Objective To discuss the clinic and imaging features of solitary enchondroma.Methods Radiography,CT and MRI were performed in 11 cases of solitary enchondroma confirmed by pathology.The imaging findings were retrospectively analysed.Results The tumors in 11 cases localized in metacarpal bone in 3, in bones of fingers in 4, in shaft of humerus in one,in metaphysis of femur in 2 and in metaphysis of tibia in one.Plain radiography showed typical radiographic features including a well defined central lucency in the diaphysis of the metacarpal bones and bones of fingers with calcifications inside the lesions and lobulated contour,the cortex was thinned and cortical expansion also might occur.The lesions appeared as soft tissue density with stippling calcification on CT,low signal intensity on T1WI and mixed mainly high signal intensity on T2WI.A low signal zone around the lesion could be seen on T2WI in one case.Conclusion The qualitative and differential diagnosis of solitary enchondroma can be made mostly by imaging examination.

【Objective】 To establish a postoperative recovery scale for Chinese people and to make a preliminary assessment for the scale.【Methods】Programmatic decision-making method was used to establish the basic items and structure of the scale.And then 70 postoperative patients were sampled to assess the scale by grading their recovery.【Results】The postoperative recovery scale had a good validity in contents and structure,and a good reliability and responsiveness.【Conclusion】The postoperative recovery scale established preliminarily can be used as the initial scale for evaluating the recovery of postoperative patients treated by traditional Chinese and western medicine.

Objective To improve the differential diagnostic accuracy of abnormal image in the nasopharyngeal cavity and wall.Methods Sixty-five cases with abnormal image in the nasopharyngeal cavity and wall were collected.Twenty cases were proven by operation and pathology.Forty-five cases were proven by biopsy and pathology. All the patients were examined by using CT and (or) MRI. Their imaging features were analyzed in details.Results In 19 cases, polyp and inverted papilloma in the nasal cavity and choanal projected into the nasopharyngeal cavity. Small air bubbles or contact between the lesion and the nasopharyngeal wall were detected in 18 of them. The edge of the polyp was regular, while the margin of the inverted papilloma was irregular. In 11 cases, nasopharyngitis or adenoidal hypertrophy located in the posterosuperior wall. The anterior borders were almost straight or curve toward inside, and the contrast enhanced CT and MRI scans showed that the mucous membrane lines were continuous. Oropharyngitis in the right side spread to the right wall of the nasopharynx without clear borderline and the space occupying effect was little in 1 case. There were 33 cases of nasopharyngeal carcinoma (NPC) and 1 case of non-Hodgkin′s lymphoma (NHL), and the anterior borders of the masses were evaginated like a curve, and most of them were accompanied with shallowing or disappearing of pharyngeal recess and tumefaction of the levator muscle of palatine velum.Conclusion According to the imaging features, most of the abnormalities in the nasopharyngeal cavity and wall can be diagnosed correctly.

