Objective To establish a clinical score system of giant cell tumors (GCT) according to its morphological features presented on three-dimensional (3D) computed tomographic imaging. Methods Sixteen patients with GCT around knee were included from January 2006 to March 2009. Of the tumors, 9 were located in the distal part of femur, and 7 were in proximal part of tibia. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were inputted into digital Orthopedics clinical research platform. With 3D surfaces reconstruction and volume rendering, we reconstructed 3D morphology of GCT. The measurement index included pathological fracture, the degree of involvement of cortical bone, the volume of tumor, the distance between tumor and joint surface and the percentage of involvement areas of articular surface. On account of previous literature and above data, clinical score system of GCT was established. Its feasibility was testified by clinical data. Results A new clinical score system of GCT was established. It was named Hu-Chen Giant Cell Tumor Scale. Full score of the system was 12. In the 16 patients, 5patients whose points was more than 9 elevated by Hu-Chen Giant Cell Tumor Scale preoperatively were treated by wide excision and prosthetic replacement. The postoperative average MSTS score of 5 patients was 27, and there were no recurrence. The 5 patients whose points was 6-8 elevated by Hu-Chen Scale were treated by intralesional excision and structured allograft. The postoperative average MSTS score of the patients was 29, and 1 case underwent recurrence whose points was 8. The 6 patients whose points were less than 6 elevated by Hu-Chen Scale were treated by intralesional excision and morsellized allograft. The postoperative average MSTS score of the patients was 27, and there were no recurrence. Conclusion Hu-Chen Giant Cell Tumor Scale established based on digital techniques includes lots of factors which determined surgical strategy. The grating system is an effectively, reliable method in treatment of GCT.

Objiective To provide the applied anatomy for the eyebrow lifting plasty. Methods The clinical surgical anatomy of the eyebrow region were studied bilaterally in 15 embalmed cadaveric heads and 9 fresh adult cadaveric heads. The cross sections of 2 embalmed cadaveric heads were observed. Results ⑴ A lot of fibrous tissue origined from the dermis of eyebrow attached to the SMAS. The eyebrow was moved by those fibrous tissue when the frontalis contracted. ⑵ The eyebrow was moved on the loosen layer under the SMAS. Conclusions ⑴ The loosen layer under the SMAS is the anatomic basis of eyebrow movement. ⑵ The basic methods of eyebrow lifting are the skin excision or suspension and restoration of the eyebrow.

Objective To investigate the establishment of secure tunnel in fixation for the talar neck fracture when screws were fixed from the medial wall of talus.Methods The age of volunteers was limited from 20 to 60 years old,and the height of male volunteers was from 165 to 185 centimeters,while the female volunteers' height was from 155 to 175 centimeters.The body mass index (BMI) was less than 25.The volunteers who were not heavy manual workers or standing working for long time had no history of ankle or foot fractures,and there were no evidence of degeneration changes in ankle joints according to X-ray.At last there were 33 males in this study with an average age of 43.7 (21-59) years and an average height of 176.0 (168-184) centimeters.There were 22 females with an average age of 43.2 (22-60) years and an average height of 165.4 (158-172) centimeters.After the volunteers' ankle joints and feet were scanned by CT,the reconstructed images were stored in CD and the slice thickness was 0.75 millimeters.The SuperImageTM Orthopedics Edition1.1 software was used to display the images and perform three dimensional reconstruction.The height of talar neck and the height of tarsal canal were measured.The models that screws passing into tarsal canals were built.The maximal length and angle that screws were inserted in the middle 1/3 and in the inferior 1/3 of medial wall of talus and run along to two directions were measured.At last,the data were analyzed with SPSS 13.0 software.Results The height of talar neck and tarsal canal had no significant difference between left side and right side in the same gender.The height of male talar neck was greater than the female' s.The models of screws passing into tarsal canals was gained.The length and angle in different insert points and different directions of screw fixation were also gained.When the screws were inserted from the middle 1/ 3 of the medial wall of talus,the angle of screw fixation was much wider than that when the screws were inserted from the inferior 1/ 3 of the medial wall of talus.At last,the safe range of the length and angel of screw fixation was calculated.Conclusion Damage of the blood of talus during internal fixation should be avoided.The middle 1/3 of the medial wall of talus is the most favourable choice to the fixation.Combining the digital technology with internal fixation for talar neck fracture could promote the operation' s security and feasibility.

