Objective To evaluate the clinical efficacy of AF (atlas fixator) internal fixation in treatment of thoracolumbar fracture and dislocation. Methods 42 cases of thoracolumbar fracture were treated by posterior AF internal fixation. Prior to surgery, anteroposterior and lateral radiographs, and CT scan through bone windows were done for all the patients. During surgery, all the pedicle screws were inserted by Mergerls method and proper insertion was confirmed by radiographs. Results The follow ups of 39 patients averaged 21 months (ranging from 6 to 29 months). After surgery, the correction of anterior vertebral body height averaged 40.2%, and of Cobbs angle 23.2?. 12 cases of incomplete spinal cord injury had significant improvement and 2 ones of complete spinal cord injury had no improvement. Conclusion The AF screw is especially helpful in reconstruction of stability of thoracolumbar region after posterior decompression and reduction, because it results in simplicity, safety, less fixation segments, and little invasion or bleeding.

Objective To investigate the application of hysteroscopy combined ultrasonography and laparoscopy in the diagnose and treatment of post-cesarean section scar diverticulum (PCSD). Methods From March 2011 to February 2013, 27 patients with PCSD were diagnosed and treated in Beijing Obstetrics and Gynecology Hospital. All patients were diagnosed by hysteroscopy and ultrasonography. Treatment protocols were decided by the thickness of the diverticulum. The clinical data of all patients were analysed fully. Results (1)All patients were diagnosed by hysteroscopy combined ultrasound, of which only 17 cases were diagnosed by preoperative ultrasound, the coincidence rate was 63%(17/27). (2)The thickness of diverticulum was measured by hysteroscopy combined ultrasound. Thickness of less than 3 mm in 19 cases, were treated by hysteroscopy combined with laparoscopy diverticulectomy repair;no less than 3 mm in 8 cases, were used hysteroscopy diverticulum incision. (3)The effective rate was 7/8 after hysteroscopy, and which was 16/19 after laparoscopy combined with hysteroscopy surgery. There was no difference in the treatment effect (P=0.663). The ineffective rate was 1/8 after hysteroscopy, and which was 3/19 after laparoscopy combined with hysteroscopy surgery. The size of the PCSD was smaller and the thickness of diverticulum was thicker than preoperation in the later one, which has no difference in the former one. Conclusions (1)Hysteroscopy combined ultrasound is an accurate method for the diagnose of PCSD. (2)According to the thickness of the diverticulum operation method is choosed, which is beneficial to reduce the trauma, and relieve symptoms. (3)Diverticulum poor positioning and incomplete resection are the main causes of postoperative recurrence of the diverticulum.

Objective To study the ultrastructural features of myocytes in uterine junctional zone (JZ).Methods From August 2010 to August 2013,there were 16 pre-menopause patients who suffered from cervical neoplasm to be performed hysterectomy.Samples of JZ and outer myometrium (OM) of hysterectomy specimens were collected.There were 8 specimens from the proliferative-phase and 8 specimens from the secretory-phase of endometrium.Ultrastructural features of JZ and OM were examined by using transmission electron microscopy and the related indices of myocytes were compared by using Student's t test.Results At JZ,there were more cytoplasmic process in the myocytes.The myocytes of JZ exhibited significant difference compared with those of OM.Firstly,the contractile structural components,such as the dense patches,dense bodies and the myofilaments were less abundant.In contrast,the perinuclear cell organelles were more distinct.The mitochondria,endoplasmic reticulum and Golgi apparatus were more prominent,denoting active protein synthesis.Secondly,the mean diameter of cell and nuclei demonstrated cyclic change.In proliferative phase of endometrium,the cell diameters of JZ and OM were (4.70_±0.52) and (4.69± 1.20) μm,respectively,which there were no significant difference(P=0.987).While in secretory phase,the cell diameters of JZ and OM were (3.75±0.36) and (4.92±0.51) μm,which there were significant difference (P=0.006).In proliferative phase,the nuclei diameters of JZ and OM were (3.24±0.41) and (2.90±0.62) μm,and in secretory phase,the nuclei diameters of JZ and OM were (2.44±0.27) and (2.92±0.44) μm.There were no significantly different in both phases (P=0.374,P=0.097).The diameters of cell and nuclei had cyclical changes (P ＜ 0.05).However,the cyclical changes were absent in OM (P＞ 0.05).Thirdly,the myofilaments/cytoplasm ratio of JZ in proliferative and secretory phases were 0.27±0.04 and 0.34±0.03,which were significantly less than those of OM in respective phases (0.49±0.03and 0.54±0.03;P=0.000,P=0.000).The myofilaments/cytoplasm ratio exhibited cyclical changes in JZ (P=0.029),but in OM,the cyclical changes were absent (P=0.083).Conclusions Compared with OM,ultrastructures associated with synthetic organelles are prominent,whereas the contractile organelles are reduced.And there are the cyclical changes in ultrastructural characteristics.The ultrastructural features of JZ are the basis of its physiology.

Objective To evaluate effect of clinical study combined with short-term intensive simulation on training of hysteroscopy technology. Methods Trainees receiving training of hystero-scopy technology from the January to December 2012 in Gynecology Minimally Invasive Center, Bei-jing Gynecology and Obstetrics Hospital Affiliated to Capital Medical University were enrolled and di-vided into two groups depending on the different training modes. Twenty-four trainees in group1 par-tic-ipated in three-month hysteroscopic clinical study program. Twenty-two trainees in group2 partici-pated in three-month clinical study program including one-week short term intensive simulation. After the training, the effect was evaluated by the rating scale and the Rank sum test was used for statisti-cal analysis. P<0.05 signifies statistically significant difference. Results The operation time(P=0.03), forward planning (P=0.02), instrument handing (P=0.00) and knowledge of specific procedure (P=0.04) were improved significantly in group 2 compared with those in group 1. Conclusions The training mode of clinical study combined with the short-term intensive simulation can improve hys-teroscopy technology effectively and should be widely applied.