Objective:To explore the environmental risk factors of different categories of congenital heart defects ( CHD) and provide evidence for further risk factors and prevention research of CHD pheno-types. Methods:Data of Guangdong CHD Register Study from 2004 to 2012 were used. In the study, 3 038 CHD cases and 3 038 paired controls from 34 hospitals distributed in 17 cities were registered and related information were collected using uniform, and structured questionnaires. All the CHD phenotypes were coded according to the International Classification of Diseases 10th Revision (ICD-10) and classified into 6 categories according to their pathological features. Univariate analyses were adopted to filter poten-tial risk factors for each category of CHD. Then multivariate conditional Logistic regression was used to calculate the odds ratios of the risk factors for each category of CHD. Results:The risk factors for left-to-right shunt CHD included low ( OR=2 . 63 , 95%CI:2 . 04 -3 . 39 ) or over birth weight ( OR =2 . 21 , 95%CI:1 . 47-3 . 32 ) , premature delivery ( OR=1 . 95 , 95%CI:1 . 53-2 . 49 ) , polyembryony ( OR=1. 99, 95%CI: 1. 22 -3. 26), maternal low education, mother as factory worker (OR =1. 62, 95%CI:1 . 32-1 . 98 ) , parity≥2 ( OR =1 . 38 , 95%CI: 1 . 13 -1 . 69 ) , maternal abnormal reproduction history ( OR=2 . 29 , 95%CI:1 . 75-3 . 01 ) , fever ( OR=2 . 38 , 95%CI:1 . 26-4 . 48 ) , virus infection ( OR=1 . 80 , 95%CI:1 . 29 -2 . 51 ) , medicine usage ( OR=1 . 73 , 95%CI:1 . 11 -2 . 69 ) , passive smoking ( OR=1 . 69 , 95%CI:1 . 26-2 . 29 ) , chemical agent contact ( OR=8 . 71 , 95%CI:2 . 33 -32 . 58 ) , living in newly decorated houses ( OR=2 . 56 , 95%CI:1 . 60-4 . 09 ) or room close to the main road ( OR=1 . 40 , 95%CI:1 . 14-1 . 72 ) in the first 3 months of pregnancy and father as factory worker ( OR=1 . 46 , 95%CI:1 . 23-1 . 73 ) . The risk factors for pulmonary outflow tract obstruction CHD in-cluded low ( OR =5 . 98 , 95% CI: 2 . 88 -12 . 44 ) or over birth weight ( OR = 6 . 56 , 95% CI:1. 19-36. 26), maternal low education, parity≥2 (OR=2. 08, 95%CI:1. 03-4. 22), virus infection in the first 3 months of pregnancy ( OR =4 . 30 , 95%CI: 1 . 27 -13 . 45 ) . The risk factors for left ventricular outflow tract obstruction CHD included father as factory worker ( OR=6 . 01 , 95%CI:1 . 05-34. 59). The risk factors for transposition of the great arteries included low birth weight (OR=12. 93, 95%CI:1. 14-146. 26), maternal low education, mother as factory worker (OR=3. 69, 95%CI:1. 53-8. 91). The risk factors for conditions with intra cardiac mixing of oxygenated and deoxygenated blood in-cluded parity=2 ( OR=3 . 45 , 95%CI:1 . 42-8 . 38 ) . The risk factors for other CHD included over birth weight (OR=4. 87, 95%CI:1. 19-19. 94), maternal abnormal reproduction history (OR=2. 96, 95%CI:1. 14 - 7. 68 ), virus infection ( OR = 4. 92, 95% CI: 1. 56 - 15. 47 ), medicine usage (OR=4. 90, 95%CI:1. 22-19. 77) or passive smoking (OR=10. 31, 95%CI:1. 25-85. 05) in the first 3 months of pregnancy. Conclusion:The environmental risk factors were discrepant among different categories of CHD. Further risk factors study of CHD phenotypes should be performed specially. To prevent CHD, attention should be paid to the risk factors which are related to multi or complex categories of CHD.

[Objective]To evaluate the effects of sutureless technique in comparison to conventional techniques for repair of total anomalous pulmonary venous connection(TAPVC)with the method of propensity score analysis.[Methods]From October 2007 to December 2013,179 consecutive patients were enrolled in this study. Patients were operated with sutureless technique(n = 81)or Conventional technique(n=98),and followed up at an interval of 1 month,3 months,6 months and then once a year post-operation. During analysis,three type of propensity-score matching methods,including nearest neighbor caliper matching,Mahalanobis metric matching with propensity score ,optimal full matching were used to create balanced groups of patients receiving each treatment. Surgeons’performance difference was assessed with random frailty proportional hazards models with gamma. Composite endpoints was defined by postoperative death or late death or postoperative pulmonary venous obstruction(PVO),which was evaluated with Kaplan-Meier curve and multivariable Cox proportional hazard model,adjusted by Preoperative-PVO,age,gender,weight and TAPVC type.[Results]Nearest neighbor caliper matching method was the best choice during propensity score analysis. After matching ,sutureless group included 73 patients and Conventional group73 patients. In sutureless group,cardiopulmonary bypass(CPB)time(Z=2.18, P=0.030),cross-clamp time(Z=3.63,P<0.001),rate of composite endpoints(HR 95%CI=0.20(0.06~0.61),P=0.005),late death(HR 95%CI=0.03(0.01~0.55),P=0.017)were significantly better than that in Conventional group. In subgroup analysis ,for patients with pre-PVO,decreased composite endpoints was seen in sutureless group.[Conclusion]Comparison using thepropensity score analysis demonstrated that sutureless strategy for primary repair of TAPVC may associate with decreased mortality rate of post-PVO and CPB time and cross-clamp time.

Objective The clinical effect of the lateral femoral cutaneous artery flap for soft tissue defects of leg wounds. Methods From October 2007 to January 2016, VSD was firstly used to promote the growth of granulation tissue. When the growth of granulation tissue became satisfactory, flaps were designed based on the anatomical characteristics of the lateral femoral cutaneous artery. We repaired 20 cases of wound defects by cutting flaps that coincide with the recipient vessels. Result 20 cases were followed up for 6 to 24 months, 12 months on average. All flaps were survived and only one case had small area of necrosis flap which was healed by replacing medicines. In all cases, wounds were healed and flaps showed good color and good texture. The strength of quadriceps muscle was good and the extension of knee flexion was 0° to 150°. Conclusion To The lateral femoral cutaneous artery flap is used for soft tissue defects of refractory wounds on leg , flap donor sites are sutured directly, the treatment period is shorten and the method is safe and effective. The lateral femoral cutaneous artery flap is one of ideal choices for wound tissue defects.

