Purpose To investigate the MRI characteristics and differential diagnosis of intraventricular meningioma. Materials and Methods The clinical manifestation and MRI characteristics was retrospectively analyzed in the 11 patients with confirmed intraventricular meningioma by pathology. Results The intraventricular fibrocellular meningioma (7 cases) showed iso- and slightly short T1 signal and short and heterogeneously iso-T2 signal. The syncytial (1 case) and mixed (1 case) miningioma in the fourth ventricle, the syncytial meningioma in the third ventricle, and endothelial meningioma in the septum pellucidum (1 case) all showed slightly long T1 and slightly long T2 signal. Pathology results showed that 7 cases of fibrocellular meningioma in lateral ventricle, 1 case of syncytial meningioma and mixed type in the fourth ventricle, 1 case of syncytial meningioma in the third ventricle, 1 case of endothelial meningioma in septum pellucidum Conclusion The fibrocellular type was commonly encountered for the lateral ventricle meningioma, and hypointensity on T2WI could be regarded as its typical MRI characteristics, and it is diffcult for the differential diagnosis for the other intraventrical meningiomas.

[Objective]To investigate the surgical method and clinical effects of the anterior approach operation in the treatment of thoraco-lumbar vertebral fractures through limited incision.[Method]Thirty-four cases of bursting fracture of thoracolumbar vertebral body were treated with the operation of anterior decompression,bone grafting and internal fixation by the anterior retropleuro-peritoneum approach.The MRI combined with clinical examination,X-ray,CT results were taken as selection criteria of treatment.[Result]Thirty-four cases were treated with this operative technich.Hemorrhage capacity is about 300-800ml with average 600ml.The operation time was 2-2.5 hours.All patients were followed-up with an average period of 18 months(ranged,6-24months).No aggravation of nerve injury appeared in 34 cases.X-ray manifested good fusion,no broken nails and no recurrence of kyphosis was found in all cases.[Conclusion]Anterior approach operation through limited incision is an effective way for severe thoracolumbar fractures. It has significantly low complication and allow early recovery of function.

The interaction between the anti-Ractopamine (Rac) monoclonal antibody and the Rac derivation immobilized on the sensor chip surface was studied with surface plasmon resonance (SPR) biosensor. A continuous detection method based on the linear response during the association phase was developed. The sensor chip surface was regenerated after several tests performed continuously, thus the detection step was simplified and the life span of the chip was prospected to be prolonged. The detection was performed as an inhibitive immunoassay. The mixture of anti-Rac monoclonal antibody and the sample flowed over the surface with Rac derivation was immobilized. The relative response was in inversely proportion to the concentration of Rac. The detection limit was less than 4 μg/L with a detection time of 15 min.

Objective To investigate the the operative time of two stage soft ureteroscope lithotripsy for hemorrhagic embolism after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 1 patient with massive hemorrhage after PCNL who treated with superselective renal artery embolization and ureteral soft lens were analyzed.Results The patient with postoperative bleeding after PCNL was treated with superselective renal artery branch embolization,after 30d embolization,the holmium laser lithotripsy under the soft ureteroscope for ureteral calculi was performed,and the renal pelvis mucosa smooth,no bleeding and scar formation were intraoperative visible.After operation,the stone was removed basically,and the double J tube was removed 2 weeks after operation.The patient had no special discomfort and the renal function was normal.Conclusion Postoperative 14-30d is a relatively safe time to perform flexible ureteroscopic lithotripsy for super selective renal artery embolization in the treatment of patient with massive hemorrhage after PCNL.

Objective To investigate the associations between the single nucleotide polymorphisms of TERT rs2736098, CLK3 rs11543198 and bladder cancer. Methods 201 bladder cancer cases and 200 healthy controls were included in the research, and the genotypes of TERT rs2736098 and CLK3 rs11543198 were determined using the PCR-RFLP method. Relationship between genotypes and bladder cancer risks was investigated. Results There were statistical significance in the rs2736098 genotype frequencies and allele frequencies between cases and controls (χ2= 6.973, P = 0.031; χ2= 7.412, P = 0.006). Compared with the individuals with the GG genotype , the risk of bladder cancer increased 2.069 times with the AA genotype (OR = 2.069, 95%CI: 1.181-3.624, P = 0.011). And there were no significant associations between the rs11543198 genotype frequencies and allele frequencies between cases and controls (χ2 = 0.202, P = 0.904; χ2 = 0.188, P = 0.665). Rs2736098 and rs11543198 genotype distribution in bladder cancer pathologic grade and stage had no statistical significance (P > 0.05). Conclusion Rs2736098 polymorphism is associated with risk of bladder cancer and rs11543198 polymorphism was not associated with risk of bladder cancer.

