Purpose To explore the ultrasonic features of tibial nerve (TN) in tarsal tunnel of type 2 diabetes mellitus patients with diabetic peripheral neuropathy (DPN), and to provide the basis for assessment and treatment. Materials and Methods Fifty-four patients with type 2 diabetes mellitus were divided into the DPN group including 31 patients with diabetic periphreal neuropathy and the non-DPN group including 23 patients without diabetic periphreal neuropathy, 22 cases of non diabetic patients were also enrolled as the control group, all the subjects underwent medial tibial nerve ultrasound examination, and the ultrasonic features of tibial nerve (including morphological parameters:left-right diameter, anterior-posterior diameter, thickness sectional area and color Doppler lfow signals) were compared. Results Left-right diameter and anterior-posterior diameter of DPN group were larger than those of non-DPN group and the control group (P<0.01). Ultrasonic features of tibial nerve of DPN group included nerve bundle hypoechoic, vaguedscreen clothstructure, thickening and fuzzy of neural membrane, and the unclear boundaries to adjacent tissue. There was no statistically signiifcant difference in color Doppler signal of TN (P>0.05) among the DPN group, non-DPN group and the control group. Conclusion There are some characteristics features of tibial nerve in tarsal tunnel of type 2 diabetes mellitus patients with DPN, ultrasound can be used to evaluate the morphology of TN in type 2 diabetes mellitus patients with DPN and to provide morphological basis for evaluation and treatment selection.

Objective To investigate the outcomes of arthroscopic treatment of anterior cruciate ligament tibial eminence avul-sion fractures by using loop ligature fixation .Methods 26 patients with anterior cruciate ligament tibial eminence avulsion frac-tures .All the patients were fellowed up at least one year .Results The X-ray indicated that all the avulsion fractures of tibial anteri-or eminence were healed after 6 months of the operation .The mean Lysholm score improved from (50 .8 ± 6 .5) preoperatively to (92 .7 ± 4 .3)postoperatively(t=36 .7 ,P<0 .05) .The mean IKDC 2000 subject score improved from (55 .6 ± 7 .4)preoperatively to (90 .7 ± 4 .2) postoperatively(t=22 .5 ,P<0 .05) .Conclusion Arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fractures by using loop ligature fixation could provide satisfying reduction ,stable fixation and well healing of the avulsed fragment .This arthroscopic suture fixation method is a minimally invasive ,simple and effective treatment for patients with tibial eminence fracture .

Although the new edition of university student management methods has been implemented for several years,many educators and student managers in higher educational institutions are still lack of full grasping and understanding,which led to a series of legal disputes in university students management.Based on many years' experience of university students management,authors discuss the relationship between legal regulations and ethical principles in university students management,analyze the causes of legal disputes,and give out unique suggestions and specific measures in order to provide reference for university students managers.

The endocrine therapy of hormone receptor -positive breast cancer has been widely recog-nized.Aromatase inhibitors are better than tamoxifen in efficacy ,tolerability and other aspects .However,AIs is on-ly applied in the menopausal status of breast cancer patients .Therefore,for premenopausal patients with tamoxifen resistance ,the presence of contraindications or the existence of risk factors ,ovarian castration undoubtedly open a gateway to the more and better option for them .Because of the disadvantages of the reversibility, controllability and side effects ,castration surgery and radiotherapy have been gradually replaced by medical castration .In this paper , the new progress are reviewed .Our article aims to make a review on the lastest research on the new progress of breast cancer medical ovariectomized on endocrine therapy ,the comparison with chemotherapy and other aspects .

With the development of minimally invasive surgical technology, laparoscopic cholecysteeto-my, endoscopic retrograde cholangiopanereatography, endoscopic sphincterotomy and choledochoscopy were applied increasingly in the clinical practice. Based on the domestic and foreign literatures, this article re-viewes these minimally invasive surgical technologies.

Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate.

