Objective To discuss the numerial defecography for cases with obstinate constipation.Methods A retrospective study of the data of 60 cases with obstinate constipation,was carried on the radiodiagnosis through the ralative measurement. Results 25 cases with the perineum descending,16 cases with the anterior mucosal prolapse,37 cases with the internal rectal intussusception,12 cases with the external rectal prolapse,47 cases with the rectocele,13 cases with the spastic pelvic floor syndrome,39 cases with the puborectalis muscle hypertrophy,11 cases with the enterocele,12 cases with the sacrum-rectal separate,and 10 cases with the achalasia of anal muscle of internal enlarge. Conclusion It was important that numerial defecography in the diagnosis of obstinate constipation.

ObjectiveTo observe the effect ofhydroxyethyl starch 130/0.4 combined with sodium aesinate tablets in treating edema of tibiofibular fracture(ETF).Methods105 ETF patients were randomly assigned to tow groups,the treated group ( n =55 ) was treated with hydroxyethyl starch 130/0.4 injection (20ml.kg - 1 · d - 1 ) with sodium aesinate tablet( 30mg,bid,po),while the control group (n =50) was treated with sodium aesinate for injection (20mg in 5％ GS 500ml,ivgtt,qd),observe the decrudescence time of the fracture edema.ResultsThe significant effective rate and total effective rate were 40.0％,94.5％ in treated group and 14.0％,84.0％ in control group,showing statistical significance( P ＜0.05).The decrudescence time of Ⅱ degree and Ⅲ degree edema in treated group were (5.75 ± 2.21 ),( 8.14 ± 2.49),and ( 7.09 ± 2.03 ),( 12.18 ± 3.76 ) in control group,the difference among them was significant( P ＜ 0.05 or P ＜ 0.01 ).ConclusionThe combined therapy of hydroxyethyl starch 130/0.4and sodium aesinate tablets has good clinical curating effect in treating edema of tibiofibular,and also can reduce the adverse reaction.

BACKGROUND:Changing the acetabular orientation is the best method for the treatment of acetabular dysplasia, and Bernese periacetabular osteotomy is one of the most commonly used and successful treatment methods. OBJECTIVE:To review and analyze the operation indication, surgical technique and influencing factors of Bernese periacetabular osteotomy for better clinical application. METHODS:The PubMed database, Elsevier database and Springer database were retrieved for related articles published before December 2012 with the key words of“Bernese osteotomy, Ganz osteotomy, periacetabular ostetomy”. The articles that related to the clinical application of Bernese periacetabular osteotomy in patients with acetabular dysplasia were enrol ed in this study. Repetitive studies and Meta analysis were excluded. And the analysis emphasis was put on the operation indication, surgery technique and influencing factors of Bernese periacetabular osteotomy. RESULTS AND CONCLUSION:A total of 483 articles were screened out after primary computer-based online research. And according to the exclusion criteria, 43 articles were selected for review. Bernese periacetubular osteotomy was performed through polygonous osteotomy around the acetabula by modified Smith-Peterson approach. The surgical technology was improved gradual y, but the major osteotomy procedures never changed, only the soft tissue release method was modified. The direct factors that influence the surgical effect of Bernese periacetabular osteotomy are the degree of radiographic hip degeneration and dysplasia. In the future, with the in-depth understanding of hip deformity, the operation indication and technique of Bernese periacetabular osteotomy wil also developed.

The results of electrocardiogram and coronary angiography were compared in 69 patients with acute inferior myocardial infarction(right ventricle, later wall). The sensitivity and specificity of ST segment elevation Ⅲ> Ⅱ in diagnosis of right coronary artery (RCA) as the infarction related artery (IRA) were 92.00% and 84. 21% respectively;those for ST segment depression avL > Ⅰ were 90. 00% and 89. 5% respectively. Therefore if ST-elevation Ⅲ > Ⅱ , ST-depression avL > Ⅰ and no depression on STV1 and V2 in acute inferior myocardial infarction may highly indicate that RAC be the IRA;on the contrary, the LCX be the IRA.

The clinical data of 195 patients in intensive care unit (ICU) were retrospectively analyzed. The total nosocomial infection rate was 15.5% in this group of patients; respiratory tract was the predominant site of infection (71.0%); the most common infection microorganism was Gram-negative bacteria (65. 1% ) ,the top two pathogens were Escherichia (32. 6% ) and Staphylococcus ( 11.6% ). The risk factors of nosocomial infection in ICU were female sex, high age, invasive mechanical ventilation, long hospitalization in ICU, multiple organ dysfunction syndrome (MODS), etc.

Objective To investigate clinical efficacy of the CT guided mixture Danshen injection into the periganglionic space in the treatment of lumbocrural pain.Methods Mixture Danshen infiltrations were performed in 63 patients with lumbocrural pain under CT guidance.Scores of VAS were compared at 3 and 6 months after the therapeutic procedure with evaluation of the efficacy.Results Significant pain reduction was observed in 51 patients (51/63,80.95%),with the score of VAS 7.60± 2.00 (before therapy) dropping to 3.85 ± 1.60 (after 1 month) and 4.05± 1.70 (after 6 month).Differences of VAS scores before and after the therapy were statistically significant.Differences between one-month and three-month follow-up were not statistically significant.Conclusion Mixture Danshen injection around the spinal nerve roots under CT guidance is safe and useful in the treatment of lumbocrural pain.

