Objective: To evaluate the application of CT in the diagnosis of fracture position and the cause of diplopia after orbital trauma. Methods:The CT findings and the clinical informations of orbital fractures accompanying diplopias in 68 patients (70 orbits) were retrospectively analysed. Results: Orbital fractures in 70 orbits were diagnosed by CT. There were burst orbital floor fractures in 45 orbits ( among them orbital floor fracture combined with medial wall fracture in 15 orbits), non-burst obital floor fractures in 10, medial orbital fractures in 5, zygomatic-orbital fractures in 5, orbit roof fractures in 5. The accuracy of CT in diagnosing orbital fracture was 100 percent. In 68 cases, there were 64 patients with vertical diplopia and 4 with horizontal diplopia . Conclusion: CT can correctly locate the orbital fracture and diagnose the cause of diplopia.

Objective To explore the pathological and imaging features of adenosquamous carcinoma (ASC) of pancreas.Methods Both clinical data and imaging findings in seven cases with pathologically proved ASC of pancreas were analyzed retrospectively.Imaging features were compared with pathological results.Results 1 )The disease mainly occurred in people around 55 years, among the 7 cases ,5 located in the pancreatic head, 2 in the body and tail, with abdominal pain and jaundice as the chief complaint.2)Pathologically, the solid part of the tumor was made up of ductal adenocarcinoma and squamous carcinoma components, with a different rate, while the cystic part was made up of necrosis, liquefaction.3) the imaging of 5 cases with ASC of pancreas in which squamous carcinoma components predominate shows solid and cystic tumors of pancreas, furthermore the ratio of central cystic diameter and the whole tumor diameter increase with the the volum of the tumor.4) There is no partitioning in the cystic part of the tumor, with a few irregular microcyst around it.5 ) The tumor shows a pattern of infiltrative growth, associated dilatation of the common bileduct or pancreatic duct in all cases, pancreatic atrophy in part.6) Squamous carcinoma components of the tumor was the pathologic basis for the formation of the solid and cystic structure in imaging.Conclusions ASC of pancreas is a rare aggressive subtype of pancreatic adenocarcinoma with a worse prognosis than the usual type of ductal adenocarcinoma, although symptoms similar to pancreatic ductal carcinoma.Cases of ASC of pancreas in which squamous carcinoma components predominate have certain characteristic imaging and pathologic features,which is important to early diagnosis.

Epilepsy is a common chronic nervous system disease, about one third of patients with intractable epilepsy, which brings a heavy burden to the society. At present, the specific etiology and drug-resistant mechanism are still unclear. Minimally invasive, reliable and economic biomarkers are of great help to improve the diagnosis and prognosis of drug-resistant epilepsy. In recent years, microRNA has gradually become a research hotspot of intractable epilepsy and is expected to become a biomarker. This paper briefly reviews the microRNA related to intractable epilepsy.

Objective:To explore therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure (CHF).Methods:A total of 98 CHF patients were selected from our hospital from Feb 2012 to Dec 2014. According to random number table,they were randomly and equally divided into control group (received valsartan therapy) and combined treatment group (received valsartan combined carvedilol therapy).Therapeutic effect and incidence rate of adverse reactions were compared between two groups.Results:There were no significant differ- ence in all cardiac function indexes before treatment between two groups (P>0.05 all).After treatment,compared with control group,there were significant reductions in HR [(95±14)beats/min vs.(74±16)beats/min],left ventricular end-diastolic dimension (LVEDd)[(74.9±2.9)mm vs.(50.9±1.7)mm],left ventricular end-sys- tolic dimension (LVESd)[(64.9±3.8)mm vs.(45.7±2.0)mm],left ventricular end-diastolic volume (LV- EDV)[(198.7±60.5)ml vs.(165.9±52.3)ml]and left ventricular end-systolic volume (LVESV)[(148.9± 62.7)ml vs.(111.4±51.7)ml];and significant rise in left ventricular ejection fraction (LVEF)[(34.2±6.5)%vs.(56.9±10.1)%]and stroke volume (SV)[(68.4±5.1)ml vs. (81.5±6.0)ml]in combined treatment group,P<0.05 or <0.01.Total effective rate of combined treatment group was significantly higher than that of valsartan group (91.8% vs.71.4%),P<0.01.There were all no apparent adverse reactions in both groups.Con-clusion:The therapeutic effect of valsartan combined carvedilol is significant and its safety is good in patients with chronic heart failure.

