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Objective To observe biomechanical characteristics and advantages of the self-developed anatomical locking plate of sternoclavicular joint by comparison with the radial distal oblique T-shaped locking plate and sternoclavicular hook plate. Methods Nine embalming and moistening adult corpses were selected, including 6 males and 3 females. Model of complete dislocation of the sternoclavicular joint caused by complete removal of the sternoclavicular joint specimen. The bilateral sternoclavicular joints of 9 specimen models were randomly numbered, matched and divided into Group A(experimental group, sternoclavicular joint anatomical locking plate), Group B(control group 1, the radial distal oblique T-shaped locking plate) and Group C(control group 2, sternoclavicular hook plate), with 6 sternoclavicular joints in each group. All specimens were placed with steel plates on both sides and fixed on the universal mechanical test machine. Three biomechanical experiments were carried out, including loading of distal clavicle, torsion of distal clavicle and anti-pull out of sternum handle screw. Results Distal clavicle loading test: the load-displacement of specimens in three groups showed a linear relationship. The compressive deformation resistance in experimental group was stronger than that in two control groups. Distal clavicle torsion test: the relationship between torque and torsion angle was linear. The torsional deformation resistance in experimental group was stronger than that in two control groups. Anti-pullout test of sternum handle screw: there was a significant difference in the maximum anti-pullout force of sternum handle screw among the three groups (P＜0.05). The anti-pullout performance of the sternum handle screw in the experimental group was better than that in the two control groups. Conclusions The self-developed sternoclavicular joint anatomical locking plate is superior to the oblique T-shaped locking plate of distal radius and the plate of sternoclavicular hook in terms of anti-compression, anti-torsion and anti-pullout of sternoclavicular screw, so as to provide an ideal internal fixation device for the treatment of fracture and dislocation of sternoclavicular joint.
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Objective@#To investigate the application value of Overlap anastomosis in Billroth I digestive tract reconstruction after laparoscopic distal gastrectomy in gastric cancer.@*Methods@#Clinical data of 68 stage T1-2 gastric cancer patients undergoing laparoscopic distal gastrectomy for D2 radical gastrectomy from January 2015 to January 2016 at China Japan Union Hospital of Jilin University were retrospectively analyzed. Inclusion criteria: (1) no distant metastasis of gastric cancer confirmed by gastroscopy and pathology before surgery; (2) T1-2 tumor with diameter <3 cm; (3) the lesion locating in the antrum of the stomach with distance >1 cm from the pylorus, and no invasion into middle area; (4) R0 resection confirmed by postoperative pathology; (5) no history of abdominal surgery. Among 68 cases,23 cases were in Overlap anastomosis group and 45 cases in Billroth I anastomosis group. D2 lymph node dissection and distal gastrectomy were performed in both groups. In the Overlap anastomosis group, the duodenum and stomach were severed by a linear stapler under endoscopy, and the residual gastric curve anastomotic opening was selected. According to the tension between the duodenum and the remnant stomach, the anastomotic opening was selected at the upper edge of the remnant duodenum, and the anastomosis between the posterior wall of the remnant stomach and the upper wall of the duodenum was completed by placing the stapler under endoscopy. Then the common opening was closed and the remnant duodenum was resected. In the traditional Billroth I anastomosis group, pneumoperitoneum was discontinued after amputation of the duodenum under laparoscopy. The median incision of the upper abdomen was 9-12 cm. The distal stomach was pulled out to complete the excision of specimens, the extraction of specimens and Billroth I digestive tract reconstruction. The intraoperative and postoperative conditions of the two groups were compared with student t test (continuous variable) and chi-square test (categorica variable).@*Results@#Of the 68 patients,39 were males and 29 were females,with age of (65.5±10.2)(51 to 77)years. Differences in baseline data between Overlap group and Billroth I group were not statistically significant (all P>0.05). Laparoscopic surgery was successfully performed in both groups without conversion to open operation. As compared with the Billroth I group, the Overlap group had significantly shorter operation time [(149.8±10.1) minutes vs. (169.8±15.3) minutes, t=5.658,P=0.008], shorter anastomotic time of digestive tract reconstruction [(31.2±3.8) minutes vs. (36.3±3.3) minutes, t=3.389, P=0.003] and shorter abdominal incision length [(4.5±0.9) cm vs.(11.0±2.3) cm, t=13.244,P=0.004]. There were no significant differences between two groups in intraoperative blood loss [(92.9±22.4) ml vs. (87.0±7.3) ml,t=1.186,P=0.366], number of lymph node dissected (28.4±5.7 vs. 27.3±5.2, t=0.838, P=0.383), postoperative flatus time [(4.4±2.1) days vs.(4.2±1.8) days, t=0.391, P=0.563], morbidity of postoperative complication [4.3%(1/23) vs. 6.7%(3/45), χ2=0.148,P=0.701]. All the patients were followed up for 28±10 (10-46) months. There were no long-term complications, recurrence or death in two groups.@*Conclusion@#Overlap anastomosis in Billroth I digestive tract reconstruction after laparoscopic distal gastrectomy is safe and effective, and can reduce the anastomosis time.
