Objective To describe a minimal invasional surgical procedure for the treatment of avulsion fracture of tibial intercondylar eminence. Methods From July 1999 to December 2000, 26 cases of avulsion fracture of tibial intercondylar eminence were treated. With the arthroscope, reduction and absorbable suture fixation of anterior cruciate ligament or the avulsion fracture were performed. Taking the advantage of ACL－ aimer, bone tunnels, through which the suture can be pulled out and tied outside the joint, could be accurately produced. Results Twenty-two patients were available for 2－ 17 months(mean 10.5 months) follow-up. Seventeen patients gained normal range of motion, 5 have limited flexion but exceeded 90 degrees. X－ ray demonstrated bone union in all the cases and anatomical reduction obtained in 21 cases. Conclusion Arthroscopically guided operation, gives less trauma, and is a simple and effective method for the avulsion fracture of the tibial intercondylar eminence.

Objective To evaluate the effect of a new one-piece PHEMA keratoprosthesis(Kpros) implanted in alkali burned rabbit corneas. Methods The experiment included two parts. In part one, the porous discs of PHEMA were inserted into the lamellar pockets of alkali-burned corneas and the results were observed clinically and histologically at various periods. In part two, seven one-piece Kpros were implanted into alkali burned rabbit corneas. The Kpros consisted of a central transparent optical area and a porous semi-transparent peripheral skirt. The surgical procedure was similar to that of penetrating keratoplasty. Clinical observations were carried out till 28 weeks. Results Both the porous discs and one-piece Kpros had been retained during the experiment. Severe complications as cataract, retro corneal membrane, retinal detachment and extrusion of material were not found until 28 weeks. There was no calcification in the samples, and inflammation was mild. Two weeks after implantation, fibroblasts and deposition of collagen were found in the pores of PHEMA discs. The fibroblasts in the pores look healthy and functionally active. The preliminary results were satisfactory. Conclusion This new one-piece Kpros had shown good biocompatibility. The porous peripheral skirt fuses well with the bed of burned cornea and proved to be stable. PHEMA materials is suitable for one-piece Kpros.

Objective To analyze the impacts of early enteral nutrition (EN) and parenteral nutrition (PN) on the prognosis of acute pancreatitis.Method By searching relevant literature between January 1996 and August 2013 in Chinese and English databases including Wanfang,VIP,CNKI,PubMed,the Cochrane Library,CBM,and EMABSE,we compared the prognosis of acute pancreatitis after EN or PN in terms of casefatality rate,infections,multiple organ failure,and other complications.Result Compared with PN,early EN significantly reduced the case-fatality rate [OR =0.37,95％ CI (0.23,0.58),P ＜ 0.000 1],decreased the infection rate [OR =0.24,95％ CI (0.15,0.39),P ＜0.000 01],shortened hospital stay [MD =-9.87,95％ CI (-10.84,-8.89),P ＜ 0.000 01],and reduced complications [OR =0.26,95％ CI (0.12,0.58),P =0.001 0] in patients with acute pancreatitis,although the incident of multi-organ failure showed no significant difference [OR =0.35,95％ CI (0.10,1.19),P =0.09].Conclusions For patients with acute pancreatitis,early EN is superior than PN in terms of case-fatality rate,infection rate,hospital stay,and complications.Therefore,it should be applied in such patients whenever condition allows.

