Adult ; Histiocytosis, Sinus ; Humans ; Male ; Nasal Cavity ; Paranasal Sinuses

OBJECTIVETo compare two kinds of method for treating lumbar tuberculosis with psoas abscess, to provide reference for clinical reasonable select of therapy treatment.

METHODSFrom January 2010 to January 2013,42 patients with lumbar tuberculosis combined with psoas abscess with obvious surgical indications were enrolled, including 24 males and 18 females with an average age of (38.5 ± 10.2) years old ranging from 21 to 63 years old. All patients were followed up for 18 to 24 months with an average of 20.9 months. Twenty-two patients underwent posterior vertebral body lesions cleared, bone graft fusion and internal fixation and percutaneous puncture catheter drainage for treatment of psoas major abscess as group A, and twenty patients underwent one-stage extraperitoneal approach to remove abscess, posterior vertebral body lesions cleared, bone graft fusion and internal fixation as group B. The operative time, loss of blood, length of hospital stay, clinical cure rate and other clinical results for the two groups were analyzed and compared.

RESULTSThe loss of blood was (452.3 ± 137.6) ml in group A and (603.5 ± 99.6) ml in group B, there was significant statistical difference (P < 0.05). The time of operation was (193.6 ± 91.2) min in group A and (230.5 ± 56.6) min in group B, there was significant statistical difference (P < 0.05). The time of operation and the loss of blood in group A were obviously less than which in group B. In group A 20 cases were cured and 2 cases relapsed, 19 cases were cured and 1 case relapsed in group B, there was no significant statistical differences between two groups regarding cure rate with chi-square test (χ² = 0.000, P = 1.000). All patients in two groups obtained good clinical curative effect. There were no significant statistical difference between two groups regarding for length of hospital stay with t-test (P > 0.05).

CONCLUSIONLumbar spinal tuberculosis with psoas abscess is not absolute indications for anterior open operation. Compared with the combined anterior and posterior surgical procedure, the percutaneous puncture catheter drainage combined with posterior debridement, interbody fusion and internal fixation can achieve the same clinical effect but less trauma for the patients.

Adult ; Case-Control Studies ; Debridement ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Psoas Abscess ; etiology ; surgery ; Spinal Fusion ; Tuberculosis, Spinal ; complications ; surgery ; Young Adult

Humans ; Otitis Media ; classification ; diagnosis ; therapy

Objective To discuss the Clinical character of pulmonary tuberculosis combined malignant lymphoma and its Pathogenesis,and to review the literature.Methods Eighteen cases of pulmonary tuberculosis combined malignant lymphoma from 1996 to 2003 were retrospectively analyzed by its clinical manifestations,X-ray features,diagnosis and treatments.Results 18 cases were all infiltrative pulmonary tuberculosis,13 them were calcification focals,5 were active pulmonary tuberculosis;5 of all were Hodgkin’s lymphomas,13 of all were non-Hodgkin′s lymphomas.16 cases were lymphomas after tuberculosis,2 cases tuberculosis after lymphomas,none were co-existent malignant lymphoma and tuberculosis.Tuberculosis may precede or complicate a lymphomatous process during the development of both diseases,This might is linked to immune deficiency and chronic inflammation;Lymphomas might cause pulmonary tuberculosis,it might cause the immune turbulence of an individual,Pulmonary tuberculosis infection occurring during or after the radiotherapy and chemotherapy of lymphoma.Conclusions It may pulmonary tuberculosis combined malignant lymphoma in the patients in the endemic areas of tuberculosis,Appropriate invasive biopsy procedures are necessary for early diagnosis.

