Objective To evaluate the safety and efficacy of CT-guided transgluteal approach for drainage of deep pelvic abscesses. Methods From April 2000 to August 2007, 12 patients with deep pelvic abscesses underwent CT-guided transgluteal drainage. The clinical data, number of drainage cathete rsplaced, amount of drain, duration of placement, complications and follow-up were retrospectively analysed.Results One drainage catheter was successfully placed for each patient. The amount of abscess drained was30 to 180 ml (mean 52 ml) and the duration of placement was 6 to 34 days (mean 11 days). No major complications occurred. Conclusion The transgluteal approach to the drainage of deep pelvic abscess under CT guidance was safe and effective.

Objective To detect the serum prohibitin protein(PHB)level in children with renal interstitial damage and analyze the correlation between PHB and renal interstitial fibrosis(RIF). Methods Serum PHB protein levels were determined by Western blot analysis in 36 children with kidney diseases,and 30 healthy children were studied as control. Levels of BUN,Scr,and urinary microprotein series(including ALBU/Cr,NAGU/Cr,IgG U/Cr,α1-MU/Cr)were studied by automatic biochemical analyzer. Renal interstitial damage was semiquantitatively graded according to Katafuchi's method. The correlation between serum levels of serum PHB protein and those of BUN,Scr as well as urine microprotein were analyzed. Results Serum PHB protein was positive in children with diverse kidney diseases however it was negative in the normal controls(P ＜ 0.05). Serum PHB levels were significantly higher in children with proliferative glomerulonephritis than those with non-proliferative glomerulonephritis(P ＜ 0.05). Statistical analysis indicated that serum PHB levels positively correlated with the degree of tubulointerstitial lesions(r ＝ 0.868,P ＜ 0.001)as well as the glomerular injuries(r ＝ 0.753,P ＜ 0.001). And,serum PHB levels were also positively correlated with urinary microprotein including NAG(r ＝ 0.586,P ＜ 0.001)and IgG(r ＝ 0.341,P ＜ 0.001). Conclusions Serum PHB levels were significantly increased in children with kidney diseases and were positively correlated with the degrees of renal interstitial damage,suggesting that PHB might be a potential clinical marker for detecting tubulointerstitial lesions.

Objective To explore the long-term effect of open reduction and internal fixation for the treatment of displaced acetabular fracture,and analyze the influence of risk factors.Methods The clinical data of 62 patients with acetabular fracture from August 2005 to February 2009 was analyzed retrospectively.All the cases were treated with open reduction and internal fixation.The long-term effect and related risk factors were analyzed.Results All the cases were followed up for 24-52(38.8 ± 2.6) months.According to the Matta standard of replacement of fracture,there were 43 cases with anatomic reduction,14 eases with satisfactory reduction,5 cases with unsatisfactory reduction.Fracture union was obtained in all the patients.Based on the modified Merled' Aubigne -Postel clinical grading system,the result was excellent and good in 50 patients,fair and poor in 12 patients,with excellent rate of 80.65％ (50/62).Postoperative complications including traumatic arthritis were seen in 7 patients,heterotopic ossification in 3 patients and femoral head avascular necrosis in 1 patient.The related risk factors of clinical results of displaced acetabular fracture were age,Letournel-Judet fracture type,operation time,cartilage surface damage of the femoral head and quality of reduction (P ＜ 0.05 ).However,gender,AO fracture type,surgical approach and hip dislocation were not affecting factors of the acetabular fracture(P ＞ 0.05 ).Conclusions Open reduction and internal fixation can result in a satisfactory clinical outcome.Age,Letournel-Judet fracture type,operation time,cartilage surface damage of the femoral head and quality of reduction are independent risk factors affecting postoperative long-term functional outcomes.

