Objective To investigate the clinical value of CT scanning combined with ultrasound technique in diagnosis of malignant bone tumor.Methods 100 patients with malignant bone tumor were randomly divided into control group(50 cases with CT scan),and observation group (50 cases received CT scanning combined with ultrasound technology).The diagnostic accuracy rate,tumor bone formation and destruction of bone,periosteal reaction and soft tissue mass were compared between the two groups.All results were judged by the results of MR.Results Diagnostic accuracy rate of the observation group was 80.0％ (40/50),which was significantly higher than 64.0％(32/50) in the control group (x2 =4.65,P ＜ 0.05).In observation group,diagnosis of bone destruction in 60 cases,the tumor bone formation 10cases,83 cases of periosteal reaction and soft tissue mass in 40 cases,those in the control group were 40 cases,5 cases,62 cases,30 cases,the differences between the two groups were statistically significant(x2 =4.86,5.71,6.21,5.22,all P ＜ 0.05).Conclusion The combination of CT and ultrasound in the diagnosis of malignant bone tumors had high diagnostic accuracy rate,and could guide clinical treatment.

ObjectiveTo explore the etiology of incisional hernia of abdomianal wall.Methods98 cases with incisional hernia were analyzed retrospectively in terms of incision type, technique of suture, suture materials,infection of incision, and the time of occurrence.ResultsLongitudinal incision, improper technique of suture,infection, increase of intraabdominal pressure, and diabetes mellitus were risk factors of incisional hernia. ConclusionsTransverse incision, prevention of infection of the incision, strict aseptic manipulation and hemostasis were effective in the prevention of incisional hernia. Most hernia developed within 6 months postoperatively.

OBJECTIVE:To investigate influential factors of standardization of clinical research on therapeutic efficacy of Yao-tongning capsules,and to provide direction for reasonable and standard development of clinical research. METHODS:Retrieved from CJFD,VIP and Wanfang database,RCTs about Yaotongning capsules in the treatment of related disease were collected. After data extraction and quality evaluation,Meta-analysis was conducted by using Rev Man 5.3 statistical software. The effects of the di-alectical situation,treatment course and route of administration on the evaluation of therapeutic efficacy of Yaotongning capsules were compared;based on this,the concepts of index evidence-based value which reflected clinical standardization were put for-ward,and its effects on Yaotongning capsules were investigated. RESULTS:A total of 71 RCTs were included,involving 11009 patients. Results of Meta-analysis showed therapeutic efficacy of Yaotongning capsules was better than that of other drugs in dialecti-cal case(P=0.02),while therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs in non-dialectical case(P<0.01);therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs when treatment course was shorter than 30 days(P<0.05),while treatment course was longer than 30 days,there was no difference in therapeutic efficacy between Yaotongn-ing capsules and other drugs(P=0.99). When did not take medicine according to the instruction,therapeutic efficacy of Yaotongn-ing capsule was inferior to that of other drugs(P<0.05);when taking medicine according to the instruction,there was no differ-ence in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.94). When evidence-based value was ≥5,thera-peutic efficacy of Yaotongning capsules was better than that of other drugs(P=0.03);when evidence-based value was equal to 4, there was no difference in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.56);when evidence-based val-ue was ≤3,therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs(P<0.05),with statistical significance. CONCLUSIONS:It is an important guarantee of playing therapeutic efficacy of Yaotongning capsules to regularly use drugs strictly according to the principle of dialectical treatment,and take drugs according to treatment course and instructions. Clinical trials should be standardized strictly in accordance with the instructions,so as to provide objective and fair clinical findings.

Objective To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81 2% of the cases, and the survival time of patients had been prolonged (mean 29 5 months). Conclusions RACT is more effective for treating URGC and worthly of further clinical study.

Objective　To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods　The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results　In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81.2% of the cases, and the survival time of patients had been prolonged (mean 29.5 months). Conclusions　RACT is more effective for treating URGC and worthly of further clinical study.

OBJECTIVE To explore the pathogenesis of pelvic and peritoneal abscesses and their clinical(management).METHODS Clinical data of 109 patients with pelvic and peritoneal abscesses between 1999 and 2005 were retrospectively(evaluated).The connection of their pathogenesis,antibiotics choice,and treatment types with(prognoses) was analyzed.RESULTS Pus from all patients was collected and sent to do germ culture and antibiotic susceptibility testing.Seventy five cases were with positive germ culture.The most germs were Escherichia coli and meropenem and amikacin were considered effective.Four cases were relapsed after surgery from 90 cases.(Pelvic) abscess drainage was performed through vagina under B type ultrasound guiding in 9 cases.Conservative treatment was given in 10 cases and no patient died.CONCLUSIONS Pelvic and peritoneal abscesses should be treated early with antibiotic according susceptibility testing to make a choice.And surgery or sufficient abscess drainage can(improve) their prognosis.

