Objective To investigate and evaluate the clinical value of trepanation and drainage in bilateral chronic subdural hematoma aged patients.Methods Chose 52 bilateral chronic subdural hematoma aged patients received trepanation and drainage for objects of study,and analyzed the clinical data of these patients.Results The procedure was successful in all 52 patients and no death was related to the procedure.Only 5 patients recurred after operations.Conclusion Trepanation and drainage possesses high application value in bilateral chronic subdural hematoma aged patients,due to its slight injury,high success rate and low complication.

Objective To study the CT signs of bronchotracheal transparent foreign body and its diagnostic value.Methods The X-ray and CT findings of bronchotracheal trasparent foreign body in 46 cases were analysed comparativly.Results Among 46 cases,9 cases of trachea foreign body,13 cases of right bronchial foreign body,7 cases of left bronchial foreign body,2 cases of both sides of bronchial foreign body were showed directly by CT,and 8 cases of right bronchia foreign body,6 cases of left bronchia foreign body,1 case of both sides of bronchia foreign body showed indirectly on CT,the sensitivity was 100 percent,while the foreign body and its anatomical location could not be showed on X-ray film,but the indirect signs just like pulmonary emphysema,obstructive pulmonitis and drowned lung etc,could be showed by X-ray films in 34 cases.In another 12 cases were negative,the sensitivity was 73.9 percent.Conclusion The transparent foreign body can not be showed but indrect signs by X-ray film;While CT scan can not only shows the anatomical location of foreign body,but also the shape and size of the foreign body,it offers more information than X-ray films and has important refering value to clinicians to take out the foreign body.

Objective To evaluate the diagnostic value and technique advantage of 16-slice CT angiography(16SCTA) in aortic dissection.Methods 39 cases of aortic dissection underwent 16SCTA.The data were reconstructed by multiplanar reconstruction(MPR),curved planar reconstruction(CPR),volume rendering(VR),maximum intensity projection(MIP),virtual endoscopy(VE),and generally analyzed in combination with original axial images.Results According to DeBakey's classification,DeBakey's type Ⅰ in 5 cases,type Ⅱ in one case and type Ⅲ in 33 cases were founed in the 39 cases.16SCTA clearly showed that including the ture and false lumen(39 cases,100%),intimal flaps(39 cases,100%),intimal tear(25 cases,64.1%),and thrombus inside the false lumen(17 cases,43.6%).Conclusion 16SCTA may be as the first choice method in diagnosis of aoric dissection,and which is considered as having great value.

Objective To evaluate CT staging and resectability of esophageal carcinoma.Methods The esophageal barium examination,esophagoscopy and CT scan were performed in 42 cases with esophageal carcinoma.CT findings were put the stress on analyzed.Results CT clearly demonstrated the location, thickness, actual length and extent of esophageal carcinoma as well as its relation with surrounding structures in all 42 cases.According to staging standard of Moss and Reining there were four stages,Ⅰ stage 0 case,Ⅱ stage 33 cases,Ⅲ stage 6 cases,Ⅳ stage 3 cases.In all cases,operations were in 34 cases,detecting were in 3 cases,no-operations were in 5 cases.Conclusion CT imaging playes an important role in preoperative diagnosis,staging and the evaluation of resectability of esophageal carcinoma.

Objective To investigate the effect of hypoxia-inducible factor (HIF)-1α and vascular en-dothelial growth factor (VEGF) on the angioge-nesis of rheumatoid arthritis (RA). Methods The collagen-induced arthritis (CIA) model was set up in male Wistar rats. The pathological angiogenesis and expression of HIF-1α and VEGF in the synovia different time points were observed by H&E and immunohistochemistry staining. Results The expressions of HIF-1α and VEGF on CIA synovium were significantly elevated and their expression increased gradually with the prolonged disease course. Both synovial HIF-1α expression and VEGF expression were correlated significantly with the pathological angiogenesis score. Synovial lining and sublining HIF-1α expression were correlated significantly with VEGF expression respectively. Conclusion H1F-1α may play an important role in the pathogenesis of RA by upregulating the expression of VEGF and then promoting angiogenesis.

Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.

Objective To investigate the effect of vascularized fibula with fibular flap to repair limb bones and soft tissue defects.Methods Transpositional fibulas were used to repair tibiae defects in 4 cases.Free fibular transplantation was used in 6 cases,including folded fibular transplantation in 3 cases distal femur repair in 2 cases,calcaneus repair in I case.Hole fibular transplantation was used in 11 cases to repair tibia radius and metatarsal bones.Semi-fibular transplantation was used to repair metacarpal bone defects in 2 cases.All transplanted bones were together with the flap to repair bones and soft tissue defects.Results Twenty cases were all survived,with bone healing time of 6 to 10 weeks,and weight bearing time of 3 to 6 months,fifteen cases were followed up for 6 months to 4 years,and the results showed that their transplanted bones became thicker,their lower limbs recovered to normal walking,hand grip function recovered,the transplanted flaps were elastic.Conclusion Vascularized fibula and fibular flaps transplantation was an effective way to repair limb bones and soft tissue defects.

Objective To explore the applied value of the super-short exposure time of the DR adjustable control in radiography of infant chest.Methods 100 chest radiographic films of infant in adjustable control group and fixed control group respectively were selected randomly.The quality of all films was evaluated by 4 technicians in charge in 4 grades(A,B,C and waste)and the detective rate of the tiny parts of the images was also evaluated.Results DR adjustable control:the rate of grade A,B,C and waste was 70%,20%,10% and 0% respectively.DR fixed control:the rate of grade A,B,C and waste was 42%,41%,15% and 2% respectively.The detective rate of tiny parts was 100% and 90% in DR adjustable control group and DR fixed control group respectively.Conclusion DR adjustable control chest film in infant is better than DR fixed control in image quality.DR adjustable control system is good for radiographic diagnosis.

Objective To evaluate the feasibility and clinical efficacy of lateral femoral circumflex artery perforator flaps and fit together in the treatment of limbs complex wound surface.Methods From January 2010 to March 2012,use the characteristics that the descending branch of lateral femoral circumflex artery extend its branches over the flap,fascia and skin,to form lenticulostriate arteries,which contain 2 to 3 different species tissues fits together,flaps cover the important tissues such as vessel,nerves and bones.Fascia covers the tendinous tissues etc.Muscle can not only cover the tissues,but also fill in the space,and followed by skin grafting.This research was to perform the treatment for 4 cases of lacking limbs ring tissue,three cases of multiple wound surface,six cases of hand avulsion injury of skin and 9 cases of Gustilo grade-Ⅲ C.Results As for the 22 cases in the research,nineteen cases of flaps survived,the other 3 cases were necrosis with length of 1cm to 2 cm at distal and self-healed later.During 6 months to 2 years followed-up of 18 cases,external flaps were satisfactory,skin grafting over the fascia layers develops very well,smooth with great elasticity,no recoil,and no color change.Conclusion Lateral femoral circumflex artery is one of effective restoration methods for limbs with complex wound surface.

Objective To study the material attribute of articular cartilage.Methods An improved 4 parameters inhomogeneous triphasic model based on 3 parameters model was developed to estimate the uniaxial modulus Ha of cartilage and to predict the swelling pattern of cartilage.Results The results showed that more accurate uniaxial modulus can be extracted using 4 parameters inhomogeneous triphasic model,and the predicted results appeared to match the experimental strain data better than other models.Conclusion Inhomogeneous 4 parameters triphasic model can describe the depth-dependent material attribute of articular cartilage more exactly.