BACKGROUND: Distractor has decided the development of distraction osteogenesis since it was applied in oral and maxillofacial surgery. How to breach the limit of traditional distraction osteogenesis lies on designing three-dimensional (3-D) distractor.OBJECTIVE: To explore the design and manufacture of 3-D external distractor for zygomatic bone.SETTING: Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Anhui Medical University.DESIGN: An experiment of the external distraction system for 3-D distraction osteogenesis.MATERIALS: The distractor was made of biological material titanium with well histocompatibility, and consisted of three parts (support, expansion and direction-change) as well as some fittings such as titanium backup plate, spanner and rubber mat, etc.METHODS: Caprine of 10 months old were selected to separate the heads and prepare for isolated zygomatic models. Zygomatic bones were generally curve and made up of four-process-in-one, with the identical formation as human being. According to principle of mechanical movement,two support plates were designed to move relatively, which transferred randomly along with two perpendicular directions. It was done to change the direction and model 3-D distraction osteogenesis on zygomatic bone of the isolated caprine cranium.MAIN OUTCOME MEASURES: 3-D transference of expansion board and whole stabilization of distractor were observed in the process of distraction osteogenesis.RESULTS: The self-prepared 3-D external distractor was 30 g. The lengthener was built to provide 3-D suture expansion osteogenesis by changing the direction. The expansion bar could be moved about 2 cm in anteroposterior axes, 3.5 cm in perpendicular axes, 3 cm in coronal axes.CONCLUSION: The 3-D distractor is simple, accurate and practicable in experimental study, and lays a foundation for clinical study in the future.

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

Objective To investigate the properties of hind foot motion and it's changes in ankle or subtalar joint arthrodesis. Methods Eight fresh frozen adult leg-foot specimens were mounted in a coordinated system, a Steinmann pin was perforated across the calcaneus as a marker. The displacements of the marked points in the coordinated system were recorded when subtalar or ankle joint was fixed respectively. Through matrix translation and Euler equation, the angle of the calcaneus rotation were calculated, representing the motion of the subtalar and ankle joints in different condition, Statistical analysis were also taken between different conditions. Results Three dimensional (3-D) motion was observed in hind foot motion. The range of motion with ankle joint fixation was: inversion 15.99??2.81?, eversion 8.62??1.90?, dorsiflexion 3.70??1.00?, plantar flexion 5.87??1.39?, adduction 7.64??2.04?, and abduction 3.99??1.78?. When subtalar joint was fixed, they were: 7.13??1.07?, 5.52??0.85?, 17.09??2.87?, 30.75??5.04?, 10.77??1.56?, and 6.54??1.88? respectively. While they were 22.62??3.21?, 40.88??5.77?, 18.87??3.89?, 9.12??2.05?, 17.48??2.26? and 11.47??2.29?, when no joint was fixed. Arthrodeses of ankle or subtalar joint would affect the hindfoot motion significantly (P

Based on the anatomic data and fractal theory, the vascular tree model of forearms similar to actual vessel was established, and then the 3D heat transfer model of forearms based on the actual vessel anatomic structure was created. The model was analyzed and investigated with finite element method to explore the influential factors such as dimensional distribution of vessel, blood perfusion rate and external heat source for the 3D temperature field. The simulation results were consistent with the experimental data derived from Pennes. The model well reflects the regional difference of tissue temperature caused by the irregular distribution of vessel, and provides temperature guidance for tumor thermotherapy.

