[Objective]To explore the clinic results of bi-posterolateral fusion combined with coralline hydroxyapatite interbody fusion,a three point stable spine fusion technique in the treatment of degenerative vertebra disc disorder.[Method]Bi-posterolateral fusion combined with posterior interbody fusion were performed to treat 41 cases of degenerative vertebra disc disorder from August 1998 to August 2006.The patients included 18 men and 23 women;their average age was 48 years.The slippage and grade of spondylolisthesis before and after spine fusion were investigated.The severity and slippage of radiographic measurements were also recorded,along with the average follow up of 19.1 month(range 12-48 months).The three point spine fusion applied autologous bone chips for bi-posterolateral fusion and one cubic block of coralline hydroxyapatite for anterior inter body fusion which achieved by PLIF technique.[Result]In the 41 patients who had underwent three point spine fusion surgery,only 1/41 patients experienced nerve root pain after surgery,and in most cases clinical symptoms were improved greatly.In 21/41 patients who had severe lower back pain completely disappeared after surgery,and in 9/41 cases these symptoms were minimal.The clinical evaluation according to the symptoms before the operation was excellent 2.4%(1/41),good 19.5%(8/41),fair 21.9%(9/41),bad 56.1%(23/41);after operation excellent 68.3%(28/41),good 29.2%(12/41),fair 2.4%(1/41),bad 0.0%(0/41).A radiographic measurements showed the anterior disc height was 8.05?2.35mm before operation and 11.44?3.38mm after operation(P

Objective:To investigate the clinical characters and therapeutic methods of orbital apex syndrome caused by sinus diseases.Method:Six cases of orbital apex syndrome originated from sinus diseases were retrospective analyzed in our hospital from August 2003 to February 2009. Different therapeutic methods were taken according to different causes of disease.Result:Four cases of sinus infection,one cases of sphenoethmoid mucocele , one cases of sinus squamous cell carcinoma. The results of patients with orbital apex syndrome included cure and effectiveness in 2 cases respectively, death from myocardial infarction in one case, and one case is still following up.Conclusion:Orbital apex syndrome originated from sinus diseases was rare, which was mainly caused by sinus infection . The key point is the correct etiology diagnosis in early phase . Treatment with endoscopic sinus surgery early is a good effective method for orbital apex syndrome caused by sinus diseases, in the same time with enough dosage of antibiotic and glucocorticoid therapy intravenously.

OBJECTIVE To investigate the best approach of diagnosis and treatment of spontaneous cerebrospinal fluid rhinorrhea.METHODS The clinical data of 13 cases with spontaneous cerebrospinal fluid rhinorrhea performed in our hospital from 1998 to 2007 were analyzed retrospectively.RESULTS The diagnosis of spontaneous cerebrospinal fluid rhinorrhea was established for these 13 cases on a set of diagnostic program,including qualitative determination of sugar in the nasal leakage,nasal endoscopy, CT and MRI scan.All the patients were failed with conservative treatment.All of the 13 patients were cured by surgical repairing under nasal endoscope for follow up of 6 months to 6 years.CONCLUSION The diagnosis program for spontaneous cerebrospinal fluid rhinorrhea includes qualitative determination of sugar in the nasal leakage,nasal endoscopy,CT and MRI scan.Transnasal endoscopic management is the best method for repairing spontaneous cerebrospinal fluid rhinorrhea.

OBJECTIVE To improve the knowledge on the early diagnosis and treatment of the isolated fungus ball sphenoid sinusitis.METHODS A retrospe ctive study was made on10cases of isolated fungus ball sphenoid sinusitis to discuss the clinical manifestation,radiographic features and treatment with endoscopic sinus surgery.RESULTS The common symptoms in10cases were headache and/or bloody nasal discharge.Radiographic features of the disease were a soft tissue image occupying the sphenoid sinus with bones wall thickening.A soft tissue image with calcification in the sphenoid sinus was the feature of CT image.All the patients were treated by nasal endoscopic sinus surgery and cured after followed up for3to18.CONCLUSION Isolated fungus ball sphenoid sinusitis was difficult to diagnose in early stage because of its non-specif ic symptoms.The nasal endoscopy and CT scan make the early diagnosis possible.The diagnosis can be def initely confi rmed by pathological studies.Treatment with endoscopic sinus surgery is an effective method for fungus ball sphenoid sinusitis.

