Objective To explore the changing regularity of humeral distal epiphysial anteverted angulation with ultrasonic measurement. Methods Using an ultrasonic diagnostic apparatus with a high frequency bougie to detect the dextral elbow joint of 203 normal individuals whose age range is from 5 d to 23 years old. The subjects were divided into 5 groups by age (5 d-4 years old, 5-8 years old, 9-12 years old, 13-16 years old, ≥17 years old),and by sex into two large parts.Anteverted angulation of capitellum and lateral semitrochlear ossification center were measured with statistic analysis and correlation calculation.Results Anteverted angulation of capitellum was 48.89?? 8.96?, lateral semitrochlea 33.70?? 7.18?. Anteverted angulation of capitellum enlarges with age growth, and it reaches the climax ( 55.00?? 5.88?) at the age 13-16 years old. There was a significant difference among groups. After 17 years old, anteverted angulation slightly reduces to 52.38?? 8.27?, compared with the climax ( 55.00?? 5.88?), there was no statistical difference. Changing regularity of anteverted angulation was similar to that of capitellum. Just between the 5 d-4 years old group and 5-8 years old group, the difference was significant in angulation enlargement. There was no statistical difference among the groups above the 5-8 years old group, and no significant difference between male and female in humeral distal epiphysial anteverted angulation. Conclusions Ultrasonic examination can clearly display the images of humeral distal epiphysis. Observation and measurement is available for the epiphysial anteverted angulation by acoustic images, and the changing regularity of anteverted angulation can be illustrated.

ObjectiveTo explore the effect of the microsurgical treatment for intramedullary spinal cord tumors.Methods38 patients with intramedullary spinal cord tumors were retrospectively analyzed,and the removal of the tumor cases and functional changes in patients after surgery was summarized.Results38 cases of intramedullary spinal cord tumors,17 cases of ependymoma were all totally removed under the microscope;13 cases of astrocytoma resection achieved in 5 cases,near total resection in 4 cases,partial resection in 4 cases;5 patients most of the lipoma removed;3 cases of hemangioblastoma resection were done.32 patients before surgery in patients with different degrees of movement disorders at discharge in 29 patients with different degrees of improvement,no change in 1 case,2 cases decreased compared with preoperation ;29 patients with varying degrees of preoperative sensory disturbance,21patients at discharge with improvement,5 patients had no change,three cases aggravated; 14 patients had sphincter dysfunction,12 patients improveed than before surgery 2 patients had no change.ConclusionEarhy diagnosis and taking early microsurgical treatment was the preferred method in treatment of Intramedullary spinal cord tumors in clinical application.

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.

Objective To investigate the therapeutic effect of the ultra-early stent-assisted coil embolization of the ruptured intracranial aneurysms. Methods The clinical data of 13 patients with ruptured intracranial aneurysm treated by ultra-early stent-assisted coil embolization were analyzed retrospectively. The preoperative Hunt-Hess gradeⅠ-Ⅱ was in 7 cases,gradeⅢ was in 4 cases,and grade Ⅳ was in 2 cases. The patients were treated with stent-assisted coil embolization under the general anesthesia with endotracheal intubation within 24 h of aneurysm rupture. The postoperative embolization was assessed according to the Raymond grading standard. The postoperative complications and the assessment of the follow-up results from 1 to 6 months after procedure according to the modified Rankin scale (mRS ) scores were observed. Results All 11 patients recovered well,1 case had postoperative hemiplegia,1 case had postoperative bleeding,and none of them died. During the follow-up period,no patients had rebleeding, 1 had recurrence,and DSA revealed that the patient was embolized completely at 2 months after reembolization. Conclusion The method of ultra-early stent-assisted coil embolization of ruptured intracranial aneurysms is feasible. It may improve the cure rate of the ruptured aneurysms and improve the prognosis of patients.

