Objective To evaluate the morphological and signal intensity changes after anterior cruciate ligament reconstruction , and to analyze the correlations between MRI evaluation and clinical examination .Methods Totally 34 patients who underwent anterior cruciate liga-ment reconstruction in our hospital from July 2013 to June 2015 were given MRI examination .The morphology ,orientation and signal intensity of the anterior cruciate ligament grafts were evaluated on axial ,sagittal and coronal images .The grafts were assessed with Rak method ,and the clinical assessment was adopted with physical assessment method ,including drawer test ,axial shift test and Lachman test .The correlations be-tween MRI evaluation and clinical examination results were further analyzed by SPSS 16.0.Results After anterior cruciate ligament recon-struction,79%of the graft were visualized as a smoothly continuous low signal (well-defined type),15%of the graft showed increased signal intensity with only a small part of low signal bands ( intermediate type ) ,and 6% of the grafts showed remarkably increased signal intensity (indiscernible type).A statistically significant correlation was identified in MRI evaluation and clinical examination results (P<0.05). Spearman’ s correlation coefficient was 0.747 2 which indicating significantly positive correlation .Conclusion Magnetic resonance imaging is a noninvasive high-resolution imaging technology and it is an effective tool for evaluating anterior cruciate ligament reconstruction .

BACKGROUND:Individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization are common methods for treating nondisplaced wrist scaphoid fracture. However their clinical outcomes are stil unclear. ＜br> OBJECTIVE:To compare the clinical results of individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization for treatment of Herbert type Ib scaphoid fracture. ＜br> METHODS:A total of 36 patients with fresh Herbert type Ib scaphoid fracture were divided into two groups, individualized percutaneous cannulated screws fixation with the help of computer-assisted design group (screw group, 20 cases) and cast immobilization group (cast group, 16 cases). In the screw group, cannulated screws were inserted using 0.8 mm kirschner wires from scaphoid tuberosity based on the preoperative individualization fixation parameters. The direction of the wires was guided under C-arms and Herbert screws were percutaneously immobilized after fluoroscopy. In the cast group, radial deviation and palmar flexion plaster casts were immobilized for 3 months. The time of bone union, rate of bone nonunion, time return to work, wrist motion were recorded and compared in the fol ow-up. ＜br> RESULTS AND CONCLUSION:Al cases were fol owed for 10-24 months. Al patients in the screw fixation group and 13 out of 16 patients in the cast group achieved bone union. The average time of bone union of the two groups was 6 weeks and 14 weeks respectively (P＜0.001). The time of returning to work was 7.6 weeks and 16.8 weeks respectively, with significant differences between the two groups (P＜0.001). The range of motion of screw fixation group at the final fol ow-up was 96.4°-114.4°, average 104.4°, which was significantly higher than that in the cast group (66.4°-104.2°, average 94.2°;P＜0.001). Individualized percutaneous cannulated screws fixation with the help of computer-assisted design can provide mini-invasion, high accuracy and good reproducibility, has better results than cast immobilization in the treatment of Herbert typeⅠscaphoid fractures.

The concepts and relations of explanatory clinical trials and pragmatic clinical trials on randomized controlled trials of acupuncture are stated. The explanatory clinical trials and pragmatic clinical trials are different in the purpose of study, the controlled method, the treatment method and the solution problems. The explanatory clinical trials may enhance the understanding of the mechanism of a treatment; the findings of pragmatic clinical trials may be applied immediately in clinical practice. This paper explains that these clinical trials are of great importance to the methodology and practices of clinical effective evaluation of acupuncture based on TCM theory.
Acupuncture Therapy ; standards ; Humans ; Randomized Controlled Trials as Topic ; methods ; standards

ObjectiveTo explore the expression rule and clinic significance of Twist and E-cadherin and Vimentin in cervical squamous epithelial cancerization.MethodsChronic cervicitis were used as control group,the expression of Twist (using hybridization in situ),E-cadherin and Vimentin( SABC immunohistochemical stain) in tissues of cervical intraepithelial neoplasia (CIN) and cervical squamous carcinoma were detected,and the correlations were analyzed.ResultsThe positive rate of Twist in group of chronic cervicitis,CIN Ⅰ,CINⅡ,CIN Ⅲ and cervical squamous carcinoma was 10.0％,28.1％,29.6％,42.9％ and 64.3％,respectively.The expression rate of Twist in cervical squamous carcinoma group was higher than other groups ( P ＜ 0.05 ).The positive rates of E-cadherin and Vimentin were 80.0％,68.8％,55.6％,51.4％,39.3％ and 0,6.3％,7.4％,31.4％,32.1％,respectively.The difference of E-cadherin and Vimentin expression between the cervical squamous carcinoma ( or CIN Ⅲ group) and the chronic cervicitis group was obvious ( P ＜0.05,respectively).The expression of Twist was negatively correlated with E-cadherin( r =-0.37,P ＜0.01 ),and it was positively correlated with Vimentin in all cases of CIN and cervical squamous carcinoma( r =0.23,P ＜0.05).ConclusionsThere is a close relationship between abnormal expression of Twist and cervical squamous epithelial cancerization.Twist may participate in the genesis of cervical squamous carcinoma through mediating the expression of E-cadherin and Vimentin in cervix tissue.

OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

ObjectiveTo investigate the biological variations ( CVI,CVG ) of serum high-density (HDL2-C,HDL3-C ) and low-density (LDLa-C,LDLb-C ) lipoprotein subfractions and high-density lipoprotein cholesterol esterification rates (FERHDL and MERHDL ).MethodsTwenty healthy volunteers,10 males and 10 females,were recruited for this study from September to October,2010.Blood was collected four times from each individual with a 2-week interval between each sampling.Serum lipoprotein subfraction cholesterol levels were measured by ultracentrifugation/HPLC,FERHDL and MERHDL were measured by HPLC.Within-subject ( CVI) and between-subject ( CVG.) biological variations and quality specifications for precision,bias and total error were calculated.Results The average CVI of this group were 5.5％ and 7.2％ for HDL3-C and HDL2-C,11.2％ and 18.7％ for LDLa-C and LDLb-C,11.95％ and 12.3％ for FERHDL and MERHDL,respectively.The CVG for HDL2-C was 45.5％,much higher than that of HDL3-C (8.7％),and FERHDL(49.5％ ) had a higher CVG than MERHDL (30.6％ ).For each analyte,there was a considerable variation of CVIamongindividuals.ConclusionsBiologicalvariationsof lipoprotein subfractions,FERHDI and MERHDL have been estimated.These rsults will play an important role in quality specifications and cardiovascular disease risk assessment.

Objective To prepare a glycerol reference material.Methods The material was prepared and characterized according to the primary standard substance technological specification(JJG 1006- 1994).Glycerol was dissolved in water containing 0.5% sodium azide and dispersed to glass ampules.The homogeneity and stability of this material were tested with an HPLC method.Glycerol concentration was determined by a titration method as specified in the Pharmacopoeia of China.Results The three time measuring result of glycerol reference material was 1.297 5?0.014 3,1.302 0?0.008 9,1.313 7? 0.007 8,respectively.Statistical analysis showed that this material was homogeneous (F=1.462,P=0.166) .It was stable for at least 4 years at 4℃.The assigned reference value was 0.103 6 g/g and the expanded uncertainty was 0.000 4 g/g.Conclusions This material meet the technical requirements of national primary standard reference material.It is approved as the Certified Reference Material (GBW 09149) by General Administration of Quality Supervision,Inspection,Quarantine of the People's Republic of China in May,2006.

Objective To determine the value of Magnetic resonance imaging(MRI)technique on diagnosis of adrenal medulla hyperplasia model rats confirmed by pathology study.Methods Sixty male SD rats were divided into 6 groups randomly,10 rats in each group.As experiment group,A,B,C groups were subcutaneously injected with reserpine(0.4 mg?kg~(-1)?d~(-1))from the beginning to 40,60,80 days respectively.As compare,the control groups(a,b,c group)were only injected with sodium chloride simultaneously.MRI technique and pathology study were performed for all the subjects on 40,60,and 80 days respectively.Results The percent of medulla were higher in B and C groups than that in b and c groups respectively[(34.3?5.8)% vs.(25.7?8.9)%,t=2.462,P

Objective To study CT and MRI appearance of transient hepatic attenuation difference (THAI)) .to reveal the cause of THAD),and to avoid false positive and misdiagnosis.Methods 10 cases appearing THAD in CT and 5 cases appearing THAI) in MRI were reviewed and all were processed with plain scan and dy- namic contrast with CT or MRI.Results 7 cases appeared transienl hypertransfusion of CT,4 cases appeared tran- sient hypertransfusion of MRI;3 cases appeared transient Hypoperfusion of CT,1 case appeared transient hypoperfu- sion of MRI.Conclusion The appearance of THAD in CT and MRI,was related to the quick-scan with CT and MRI only sufficient comprehension of the characteristics of blood supply in normal physiology and pathology of liver, combined with plain scan,could make correct decision possible in the final diagnosis when it occurred regional perfu- sion difference in liver.

Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma,especially in the complex cases of which the hepatic ducts are invaded.Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses.The cause of hilar obstructions in these patients were all cholangiocarcinoma,including Bismuth classification type Ⅱ(n 12 ),Ⅲa(n 17),Ⅲb(n 10),and Ⅳ(n 6).Two or 3 stents were placed in the configuration of T,Y or X over the strictures.Results Stent placement with 2 or 3 endoprostheses was successful in all patients.All patients showed significant decrease in serum bilirubin level.The mortality rate within 30 days of stent placement was 2.2%(1/45).The mean survival and stent patency times were 215.3 d(26— 516 d)and 181.5 d(26—473 d),respectively.Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma,especially for the cases of which hepatic ducts are invaded:the henatic ducts should be drained as much as nossible.