Objective To evaluate diagnostic value of X-ray computed tomography(CT) neck masses in children.Methods Clinic,pathologic diagnosis and CT scans of 26 patients from Jan.2004 to Jun.2006 with neck masses which location,density,edge and near construction were reviewed retrospectively.Results Seven cases in neck anterior area,13 cases in neck lateral area,6 cases in other areas or unconfirmed.Eight cases with lower density than cervical muscles,2 cases with same density,2 cases with higher density,14 cases with mixed density.Inflammatory masses were observed in 13 cases,congenital malformation in 11 cases,thyroiditis in 1 case,pharyngeal tumor-like proliferation in 1 case.Conclusion CT scan is the best choice of diagnosis of neck masses in children,and is valuable to diagnosis associated with history and physical examination.

OBJECTIVETo determine the mechanism of pseudo-tears of the lateral meniscus caused by the transverse geniculate ligament (TL) and the miniscofemoral ligament(MFL) and to investigate a method to differentiate pseudo-tears from true tear of the lateral meniscus.

METHODSForm June 2012 to February 2014, MR examinations of 72 knees (44 left knees and 28 right knees) without tear of the lateral meniscus verified by arthroscopy were performed in the sagittal and coronal plane. There were 41 males and 31 females in the group, with an average age of 33.7 years old (ranged from 25 to 61). The MR appearance of the TL and the MFL was carefully observed.

RESULTSThere existed fatty tissue in the gap between the TL and the anterior horn of the lateral meniscus and its central tendinous attachment. On the sagittal images, the fatty tissue formed a linear high-signal cleft between the TL and the anterior horn of the lateral meniscus. This might be mistaken as an oblique tear within the anterior horn of the lateral meniscus. It was called as pseudo-tears of the anterior horn of the lateral meniscus. In sagittal plane, the MFL was identified as a circle-like or short stick-like area of low signal intensity anterior or posterior to the posterior cruciateligament. Nevertheless, a belt-shaped area of low signal intensity from the posterior horn of the lateral meniscus to lateral facet of the medial femoral condyle was identified in the coronal plane. A linear area of high signal intensity between the MFL and the lateral meniscus was found in sagittal plane, which might be mistaken as an oblique tear within the posterior horn of the lateral meniscus. It was called pseudo-tears of the posterior horn of the lateral meniscus. The occurrence rate of the TL was 34.7% (25/72). The prevaleribe of pseudo-tears of the anterior horn of the lateral meniscus was 18 cases. The shape of the anterior horn of the lateral meniscus was regular, and the course of the pseudo-tears cleft was oblique. The occurrence rate of the MFL was 73.6% (53/72), which included the anterior MFL 23.6% (17/72), the posterior MFL 70.8% (51/72) and the two ligaments coexisted 16.7% (12/72). The prevalence of pseudo-tears of the posterior horn of the lateral meniscus was 25 cases. All observed pseudo-tears had either in posteroinferiorly oblique direction (19/25) or in vertical direction (6/25).

CONCLUSIONBased on the location and direction of pseudo-tears and observation in the continuous sagittal plane and the coronal plane, pseudo-tears is easily differentiated from the true tear of the lateral meniscus

Adult ; Female ; Humans ; Knee Injuries ; diagnostic imaging ; surgery ; Knee Joint ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; diagnostic imaging ; surgery ; Middle Aged ; Radiography ; Tibial Meniscus Injuries

OBJECTIVETo explore the diagnostic value of 3D-indirectmagnetic resonance (MR) arthrography in detecting meniscustears of the knees.

METHODSForm January 2013 to January 2014, routine plain MR of the knees followed by the 3D-indirect MR arthrography was performed in 42 patients with suspected meniscal tears clinically. There were 31 males and 11 females, with an average age of 38.4 years old (ranged, 21 to 67 years old). The duration of the course ranged from 2 h to 15 d. The clinical symptom was knee pain. All the patients got subsequently arthroscopic examination or operation. The sensitivity and specificity of routine plain MR and 3D-indirect MR arthrography were compared based on the results of arthroscopic examination or operation.