Objective To evaluate the regional long-axis systolic function of left ventricular in patients with coronary artery disease and healthy subjects by two-dimensional strain rate imaging (2D-SRI). Methods During October 2011 to August 2012 , 53 inpatients with coronary artery disease in the department cardiology from the Afifliated Hospital of Medical College, Qingdao University were enrolled. Twenty-nine patients with anterior wall infarction induced by left front-descending coronary artery disease (group LCA) and twenty-four with interior wall infarction induced by right coronary artery disease (group RCA) proved by coronary angiography and echocardiography were enrolled into the study and thirty healthy volunteers in the control group. High frame rate two-dimensional dynamic images were recorded in apical four-chamber view and two-chamber view of the left ventricle. Using two-dimensional strain software, peak systolic longitudinal strain rate (PSRs) of interventricular septum, anterior wall, lateral wall and interior wall of left ventricle were measured. All data of 3 groups were analyzed using One-Way analysis of variance, and LSD-q test used to compare the 2 groups. Results The PSRs were (4.61±0.60) s-1, (5.18±0.87) s-1, (5.60±0.70) s-1, (6.05±0.74) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the control group. There were signiifcant differences among the groups (F=20.95, P=0.00), and there were signiifcant gradient changes from intervetrivular septum, anterior wall, lateral wall to interior wall in the control group. The PSRs were (4.31±0.85) s-1, (1.96±0.93) s-1, (5.54±0.83) s-1, (5.93±0.80) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the LCA group respectively. There were signiifcant differences among the different walls (F=127.25, P=0.00), which was signiifcant lower in ischemic anterior wall than interventricular septum, lateral wall and interior wall, and the significant differences were identified in anterior wall with lateral wall and interior wall (q=22.62, 25.04, both P<0.01). The PSRs were (4.51±0.62) s-1, (4.99±1.13) s-1, (5.31±0.81) s-1, (2.84±0.85) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in RCA group respectively. There were signiifcant differences among the different walls (F=38.12, P=0.00), which were signiifcant lower in ischemic interior wall than interventricular septum, anterior wall, and lateral wall, and the signiifcant differences were identiifed in interior wall with lateral wall and interior wall (q=13.88, 12.08, both P<0.01). Comparing the same part among 3 groups, signiifcant differences were identiifed as following:the PSRs of anterior wall in group LCA vs control group (q=20.17, P<0.01), the PSRs of interior wall in group RCA vs control group (q=19.98, P<0.01). Conclusions Longitudinal systolic function changes of left ventricular regional myocardium in patients with coronary artery disease and healthy subjects could be accurately analyzed by 2D-SRI. The early changes in ischemic myocardium would be assessed quickly in patients with coronary artery disease using 2D-SRI.

Objective To evaluate the feasibility of real-time triplane strain rate imaging for the quantitative assessment of left atrial function in normal subjects. Methods Totally 40 healthy volunteers were enrolled. Left atrial expansion index (LAEI), left atrial passive emptying fraction (LAPEF) and left atrial active emptying fraction (LAAEF) were measured using real-time triplane volume analysis. Mean systolic peak strain rate (MSRs), mean early diastolic peak strain rate (MSRe) and mean late diastolic peak strain rate (MSRa) were measured using real-time triplane strain rate imaging. The results were compared respectively. Results MSRs correlated positively with LAEI (r=0.61, P<0.01). MSRe correlated inversely with LAPEF (r=-0.67, P<0.01), so did MSRa with LAAEF (r=-0.78, P<0.01). Conclusion Real-time triplane strain rate imaging is feasible for the quantification of left atrial function in normal subjects.

Objective To investigate the clinical effects and safety of urethral anastomoses and ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure. Methods Ninety patients with urethral straddle injury and catheter placement failure were chosen and divided into A group (45 patients, choosing urethral anastomoses) and B group (45 patients, choosing ureteroscopy urethral realignment). The operation time, intraoperative blood loss, hospital staying time and peri-operation complications in both groups were compared. Results The operation time, intraoperative blood loss, hospital staying time in B group were significantly lower than those in A group: (26.15 ± 10.41) min vs. (71.93 ± 14.50) min, (22.37 ± 7.41) ml vs. (50.70 ± 13.25) ml, (3.22 ± 0.97) d vs. (5.19 ± 1.43) d, P<0.05. After 6 months′follow-up, the clinical indicators in peri-operation period of B group were significantly better than those in A group (P<0.05). The complications incidence in B group was significantly lower than that in A group: 2.22%(1/45) vs. 13.33%(6/45), P <0.05. Conclusions The technology of ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure can efficiently shorten the operation time, reduce the degree of trauma and accelerate the rehabilitation process, and it is helpful to reduce the risk of complications in peri-operation period.