Primary mediastinal large B-cell lymphoma (PMBCL) has specific phenotypical features, pathological features and clinical presentation.PMBCL patients are predominantly female and typically present early stage disease and mediastinal involvement.Due to the lack of randomized studies, most patients with PMBCL usually receive combination chemotherapy with consolidation IF-RT.Considering IF-RT can improve the complete remission rates and recurrence-free survival, the combined therapy achieved good results.The different chemotherapeutic regimens were used in clinical practice of different institutions and clinicians, including CHOP or CHOP-like, intensive chemotherapy or the third-generation regimens.Recent studies have showed promising outcomes when rituximab is added to doxorubicin-containing chemotherapy.Patients treated with R-CHOP with radiotherapy had significantly better local control rates compared with R-CHOP without radiotherapy, especially for bulky diseases.Intensity-modulated radiation therapy offers excellent target coverage, favorable outcome and minimal toxicity in PMBCL.Although the majority of patients with PMBCL receive radiotherapy following chemotherapy, few studies have specifically addressed the role of consolidation radiotherapy for the treatment of PMBCL.The prognostic importance of rituximab and radiotherapy has not been clearly defined in patients with PMBCL.Heterogeneous treatment options and small number of patients have made it difficult to draw definitive conclusions about the potential advantages of rituximab and radiotherapy in patients with PMBCL.

50 caese of gastric carcinoma and 24 caese of superficial gastritis were studied by PAP immunohistochemical staining,with monoclonal antibody MG_7,MGd_1 for determining the associated antigen of gastric carcinoma. Among the 50 cases of gastric carcinoma,the positive rates of MG_7,MGd_1 were 92%,90%;whereas in the cases of superficial gastritis,those were 0% and 4% respectively.These results suggest a high specificity of MG7,MGd1 for gastric carcinoma.When the two monoclonal antibodies were used together,the positive rate was as high as 96%.So the combined use would be of more diagnostic value.

Objective To discuss the effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy (DPN).Methods Eighty-two patients with DPN were divided into the control group(n=41) and research group(n=41) according to the random number table method.The patients of the control group were given alprostadil based on conventional therapy, while the research group were given alpha lipoic acid based on treatment of the control group, the course was two weeks.The bilateral median nerve and sural nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) were tested by electromyograph.Disease severity were evaluated by neuropathy symptoms questionnaire (TSS) and pain degree were tested by Visual analogue scales(VAS).The MNCV, SNCV, TSS and VAS of before and after treatment and the clinical effect of the two groups were compared.Results There were no statistically significant difference about MNCV and SNCV of the two groups before treatment (P＞0.05).After treatment, the MNCV and SNCV of nervus medianus and nervus peroneus communis of research group and control group were significantly higher than before treatment, and the differences of research group before and after treatment (MNCV of nervus medianus: (42.5 ± 3.6) m/s vs (47.8± 4.6) m/s, t =-5.752, P ＜ 0.05;SNCV of ervus medianus : (39.6 ±1.6) m/s vs (46.2±4.5) m/s,t =-5.882,P＜0.05;MNCV of nervus peroneus communis: (39.8±3.2) m/s vs (44.5±2.5) m/s,t=-4.263,P＜0.05;SNCV of nervus peroneus communis: (36.5±1.7) m/s vs (48.7± 2.6) m/s, t =-7.526, P ＜ 0.05), significantly obvious than the control group (MNCV of nervus medianus: (42.3 ±4.2) m/s vs (44.5±5.3) m/s,t =-4.627,P＜0.05;SNCV of nervus medianus: (39.8 ±2.4) m/s vs (42.4±2.5) m/s,t =-5.527,P＜0.05;MNCV of nervus peroneus communis: (40.3±1.6) m/s vs (42.2± 1.6) m/s, t =-4.181, P＜ 0.05;SNCV of nervus peroneus communis: (36.4± 2.3) m/s vs (41.2±3.5) m/s,t =-5.928,P＜0.05).Before the treatment,the TSS and VAS of the control group were (11.4±2.5) sore and (5.3±1.6) sore,of the research group were (11.6±1.6) sore and (5.2±1.8) sore,and there was no significant difference between the two groups (P＞0.05).After treatment, the TSS and VAS of the control group were (6.4± 1.3) sore and (3.6± 1.3) sore, of the research group were (4.2± 3.3) sore and (1.7 ±0.9) sore, and compared to before treatment, there was significant difference (P＜0.05), and the research group was significantly lower than the control group, the difference between the two groups was statistically significant (P＜ 0.05).The total effective rate of research group was obviously higher than that of control group, the differences were statistically significant (95.1％ (39/41) vs 65.9％ (27/41), x2 =5.363, P =0.031) .Conclusion The effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy is obviously better than that of using alprostadil only,it is worth popularization and application.

The Sino-US Joint Clinical and Molecular Laboratory (JCML) is a comprehensive clinical research laboratorywith main focus on study of hematopoetic diseases including myelodysplastic syndrome, leukemias and lymphomas.The JCML is located in the Shanghai Medical College of Fudan University (formerly Shanghai Medical University)in Shanghai, China and was established as part of a large multi-center, international study of benzene health effectin China that is sponsored by the international consortium on benzene health effect.