BACKGROUND:Radial head re-dislocation is one of the alarming complications of old Monteggia fracture. Many treatment methods have described the necessary of fracture and annual ligament reconstruction during treatment, but stil unclear.
OBJECTIVE:To emphasize the practicality of annular ligament reconstruction through comparing the children’s treatment in two groups.
METHODS:Twelve patients with children’s old Monteggia fracture were included for retrospective analysis. Al the patients were treated with radial head open reduction and internal fixation. Among them, five cases received ulna extending osteotomy and annual ligament reconstruction, and seven cases received ulna extending
osteotomy without annual ligament reconstruction. The course was 3-18 months from damage to the clinical
manifestations (an average of 9 months). Ten cases with Bado type Ⅰ and two cases were Bado type Ⅱ andⅢ. The reliability of ligament reconstruction was evaluated before and after treatment with Kim standard.
RESULTS AND CONCLUSION:Al the 12 cases were fol owed-up for 22 months (8-26 months). Evaluation
according to the Kim standard after treatment showed excel ent in 10 cases without abnormalities and pain, the range of motion>250 °, and no elbow was limited, the activities of daily living was 25 points;good in two cases with mild deformity and mild or intermittent pain, the range of motion was 200°-250° with elbow limited, activities of daily living was 15 points;no poor (serious deformity, pain, range of motion<200°, elbow severely limited, activities of daily living was 0 points). Fol owed-up lasted for 22 months and found that the average healing time of ulnar
osteotomy was 8 weeks (6-14 weeks). The wounds were healed primarily without infection and nonunion. The
results indicate that ulna extending osteotomy has great significance in keeping stability of radial head, and annular ligament reconstruction is determined by the time of injury, surgical procedures and intraoperative radial head stability.

Objective To observe the performance of two-dimensional echocardiography and CDFI of metastatic cervical lymph nodes in nasopharyngeal carcinoma before and after induction chemotherapy,and to predict the short-term effect of the lymph nodes after sequential chemoradiotherapy.Methods Forty patients with sixty-five metastatic cervical lymph nodes which were confirmed as nasopharyngeal carcinoma by biopsy and CT were studied.CDFI was used to observe its size,the peak systolic velocity (PSV),resistivity index (RI),and record its classification of blood flow before and after induction chemotherapy,after radiotherapy 1 to 2 months for ultrasound,respectively,and the measured values and short-term effect in cervical lymph node metastasized were compared.Results According to the changes of blood supply after induction chemotherapy,lymph nodes were divided into three groups,the group of improve blood supply was given priority (55 ％),blood supply to reduce and no change groups were 23 ％,22％,respectively.After induction chemotherapy and sequential radiotherapy,all lymph nodes were narrow,regression rate after induction chemotherapy in blood supply to reduce,improve and no change groups were 52％,36％,25％,respectively,the regression rates of sequential chemoradiotherapy were 90％,81％,70％,respectively,among three groups are in degressive tendency,differences were significant (P ＜ 0.05).The blood supply changes after induction chemotherapy related well with the regression rate of chemotherapy(r =0.572,P =0.000) and sequential radiotherapy(r =0.553,P =0.000).The regression rate of chemotherapy related well with the regression rate of sequential chemoradiotherapy(r =0.621,P =0.000).After chemotherapy three groups of lymph node RI decreased,the difference was significant compared with that before treatment (P ＜ 0.05).After chemotherapy the groups to reduce and improve of PSV had significant differences compare with that before treatment (P ＜ 0.05),the group of blood supply no change of PSV had no significant difference (P ＞ 0.05).Conclusion Application of CDFI can clearly and accurately observe changes of metastatic cervical lymph nodes from nasopharyngeal carcinoma before and after induction chemotherapy,and the changes of blood supply and size after induction chemotherapy can predict the short-term effect after chemoradiotherapy.

Objective To analyze the curative effects in hyperthyroidism radioiodine treatment which using different methods to measure thyroid weight in order to calculate therapeutic dose.Methods 265 hyperthyroidism underwent radioiodine treatment,then they were divided into 4 groups.Calculating therapeutic dose was done according to SPECT tomography,nuclear plane imaging,ultrasonography and palpation to measure thyroid weight.We Compared and analyzed the curative effects after 6 months.Results The curative effects of 4 groups had obviously difference(P

10.3969/j.issn.2095-4344.2013.26.010

For the problems that 3 first-class ternary hospitals which are not directly affiliated to medical universities are facing in cultivating high-educated staff's scientific abilities,analyze the importance to carry out scientific work in clinic and discuss how to improve their scientific abilities from hospitals,departments and high-educated staff themselves.

Objective To elucidate the action of carbohydrates metabolism-associated genes on rat liver regeneration(LR). Methods We obtained the above genes through collecting website data and retrieving related articles,and detected their expression changes in rat LR with Rat Genome 230 2.0 array,then determined LR-associated genes by comparison of gene expression discrepancy between partial hepatectomy(PH) group and sham operation(SO) group. Results 118 carbohydrates metabolism genes were proved to be LR-associated.Number of the initial and total expressing genes occurring in forepart(0.5-4 hours after PH),prophase(6-12 hours after PH),metaphase(16-66 hours after PH) and anaphase(72-168 hours after PH),were 33,6,68,7 and 68,44,210,83,respectively,demonstrating that expression of these genes were triggered mainly at the initial stage of LR,and functioned in different phases.The number of their up-regulation and down-regulation was 205 and 200,and their expression patterns were classified into 12 types,implying that the cellular Carbohydrate metabolism during LR were characterized by diversity and complication.Monosaccharides and glycogen metabolism-associated genes,glycoprotein and glycosphingolipid(mainly gangliosides) biosynthesis-associated genes were up-regulated almost in the whole LR.In contrast,oligosaccharides and glycosaminoglycans biosynthesisassociated genes,glycoprotein and glycosphingolipid degradation-associated genes were down regulated.Conclusion Liver regeneration was closely related to carbohydrate metabolism.

