Objective To compare the biomechanical properties of non-locking compression plate (DCP) and locking compression plate (LCP) in the internal fixation of humeral shaft fracture by means of finite element analysis.Methods Three-dimensional finite element models were constructed to simulate DCP and LCP internal fixation of humeral transverse fracture.The DCP and LCP groups were compared in terms of peak stress on the humeral fracture fragments (MPa),peak stress on the screws (MPa),and overall displacement peak value (mm) under 4 basic loads (bending,shear,torsion and compression).The biomechanical stability was analyzed after fracture fixation.Results The stress tended to concentrate at the connection sites of plate and screws and distributed evenly on DCP.The stress distributed in a gradient manner at the multiple screw holes and tended to concentrated on the central screws on LCP.Under the bending,shear and torsion loadings,the peak stresses on the fracture fragments and screws in the DCP fixation were larger than in the LCP fixation.However,under the compression loading,the peak stresses on the fracture fragments and screws in the DCP fixation were smaller than in the LCP fixation.DCP and LCP had similar trends in displacement.Under the bending,shear and torsion loadings,the overall displacement peak values in LCP fixation were smaller.However,under the compression loading,the overall displacement peak values in DCP fixation were smaller.Conclusions DCP and LCP have similar biomechanical properties to resist bending,shear,torsion and compression.Due to the gradient distribution of stress among the screw holes,LCP is more suitable for patients with comminuted fracture or osteoporosis.Stress distribution is more even in DCP.Surgeons should consider the advantages of both DCP and LCP to achieve better stability.

Objective The retrospective analysis was carried out to evaluate the results of humeral intercondylar fracture treated with AO reconstruction plate internal fixation accompanied by anterior transposition of the ulnar nerve. Methods From March 1996 to September 2001, sixty-eight patients diagnosed as humeral intercondylar fractures were treated in our hospital, forty-three of which were followed up and evaluated. By AO/ASIF classification, there were type C1 in 14 cases, type C2 in 18 cases, and type C3 in 11 cases. There were 18 male and 15 female patients with an average of 41 years ranging from 18 to 65 years. The patients were open fracture in 7 cases and closed fracture in 36 cases, of which were associated with humeral shaft fracture in 4 cases, Colles fracture in 5 cases, Monteggia fracture in 3 cases, olecranon fracture in 5 cases, and ulnar nerve injury in 6 cases. They were treated with open reduction and AO reconstruction plate internal fixation combined with routine anterior transposition of the ulnar nerve followed by early CPM mobilization. Results The mean follow-up of the group was 17.7 months ranging 12 to 37 months with bone union in 12 to 18 weeks. The outcome was evaluated with Aitken-Rorabeck rating system, 33 of which were graded as excellent, 4 cases as good, 5 cases as fair, 1 case as poor, as a result, the elbow function was excellent to good in 86.1%. One case experienced three degrees cubital varus without an influence on function of the elbow. The wound infection occurred in three cases healed following dress change. A heterotopic ossification developed in two cases 4 weeks later after operation. The preoperative ulnar nerve palsy recovered in all 6 cases, and there was no delayed ulnar nerve palsy happened postoperatively. Two elbow joints were restricted during extension to flexion activity by 43 degrees and 62 degrees respectively. Conclusion Intercondylar fractures of the distal humerus should be treated surgically as early as possible. Anatomical reduction, rigid fixation and early CPM exercise are the key prognostic factors, which could improve the elbow function. Otherwise routine anterior transposition of the ulnar nerve may be helpful to reduce the incidence of delayed ulnar nerve palsy.

Objective To explore the related factors of local reccurrence to rectal cancer after Dixon operation. Methods 100 patients with rectal cancer were used Dixon treatment. Then the tumor cells in the intestine and peritoneal fluid were qualitatively and quantitatively analyzed by flow cytometry during operation. The patients were followed up 2 years to understand the local recurrence. Results In 100 patients,8 cases were found in local recurrence after 2 years. 6 cases of recurrence were in the anastomotic site. Conclusion The local recurrence was related to Dukes stage,tumor distance from the anus,much margin of tumor length,tumor differentiation,intestine and abdominal shed close tumor cells,and it was worthy of attention.

