Objective:To evaluate non-enhanced MR imaging,static and dynamic enhanced MR imaging in differentiation of be-nign from malignant vertebral compression fractures and to evaluate which MR imaging parameters are most predictive of malignancy.Methods:Non-enhanced MR imaging,static and dynamic gadolinium-enhanced MR imaging were performed on 43 patients with acute osteoporotic compression fracture and 49 patients with malignant compression fracture proved by clinical follow-up and/or histologic findings.Binary multivariate logistic regression analysis was used to identify the best combination of MR imaging parameters that might be predictive of malignancy.Subjective overall performance of diagnostic models for sensitivi-ty,specificity and accuracy was evaluated with receiver operating characteristic curve(ROC).Results:Univariate analysis showed that the frequency distribution of MR imaging parameters including T1 weighted imaging homogeneity of vertebrae,convex pos-terior of vertebrae,retropulsion of the posterosuperior angle of vertebrae,pedicle involvement,epidural soft tissue mass,paraverte-bral soft tissue lesions,pattern of enhancement of vertebrae,pattern of enhancement of paravertebral soft tissue lesions,start of dynamic enhancement and pattern of time-intensity curve(TIC) were different between benign and malignant compression frac-ture(P0.05).ROC analysis showed that combined non-enhanced,static and dynamic enhanced MR imaging parameters(model 3) were superior to non-enhanced MR imaging pa-rameter(smodel 1)iction of malignancy.The sensitivity,specificity and accuracy of model 3 were 81.6%,90.7% and 85.9%,respec-tively.Multivariate logistic regression analysis revealed the most discriminating parameters were pedicle involvement,pattern of enhancement of vertebrae and pattern of TIC(OR value were 3.558,4.666 and 0.007,respectively,P

BACKGROUND:Lisfranc injury is a concealed or low-energy damage in the athletic population. The optimal treatment strategies for Lisfranc injury in the athletes, especial y for high-level or professional athletes, remain controversial. Improvement and development in treatment for Lisfranc injury are ongoing. OBJECTIVE:To summarize the diagnostic and therapeutic strategies and problems in surgery in Lisfranc injuries in the athletic population. METHODS:A computer-based online search was conducted in PubMed and Web of science databases from June 1909 to June 2014 to screen the relevant articles regarding the diagnostic and therapeutic strategies for Lisfranc injury using the key words“Lisfranc, injury, athletes”. The irrelevant and duplicate articles were excluded, and final y 43 articles were reviewed. RESULTS AND CONCLUSION:With the improvement and development in the therapeutic methods for Lisfranc injury, suture button fixation and bioabsorbable screw technology, as novel treatment strategies, have the potential to help restore and/or preserve stability at the tarsometatarsal joints, to avoid the potential risk for internal fixation irritation or the need for removal of hardware after fixation. However, more multi-center, prospective, randomized control ed clinical trials are required for seeking the optimal treatment for Lisfranc injury. For the athletes with Lisfranc injury, the best treatment option, removal timing of internal fixation devices, and the proper postoperative function exercise performed according the conditions of patients are vital for restoring the professional sports level.

Destroyed lung has resulted in the pathological changes of irreversible lung damage. The variety of reasons cause lobes of lung or the side of the whole lung loss of function and volume decrease. To the side of lung damage for patients.,it is necessary to take the whole side of surgical resection of lung disease at the right time Not only it can quickly alleviate the respiratory symptoms, but also can significantly improve the patients quality of life. Even some benign disease can be cured to achieve the purpose. Because of the extensive fibrosis of lung tissue loss of the affected lung function. Patients have varying degrees of shortness of breath and recurrent cough, cough purulent sputum, hemoptysis. Because of the thickened parietal pleura,those result in the effect of bad medical treatment. Most need surgical treatment, but the surgery cause perioperative patient physiological condition of interference, Major trauma surgical procedures, much more bleeding, and many and serious postoperative complications, those require a higher surgical technique. The article summed up the whole lung damage lung surgical methods and progress were reviewed.

Objective To evaluate the diagnostic value of the C 2 “hypertrophic sign” in the axis fracture.Methods 37 cases with C 2 fracture confirmed by radiography,CT and operation partly retrospectively analysed,there were 29 men and 8 woman.After trauma all cases were examined by X-ray and 11 cases by CT scan.27 cases underwent operation.Results The incidence rate of the C 2 “hypertrophic sign” was 53.13%.This sign characterized by the distance increased between the anterior and posterior of the axis on the lateral conventional radiography compared with that of C 3 vertebrae.The maximal increasing distance was 11 mm and minimal one was 2.3 mm with average 4.3 mm.Fracture line and swollen soft tissue in front of the vertebra were showed in some cases.Conclusion The C 2 “hypertrophic sign” is main radiographic sign of C2 fracture.

