[Objective]To analyze the clinical diagnosis and therapic level,the clinical manifestation,image manifestation and surgical treatment of the sacral epidural cystis.[Method]Eighteen cases with the sacral epidural cystis were analyzed retrospectively,17 cases(95%)with dull pain of the lumbosacral area,16 cases(90%)with radiated pain of the lower limbs and intermittent limping,14 cases(77%)with functional lesion of the nerves,2 cases(11%)with tumor of pelvic,cavity or hypogastrium.All of them were taken AP views of X-ray,17 cases taken two-dimentional CT scannings,11 cases taken MRI,7 cases taken myelography and 4 cases taken CTM scannings.[Result]The rate of the error diagnosis was 78% in the clinic,while the success diagnosis rate was 17% in the X-ray,72% in the CT,100% in the MRI,myelography and CTM.The exairesis were done in all the 18 cases,and the epidural cystis were diagnosed in pathology.No reoccurrance was found at 15~32 months follow-up.[Conclusion]There are characteristic changes in the imageology and clinic of the sacral epidural cystis.Using minimall invasive surgery(laparoscope vertebroscope and epiduroscopy)has no confirm result till now.Microsurgical techniques contribute to the improvement of the total removal rates for the intraspinal tumors.So operation is reliable method to treat this disease and to prevent its recurring.

[Objective]The naming,pathogeny,clinic,patho logical character and image manifestation of the parosteal lipoma were discussed in this paper combined with the literatures.[Method]Combined the 20 cases reported in the internal literatures,the photographs have been taken in all the 34 cases,CT in the 18 cases,MRI in the 4 cases.[Result]The data demonstrated that this disease betided in any age,more in the adult,developed more in the long canal bone of the limb,and developed in the flat bone(pelvis,scapula,costal bone,patella),anomaly bone(thoracic verthbrae,lumbar,ansa sacralis),cauda bone,short canal bone and instep bone secondly.The rate of the error diagnosis were 40.91% in the clinic,27.27% in the X-ray and no one in the CT and MRI.The excision was done in all the 34 cases,and lipoma were diagnosed in pathology,3 cases were malignant slightly.Followed up for 2 to 10 years,only 1 cases recurring and malignant.[Conclusion]The name of the parosteal lipoma is optimal,the pathogeny is not clear,and related to the heredity,hurt and inflamation.There is lipoma with bone pedicel in pathology;and adipose tissuse in cytology.There are characteristic changes in the X-ray,CT and MRI.

[Objective] To improve the clinical diagnosis and therapic effect and to discuss the clinical and imageologic manifestations and treatment of the brucellosis spondylitis(BS).[Method]Sixteen patients with BS were all taken radiographs and CT scanning and seven cases were also taken MRI.The test of SAT,test of RBP and ELISA were used in accessing BS.Pathogenic bacteria were examined in 11 cases.All cases were treated with anti-brucellosis agents and other conservative measures.Seven cases were followed with a focal debridement and 2 cases withminimal invasive surgery.[Result]Fourteen cases were misdiagnosed as spine TB before they were hospitalized with rate of error diagnosis 87.5%,even careful clinic and radiographic examination,and CT scanning had been taken,and 5 cases were misdiagnosed by MRI with the misdiagnosis rate 71.4%.The BS occurred far more in the lumbar vertebrae than in the thoracic vertebrae with its highest morbidity at the L4.Among 16 cases,the titers of SAT test were all beyond 1.160,the test of RBP all showed positive and IgG,IgM showed positive by ELISA.Eleven cases was confirmed BS diagnosis by phthogenic bacteria examination.Only 12 cases were followed up for 1～2 years(including 8 surgical-treated cases).Ten cases were cured without recurrence,and 2 cases improved.[Conclusion]Brucellosis spondylitis commonly misdiagnose before hospitalization.Characteristic imageologic changes and clinical appearance,combined tests of SAT and RBP are useful for diagnosis.Long-term and enough amount sensitive antibiotics and other conservative measures is still the major and reliable measures in treatment of BS and prevent recurrence,additional minimal invasive surgery or focal debridement could shorten the course of therapy,increase the cure rate and decrease its complication.

Objective To study the imaging findings and patholoical characterizes of chondromyxoid fibroma in order to improve its differential diagnosis.Methods 8 cases with chondromyxoid fibroma had all proceeded x-ray checked before operation. Of these cases , 4 cases were examed by CT scan .All cases were confirmed by operation and pathology. The imaging findings and pathological characterizes were analysed.Results The lesions located at metaphysis of long bone and presented as a round or elliptic transparent area which were consistent with long axis of involved bone. There were osseous crests inside the lesions and sclerosis bone around the lesions. The density of lesions was homogeneous and CT numbers were about 26 HU. On histopathology,lesions presented grey. Lobular and some what transparent . In the center of lesions there were a lots of mucus and stellate cells. The lesions were surrounded by hyperplastic area including multinuclear giant cell and chondroblast fibroblast. Conclusion chondromyxoid fibroma has characterizes on imagiology and pathology , but it has often been misdiagnosed.

