Objective To evaluate and investigate the clinical feasibility and curative effects of the computer-assisted auto-frame navigation system for distal locking of tibial intramedullary nails. Methods The hardware components of the system consisted of a PC computer with a moniter, an auto mechanical stereotactical localization cubic frame, foot holder and localization apparatus; Self-designed navigation software was used for registration and real-time tool navigation control. 21 patients of tibial and fibluar fractures were treated with closed intramedullary nailing, all fractures were close, 6 in middle third, 12 in middle and lower third, 3 in lower third; C-arm alignment, registration time, fluoroscopic time and drilling time throughtout the locking procedure were recorded. Unreamed or reamed tibial nail sizes ranged from 8/300-11/330. Results All distal holes except 1 were locked successfully, in 9 of 41 holes(21.95%), the drilling ends were in contact with the locking canal, but without any damage to the nail and drilling ends and no adverse effects. The fluoroscopy time for a couple of screws was (2.23?0.31) seconds. Conclusion The computer-assisted auto-frame navigation system for distal locking is well designed, easy to operate and additional instruments are not necessary during the procedure; the developed system enables the physician to precisely navigate surgical instruments throughout the operation using just a few computer-calibrated radiographs. The total radiation exposure time for the procedure can be significantly reduced because additional X-ray exposure is not required. The cost is less expensive and apt to be extended.

Objective To investigate clinical feasibility, security, and effects of cannulated screw fixation of femoral neck fractures aided by the bi-planar navigation robot system. Methods Under the guidance of the robot system which was developed jointly by Beijing Aeronautics and Space University and our hospital, 15 pins were inserted into the femoral necks of 5 Synbone models. The difference between the distance of any 2 points at the entry point and that at the outlet point was measured in the 5 cases. The ratio (P) of the difference to the length of the pin within the femoral neck of the Synbone models was calculated to evaluate how parallel the 2 pins were. The fluoroscopic times and the radiation exposure time in the robot-aided treatment were recorded and compared with those in the 12 cases of conventional operations which were conducted in our department from June to September, 2005. Results P was about 0.003 7 to 0.018 1, and the X-ray exposure time in robot aided system was 2.32 s vs 28.30 s in the conventional operations. The average fluoroscopic times in robot aided system were 4.4 vs 54.3 in the conventional operations. Conclusion As the bi-planar navigation robot system can provide accurate space orientation and stable navigation route, and can decrease the X-ray radiation to the patient and staff, it has a significant value in clinical application.

Objective To compare the nephrotoxicity of the iso-osmolar contrast media (iodixanol) to low-osmolar contrast media (LOCM) in intravenous contrast-enhanced CT.Methods Randomized controlled trials (RCTs) of iodixanol or low-osmolar contrast media in intravenous contrastenhanced CT were searched in the database of VIP,CBM,CNKI,Wanfang,PubMed,EMBASE,Web of Science,Cochrane Library from their start year to July 2012.Screening and information extracted were did by two researchers independently.The quality of the included documents was evaluated by the criterion of Cochrane handbook.Revman software (version 5.0) of the Cochrane collaboration was used in data analysis.Results There was no significant difference in the incidence of contrast-induced nephropathy (CIN) among 6 trials recruited 907 patients between the iodixanol group and the LOCM group [RR =0.64,95％CI (0.31-1.32),P=0.22] by using serum creatinine increased by more than 44 μmol/L (0.5 mg/dl) as the diagnostic criteria.No considerable difference was existed by using serum creatinine increased by more than 25％ as the diagnostic criteria between the two groups [RR =0.79,95％CI (0.48-1.30),P =0.35].Subgroup analysis showed there was no obvious difference [RR =0.57,95％CI (0.30-1.10),P =0.09] between the two groups in patients with increased baseline of serum creatinine.No obvious difference were gained in normal baseline group [RR =1.28,95％CI (0.57-2.86),P =0.55].Conclusion Compared with low-osmolar contrast media,iodixanol is not associated with less CIN in intravenous contrast-enhanced CT.

