BACKGROUND:Spiral acetabular prosthesis has good stability during total hip arthroplasty.
OBJECTIVE:To observe the early therapeutic effect of Zweymüler spiral acetabular prosthesis in total hip arthroplasty for patients with developmental dysplasia of the hip.
METHODS:Totaly 38 patients (48 hips) with developmental dysplasia of the hip received total hip arthroplasty with Zweymüler spiral acetabular prosthesis from January 2011 to June 2013 were selected. The clinical effect was observed after the operation.
RESULTS AND CONCLUSION: A total of 38 patients were folowed up for 21-46 months (averagely 42.3 months). One case suffered from deep venous thrombosis. Harris scores and Charnely scores apparently increased after surgery compared with that before surgery. The mean length of the osteotomy was 2.42±0.48 cm, and the mean extended length of the affected limb was 4.58±1.15 cm. X-ray films showed that there was no disunion of the osteotomy, no subsidence and loosening of prosthesis. The position of the acetabulum was suitable. The healing time of bone graft was 3-11 months (averagely 5.3 months). The coverage of the acetabular component was 92.5%, with a good initial stability, and the excelent rate of the operation was 90%. The satisfaction rate of patients was 84%. These results indicate that the Zweymüler spiral acetabular prosthesis has the advantages of reasonable design, good initial stability, low loosening rate and high satisfaction degree. However, the number of cases of this study was relatively smal, the folow-up time was short, and only the short-term effect was evaluated. Thus, the midterm and long-term effects need to be observed by the folow-up evaluation.

Objective Using MRI techniques and the FreeSurfer software package to research the occipital lobe's surface area in children with ametropic amblyopia.Design Prospective,nonrandomized clinical trial.Participants The amblyopic group included 10 children with ametropic amblyopia.The control group included 10 children with normal sight.Methods The brain MRI scan was per- formed with SIEMENS AVANTO 1.5 Tesla scanner.For the surface area analysis,3-demensional MPRAGE images were analyzed with FreeSurfer software package.Main Outcome Measures Occipital lobe related surface area(cuneus,later occipital,lingual,perical- carine)of bilateral hemisphere.Results No difference was between the ages of the two groups.The surface areas of the lingual,pefical- carine,cuneus of bilateral hemisphere and lateraloccipital on the left hemisphere in amblyopic patients were smaller than those of nor- real children(P

Hepatic tumor-specific magnetic resonance (MR) enhancement with Gd-EOB-DTPA can detect and distinguish small hepatocellular carcinoma (HCC) with greater sensitivity than conventional magnetic resonance imaging and computed tomography.Hepatic tumor-specific MR enhancement with Gd-EOB-DTPA is more sensitive in detecting focal HCC,and more reliable in detecting lesions with a diameter smaller than 2cm.Gd-EOB-DTPA is excreted through the kidneys and biliary tract,and thus may provide more information about anatomic structures,demonstrate non-obstruction of the intra- and extrahepatic bile duct system,and provide information about hepatic function.

Objective To point out the weak link of general medical education and explore the training mode and evaluation mechanism for communication. Methods Totally 100 general practi-tioners from four Shanghai hospitals took a questionnaire survey to know the present situation and the training needs of doctor-patient communication skills. Results Among all the subjects, there were 73%who thought strengthening the doctor communication ability was the key to improving the doctor-patient relationship, 71%who chose doctor-patient communication practice course as the training con-tent, 78%who tended to personalized analysis and guide, 57%who accepted experienced GP in class. Conclusion For GPS communication skills training requirements, curriculum integration, clinical practice teaching should be strengthened to set up the corresponding training evaluation system.