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BACKGROUND:During joint replacement, different materials of prosthesis can be used. Different prosthesis can produce different effects and the stress distribution of bone interface. OBJECTIVE:To explore the effects of different materials on the stress distribution and biomechanics of the bone interface of artificial hip joint. METHODS:The CT scan of the hip was carried out. The image data were saved in DICOM format and processed by MIMICS software. The 3D finite element model of the femur was obtained by ANSYS. A three dimensional finite element model of the femur was made with the material properties of the femur. Three kinds of different replacement prosthesis materials (Co Cr Mo aloy, titanium aloy and composite materials) were selected, and the specific requirements of the actual joint replacement were selected, and different types of prosthesis were designed in CAE software. In the STL format, the prosthesis model was imported into MIMICS, and the femur and prosthesis were assembled. The stress status of different prosthesis was analyzed, and the stress shielding rates of exterior and interior sides of middle and lower parts of the femur, right to and 30 mm below lesser trochanter and right to lesser trochanter of the proximal femur were calculated. RESULTS AND CONCLUSION:Through three-dimensional finite element analysis, a direct and accurate model of the femur and the three-dimensional model of the prosthesis were established. According to the actual situation, material assignment of the femoral three-dimensional finite element model was conducted to obtain the corresponding model. Thus, the properties of different materials of the femur were shown visualy. The femoral stress of cobalt chromium molybdenum aloy, titanium aloy, and composite material was simulated after replacement. Results found that the stress shielding rate can decrease in the middle and lower parts of the femur. After replacement, the femoral stress is higher than that of the intact femur. The experimental results show that the stress shielding of the joint was performed after joint replacement with Co Cr Mo aloy, titanium aloy and composite materials. Among them, the composite material is more close to the actual physiological environment of the human body, and it can better reduce the stress shielding effect, and is beneficial to the stress from the prosthesis to the femur.
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BACKGROUND:More recently, the focus has been on searching for a compound Chinese medicine for reinforcing kidney, which cannot only inhibit bone absorption, but also promote osteogenesis to protect against osteoporosis. OBJECTIVE:To explore effects of drug serum of Jianbuhuqian pil s on proliferation and function of osteoblast-like cel s in vitro. METHODS:Twenty-four adult female Sprague-Dawley rats were randomly divided into low-dose, medium-dose, high-dose and normal saline groups, and given intragastric administration of 1.5, 3.0, and 6 g/kg Jianbuhuqian pills and equal volume of normal saline, respectively twice daily for 1 week. At 1 hour after final gavage, rats were decapitated to prepare drug sera used for culturing osteoblast-like cells. At 24, 48 and 72 hours of culture, the cellular morphology was observed, as well as the cell proliferation and alkaline phosphatase activity was detected by MTT assay and alkaline phosphatase staining, respectively. RESULTS AND CONCLUSION:Compared with the normal saline group, the cel density began to increase significantly in three Jianbuhuqian groups at 24 hours after culture, mitotic figures were easy to be observed, cel s were in overlapping growth, much secretions and matrix accumulation appeared, especial y in the high-dose group. The obsorbance values in Jianbuhuqian groups were significantly higher than that in the normal saline group. After 24 hours of culture, the obsorbance values in the medium-dose and high-dose groups were significantly increased compared with the low-dose group, and the values showed significant differences among three Jianbuhuqian groups after 48 and 72-hour culture. In addition, the alkaline phosphatase activity presented overt increase in the Jianbuhuqian groups compared with the normal saline group, and significant differences could be found among Jianbuhuqian groups. To conclude, the drug serum of Jianbuhuqian pil s can promote the activity of osteoblast-like cel s in a time-and concentration-dependent manner.
