Clavicle ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; complications ; surgery ; Humans

Objective To study the clinical characteristics of silent paraganglioma ( PGL) .Methods A total of 21 patients with silent PGL confirmed by surgical pathology and hospitalized in the First Affiliated Hospital of chongqing Medical University from Mar .2008 to Dec.2013 were enrolled in this study .The clinical manifesta-tions, hormone level, imaging findings, pathologic characteristic, treatment and follow-up data were reviewed and analyzed retrospectively .Results Among the 21 cases of silent PGL , 8 were male and 13 were female, with 47.05 years as the mean age(ranging from 26 to 67 years old).PGL tumors in silent group were mainly located in the right side, and left to right ratio was 2∶5.Silent PGL with tumor diameter <3 cm, 3-5 cm, >5 cm were 5, 7,and 9 cases respectively.Its constituent ratio was 23.8%, 33.3% and 42.9% respectively, significantly higher compared with that of symptomatic PGL (9.8%,43.9%,and 46.3%respectively).Silent PGL can be i-dentified from other adrenal incidentaloma based on enhanced CT value in each period .Biochemical examination or functional imaging further could facilitate the diagnosis of silent PGL .All the 21 cases were conducted with surgical treatment , and hypertensive crisis occurred to 4 cases during operation .Conclusions Silent PGL is not easy to be detected due to its non-specific clinical manifestations .The diagnosis needs the combined analysis on anatomical imaging characteristics , biochemical examination , functional imaging and pathological findings .Sur-gery is the most effective treatment .Postoperative pathological tips and long-term follow-up are both required for PGL, no matter benign or malignant .

Athletes ; Humans ; Physical Conditioning, Human ; physiology ; Running ; physiology

OBJECTIVETo observe the clinical effects of essential hypertension treated with acupuncture at Siguan [Hegu (LI 4) and Taichong (LR 3)], Quchi (LI 11) and Xingjian (LR 2).

METHODSSixty cases of essential hypertension were randomly divided into an acupuncture group and a medication group, 30 cases in each group. Two groups of acupoint, which were (1) Siguan [Hegu (LI 4) and Taichong (LR 3)] and (2) Quchi (LI 11), Xingjian (LR 2), were selected alternatively in the acupuncture group, once everyday. In the medication group, captopril was prescribed for oral administration 25 mg per time, three times per day. Seven days made one session in both groups and totally three sessions were required.

RESULTS(1) After treatment, the blood pressure were decreased significantly in the two groups (all P < 0.01). Compared with the medication group, the diastolic pressure after 14 days, 21 days of treatment in the acupuncture group was decreased significantly (both P < 0.01). (2) In the terms of TCM syndrome score, the improvement of dizziness, soreness and weakness of waist and knees, palpitations was significant in the acupuncture group compared with that in the medication group(all P < 0.05). (3) The acupuncture group had less adverse reactions compared with the control group (P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI4) and Taichong (LR 3), Quchi (LI 11) and Xingjian (LR 2) can effectively decrease blood pressure; the effect of controlling diastolic pressure is better than captopril. It can also improve the symptoms of dizziness, soreness and weakness of waist and knees, and palpitations.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; therapy ; Yin-Yang

Objective To evaluate the clinical value of multi-slice spiral CT in diagnosing tracheobronchial foreign bodies in chil-dren.Methods 139 patients with airway foreign body confirmed by bronchoscopy were examined with 128-slice spiral CT,and then the CT data was reconstructed by using multiple-planar reconstruction(MPR),curved planar reconstruction (CPR),volume render-ing(VR),minimum intensity projection(MinIP)and virtual endoscopy (VE).The CT results were compared with bronchofibersco-py findings.Results Among the 139 cases,the foreign bodies located at trachea in 13 cases,right bronchia in 75 cases,left bronchia in 48 cases,and bilateral bronchia in 3 cases.137 cases (98.6%)were correctly diagnosed,and 2 cases (1.4%)were missed on CT.Although the difference of the results at trachea and right main stem bronchus was statistically significant (P <0.05),the over-all results was not significant difference between CT and bronchoscopy examination (P =0.340).Associated findings included em-physema in 74 cases,pneumonia in 48 cases,atelectasis in 22 cases,mediastinal displacement in 57 cases,lung interstitial emphyse-ma in 4 cases,pneumomediastinum and pneumoderma in 4 cases,bronchiectasis in 2 cases,and pleural effusion in 4 cases.Conclu-sion MSCT and its postprocessing techniques can accurately and intuitively display the tracheobronchial foreign body and complica-tions,which has important value for clinical application.