RESULTSThe signal intensity in the area of meniscal tears on image of 3D-indirect MR arthrography was obviously higher than that of routine plain MR. The sensitivity of 3D-indirect MR arthrography was 85.79% (87/102), while the routine plain MR was 52.94% (54/102), and the specificity improved from 67.78%(61/90) to 86.67%(78/90). The difference was statistically significant (χ2 = 25.90, P < 0.01; χ2 = 9.13, P < 0.01).

CONCLUSIONIn comparison with the routine plain MR findings, 3D-indirect MR arthrography demonstrates meniscus tears of the knee with the better sensitivity and specificity.

Adult ; Aged ; Arthrography ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Knee Injuries ; diagnosis ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Tibial Meniscus Injuries

Objective To study the effects of cooking practice education on their status of nutrient intake and blood glucose control in patients with type 2 diabetes mellitus (T2DM) over 60 years old.Methods Four-hour cooking practice education lecture was offered per month for 57 patients with T2DM over 60-year old based on balance diet and food exchange list,with features including requiring patients joining the lecture with their family members together,demonstration of raw and fresh dietary materials and cooked food,choice of food to eat by the patients themselves according to their own dietary regimen.Sixty patients with T2DM who were only educated by outpatient department of nutrition for 35 minutes were selected as control.After twelve months of education,indices such as scores of awareness of knowledge of food exchange list,status of nutrient intake and blood glucose control,and so on,were compared between the two groups to evaluate the effects of cooking practice education.Results After 12- month education,score of knowledge of food exchange list in the experiment group increased significantly,as compared to that in the control group.Intake of energy [(6304?826) kJ] and fat [(46?6) g] decreased significantly in the experimental group [(6921?860) kJ and (63?9) g,respectively],and fasting blood glucose [(7.1?0.8) mmol/L],postprandial blood glucose [(11.2?1.1) mmol/L] and glycosylated hemoglobin A1c [(6.2?0.5)%] were decreased significantly,as compared to those in the control group [(7.8?0.9) mmol/L,(12.4?1.2) mmol/L,and (6.5?0.7)%)],respectively.Conclusions Cooking practice education is effective to correctly use diet regimen and improve status of nutrient intake and control of blood glucoses for over-60-year patients with T2DM.

OBJECTIVETo explore the method of rapid detection of skin fungi and the significance of conventional diagnosis liquor worker tinea corporis and tinea cruris using arbitrarily primed polymerase chain reaction AP-PCR.

METHODSAmong liquor workers who were 50 tinea corporis patients, 58 tinea cruris patients and 50 health persons, we amplified the DNAs of the dermatophytes were amplified using AP-PCR and random primers OPD18 5'-GAGAGCCAAC-3' and OPAA11 5'-ACCCGACCTG-3', at the same time, the dermatophytes with microscope were detected and cultured.

RESULTSAP-PCR analysis detected fungal DNA in 45 patients(90.00%) among 50 liquor worker patients with tinea corporis, 31 patients(62.00%) had the positive results of microscope detection, and 41 patients(82.00%) had the positive results of standard culture. Among these workers who suffered from tinea corporis, T.rubrum, T.mentagrophyte, M. canis and E.floccosum were detected by AP-PCR. T.rubrum, T.mentagrophyte and M.canis were detected by standard culture. AP-PCR analysis detected fungal DNA in 53 patients(91.38%) among 58 liquor worker patients with tinea cruris, 37 patients(63.79%) had the positive results of microscope detection, and 48(82.76%) had the positive results of standard culture. Among the 58 workers who had tinea cruris, T.rubrum, E.floccosum and T.mentagrophyte were detected by AP-PCR and standard culture. Among 50 health persons, AP-PCR analysis detected fungal DNA in 3 persons(6.00%). The detection result with AP-PCR indicated that the kinds of fungi were T.rubrum and T.mentagrophyte. No one health person had the positive result in detection of fungi using microscope detection. Only one(2.00%) health person was detected to be infected by fungus with cultural way. The kind of fungus was T.rubrum.

