[Objective]To investigate the operation indications and techniques of the ISOLA spinal system in reconstruction of the lumber-pelvis continuity after resection of high-level sacral tumors. [Method]A retrospective study was performed in 43 patients with high-level sacral tumor (HLST) between July 2001 to January 2007. Symptoms, signs, histological findings of the tumors and their outcomes were analyzed. All patients underwent resection of HLST and spinopelvic reconstruction with ISOLA spinal system,11 unilateral and 32 bilateral.[Result]Among the 43 patients, 33(77.1%)had chordoma, giant cell tumor of bone and neurogenic tumors. Thirty-four patients alive were followed-up for an average of 35 months(12~62 months), 5 patients had a recurrence of chordoma and 29 patients with HLST were under control. The pain originated from the lumbosacral joint and the spinal nerve root was obviously relieved.The patients could stand and ambulate normally. No loose screw or broken rod were found.X-rays showed no signs of the enlarged screw canal or lowered lumbar spine.The effect was 76.5%(26/34) excellent judged by the ISOLS system.[Conclusion]Spinopelvic reconstruction by ISOLA system after resection of HLST is characterized by easy manipulation, less complications and instant stable fixation. It may be widely used in the clinical practice.

Objective: To approach the effects of glutamine supplementation on plasma and muscle levels of glutamine, and the activities of tissue glutamine synthetase and glutaminase after high intensity exercise. Methods: BAL/C mice were randomly divided into high intensity exercise(2% body weight load) and control groups to swim 2 hours per day for 8 weeks. Results: To compare with control group, high intensity exercise reduced glutamine levels in plasma and muscle by 74% (P

Objective To analysis the biomechanical properties of four-rod fixation system for lumbosacral reconstruction after sacrectomy.Methods Two finite element models of lumbosacral area were established according to pelvic CT images:a subtotal saerectomy model and a total sacrectomy model.The range of motion of L3 vertebral body and max yon Mise stress of instruments of a novel four-rod fixation system were evaluated and compared with those of modified Galveston technique(MGT)under conditions of veaebral body and max von Mise stress of instruments of the four-rod fixation system were evaluated and compared with those of MGT under vertical compression.Results In subtotal sacreetomy model,the range of motion of L3 vertebral body in the four-rod fixation system were 4.2 mm,0.49°,0.49°,0.24°and 0.26°compared to 5.5 mm.0.74°,0.74°,0.27°and 0.30°in the MGT.The max von Mise stress of instruments in the four-rod fixation system were 810.7,148.0,148.0,134.6 and 14.4 MPa,compared to 655.0,109.9,109.9,119.1 and 11.4 MPa in the MGT.In total sacrectomy model under veaical compression,the range of motion of L3 vertebral body and max van Mise stress of instruments in the four-rod fixation system were 10.9mm and 2172 MPa compared to 49.1 mm and 4325 MPa in the MGT.Conclnsion Comparing with the MGT.the four-rod fixation system was stiffer and showed a significant increase in the stability of lumbosacral area.When total sacrectomy without bone graft were performed,the max stress of the four-rod fixation system was much lower than that of the MGT,which means smaller risk of instrument failure.When subtotal sacrectomy or bone graft were performed,despite better stability,the higher stress shielding-effect of the four-rod fixation svstem might be unfavorable for bone fusion,which still need to be evaluated by clinical trials.

Objective To analyze the cases of anaphylactic death cases and explore the standards of judi-cial expertise of anaphylactic death for providing evidence for judicial expertise. Methods Fifty-nine cas-es death due to allergic reaction in Shanghai were collected. And details of medical history, clinical manifestation of anaphylactic reaction and postm ortem exam ination findings were review ed for all cases. Results In the 59 cases, there were 58 cases died from drug allergy, including 77.6% of them were an-tibiotics. The rates of treating in standard hospital and illegal clinic were 37.3% and 61.0%, respectively. The allergic sym ptom s were dyspnea and facial cyanosis. The time from contacting allergens to death ranged from 1 m in to 3 d. The concentration of total serum IgE ranged from 50 to 576.92 IU/m L . The results of clinical manifestation and pathological anatomy had obviously changes. Conclusion B ased on the exclusion of all other cause of death and synthetically analysis of details of cases, medical history, clinical manifestation and anatomy, the conclusion of anaphylactic death can reached. The details of cas-es including clinical history, exposure to allergens, and clinical manifestation play an im portant role in diagnosis of anaphylactic death.

Finite element method (FEM) is an effective mathematical method for stress analysis, and has been gradually applied in the study of biomechanics of human body structures. This paper reviews the construction, development, materials assignment and verification of FEM model of cervical vertebra, and it also states the research results of injury mechanism of whiplash injury and biomechanical re-sponse analysis of the cervical vertebra using FEM by researchers at home and abroad.