Objective To investigate morphosis of the epiphyseal plate and the expression of vascular endothelial growth factor (VEGF) in the epiphyseal plate during healing of injured epiphysis.Methods Thirty SD rats aged 4-5 weeks were used to make models of proximal tibia epiphysis injury.These models were equally divided into 5 groups in random,with 6 rats in each group,and these groups of rats were killed separately at 2,4,6,10,21 days postoperatively to harvest the proximal tibia epiphysis,in order to explore the morphosis of the epiphyseal plate and VEGF expression pattern in the epiphyseal plate at different healing phase.The structure of the epiphyseal plate was evaluated by measuring the length of the limb and radiographic examination of the limb.The ratio of length of injured tibia and that of the other side was used to describe the tibia length discrepancy.The micro structure of the epiphyseal plate and situation of the bone bridge in the epiphyseal plate were measured by using Micro CT.By using HE stain and VEGF immunohistochemistry,the changing of chondrocyte and VEGF expression pattern in the epiphyseal plate were observed at different healing phase.Results The limb discrepancy appeared at 4 days postoperatively,became biggest at 10 days postoperatively,and tended to decrease at 21 days postoperatively.Micro CT demonstrated the fibrous bone tissue formation in the epiphyseal plate at about 6 days postoperatively,which became bone bridge finally.HE stain showed chondrocyte in the rest zone had the tendency to aggregate after injury,and the highly ordered structure of chondrocyte in the epiphyseal plate no longer existed,chondrocyte differentiation was accelerated.VEGF immunohistochemistry stain showed the high reaction of VEGF in the epiphyseal plate appeared after surgery,and the positive zone of VEGF expanded through the physis with time,which finally led to angiogenesis and ossification.Conclusion A serial alteration of morphosis of the epiphyseal plate occurred during the healing process.Fibrous bone tissue formation in the epiphyseaL plate could be observed in the early and mid-term of the healing process.With progress of healing,VEGF expression zone gradually expanded across the epiphyseal plate,which is related to the formation of bone bridge.

Calibration ; Dose Fractionation ; Humans ; Imaging, Three-Dimensional ; instrumentation ; Movement ; Particle Accelerators ; instrumentation ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; Respiration ; Stereotaxic Techniques ; Technology, Radiologic ; instrumentation ; methods ; Tomography, X-Ray Computed ; methods

ObjectiveFollow-up of the clinical outcome of prosthetic disc nucleus replacement on patients with lumbar intervertebral disc herniation. Methods16 patients with lumar intervertebral disc herniation were implanted prosthetic disc nucleus from June to August 2003, including 10 males and 6 females. The operation levels were at L4-5 in 10 patients and L5～S1 in 6 patients. All patients were followed up from 28 to 32 months (averaged 30 months). The contents include pain, physical examination, Short-form of McGill Pain Questionnaire investigation, Visual Analogue Scales(VAS) and Present Pain Intensity(PPI), X-ray and MRI examination, etc. ResultsAfter surgery, 16 patients experienced clinical symptom relief, the displacement of PDN in 1 case and dislocation in 1case, the height of intervertebral space becoming narrower in 5 cases and endplate subsiding in 1 case. ConclusionProsthetic disc nucleus replacement acquired satisfactory after operation, but some complication may occurre in long-term.

Objective: To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. Methods : The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model. Results: Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. Conclusions The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.

Objective To analyze the imaging characteristics of hepatic involvement in Langerhans cell histiocytosis(LCH) in children on MRCP, MRI and CT. Methods Twenty-nine children from three children hospitals in China, who were diagnosed as hepatic involvement by disseminated LCH during Aug 2008 and Jan 2015 were included in this study. Their MRCP (n=16), MRI (n=22), contrast?enhanced CT (n=15) data were retrospectively analyzed. The stenoses and dilatation of the intrahepatic bile ducts, the common hepatic bile duct and its first order branches and the common bile duct were evaluated on the MRCP image. The size and shape of the liver, the imaging characteristics of the periportal lesions in the Glisson sheath and hepatic parenchymal lesions were also evaluated on the cross?sectional images. Results MRCP indicated alternative stenoses/dilatation of the bile duct tree (n=16), stenoses of the common hepatic duct and its first?order branches (n=15), partialindistinctness of the common bile duct (n=2) and multiple cystic lesions along the biliary tree (n=5). On the cross?sectional images, the periportal lesions in the Glisson sheath were observed in 28 children. On MRI, the periportal lesions were shown in all the 22 children with MRI, presented as hypo-signal intensity on T1WI, hyper?signal intensity on T2WI (n=11) or mixed?signal intensity on T1WI and T2WI (n=11); On CT, the periportal lesions were found in 14 of the 15 children with CT, presenting as low density (n=13) and mixed density (n=1). Multiple nodular or cyst?like parenchymal lesions were observed in 21 patients including 18 patients on MRI and 5 patients on enhanced CT. Sixteen patients presented as hypo?intensity on T1WI, hyper?intensity on T2WI and low density on plain CT, and 5 patients with iso? or hypo?intensity on T1WI, hypo?intensity on T2WI,and milder enhancement relative to the adjacent parenchyma on contrast?enhanced CT. Conclusions The imaging characteristics of hepatic involvement by LCH include alternative stenoses and dilatation of the intrahepatic ducts, stenoses of the common hepatic bile duct and its first?order branches on MRCP, the periportal lesions in the Glisson sheath and hepatic parenchymal nodular or cyst?like lesions on cross?sectional images.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood