Objective To observe the clinical effects of coronoid process of ulna osteotomy and bilateral anatomic locking plate on humerus condyle comminuted fracture in the elderly.Methods 17 elderly patients with humerus condyle comminuted fracture were collected in department of orthopaedics in our hospital from July 2005 to December 2013 and graded into C2 (6 cases) and C3 (11 cases) according to the standard of the American society for the prevention of bone trauma.All patients were treated by coronoid process of ulna osteotomy and bilateral anatomic locking plate and accessed by Mayo elbow performance score (MEPS) at the last follow-up.Results Postoperative incision in all patients were healed,and X-ray showed fracture healing occurred at 10 to 24 weeks after coronoid process of ulna osteotomy (average of 14 weeks).No iatrogenic ulnar nerve injury and nonunion were found at the follow-up.The MEPS were excellent in 13 cases,well in 3 cases,ordinary in 1 case,and the excellent and good rate was 94.1％.Conclusions Coronoid process of ulna osteotomy and bilateral anatomic locking plate in the treatment of humerus condyle comminuted fracture in the elderly have good clinical effects with many advantages such as exposure clearly,early elbow joint function exercise and avoiding the aggravation of elbow joint osteoarthritis.

Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods

Objective To study the correlations between MR imaging and histological classification of intracranial meningiomas.Methods MR imaging findings of 128 cases of intracranial meningiomas proved by operation and pathology were analyzed retrospectively.Results On T 1-weighted images,29(49%) meningothelial meningiomas were hypointense, 11(19%) were slightly hypointense and 17(29%) were isointense, while fibrours meningiomas were respectively in 23(59%),5(13%) and 9(23%). On T 2-weighted images, 34(58%) meningothelial meningiomas were hyperintense, 15(25%) were slightly hyperintense and 10(17%) were isointense, while fibrours meningiomas were in 2(5%),8(20.5%) and 11(28%) respectively. Most of the intracranial meningiomas such as meningothelial, fibrours and transitional were iso- and hypo-intense to the cortex on T 1-weighted imaging. On T 2-weighted imaging, meningothelial, angiomatous and transitional were hyperintense or slightly hyperintense, while fibrous tended to be hypointense or slightly hypointense. Conclusion The signals of meningiomas of different histologic type on T 1-weighted images are no significant different.On T 2-weighted images,there are significant correlation between signal intensity and tumor histology.

Objective To discuss the feasibility of TIPS in the treatment of complicated Budd Chiari syndrome(BCS) and to evaluate its clinical effect. Methods Five patients (male/female=4/1) aged from 30 to 35(mean 33 years). Four of 5 patients with varied degree of esophago gastric varies had the history of upper gastrointestinal bleeding and two had obvious ascites. We punctured the stenotic or occluded hepatic vein into the branch of portal vein in liver parenchyma. Balloon catheter expanding and installing were followed by the gastric coronary vein embolization. Results Successful operation were obtained in all 5 patients. The mean portal vein pressure dropped from(4.7?1.3)kPa before operation to(3.5?1.5)kPa after TIPS. One patient died in 24 hours after an emergency TIPS. One patient died of liver function failure three weeks later. In the mean 64 months′ follow up, 2 of the remaining 3 patients received angiography examination and were demonstrated stenosis at the end of hepatic vein. Both patients were treated with re intervention successfully. Conclusion TIPS was a safe, effective, and feasible method in the treatment of patients with complicated BCS with portal hypertension.

