Objective To study the relationship between environment selenium distribution characteristic and Kaschin-Beck disease (KBD) in the Yarlung Zangbo River banks and to provide some measures for prevention and control of KBD in the north side of the river bank.Methods Considering the geography and KBD distribution,we made a survey in Xietongmen (KBD area),Lazi and Sajia (non-KBD area) counties in 2013 and 2015.Water,soil,herbage,grain food and children hair samples were collected.Selenium of the samples was measured by hydride generation-atomic fluorescence spectrometry.Results A total of 246 samples of natural soil,cultivated soil,drinking water,food and forage,and 103 samples of children hair were collected.The selenium in natural soil,cultivated soil,herbage,barley,tsampa,self-produced wheat in non-KBD area in the south side of Yarlung Zangbo River bank were significantly higher than those in KBD areas in the north side [mean (μg/kg):288.62 vs 134.90,228.26 vs 160.28,41.85 vs 5.10,13.99 vs 4.02,12.64 vs 8.07,27.44 vs 13.56,U =7,23,0,19,62,0,P ＜ 0.05].Hair selenium in school children in KBD area in the north side was higher than that previously reported,but still significantly lower than that in non-KBD areas in the south side of the river bank [mg/kg:0.221 vs 0.306,U =650,P ＜ 0.01],and about 65.45％ (36/55)of school children in KBD area were at a risk of selenium deficiency in the north of the Yarlung Zangbo River bank.Conclusions The selenium contem in the food chain of soilplants-animals (human being) is significantly lower in KBD area in the north side of Yarlung Zangbo River bank than that in non-KBD areas in the south side.It's still a key factor for the occurrence and prevalence of KBD that low selenium in environment in KBD areas in the north side.

Objective: To explore the feasibility and effectiveness of transoral surgery (TOS) for the treatment of hypopharyngeal carcinoma by means of the radiofrequency coblation(RFC). Methods: Twenty-two patients with hypopharyngeal carcinoma who were treated with TOS using RFC during the years of 2010-2016 were enrolled. Among these patients, 15 suffered from pyriform sinus carcinoma, 4 suffered from postcricoid carcinoma, and 3 suffered from posterior hypopharyngeal wall carcinoma. According to the AJCC 2002 guideline, the tumor stages were T1N0M0 for 3 patients, T2N0M0 for 9 patients, T1N1M0 for 1 patient, T1N2M0 for 1 patient, T2N1M0 for 4 patients, and T2N2M0 for 4 patients respectively. All patients with N+ underwent concurrent neck dissection; 2 patients underwent concurrent prophylactic tracheotomy; 17 underwent post-operative radiotherapy for 50-66 Gy. The follow-up time was 6-72 months with a median 35 months.Two patients were lost to follow-up. Results: All patients except 2 underwent the TOS successfully, while the two patients were treated with open approach surgery due to unsure safe margin. Most patients returned to oral feeding within one week. Among the 18 patients with complete follow up data, 3 had the local recurrence of the tumor (16.7%) and one died due to local recurrence, multiple primary esophageal carcinoma, and distant metastasis 4 years after surgery (5.6%). According to the Kaplan-Meier method, the 5-years local control rate and survival rate were 57.8% and 67.5% respectively. All patients had no disorders in speech, swallowing and respiration during the follow up. Conclusions The RFC can be applied in TOS for the treatments of hypopharyngeal carcinoma with high cutting efficiency and better control of intraoperative hemorrhage, which is useful in lowering the operation difficulty. The oncologic results are comparable to the open surgery with satisfactory postoperative organ function preservation.

OBJECTIVETo verify the feasibility and safety of the vascular interventional vascular interventional surgical robot system applied to vascular interventional operation.

METHODSFrom March to September 2013, 10 patients had undergone robot-assisted cerebral angiography. There were 6 male and 4 female patients; aged from 19 to 58 years, with an average age of 38.4 years. The operation were carried out by neurosurgeons and vascular interventional robot. After successfully implanted of femoral artery sheath by hand, the catheter was fixed on the robot, under the guidance of navigation image the surgeon manipulate the master part and control the slave part of robot by sending command through network transmission, finally finished the whole cerebral angiography. The operation time was recorded from placing the sheath into femoral artery to finishing cerebrovascular selective angiography, simultaneously the time of staff under exposure of X ray was recorded, and the position difference between the setted targets and the actual position(positioning accuracy).

