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.

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 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 evaluate the enhanced magnification endoscopy in the diagnosis of Barrett esophagus,and to explore the relationship between mucosal surface patterns and pathological epithelial types of Barrett esophagus.Methods Enhanced magnification endoscopy was performed 'after spraying 2%-3% acetic acid on the surface of distal esophagus in 40 Barrett esophagus patients.Mucosal specimen were biop- syed.Results According to the mucosal types of Toyoda in 2003,there were three mucosal types:Ⅰ dot pat- tern 7(17.5%),5 of 7(71.4%)fundie type,Ⅱ reticular pattern 24(60.0%),16 of 24(66.7%)fundic type,Ⅲ cerebroid/villous 9(22.5%),intestinal metaplasia or dysplasia.Conclusion Enhanced magnifi- cation endoscopy helps to identify areas with intestinal metaplasia and dysplasia,and is useful in the diagno- sis of Barrett esophagus.

Objective To evaluate the clinical application and significance of lengthen-stem bipolar-femur prosthetic replacement for the treatment of old-age patients with intertrochanteric fracture osteoporosis.Methods 28 cases of patients aging from 75 to 99 years old of intertrochanteric fracture osteoporosis treated with lengthen- stem cemented bipolar prosthesis were studicd from March 2000 to December 2006.After taking the blank margin, the bones of different sizes were replaced and the steel wire was fixed.After determining the depth of the front an- gle,the artificial bone was placed.Results After 28 examples attaining the following-up examination for 7 months to 3 years,with an average of 1.5 years,its function according to Harris standard was evaluated 3 months after the operation,8 examples were excellent,13 examples good,5 examples pass,2 examples inferior.The excellent or good rate reached 75% ,with no abnormal cases,no joint dislocation during the followed-up period.1 example had the phantom phenomenon 1 year after the operation.2 examples among the inferior had got more serious internal medicine disease which affected the restoring function.1 example died of the internal medicine disease 1 year after the operation.Conclusion By using the lengthen-stem bipolar-femur prosthetic replacement for the treatment of old patients with inrertrochanteric fracture osteoporosis,the patients will restore quickly after the operation and can carry a heavy load at an early time.The illness complication and the mortality rate will be redaced.But its related disease must be strictly dealt with and the surgery operating skill must be grasped.

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