Objective To investigate effect of arterial embolization therapy in the mid-late pancreatic head carcinoma.Methods 13 cases with pancreatic head carcinoma were treated with superselective intra-arterial infusion of gemcitabine by superior pancreaticoduodenal artery followed by arterial embolization using sodium-iodinated oil and 200 mg gemcitabine.Clinical therapeutic effectiveness was evaluated by CT 4 weeks after treatment.Results The clinical symptoms of all patients had obvious improvement and the tumor's size was reduced.Conclusion The therapy of arterial embolization has good clinical effect for pancreatic head carcinoma,and it is one of the most effective therapy at present.

Objective To investigate risk factors for healthcare-associated infection(HAI)in patients with craniocerebral operation,and provide reference for the prevention and control of HAI.Methods A total of 4 246 cases of craniocerebral surgery in a neurosurgery department from January 2010 to December 2012 were enrolled in the study,the risk fac-tors for HAI were analyzed.Results Of 4 246 cases of craniocerebral surgery,393 patients developed 446 times of post-operative HAI,HAI incidence rate was 9.26%,case infection rate was 10.50%,which were higher than inci-dence (2.02%)and case infection rate (3.02%)of HAI of all hospital during the same period,the difference was statistically significant (χ2 =811 .06,629.30,respectively,P <0.001).The major infection site was central nervous system (56.50%),followed by respiratory system (27.36%).Unconditional univariate logistic regression analysis showed that sex,age,community-acquired infection,primary disease,operative time,length of stay in intensive care unit (ICU)before infection,the number of surgery,invasive procedures and nasogastric tube,the difference was statistically significant (all P <0.05 ).Multivariate logistic regression analysis showed that sex,elderly pa-tients,congenital brain diseases,stay in ICU>7 d,antimicrobial use >7 d,central venous and urinary tract cathe-terization,invasive ventilator were risk factors for HAI in patients with craniocerebral operation.Conclusion The incidence of HAI in patients with craniocerebral operation is high,effective preventive and control measures accord-ing to risk factors should be strengthened to reduce the incidence of HAI.

Objective To explore the therapeutic efficacy of percutaneous compression plate internal fixation in the treatment for elder-ly patients with interchanteric fractures. Methods All 17 patients with interchanteric fractures from March 2012 to January 2013 were trea-ted with percutaneous compression plate internal fixation(Fracture classification:type A1. 2 with 3cases,A1. 3 with 4cases,A2. 1 with 6 ca-ses,A2. 2 with 3 cases,A2. 3 with 1 case). After operation,the patients did functional exercises at the early stage. Then the efficacy were e-valuated and analyzed. Results Operation time was 30~80 min,with average time 50 min, blood loss was (40~100) mL,with average volume 60 mL,time of X-ray exposure was 12~22 s,with average time 20 s. All 17 patients were followed up for 3~18 months. Postoperative function were evaluated according to Harris Hip Score,15 cases were excellent,and 2 cases were good,the excellent and good rate was 100%. Conclusion Percutaneous compression plate internal fixation is suitable for the elderly patients of interchanteric fractures,with shorter oper-ation time,less blood loss,reliable fixation and less complications.

Objective To discuss the feasibility and clinical outcomes of mini-open reduction through lateral deltoid muscle and locking plate fixation in treatment of proximal humeral fractures.Methods A retrospective study was carried out on 39 patients with proximal humeral fractures treated with mini-open reduction through lateral deltoid muscle and locking plate fixation from September 2012 to September 2015.There were 7 males and 32 females,with a mean age of 66.8 years (range,33-86 years).According to the Neer's classification system,there were 26 patients with two-part fracture and 13 with three-part fracture.visual analogue scale (VAS),Constant-Murley shoulder score,time of bone healing and complications were evaluated for all patients.Results All patients were followed up for 12-48 months (mean,21.3 months).All fractures were proved to be bone healing with duration of (12.0 ± 2.7) weeks.The VAS was improved from preoperative (5.7 ± 1.0) points to (0.9 ± 0.6) points at the final follow-up (P ＜ 0.05).The Constant-Murley shoulder score was increased from preoperative (42.3 ±5.1) points to (89.2± 2.5)points at the final follow-up (P ＜ 0.05).Ranges of shoulder motion were improved with satisfactions.There were no complications like axillary nerve injury,loss of reduction,nonunion or humeral head necrosis.Conclusion For proximal humeral fractures,the miniopen reduction through lateral deltoid muscle and locking plate fixation has advantages of minimal invasion,excellent shoulder function,high rate of bone healing and low incidence of complications.