Objective To evaluate the response rate and efficacy of Cyberknife in the treatment of iliac lymph node metastases (ILNM).Methods Twenty-two patients with 27 ILNM were treated by Cyberknife from May 2010 to May 2016.Tumor volume range from 0.88 to 125.66 cm3 (median 18.87 cm3).The total doses ranged from 21 to 51 Gy (median 39 Gy) and biological effective doses from 35.7 to 100 Gy (median 72.6 Gy) in 3-8 fractions (median 5).Sixty-four percent to eighty-two percent (median 72％) isodose line covered planning target.The survival rates were calculated by Kaplan-Meier method and compared with Log-rank test.Results Follow-up time ranged from 8 to 97 months (median 33 months).The complete response,partial response,stable disease and progression disease rates were 37％,48％,7.5％,48％,respectively.In addition,effective rate was 92.5％.Overall survival range from 4 to 68 months (median 21 months).The 1-,2-,3-year local control rate was all 90.6％ and the survival rates were 78.8％,60.6％ and 43.3％,respectively.Adverse reactions after treatment were gastrointestinal reactions such as nausea,vomiting,fatigue.The chemotherapy before Cyberknife helped to improve overall survival.The patients with backache or edema of lower extremity got rapid relief after treatment.Conclusion The treatment of ILNM with Cyberknife has provided a high response rate with minimal side effects.Cyberknife is a safe and effective local treatment method for ILNM.

Objective To investigate the preliminary experience of mechanical thrombectomy with a tri-axial system of the Solitaire AB stent through a Neuro delivery catheter to treat intracranial large artery occlusion. Methods A tri-axial system was used to deliver the Solitaire AB stent through a Neuro delivery catheter to provide intracranial aspiration in close proximity to the stent. This technique was used in 1 case of acute middle cerebral artery occlusion and 1 case of acute basilar artery occlusion. Results Successful revascularization was achieved in these 2 cases. Thrombolysis in cerebral infarction (TICI)score was 3. The clot length of acute middle cerebral artery occlusion was 3 cm and the modified Rankin Scale (mRS)score of this case was 3 at 90 days follow-up. Another patient with acute bilateral vertebral occlusion was revealed successful recanalization by angiography. Conclusion The results suggest that this technique of a tri-axial system used of the Solitaire stent through a Neuro delivery catheter can effectively retrieve clots from the occlusive artery and minimize the chance of antegrade blood flow dislodging the thrombus.

Objective To assess the efficacy and safety of CyberKnife radiotherapy in the treatment of locally advanced pancreatic carcinoma. Methods The data of 59 patients with locally advanced pancreatic carcinoma who were treated with CyberKnife radiotherapy from 2006 to 2014 were retrospectively analyzed. The tumor volume ranged from 13?? 0 cm3 to 125?? 1 cm3 with a median value of 27?? 1 cm3 . A dose of 35?50 Gy (median value= 45 Gy) in 3?8 fractions (median value = 5 fractions) was prescribed. The tumor progression was evaluated based on computed tomography. The overall survival (OS) and local progression?free survival ( LPFS) rates were calculated using the Kaplan?Meier method. Results The 1?and 2?year sample sizes were 26 and 17, respectively. The 1?and 2?year OS rates were 54% and 35%, respectively, while the 1?and 2?year LPFS rates were 91% and 70%, respectively. The median OS and LPFS times were 12?? 5 and 10?? 9 months, respectively. The overall incidence of grade 1?2 acute and late gastrointestinal toxicity was 61%. One patient with grade 3 late gastrointestinal toxicity had incomplete intestinal obstruction. Conclusions CyberKnife radiotherapy can achieve excellent treatment outcomes and mild complications in the treatment of locally advanced pancreatic carcinoma.

Objective To explore the impact of different times for endovascular embolization thera-py on the prognosis of elderly patients with intracranial aneurysm(IA)rupture and bleeding.Methods Clinical data of 156 elderly patients with IA rupture and bleeding admitted to our hos-pital from January 2019 to December 2022 were collected and analyzed retrospectively.All of them underwent intravascular embolization treatment.According to the timing of intravascular emboli-zation,they were divided into super early group(within 24 h from onset,n=66)and delayed group(in 24 h after onset,n=90).The Hunt-Hess grade,aneurysm location,cerebrospinal fluid exchange,embolization situation and success rate of embolization treatment were observed and re-corded.The prognosis of the two groups were evaluated with NIHSS score and mRS score.Results In terms of prognosis,no significant differences were observed in cerebrovascular spasm,disorders of consciousness,limb movement disorder,proportion of re-bleeding,and mRS score between the two groups(P＞0.05).The ratio of hydrocephalus was obviously lower in the super early group than the delayed group(4.55％vs 15.56％,P＜0.05).Though no statistical difference was seen in the pre-operative NIHSS score between the two groups(P＞0.05),the score was declined after treatment(P＜0.05),with that of the super early group notably lower than that in the delayed group(6.62±1.25 vs 7.82±1.35,P＜0.01).Conclusion Super early endovascular embolization can effectively reduce the incidence of hydrocephalus and improve neurological function in elderly patients with IA rupture and bleeding.