Objective To investigate the mutation screening of the GJB3,GJB2,mtDNA 1555 A>G and SLC26A4 gene in Hainan Pronive population with non-syndromic hearing impairment.Methods PCR were performed with one pair of primer in the coding sequence of GJB3,GJB2,mtDNA 1555 A>G and SLC26A4 gene.Bidirectional sequencing of PCR products was subsequently applied in 429 patients with hearing loss.Results 55 patients gene mutation of 429 patients were found. The point mutation in mtDNA was found in 5 patients (1.1 7%).1 5 5 5 A>G mutation of mtDNA was found in 4 patients. 1494 C>T mutation of mtDNA was found in one patients.GJB2 gene mutation was found in 25 patients (5.83%).235 del C mutation of GJB2 gene was found in 9 patients.235 del C/GJB2 299 del AT mutation was found in two patients.235 del C mutation was found in 10 patients.176 del 16 mutation was found in 4 patients.SLC26A4 mutation was found in 22 patients (5.13%).IVS7-2 A>G mutation of SLC26A4 was found in 4 patients.2168 A>G mutation of SLC26A4 was found in one patient.IVS7-2 A>G mutation was found in 12 patients.2168 A>G mutation was found in 5 patients.538 C>T mutation of GJB3 gene was found in 3 patient.IVS7-2A>G mutation and 2168 A>G muation of SLC26A4 gene was found in 4 of 22 EVA patients.Conclusion GJB2 gene and SLC26A4 gene have revealed responsible genes for Hainan deafness patients.

Objective To investigate the clinical effect of posterior short-segment pedicle screw reduction and fixation without fusion in treatment of thoracolumbar mono-segmental compression fractures.Methods Thirty cases of thoracolumbar mono-segmental compression fractures admitted from January 2009 to February 2010 were assigned to single posterior pedicle screw fixation (screw group,n =15) and posterior pedicle screw fixation with posterolateral fusion (fusion group,n =15) according to random number table.Clinical results in the two groups were assessed based on Cobb' s angle,anterior vertebral body height ratio (％) and Oswestry disability index (ODI) before operation,after operation,prior to the removal of implant and at the latest follow-up.Results All the cases were followed up for average 24 months.Both operation time and blood loss were less in screw group than in fusion group [(76.58 ±12.67) min vs (116.29 ± 17.45) min,P ＜ 0.01 ; (287.54 ± 30.76) ml vs (480.34 ± 100.54) ml,P ＜0.01],whereas there were no statistical differences between the two groups in aspects of Cobb' s angle and anterior vertebral body height ratio before and after operation,prior to the removal of implant as well as at the latest follow-up.Moreover,no statistical difference of ODI was noted between the two groups prior to the removal of implant and at the latest follow-up.Conclusion Posterior pedicle screw fixation without bone grafting achieves similar effects with pedicle screw fixation with bone grafting.

Objective To evaluate diagnostic value of mitral regurgitation jet volume(MRvol) in the quantification of mitral regurgitation severity by general imaging three-dimensional quantification (GI3DQ) using the guideline recommended 2D integrative method as a reference.Methods Ninety-three patients with MR were divided into central MR group(n =41) and eccentric MR group(n =52).The American Society of Echocardiography (ASE)-recommended 2D integrative method was used as a reference for MR grading and MRvol was directly measured by GI3DQ method.Results In central MR,as assessed by receiver operating characteristic (ROC) analysis,the area under the curve(AUC)was 0.87(P <0.0001), and MRvol by GI3DQ at a cutoff value of 16.2 ml yielded 96.2% of sensitivity and 63.6% of specificity to differentiate mild from moderate MR;the AUC was 0.98(P < 0.0001),and a cutoff value of 47.8 ml yielded 98.6% of sensitivity and 96.2% of specificity to differentiate moderate from severe MR. In eccentric MR,the AUC was 0.76(P =0.086),and MRvol at a cutoff value of 14.8 ml yielded 90.9% of sensitivity and 60.0% of specificity to differentiate mild from moderate MR;the AUC was 0.84(P <0.0001) and a cutoff value of 40.7 ml yielded 80.0% of sensitivity and 79.7% of specificity to differentiate moderate from severe MR.Conclusions MRvol measured directly by GI3DQ could more exactly evaluate MR severity,and have better sensitivity and specificity to differentiate moderate from severe MR in central MR.