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

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.

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 investigate simple manual humeroulnar distraction for alleviating elbow stiffness due to upper limb fracture. Methods Twenty-seven patients with elbow stiffness due to upper limb fracture were divided into control and experimental groups. Before treatment there was no significant difference in stiffness between the groups. The controls were treated with the combined mobilizations and passive stretching. The experimental group was treated with manual humeroulnar distraction alone. Both groups were treated for four weeks. Range of motion ( ROM) and the Mayo elbow function scale (MEFS) were used to evaluate elbow function before and after 4 weeks of treatment. Results After 4 weeks, there was a significant difference between the groups. In the experimental group average ROM reached (110±20) °,an average of 29.6°better than the controls (80.4±23.6) °. MEFS scores also showed significant differences between the experimental group (93. 85±7. 95) and the control group (83.93±9. 24). Conclusions Humeroulnar joint distraction might increase ROM and improve the functioning of stiff elbow joints. This finding may help rehabilitation professionals choose more effective manual mobilization techniques for treating elbow stiffness after upper limb fracture.

In this paper,the mini-implant as anchorage for orthodontic is described by application in closing the space following teeth extraction,distal movement of molars,posterior teeth intrusion,anterior teeth intrusion,scissors bite solving,unilateral maxillary expansion,induced eruption,upright and mesial movement of molars.In this way,we introduce the clinical normal application of mini-implant anchorage for orthodontist.

The majority of women diagnosed with early-stage breast-cancer have an excellent long-term prognosis, but many still suffer from worsened life quality and infertility caused by chemotherapy-induced amenorrhea(CIA). The risk of CIA varies by patient age, but is not significantly influenced by chemotherapeutic regimens. CIA will improve disease-free survival and overall survival for patients with hormonal receptor positive tumors. For low-risk patients and patients with the intention of maintaining fertility, proper treatments need to be chosen to preserve their reproductive function.

Rectal prolapse is a rare disease, has been attracting many surgeons to study it.Surgical treatment of rectal prolapse is currently more than 50 kinds, most of which are modifications of several basic modes treatment, depending on the doctor' s grasp on the patient anatomy.Currently comprehensive treatment of a variety of therapies is a more ideal way for the treatment of rectal prolapse.

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 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.