Objective To investigate the feasibility of using CT texture analysis to differentiate among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.Methods 66 lipid-poor adrenal adenoma,98 pheochromocytoma and 101 adrenal metastases lesions were analyzed retrospectively.All the patients had abdominal non-enhanced CT and adrenal enhanced CT scans.We used TexRAD software to analyze the textural features of CT images and compared the differences in each texture parameter among three adrenal lesions.Results On non-enhanced CT images,there were significant differences in Mean and Kurtosis at all the texture scales(SSF 0-6) among the three types of adrenal lesions (P<0.05),as well as SD at fine and coarse texture scale (SSF 2,6)(P<0.05).Entropy (SSF 0-3, 5-6) and MPP (SSF 0-2, 4-6) were significantly lower in lipid-poor adrenal adenoma and adrenal metastases than that in pheochromocytoma (P<0.05).There were significant differences in Skewness (SSF 0-3) among three types of lesions, which was lowest in pheochromocytoma and highest in adrenal metastases.On enhanced CT images, Mean, SD, Entrophy and MPP showed significantly differences among the three types of adrenal lesions at all the texture scales (SSF 0-6) (P<0.05), which were all highest in pheochromocytoma and lowest in adrenal metastases.Skewness (SSF 0) and Kurtosis (SSF 0, 2) were significantly lower in adrenal metastases than that in lipid-poor adrenal adenoma and pheochromocytoma (P<0.05).Conclusion There are significant differences in CT texture analysis parameters among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.CT texture analysis has potential clinical application values in differentiating these three adrenal lesions.

Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To analyze the risk factors and treatment of early renal failure associated with orthotopic liver transplantation(RFALT).Methods Clinical data of 110 adult patients,who underwent orthotopic liver transplantation from January 2005 to December 2007,were retrospectively analyzed.These patients were divided into two groups based on whether RFALT occurred or not.Clinical and laboratory data in pre-and intra-operative periods were discussed with a univariate analysis,and then a logistic regression analysis was performed with variables that achieved a significant level of

Objective To evaluate the feasibility and safety of transrudial cerebral angiography and to discuss the technique points, advantages, disadvantages, indication and contraindication. Methods Transradial cerebral angiography was performed in 52 patients who were not suitable for transfemoral access or could not suffer from being kept in bed for 24 hours after transfemoral angingraphy, related comphcations and success rate of puncture and selective angiography were recorded and compared with transfemoral group (n = 83 ). Chi-square test was used for statistics. Results The success rate of puncture and selective angiography and the comphcation rate of transradial and transfemoral groups were 96.2% (50/52),94.2% (49/52),9.6% (5/52) and 100% (83/83),95.2% (79/83),8.4% (7/83),respectively. There were no significant differences between two groups (X2 = 0.000, P>0.05). After angiography, 2 patients of transradial group developed a mild bruise at the puncture site, no hematoma,pseudoaneurysm and artery- venous fistula occurred. Conclusion Transradial selective cerebral angiography is technically feasible and safe with comfortable and minimal comphcations. It should be used as the choice of mutes for selective cerebral angiography.

OBJECTIVE: To study the function of Qiyeling Decoction in inducing apoptosis of transplanted human lung adenocarcinoma cells A549 in nude mice. METHODS: Nude mice with transplanted A549 tumor were randomly divided into the untreated control group (group A), chemotherapy treated group (group B), chemotherapy plus Qiyeling Decoction treated group (group C), Qiyeling Decoction treated group (group D) and managed correspondingly. The tumor volume was measured and calculated into tumor weight. The apoptosis of tumor cells were examined using in situ cell apoptosis detection kit. RESULTS: The tumor weight was lower obviously in groups B, C and D than that in group A (P<0.05). The apoptosis of tumor cells was lower obviously in groups B, and C than that in group D (P<0.05). Cells in group A appeared perfect differentiation during the early stage and apoptosis later. CONCLUSION: Qiyeling Decoction can induce A549 cell apoptosis in nude mice.