Objective To evaluate effect of combined corpeetomy for multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).Methods Fifteen patients with CSM or OPLL,including 9 males and 6 females,were treated with combined corpectomy which is characterized by C4 and C6 corpectomy,excision of osteophyma,protruded disc and/or ossified posterior longitudinal ligament on basis of preservation of C5 vertebral body,structural bone grafting in C3-5 and C5-7,and anterior cervical plate fixation at C3,C5,and C7.The clinical results were evaluated with Japanese Orthopaedic Association (JOA) score.X-rays and CT scans were taken to evaluate vertebral fusion,and MRI was used to access spinal canal decompression and condition of spinal cord.Results All patients were followed up for 9 to 42 months (average,26.7 months).Bony fusion was achieved in all 15 patients.The JOA score improved from preoperative 13.44±2.81 to postoperative 16.16±2.19 (P=0.0354).The cervical lordosis improved from preoperative 1.16°±11.74° to immediately postoperative 14.36°±7.85° (P=0.00217),and 12.92°+6.17° at the final follow-up (P=0.00292).The complications included temporary hoarseness in 2 cases,dysphagia in 1 case.Conclusion The combined corpectomy for treating CSM and OPLL can obtain reliable and satisfactory results.In operation,the preservation of C5 vertebral body can provide an additional screw anchoring force and strengthen stahility.

Objective:To investigate the risk factors affecting the occurrence of perioperative complications in patients with locally progressive gastric cancer undergoing radical gastric cancer treatment.Methods:The clinical data of 129 patients with locally progressive gastric cancer from January 2017 to December 2019 in Shaanxi Provincial People′s Hospital were retrospectively analyzed, including 98 males and 31 females, with an age ranged from 27 to 79 years and a mean age of (60.61±10.00) years. The postoperative complications of 129 patients with gastric cancer were firstly counted, and then the relationship between clinical data such as patients′ general condition, intraoperative status and pathological indexes and the occurrence of perioperative complications was analyzed by using univariate analysis, and significant factors were included in the logistic regression model for multifactor analysis to study the independent risk factors for the occurrence of perioperative complications.Results:Of the 129 patients, 25 cases (19.38%) had postoperative complications, including 10 cases (7.75%) with Clavien-Dindo classification combined with grade Ⅲ or higher complications. The results of univariate analysis suggested ACCI score >4 (30.76% vs 68.00%, χ2=11.86, P=0.001), body mass index ≥25 kg/m 2 (24.03% vs 60.00%, χ2=12.18, P=0.001), and preoperative hypoproteinemia (17.30% vs 36.00%, χ2=4.25, P=0.039), vascular cancer embolism (14.42% vs 40.00%, χ2=7.70, P=0.006), operative time ≥ 400 min (26.92% vs 52.00%, χ2=5.84, P=0.016), intraoperative bleeding ≥ 400 mL (13.46% vs 44.00%, χ2=12.03, P=0.001) were risk factors for the development of perioperative complications in patients with locally progressive gastric cancer. Multifactorial analysis showed that ACCI score >4, body mass index ≥25 kg/m 2, preoperative hypoproteinemia, vascular cancer embolism, and intraoperative bleeding ≥400 mL were independent risk factors for the occurrence of perioperative complications in patients with locally progressive gastric cancer ( P<0.05). Conclusions:The occurrence of perioperative complications in locally progressive gastric cancer hands was closely associated with ACCI score, body mass index, preoperative hypoproteinemia, vascular cancer embolism and intraoperative bleeding. ACCI score is expected to be a predictor of the occurrence of perioperative complications in patients with locally progressive gastric cancer.

OBJECTIVE: To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture. METHODS: Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically. RESULTS: All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover. CONCLUSION Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; complications ; surgery ; Fractures, Compression ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Multiple Trauma ; classification ; Spinal Fractures ; classification ; complications ; surgery ; Sternum ; injuries ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

Purpose The clinical manifestation of insufficiency fracture (IF) is in lack of specificity,thus it is prone to misdiagnosis.This paper aims explore imaging characteristics of 99Tcm-MDP whole-body bone scan and local SPECT/CT tomography for IF in the anticipation to improve its cognition and diagnosis capability to imaging manifestations.Materials and Methods Thirty patients who were diagnosed as IF by follow-up or imaging in Affiliated Hospital of Southwest Medical University from September 2015 to September 2016 were enrolled.The imaging features of their whole-body bone scan and local S PECT/CT tomography were retrospectively analyzed.Results For 30 patients,20 cases were single bone lesion,and 10 cases were multiple bone lesions.Lesions on the whole-body scan were represented as developer concentration of different level.Fracture line,sclerosis rim/line,soft tissue swelling,wedge-shaped or concave deformity of the vertebra could be observed on the images of SPECT/CT scan.Osteoporosis of different level could be seen on all the 30 patients.No bone destruction could be seen on the lesions and no obvious soft tissue mass around the lesions were formed.Conclusion Manifestation of whole-body bone scan and local SPECT/CT scan of IF is with certain specificity and is of significance in the early-stage diagnosis and differential diagnosis of IF.

Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.