Objective To evaluate the expression of endostatin in bronchoalveolar lavage fluid (BALF) and serum in patients with lung cancer, and to analysis the relationship between endostatin expression and clinical prognosis as well as pathophysiological characteristics. Methods The samples of serum and BALF were obtained from 57 patients with untreated primary lung cancer ( lung cancer group) and 27 patients with benign pulmonary diseases (control group). The levels of endostatin were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The expression of endostatin in serum and BALF in lung cancer group was significantly higher than that in control group ( P ＜0. 01 ). The levels of endostatin in serum and BALF in late-stage ( stage Ⅲ or Ⅳ ) lung cancer patients were significantly higher than that in early-stage ( stage Ⅰ or Ⅱ , P ＜ 0. 01 ).The expression of endostatin both in serum and BALF were significantly higher in adenocarcinoma patients than that in squamous cell carcinoma or SCLC patients. Endostatin concentrations in BALF and serum were significantly greater in patients with lymph node and distant metastasis than those patients without. the expressions of endostatin in serum were closely related to that in BALF in patients with lung cancer ( P = 0. 000). Conclusion The expression of endostatin in serum and in BALF is higher in lung cancer than benign pulmonary diseases and it was associated with TNM stage, lymph node metastasis and clinicopatholgical variables. The level of endostatin in BALF is higher than that in serum and may be used as a significant marker to direct clinic therapy and estimation of prognosis.

Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were analyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.

Objective To investigate the effect of Zishen Yutai Pills on follicle apoptosis and related protein expression in diminished ovarian reserve(DOR) rat model induced by tripterygium glycosides.Methods Forty rats were divided into the control group,model group,progynova group,and Zishen Yutai Pills high and low dose groups,8 cases in each group.Tripterygium Wilfordii Glycosides Tablets were given by gavage for establishing the rat DOR model.Then the HE staining was used to detect the pathological morphology of rat ovary.All levels of follicles were counted.Expression levels of Bcl-2 and Bax protein in follicle and ovarian stroma of each group were detected by using the immunohistochemical method.Results Compared to the control group,the number of great and small follicles in the model control group was decreased,number of atretic follicles was increased,Bcl-2 expression in all kinds of follicles was decreased,and Bax expression was increased,the differences were statistically significant(P＜0.05).Compared to the model group,the number of great and small follicles in the Zishen Yutai Pills high and low dose groups and progynova group was increased,number of atretic follicles was decreased,the Bcl-2 expression in great and small follicles was significantly increased and the Bax expression was significantly decreased,the differences were statistically significant(P＜0.05).Conclusion Zishen Yutai Pills can inhibit the premature and too fast follicles apoptosis by upregulating the expression of Bcl-2 protein and down-regulating the expression of Bax protein,thus plays the effect for treating DOR.

This article reports a case data of primary malignant melanoma of the penis admitted to the Affiliated Hospital of Qinghai University. A 56-year-old patient was admitted to the hospital 1 month after the discovery of a penile mass. Physical examination: An irregular cauliflower-like mass about 1.5 cm×2.0 cm in size was seen below the external urethral orifice, covered with yellow necrotic tissue, and tenderness was positive. Several nodes were palpable in the left and right groin areas, tenderness positive. Laboratory examination showed no abnormality. The CT examination of head, chest, abdomen and pelvis showed no obvious abnormality. The biopsy of the penile mass showed malignant melanoma of the penis. The pathological results of biopsy of the right inguinal lymph node considered local inflammation. Combined with the patient's medical history, physical examination, imaging examination and lymph node biopsy results, a diagnosis of primary penile malignant melanoma was made. Partial penile resection was performed, and the postoperative pathological diagnosis was malignant melanin invasion of the epidermis with ulceration. There was no local recurrence and metastasis during the 9-month follow-up.