Objective To evaluate the findings of computerized tomography (CT) imaging in patients with primary pulmonary fungal infections.Methods CT findings and clinical data of 18 cases of primary pulmonary fungal infections from 2004 to 2012 were retrospectively analyzed.The diagnoses of all patients were confirmed by pathology or serology.Results The CT of primary pulmonary fungal infections showed soft tissue density nodules in 15 out of 18 cases,and masses in 3 out of 18.By pathology or serological examination,there were 12 cases of Aspergillus infections,3 cases of cryptococcal infections and 3 cases of coccidioidomycosis.The CT findings of all of the 12 cases of Aspergillus infection showed quasi-circular shaped lesions,with lobulation and spiculation (6/12),bronchial through syndrome (3/12),the air crescent sign (6/12),or mediastinal/hilar lymphadenopathies (3/12).Six cases presenting air crescent sign were all diagnosed with primary pulmonary aspergillosis.Among 12 aspergillosis cases,6 cases underwent CT enhancement scan,among which 3 showed no enhancement and 3 showed slight enhancements.The CT findings of all eases of Cryptococcus neoformans infections were cauliflower-like shape,with lobulation,spiculation,and no focal point calcification or mediastinal/hilar lymphadenopathies.After enhancement,all of the lesions were enhanced heterogeneously.The CT findings of all the coccidioidomycosis were irregular shaped lesions with halo sign and mediastinal/hilar lymphadenopathies.All 3 cases of halo signs were diagnosed with primary coccidioidal infections.Conclusions The CT findings of primary pulmonary fungal infections have certain characteristics.Diagnosis could be made based on CT imaging together with clinical manifestations before pathological results are available.

Objective To investigate the contribution of Cystatin C to the preoperative diagnosis and clinical therapy of gastroenteric tumor.Methods Using surgical materials from patients with stomach, colon and rectum cancer, immunohistochemisty, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis were performed with antibodies against Cystatin C.Cystatin C of the cancerous and paired noncancerous lesions were determined by enzyme-linked immunosorbent assay (ELISA).Results (1)Immunohistochemical staining of Cystatin C was evident expression in cancer cells and associated stromal tissues, this was not the case in paired noncancerous tissues,there were also statistical relationship between the expression of Cystatin C in cancerous and that in noncancerous tissues (?~2=6.825,P

AlM: To evaluate the application of phacoemulsification of different nucleus density using ozil and traditional mode.METHODS: A total of 89 eyes (72 patients ) ( visual acuity was of 0. 6 and above after 1mo follow - up) of different nucleus density level (LOCS Ⅱ criteria grade Ⅲ 46 eyes, grade Ⅳ and more 43 eyes ) were randomly assigned into 2 groups: ozil group (group A), grade Ⅲ 22 eyes (torsional energy 80% lP on);grade Ⅳ and more 17 eyes (torsional energy 100% lP on); Traditional mode group(group B), grade Ⅲ 24 eyes (energy 50% ), grade Ⅳ and more 26 eyes (energy 60% ~ 70% ) . All surgeries were performed by the same experienced surgeon,who use the chop to split the nucleus in the application of phacoemulsification. lntraoperative parameters were total equivalent pawer ( TEP ), cumulative dissipated energy ( CDE ) and effective phaco time ( EPT ) and surgical complications. The effectiveness of the two modes in dealing with hard - core cataract phacoemulsification were compared.RESULTS: GradeⅢ nucleus dealing: TEP of ozil group was significantly higher than that of the traditional mode group [(24.58±7.78)% vs (13.84±1.97) %]and EPT of ozil group was significantly lower than that of the traditional mode group (50. 59±14. 73 s vs 60. 19±9. 04 s, P<0. 05). CDE showed no difference between two groups [(13.12±6.03)% vs (13.38±2.85)]. Grade Ⅳ and more nucleus dealing: CDE [( 34. 10 ± 13. 48 )%] and EPT (104. 64±32. 4s) of the ozil group was higher than CDE [(30. 31 ± 13. 48)%] and EPT (93. 01 ± 41. 01s) of the traditional mode group, but there were no difference between two groups. Obstacles in the needle of phacoemulsification surgery: ozil group 4/17, traditional mode group 2/26 (χ2=2. 16, P=0. 14).CONCLUSlON: Bothozil and traditional mode can deal with all kinds of nucleus effectively and safely. Ozil mode is more efficacy and quick deal in gradeⅢnucleus. With the increase of nucleus hardness, the traditional mode still have the advantage of high efficiency and no obstacle to dealing patients with grade Ⅳ and more nucleus. Choose according to different nuclear hardness ultrasonic model can improve the operation efficiency and security.