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<p><b>OBJECTIVE</b>To compare the handling and efficacy between three-dimensional(3D) imaging system and two-dimensional(2D) imaging system for laparoscopic surgery of rectal cancer deep obturator lymph node dissection.</p><p><b>METHODS</b>Clinical data of 36 patients who underwent rectal cancer resection and obturator lymph node dissection with 3D or 2D imaging system from January 2013 to May 2014 in our department were retrospectively analyzed. There were 16 cases and 20 cases in 3D group and 2D group respectively. Completion time of obturator lymph node dissection, total operation time, total number of lymph node dissected, number of wrong grasping (more than twice for correct positioning in the same site) times and blood loss during obturator lymph node dissection were compared between two groups.</p><p><b>RESULT</b>The laparoscopic rectal cancer resections were successfully completed without laparotomy in both groups. The completion time of obturator lymph node dissection was (23.5 ± 2.5) min and (25.0 ± 3.0) min respectively (P<0.05); the number of wrong grasping was 5.0 ± 2.0 and 6.0 ± 4.0(P<0.01); the blood loss during obturator lymph node dissection was (15.5 ± 1.5) ml and (17.5 ± 2.5) ml (P<0.01). The differences were all statistically significant. The total operation time of 3D and 2D group was (206.0 ± 26.0) min and (222.5 ± 27.5) min (P<0.05); the total number of lymph node dissected was 24 ± 6 and 21 ± 9 (P<0.05). The differences were statistically significant as well. Six cases in 3D group and 11 cases in 2D group were followed up for 1 year and there was no tumor recurrence or death case.</p><p><b>CONCLUSION</b>3D laparoscopic technique has more obvious advantages as compared with 2D laparoscopic system in rectal cancer deep obturator lymph node dissection, so it is worthy to spread.</p>
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Humans , Digestive System Surgical Procedures , Laparoscopy , Lymph Node Excision , Methods , Lymph Nodes , Neoplasm Recurrence, Local , Rectal Neoplasms , General Surgery , Retrospective StudiesABSTRACT
Objective: To explore whether the Cognitive-Behavior Training is feasible and effective in promoting the class attention behavior of a primary student. Methods: The subject was received 4 times of Cognitive-Behavior Training. Her class inattention behaviors were compared before and after the training. Results: (1) During training period, the frequencies of class inattention behavior reduced significantly from 8 times in one session to less than 2 times in average; (2) the class inattention behavior during follow up was a little more frequent than that during training, but not statistically significant.Conclusion: The Cognitive-Behavior Training is feasible and effective in promoting the class attention behavior of the case; the self- instructional training based on behavioral corrective technology may have longer effect than the behavioral technology.
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Objective:To study the relationship between and maladjustment of middle school students and their attitude towards help-seeking.Methods:276 middle school students completed questionnaire of maladjustment and attitude towards help-seeking.Results:There exists grade difference on the problem of school life and the stigma tolerance, and there was also gender difference on the physical and mental development problem, the reliance on the counselor and the integral for help. The experience of help seeking had no influence on maladjustment and attitude toward help seeking.Conclusion:The maladjustment of middle school students is not so severe and the attitude towards help is comparatively positive; the more serious the maladjustment is, the more negative attitude toward help seeking.