Objective To discuss the value of preoperative digital design of struetund bone graft for acetabular wall defects. Methods The . dieom data from spiral CT scans were imported into Mimics 10.0 to build the 3D solid model of the pelvis of an old female patient with left acetabular wall defects. The 3D solid model of the defect area was built by Mirror and 3D mask editing. A simulated bone graft was conducted on the 3D model by segmentation and trimming according to the data measured on the reconstructed model. Results The reconstructed 3D model of the patient's pelvis could be presented in different colors, transparenees, or combinations of interested tissues. The acetabular wall defects could be visualized very clearly at different angles. The geometric data of the bone graft could be measured to ensure the bone graft would fit the defects accurately. Conclusion Preoperative digital design based on 3D com-puterized reconstruction of acetabular wall defects may provide a valuable aid to clinical treatment, because it is a simple, rapid, and accurate method of increasing the fitness of bone graft and the defects,

Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.

120 teeth with wedge-shaped defects at subgingival depth of 0 ~2 mm were selected and divided into 3 groups(n =40).Gingival retraction code and EXPASYL gingival retraction paste were used for gingival retraction in the 2 retraction groups,and none retraction was used in the control group.After restoration of the defects,all cases were followed up for 1 year and 2 years.The results were evaluated by modified USPHS criteria.No significant difference was detected for 1 year and 2 year successful rates between the extraction groups(P >0.05).The successful rate in extraction groups was higher than that in the control group(P ＜0.05).

The effects of cotton roll and the traditional gauze wrapper in the protection of endodontic files were observed.Cotton roll showed firm protection and feasible operation advantages,it was more effective than gauze wrapper in the protection of endodontic files(P<0.01).

Objective To explore the safety and efficiency of holmium laser percutaneous nephrolithotomy in the treatment of upper ureteral calcui.Methods A retrospective analysis was made on 132 cases of upper ureteral calcui treated by holmium laser percutaneous nephrolithotomy.After retrograde placement of the ureteral catheter,a track from the skin surface into the middle renal calyx was established under the guidance of a C-arm fluoroscopy.Then a ureteroscope was passed to introduce a holmium laser lithotriptor.Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney.Results Holmium laser percutaneous nephrolithotomy was completed on one session in all the 132 cases(155 sides),including 116 cases of single-tract nephrolithotomy and 16 cases of double-tract nephrolithotomy.The stone-free rate was 95.5%(148/155).The duration of operation was 30~320 min(mean,108 min).The intraoperative blood loss was 50~200 ml(mean,100 ml).No blood transfusion was required and no postoperative hemorrhage happened.No analgesics were needed after operation.The nephrostomy tube was left for 3~8 d(4.6 d).The length of postoperative hospital stay was 5~11 d(mean,7.4 d).Follow-up observations in the 132 cases for 1~6 months(mean,3 months) showed complete relief of symptoms.B-ultrasonography showed a mean of renal pelvis separation of 15 mm,which had decreased by 9~28 mm postoperatively.Conclusions Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of upper ureteral calcui.

Objective To evaluate the clinical efficiency of laparoscopic operation for the treatment of ureteropelvic junction obstruction(UPJO).Methods A total of 19 patients with UPJO underwent laparoscopic dismembered pyeloplasty.The operation was performed under general anesthesia.The patients were maintained in a lateral decubitus on unaffected side.After the establishment of pneumoperitoneum,3~4 trocars were introduced at proper sites.During the operation,the lateral peritoneum was opened and the ureteropelvic junction obstruction was dissociated and dissected.The end-to-end anastomosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter.Results All the operations were performed successfully.The operation time was 110~240 min(mean,150 min),the blood loss was 50~100 ml(mean,80 ml),and the postoperative hospitalization time,6~10 d(mean,7.8 d).No severe complications occurred.Follow-up assessment with intravenous urography for 3~15 months(mean,6 months) in 14 patients showed no ureteral stricture.Conclusions Laparoscopic dismembered pyeloplasty is an effective and safe procedure in the treatment of UPJO.It can replace the open surgery.