OBJECTIVE To improve the solubility of the insoluble drug aprepitant, solve the problem of solubilization in acid and crystallization and precipitation in alkali of aprepitant, select polymer carriers with different functions, prepare ternary solid dispersions, and investigate their performance. METHODS Binary solid dispersions were prepared by solvent-melt method, and the solubility and dissolution rate were used as indicators to screen the solubilization-enhancing carrier materials. The crystallization inhibition performance of each polymer in different concentrations of drug solutions was investigated by the medium transfer method, and the best precipitation inhibitor was screened. The ternary solid dispersions were prepared by hot melt extrusion technique, and the ternary solid dispersion prescriptions were preferably selected with the indexes of solubility and crystal inhibition time. The presence of the drug in the carrier was confirmed by X-ray diffraction analysis, and the dynamic solubility and physical stability of the ternary solid dispersion in simulated intestinal fluid under accelerated conditions were investigated. RESULTS The binary solid dispersion prepared by hydrophilic polymer PVP K30 showed fast dissolution and good solubilization, the enterosoluble polymer HPMCAS showed superior crystal inhibition and prolonged the supersaturation point of aprepitant, and the ternary solid dispersion with a mass ratio of 1∶1∶3(APR∶PVP K30∶HPMCAS) was rapidly and completely released in acid(95% dissolution at 120 min). The ternary solid dispersions were completely released and maintained the solution in a highly supersaturated stable state at 6 h when the pH of the medium was shifted to 6.8, which significantly increased the dissolution degree and dissolution rate relative to the APR, and the drug existed in the carrier matrix in an amorphous form, while being able to maintain the amorphous state for at least three months under accelerated conditions. CONCLUSION Based on the physicochemical properties of different polymers, the ternary solid dispersion prepared in this work not only significantly improves the solubility of aprepitant by coordinating the dissolution rate and crystallization inhibition effect, but also solves the problem of aprepitant dissolution in stomach and precipitation in intestine, with good dissolution characteristics.

Objective:To explore the application and clinical efficacy of functional neural navigation multimodal image fusion technology combined with intraoperative fluorescein sodium in the surgery of lung cancer brain metastases.Methods:Forty patients with lung cancer and brain metastasis admitted to the Department of Neurosurgery of Inner Mongolia Autonomous Region People's Hospital from January 2020 to January 2024 were collected as the observation group. Another 40 patients with lung cancer brain metastases who underwent microscopic resection at Inner Mongolia Autonomous Region People's Hospital from January 2016 to December 2019 were selected as the control group. All patients received head CT examination, head MRI examination, MRI enhanced sequence and MRA, MRV and DWI sequence scanning before operation. Functional neural navigation system was used to perform preoperative multi-modal image fusion to realize three-dimensional display of tumor lesions, and display the position relationship between tumor and functional areas, conduction bundles and large blood vessels, so as to make preoperative navigation plan. After conducting a fluorescein sodium allergy test on the patient before surgery, a small dose of fluorescein sodium (2 mg/kg) was intravenously injected during the operation. During the operation, neuro navigation was combined with fluorescein sodium to perform tumor resection by displaying the boundary between tumor tissue and normal brain tissue under a Pentero 900 Zeiss microscope 560 fluorescence mode. Both groups collected tumor tissue samples for pathological classification and immunohistochemical analysis, comparing and analyzing differences in tumor resection degree, postoperative occurrence of new neurological dysfunction, postoperative muscle strength improvement, changes in KPS scores before and after surgery, and the occurrence of complications. The metric data that conforms to normal distribution is represented by xˉ± s, and the comparison of means between two groups is conducted using independent sample t-test. Calculate the percentage based on the count data, and compare the inter group rates using the χ2 test. P<0.05 indicates statistical significance of the difference. Results:Compared with the control group, the total tumor resection rate of observation group (75.0% (30/40) ) and KPS score of 3 months after surgery (82.5% (33/40)) were better than those of the control group (52.5% (21/40) and 60% (24/40)), and the differences were statistically significant ( χ2 value was 4.94 and 4.38, P values were 0.026 and 0.036). The rate of postoperative new neurological dysfunction in the observation group (22.5% (9/40)) was lower than that in the control group (45.0% (18/40)), and the difference between the two groups was statistically significant ( χ2=4.53, P=0.033). The length of hospital stay ((21.48±3.23) days), operation time ((216.65±56.76) points) and complication rate (37.5% (15/40)) in observation group were lower than those in control group ((22.43±2.34) days, (225.62±37.68) points, 45.0% (18/40)). However, the difference was not statistically significant ( t/ χ2 values were 1.51, 0.83, and 0.46, respectively; P values were 0.136, 0.408, and 0.496, respectively). The 12-month survival rate of observation group (67.5%(27/45) respectively was significantly higher than that of control group (40.0%(16/40) respectively, and the difference was statistically significant ( χ2=6.08, P=0.014). Conclusion:Functional neural navigation multimodal image fusion technology combined with intraoperative fluorescein sodium can accurately locate the tumor and determine the boundary relationship between the tumor and normal brain tissue during lung cancer brain metastasis surgery, improve tumor resection rate, enhance patient quality of life, and ultimately improve patient prognosis without increasing the risk of related complications.