CONCLUSIONAP-PCR is a rapid, sensitive and specific detection method for occupational dermatophyte patients. It can be used to detect and diagnose professional dermatophytosis.

Adolescent ; Adult ; DNA Primers ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; microbiology ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Tinea ; diagnosis ; etiology ; microbiology ; Young Adult

OBJECTIVE: To analyze the relation between the clinical outcome and the integrity of the facets after a lumbar operation,and to provide a reference for choosing operative method and clinical prognosis. METHODS: Forty-three patients with complete data underwent uni-segment discectomy were enrolled. There were 3 surgical interventions: open-window discectomy, full or semi-laminectomy. Groups were divided based on the integrity of the facets after the operation, and the clinical symptoms and signs were evaluated using the Japanese Orthopaedic Association Back (JOA) scores at 24-month follow-up. RESULTS: Preoperative JOA scores were not significantly different among the groups (P>0.05). Compared with the facet intact group at 24-month follow-up,JOA scores were descended statistically in total uni-facetectomy group and total uni-facetectomy plus partial opposite facetectomy group (P<0.01). CONCLUSION Keeping facets integrated plays an important role in achieving good clinical results,and the damage of facet should be avoided in the lumbar operation.
Adolescent ; Adult ; Diskectomy ; methods ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Laminectomy ; methods ; Lumbar Vertebrae ; Male ; Middle Aged ; Young Adult ; Zygapophyseal Joint ; surgery

OBJECTIVE: To design and manufacture a new type instrument and its matching tools for the proximal femur. METHODS: A new type instrument of subtrochanterical fracture-static 3-dimensional screw-plate system(STDSP)was designed and manufactured. The different types of accessory instruments which adapted to STDSP,the aiming guide, and the accessory tools were also designed and manufactured, and they were tested on bones. RESULTS: STDSP included 3 special lag screws and 1 anatomic plate. The lag screws distributed in femoral neck like "or"shape. There was 135 degree between the lag screws and femoral shaft. The shape of the plate was similar to the anatomic structure of the proximal thighbone. The posterior screw was stably connected to the plate. The plate was affixed crosswise to the lateral and anterior side by bicortical screws. The aiming guides and all kinds of accessory tools could help to install STDSP exactly and conveniently,which was verified on cadavers and X-ray photographs. CONCLUSION STDSP has the function of dynamic compressing in 3-dimensional space, and can match with the structure of the proximal femur preferably. STDSP may be a suitable instrument to the subtrochanteric fractures. The accessory apparatus of STDSP has simple configuration,and can let the STDSP be installed accurately, conveniently and rapidly.
Bone Plates ; Bone Screws ; Cadaver ; Equipment Design ; Fracture Fixation, Intramedullary ; instrumentation ; Hip Fractures ; surgery ; Humans

OBJECTIVETo explore CT and MRI manifestations of the axial area peripheral primitive neuroectodermal tumors (pPNETs) in order to improve the knowledge of this disease.

METHODSThe clinical data of 10 patients with pPNETs underwent pathologically confirmed were retrospectively analyzed from October 2008 to May 2014. There were 7 males and 3 females, aged from 8 to 49 years old with median of 23.6 years. The preoperative multi-slice spiral CT scan was completed in 3 cases, plain CT scan and enhancement in 4 cases; MRI and enhancement scanning in 5 cases; and among them, 2 cases underwent both MRI and CT scan.