Objective To explore the cause and prevention of skin flap necrosis after radical operation for breast cancer and reduce the incidence of skin flap necrosis.Methods The data of 158 patients with breast cancer who had surgical treatment were analysed.The data included the thickness of the skin flap,tension of the skin flap,and the mode of the operation and their relation with necrosis of the skin flap.Results Among the 158 operated cases,32 cases(20.25%) had skin flap necrosis.The incidence of the flap necrosis in the thick skin flap group was lower than in the thin skin flap group(10.87%vs28.95%,P

Objective: To evaluate the short-term effect of thrombus aspiration catheters combining tiroifban medication for myocardial tissue reperfusion recovery in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 105 STEMI patients with percutaneous coronary intervention (PCI) in our hospital from 2011-05 to 2013-05 were studied, there were 73 male and 32 female with the mean age of (58.39 ± 10.37) years. The patients were randomly divided into 2 groups, Group A, the patients received thrombus aspiration catheters with intravenous tiroifban, n=53 and Group B, the patients received tiroifban and PCI, n=52. The basic clinical features, myocardial tissue perfusion level, major adverse cardiovascular events (MACE) at post operative and in-hospital period were recorded, the cardiac function was examined by echocardiography at 6 months after PCI in both groups.
Results: The basic clinical features were similar between 2 groups. The thrombolysis in myocardial infarction trial (TIMI) 3 lfow rate was higher in Group A than that in Group B (92.45% vs 55.77%), P=0.000. TIMI 2 and TIMI 0~1 lfow rates were lower in Group A than that in Group B (7.55%vs 26.92%), P=0.008 and (0%vs 17.31%), P=0.002. The adjusted TIMI frame was lower in Group A (27.26±5.50) vs (38.98±5.42), P<0.001. The echocardiography at 6 months after PCI indicated that Group A had higher LVEF than that in Group B (0.55±0.06) vs (0.47±0.06), P<0.001;lower left ventricular end diastolic diameter (50.77±5.45) vs (54.76±5.34), P<0.001;less angina and target vessel revascularization (16.98%vs 40.38%), P=0.008 and (9.43%vs 17.31%), P=0.008. The incidence of MI, acute heart failure, cardiac death and non-target vessel revascularization were similar between 2 groups, P>0.05.
Conclusion:Thrombus aspiration catheters combining tiroifban medication may obviously improve the myocardial tissue reperfusion and the short-term cardiac function in STEMI patients after PCI, it could reduce the incidence of no-relfow without increasing MACE.

BACKGROUND:Cytokines and neurotrophic factors secreted from human umbilical cord blood-derived mesenchymal stem cells secrete have neuroprotective effects on cerebral ischemia-reperfusion injury, but there are few reports about intranasal administration of human umbilical cord blood-derived mesenchymal stem cellconditioned medium in the treatment of stroke.
OBJECTIVE:To investigate the protective effects of intranasal administration of human umbilical cord-derived mesenchymal stem cells-conditioned medium on neurologic function of rats with cerebral ischemia-reperfusion injury.
METHODS:Adult rats were subjected to 2 hours of right middle cerebral artery occlusion and the human umbilical cord-derived mesenchymal stem cells were isolated from the postpartum human cord. We made the conditioned medium of human umbilical cord-derived mesenchymal stem cells. Ischemic rats were randomized and assigned to three groups and were treated by intranasal routine starting 24 hours after middle cerebral artery occlusion with:(1) saline for control group;(2) Dulbecco’s modified Eagle’s medium/Ham’s nutrient mixture F-12 medium for medium control group;(3) conditioned medium treatment group (10mL/kg) daily for 14 days. Behavioral tests (foot fault test, and modified Neurological Severity Score) were performed before and at 1, 7, 14 days after middle cerebral artery occlusion.
RESULTS AND CONCLUSION:There was no difference in the behavioral tests among the three groups at postoperatively 1 day (P>0.05). Compared to the control and medium control group rats, respectively, rats in the conditioned medium group significantly improved functional outcome after stroke in days 7 and 14 (P<0.05). There was also no significant difference in functional tests between the control group and medium control group in days 7 and 14 (P>0.05). These results suggest that human umbilical cord-derived mesenchymal stem cells-conditioned medium via intranasal administration can significantly improve neurologic functional outcome after cerebral ischemia-reperfusion injury.

Objective: To explore the clinical response on cardiac resynchronization therapy (CRT) in patients of chronic heart failure (CHF) with different QRS wave morphology. Methods: A total of 52 CHF patients received CRT in our hospital and the Seventh People's Hospital of Zhengzhou City from 2010-03 to 2013-07 were retrospectively studied. The patients were divided into 3 groups: True-complete left bundle branch block (t-CLBBB) group,n=20, Classic LBBB (CLBBB) group,n=15 and IVCD group,n=17. The general clinical condition, the indexes of echocardiography at 6 months of follow-up study including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NYHA classiifcation and 6-MWT were examined and compared among different groups. Results: In general clinical condition, the ratio of non-ischemic heart disease patients in t-CLBBB group was higher than those in CLBBB group and IVCD group, allP<0.05. By 6 months follow-up study, LVEDD in t-CLBBB group (62.6 ± 8.9) mm was lower than those in CLBBB group (70.0 ± 8.9) mm and IVCD group (72.8 ± 8.0) mm, LVEF was higher in t-CLBBB group (38.5 ± 6.2) % than those in CLBBB group (31.7 ± 6.7) % and IVCD group (30.1 ± 6.7) %. NYHA classiifcation in t-CLBBB group (2.00 ± 0.45) grade was lower than those in CLBBB group (2.73 ± 0.80) grade and IVCD group (3.12 ± 0.78) grade . 6-MWT in t-CLBBB group (302.0 ± 57.9) m was longer than those in CLBBB group (257.3 ± 59.0) m and IVCD group (220.2 ± 57.9) m, allP<0.05. Conclusion: CRT is an effective method for treating CHD patients, different QRS morphology may have different response, the patients with t-CLBBB would make better response.