Objective To investigate and evaluate the clinical value of trepanation and drainage in bilateral chronic subdural hematoma aged patients.Methods Chose 52 bilateral chronic subdural hematoma aged patients received trepanation and drainage for objects of study,and analyzed the clinical data of these patients.Results The procedure was successful in all 52 patients and no death was related to the procedure.Only 5 patients recurred after operations.Conclusion Trepanation and drainage possesses high application value in bilateral chronic subdural hematoma aged patients,due to its slight injury,high success rate and low complication.

Objective To evaluate CT staging and resectability of esophageal carcinoma.Methods The esophageal barium examination,esophagoscopy and CT scan were performed in 42 cases with esophageal carcinoma.CT findings were put the stress on analyzed.Results CT clearly demonstrated the location, thickness, actual length and extent of esophageal carcinoma as well as its relation with surrounding structures in all 42 cases.According to staging standard of Moss and Reining there were four stages,Ⅰ stage 0 case,Ⅱ stage 33 cases,Ⅲ stage 6 cases,Ⅳ stage 3 cases.In all cases,operations were in 34 cases,detecting were in 3 cases,no-operations were in 5 cases.Conclusion CT imaging playes an important role in preoperative diagnosis,staging and the evaluation of resectability of esophageal carcinoma.

Objective To study the CT signs of bronchotracheal transparent foreign body and its diagnostic value.Methods The X-ray and CT findings of bronchotracheal trasparent foreign body in 46 cases were analysed comparativly.Results Among 46 cases,9 cases of trachea foreign body,13 cases of right bronchial foreign body,7 cases of left bronchial foreign body,2 cases of both sides of bronchial foreign body were showed directly by CT,and 8 cases of right bronchia foreign body,6 cases of left bronchia foreign body,1 case of both sides of bronchia foreign body showed indirectly on CT,the sensitivity was 100 percent,while the foreign body and its anatomical location could not be showed on X-ray film,but the indirect signs just like pulmonary emphysema,obstructive pulmonitis and drowned lung etc,could be showed by X-ray films in 34 cases.In another 12 cases were negative,the sensitivity was 73.9 percent.Conclusion The transparent foreign body can not be showed but indrect signs by X-ray film;While CT scan can not only shows the anatomical location of foreign body,but also the shape and size of the foreign body,it offers more information than X-ray films and has important refering value to clinicians to take out the foreign body.

Objective To evaluate the diagnostic value and technique advantage of 16-slice CT angiography(16SCTA) in aortic dissection.Methods 39 cases of aortic dissection underwent 16SCTA.The data were reconstructed by multiplanar reconstruction(MPR),curved planar reconstruction(CPR),volume rendering(VR),maximum intensity projection(MIP),virtual endoscopy(VE),and generally analyzed in combination with original axial images.Results According to DeBakey's classification,DeBakey's type Ⅰ in 5 cases,type Ⅱ in one case and type Ⅲ in 33 cases were founed in the 39 cases.16SCTA clearly showed that including the ture and false lumen(39 cases,100%),intimal flaps(39 cases,100%),intimal tear(25 cases,64.1%),and thrombus inside the false lumen(17 cases,43.6%).Conclusion 16SCTA may be as the first choice method in diagnosis of aoric dissection,and which is considered as having great value.

Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.

BACKGROUND: It has been found that drug-coated balloons can reduce the loss of lumen in the advanced stage of coronary small-vessel disease, and the incidence of major adverse cardiovascular events at 6 months after surgery with drug-coated balloons is similar to that of drug-eluting stents. However, clinical studies on the efficacy of drug-eluting stents in older adult patients with type 2 diabetes mellitus complicated by coronary artery small vessel disease are still lacking. OBJECTIVE: To investigate the efficacy and safety of drug-coated balloon versus drug-eluting stent in the treatment of type 2 diabetes mellitus complicated by coronary artery small vessel disease in older adult patients. METHODS: A total of 122 older adult patients with type 2 diabetes mellitus complicated by coronary artery small vessel disease who received treatment in Jiaozuo People’s Hospital between January 2016 and September 2018 were included in this study. These patients were randomly divided into a drug-eluting stent group (n=62) and a drug-coated balloon group (n=60). Patients in both groups underwent coronary artery predilation with a semi-compliant balloon, followed by implantation of corresponding stents. Selective quantitative coronary angiography was performed before surgery, immediately, 6 months and 12 months after surgery. The minimum lumen diameter, residual stenosis, lumen increase and late lumen loss of target lesions were observed in the two groups. At 6 and 12 months after surgery, major adverse cardiovascular events and bleeding events were followed up. This study was approved by the Medical Ethics Committee of Jiaozuo People’s Hospital, China (approval No. 201503). RESULTS AND CONCLUSION: (1) The success rate of surgery in the drug-coated balloon group was significantly higher than that in the drug-eluting group (P=0.028). (2) Immediately after surgery, the minimum lumen diameter and lumen increase in the drug-coated balloon group were less than those in the drug-eluting stent group (both P < 0.01). The residual stenosis in the drug-coated balloon group was significantly greater than that in the drug-eluting stent group (P < 0.01). (3) At 6 months after surgery, late lumen loss of target vessels in the drug-coated balloon group was smaller than that in the drug-eluting stent group (P < 0.001). The rates of target vessel revascularization and major adverse cardiovascular events in the drug-coated balloon group were lower than those in the drug-eluting stent group (P=0.028, 0.010). (4) At 12 months after surgery, the minimum lumen diameter in the drug-coated balloon group was larger than that in the drug-eluting stent group (P=0.033). The residual stenosis and late lumen loss in the drug-coated balloon group were lower than those in the drug-eluting stent group (P=0.008, 0.002, 0.019). (5) These results suggest that drug-coated balloon for treatment of type 2 diabetes mellitus complicated by coronary artery small vessel disease is simple and easy to operate, with a high surgical success rate. Drug-coated balloon can reduce residual stenosis degree and late lumen loss, decrease the revascularization rate of target vessels, and reduce the incidences of major adverse cardiovascular disease and bleeding events. The clinical prognosis of drug-coated balloon is superior to that of drug-eluting stent.