Objective:To analyze the causes and risk factors for failure of internal fixation with proximal femoral nail antirotation (PFNA) in the treatment of femoral intertrochanteric fractures.Methods:A retrospective analysis was conducted of the 568 patients with femoral intertrochanteric fracture who had been treated with PFNA fixation at Department of Orthopaedic Surgery, The Fifth Central Hospital of Tianjin from March 2013 to March 2018. They were 348 males and 220 females, aged from 44 to 93 years (average, 74.6 years). According to the fracture stability classification, the patients were divided into a stable group of 424 cases and an unstable group of 144 cases. According to the AO classification, the stable group had type 31-A1 and type 31-A2.1 while the unstable group type 31-A2.2, type 31-A2.3 and type 31-A3. The 2 groups were compared in terms of reduction quality, rate of internal fixation failure, and function of the affected hip. Single factor and multi-factor binary logistic regression analyses were conducted to determine the risk factors responsible for failure of PFNA fixation of femoral intertrochanteric fracture.Results:There were no significant differences in the preoperative general data between the 2 groups, showing comparability between groups ( P> 0.05). Internal fixation failure occurred in 19 cases, which was caused by spiral blade withdrawal in 13 cases, femoral neck shortening in 17 cases, hip varus in 14 cases, and spiral blade cut-out in 14 cases. The failure rate for the stable group was 1.2% (5/424), significantly lower than that for the unstable group [9.7%,(14/144)] ( P<0.05). The Harris hip score at the last follow-up for the stable group [98(95,100)] was significantly higher than that for the unstable group [84 (82, 87)] ( P<0.05). There was no significant difference in reduction quality between the 2 groups ( P>0.05). The multivariate analysis showed that osteoporosis ( OR=7.283, 95% CI: 1.626 to 32.623, P=0.009) and unstable fracture ( OR=11.607, 95% CI: 4.039 to 33.355, P<0.001) were risk factors responsible for the failure of PFNA fixation of femoral intertrochanteric fracture. Conclusions:PFNA fixation for unstable intertrochanteric fracture can lead to a high failure rate. It forms a lever like structure so that the main stress is shifted to the internal fixation. Its lever fulcrum is located at the angle of intramedullary fixation so that a long arm forms at the load-bearing side, leading to a high failure rate. The weight-free time should be longer for patients with osteoporosis and unstable fracture after operation.

Objective To explore the management,curative effect and safe of superficial bladder tumor(BT)by greenlight photoselective vapontion per urethra(GPVPU). Methods 32 patients of BT were treated by GPVPU,and operation time,postoperative complications,relapse rate and so on were observed. Results All cases were completed successfully. No complication happened in operations. Urinary canal was detained 2 ～4 days and bladder washout(BW) did not need after operation. Follow-up average time was 16 months. Irrigation chems of bladder and cystoscopy were applied routinely. Conclusion GPVPU was safe and effective in treatment of superficial bladder tumor.

Objective To explore the management of benign prostatic hyperplasia(BPH)by photoselective vaporization of prostate(PVP)and curative effect in the near future. Methods Clinical data of 60 BPH patients underwent PVP were retrospctively aralyzed.The changes of IPSS and QOL and the max urine flow rate and residual urine volume(RUV)perioperatively were compared through observations of the operation time and complication. Results The therapeutic efficacy was favourable.No transurethral resection of prostate(TURP)syndrome and uroclepsia happens.IPSS(t=2.471,P <0.05)and QOL(t=2.392,P <0.05)and the max urine flow rate(t=2.287,P ＜0.05)and residual urine volume(t=2.513,P＜0.05)obviously improved(P ＜0.05). Conclusion PVP had many advantages such as operated simply and no serious complications.It was a good operation method to treat BPH.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

Cancer cell exfoliation,invasion and entry into circulation system is the early event with metastasis,which provide the possibility to formation of clinical metastase.Further research about the circulating cancer cells can help us to understand the mechanism of metastasis and offer the scientific proof against anti-metastasis.The detection of circulating tumor cells and clinical significance were reviewed.

Objective To investigate the biological characteristics of neural stem cells from the striatum of human embryos. Methods Neural stem cells were isolated from the striatum of 16-20 weeks human embryos.These cells were cultured to proliferate and then differentiate without mitogens or inductive factors.At various time points the progeny of neural stem cells differentiation were analyzed.Using immunocytochemistry stainings,the biological characteristics of neural stem cells were examined. Results Neural stem cells in the striatum of 16-20 weeks human embryos proliferated rapidly in vitro within the first one month of culture at an average doubling time of 3-4 days.Upon mitogen withdrawal,the differentiation of neural stem cells to neurons exceeded 50%.After 8 weeks in culture,however,the proliferation speed of neural stem cells lowered significantly.The proportion of neurons induced by mitogen removal was under 20%.There were about 20% of cells within neurosphere continue to divide.Conclusion The proliferation and self-renewal ability of neural stem cells in the striatum of 16-20 weeks human embryo is robust.In vitro,the rate of proliferation went down with time,and the ability of differentiation to multiple neural cells varied.The different mitogen factors in media have different effects on neural stem cell.Within neurospheres,neural stem cells are not homogenous,as only a portion of cells can divide.