Objective To evaluate the improvement of cone beam CT (CBCT) image quality by using bewtie filter (F_1) and water calibration. Methods First the multi-level gain calibration of the detector panel with the method of Cal_2 calibration was performed, and the CT images of CATPHAN503 with F_0 and bowtic filter were collected, respectively. Then the detector panel using water calibration kit was calibrated, and images were acquired again. Finally, the change of image quality after using F_1 and (or) water calibration method was observed. The observed indexes included low contrast visibility, spatial uniformity, ring artifact, spatial resolution and geometric accuracy. Results Comparing with the traditional combination of F_0 filter and Cal_2 calibration, the combination of bowtie filter F_1 and water calibration improves low contrast visibility by 13.71%, and spatial uniformity by 54. 42%. Water calibration removes ring artifacts effectively. However, none of them improves spatial resolution and geometric accuracy. Conclusions The combination of F_1 and water calibration improves CBCT image quality effectively. This improvement is aid to the registration of CBCT images and localization images.

Objective To verify the dose delivery accuracy of volumetric-modulated arc therapy plan by log-file analysis of linear accelerator that can be created when a dynamic delivery occurs.Methods Accelerator log file in binary format recorded the accelerator execution plan for each control point corresponding to the gantry angle,multi-leaf collimator leave position,cumulative machine monitor units ( MU).These information were read from the accelerator log file with Matlab7.1,then the original control points in the plan file replaced the corresponding information for the log,which generated a new plan.New plan was exported into the planning system to reculculate the dose.The volume dose histogram (DVH) and dose distribution was contrasted to determine the accuracy of the accelerator plan of implementation between two plans.Results Compared with the original plan,antry angle difference over ± 1° accounted for about 35％ of the entire arc of control points in 4 of 12 arcs and the percentage of the leave error of ±0.5 mm was about 95％.MU error of a single control point was larger,but the cumulative MU for each are was small which was located between-0.09％ to 0.11％ in the selected 12 arcs.Between the targets,the maximum dose,minimum dose,the mean dose differences were from-0.07％ to 0.42％,-0.38％ to 0.40％,0.03％ to 0.08％,respectively.The maximum dose and mean dose differences of organs at risks were located from-1.16％ to 2.51％,-1.21％ to 3.12％,respectively.Conclusions Accelerator log-file analysis to verify the VMAT plan nan be supplyed to the experimental method supplement.

Objective To evaluate the sensitivity of patient-specific volumetric-modulated arc therapy (VMAT) quality assurance (QA) to minor multileaf collimator (M LC) positioning errors.Methods Systematic multileaf collimator (MLC) positioning errors (+0.5 mm,+ 1 mm and +2 mm) were introduced into the clinical VMAT patient plans with 2 types of MLC positioning errors:systematic MLC gap width errors and systematic MLC shift errors for 6 cases,including 3 cases with prostatic cancer and 3 cases with nasopharyngeal cancer.The planar dose distributions of the original and modified plans were measured using ArcCheck array.The coincidence between the measured results and the calculated results was evaluated using both absolute distance-to-agreement (AD-DTA) analysis with 3％/3 mm and 2％/2 mm criteria.Results The average passing rate of the 6 original VMAT plans was 96.0％ with the ADDTA criteria of 3％/3 mm which was commonly adopted in clinical practice.For the MLC gap width errors of + 1 mm,+2 mm,and-2 mm and the MLC shift errors of 2 mm,the drop levels in average passing rate with the AD-DTA criteria of 3％/3 mm were 8.8％,15.5％,6.1％ and 7.9％,respectively.The + 2 mm MLC positioning errors and + 1 mm MLC gap width errors could be detected by the patient-specific VMAT QA procedure.The AD-DTA criteria of 2％/2 mm was more sensitive compared with the criteria of 3％/3 mm.Conclusions Patient-specific VMAT QA is not sensitive enough to detect the systematic MLC positioning errors within 1 mm.Additional MLC QA is needed to guarantee the accuracy of VMAT delivery.

This paper presented the practice of performance evaluation at public hospitals in Wuhu.The performance evaluation system at public hospitals should emphasize public benefits,present a true picture of work and management performance,and help build the incentive and constraint mechanism.In addition,it should encourage public hospitals to strengthen management,improve quality of care and control health care costs.The system is designed for providing a safe,effective,convenient and inexpensive medical and health services for the people.

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.