Objective To investigate the cortex gray matter configuration in amnestic mild cognitive impairment(aMCI)patients using MRI technology, FMRIB software library(FSL)and Freesurfer software.Methods Twenty aMCI patients and 20 normal control subjects were recruited and studied. They were matched by age, sex and education. All the patients and healthy volunteers underwent MRI scan using SEMENTS trio 3.0 T MRI. The subtile three-dimensional brain images were obtained using high resolution scanning technique. The imaging data was processed and analyzed with FSL and Freesurfer software. The cortex gray matter density and thickness in different brain areas of aMCI patients and normal control subjects were calculated and compared using statistic analysis. Results Compared to that in the controls, cortex gray matter density in the aMCI patients showed remarkable decreases in left frontal lobe, temporal lobe,parietal lobe, and slight decrease in right thalamus, temporal lobe and island lobe; For cortex thickness,aMCI patients showed significant decreases in left anterior cingulate gyrus((2. 19 ±0. 24)mm), inferior parietal lobe((2. 27 ± 0. 15)mm), bilateral parahippocampal gyrus((2. 03 ± 0. 15),(2. 04 ±0. 17)mm), precentral gyrus((2. 20 ± 0. 11),(2. 31 ± 0. 19)mm), postcentral gyrus((1.88 ± 0. 11),(1.82 ± 0. 09)mm), superior frontal gyrus((2. 42 ± 0. 34),(2. 40 ± 0. 28)mm), middle frontal gyrus ((2.31±0.31),(2.33 ±0.29)mm), supramarginal gyrus((2.53 ±0.33),(2.55 ±0.23)mm),temporal pole((3.41 ±0.68),(3.30 ±0.56)mm)and transverse temporal gyrus((2.04 ±0. 12),(2. 01 ± 0. 11)mm; t = 2. 13-3.75, P ＜ 0. 05), no significant changes in the other areas(t = 0. 09-1.88, P ＞ 0. 05). Conclusions Our results suggest that there are significant changes in gray matter configuration in cortex of aMCl patients. The changes of cortical thickness is earlier than the changes of gray matter density.

Objective To value the clinical application of diffusion tensor imaging (DTI) in cerebral diseases. Methods Six volunteers and 6 patients (including 3 patients with ischemic stroke and 3 patients with glioma) were examined by DTI and T1weighted, T2weighted MR scan. All data were processed with DtiStudio software to show the white matter fiber tracts. The fractional anisotropy (FA) of the diffusion tensor were measured between the affected and the unaffected side. Results The white matter fiber tract could be observed clearly on the FA map. The pyramidal tract with different degree disruption could be showed in 3 patients with ischemic stroke. Compression, displacement, infiltration or destruction of pyramidal tract, corpus callosum or internal capsule and external capsule could be seen in 3 patients with glioma, and FA was significantly reduced on the affected side as compared to the unaffected side. Conclusion Diffusion tensor imaging is useful in observing the damage and displacement of the white matter fiber tracts in vivo, beneficial to the surgical plan for patients and prognosing recovery of function.

Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Treatment Outcome

Bronchoalveolar Lavage Fluid ; Humans ; Interleukin-1beta ; metabolism ; Macrophages, Alveolar ; cytology ; drug effects ; metabolism ; Silicon Dioxide ; adverse effects ; Silicosis ; metabolism

Objective To introduce the experience and analyze the clinical outcome of applica- tion of reinforced bar-ring hybrid external fixator combined with limited internal fixation for complex frac- turcs of tibia plateau in patients.Methods From Aug.2002 to Feb.2005,21 patients with complex fractures of tibial plateau were treated with reinforced bar-ring hybrid external fixatar combined with lim- ited internal fixation.According to Schatzker classification,there were 13 patients with typeⅤfracture and 8 with typeⅥfracture.Voluntary and non-weight beating knee joint motion to partially weight bear- ing was taken one week after operation.Progressive loading was taken continuously until there was clinical evidence of fracture stability and then full weight bearing was done.Results The mean follow-up peri- od was 15.9 months (10-24 months).All the fractures got united and the mean union time was 4.2 months(3-8 months).All the injured knees could extend to less than 5 degrees and flex to more than 90 degrees after rehabilitation.Evaluated by Merchant score system for knee joint,81% of patients achieved excellent healing (7 cases) and good healing (10 cases).Conclusion Operation by using reinforced bar-ring hybrid external fixator combined with limited internal fixation can reduce complications and avoid stiffness of the knee joint.It is an effective method for complex fractures of tibial plateau.

· AIM: To study the in situ relative intraocular position of the iris-claw phakic intraocular lens (PIOL)for high myopia using an anterior chamber optical coherence tomography (AC OCT)prototype.· METHODS: Six PIOLs (11.50 to 22.00D lens powers) were implanted in phakic myopic eyes. Using AC OCT, tomography was taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens.· RESULTS: Preoperative anterior chamber depth ranged from 3.27 to 3.91 mm and the postoperative endothelial-optic distance measured 2,07 to 2,24 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.82 to 1.32 mm. Several tomography revealed the position of the PIOL on the iris, The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL.· CONCLUSION, The original anterior chamber depths were reduced by 36,1% to 44.6% after implantation. This study of 6 eyes revealed that tomography taken by AC OCT are useful in verifying the intraocular position of the PIOL within the anterior chamber. Adequate space was maintained between the iris-fixated phakic intraocular lens and the corneal endothelium, angle, and crystalline lens.