Objective To investigate the effects of airway pressure release ventilation (APRV) in children with severe pneumonia-related acute respiratory distress syndrome(ARDS).Methods Ten children suffering severe pneumonia-related ARDS with APRV were included in Pediatric Intensive Care Unit, Beijing Children's Hospital,Capital Medical University from March 2011 to October 2014.Ventilation variables, changes of airway pressure and Ramsay scores were collected and compared with that in conventional ventilation (CV).Clinical variables were measured at CV before APRV and at 1,4,12,24 hours after transition to APRV.Results High airway pressure(Phigh) at each time point during APRV was significantly lower than peak airway pressure (Ppeak) or plateau airway pressure (Pplat) in CV[(26.00 ±2.94) cmH2O(1 cmH2O =0.098 kPa) ,(24.40 ±3.34) cmH2O,(23.30 ±3.46) cmH2O,(23.00 ± 3.80) cmH2O vs (31.80 ± 5.59) cmH2O, P ＜ 0.01].Mean airway pressure (Pmean) at each time point during APRV was significantly higher than that in CV [(23.00 ± 2.86) cmH2 O, (21.69 ± 3.12) cmH2 O, (20.89 ± 3.31) cmH2 O, (20.46 ± 3.48) cmH2 O vs (17.50 ± 2.37) cmH2 O, P ＜ 0.05].Fraction of inspired oxygen (FiO2) were significantly decreased at 4, 12 and 24 hours after APRV than that in CV [(73.00 ± 22.39) ％, (63.50 ± 20.16) ％, (63.00 ± 21.11) ％ vs (88.00 ± 15.49) ％, P ＜ 0.05].Ramsay scores were significantly decreased at each time point during after APRV than that in CV [(3.90 ± 0.74) scores, (2.90 ± 0.88) scores, (3.00 ± 1.15) scores,(3.50 ± 0.71) scores vs (4.60 ± 0.52) scores, P ＜ 0.05].Conclusions Compared with CV, APRV had a lower Phigh and FiO2 ,a higher Pmean and more shallow sedation.APRV may be an effective ventilation mode in children's severe pneumonia-related ARDS.

Objective To prove with mathematical formula that the patient's blood electrolyte concentration shows a tendency to approach that of replacement-fluid after continuous renal replacement therapy (CRRT).Methods Electrolyte concentration of plasma,replacement-fluid and returning fluid were compared,and they were labeled as Cblood,Cnom,and Creturn respectively.The Creturn was calculated,and the relationship among them was demonstrated with comparison by mathematical formula.At last,according to their relationship,plasma change towards to the replacement fluid was analyzed.Results It was showed that Cblood＜Creturn＜Cnom or Cblood＞Creturn＞ Cnom,and according the relationship,it was derive that the trend of change in Cblood after circulation for m unit time was Cblood1 ＞Cblood2 ＞Cblood3 ＞ … ＞Cbloodm ＞Cblood or Cblood1 ＜ Cblood2 ＜Cblood3 ＜ … ＜Cbloodm ＜Cnom.The plasma electrolyte concentration would close to that of replacement fluid infinitely with the continue of CRRT.Conclusions With mathematical model,it is proved that the replacement fluid electrolyte concentration is the final target of the plasma.We must make up the replacement fluid correctly.And this results provide the basis for CRRT treatment of electrolyte disorder.

OBJECTIVE:To establish an effective technical system to achieve the informatization management in drug produc-tion process,and provide reference for the drug informatization management during production process in China. METHODS:Through analyzing the common problems existing in informatization management in drug production process,above problems were solved by interactive integration marketing system(IIMS)based on mobile internet. Informatization supervision was conducted for the production progress of a batch of drugs in a pharmaceutical production enterprise,and feasibility of the technical system was in-vestigated. RESULTS:There were problems commonly existed in the production process,such as supervision and data collection out of touch,no advanced means,delayed and closed informatization transmission,high cost of informatization collection,hard to develop,etc. IIMS consisted of transit label,informatization collection terminal and monitoring management platform had achieved batch production records paperless data interaction and solved informatization interaction and supervision issues in process of drug quality. In the actual study,IIMS totally supervised 15 links from raw materials purchasing to finished products,and all data were successfully collected. IIMS achieved the real-time remote control of data to make the government easy to regulate,without chang-ing the operational processes,and did not cause economic burden to the enterprises. CONCLUSIONS:The technical system is suit-able for the informatization management in drug production process in pharmaceutical production enterprise,and it can be extended to the scientific research institutes and drug supervision departments in the further.

Objective To investigate the incidence of middle ear barotrauma due to hybaric oxygen therapy by using Health Education Atlas.Methods 100 patients were divided into two groups by random number table. The research group(49 patients)was educated by Health Education Atlas.The control group(51 patients)was educated by traditional education approach.During the first three days,we observed and recorded the eardrum injury and asked patients ear discomfort everyday.Results The incidence rate of middle ear barotrauma of the research group was 6.1%,which of the control group was 19.6%.The eardrum injury of the research group was milder than the control group(χ2 =4.02,P <0.05).Conclusion Education using Health Education Atlascan reduce the incidence of middle ear barotrauma due to hybaric oxygen therapy.

