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.

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.

Objective To evaluate the technique of Kirschner with a hole and tensile developed from the Kirschner tensile band wire.Methods Forty-two cases with fracture of patella and 23 cases with fracture of ulna olecranon were successfully operated with this apparatus.Average age was 42 years old(range,24～78 years),including 38 male patients and 27 females totally.Results Fracture healing rate was 100%,the rate of excellent and good result was 95% after 9 months to 3 years follow-up.No tenderness,skin penetrating caused by the bolt ends,and loosen fixations were found.Conclusion This apparatus can be considered as a rigid,safe and effective method and can meet the biomechanics principle of the Kirschner tensile band wire,complication of the Kirschner tensile band wire could be avoided by using this technique.

Objective: To investigate alteration and cross link of the aortic intima and platelet endogenous L-Arg/NOS/NO pathway induced by water immersion restraint (WIR) stress. Methods: After 7 h of WIR stress, the aortic intima was isolated and prepared the platelet, then NO_2- production released from aortic intima and platelet was measured with Greiss regent, NOS activity and L-arginine transport activity were detected by isotope tracer method. Results: After 7 h of WIR stress, the levels of NO_2- from platelet and aortic intima obviously decreased by 57% and 46% respectively as comparied with the control rats (P

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 Pulmonary artery atresia (PAA) with intact ventricular septum (IVS) is an anatomically heterogeneous entity. A variety of surgical strategies is possible. We sought to evaluate the clinical results of various surgical corrections of PAA with IVS. Methods A retrospective review of our surgical database revealed 17 patients with PAA and IVS operation between January 1992 to August 2004. There were 9 males and 8 females. The age ranged from 15 days to 12 years [(25.5?7.9) months]. The body weight was 3.5 to 28.0 kg [(7.8?5.4) kg]. Radical operation was performed in 10 cases with the Z score -2.3～1.2 (-0.78?0.34), the pulmonary artery index (PAI) 149.53～297.89 mm~2/m~2 (206.35?82.15 mm~2/m~2). Two infants received BT shunt operation for the severe hypoxia at first postoperative day. Palliative operation was performed in 6 cases with the Z score -6.1～0.2 (-2.7?0.92), the PAI 39.88～218.29 mm~2/m~2 (131.85?72.93 mm~2/m~2), including bi-directional Glenn bypass (2 cases), systemic-to-pulmonary arterial (BT) shunt (1 case), right ventricular outflow tract (RVOT) reconstruction and BT shunt (3 cases). One patient accepted one and a half ventricular repair, first underwent bi-directional Glenn bypass operation, two years later ,underwent ASD occulsion、PDA occlusion and RVOT reconstruction. Results 3 patients(16.7%) died at perioperative time [two patients who had the radical operation, but next day, had the BT shunt operation, one patient had the right ventricular outflow tract (RVOT) reconstruction and BT shunt]. The rest recovered smoothly. The main complications included low cardiac output in 3 patients, hypoxemia in 3 patients, hydrothorax in 1 patients and right heart failure in 3 patients. Conclusion Surgical outcome for patients with the PAA with IVS maybe satisfactory, strategries are to be chosen according to the anatomic subtypes such as the tricuspid valve diameter, right ventricular size, pulmonary artery index and coronary anatomy.

Objective To establish GC and GC/MS qualitative and quantitative analysis methods for identification of cocaine cases. MethodsChoosed and optimized the best analysis parameters of cocaine by GC/MS and GC. We prepared 0.10, 0.20, 0.40, 0.60, 0.80, 1.00, 1.20mg/ml ethanol solution of cocaine standard which all contained 0.6mg/ml diazepam (internal standard) to study the analyse standard curve and the detection limit of cocaine drugs. ResultsThe linear equation of cocaine by GC/FID was Y=1.055X-0.0021, R2=0.9999; That of GC/NPD was Y=0.556X-0.0016, R2=0.9996; The detection limits of cocaine were 10ng by GC/FID method and 2ng by GC/NPD method. On the other hand, we used GC/FID and GC/NPD methods and internal standard to quantitate the cocaine drugs sized by police respectively, the result of concentration was 72%?2.3%. The quantitative data of both methods had good repeatability. ConclusionThe methods established are useful to examine and identify cases of cocaine.