Objective To explore the correlation of data obtained through three dimensional reconstruction and measurement of mandibular angle related angles and bigonial breadth.Methods Sixty cases of adult female head spiral CT data were involved in this study.By the three dimensional reconstruction,mandibular angle related angles and bigonial breadth were measured.Through SPSS13.0 software their correlation was analyzed,including among mandibular angle related angles and these with bigonial breadth.Results The related data of the mandibular angle were measured on the image of three dimensional reconstruction; the mandibular angle was (124.28-±-4.12)°,the mandibular elevated angle was (25.52±2.22)°,the valgus angle of mandibular angle was (9.35±7.85)°,the mandiblular included angle was (77.32 ± 2.34)°,and the tangent angle of mandible was (105.53 ± 1.79)°.The correlation analysis of the related angles of mandibular angle and bigonial breadth showed that there was a significant correlation between the angles.Conclusions Three dimensional reconstruction and measurement of mandibular angle related angles and their correlation analysis can provide theoretical foundation and basis for the preoperative design and effect evaluation of mandibular angle plastic surgery.

Objective To explore the effect of botulinum toxin type A(BTXA)in the treatment of early hypertrophic scars(HTS).Methods BTXA was injected into and around the eady HTS,and then the modal and histological changes of the scars as well as the clinical reaction were observed in the patient.BTXA was also injected into muscle around the incision and effect on the cicatrization observed.Results Injection of BTXA could obviously alleviate ache and pruritus of eady HTS and could impel the atrophy and inteneration of eady HTS.Changes were found in paraffin-embedded tissue section by the hemetoxylin and eosin(HE)staining.Injection of BTXA into muscle around the cut could can reduce occurrence of HTS.Conclusion BTXA can help prevent the early HTS to a certain extent.The mechanism underlying this effect may be related to the reducing the tension around scars and proliferative activity,interfering with the signal transduction of small nerves,affecting the proliferation and apoptosis of fibroblasts and subsequently decreasing the collagen synthesis.

Objective To compare the effect of different gastrointestinal motility drugs on capsule endoscopy. Methods Seventy-one patients with suspected small bowel disease were randomly divided into metoclopramide group (24 patients), mosapride group(25 patients) and control group (22 group). The patients in metoclopramide group swallowed capsule endoscopy immediately after intramuscularly injecting 10 mg metoclopramide, the patients in mosapride group swallowed capsule endoscopy 15 min after taking 5 mg mosapride, and the patients in control group did not take any of the gastrointestinal motility drugs. Three groups had the same bowel preparation before checking. The finishing rate of small bowel examinations, stomach and small intestinal transit time, intestinal cleanliness and the detection rates of lesions in three groups were compared. Results The total small bowel examination finishing rate was 94.4%(67/71). The small bowel examination finishing rate in metoclopramide group, mosapride group, and control group was 95.8%(23/24), 96.0%(24/25), and 90.9% (20/22), and there was no significant difference(P>0.05). The stomach transit time in metoclopramide group, mosapride group and control group was(27.5 ± 20.7), (28.1 ± 20.9) and (52.3 ± 33.5) min. The stomach transit time in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly lower than that in control group (P<0.05). The small intestinal transit time in three groups had no significant difference (P>0.05). The image class scores in metoclopramide group, mosapride group and control group was (2.5 ± 0.4), (2.7 ± 0.4) and (1.7 ± 0.3) scores.The scores in metoclopramide group and mosapride group had no significant difference (P>0.05), but they were significantly higher than that in control group (P<0.05). The detection rate of lesions in metoclopramide group, mosapride group and control group was 45.8%(11/24), 56.0%(14/25) and 18.2%(4/22). The detection rate of lesions in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly higher than that in control group (P<0.05). Conclusions The use of gastrointestinal motility drugs before capsule endoscopy can improve the quality of inspection, and metoclopramide and mosapride shows no significant difference.

Objective To investigate the association between left ventricular hypertrophy and peritoneal transport properties in Peritoneal Dialysis patients.Methods Sixty-nine Continuous Ambulatory Peritoneal Dialysis (CAPD)patients were enrolled in current study.All patients underwent echocardiography for left ventricular mass index (LVMI).Transport status was categorized as high transport,high average transport,low average transport and low transport based on modified peritoneal equilibration test (PET).The data collected included hemoglobin,albumin,blood urea nitrogen,creatinine,urea clearance (Kt/V) and creatinine clearance rate (Ccr),dialysis vintage,systolic blood pressure,diastolic blood pressure.Results Patients with high transport status were 41 cases,more than those with low transport status(28 cases).The dialysis age of high transport,high average transport,low average transport and low transport vintage were (39.2 ± 21.8),(26.6 ±15.6),(28.6 ± 14.4),(45.7 ± 35.0) years old respectively,and the difference was significant (F =4.128,P ＜ 0.05).The dialysis age in the higher transport group was longer than that in high average transport group and low average transport group (P ＜ 0.05).LVMI has significant positive correlations with D/Pcr at 4th hour,SBP and DBP (r =0.339,0.351,0.316,P ＜ 0.01) and the negative correlation with albmin (r =-0.292,P ＜0.05).Left ventricular hypertrophy(LVH) in all patients was 63.8％,ant it was higher in high transport group than that low average transport and low transport group (x2 =5.455,5.091,P ＜ 0.05) Conclusion High transport status is the most common in CAPD patients.There is high incident rate of LVH in this population.LVH has significant positive correlations with D/Pcr,higher SBP,DBP,and lower albumin.

