Objective:To explore the therapeutic effect of the extraction of bone-melon injection for the earlier fracture.Method:100 patients with early fracture were divided into two groups.50 cases in the treatment group used the extraction of the bone-melon injection and 50 cases in the controlled group used compound ossotide injections.Their curative effects were judged according to their healing time,level of relieving pain and functional recovery condition.Result: The patients in the treatment group healed earlier(P

Objective To investigate the imaging features of splenic littoral cell angioma (LCA)and correlate with pathological findings.Methods Ten patients of LCA with pathologically confirmed diagnosis were included in this study.A retrospective review of clinical data and imaging findings on CT and MRI was performed,along with review of the literature.Results Splenic littory cell angiomas presented with multiple nodules of varying sizes with a predoninance of small ones.Nine of 10 patients had clinical symptoms of splenomegalia and hypersplenia.MR T2WI and DWI showed masses with high-signalintensity.The CT and MRI enhancing pattern of LCA was similar to splenic hemangioma.There were many mammiliform structures pointing inside in the wall of the vascular channels,a hallmark feature allowing its differentiation from splenic hemangioma pathologically.Conclusion The CT and MRI findings of LCA can show some of its characteristic signs,especially on DWI,which can assist to identify LCA in clinical practice.

Objective To explore the management strategy for liver trauma combined with juxla-hepatic venous injury and discuss relating factors leading to postoperative deaths. Methods The clini-cal data of 11 patients with juxtahepatic venous injury were retrospectively analyzed in aspects of prefer-ence of irregular hepatectomy and vein repair.There were 8 males and 3 females,at age range of 22-65 years(mean 33.7 years).Injury causes included traffic injury in 7 patients,fall-from-height injury in 3 and crush injury in 1.Of all,9 patients were combined with other abdominal organ injury and 7 with over one part fractures.All patients showed symptom of shock on admission. Results No patient died dur-ing operation but 3 died after operation.The complications included bleeding in 6 patients,severe infec-tion in 2.liver function failure in 3, acute renaI function failure in 2.bile-1eakage in 4,abdominal ab-scess in 4 and incision infection in 6. Conclusion Low blood pressure in the operation is the main cause for death.It is safe and effective to treat liver trauma combined with juxtahepatic venous injury with irregular hepatectomy and vein repair.

Objective To document the impact of conversion to mycophenolate mofetil (MMF)at different time points after transplantation on the renal function of renal function.Methods A longterm,multicenter,non-interventional and observational study was done.Two cohorts were included:One was Switch cohort (340 cases) including renal allograft recipients who switched to MMF at least 6 months after renal transplantation and followed up for 4 years after switch; The other was Stay cohort (123 cases),including renal allograft recipients who received MMF treatment after transplantation and followed up for 4 years after enrollment.Results GFR values of patients in Switch cohort was significantly increased after switch,and the change in GFR slope was 3.1 mL· min-1 · year-1 (P＜0.01).GFR values of patients in Stay cohort kept steady before and after enrollment,and the change in GFR slope was 0.44 mL·min-1 ·year-1 (P＞0.05).Statistically significant difference in the onset time of GFR decline (defined as 20％ decline from the baseline) was observed among subgroups within Switch cohort (P＜0.01),but there was no significant difference among subgroups within Stay cohort (P＞0.05).Stay cohort was 12％ higher than in Switch cohort every year.Conclusion Conversion to MMF ＞6 months or even many years after transplantation can obviously improve the renal function of recipients.The earlier conversion can benefit improvement of the renal function.

Objective To construct a predictive model for the survival of transplant kidneys after kidney transplantation. Methods The clinical data of 366 kidney transplant recipients and donors were retrospectively analyzed, and the recipients were divided into low-risk group (n=101), medium-risk group (n=189), and high-risk group (n=76) based on the kidney donor profile index (KDPI). Each group was further divided into Remuzzi score ≤3 group and Remuzzi score >3 group based on time-zero biopsy Remuzzi scores. Kaplan-Meier method was used to analyze the survival of transplant kidneys. Univariate and multivariate Cox regression analyses were performed to identify risk factors affecting long-term survival after kidney transplantation. A predictive model for transplant kidney survival was established and a nomogram was drawn. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results The median KDPI was 65%, and the median Remuzzi score was 3. The 5-year survival rate of transplant kidneys was 83.5%. Kaplan-Meier survival curves showed that in the KDPI medium-risk and KDPI high-risk groups, the subgroup with lower Remuzzi score had a higher survival rates of transplant kidneys than the subgroup with higher Remuzzi score. Univariate and multivariate Cox regression analyses showed that KDPI, Remuzzi score, and donor’s age were independent risk factors for transplant kidney loss (all P<0.05). The ROC curve showed that the AUC of the nomogram prediction model established based on independent risk factors for the 1, 3 and 5-year survival rates of transplant kidneys were 0.91, 0.93 and 0.94 for the training set, and 0.89, 0.85 and 0.88 for the validation set. Calibration curves shows good consistency between the training and validation sets of the model. Conclusions The nomogram predictive model based on KDPI, time-zero biopsy Remuzzi score and donor’s age has good predictive value for transplant kidney survival.