a short time (6mo).But the long-term efficacy is poor.