OBJECTIVE: Based on contiguous axial computed tomography (CT) images of the frontal sinus, a three-dimensional (3D) visualization and reconstruction of fronto-ethmoidal cells was performed using Intage Realia (version 2011) software to generate a model to accurately understand the anatomical structure of fronto-ethmoidal cells. METHOD: Retrospective analyses of nose CT scan data of 50 patients without sinusitis were performed. Using Digital Imaging and Communications in Medicine (DICOM) images of sinus axial CT scans, the 3D visualization and reconstruction of the sinus was performed using the Achilles tendon and nasal passage modes in Intage Realia (version 2011) software on personal computers. Two segmentations were performed on the reconstructed sinus, and the structures of the agger nasi, frontal cells, and supraorbital cells and the relative locations of the frontal sinus drainage pathway and cells were observed. RESULT: The 3D visualization of the fronto-ethmoidal cells and frontal sinus drainage pathway was successful, allowing accurate observation of the anatomical characteristics of the fronto-ethmoidal cells. CONCLUSION The 3D visualization of fronto-ethmoidal cells can be reconstructed based on contiguous axial CT images of the sinus, allowing an accurate understanding of the anatomical structure of fronto-ethmoidal cells and is well prepared for frontal sinus surgeries.
Frontal Sinus ; anatomy & histology ; surgery ; Humans ; Image Processing, Computer-Assisted ; Nasal Cavity ; Nose ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis ; Software ; Tomography, X-Ray Computed

Objective To compare the effects of sevoflurane versus propofol on a tourniquet-induced lower extremity ischemia-reperfusion (I/R) injury in patients undergoing orthopedic operation.Methods Fifty-four ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 44-85 kg,scheduled for elective orthopedic operation,were randomly assigned into 3 groups (n =18 each)∶ control group (group C),propofol group (group P) and sevoflurane group (group S).After lumbar plexus-sciatic nerve block,the laryngeal mask airway insertion was facilitated with propofol 2-4 mg/kg and anesthesia was maintained with infusion of propofol at 2-4 mg· kg-1 · h-1 during operation in group P.In group S,8 ％ sevoflurane was inhaled,the laryngeal mask airway was inserted and anesthesia was maintained with inhalation of 2％ sevoflurane during operation.A tourniquet was applied and inflated (300 mm Hg)during 15-20 min after administration of propofol or sevoflurane in groups P and S,and a tourniquet was also applied at the same time point in group C.The tourniquet was released at the end of operation.Postoperative analgesia was performed with oral meloxicam or intramuscular pethidine and VAS score was maintained ＜ 3.Blood samples were taken after admission to the operating room (T1) and 30 min after tourniquet release (T2) to determine the plasma concentrations of MDA and TNF-α.The changing rate of MDA and TNF-α concentrations was calculated.The tourniquet-related adverse events and amount of analgesics consumed within 24 h after operation were recorded.Results No tourniquet-related adverse events occurred in all the patients.Compared with group C,the plasma concentrations of MDA and TNF-α and changing rate were significantly decreased at T2 in groups P and S (P ＜ 0.05).There were no significant differences in the plasma concentrations of MDA and TNF-α and changing rate between group S and group P (P ＞ 0.05).Compared with the baseline value at T1,no significant change was found in the plasma concentrations of MDA and TNF-α at T2 in groups P and S (P ＞ 0.05),and the plasma concentrations of MDA and TNF-α were significantly increased at T2 in group C (P ＜ 0.05).There was no significant difference in the amount of analgesics consumed within 24 h after operation between the three groups (P ＞ 0.05).Conclusion Both sevoflurane and propofol can reduce a tourniquet-induced lower extremity I/R injury in patients undergoing orthopedic operation and the efficacy is comparable.

ObjectiveTo study the clinical effect of locking compression plate fixation in treatment of the elders with unstable fractures of the distal radius. Methods17 cases with unstable distal radius fractures were treated by volar locking compression plate. The function of the carpal joints and the bone healing conditions were evaluated after operations. ResultsAll cases were followed-up for 7 to 16 months ( mean 12. 6 months). Union was obtained in all the patients after 11.4 weeks. The clinical outcomes were evaluated according to modified X-rays and wrist assessment. 12 cases were graded as excellent and 4 as good. 1 case were graded as poor. The overall satisfactory rate was 94. 1％. ConclusionThe unstable distal radial fractures could be effectively treated with open reduction and LCP fixation through volar approach.

Objective To investigate the curative effect and the feasibility of treating femoral neck fractures with cannulated screw fixation.Methods Twenty-three patients with femoral neck fractures were treated with cannulated screw fixation,their average age was 51 years old(range,12～86 years),including 7 male patients and 16 females totally.Garden Ⅱ 2 cases,Garden Ⅱ 6 cases,Garden Ⅲ 12 cases,Garden Ⅳ 3 cases.A patient who suffered from fractures displacement needed traction for 3～7 days before surgical operation and the opening reduction was necessary if reduction was not satisfactory.Results During the follow-up 11～33 months the rate of nonunion was 9%(2 cases) and the rate of avascular necrosis was 13%(3 cases).Conclusion Trectin femoral neck fracture with cannulated screw fixating is very simple and the trauma is small.This may improve the cure rate of the femoral neck fractures and it is easy to be spreaded across the basic-level hospital.

