Objective To explore the imaging typing of skull eosinophilic granuloma( SEG) in children,and the clinical significance of this typing system was determined. Methods The clinical and radiological data of 32 cases of SEG confirmed by pathology in the past six years were retrospectively reviewed. According to the imaging findings,which included the size and shape of the granuloma,and the degree of skull destruction,SEGs were divided into four types:typeⅠ( subtle granumoma) ,typeⅡ( exteriorly convex granuloma) ,typeⅢ( biconvex granuloma) and typeⅣ(multiple granulomas and destructions). The imaging features of different types of SEG were analyzed,and the signif-icance of imaging typing was explored combining with the clinical manifestations,treatment programs and prognosis. Results Three cases (9. 4%) were included in typeⅠ,in which,the granuloma was not obvious and the skull destruction was confined in the diploe and outer plate. In type Ⅱ (21 cases,65. 6%),the imaging features included an obvious exteriorly convex mass and complete skull destruction of in-side and outside panels. Granuloma remove and destructed skull repair were performed in all cases,in which 15 were followed up and no re-currence was found. The imaging features of type Ⅲ (5 cases,15. 6%) were biconvex mass which broke through the inner plate and op-pressed the dura and cerebral parenchyma. Therapy program included not only surgical excision of the lesion but also repair of skull and dura. Three cases were followed up and no recurrence was found. Type Ⅳ (3 cases,9. 4%) showed multiple skull destructions and granulomas of various sizes. Chemotherapy and surgery treatment,poor prognosis and ease recurrence were characterized by this type. Conclusion we put forward a imaging typing method for SEGs. This typing system is helpful in guiding clinical protocols and prognosis of SEGs in children.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.

Objective To observe the effect of Xiaoxianxiong Decoction combined with metformin on glucose and lipid metabolism of phlegm-heat type 2 diabetic patients (T2DM). Methods Totally 104 phlegm-heat T2DM patients were randomly divided into two groups (each contains 52 cases), and given the diabetes lifestyle intervention. Control group additionally took 0.5 g metformin twice daily. And treatment group, besides taking 0.5 g metformin, was given Xiaoxianxiong Decoction, one dose and three times per day warmly. After 12 weeks, FBG, HbA1C, TC, TG, HDL-C, LDL-C, 2 hPG of the two groups were determined, and the therapeutic effect was evaluated. Results The total effective rate in the treatment group was 92.31%, and 76.92%in control group (P<0.01). The difference in symptom score, FBG, 2 hPG, TC, TG, HDL-C and LDL-C between the two group were significant, so as that between before and after treatment of both groups (P<0.05). Conclusion Xiaoxianxiong Decoction combined with metformin can effectively lower the levels of blood glucose and blood lipid in phlegm-heat T2DM patients, enhance the therapeutic effect and improve the metabolism of glucose and lipid.

Blood Gas Analysis ; Hepatopulmonary Syndrome ; therapy ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Treatment Outcome