Objective To investigate the clinical outcome of arthroscopic percutaneous cannulated screw fixation with subtalar fusion in the treatment of post-traumatic subtalar arthritis. Methods The study involved 12 patients (five males and seven females) with severe post-traumatic subtalar arthritis admitted to our hospital from April 2006 to December 2009. The patients were at age range of 28-68 years ( mean 45.6 years). All patients had the history of conservative treatment but failed in pain alleviation.Then, the percutaneous cannulated screw fixation plus subtalar fusion was selected. The ande and hind foot of all patients were evaluated preoperatively and postoperatively by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Imaging assessment was carried out by X-ray examination.Results The patients were followed up for mean 21.2 months (range 6-48 months), which showed thatthe mean AOFAS ankle-hindfoot scale was increased from (54.67 ± 5.28 ) points (range 43-61 points)preoperatively to (89.17 ±3.56) points (range 78-95 points) at final follow-up, with excellence rate of 93%. Eleven patients got good fusion with the mean time of 12.4 weeks (range 9-15 weeks). Only one patient had nonunion, with the pain in the lateral malleolus. The subtalar joint of the patient got union after plaster immobilization for three months, which was proved by X-ray examination. Conclusions The arthroscopic percutaneous cannulated screw fixation and subtalar fusion can acquire good clinical outcomes and hence is a recommended procedure for post-traumatic subtalar arthritis.

Objective:To investigate the efficacy of flexion-lateral curvature-supination reduction combined with primary anterior surgery for the treatment of lower cervical dislocation with unilateral facet inter-locking.Methods:A retrospective analysis was performed in the 32 patients who had been admitted to Department of Spine Surgery, Honghui Hospital for lower cervical dislocation with unilateral facet interlocking from November 2015 to October 2018. According to their treatments, they were divided into 2 groups. In the emergency group treated by flexion-lateral curvature-supination reduction combined with primary anterior surgery, there were 13 males and 3 females, aged from 24 to 63 years. In the traction group treated by cranial traction reduction combined with secondary anterior surgery, there were 12 males and 4 females, aged from 20 to 64 years. The operation time, intraoperative blood loss, hospital stay, bone graft fusion, American Spinal Injury Association (ASIA) grade and Japanese Orthopaedic Association (JOA) score were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P<0.05). All patients were followed up from 26 to 40 months. The hospital stay for the emergency group [(7.2±1.2) d] was significantly shorter than that for the traction group[(10.9±1.2) d] ( P<0.05). There was no significant difference in the operation time, blood loss, ASIA grade or JOA score between the 2 groups ( P>0.05). All patients achieved osseous fusion of intervertebral space. Conclusion:Compared with traditional methods, flexion-lateral curvature-supination reduction combined with primay anterior surgery shows no significant difference in the recovery of neurological function but leads to a shorter hospital stay.

Objective:To observe the ocular clinical features of infantile cytomegalovirus (CMV) infection.Methods:A retrospective clinical study. From March 2019 to July 2021, 876 eyes of 438 children with CMV infection who visited Department of Ophthalmology of Henan Provincial Children's Hospital were included in the study. Among them, there were 254 males and 184 females; the age ranged from 3 days to 11 months; the gestational weeks were 28 to 42 weeks; the birth weight was 1 120 to 8 900 g. There were 384 and 54 full-term and premature infants, respectively. Fundus examination was performed in 385 cases (770 eyes) after medical consultation; 53 cases (106 eyes) of premature infants were routinely screened. CMV retinitis (CMVR) was divided into granular type and fulminant type. Patients with CMV-related diseases with moderate to severe symptoms were given intravenous drip and/or oral ganciclovir; patients with severe fundus vasculitis were combined with intravitreal injection of ganciclovir. The follow-up period was from 4 to 28 months, and the characteristics of eye lesions, systemic comorbid diseases and treatment outcomes were observed.Results:There were 516 eyes of 258 cases with normal fundus (58.9%, 258/438); 291 eyes of 180 cases with CMVR (41.1%, 180/438), of which binocular and monocular were 111 (61.7%, 111/180) and 69 (38.3%, 69/180) cases. Among the 291 eyes of CMVR, 281 eyes (96.6%, 281/291) of granular type; yellow-white point-like opacity and/or retinal hemorrhage; 10 eyes (3.4%, 10/291) of fulminant type; fundus Showed a typical "cheese ketchup-like" and vascular white sheath-like changes. Among the 180 children with CMVR, 72 patients (118 eyes) were given systemic intravenous drip and/or oral ganciclovir; 5 patients (10 eyes) were given intravitreal ganciclovir, all of which were fulminant CMVR. At the last follow-up, fundus lesions regressed significantly in 100 eyes of 61 cases; 18 eyes of 11 cases had old lesions or uneven retinal pigment; 108 cases were not treated.Conclusion:The most common fundus manifestation of CMV infection in infants is granular retinitis, and fulminant retinitis is more severe, and the lesions can be significantly regressed after timely antiviral treatment.