Objective To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in treatment of symptomatic uterine leiomyoma among Chinese reproductive age women.Methods From April 2010 to April 2012,80 premenopausal women with symptomatic leiomyoma volunteered to participate in this prospective study in Department of Outpatient of Peking Union Medical College Hospital.Among 23 reproductive aged patients with size of uterus less than 16th gestational weeks,2.5 to 10 cm of diameter of myoma,less than 10 myomas and expressing symptoms clearly were treated by MRgFUS.Treatment data,non-perfused volume ratio (NPVR) and adverse events were recorded.After treatment,patients were followed up at 1 week,1,3,6,12 and 24 months,respectively.Patients at initial screening and each time of the follow-up filled out uterine fibroid symptoms quality of life (UFS-QOL),which include symptoms severity score (SSS) and health-related quality of life (HRQL).The volumes of leiomyoma and uterine were evaluated on MRI before and after the treatment (at 6 and 12 months,respectively).Before operation,routine blood test were performed on all patients,anemia patients at 3 months and 1 year after treatment were checked with blood test.Results (1) Treatment data and adverse events:the mean therapeutic temperature was (69 ± 7) ℃,the mean treatment time was (144 ±62) min,the mean NPVR was (62 ±23)％.Adverse events included mild erythema(1/23),abdominal cramp(8/23),vaginal discharge (5/23),and leg numbness (4/23).(2) The rate of secondary surgery:one patient was treated by myoectomy and hysterectomy within one year following up and 4 patients chose surgical treatment during the second-year follow-up.(3) Volume change:the volumes of leiomyoma before the treatment and 6,12 months after the treatment are 75.6 (P25 =43.8,P75 =128.9),52.3 (P25 =23.8,P75 =111.2),45.9 (P25 =26.3,P75 =71.7) cm3,respectively; and the volumes of uterine before the treatment and 6,12 months after the treatment are 270.0 (P25 =208.4,P75 =390.3),216.4 (P25 =151.1,P75 =290.0),200.0 (P25 =149.1,P75 =267.6) cm3,respectively.Both leiomyoma and uterine volumes decreased significantly after treatments (P ＜ 0.01).(4) UFS-QOL change:the symptoms severity score (SSS) before the treatment and 3,12 months after the treatment are (34 13),(22 ± 11),(19 ± 12),which decreased significantly (P ＜ 0.01).The health-related quality of life (HRQL) before the treatment and 3,12 months after the treatment are (74 ± 15),(82 ± 13),(89 ± 10),which increased dramatically (P ＜0.01).(5) Hemoglobin(HGB) change:eleven patients suffered from anemia before treatments,the mean HGB before treatment was (87 ±6) g/L and were (106 ± 14) g/L 3 months after treatment,(112 ± 10) g/L 12 months after treatment.The HGB was increased significantly after treatments (P＜0.01).Conclusions MRgFUS is a safe and effective non-invasive management for symptomatic uterine leiomyoma in short-term follow up.But there is additional treatment ratio after MRgFUS.

Objective To introduce the procedures and to evaluate the application value of the optical navigating interventional MR-guided percutaneous biopsies and therapies. Methods Thirty-five of 54 patients (33 males, 21 females) underwent percutaneous biopsies and 19 of 54 patients underwent percutaneous therapies under optical navigating interventional MR-guidance. The age ranged from 9 months to 78 years (mean 38.8 years). All patients were performed under a 0.23 T open MRI system (Proview, Philips Medical System) with optical navigating system (iPath 200, Philips Medical System). The needle and bone biopsy drill were MR-compatible (Daum, Germany). Results Punctures were accurate in all patients (54/54). 33 of 35 biopsies got the pathological diagnosis. All therapies (19/19) got the definitive curative effect. All patients had no obvious complications, such as severe hemorrhage, viscera or nerve injury.Conclusion iPath 200 interventional MR-guided percutaneous biopsies and therapies are accurate and safe techniques.