BACKGROUND: There are disputes concerning limb salvage and reconstruction in treating pelvis malignant tumor.OBJECTIVE: To study the surgical treatment following resection of tumor at acetabular region in order to restore pelvic stability with less damage or recurrence.METHODS: Thirty-three patients diagnosed with pelvic tumor at Department of Orthopaedics, First Affiliated Hospital of Second Military Medical University from April 2002 to June 2008 were selected. All patients were received tumor resection and computer-aided prosthetic replacement, 18 patients (8 cases with chondrosarcoma, 2 cases with Ewing sarcoma, 2 cases with osteosarcoma, and 6 cases with malignant fibrous histiocytoma) were combined with antitumor drug treatment. Functional assessment of therapeutic efficacy was divided into 4 levels: excellent, good, moderate, and inferior.RESULTS AND CONCLUSION: Two patients died at months 4 and 6 after prosthetic replacement; 31 cases were followed-up for 8-32 months, mean 12.5 months. Seven cases were recurred chondrosarcoma, the recovery of other patients were as follow: 18 cases were excellent, 4 cases were good, 2 cases were moderate and no case was inferior. Most of limb function and pelvic stability was preserved. The results suggested that malignant fibrous histiocytoma and Ewing sarcoma can receive a high rate of limb preservation if treated by effective chemotherapy with low recurrence; the recurrence of chondrosarcoma was high. Tumor resection combined with computer-aided prosthetic replacement can maximatily reserve limb function and raise life quality.

Objective The aim of this study was to investigate the accuracy and reliability of linear measurements using cone beam computed tomography(CBCT) system and to provide theoretical application of CBCT in oral implantation. Methods Ten experimental models of different toothless mandibles mixed with 10% of barium sulfate were used in this study. All these mandible models were marked with gutta-percha markers to standardize the plane of the transverse cross-sections and path of measurements. The mandible models were imaged using Mayer SS-X9010D CBCT device. Measurements were taken with DCT Viewer software and compared with measurements recorded directly in the mandible models using vernier caliper. A paired sample t-test was performed to compare difference between CBCT measurement and vernier caliper measurement. Less than 0.05 were considered statistically significant. Results The differences of vertical lines between CBCT and vernier caliper were (-0.089 5±0.220 0) mm in anterior teeth area and (-0.083 0±0.190 0) mm in posterior teeth area. The differences of vertical lines between CBCT and vernier caliper were (-0.052 0 ± 0.140 0) mm in anterior teeth area and (-0.084 7 ± 0.320 0) mm in posterior teeth area. The corresponding t values were-1.784,-1.981,-1.621 and-1.684, respectively. All the P values were greater than 0.05. There was no significant difference between CBCT measurement and vernier caliper measurement. Conclusions CBCT is auseful tool to provide good accuracy and precision of linear measurement in dental implants.

In drowning cases, it is difficult to judge whether the deceased died from drowning or throw-ing into the water after killed or identificate the cause of death of the decom posed corps in forensic practices. The diatom test is still considered as the im portant assistant evidence in drowning cases. This paper reviews research progress on technologies in recent years of forensic diatom test, and the applica-tion value of the newdeveloping approach in the field of forensic m edicine.

Objective To investigate microvascular injury-related factors post-percutaneous coronary intervention (PCI). Methods Seventy-two elderly patients with stable angina , who underwent PCI from February 2009 to February 2014, were enrolled in this study. The index of microvascular resistance (IMR) was assessed and the clinical data were collected. The correlation between general clinical data and the IMR value before and after PCI were analyzed, and regression analysis was conducted on the relevant factors with postoperative microcirculation after PCI. Results After PCI, FFR, CFR, CK-MB, troponin were higher than those before PCI, with significant differences (P < 0.05). Linear regression analysis result showed that glycated hemoglobin, the degree of stenosis after PCI were positively correlated with IMR, but ejection fraction and CFR before PCI were negatively correlated with IMR. Conclusion Clinically, diabetes, severe vascular stenosis, low ejection fraction, low CFR before PCI in patients with unstable angina may likely occur microcirculation after PCI.

Objective To explore the related risk factors for bypass graft occlusion in patients within 1 year after coronary artery bypass grafting,in order to provide the basis for the prevention of postoperative bypass graft occlusion.Methods Clinical data of 197 cases treated with coronary artery bypass grafting were collected,and the incidence rate of bypass graft occlusion and its related risk factors were analyzed.Results Graft occlusion occurred in 28 (14.2％) of 197 patients.The incidence rate of bypass graft occlusion were much higher in patients with BMI ≥24 kg/m2,smoking,hypertension,hyperlipemia,diabetes,peripheral vascular diseases and cerebrovascular disease than in patients with BMI ＜24 kg/m2,non-smoking,patients without hypertension,hyperlipemia,diabetes,peripheral vascular diseases or cerebrovascular disease (20.0％ vs.9.8％,22.4％ vs.10.8％,21.2％ vs.3.8％,31.1％ vs.9.2％,23.4％ vs.9.8％,25.5％ vs.10.7％,26.3％ vs.11.3％,x2 =4.106,4.534,11.735,13.658,6.615,6.486,5.656,respectively,P=0.043,0.033,0.001,＜0.001,0.010,0.011,0.017).Smoking,diabetes,hyperlipidemia,peripheral vascular diseases and cerebrovascular disease were the independent risk factors for bypass graft occlusion.Conclusions Many risk factors are related with short-term postoperative bypass graft occlusion in patients with coronary artery bypass grafting.The corresponding control measures should be conducted to decrease the risk of postoperative bypass graft occlusion,aiming directly at the risk factors,especially the independent risk factors.