ObjectiveTo explore the efficacy of large trauma craniotomy with bilateral frontal coronal incision in treating contusion and laceration of bilateral frontal lobes.MethodsThe clinical data of 68 patients with contusion and laceration of bilateral frontal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively.There were 36 cases(observation group) treated with large trauma craniotomy with bilateral frontal coronal incision and 32 cases (control group) given bilateral decompressive craniectomy by stages.The prognosis of two groups were observed and compared.The prognosis was evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.ResultsThere were 23 cases (63.89％,23/36) who got good recovery,8 cases(22.22％,8/36) with poor prognosis and 5 dead cases (13.89％,5/36) in observation group.There were 11 cases (34.38％,11/32) who got good recovery,9 cases (28.12％,9/32) with poor prognosis and 12 dead cases (37.50％,12/32) in control group.The rate of good recovery and mortality between two groups had significant differences (P ＜ 0.05).ConclusionsThe large trauma craniotomy with bilateral frontal coronal incision can significantly relieve or ease intracranial hypertension of patients with contusion and laceration of bilateral frontal lobes.And it can improve the prognosis and decrease the mortality.

With the improvement of the complexity of medical image synthesis and the demand for the accuracy of clinical radiotherapy, deep learning algorithm plays an increasingly important role in pseudo CT image synthesis and analysis. This paper classifies and analyzes the pseudo CT image synthesis technology based on deep learning method in terms of the types of image modes, and describes the ongoing application in radiotherapy.

8 cases of adrenal tumors were subjected to laparoscopy from October 2000 to June 2001.Success was achieved in 7 cases, one patient was convevted to open surgery because of bleeding. Recovery was uneventful in all without complication. The indications and technique of operation as well as complications were discussed.

More and more patients were treated by surgery with metal implants in clinic.Metal artifacts in CT images caused by metal implants brought challenges for postoperative evaluation and diagnosis of tumor.It also led to the possibility of missed diagnosis and misdiagnosis.In recent decades,the improved methods based on filtered-backprojection and iterative reconstruction algorithms have great progresses in reducing effects of metal artifacts.The actuality of techniques for metal artifact reduction were reviewed in this article.

Objective To perform modification study of cyanoacrylate (CA) medical adhesive and to select the optimal mo-difying material and the best ratio.Methods Carboxylic multi-walled carbon nanotubes (MWCNTs-COOH), multi-walled carbon nanotubes (MWCNTs), hydrophobic nano-silica, nitrile rubber, epoxy resin and polymethyl methacrylate (PMMA) were used to modify 5% triclosan/cyanoacrylate antimicrobial adhesive respectively. The bond strength, toughness and viscosity of the modified adhesive were examined in different concentrations.Results 0.064% MWCNTs-COOH, 6% nano-silica, 4% nitrile rubber and 6.4% epoxy resin all had good effects in strength modification. The bond strength were (14.71±1.48)MPa, (14.03±1.92)MPa, (14.6±1.78)MPa and (14.05±1.46)MPa respectively. 8% nano-silica had the lowest Tg of (1.1±0.24)℃ and the strongest viscosity of (15 536.68±28.4)cP. When the nano-silica concentration was 8%, the compound was very viscous and sticky. When the antimicrobial adhesive modified with 6% nano-silica, the bond strength was (14.03±1.92)MPa, the Tg was (3.6±0.68)℃, and the viscosity was (5 278.87±31.68)cP.Conclusion 6% nano-silica is the best modifying material, and has the optimal effect of modification.

Objective To explore the impact and value of 11C-MET PET/CT for high-grade glioma in making conformal radiotherapeutic planning compared with MRI.Methods From October 2011 to September 2013,11C-MET PET/CT and MRI were performed in 25 initial glioma cases and 9 recurrent cases.All 34 cases (19 males,15 females) were classified into initial group (n=17),initial surgery group (n=8) and recurrent group (n=9).GTV was outlined using PET/CT images combined with T1 weighted MRI images.Results 11 C-MET PET/CT optimized radiotherapy targets in 22 cases,including 7 initial cases,8 initial surgery cases and 7 recurrent cases.GTV was consistent with the volume of abnormally enhanced region on T1 weighted MRI (VMRI) in 10 initial cases,GTV＞VMRI in 5 cases,and GTV＜VMRI in 2 cases.GTV＜VMR1 in the initial surgery group.GTV was consistent with VMRI in 2 recurrent cases,GTV＞VMRI in 2 cases and GTV＜VMRI in 4 cases; 1 recurrent case's GTV located largely outside the VMRI.Conclusions There are some differences on locating the lesions of high-grade gliomas between 11C-MET PET/CT and MRI.Using 11CMET PET/CT in sketching radiotherapy target could significantly optimize the high grade glioma's radiotherapeutic planning,which may be more valuable in recurrent or operative cases.

