Objective To explore regional characteristics of road traffic injury in urban Beijing through analysis of the investigation by a single hospital. Methods Using Emergent Road Traffic Injury Questionnaire we designed, we performed a survey for 2 weeks on all the patients with road traffic injury who had sought medical care in the emergency department of our hospital. A comparison was made between them and other patients at the emergency department at the same period. Results From 8:00 on 25 April 2006 to 8:00 on 8 May 2006, 18 emergent cases of road traffic injury were treated. They accounted for 0.54% of all the emergency patients and 4.5% of all the trauma patients. They were 7 males and 11 females, with an average age of 48.3±14. 3 years. The average time to hospital was (26.8±14.4) rain. Seventeen cases of injury happened in the street, 1 in the highway;15 in Xicheng District, 1 in Haidian District, and 2 in the suburbs. They included 8 pedestrians, 9 riders, and 1 passenger. They were injured by 12 light vehicles, 2 heavy vehicles, 2 special vehicles, and 2 bicycles. Twelve patients had injury at extremity, 3 at spine, and 3 at multiple sites, They received treatment only in Emergency Department. No one was dead or hospitalized. Conclusions Contrary to common belief, road traffic injury patients seem to account for a small part of trauma patients and the injury tends to be moderate. Females and extremities may be more likely to get injured.

Objective To compare the clinic features of neuromyelitis optica (NMO) and multiple sclerosis(MS).To compare the positive rate of NMO-IgG in NMO,MS and other related diseases,and determine whether it can be considered as a biomarker for differential diagnosis.Methods Detected serum NMO-IgG in 34 NMO patients,22 MS patients,24 high risk syndrome,5 clinical isolated syndrome,and 35 patients with other neumlogical diseases.Compared the clinic features(onset age,severity,prognosis,MRI lesions,autoimmune antibodies,CSF)of 34 NMO patients and 22 MS patients.Results The onset age of NMO is older than that of MS.It is more severe and with worse prognosis than MS.Longitudinal spinal cord lesions are easily found in NMO.NMO-IgG positive rate in NMO and high risk syndrome patients are 58.8% (20/34)and 45.8%(11/24)respectively,which are higher than that in MS(1/22),clinical isolated syndrome(1/5)and other neurological diseases(1/35;x2=37.2,P<0.01).The positive rate may have a relationship with the length of spinal cord lesions.Condusions MS and NMO are probably different diseases.NMO-IgG positive rate in NMO is significandy higher than that in MS,it can be considered as a biomarker for differential diagnosis.

ObjectiveTo analyze treatment methods for radial head fractures combined with ulnar collateral ligament injuries and discuss the related effects.MethodsA total of 38 patients undergone operations for radial head fractures combined with ulnar collateral ligament injuries from August 2004to January 2011 at People' s Hospital of Peking University were followed up and 24 patients had complete follow-up data.According to the modified Mason typing,there were six patients with Mason-Johnston type Ⅱ fractures,15 with type Ⅲ and three with type Ⅳ. Conventional screws,Herbert screws,hollow screws,absorbable screws and mini-type plates were used for fracture fixation respectively.Severe communicated fractures were treated with radial head replacement and the injured collateral ligament complex with direct suture or ligament reconstruction.Results The duration of follow-up was 10-84 months (average 37.1 months).According to the Mayo Elbow-Performance Score,the results were excellent in 18 patients,good in four and fair in two,with excellence rate of 92％.ConclusionsFor the radial head fractures combined with ulnar collateral ligament injuries (severer than Mason type Ⅱ ),the first choice should be radial head reconstruction.If the fractures cannot be reconstructed,the radial head replacement is the best choice.If there still exists the elbow valgus instability after radial head reconstruction,the ulnar collateral ligament should be repaired or constructed.Primary repair and reconstruction of the radial and ulnar collateral ligaments is necessary when the radial head replacement is performed.