Background Immediately ocular rinsing is a key step for the prevention of eye tissue damage after acute chemical bums.A good ophthalmic rinsing solution can neutralize chemical substance and improve the prognosis of patients.Objective This study attempted to evaluate the therapeutic effect of self-made citric aciddisodium hydrogen phosphate buffer and citric acid-disodium hydrogen phosphate-potassium chloride buffer on corneal chemical burns in mice.Methods Citric acid-disodium hydrogen phosphate buffer solution (solution 1) and citric acid-disodium hydrogen phosphate-potassium chloride buffer solution (solution2) with the pH 7.4 were prepared.One hundred and twenty clean male C57 mice aged 6-8 weeks were randomized to two groups,and filter papers containing 1 mol/L H2SO4 or 0.15 mol/L NaOH were attached to the central corneas of the right eyes to create the acid or alkali burning models.Then the eyes were immediately rinsed by 40 ml solution 1,tap water or solution 2 according to the grouping and the model eyes without rinsing served as the control group.The corneal opacity was examined by slit lamp microscope and scored in 3,7 and 14 days after modeling.The percentages of corneal fluorescein staining,corneal neovascularization and corneal ulcer were analyzed.The study protocol was approved by Experimental Animal Ethic Commission of Second Military Medical University.Results In the corneal acid burning models,the number of eye with corneal opacity scored 1 in the solution 1 group,tap water group and solution 2 group was significantly more than that in the non-rinsing group in 3,7 and 14 days after modeling (all at P＜0.01);In 3 days after modeling,the numbers of eye scored 1 were more in the solution 1 group than those in the tap water group and solution 2 group (x2 =11.000,P =0.001;x2 =4.000,P =0.046).There were no differences in the eye number of different corneal opacity scores in 14 days after acid burning (all at P＞0.05).In 3,7 and 14 days after corneal alkali burning,the number of eyes with corneal opacity scored 1-2 was significantly increased in the solution 1 group,tap water group and solution 2 group compared with non-rinsing group (all at P＜0.01).The percentage of corneal ulcer in the solution 1 group,tap water group and solution 2 group was 7％,27％ and 13％,respectively,which was significantly lower than 73％ in the non-rinsing group (P =0.000,0.027,0.003),and no significant differences were seen in various time points after corneal alkali burning (all at P＞O.05).Corneal neovascularization occurred in 50％ mice in non-rinsing group in 14 days after acid burning.However,no neovascularization was seen in the mice of the solution 1 group,tap water group and solution 2 group in both acid and alkali burning mice.Conclusions Citric aciddisodium hydrogen phosphate buffer (pH 7.4) appears to be an effective emergency rinsing solution for corneal chemical burns and the rinsing solution with or without potassium chloride is not obviously affected to the prognosis of corneal chemical burns in the mice.

Objective To study the possible mechanisms by which repetitive transcranial magnetic stimulation (rTMS) pretreatment antagonizes seizures induced by lithium chloride-pilocarpine and any correlation with antiapoptosis in hippocampal CA1 neurons.Methods Thirty rats were randomly divided into a control group, a sham stimulation group and an rTMS pretreatment group. The rTMS pretreatment group was pretreated on 7 consecutive days with low-frequency rTMS (0.5 Hz, 75％ of threshold intensity, 20 times/bundle, and 5 bundles/d), while the sham-stimulation group was sham-stimulated with a similar sound. Lithium chloride-pilocarpine ( LPC ) was used to induce a model epileptic state.Epileptic stroke latency and severity were recorded ; neuronal morphology was observed using hematoxylin and eosin (HE) staining; mean positive-reactive cell number and mean optical density and absorbance of B cell lymphoma/leukemia gene-2 (Bcl-2) were recorded, and Fas and Caspase-3 protein in the hippocampal CA1 region were observed with immunohistochemistry.Results Compared with the sham stimulation group, epileptic latency in the rTMS pretreatment group was significantly longer. Seizures in the rTMS pretreatment group were less severe, and a number of degenerated neurons were observed to be apoptotic. Bcl-2 protein expression increased at each time point, but Fas and Caspase-3 protein expression decreased.Conclusions rTMS pretreatment has an anti-epilepsy effect. The possible neuronal protection might be produced by regulating the expression of Bcl-2, Fas and Caspase-3 protein in the hippocampus.

Objective To explore the association between interleukin (IL)-28B variation and spontaneous clearance of hepatitis C virus (HCV) infection.MethodsA total of 280 HCV infected patients including 200 chronic hepatitis C (CHC) patients and 80 spontaneous clearance patients of HCV infection were enrolled in the study.The rs8099917 single nucleotide polymorphyism (SNP) of IL-28B gene was detected and the association between IL-28B variation and spontaneous clearance of HCV infection was analyzed.The data were compared using chi square test.ResultsThe genotype frequencies of TT and non TT (TG and GG) of IL-28B rs8099917 between CHC patients and spontaneous clearance patients were not significantly different ( x2 =15.874,P ＜ 0.01 ). The prevalence of TT genotype in the spontaneous clearance group was 86.2％,which was higher than that in CHC group (62.0％).T and G allele frequencies in CHC group were 78.0％ and 22.0％,respectively,and those in spontaneous clearance group were 92.5％ and 7.5％,respectively,which indicated that T allele was dominant in spontaneous clearance patients. The allele frequency of rs8099917 was statistically different between the two groups (P＜0.01).The spontaneous HCV clear rate in rs8099917 TT patients was 2.84 folds of non-TT patients,while the risk of chronicity of non-TT (TG+GG) patients was 1.36 folds of TT patients.Conclusion The IL-28B (rs8099917) TT genotype is associated with spontaneous clearance of HCV infection,which can be an important factor to predict the spontaneous clearance of HCV.