OBJECTIVE To discuss the effect of regular emptiness of humidification pot on ventilator associated pneumonia(VAP) in the patients with mechanical ventilation.METHODS Totally 240 mechanical ventilation patients were randomed to 2 groups,in an observation group the humidification pots were emptied per 24 hours and in a control group the fluid was added only when its water was lower limit and compared their incidence rate of VAP.RESULTS Ninety-six of 240 patients with mechanical ventilation had developed VAP and 238 pathogen strains were cultured.Altogether,the incidence of VAP in observation group was lower than those in control group significantly,?2=4.4,P

Objective To analyze the correlation between quantitative evaluation of high-resolution CT (HRCT) and pulmonary function tests (PFT) in chronic obstructive pulmonary disease (COPD), and evaluate the characteristics of PFT in different CT phenotypes of COPD. Methods 65 patients with COPD underwent CT chest scan and PFT. The dimensions of subsubsegmental apical bronchi of right upper lobes were measured , which included the following parameters:airway wall thickness (T), total airway diameter (D), and pulmonary artery (PA), ratio of airway wall thickness and pulmonary artery (T/PA), thickness diameter ratio (TDR), percentage of wall area (WA%) and percentage of airway luminal area (Ai%). The percentage of total lung area occupied by low attenuation area (LAA%) was measured by lung density software. The relationship between the measurements and PFT parameters were analyzed. Patients were classified into three phenotypes based on the presence of emphysema or bronchial wall thickening evaluated by HRCT. Phenotype A: without or with little emphysema (LAA% < 25%), with or without bronchial wall thickening; Phenotype E: emphysema without bronchial wall thickening (LAA%≥25%, T/PA < 30%); Phenotype M: emphysema with bronchial wall thickening (LAA%≥25%, T/PA≥30%). The characteristics of different CT phenotypes were analyzed. Results LAA% had a good correlation with PFT parameters. PA, T/PA, WA% and Ai% also had correlation with PFT parameters. There was 53 patients of Phenotype A, 12 patients of Phenotype M. PA, T/PA, LAA%and PFT were different in two groups. Conclusions LAA%and airway quantitative measurements in HRCT have certain correlation with PFT parameters. Patients with different CT phenotypes differs in PFT parameters , which can provide reference for clinical diagnosis and treatment.

Objective To obtain conversion formulae of cyclosporine test results between TDX and AXSYM system and evaluate the influence of different sample diluents in over-range samples on AXSYM system.Methods One hundred samples with different concentration were analyzed by TDX and AXSYM system, respectively. The results were compared. Fifty over-range samples were diluted with prepared diluents such as whole blood, phosphate buffer, self-prepared diluents and zero point calibrator and then analyzed on AXSYM system.Results There was a significant difference in the results between TDX and AXSYM system. Reasonable formulae were concluded based on different concentration ranges. Results obtained by using whole blood and phosphate buffer as diluents differed from that got by using zero point calibrator. In contrast, there was no significant difference between self-prepared diluents and zero point calibrator.Conclusion The conversion formulae are helpful to evaluate the variation of the results while the analysis system was changed. Self-prepared diluents could be used to replace zero point calibrator as sample diluents.

BACKGROUND:Foreign scholars have obtained a success to cure fracture by implanting the complex of red bone marrow and formation factor.Due to the in vitro culture process is not necessary,the complex of red bona marrow and scaffold formation factor is only required to be implant immediately,called uncellular tissue engineered bone.OBJECTIVE:This study innovatively constructs uncellular tissue engineered bone with autologous red bone marrow wrapped by fascial flap with pedicle,and validates the superiority of repairing bone defects.DESIGN,TIME AND SETTING:Homebody controlled animal experiment was performed in the Hebei North University and the Experiment Center of the Affiliated Hospital to Hebei North University from December 2007 to February 2009.MATERIALS:A total of 24 News Zealand albino rabbits,aged 4-5 months; uncellular tissue engineered bone was a mixture of autologous red bone marrow and osteoinductive absorbing materials containing bone morphogenetic proteins.METHODS:Bone defect models were induced on adult New Zealand rabbits' right radial bone,left side served as control group,only implanted with osteoinductive absorbing materials complex,while right side served as experiment group,which contained fascial flap with pedicle.A fascial flap prepared with capillary network containing nameless blood vessel pedicle was located to be adjacent to the bone defect using micro-surgical technique,to wrap the tissue engineered bone and to fill the bone defect.MAIN OUTCOME MEASURES:At 4,8,12,16 weeks postoperation,six rabbits were tested by radiograph,spectrodensitometry,gross morphology observation,histological inspection,quantitative analysis of bone morphometry in bone defect area and analysis of vessels image in the junctional zone.RESULTS:①X-ray determination:At 16 weeks,the implant surrounding bone defects formed bone shaft structure in the control group,cortical bone was not continuous and medullary cavity was obstructed; in the experiment group,normal bone shaft structure was formed and recanalization of medullary cavity was observed.②Histological observation:At 16 weeks,few vessels grew into implant in the control group,mature bone trabecular were observed,and medullary cavity was obstructed; in the experiment group,the implanting materials were completely degraded and substituted by new bone,mature bone structure formed and recanalization of medullary cavity was observed.③Quantitative analysis of bone morphometry in bone defect area:At 4,8,12,16 weeks postoperation,the volume of bone trabecula in the experiment group was more than that in control group (P ＜ 0.05).④Analysis of vessels image in the junctional zone:The area of vessels in the unit area in the experiment group was greater than that in control group in every time stage (P＜0.05).CONCLUSION:The uncellular tissue engineering complex constructed by autologous red bone marrow wrapped by fascial flap with pedicle shows double effects of hymeno-inducing regeneration of bone and the vascularization.It is feasible to repair large-segment bone defects.It has obvious therapeutic effect in the aspects such as reducing the bone defect reparation time and advancing the quantity and quality of the bone generation.