Objective To evaluate the clinical efficacy of Achillon,a novel guide for Achilles tendon suture produced by Newdeal Ltd in France,in the mini-invasive surgical treatment of acute Achilles tendon rupture. Methods Between December 2010 and March 2011,7 patients(7 feet) with acute Achilles tendon rupture were treated in our department.They were 5 males (5 feet) and 2 females (2 feet),with an average age of 34.2 years (range,21 to 53 years).The interval between injury and operation ranged from 1 to 11 days(3.8 days on average).A longitudinal incision approximately 2.0-3.5 cm in length was made around the ruptured Achilles tendon for minimally invasive repair after insertion of the Achillon.Postoperative rehabilitation was carried out. Results All the wounds healed at the first stage.All patients were followed up for 5 to 11 months, with an average of 7.2 months. All patients regained normal weight-bearing walking 3 months after operation without any re-rupture. According to the ankle-hindfoot scoring system of American Orthopaedic Foot and Ankle Society (AOFAS),they scored 93.2 points.By the visual analogue scale(VAS),they scored 1.2 points at the operation site. Conclusion The surgical treatment of acute Achilles tendon rupture with Achillon has advantages of mini-invasion,a low rate of incision problems and quick function recovery.

Objective To analyze CT characteristics of spherical pneumonia in order to differentiate it from other lesions especially lung cancer. Methods The CT and X-ray film of 25 cases diagnosed clinically as spherical pneumonia were analysed retrospectively.Results CT features of 25 patients were summarized as follow : ⑴Lesions were usually located in the posterior lung fields.(2)The central part of the lesions showed high density, while periphery part of lesion were low in density and blurred. (3)The bilateral margin of lesions were straight, and the lesions appeared square or triangular in shape. ⑷Margins of the lesions may be irregular and blurred. ⑸There were marked pleural reaction around the lesions and some times pleura diffusely thickening occurred. ⑹Vascular marking around the lesions were exaggerated increase and thickened, nevertheless they were not stiff. Conclusion CT is valuable in diagnosing and differential diagnosing spherical pneumonia.

Objective To develop a field psychological emergency rescue chest to improve mental health service during disaster relief.Methods The instruments and medicine involved in for mental health were determined based on service orientation,function design and expert survey,and the psychological emergency rescue chest was developed based on optimization of the external and internal structures of field Ⅳ-type chest.Results The chest developed was composed of office instruments,psychological devices,logistics instruments and first-aid medicine for mental health.conclusion The chest gains advantages in design,structure,size,transport,utilization,equipped devices and function integration,and thus is worthy promoting for field mental health service during disaster relief.

Objective To analyze the mortality in the aged patients with hip fractures who have been treated by operations. Methods We collected the clinical data of 349 aged patients (60 to 98 years old) with hip fracture who had been treated by operations from March 1999 to January 2008 in our hospital. Their overall mortality and one-year mortality were analyzed to find the causes for death. Results Thirty-one cases died and the overall mortality was 8.9% (31/349). Nineteen patients died within one year and the one-year mortality was 5.4% (19/349). Three patients died in hospital after surgery, 28 patients died in the follow-up period. Cardiac event, pulmonary dysfunction, cancer, cerebral vascular disease, hepatic cirrhosis, multiple organs dysfunction and infection were sequentially the major causes for death. Statistical results showed the factors which had definitely influenced the mortality were age and sex. Patients treated with proximal femoral nail anti-rotation (PFNA) had the lower mortality than with proximal femoral nail (PFN). Conclusions Operations can lead to a low mortality for aged patients with hip fractures. Ad-equate preparation and mini-invasive surgery can reduce the mortality.

Objective To evaluate the therapeutic efficacy of ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi. Methods Clinical data of 56 cases with complicated ureteral calculi who were treated with ureteroscopic pneumatic lithotripsy was reviewed. Among them 15 cases were proximal ureteral calculi,41 cases were middle and distal ureteral calculi. Treatment by extracorporeal shockwave lithotripsy (ESWL) failed in 25 cases,8 cases complicated with fever. Results In 41 cases with middle and distal ureteral calculi, successful lithotripsy was achieved after the first treatment session,the success rate was 100.0% (41/41). In 15 cases with proximal ureteral calculi ,successful lithotripsy was achieved in 10 cases after the first treatment session,the success rate was 66.7%(l0/15). Calculi migrated to kidney in 3 cases who treated by ESWL for 1-2 times. The failure was due to ureteral kink in 1 case and due to ureteral perforation that required surgical repair in another case. Forty-nine cases were calculi-free after 4 weeks,the calculi-free rate was 87.5%(49/56). Emergency operation was performed in 8 cases complicated with fever. Successful lithotripsy was achieved after the first treatment session in 7 cases. In one patient,calculi migration occurred. Within all 8 cases obstruction was released and fever was allayed after operation.The complication rate was 1.8% (1/56). Conclusion Ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi is a safe and effective method.