Objective To summarize the clinical features and diagnostic flow of cervical spondylosis with proximal upper extremity amyotrophy;and further analyze the clinical effect of cervical anterior decompression and fusion on cervical spondylosis with proximal upper extremity amyotrophy.Methods Twenty-two cases of cervical spondylosis with proximal upper extremity amyotrophy were analyzed retrospectively from June 2006 to December 2013.Seventeen males and 5 females with an average age of (55.73 ± 8.64) years (38 to 68 years) were included.The mean preoperative course of disease was (19.2 ± 21.86) months (1-72 months).Clinical symptoms,imaging findings and electrophysiological findings were analyzed.The muscular strength recovery of atrophic muscles was evaluated by Manual Muscle Testing (MMT).The clinical improvement rate was evaluated by the Japanese Orthopedic Association (JOA) score,and the clinical satisfaction was assessed at followed up.Results The muscles involved in patients of cervical spondylosis with proximal upper extremity amyotrophy are mainly the deltoid muscle,biceps and scapula levator muscle.Most cases of imaging findings showed multi-segmental degeneration,of which C4,5,C5,6 segments were most common.Neuroelectrophysiological examination showed that affected muscles experienced obvious denervation and decreased action potential.The average follow-up time was (44.14 ± 20.51) months (14 to 102 months).At the last follow-up,the JOA score (16.29 ±0.59) in 17 cases was higher than preoperative (15.12 ± 0.93),the difference was statistically significant (F=51.814,P=0.000),and the average improvement rate was 73.3％.MMT assessment showed that 19 patients (86.4％) in this group had muscle strength recovery for more than 1 grade at the last follow-up.The average clinical satisfaction was 83.7％.Conclusion The clinical diagnosis of cervical spondylosis with proximal upper extremity amyotrophy requires a combination of clinical symptoms,imaging findings and neurophysiological examination results for comprehensive judgment.Anterior cervical decompression and fusion in the treatment of cervical spondylosis with proximal upper extremity amyotrophy patients can achieve good clinical results.

Objective To measure the related anatomical parameters of lumbosacral nerve root and adjacent structures by magnetic resonance neurography,and to analyze operative safety of transforaminal lumbar interbody fusion in Chinese people.Methods A total of 12 healthy volunteers,including 6 males and 6 females,underwent magnetic resonance neurography of lumbosacral nerve root using a Siemens 3.0T MRI machine.The Osirix software was used to reconstruct the three-dimensional imaging and measure the following anatomic parameters: 1) the distance between the nerve root and the superior pedicle; 2) the distance between the nerve root and the inferior pedicle; 3) the angle between the nerve root and the sagittal plane; 4) the distance between the superior and inferior nerve roots; 5) the distance between the superior and inferior pedicles.Results L1-L5 nerve roots got a good imaging by magnetic resonance neurography in all 12 volunteers.The distance between the nerve root and the superior pedicle and the angle between the nerve root and the sagittal plane gradually became smaller from L1 to L5.But the variation in the distance between the nerve root and the inferior pedicle and the distance between the superior and inferior pedicles was not obvious.The distance between the nerve root and the inferior pedicles,which was closely related to the operating space of TLIF,ranged from (8.99±0.88) mm to (10.72±1.01) mm for males and from (7.76±0.46) mm to (8.54±0.65) mm for females; it was less than 10 mm in each segments in the majority of subjects,and the data of females was significantly smaller than that of males.No significant differences were found in parameters between the left and right sides in the same segment.Conclusion Based on the above anatomical study and measurement analysis,we believe that there is some harassment to the upper nerve root in TLIF for Chinese patients,and for some patients there is a certain injury risk.

ObjectiveTo evaluate the surgical techniques and 2-year follow-up results of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF).MethodsFrom September 2006 to October 2008,54 patients with single-level lumbar degeneration disease were treated by Mast Quadrantassisted modified TLIF.Under the guidance of C-arm,the Mast Quadrant's retractor was placed and the lower articular process of the upper vertebrae and 1/2-2/3 of the lamina,flavum ligament and hyperplastic cohesive part of the lower articular process were removed,the nerve roots and the central canal were decompressed.After cleaning up intervertebral disc space,bone grafting and pedicle screw fixation were achieved.Visual analogue scale(VAS) and Oswestry disability index(ODI) results,as well as the fusion rate at the last follow-up were analyzed.ResultsAll patients were treated by Mast Quadrant-assisted modified TLIF,in which 51 patients were followed up for 2 years.An average operating time was(178.7±63.2) min,and an average blood loss was (224.2±136.5) ml; an average postoperative drainage loss was (117.2±91.4) ml,and an average postoperative stay was(5.8±3.6) d.There were statistic significances between pre- and post-operative ODI and VAS scores,respectively.At last follow-up,51 patients were achieved radiographic fusion without internal fixation failure and other complications.ConclusionMast Quadrant-assisted modified TLIF had a good vision,was relatively safe and easy to be acceptable by surgeons,and which had a good clinical results for the patients with single-level lumbar degenerative disease.