Objective To describe the feat ures of Balo′s concentric sclerosis o n MRI and ~1?H-MRS. Methods Three patients of Balo′s concen tric sclerosis were rep orted on the basis of brain MRI and stereotactic brain biopsy. Proton MR spectro scopy was carried out on 1 patient. Results Multiple ring-li ke lesions of lam inated demyelination alternating with spared white matter were demonstrated in a ll 3 patients, and the lesions were best seen in post-contrast images. ~1 ?H-MR S showed a decreased NAA peak, an increased choline peak, and the presence of la rge lipid peak. Conclusion Balo′s concentric sclerosis has cha racteristic findi ngs on MRI and ~1?H-MRS. MRI is very useful in the diagnosis of Balo′s c oncentric sclerosis.

Diabetic foot is one of the chronic complications of diabetes,which has great harm.Through active treatment such as anti-infection,debridement,surgical intervention,amputation rate can be declined.

Mixed-ownership hospitals constitute an experiment of such ownership in the health care sector,attracting high attention as of its birth.This paper introduced the background of such ownership,and analyzed the development of such hospitals in terms of policy,present situation and external effects.The authors,arguing against major challenges,stated their views on such hospitals along with in-depth analysis of key issues in their development.

Based on a field survey of typical hospitals in Zhejiang,this paper drew a conclusion on three models of the mixed-ownership hospitals development in Zhejiang.It summed up the experiences learnt in the practice about how to maintain the public welfare of the public hospitals,how to ensure the essential health services supply as well as the incentive mechanism for social capital.Suggestions were proposed to develop the mixed-ownership hospitals based on the analysis.

Objective To summarize the clinical experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas(SPTP),and to work out the diagnosis and treatment process which matches the conditions of China.Methods The clinical data of consecutive 50 patients with SPTP who had been admitted to our hospital from January 2001 to March 2007 were retrospectively analyzed.Of all patients,3 were male and 47 female.Their median age Was 24 years(13-60 years).Preoperative imaging examination revealed typical findings and tumor markers were negative.SPIP of 23 cases were located in the head of pancreas,3 in the neck of pancreas,2 in the uncinate process of pancreas.3 in the body of pancreas,18 in the tail of pancreas,and the location of SPTP of 1 case was uncertain.Forty-eight patients underwent the operation of SPTP resection,1 of exploratory laparotomy and 1 of CT-guided fine-needle aspiration biopsy of metastatic lesions.Results Forty-nine out of 50 patients were diagnosed"pancreatic mass"preoperatively.Eighteen of the 32 patients with intact tumor capsule and 11 of the 16 patients without intact tumor capsule underwent operation without pathological examination.Thirty-two patients were followed up for 3-55 months,and no metastasis or invasion of the SPTP was observed.Conclusions Yong females are in the high risk group of SPTP.CT is the most valuable preoperative imaging test.Complete surgical resection is the first choice treatment with good prognosis.Resection of the head of pancreas with the preservation of duodenum and resection of body and tail of pancreas+splenectomy are the commou modalities used for the treatment of SPTP.The intactness of the tumor capsule is an important factor in making surgical plan and deciding the necessity of intraoperative frozen section pathological examination.The most common postoperative complication of SPTP resection is pancreatic fistula.