Objective To explore the effects and feasibility of minimal local analgesic dose of hyperbaric levobupivacaine in elderly patients undergoing unilateral spinal anesthesia during lower limb orthopedic surgery.Methods Seven hundred and fifty-six elderly patients who scheduled lower limb orthopedic surgery were assigned to levobupivacaine group (383 patients) and bupivacaine group (373 patients) by random digits table method.Haemodynamic change were monitored before,during and after anesthesia.The level and duration of sensory and motor block in each group were evaluated.Results Compared with bupivacaine group,the sensory block and motor block onset time was significantly longer in levobupivacaine group [(5.9 ± 1.4) min vs.(4.2 ± 0.3) min,(11.7 ± 3.0) min vs.(9.1 ± 3.3) min] (P ＜0.05),but the motor block duration was shorter [(152.8 ± 17.5) min vs.(195.4 ± 18.7) min] (P ＜ 0.05).The scores of maximum motor block in levobupivacaine group was significantly lower than that in bupivacaine group[(1.1 ±0.3) min vs.(2.3 ±0.6) min](P＜ 0.05).There was no significant difference in peak sensory block and haemodynamic between two groups (P ＞ 0.05).Conclusions Although levobupivacaine may be less potent than bupivacaine,it may be preferred for elderly patients with lower limb surgery because of satisfactory spinal anesthesia,good hsemodynamic stability and fast motor block regression.

0.05).②For the neonates passed DPOAE screening,the ASSR thresholds at 250,500 and 1 000 Hz and the ABR thresholds were not correlated,but there were significant correlations at 2 000 and 4 000 Hz.For the neonates whose DPOAE screening results were abnormal,the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies.Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

Objective To explore the use of auditory steady-state response (ASSR) for threshold evaluation in neonates. Methods 30 neonates 60 ears) were included in the study who passed distortion product otoacoustic emission (DPOAE) screening and 45 neonates (78 ears) who failed DPOAE. The ASSR thresholds were evaluated screening, the significant difference was found between the ASSR thresholds at 250 Hz and the ABR thresholds (P ＜0.05), however the ASSR thresholds at 4 000 Hz and average thresholds were not different from the ABR thresholds (P＞0.05). For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds from 250 to 4 000 Hz and average thresholds were not significant different from the ABR thresholds respectively (P＞0.05). olds were not correlated, but there were significant correlations at 2 000 and 4 000 Hz. For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies. Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

Objective To study the influence of aging and chemotherapeutic drugs of breast cancer patients on chemotherapy-induced amenorrhea (CIA) and to guide the further selection of drugs for chemotherapy.Methods We prospectively studied the CIA of the premenopausal breast cancer patients and compared the difference in CIA between the patients who were at different aging periods or received different chemotherapeutics. Results 137 patients were followed up.The occurrence rate of CIA and long-term chemotherapy-induced amenorrhea(LCIA)were 73.72%(101/137)and 43.80%(60/137)respectively.The rate of CIA and LCIA was significandy higher in older women(＞40 years)than young women(≤40 years,X2=25.32,18.42,P＜0.05).The recovery rate of CIA in young women was 61.90%(13/21)which was significantly higher than the older women[35.00%(28/80);X2=4.99,P=0.025].The difference in the rate of LCIA was statistically significant between the older women (＞40 years)who received different anthracyclinebased chemotherapy(X2=6.92,P=0.031).Conclusion Age is an important factor for the CIA.Chemotherapy has less influence on the menstruation of younger women(≤40) and most amenorrhea is reversible.For older women,the rate of LCIA is different in patients who receive imported epirubicin,domestic epirubicin or pirarubicin.

ObjectiveTo study the clinical value of minimally invasive treatment of the doppler-guided hemorrhoid artery ligation with lauromacrogal sclerosis injection in treatment of hemorrhoids.MethodsA retrospective analysis was made on treatment of 32 cases with hemorrhoids using doppler-guided hemorrhoid artery ligation combined with lauromacrogal sclerosis injection.ResultsAccording to the branch of the Chinese Medical Association by the Surgery the clinical diagnosis and Treatment Guidelines of Hemorrhoids (draft),the Ⅰ degree hemorrhoid was found in 1 case,Ⅱ degree hemorrhoids in 18 cases,Ⅲ degree hemorrhoids in 13 cases.Recovery was found in 32 cases.The longest follow-up time was 30 weeks.No relapse was found. ConclusionsDoppler-guided hemorrhoid artery ligation combined with lauromacrogal case sclerosis injection is a low aggressive minimally invasive method to treat hemorrhoid and has small trauma,definite effect,less pain,fewer complications,and short course and other advantages,but the longterm outcome needs further observation.

Objective To study the comparability of two personality diagnostic instruments(SCID-Ⅱ and PDQ-4)in psychiatric patients. Methods One hundred and twelve mental disorder patients were investigated with the SCID-Ⅱ and PDQ-4. Results 1)Significant differences were found between groups(dividing by total scores on PDQ-4)by means of SCID-Ⅱ interviews(P＜0. 0 1). 2)Categorical personality disorder(PD)groups by means of SCID-Ⅱ interviews had hisher scores on PDQ-4 than their related non-PD groups. 3)For agreement on categorical diagnoses between SCID-Ⅱ and PDQ-4, the correlation coefficients varied from 0. 17 to 0. 57. Except for antisocial PD(r=0. 57), the others had poor-fair coefficients, as r＜0. 50. Conclusions In general, there is some correlation between SCID-Ⅱ and PDQ-4. Low agreement between PDQ-4 and SCID-Ⅱ is observed for categorical PD evaluations. Thus, PDQ-4 can't be a substitute tool for SCID-Ⅱ.