Objective To investigate the effect of different dose of dexmedetomidine for pre-venting the visceral traction reaction during caesarean section under spinal anesthesia.Methods Two hundred ASA physical status Ⅰ-Ⅱ patients,full-term primiparas scheduled for elective cesarean sec-tion were enrolled in this randomized,placebo-controlled study.Patients were randomly allocated to receive dexmedetomidine in four groups:group C (0.9% normal saline),group D1(dexmedetomidine 0.6 μg/kg),group D2(dexmedetomidine 0.8 μg/kg),group D3 (dexmedetomidine 1.0 μg/kg),50 cases in each group.Two minutes after cutting umbilical,groups D1,D2,D3 received an intravenous infusion single-dose of 0.6,0.8,1.0 μg/kg dexmedetomidine respectively for 10 minutes.Group C was injected the same dose of saline.Maternal blood pressure (BP),heart rate (HR),Ramsay scores,visceral traction reaction conditions were recorded at three points:before iv (T0 ),10 min af-ter iv (T1 )and abdominal exploration (T2 ).Results As for the inhibition of visceral traction pain, groups D2 and D3 were obviously better than groups D1 and C,and there was no statistically signifi-cant difference between groups D2 and D3 at T2 (P <0.05 ).The effects of slowing down heart rate and increasing blood pressure were weaker in group D2 than that in group D3 at T2 .Ramsay scores were higher in groups D2 and D3 than in groups D1 and C (P <0.05),and there was no significant difference between groups D2 and D3 at T2 .Conclusion Administration of dexmedetomidine 0.8 μg/kg could alleviate the visceral traction reaction and had little effect on maternal hemodynamics.

To investigate the effect of semi-joint prosthesis replacement in treating osteosarcoma around the knee joint,15 children with osteosarcoma around the knee joint underwent semi-joint prostheses replacement and removal of the section with tumor from October 1998 to July 2006.Imageology showed that tumor of 9 children was located at the distal femur,and 6 cases at the proximal tibia.The pathologic changes involved the upper segment of the tibia 9-11 cm in length.All the children had been diagnosed with osteosarcoma by pathological examination,which was graded as stage Ⅱ a according to Enneking staging system.All the patients underwent neoadjuvant chemotherapy preoperatively for 1-2 courses.The size of prosthesis was determined based on preoperative X-ray,CT and MRI.The length of the prosthesis should be 1.0-2.0 cm longer than that of the excised bone.Patellar and collateral ligaments were reconstructed in the artificial semi-knee joint prosthesis.All the 15 patients had a successful semi-joint prosthesis replacement.During the follow-up of 2 to 6 years,body height of the children increases by 4-6 cm,and the affected limbs shortened 1-3 cm.All children could live and study normally.There were 7 excellent,5 good,2 fine and 1 poor according to Enneking evaluation system.The semi-joint prosthesis replacement in the limb salvage surgery for child osteosarcoma around the knee joint can reconstruct knee joint function,remain normal osteoepiphysis,minimize affected limb crispation after operation,and create the condition for total knee replacement in adults.

Objective:To study the clinical value of artificial dermis combined with autologous thin skin graft in the repair of burn scar contracture in joints.Methods:A total of 52 patients with burn scar contractures were enrolled in the No.5 Hospital of Baoding from July 2015 to April 2018. According to different methods of repair, 26 cases were used in each group. The observation group was treated with artificial dermis combined with autologous thin skin graft. The control group was treated with medium-thickness skin grafting. The survival rate of autologous skin was compared between the two groups. The tissue of artificial dermal polyester fiber was taken and HE staining was performed to observe the pathological changes. The Vancouver skin scar assessment score (VSS), functional activity, infection rate, wound healing time, and VSS score after healing of the donor site were compared between the two groups.Results:The survival rate of autologous skin in the observation group (92.31%) was not significantly different from that in the control group (84.62%) ( P>0.05). Compared with preoperative, the VSS scores at 3, 6 months and 1 year after operation in both groups were decreased ( P<0.05). The VSS scores of the observation group were lower than those of the control group at 3, 6 months and 1 year ( P<0.05). The excellent rate of functional activity in the observation group (100.00%) was higher than that of the control group (76.92%) ( P<0.05); There was no significant difference in the infection rate (3.85% vs 7.69%) and healing time of skin grafting area between the two groups ( P>0.05). The healing time of donor site was shorter than that of the control group ( P<0.05). The VSS score of the donor site was lower than that of the control group ( P<0.05). Conclusions:Artificial dermis combined with autologous thin skin graft can be used in patients with burn scar contracture in joints, which can improve the scarring of skin grafting area and donor site, shorten the healing time of donor site and improve the function of burn scar contracture joint.