Objective To observe the impact of hypoxia/reoxygenation on myocardial cytoskeletal proteins (α-actinin protein,tubulin protein,desmin protein) and to investigate EPO lessening the damage of myocardial cytoskeleton proteins in rats proved by culturing hypoxia/reoxygenation injured myocardial cells in presence of EPO.Methods The rat model of asphyxia-induced cardiac arrest was performed by turning-off the ventilator and clamping the endotracheal tube.After asphyxia for 8 minutes,CPR was carried out.A total of 24 rats were divided into normal group,ischemia/resuscitation (I/R) group and the EPO group (n =8).The model of myocardial dysfunction was determined 2 hours after restoration of spontaneous circulation (ROSC).The rats of EPO group were given EPO 5000 U/kg after ROSC.The rat heart specimens were collected.Actinin,Tubulin and Desmin protein were observed by SABC immunohistochemistry.The cultured cardiomyocytes were taken from neonatal rats and were divided into three groups:the normal group,the hypoxia/reoxygenation (H/R) group (hypoxia 10 h/reoxygenate 4h),the EPO group (hypoxia 10 h/reoxygenate 4 h,plus 10 U/mL EPO).The changes of tubulin and actinin in cultured cardiomyocytes were observe by Immunofluorescence.Results From immunohistochemistry,there were no significant difference in the optical density of actinin,tubulin and desmin among the normal,I/Rand EPO groups.After H/R injury,the structures of the actinin,tubulin protein were destroyed,the network structure of both protein were unclear in cultured myocardial cells.The grades of fluorescence intensity of actinin and tubulin in H/R group were significant lower than those in normal group,but there was no significant difference between H/R group and EPO group.Conclusions The damage of cytoskeleton during ischemia/reperfusion may be time-dependent.EPO has no beneficial effect on the cytoskeleton after I/R injury.

Objective To discuss the measurement of bone tumor volume on the basis of three dimensional images segmentation technology. Methods Twenty patients with lacunar bone tumor from Tianjin hospital and Tongji hospital were included in the study from January 2010 to August 2010. There were 11 males and 9 females. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were imported into digital orthopedics clinical research platform (SuperImage orthopedics edition 1.1, Cybermed Ltd). The volume and maximum diameter of bone tumor were measured before operation by three-dimensional reconstruction technology. The actual tumor volume was measured during the operation. The tumor volume was also calculated from plain X-rays and CT scans as ellipsoidal or cylindrical depending on the tumor configuration and presence or absence of a soft tissue component. Results The tumor volume was measured to be (14.92±7.34) mm3, (16.65±6.95) mm3 and (34.29±15.70) mm3 using three-dimensional reconstruction technology, intraoperative elevation, and traditional radiograph measurement separately. It was found that there was no difference regarding the outcomes of measurement between three-dimensional reconstruction technology and gross intraoperative measurement. But obvious difference was detected between gross intraoperative measurement and traditional radiograph measurement. Coefficient of correlation between diameter and volume of bone tumor was 0.325 (P=0.162). Conclusion Digital measurement is a precise, efficient,convenient and repeatable method for bone tumor measurement.

Objective To observe the effect of fleabane injection on serum level of D-dimer, fibrinogen and hypersensitive C-reactive protein in patients with IgA nephropathy and to explore the mechanism of fleabane injection for treating IgA nephropathy. Methods 29 patients with IgA nephropathy were given fleabane injection together with routine treatment. Another group of 28 patients with IgA nephropathy were only treated with routine treatment as con-trol. Determinations of 24 hours urine protein output(24HPQ), serum level of D-dimer(D-D), Fibrinogen(Fib) and hypersensitive C-reactive protein (hsCRP) were carried out pre- and post-study. Results Significant decrease in 24HPQ , serum level of D-D, Fib and hsCRP were observed in both treatment group and control group(P <0. 01 ～0. 05), but more significant in treatment group as compared with control group ( P < 0. 05). Conclusion Flea-bane Injection plus routine treatment could significantly decrease 24HPQ in patients with IgA nephropathy, and this maybe contribute to regulation of D-D, Fib and hsCRP by fleabane injection.