Translumbar amputation, also known as hemicorporectomy, is a life-saving procedure for patients with a life-threatening diagnosis but with a normal life expectancy. In the surgical procedure, the pelvis, pelvic contents, lower extremities and external genitalia are removed following transection of the lumbar spine. The operation makes the patient lose the ability of being upright. With the interdisciplinary cooperation of doctors, nurses, prosthetists, psychologists, vocational rehabilitation workers and social rehabilitation workers, the patient can realize most of independent activities of daily living through rehabilitation. The rehabilitation associated with the procedure is reviewed.

Objective To investigate CT stage of carcinoma of gallbladder and its role in preoperative evaluation of surgical resectability.Methods CT staging with reference to current literature was made retrospectively in 80 cases of carcinoma of gallbladder proved pathologically and imaging studies.Surgical resectability was evaluated in combination with surgical and pathological results on different stages of this disease.Results In this group,there were stage Ⅰin 9 cases,stageⅡ in 18 cases,stage Ⅲin 42 cases and stageⅣ in 11 cases.32 cases were radically resected,among them,9 were stage Ⅰ,18 stage Ⅱ and 5 stage Ⅲ.Palliative resection was done on 31 cases;all were stage Ⅲ.Exploratory surgery were done on 9 cases(6 stage Ⅲ and 3 stage Ⅳ),by they were unresectable.8 cases (CT stage Ⅳ on CT)had no surgery,but treated otherwise.Conclusion CT studies and staging of gallbladder carcinoma are conducive to preoperative evaluation of surgical and choice of appropriate treatment planning.

Objective To evaluate the application of MSCT in diagnosing the injury of atlantoaxial joint.Methods MSCT data of 20 cases of traumatic atlantoaxial joints were analyzed,the ability of different reconstruction methods in showing the traumatic aspects were evaluated.Results Axial MSCT and in combination with reconstruction methods such as MPR and Direct 3D could distinctly depict atlantoaxial joint in full view.Conclusion MSCT plays an important role and could be the first choice of imaging examination in the detection of injury of atlantoaxial joint.

Enamel hypoplasia is a surface defect of the tooth crown caused by a disturbance of enamel matrix secretion.Enamel hypoplasia may be inherited,or result from illness,malnutrition,trauma,or high concentrations of fluorides or strontium in the drinking water or food.Different types of enamel hypoplasia have been distinguished,such as pit-type,plane-type,and linear enamel hypoplasia.Hypoplasia has been related to the intensity and duration of stress events,the number of affected ameloblasts,and their position along the forming tooth crown.Amelogenesis imperfecta(AI) is a heterogeneous group of inherited defects in dental enamel formation,most teeth are affected in both the primary and permanent dentition.The malformed enamel can be unusually thin,soft,rough and stained.The strict definition of AI includes only those cases where enamel defects occur in the absence of other symptoms.Currently,there are seven candidate genes for AI: amelogenin,enamelin,ameloblastin,tuftelin,distal-less homeobox 3,enamelysin,and kallikrein 4.Since the enamel is formed according to a strict chronological sequence,and once formed,undergoes no repair or regeneration.Then the analysis the phenotype of enamel hypoplasia can provide insights of the severity of inherited or environmental stress and the molecular mechanism during the period of enamel formation.

Objective To sum up CT findings of sacroiliac joints in ankylosing spondylitis with an attempt at further improving early and even accurate diagnosis of the disease.Methods CT features of sacroiliac joints in 80 cases with anklyosing spondylitis proved clinically were analysed,and their application in making the diagnosis was evaluated.Results 73 of the 80 cases had abnormal CT findings of the joints,with different features according to different stages of the disease.In early stage,most cases were with symmetric involvement of the joints showing shaggy appearance of the articular surface with interruption or disappearance of the joint cortex,subcortical microcysts and mild sclerosis of iliac surface of joint .In advanced stage,cases were with irregularity of sacroiliac articular surfaces,showing serrated or brush-like appearance,subcortical systic destruction,sclerosis or hypertrophic changes around the joints,and pseudo-widening,irregular narrowing or even vacuumization of the joint space.In the late or stable stage,ossification of ligaments,bony ankylosis of the joints with obliteration of joint space and osteoporosis or osteosclerosis were seen.Conclusion CT study of sacroiliac joints could be helpful in making an early and even accurate diagnosis of ankylosing spondylitis as well as in clinical staging of the disease.

Objective To analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection. Methods The clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model. Results The overall 1-year, 3-year and 5-year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P

Paraneoplastic pemphigus(PNP) is a clinically, histologically, and immunopathologically distinct autoimmune bullous disease characterized by severe painful mucosal erosions and polymorphous skin lesions. Histopathology shows acantholysis with lichenoid dermatitis or keratinocyte necrosis, and there are autoantibodies to various epidermal proteins with underlying neoplasia. We report two cases of paraneoplastic pemphigus in China firstly. The clinical, histologic, and immunopathologic findings of both cases strongly suggest the diagnosis of paraneoplastic pemphigus associated with Castleman′ s tumor.

Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Methods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significantly less in the patients than in the controls (P<0.05) in the indoor 6-minute walking test, and the cycle of gait and energy expenditure were significantly more (P<0.05); single support time, double and single/double support time were different (P<0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (P>0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P<0.05). There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test between amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expenditure of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait, and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.

Objective To compare the energy expenditure of a hemicorporectomy amputee moving with different mobility devices. Methods A middle-aged male hemicorporectomy amputee was measured with cardiopulmonary exercise test when moving with 4 kinds of transport: socket, cart, wheelchair, and prosthesis. Results The patient moved the slowest with prosthesis, fastest with wheelchair. The heart rate was the highest with prosthesis and lowest with cart. The absolute oxygen consumption, the relative volume of oxygen consumption and metabolic (Mets) were the most when hand walking with socket, and lowest with cart. Conclusion Hand walking with socket costs the largest energy when walking, and the rest are prosthesis, wheelchair, and cart.

Objective To observe the effect of Dezocine in preventing the adverse reactions during the operation of cesarean delivery.Methods We selected 60 pregnant women in the ASA level Ⅰ who were going to undergo the operation of cesarean delivery.Then we divided them into two groups in random:group A (studying group) and group B (control group),each group had 30 patients.After the fetus were delivered,the patients in group A were given intravenous injection of 1mg of dezocine,and the patients in group B were only given 1 ml saline.Then we observe the heart rate (HR),systolic blood pressure (SBP) and the degree of blood oxygen saturation (SpO2) in seven time points,and analyzed the incidence of contraction pains,chills,nausea and vomiting during the operation in both groups.The time points were when patients entered the operation room (T0),the level of anesthesia was established (T1),5 minutes after fetus were delivered (T2),10 minutes after fetus were delivered (T3),15 minutes after fetus were delivered (T4),30 minutes after fetus were delivered (T5) and the end of operation (T6).Results Compared with group A,the SBP at T2,T3 and T4 were obviously higher than those in group B (P＜0.05).And the HR increased at T2 to T6 in control group (P＜0.05) as compared with group A.The incidence of contraction pains were milder in group A than group B (P＜0.05).In group A,the incidence of chills was13.3％,and in group B,the rate was 30％.Conclusion Dezocine can prevent the adverse reactions during the operation of cesarean delivery.