OBJECTIVETo study the biocompatibility of porous calcium phosphate ceramics nanocomposite.

METHODSThe biocompatibility was evaluated via experiments including the hemolysis test, hemopexis test, acute systemic toxicity test, pyrogen test, and intramuscular implant test, in which biphasic calcium phosphate nanocomposite (NanoBCP) presented as leaching solution, suspension or blocks of 5 mmx5 mmxl mm. Animals including New Zealand Rabbits, Kunming mice, SD rats were selected as the host.

RESULTSThe hemolysis of NanoBCP was 1.1% (<5%). Four coagulation index levels were within the normal range. In pyrogen test, the temperature of each experimental rat increased by 0.35, 0.40, 0.28 degrees C (<0.60 degrees C, in accordance with the pyrogen-free criterion for biomedical materials). No consequent death, dyspnoea, organ dysfunction, severe peritoneal irritation or ptosis was observed in acute systemic toxic test. Newly-formed fibrous tissue could be found after the implantation.

CONCLUSIONThe material possesses outstanding biocompatibility and degradability with no toxicity or irritation, contains no pyrogen, as well as better degradation properties than biphasic calcium phosphate.

Animals ; Biocompatible Materials ; Calcium Phosphates ; Ceramics ; Hydroxyapatites ; Mice ; Nanocomposites ; Prostheses and Implants ; Rabbits ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the steroidal alkaloids in Veratrum dahuricum.

METHODThe compounds were isolated and purified by various column chromatographic methods. Their structures were identified by spectroscopic analysis.

RESULTFive compounds were isolated and identified as (20R, 22S, 25S)-veratra-5,13-dien-3beta-ol (1), angeloylzygadenine (2), 15-O-(2-methylbutanoyl)-3-O-veatroylprotoverine (3), 20-isoveratramine (4), veratramine (5).

CONCLUSIONCompound 1 was a new compound, compounds 24 were obtained from the plant for the first time.

Alkaloids ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Isomerism ; Steroids ; chemistry ; Veratrum ; chemistry

Objective This retrospective cohort study aims to evaluate and compare the prognosis of surgical repair for total anomalous pulmonary venous connection(TAPVC) with different drainage type.Methods From January 2006 to Decem-ber 2013, 328 consecutive patients were enrolled in this study .The distribution of the defects was 109 cases with cardiac, 161 with supracardiac, 32 with infracardiac, and 26 with mixed type of the drainage into the systemic circulation .The clinical re-cords of all the patients were reviewed.Studied variables were extracted from the clinical records.Followed-up was conducted at an interval of 1 month, 3 months, 6 months and then once a year post-operation.Prevalence of peri-operative conditions were compared among four different types.Studied endpoints was defined by postoperative total death or pulmonary venous obstruc-tion(PVO), which was evaluated with Kaplan-Meier curve and multivariable Cox proportional hazard model, adjusted by differ-ent surgical strategy, emergency operation, preoperative-PVO, neonates, weight, combing with other complex cardiac defects,NYHA cardiac function, severe pulmonary hypertension and severe tricuspid regurgitation.Results There were significant discrepancyof preoperative conditions among four types of TAPVC.Patients with infracardiac TAPVC presented the most criticalsymptoms and clinical indexes, which included having largest proportion of neonates, preoperative PVO, severe NYHA grading,pulmonary hypertension and tricuspid regurgitation, having lowest body weight at operation and youngest age.The cardiopulmonarybypass time, aortic crossclamp time and mechanical ventilation time were significantly longer in infracadiac and mixedTAPVC comparing to the other two types.For early mortality(death in hospital), infracadiac(9.4%) and mixed(11.5%)TAPVC demonstrated higher rates of death than cardiac(4.6%) and supracardiac(7.5%)TAPVC, although had no statisticalsignificance.For intermediate-term results, mortality in infracadiac(21.9%) and mixed(30.8%) TAPVC were significantlyhigher than cardiac ( 8.3%) and supracardiac (11.8%) TAPVC.Reoperation was more frequently required in mixed(19.2%), then infracadiac(15.6%)TAPVC.Mixed and infracadiac types are independent risk factors for TAPVC prognosis,after adjusting by the confounding factors.Conclusion Mixed and infracadiac types are independent risk factors for postoperativedeath and PVO among TAPVC patients.This study provided evidence for clinical assessment and management strategy fordifferent types of TAPVC.