RESULTSIt took 25-41 minutes to finish the cerebral angiography, the average time was (31 ± 5) minutes, and the robot-assisted angiography went quickly and smoothly without surgical complications. The remote positioning accuracy was (1.03 ± 0.23) mm. The time of staff under exposure of X ray was 0 minute, the entire experimental process was basically implemented mechanization and automation.

CONCLUSIONThis system basically achieves initial medical purposes, such as reducing the radiation, facilitating interventional procedures on the basis of enhancing the image navigation, shorting the operation time, and improve the quality of operation.

Adult ; Female ; Humans ; Male ; Middle Aged ; Robotic Surgical Procedures ; Vascular Surgical Procedures ; instrumentation ; Young Adult

OBJECTIVETo explore the effects of Yishen Zhuanggu decoction ([Chinese characters: see text], YSZGD) on the fracture healing and function of wrist joint in osteoporotic distal radius fractures (ODRF) of elderly patients.

METHODSNinety patients of ODRF were treated with splint external fixation and YSZGD, including 28 males and 62 females, with an average age of 63 years (ranged, 61 to 91 years). According to AO classification, all the patients were classified as type A or B1. Among the patients, 80 patients had a type of Colles fracture,7 patients were with a type of Smith fracture,and 3 patients had a type of Barton fracture. They were randomly divided into three groups included TCM, Western medicine and control group (30 cases each group) after the fractures were fixed manually by splint. Patients in TCM group took YSZGD orally, one potion and two time each day; the patients in Western medicine group treated with Calcitonin (50 units, intramuscular, 2 times each week), Caltrate D (1 tablets, taken orally, one time each day) and Alfacalcidol Soft Capsules (0.5 units, taken orally, one time each day); and the patients in control group took no medicine. X-ray examination on the fractured wrist was taken at the 4, 6, 8, 12th weeks after treating to observe, the fracture healings, the evaluation of wrist function and comparision of curative effects were taken at the 2nd month.

RESULTSThe fracture healing time in TCM group was 7.12 +/- 2.32 weeks and that in the Western medicine group was 9.25 +/- 3.05 weeks, showing significant differences between them (PC < 0.05), and that in the control group was 11.57 +/- 1.93 weeks which was longer thant in that in the two medicine groups (P < 0.05); According to Dienst wrist rating system, the excellent and good rates of three groups were 93.3%, 86.7% and 60% respectively which showing significant differences between medicine groups and control group (P < 0.05), and the curative effects of medicine groups were more excellent than that of control group through Ridit analysis.

CONCLUSIONYSZGD can promote the fracture healing evidently and shorten the healing time, whose curative effect surpassed Western medicine and promoted the restoration of wrist function.

Aged ; Aged, 80 and over ; Bone Density Conservation Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fracture Fixation ; Humans ; Male ; Radius ; surgery ; Radius Fractures ; drug therapy ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the effect of reconstruction of anterior cruciate ligaments (ACL) with allogeneic tendon or autologous hamstring tendon under arthroscopy.

METHODSThirty-two cases of ACL injury (3 cases compound with PCL injury) were reviewed. All the patients were divided into two groups randomly. Fifteen cases were reconstructed with hamstring tendon, including 12 male and 3 female with the age ranging from 23 to 61 years. Seventeen cases were reconstructed with allograft, including 11 male and 6 female with the age ranging from 17 to 57 years. The tendons were fixed with absorbable or Ti screws. All patients were recorded symptoms,physical signs and Lysholm Scores two weeks after operation,and functional rehabilitation of knee six months after operation.

RESULTSAll cases were followed up from 6 to 8 months. Pain and clinical symptoms disappeared and the function of knee joint was improved in all patients. Five patients of allograft with positive Lachman test result,one with severe graft rejection was found complete absorption of allograft under arthroscopy. No significant differences were seen in Lysholm Score between the two groups,average (88.5 +/- 7.2), (93.2 +/- 8.5) after operation (P > 0.05).

CONCLUSIONThe effects of reconstruction of cruciate ligaments with allogeneic tendon or autologous hamstring tendon under arthroscopy are more satisfying. But there are more symptoms and obvious individual differences in the earlier stage of rehabilitation. So reconstruction of cruciate ligaments under arthroscopy using autologous hamstring tendon should be performed as far as possible.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Tendons ; transplantation ; Transplantation, Homologous