Carcinoma ; classification ; pathology ; Carcinoma, Papillary ; Female ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; classification ; pathology ; Tracheal Neoplasms ; secondary

Objective To evaluate the short-term therapeutic effect and radiation reaction of stereotactic radiotherapy for early stage non-small cell lung cancer in the elderly patients. Methods Thirty-one patients with stage Ⅰ - Ⅱ non-small cell lung cancer were treated with stereotactic radiotherapy. Patients aged 70-88 years, median age 76; 21 were stage I patients, and 10 stage Ⅱ ; 14 patients had tumor

Abstract?AlM: To compare the in- the- bag lOL stability of different size of continuous curvilinear capsulorhexis ( CCC) in super high myopic eyes with cataract underwent phacoemulsification.?METHODS: A total of fourteen cataract patients with bilateral super high myopia were included, Phaco+lOL implantation were performed on both eyes, one eye was randomly classified into 5mm diameter CCC observation group, the fellow eye was 6mm diameter CCC observation group. Cataract extraction combined with in-the-bag intraocular lens implantation ( lOL ) with the type of hydrophilic acrylic aspheric intraocular lens ( MCX11 ) by well experienced surgeon. The operation was running smoothly, the next day after operation, all patients were confirmed by lmage-pro plus6. 0 image analysis software for the measurement of main meridian sac diameter with target capsulorhexis diameter no more than ±0. 2mm. Slit lamp examination of lOL shape and position, changes of anterior capculorhexis edge, refraction, anterior chamber depth was measured and observed of all eyes after operation 1wk;1, 3, 6mo.? RESULTS: Compared with postoperation 1wk, the former sac diameter of two groups were slightly smaller at postoperation 1mo, with no statistically significant difference between two groups. 5mm diameter CCC observation group had slightly hyperopic shift in follow-up 1-3mo, 6mm diameter CCC observation group had hyperopic shift in follow-up 1mo, and getting stable after 1mo. Refraction change was related to anterior chamber depth changes. 5mm diameter CCC observation group had 3 minor loop folding in follw-up 3mo.?CONCLUSlON:Relatively smaller continuous curvilinear capsulorhexis in super high myopic eyes underwent cataract surgery may cause a tendency of uneven construction or effective lens position change of in-the-bag lOL. Unusual refraction change or shift after operation 1mo could suggest instability of lOL, early noticing or interruption could prevent further complications.

Objective To investigate the influence of CT-guided thermochemotherapy for pig's healthy pancreas and in turn to discuss the feasibility and efficacy on pancreatic tumors.Methods 9 healthy pigs were undergone CT-guided 80℃themochemotherapy with 18 G fine meedle injecting individually of 5-Fu 750mg(10 ml)into the pancreatic tail within 2min.CT,MRI and serum analyses test were carried out as the follow up study at 1h,3rd,7th and 14th day after the procedure;since the 3rd day,3 pigs were sacrificed right after every follow up and together with comparative study between diagnostic imagings and pathologic changes. Results The pig pancreatic tail necrotic lesions appeared to be most conspicuous at the 3rd day after thermochemotherapy and shrank gradually from 7th day to 14th day.Serum amylase level reached the highest at 3rd day after the treatment and lowered down at 7th day;and near approximately normal at 14th day.The outcomings of diagnostic imagings and macroscopic pathology were in accordance.Obvious pancreatitis occurred only in one pig and all others were nearly uneventful without serious complications of pancreatitis,intestinal adhesion and mortaligy.Conclusion CT-guided themochemotherapy can induce pancreatic,focal necrosis in healthy pig but with no serious complications;and these can further more establish the foundation for clinical practiee.(J Intervent Radiol,2007,16:844-846)