ObjectiveTo analyze the clinical efficacy of open reduction and internal locking system (PHILOS) in management of three- and four-part proximal humeral fractures in the elderly patients.MethodsA retrospective study was performed on 18 elderly patients (age≥80 years) with proximal humeral fractures who were treated surgically from June 2008 to June 2010 and received complete follow-up.The fractures were Neer three- and four-part fractures and managed with PHILOS.Rehabilitation exercise was performed postoperatively and followed up regularly.ResultsThe patients were followed up for average 15.3 months,which showed sound healing of all fractures.Shoulder joint function was assessed by Constant-Murley score that was 55 to 83 points (mean 72.5 points) at 12 months,with an overall excellence rate of 67％.ConclusionOpen reduction and fixation with PHILOS can attain satisfactory clinical outcome for the elderly patients with three- and four-part proximal humeral fractures.

Objective To investigate the impact on registration accuracy with the different registration ranges of CBCT images and CT images.Methods CBCT and CT scans were performed on the of 5 patients.The registration ranges of five patients' images of abdomen,head and chest performed CBCT and CT scanning were processed with four modes.Mode 1:the registration range of CT images was larger than the registration range of CBCT images,mode 2:the registration range of CT images and CBCT images were equally,mode 3:taking a 5 cm translation of CT images range from mode 2,mode 4:The CBCT range and CT range reduced 2 cm both sides simultaneously from mode 2.Using the registration program from Insight Segmentation and Registration Toolkit (ITK) to the four modes,the Mean Square Difference (MSD) metric values of four modes after registration were compared and the relationship between mode 2 and another three modes was analyzed by paired t test.Results For the MSD metric values,mode 3 was maximum,mode 2 and 4 were minimum,and mode 1 was centered.The difference between the mode 2 and mode 4 was not statistically significant(P ＞ 0.05).The difference between the mode 2 and mode 1 was statistically significant(t =-4.586,-4.164,-5.618,P ＜ 0.05).The difference between the mode 2 and mode 3 was statistically significant(t =-6.423,-8.109,-19.601,P＜0.05).Conclusion The registration ranges of CBCT and CT images has a certain extent of influence on the accuracy of image registration.The closer the registration range of CBCT and CT is,the higher the registration accuracy is.

Following Escherichia coli lysis with alkali, cetyltrimethylammonium bromide (CTAB) was directly titrated into the supernatant. An easy and feasible technology for plasmid purification was established with the optimized proportion between the quantity of CTAB and plasmid, combined with the specific solution for DNA release and TritonX-114 for endotoxin removal. Quality detection showed that the purified plasmid was free of contamination of host RNA. The host bacterial genomic DNA, endotoxin and bacterial protein were less than 10 microg, 50 EU and 10 microg per mg plasmids, respectively. The ratio of OD260/OD280 was between 1.75-1.85. Eighty percent of the prepared plasmids were presented in the supercoiled form. The plasmid purified with this technology can satisfy all criteria stipulated by FDA. The main advantages of the technology include the avoidance of animal-derived enzymes such as ribonucleases A, Proteinase K and toxic reagents like chloroform and phenol. In addition, the technology has low cost and no pollution.
Cetrimonium Compounds ; chemistry ; Chemical Precipitation ; DNA ; genetics ; isolation & purification ; DNA, Bacterial ; genetics ; isolation & purification ; Escherichia coli ; chemistry ; genetics ; Plasmids ; genetics ; isolation & purification

Objective:To explore the risk factors for adverse cardiac events within 30 postoperative days in the aged patients with hip fracture.Methods:We retrospectively evaluated the clinical data of 1, 004 aged patients who had been admitted to Department of Orthopaedics, The 7th Medical Center, PLA General Hospital for hip fractures from January 2012 to December 2016. According to whether cardiac complications occurred within 30 days after operation, they were divided into 2 groups: a group with adverse cardiac events and a group free from adverse cardiac events. The 2 groups were compared in terms of age, gender, concomitant disease, timing of surgery, type of surgery and anesthesia mode. Multivariate Logistic regression analysis was used to determine the independent risk factors of adverse cardiac events 30 days after operation. In addition, the 2 groups were also compared in 30-day mortality, 1-year mortality, and total mortality postoperation.Results:Adverse cardiac events occurred in 45 patients (4.5%) within 30 days after operation. The multivariate Logistic regression analysis showed that advanced age ( OR=1.085, 95% CI: 1.033-1.139), chronic renal insufficiency ( OR=5.296, 95% CI: 2.172-12.910), cardiac insufficiency ( OR=2.938, 95% CI: 1.283-6.729), delayed operation ( OR=3.682, 95% CI: 1.110-12.220) were independent risk factors for cardiac adverse events 30 days after operation. The 30-day mortality, 1-year mortality, and total mortality postoperation were respectively 17.8% (8/45), 26.7% (12/45) and 46.7% (21/45) for the group with adverse cardiac events, and respectively 3.6% (35/959), 9.1% (87/959) and 28.5%(273/959) for the group free from adverse cardiac events, showing significant differences between the2 groups (all P<0.05). Conclusions:Advanced age, cardiac insufficiency, chronic renal insufficiency and delayed surgery may be independent risk factors for adverse cardiac events within 30 days after surgery in the elderly patients with hip fracture who show a significantly higher mortality than those free from adverse cardiac events.