‘Student-centered’ teaching model is the needs of higher medical education.In the process of education,we carried out comprehensive and systematic reforms by satisfying students' needs and improving students' ability as the main line.These reforms included change of teaching methods (the basic theory combined with clinical knowledge),increase of innovative experiments and change of evaluation system.These results showed that students were interested in these reforms,the innovation abilities of students were improved and students could pay more attention to the process of learning.

Objective:To evaluate the security and efficiency of a surgical robotic assisted percutaneous screw fixation for the treatment of pelvic and acetabular fractures.Methods: In the study,12 patients with pelvic and acetabular fractures who were treated in Beijing Jishuitan Hospital from January to April in 2016 were involved in this research.The research subjects were randomly divided into two groups: the experimental group and the control group.Robotic-assisted percutaneous sacroiliac screw internal fixations were performed under the guidance of fluoroscopy navigation in the experimental group;in the control group,doctors operated manually guided by fluoroscopy.Statistical analysis was performed on the total operation time,the intraoperative fluoroscopy time,the adjustment numbers of intraoperative guide wires,the excellent rate of screw placement and the incidence of adverse events in order to evaluate the security and efficiency of a surgical robotic assisted percutaneous screw fixation for the treatment of pelvic and acetabular fractures.Results: Eleven screws were placed in 7 patients from the experimental group,while 7 screws were placed in 5 patients from the control group in total.All the screw placement positions were satisfactory according to postoperative CT images.The excellent rates of screw placement position were 100％ in both groups.However,the P value was 0.016 based on the comparison between the screws' distribution in the two groups which meant that the screw distribution of the experimental group was better than that of the control group.The average fluoroscopy time needed for screw insertion was (7.36±2.63) s in the experimental group while (41.80±13.99) s in the control group (P<0.001).This suggested that the difference between the two groups had statistical significances.Intra-operative fluoroscopy time of the experimental group was significantly smaller than that of the control group.The number of the average screw adjustment was (0.36±0.48) times in the experimental group while (9.00±3.06) times in the control group (P=0.003).This suggested that the difference of the number of the guide needle adjustment between the two groups had statistical significances,and the number of the experimental group was smaller than that of the control group.The average operation time was (43.86±49.06) min in the experimental group while only (29.00±12.14) min were needed in the control group (P=0.528).This suggested that the difference between the two groups had no statistical significance.That is,the total operation time of the two groups was equal.All the screws were in satisfactory positions according to validation results of CT scans.No complications such as screw breaking out the bone cortex and entering into the knee joint cavity,wound infection occurred.Conclusion: Surgical robots are suitable for robot-assisted percutaneous screw fixation in pelvic and acetabular fractures.Robot-assisted treatment of pelvic and acetabular fractures has significant advantages over manual operations including high accuracy,small perspective radiation,safety and efficiency.

Objective To explore the relationship between KCNJ11-E23K polymorphism and essential hypertension (EH) in Kazakh from Xinjiang. Methods PCR-RFLP method was used to test KCNJ11-E23K genotypes of Kazakh from Xinjiang,including 237 EH patients and 221 normotension (NT). Logistic regression analysis was used to analyze the risk factors associated with EH. Results The frequencies of KCNJ11-E23K genotype (EE and (EK + KK)) and allele (E and K) were 34.18%, 65.82%, 61.60% and 38.40%respectively in EH group. There was a significant difference between two groups (P < 0.05). Weight and EE genotype were risk factors affecting EH in Kazakh from Xinjiang. Individual who carried EE genotype and allele E were 2.501 and 1.388 times than (EK + KK) and allele K suffered from EH respectively. Conclusion KCNJ11-E23K polymorphism was associated with EH in Kazakh from Xinjiang.

Objective To observe the protective effect of pretreatment with wortmannin against pancreas and liver injuries indued by severe acute pancreatitis(SAP) in rats and investigate its mechanism.Methods Fifty-four SD rats were randomly divided into 3 groups: control group(C group),SAP group(P group) and SAP+wortmannin group(PW group)(n=18 per group). SAP model was induced by retrograde infusion of 50g/L sodium taurocholate into the biliopancreatic duct of rats,except C group in which sodium taurocholate was replaced by normal saline. Serum level of tumor necrosis factor-alpha(TNF-?)、 alanine aminotransferase(ALT)、aspartate aminotransferase(AST)、and nuclear factor-kappa B(NF-?B)in liver were detected. Histopathology of liver and pancreas was studied.Results In P group, serum levels of TNF-?、ALT、AST and NF-?B in liver were significantly elevated(P