Patellar instability is a common cause of knee pain and a common disease of patellofemoral joint.It is one of the important etiological factors of chondromalacia patella or patellofemoral joint osteoarthritis.This paper investigates the pathological mechanism,sympton,physical examination and photographic of patellar instability.And the results showed that correct diagnosis lead to reasonable treatment.The emphasis of therapy is to restore the balance of soft tissue around palella.Combined orthopedic treatment is commonly used according to different age,different instability degrees,and pathological factors of different patients.

Abstract A method for determination of trace mercury in water was established. The trace mercury in water was adsorbed quantitatively by activated carbon, and then determined by electrical pyrolysis atomic absorption spectrometry. In comparison with the detection methods of total mercury in water at present, the method avoids the steps of digestion, reduces the mercury pollution and the loss of the mercury, and is simple in operation. The effects of particle size of activated carbon, acid treatment method, acid medium and enrichment time on the enrichment efficiency were investigated. The effect of the pyrolysis temperature and the interfering ions on the determination results was investigated. Three standard addition procedures including activated carbon blank addition, solution blank addition and environmental water samples addition were studied. Regression correlation coefficients of three standard curves drawn by the three methods reached 0 . 9999 . The slope of the three standard curves had no difference by statistical test, indicating that the determination of mercury in environmental water samples under the experiment conditions was not interfered by the coexistent elements, which showed that the activated carbon blank addition method could be directly used for preparing standard curve of the method. The water samples containing 5 ng/L and 50 ng/L mercury were determined by the method, and the relative standard deviation were 7. 2% and 4. 2% (n=11), respectively, with a detection limit of 1. 2 ng/L. The recovery experiment was carried out after adding 10 ng/L mercury to the surface water and tap water samples, and the recoveries were between 92. 0% and 103. 0%. Analysis results were compared with ICP-MS as control and the deviation of the two methods were between 2 . 9% and 3 . 4%, indicating that the method was accurate and reliable, and had good precision.

Objective To evaluate the plan quality of volumetric modulated arc therapy (VMAT) in single brain metastasis compared with the stereotactic arc therapy (S_ARC).Methods 31 patients were replanned using VMAT and S_ARC technique.Prescription dose is 40 Gy delivered in 4 fractions covering at least 95％ of the target volume while keeping minimum doses to the volume of normal brain tissue.The plans were assessed and compared using the conformity indexes (CI),gradient indexes (GI),the mean dose of normal brain tissue,the volumes of normal brain tissue receiving 4 Gy doses,the number of monitor unit and treatment times.A paired t test or non-parametric Wilcoxon signed rank test was performed to analyze the difference between these two plans.Results VMAT plans increased dose conformity,but not dose gradient,compared with S_ARC plans.The median dose conformity index values were 0.815,0.818,and 0.779 (P =0.000,0.000),and the median dose gradient score index values were 5.865,5.706,and 3.133(P =0.000,0.000,0.000),in single arc,double arc VMAT plans and S_ARC plans,respectively.The mean dose of normal brain tissue was higher in VMAT plans.And the volume of the normal brain tissue receiving doses of 4 Gy in VMAT plans was significantly larger than the volume in S_ARC plans.The VMAT plans got higher MU number (P =0.000,0.000).And the mean treatment times were (2.7 ± 0.1) min,(2.8 ± 0.1) min,and (7.6 ± 0.2) min in single arc,double arc VMAT plans and S_ ARC plans,respectively (P =0.000,0.000).Conclusions The dosimetry of VMAT plan can meet the requirements of clinical,and is recommended in the treatment of big volume single brain metastasis or single brain metastasis in cerebellum.

Alemtuzumab ; Antibodies, Monoclonal, Humanized ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Prolymphocytic, T-Cell ; Transplantation, Autologous