Objective To investigate the serum level of vascular endothelial growth factor (VEGF) in patients with coronary artery disease (CAD) and its clinical significance. Methods The study included 36 patients with CAD and 10 non-coronary heart disease patients as the control. The concentrations of serum VEGF in the coronary veins and the aorta were measured by an enzyme-linked immunsorbent assay (ELISA). Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and were cultured in M199 medium supplemented with 20% fetal bovine serum. After 7 days culture, attached cells were collected. The effect of VEGF on the migration of endothelial progenitor cells (EPCs) were assayed with modified Boyden chamber assay. Results The serum VEGF levels of stable angina pectoris (SAP) patients (208.46?44.74 ?g/L) and acute coronary syndrome (ACS) patients (267.29?93.99 ?g/L) were much higher than that of the controls group (120.77?26.25 ?g/L,P

Objective To survey the value of quantitative detection of urinary endotoxin for the diagnosis of gram-negative bacteria infection in urinary system,in order to provide evidences for early diagnosis and treatment.Methods The levels of urinary endotoxin were detected by kinetic turbidimetric technique,at the same time urine was cultured and WBC,CRP were detected.Results In 379 patients with gram-negative bacteria infection in urinary system,132 patients were upper urinary tract infection and 247 were lower urinary tract infection.The level of WBC,CRP and endotoxin were 11.25(7.98,13.99)× 109/L,81.36(76.64,83.50)mg/L and 49.57(17.28,78.37)pg/ml in upper urinary tract infection patients and in lower uri-nary tract infection patients were 10.24(7.94,12.24)×109/L,70.46(70.46,77.32)mg/L and 21.18(21.18,37.31)pg/ml. The group of upper urinary tract infection was higher than lower urinary tract infection on CRP and endotoxin,and have sig-nificant difference between the two groups of patients (P<0.05).Analysis of ROC,the diagnostic Cut-off value of 39.7pg/ml,the sensibility and specificity of endotoxin for the diagnosis of gram-negative bacteria infection on upper or lower urinary system were 84.1% and 90.3%.Conclusion The levels of urinary endotoxin detected by kinetic turbidimetric technique is simple and efficient,and have significant diagnosis value of gram-negative bacteria infection on upper or lower urinary sys-tem.

BACKGROUND:Different operation approaches can be selected during the repair of thoracolumbar fractures. Traditional posterior median approach wil cause great wound on patients, and easily induces some adverse consequences. OBJECTIVE: To compare the effects and biocompatibility of conventional posterior median approach and paraspinal approach fixation for treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on clinical data of 53 cases of thoracolumbar fracture in the Shaanxi Province Nuclear Industry 215 Hospital from December 2012 to December 2013. They were divided into two groups according to approach method. The control group (n=27) received pedicle screw placement fixation through conventional posterior median approach. The observation group (n=26) underwent pedicle screw placement fixation through paraspinal muscle approach. After repair, they were folowed up for 12 months. Imaging results, pain score and perioperative relevant indexes were observed and compared in both groups. RESULTS AND CONCLUSION: Imaging examination was conducted before repair, immediately after repair and during final folow-up in both groups. The height of vertebral anterior border and kyphosis correction effect were good after different therapies in both group, but no significant difference was detectable between the two groups (al P > 0.05). These findings suggest that height of vertebral anterior border and kyphosis correction effect were identical between the two groups. Pain visual analog scale score was significantly lower in the observation group than in the control group at 24 hours and 3 days after repair and during final folow-up (al P < 0.05). Perioperative relevant indexes were analyzed in both groups. Intraoperative bleeding amount, drainage and bed time after repair were observed in the observation group, which showed significant advantages as compared with the control group (al P < 0.05). These results confirmed that compared with the traditional posterior median approach surgery, minimaly invasive pedicle screw placement through paraspinal muscle approach for thoracolumbar fractures can obtain better repair effects and biocompatibility.

Objective] To study the determination of telomerase and CEA in differentiating benign and malignant pleural effusions. [Methods] Telomeric repeat amplification ELISA method(TRAP- PCR-ELISA) and enzyme immunoassay(EIA) were measured in 40 patients with malignant pleural effusion and 38 cases of benign pleural effusion telomeres activity and CEA levels. [Results] The telomerase activity in pleural effusions and CEA positive rate in malignant pleural effusion group were 80.0%(32/40) and 85%(34/40), benign pleural effusion group was 7.9%(3/40) and 0%(0/38), malignant pleural effusion of telomerase and CEA-positive rate was significantly higher than benign pleural effusion group, the difference was significant(χ2=40.96,57.26, P<0.001).Determination of telomerase activity in malignant pleural effusion diagnostic sensitivity and specificity of CEA rather, the difference was not statistical y significant(χ2=0.35, P>0.05). Two combined detection of tumor markers in terms of a positive diagnosis of malignant pleural effusion as the standard, the combined detection sensitivity was 97.5%(39/40), significantly higher than the telomerase and CEA single detection sensitivity 80% and 85%, the differences were statistical y significant(χ2=6.13,3.91,P<0.01). [Conclusion] Detection of the TA and CEA in pleural effusion is of a definite value in differentiating benign from malignant pleural effusion, and the detection of TA is more sensitive and specific than detection of CEA. Combining detection of both markers may raise the accuracy of the diagnosis.

Traditional Chinese medicine owns the duality of commodity property and quasi-public goods in the process of production and circulation. According to the duality of traditional Chinese medicine, giving full play to government function is the key to guaranteeing and promoting the quality and security control in the dryness process of traditional Chinese medicine. Government functions mainly focus on improving the quality and security control ability of production operators and stimulating quality and security control motive of producers. This article began with the duality of traditional Chinese medicine, expounded the government functions in the dryness process and quality control of traditional Chinese medicine from macroscopic and micro levels, and proposed the measures of improving dryness process based on government functions.

To ensure the quality of direct digital radiography images, the management and control of image quality, basic adjustment of facilities post-processing, and raising technicians' professional quality mut be performed. To protect patients from radiation should be emphasized in medical staffs. Radiation should be reduced when ensuring the images' quality, and green examination concepts should be advised.