Objective To evaluate the effectiveness and safety of rectal ultrasound-guided agon- hilium percutaneous cryoablation in treatment of patients with median and or late-stage prostate cancer patients. Methods Retrospectively analysis of 42 cases of with stage C and D prostate cancer patients treated by rectal ultrasound-guided argon&ilium percutaneous cryoablation during the follow-up of 1--12 months. The prostate specific antigen (PSA), biochemical progression-free survival (bPFS), PSA objective response, transrectal ultrasound of the prostate (TRUS), TRUS-guided biopsy of the prostate, the maximum urinary flow rate(MFR), MRI examination at before, and 3,6,12 months after cryoablatian were recorded and evaluated. The results were statistically evaluated by using variance analysis. Results The PSA value at before and 3, 6, 12 months after cryoablation were (4.48±1.35), (3.54±1.67), (3.18±1.76), (2.87±1.89) ug/L, respectively; TRUS-messured prostate volumes at before and 3, 6,12 months after cryoablation were (59.7± 8.2),(46.9±8.3),(26.2±3.9),(25.9±3.7)mm3, respectively; MFR before and 3, 6,12 months after cryoablation were (10.4±0.8), (14.3±1.2), (18.3±1.3), (18.9±1.3) ml/s, respectively; Compared with before cryoablation, the differences between before and after cryoablation was statistically significant( F = 53.93,747.92,3843.03,respectively, P<0.01). The bPFS rates in 3 months,6 months and 12 months were 95.2% (40/42), 95. 2% (40/42), and 90.5% (38/42), respectively. According to the PSA response, the total effective rate (CR 16 cases, PR 15 cases) at 12 months was 73. 8%, and SD was 16.7% (7/42), PD was 9.5% (4/42). Complications included temporary incontinence 2.4% (1/42), Penile tingling/numbness 2.4% (1/42), pelvic pain 4.9% (2/41) and Scrotum Edema 2.4% (1/42). There was no case with severe complications such as severe infection or urethrorectal fistula, etc. Condusions Rectal ultrasound-guided agon-hilium percutaneous cryoablation showed is a well tolerated and has better early clinical efficacy to the treatment of stage C and D prostate cancer.

Objective To analyze the varus deformity of caput humeri and its correlation with fuuctional outcome of unstable proximal humeral fracture managed with locking plate.Methods The study involved 62 patients (24 males and 38 females,at age range of 32-83 years,mean 63.7 years)with proximal humeral fracture who were treated by open reduction and locking plate internal fixation from May 2008 to June 2010 and had full follow-up data.According to Neer classification,there were 11 patients with two parts fractures,41 with three parts fractures,five with four parts fractures and five with dislocation.Their clinical results were evaluated with Constant-Murley scores.ResultsThe mean duration of follow-up was 20.3 months (range,14-37 months),which showed fracture healing in all the patients.There were 11 patients with varus deformity of the caput humeri. The significant difference was found in Constant-Murley score of shoulder function ( P =0.045 ),forward elevation ( P =0.006 ) and abduction (P =0.022) between the varus and non-varus groups.But there was no significant difference in shoulder external rotation( P =0.08 ).The fracture types ( P =0.037 ) and varus deformity of caput humeri ( P =0.006) were closely correlated with the shoulder function between two groups.ConclusionsThe varus deformity of caput humeri mav be predictive factor for poor outcome of the unstable proximal humeral fracture. Restoration of humeral head-shaft alignment and sound reduction should be done as possible during operation.