Objective To study the effect of fascial flap with vessels inducing the vascularization of uncel-lular tissue engingeering complex and the regenration of bone on the repair of bone defect, so as to provide the basis for the clinical application. Methods An animal model of bone defect on adult Newzland rabbits'right radial bone was established .and autologous red bone marrow were taken out and mixed into uncellulax tissue engineering comple-xes with OAM which contained BMP. The experiment animals were divided into two groups : experiment group and control group( n = 12 for each ). The control group was only implanted with complexes, meanwhile, the experiment group had fascial flap with vessels. By microsurgery technology,a non-named fascial flap with vessels was prepared, which belonged to capillary net,around the bone defect,and let it wrap tissue engineering complex,fill up bone de-fect. In a certian time, radiograph(X-ray) and light density measure was conducted, gross morphology and histological inspection was exmained. Bone shape measurement analysis and image of vessel analysis were conducted. All the sta-tistics were analyzed by the SPSS 11.5 software. Results Because of mechanically preventing fiber connective tis-sues and surrounding soft tissues from entering the areas of bone defect by fascial flap, it can keep bone defect having a relative stable environment ;The subfascial space itself, and also the shape and mass of filled-in subject had the de-cisive effect on the results of the regeneration of the bone; Owing to the establishment of blood supply during the con-structing tissue engineering complex. The experiment group was obviously superior to the control group. Compared with control group,the absor bance obviously increased in experiment group [(0. 732 ± 0. 021 ) vs (0. 651± 0.018)] (P < 0. 001 ) four weeks after the operation; also the bone trabecular body was significantly increased [(2.32±2.57)% vs(19.37±3.52)% ,(8.37±3.52)% vs(30.24±3.42)% ,(28.57±2.98)% vs(58.76± 4.62)% ,(47.24±3.42)% vs(88.72±5.84)%] ,and capillary area [(5.04±1.62)% vs(17.53±2.86)%, (10.37 ±2.96)% vs(35.24±1. 13)%,(18.20±2. 12)% vs(48.76±4. 62)%,(17.82 ±2. 74)% vs (57.72 ±5.84)%] (P <0.05) at each time period(4 weeks,8 weeks,12 weeks,and 16 weeks after operation). Despite of growth of implant's internal vessel, the number and speed of forming bone trabecula and cartilaginous tis-sue, even developing of mature bone structure, recreating of diaphysis structure, reconstructing of marrow cavity, ab-sorbing and decomposing of implant, the experiment group was obviously superior to the control group. Conclusions The induction of fascial flap with vessels shows double effects, one of which is the vascularization of uncellular tis-sue engineering complex and the other is membrane guided bone regeneration, So the method has a wonderful effect on the repair of bone defect.

Objective To detect the expression of melanoma antigen-1 gene (MAGE-l),melanoma antigen-3 gene (MAGE-3) and explore their clinical significance. Methods The expression of MAGE-1 and MAGE-3 in central tumor tissue, para-tumorous normal mucosa and tissue of resection-border were detected by RT-PCR. Results The expression of MAGE-1 was positive in 10 out of 33 (30.30 %) cases of rectal cancer, 4 out of 33 cases (12.12%) and 4 out of 33 cases (12.12 %) in para-tumorous normal mucosa and tissue of resection-border respectively; the expression of MAGE-3 was positive in 14 out of 33(42.42 %) eases of rectal cancer, 6 out of 33 cases (18.18 % ) and 5 out of 33 cases (15.15 %) in para-tumorous normal mucosa and tissue of resection-border respectively; 7 out of 33 cases (21.21%) was expressed MAGE-1 and MAGE-3 simutaneously; 17 out of 33 cases (51.51%) was expressed at least one of MAGE-1 and MAGE-3;the positive rates of MAGE-1 or MAGE-3 in center tumor tissue were significant higher than those of its para-tumorous and resection-border (P＜0.05). The expression of MAGE-1 or MAGE-3 was not related to age, sex, histological grades, metastasis to lymph nodes, duke stages (P＞0.05). Conclusion As their significance, MAGE-1, MAGE-3 protein may be used as a target molecule of immunotherapy for rectal cancer and indexes for follow-up study of rectal cancer as well.