Objective To explore the musculoskeletal MR findings in dermatomyositis and to evaluate the role of MR in diagnosis of dermatomyositis. Methods Twenty patients with early dermatomyositis and 25 patients with active disease confirmed by pathology underwent T 1-weighted (SE 450/20), T 2-weighted (FSE 4000/100), and fat-suppressed MR images. MR findings in these 45 patients were analyzed. Results Within all the myositis, MR showed symmetrical slight high patchy signals on T 2-weighted and STIR images in the muscles of bilateral thighs, but the morphology of muscles appeared normal in 26 patients, while limited high signals only appeared on STIR image in 19 patients. There was correlation between serum muscle enzymes and the signal intensity as well as affected field of myositis. The myositis often affected gluteus and the external lateral muscles in the lower part of thighs. Inflammatory changes in the subcutaneous fat in 18 patients with active dermatomyositis were the severe appearance of the disease. Inflammatory fascia in 17 patients was found in both early and active cases. 5 patients had skin damage. Conclusion MR features of dermatomyositis are multiple myositis, fascia and subcutaneous inflammation, with the latter being an appearance of severe period of the disease. Early affected location of dermatomyositis is gluteus and the external lateral muscles in the lower part of thighs. MR is an efficient examination and STIR is a sensitive sequence in the diagnosis of dermatomyositis.

Objective To investigate the efficacy of using the extensor carpi ulnaris as the motor tendon in correcting claw hand deformity and improving hand function.Methods A total of 12 patients with ulnar nerve palsy and claw finger deformity were included into this study from October, 2009 to September, 2011.Results All ceses had an average followed-up of 15.5 months, ranging from 12 months to 24 months.According to the Total Active Movement (TAM) score, there were 4 cases receiving excellent results, 6 cases receiving good results and 2 cases receiving fair results.The claw finger deformity was corrected and intrinsic hand function improved significantly.The average increase in grip strength was 41％ at the 12 months post operation, compared with the preoperative data (P ＜ 0.05).The mean DASH score decreased from 53.6 ± 11.4 preoperatively to 20.4 ± 6.8 postoperatively (P ＜ 0.05).Conclusion The technique of using the extensor carpi ulnaris as the motor tendon is effective in correcting claw fingers, increasing the grip strength and improving overall hand function.This surgical procedure is also beneficial for patients accompanied by the median nerve injury.

OBJECTIVE: To evaluate function and application of various biomaterials in tissue engineering repair skull defect, and to seek a reasonable skull substitutes. METHODS: Using "tissue engineering, skull defect, stem cells, cytokines, composite" as key words in Chinese, and using "tissue engineering, skull defect, mesenchymal stem cells, cytokines, materials" as key words in English, a computer-based online search was performed for publications from January 1993 to October 2009. Articles concerning biomaterials and tissue engineering skull defect repair were included. Articles describing repetitive study or Mete analysis were excluded. Function of various biomaterials in tissue engineering repair skull defect was assess in 17 articles. RESULTS: Stem cell technique is to obtain seed cells from a few myeloid tissues. Following in vitro induction and amplification, cells at a certain number could compound with stents, and construct tissue-engineered bone in vitro. The cells could sustain the biological features of osteoblasts, and fuse with bone tissue in the recipient site. Simultaneously, it could avoid the occurrence of immunological rejection. Two or over materials were compounded together, or biomaterial surface received various modification. These could promote adhesion between cells and materials, elevate cell bioactivity and maintain biological function. Following moved into seed cells using some vectors, the latter ossified in bone defect site, and secreted suitable bone growth factor, induced the differentiation of peripheral non-oriented osteogenitor cells into oriented osteogenitor cells, which could harvest adequate seed cells with osteogenic activity in a short time, and accelerate the healing of skull defects. The composite made by using three-dimensional virtual imaging and computer numerical control modeling techniques has the advantages of medical composite, precise anatomical consistency with surrounding tissues of skull defects, and perfect appearance. CONCLUSION: At present, no material can be accorded with the requirement of bone tissue engineering. Combination of some materials or modification of biomaterial surface can promote adhesion of cells and materials, elevate cell biological activity, and maintain biological function, which are presently hot focus of tissue engineering research of biomaterials.

Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.

Objective To investigate the diagnostic value of the early slope value of enhancement in differentiating benign from malignant musculoskeletal masses.Methods Dynamic contrast-enhanced gradient-recalled acquisition in the steady state imaging(GRASS) was performed to evaluate 36 musculoskeletal masses(18 malignant,18 benign).The difference of the early slope value of enhancement was analysed and compared between benign lesions and malignant ones.Using ROC curve plotting obtained the best decisive threshold.Spearman rank correlation analysis was used to determine the relation between slope and microvessel density of tumor tissues.Results The average early slope value of enhancement was (4.33?2.70)% per second (range 0.97%～10.50% per second)for malignant lesions,and was (1.46?0.97)% per second(range 0.37%～3.86% per second)for benign ones.There was an apparent statistical significance between benign and malignant tumors(?

