PurposeTo evaluate the diagnostic value of multi-slice spiral CT (MSCT) in preoperative TNM staging in non-small cell lung cancer (NSCLC) by comparing with corresponding postoperative pathology.Materials and Methods Ninety-two cases of surgically resected lung cancer were included. Clinical and pathological staging were made and compared, and to evaluate the sensitivity, specificity and accuracy of the MSCT in diagnosing lymph node metastasis.Results MSCT made correct T staging in 83.7% of the cases with excellent agreement (Kappa=0.727,P<0.05). Accurate N staging was in 79.3% of the patients with acceptable agreement (Kappa=0.635,P<0.05). The TNM staging was 75.0% accurate with moderate agreement (Kappa=0.680,P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in diagnosis of lymph node metastasis were 71.1%, 85.2%, 77.1%, 80.7% and 79.3%, respectively. CT accuracy in the diagnosis of groups 4, 5, 6, 10 lymph nodes metastasis was relatively low, in which group 4 had highest false positive, and group 10 had the highest false negative.Conclusion The TNM staging of NSCLC based on MSCT scan is valuable. It can be used as the main basis to evaluate the patient's ability to choose the best treatment plan and predict the prognosis.

BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem.
OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients.
METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed.
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.

Objective:To investigate the relationship between helicobacter pylori ( Hp) infection and proliferation as well as invasion of Uygur esophagus squamous cell carcinoma.Methods: Immunohistochemistry were used to detect Hp , Ki67 and MMP2 protein in 164 cases of Xinjiang Uygur esophageal squamous cell carcinoma tissue specimens.Results: The positive rates of Hp,Ki67 and MMP2 were 81.7%(134/164),67.1%(110/54) and 86.6%(142/164) respectively in 164 cases of esophageal squamous cell carcinoma.The expression of Ki67 in the Hp positive group of patients with esophageal squamous cell carcinoma were significantly higher than that in the Hp negative group and had positive correlation between them (rs=0.340,P<0.01),the expression of MMP2 in the Hp positive group were significantly higher than that in the Hp negative group and had positive correlation between them ( rs=0.739,P<0.01).Conclusion:The relationship between Xinjiang Uygur esophageal squamous cell carcinoma patients with Hp infection and cancer cell malignant degree of proliferation and invasion is close.

Objective To evaluate the risk factors of myasthenic crisis(MC) after thymectomy for myasthenia gravis (MG) Methods A retrospective study was conducted in 84 patients with MG from July 1995 to December 2009. The following factors were evaluated: sex, age, history of preoperative myasthenic crisis, Osssrmen classification, use steroid hormones and anticholinesterase drugs before operation, operation methods, operation time, thymoma, pathology, transfusion, course of disease, postopertive lung infection,etc. Multivariate logistic regrossion analysis was used to find the predictors of postoperative myasthenic crisis. Results Twenty-four patients(28.6%) developed myasthenic crisis after thymectomy. Statistics showed that history of preoperative myasthenic crisis, Ossermen classification, operation methods, operation time were related to postoperative myasthenic crisis. Conclusion Preoperative myastheric crisis, Ossermen classification≥I b, traditional operation methods, long opertion time are the independent risk factors for myasthenic crisis after thymectomy.

Objective:To investigate the application effects of self-made simple vacuum sealing drainage (VSD) device in the postoperative treatment of sural neurocutaneous flap transplantation in the foot and ankle.Methods:From January 2017 to January 2019, 36 patients with foot and ankle skin defects and bone exposure admitted to People′s Hospital of Xinjiang Uygur Autonomous Region met the inclusion criteria, and a retrospective cohort study was conducted. According to the bandaging method of the operative area, simple negative pressure group and antibacterial dressing group were both allocated with 18 patients, with 12 males and 6 females in the former group, 14 males and 4 females in the latter group, aged (41.6±2.8) and (42.3±2.6) years, respectively. Patients in the two groups all received sural neurocutaneous flap transplantation. Patients in antibacterial dressing group received nano silver antibacterial dressing change in the operative area, and the dressing was changed once every 3 days. In simple negative pressure group, the operative area was sealed with a simple VSD device made of gauze, silicone sputum suction tube with holes cut out, and biological permeable membrane, etc., which was connected with the wall central negative pressure suction system for continuous VSD treatment of -40.0 to -16.6 kPa. The negative pressure material was changed once every 5 days. The number of dressing change, the pain score evaluated by Numeric Rating Scale during each dressing change, the cost of dressing change, and the degree of flap swelling evaluated on the 3rd and 5th day after surgery were recorded, and the flap survival was observed. Data were statistically analyzed with independent sample t test, Wilcoxon rank sum test, and chi-square test. Results:The number of dressing change of patients in simple negative pressure group was (3.4±0.5) times, which was significantly less than (7.0±0.8) times in antibacterial dressing group ( t=15.338, P<0.01). The pain score during dressing change of patients in simple negative pressure group was (4.3±0.8) points, which was significantly lower than (6.8±0.7) points in antibacterial dressing group ( t=10.168, P<0.01). The cost of dressing change of patients was similar between the two groups. On the 3rd and 5th day after surgery, the degrees of flap swelling of patients in simple negative pressure group were significantly superior to those in antibacterial dressing group ( Z=4.448, 2.395, P<0.05 or P<0.01). The flap survival of patients in simple negative pressure group was significantly superior to that in antibacterial dressing group ( χ2=4.500, P<0.05). Conclusions:Compared with the traditional dressing bandage, the self-made simple VSD device used after sural neurocutaneous flap transplantation can reduce the frequency of dressing change, relieve the pain of dressing change and the swelling of flap, and promote the flap survival, which is worth popularizing and applying in clinic.