RESULTSIn-bone type was found 6 cases and out-bone type was found 4 cases. Three cases occurred in sacral vertebrae, 2 cases in lumbar vertebrae, 1 case in cervical vertebrae, 1 case in cervical spinal canal, 1 case in coccyx, 1 case in the right iliac bone, 1 case in presacral space. Cross sectional the smallest tumor maximum level was 1.1 cmx 1.2 cm in size, the biggest tumor was 8.0 cm x 9.2 cm, the median size was 4.4 cm x 5.7 cm, of them, the tumor of maximal diameter larger than 5 cm had 6 cases. Except 2 cases-without destruction of bone, the other 5 cases with osteolytic destruction, 2 cases with calcification, 1 case with mixed. Equidensite was main in CT scan, 1 case with uniform density, other 6 cases with uneven density,in which 3 cases with "floating ice" change; 1 case with moderate strengthening, other 3 cases with obviously strengthening, 2 cases with multiple small blood vessels in enhancement scanning. MRI of 5 cases showed the signal of isointensity on T1WI, the slightly high signal on T2WI and the signal was not uniform; after enhancement scan, the signal of 5 cases obviously enhanced. Two patients complicated with vertebral compression fractures, no periosteal reaction was found in all patients, and no the destruction of intervertebral disk was found in 5 patients of MRI scan.

CONCLUSIONThe axial area pPNETs is common among children and the youth, and the mass often is huge. The mass of in-bone type often envelopes the vertebral body, and main located on prevertebral space, all associated with bone destruction, osteolytic destruction is common, and primary vertebral bodies also is common, attachment primary or involvement is few found, it can involve the spinal canal and anterior wall of spinal canal is common, some cases complicate with multiple newly born small vessels. The mass of out-hone type in deep soft tissue is common, minority primary spinal canal, many complicated with vertebral bone destruction, osteolytic destruction was main. The intervertebral disk was not invaded and intervertebral space has not stenosis. CT scan offer complicate with "floating ice" sign, and in-bone type is common. Isointensity is main on MRI TlWI and slightly longer signal is main on MRI T2WI, strengthening signal is obvious.

Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuroectodermal Tumors, Primitive, Peripheral ; diagnosis ; diagnostic imaging ; Radionuclide Imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To evaluate the operative method and the clinical efficacy of volar Barton's fracture treated by internal fixation with T type titanium plate. METHODS: We performed the operation of the open reduction and internal fixation with T type titanium plate in 18 patients with volar Barton's fracture. RESULTS: The 18 patients were followed up after the operation at the average time of 13 months (6 to 31 months). X radiographs showed that all patients achieved solid bone union. Mehara's evaluation for volar Barton's fracture revealed excellent outcome in 12 patients, good in 5 patients, and fair in 1 patients. The excellent and good rate of clinical results was 94.4%. X-radiographs showed that the volar tilting angle was 8-18 (mean=11.0) degree, and the ulnar inclining angle was 16-26 (mean=22.4) degree. There was no shortening of the radius. CONCLUSION The operative treatment with titanium T type plate fixation for volar Barton's fracture is in favor of fracture anatomic reduction, solid internal fixation, and catagmatic concrescence. It is beneficial for functional recovery of the wrist at the utmost. The outcome in the near future is satisfactory. It is an ideal method for volar Barton's fracture.
Adolescent ; Adult ; Bone Plates ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Radius Fractures ; complications ; surgery ; Recovery of Function ; Titanium ; Wrist Injuries ; surgery ; Wrist Joint ; physiology

OBJECTIVE: To investigate the curative effect of the treatment of reserving limb for patients with malignant bone tumor. METHODS: Forty patients with bone neoplasms underwent the operation of reserving limbs. The neoadjuvant chemotherapy was given to all the patients before the operation. After the ablation of the tumor we used the artificial prosthetic replacement,tumor tissue deactivation and reimplant, variant bone and joint transplantation to reserve the limb. RESULTS: All the patients were followed up. The average follow-up time was 34.8 months. Eight patients got complications. And the fineness rate was 72.5% according to functional evaluation standard of Enneking after surgical treatment of bone tumor. CONCLUSION The operation of reserving limb was an ideal method to cure the malignant bone tumor. The proper operative treatment with neoadjuvant chemo-therapy is helpful to extend the life of the patients and increase the quality of life.
Adolescent ; Adult ; Aged ; Artificial Limbs ; Bone Neoplasms ; drug therapy ; surgery ; Chemotherapy, Adjuvant ; Child ; Female ; Femoral Neoplasms ; drug therapy ; surgery ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Osteosarcoma ; drug therapy ; surgery ; Tibia ; surgery