Objective To investigate the brain activation map during substraction and multiplication tasks in health adults.Methods 13 volunteers were undergone two tests of substraction and multiplication in the form of block-design.The fMRI data were analyzed by SPM99 software with statistic t-test to generate the activation map.Results In substraction ,the left middle frontal gyre(MFG),inferior frontal gyre(IFG),superior parietal lobule(SPL),inferior parietal lobule(IPL),angular gyre(AG),superior temporal gyre(STG),the right MFG,SPL,IPL , bilateral visual association cortex and cerebellum were activated.In multiplication , the left superior frontal gyre(SFG),MFG,IFG,SPL,AG,the right SPL,precentral gyre(PCG) and bilateral visual association cortex were activated.Conclusion (1)The bilateral prefrontal areas,parietal cortex and occipito-temporal areas are involved in calculation and have the function of working memory ,numerial manipulation and visua-space attention;(2)The cerebellum is involved in cognitive arithmetic.

Objective To evaluate the surgical treatment of old patients with acute perforated gastroduodenal ulcer. Method The age, complications, duration of the disease history, operative method, systemic inflammatory response syndrome (SISR) and multiple organ dysfunction syndrome (MODS) in 89 old patients with acute perforated gastroduodenal ulcers were analyzed retrospectively. Results Simple closure operation was performed in 78 cases and subtotal gastrectomy in the other 11 cases. Twelve patients died. The mortality and complications rate were significantly lower in the patients less than 70 -year old than those in the patients more than 70-year old (P

BACKGROUND:Currently, there are a lot of studies addressing oral microflora variation in patients wearing fixed orthodontic appliance. OBJECTIVE:To determine the changes in Streptococcus mutans, Lactobacil us and oral health in teenagers wearing metal orthodontic appliances. METHODS:Twenty-three who were subjected to fixed metal orthodontic appliances as testing group and 18 adolescent volunteers with no oral diseases served as controls. We col ected saliva samples from al the participants immediately, 90 days and 180 days after fixed metal orthodontic treatment to detect changes in Streptococcus mutans and Lactobacil us, which can lead to dental caries, and other oral parameters, including gingival index and oral hygiene index. RESULTS AND CONCLUSION:In the control group, there were no difference in Streptococcus mutans, Lactobacil us, gingival index and oral hygiene index at three time points. In the testing group, the hazard levels of Streptococcus mutans and Lactobacil us were significantly increased at 90 and 180 days than immediately after fixed metal orthodontic treatment (P<0.05), as wel as the gingival index at 90 days and oral hygiene index at 180 days became worse (P<0.05). At 180 days after fixed metal orthodontic treatment, the hazard levels of Streptococcus mutans and Lactobacil us, gingival index and oral hygiene index were severer in the testing group than the control group (P<0.05). These findings indicate that the fixed metal orthodontic appliance could lead to increasing of Streptococcus mutans and Lactobacil us, and reduce oral health status badly.

Objectives:To explore the influence of nutritional support treatment on patients with the injured pancreatitis. Methods:The twenty five cases with injured pancreatitis were divided into research group (13 cases of 1997-2001, with nutrition support) and control group (12 cases of 1992-1996,without nutritional support). Blood composition, biochemistry, complications, hospitalization time and mortality were compared between two groups. Results:WBC, amylase, glucose, transaminase and BUN were beginning to decrease in two days, and reached to normal limits in 6～7 days in research group. Lymphocyte count after treatment in research group was significantly different ( P

OBJECTIVETo study clinical effects of a new internal fixation by using a cable through the bone and Kirschner with a hole in the tail, for the treatment of patellar fractures.

METHODSFrom May 2012 to July 2013, thirty-four patients with patellar fractures were treated with cable through the bone and Kirschner with a hole in the tail. All the patients had close fracture,including 12 transverse fractures and 22 comminuted fractures. There were 18 males and 16 females, ranging in age from 26 to 81 years old, with an average of (46.0 ± 3.0) years old. After open reduction, two appropriate length of Kirschner with a hole in the tail were driven into the patella as perpendicular to the fracture line or the major fragments as possible. A transverse bone tunnel was then drilled with a Kirschner at one side of the patella. Then the cable, which was successively pulled through the bone tunnel and the hole of Kirschner, was crossed in a figure-eight over the anterior of the patella, tightened and fixated by special instruments. The Kirschner was clipped off on the edge of the hole. If it was a comminuted fracture, another cable was used to fasten the patella with cerclage. Postoperative evaluation was based on Bostman.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 26 months, with a mean of (16.0 ± 2.0) months. Fractures healed in all the cases without such complications as infection, loosening of Kirschner and cable loop, and skin irritation. According to the Böstman score system, 33 cases got an excellent result, and 1 good.

CONCLUSIONThe cable through the bone and Kirschner with a hole in the tail is a simple, stable and effective method for the treatment of patellar fractures, especially the transverse fractures, with earlier knee exercise and fewer complications.

Adult ; Aged ; Aged, 80 and over ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Patella ; injuries ; surgery ; Treatment Outcome ; Young Adult