Objective To observe the effect of compound fetal liver extract combined with antiviral therapy on liver fibrosis in patients with cirrhosis.Methods 60 patients with liver cirrhosis from April 2014 to July 2015 were randomly divided into treatment group and control group(n=30).The patients in control group were treated with conventional anti viral therapy , 30 cases in treatment group were treated with compound fetal liver extract combined with antiviral therapy postoperative.Results 1 month after treatment, the treatment group serum liver fibrosis HA, PCM value respectively(107.5 ±17.8,99.8 ±14.9)ng/mL, were lower than in the control group (138.4 ±15.2,124.1 ±18.1)ng/mL(P<0.05).1 month after treatment, the treatment group liver fibrosis collagen type IV, III procollagen value respectively(58.9 ±11.0,109.2 ±11.1)μg/L, were lower than in the control group (85.7 ±11.2,122.7 ±11.3)μg/L(P<0.05).Conclusion Compound fetal bovine liver extract combined with anti-viral therapy in patients with cirrhosis has good, better than the use of antiviral drugs alone.

Objective To study the material attribute of articular cartilage.Methods An improved 4 parameters inhomogeneous triphasic model based on 3 parameters model was developed to estimate the uniaxial modulus Ha of cartilage and to predict the swelling pattern of cartilage.Results The results showed that more accurate uniaxial modulus can be extracted using 4 parameters inhomogeneous triphasic model,and the predicted results appeared to match the experimental strain data better than other models.Conclusion Inhomogeneous 4 parameters triphasic model can describe the depth-dependent material attribute of articular cartilage more exactly.

Objective To discuss the treatment of half hallux toenail flap transplantation for reconstruction of the distal segment finger defect. Methods Based on using the first plantar/dorsal metatarsal artery, or toe artery as pedicle to cut off partial toenail together with toe abdomen flap or partial toenail to repair 64 cases which include 69 fingers with distal segment complete and partial defect,the distal skin avulsion,skin tube in postoperative plastic,replantation failure and so on.Depending on the size of the donor foot wound use the first dorsal metatarsal artery,second toe artery,the perforating branch of peroneal artery or plantar metatarsal artery flap to cover the wound, and then observe the appearance of the finger and foot donor site after operation. Results The finger pulp was full and elastic,nail bed of the toe was well healing,nail groove which originated from the reconstructed nail fold was shallow,the appearance wos realistic,all feelings were recover,two-point discrimination was 4 to 5 millimeter,the donor toe was plump like the original one in appearance,patients were all satisfied with the reconstructed finger and the toe shape,after a follow-up from 3 month to 4 years. Conclusion Half hallux toenail flap transplantation is an effective way to repair the distal segment finger defect.

Objective To explore the applied value of the super-short exposure time of the DR adjustable control in radiography of infant chest.Methods 100 chest radiographic films of infant in adjustable control group and fixed control group respectively were selected randomly.The quality of all films was evaluated by 4 technicians in charge in 4 grades(A,B,C and waste)and the detective rate of the tiny parts of the images was also evaluated.Results DR adjustable control:the rate of grade A,B,C and waste was 70%,20%,10% and 0% respectively.DR fixed control:the rate of grade A,B,C and waste was 42%,41%,15% and 2% respectively.The detective rate of tiny parts was 100% and 90% in DR adjustable control group and DR fixed control group respectively.Conclusion DR adjustable control chest film in infant is better than DR fixed control in image quality.DR adjustable control system is good for radiographic diagnosis.