Objective To discuss the procedural problems and solution correlatively of CT-guided percutaneous biopsy of spinal diseases,with simultaneous evaluation of the safety and clinical application.Methods Sixty-eight cases with spinal diseases were taken CT-guided percutaneous biopsy under local anesthesia and CT guidance,including 9 in cervical spine,19 in thoracic spine,28 in lumbar spine and 12 in sacral spine.The program of carrying out the procedure was decided according to the site,approach route of the lesion with the destination of sampling,under CT guidance.Results The successful rate of needle puncture was 100%(68/68)with diagnostic accuracy of 92.6%(63/68),and false-negative rate of 7.4%(5/68),together with complications rate of 5.9%(4/68).Conclusions CT-guided vertebral biopsy is safe,reliable,less complication,high accuracy and together with clear demonstration of the position of puncture needle and the complex anatomic structures nearby,providing basic information for further clinical treatment and worthy to be recommended.

Objective:To establish a GC fingerprint analysis method for identification of volatile oil in ultramicro-powder of Houttuynia cordata from different habitats, then to control the quality sensitively.Methods: GC was used to analyze the volatile constituents of ultramicro-powder of Houttuynia cordata from 12 different habitats;SPDTM-1CapillaryColumn(30m?0.32mm?0.25?m),temperature programming and FID detector were applied.Results: The mutual mode of GC fingerprints was set up and the similar degrees to the volatile oil from of different habitats were compared.Conclusion:The GC fingerprints of volatile oil in ultramicro-powder can be used to identify the Houttuynia cordata from different habitats and evaluate its quality.

Objective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC) with concurrent chemoradiotherapy.Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed,and all of them received concurrent chemoradiotherapy,either IMRT or CRT.Among them,there were 92 and 108 patients in the IMRT and CRT group,respectively.The chemotherapy scheme was paclitaxel combined with different platinum drugs (cisplatin,nedaplatin,oxaliplatin or lobaplatin).The number of chemotherapy cycles was 2-4.Results Patients who received IMRT had a significant higher 3-year overall survival (OS) than that who received CRT (63.6 ％ vs 38.9 ％,x2 =12.102,P =0.001).Three-year OS differed no significantly between different chemotherapy regimens.There were 44.6 ％,57.5 ％,52.5 ％ and 52.5 ％ for those who received cisplatin,nedaplatin,oxaliplatin and lobaplatin,respectively (x2 =2.756,P =0.431).Patients received different cycles of chemotherapy had comparable treatment outcome,and the overall survival were 44.1％,51.6 ％ and 57.4 ％ for those who underwent 2,3 and 4 chemotherapy cycles at 3 years,without any statistical significance (x2 =2.497,P =0.287).Univariate analysis indicated that lesion length on X-ray,M stage,6th edition UICC staging and radiotherapy methods were the potential predictive factors.Multivariate analysis shown that gender,lesion length on X-ray and radiotherapy methods were the significant prognostic factors.Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy are mainly lesion length on X-ray and radiotherapy methods.

Objective To explore the treatment of children with EB virus infection accompanied by facial paralysis. Method The clinical data of a child with EB virus infection accompanied by facial paralysis was analyzed retrospectively, and the related literature were reviewed. Results A 2-year-old boy was admitted to hospital due to fever and mouth askew for 4 days. After admission, he was confirmed to have EB virus infection and viremia by serology and polymerase chain reaction, and then treated with acyclovir. The symptoms of facial paralysis and EB viremia disappeared completely 14 days after antiviral treatment. There was no recurrence in the short-term follow-up. Interestingly, the literature analysis shows that there is still limited evidence for the antiviral treatment by acyclovir in children with acute infection of EB virus associated with facial paralysis. Conclusion Antiviral treatment may be beneficial to EB viremia with facial paralysis.

Objective To evaluate cause,treatment and prevention of esophageal fistula caused by anterior cervical spine surgery.Methods Between January 2004 and December 2011,2348 patients underwent anterior cervical spine surgery.Among them,5 patients suffered from esophageal fistula owing to operation,including 3 males and 2 females,with an average age of 34 years (range,14 to 48 years).The diagnosis of these patients included 3 cases of cervi(c)al injury,1 case of cervical spondylosis and 1 case of cervical tuberculosis.There was 1 patient whose esophageal injury was founded during the surgery,and that was directly repaired.For another 4 patients,esophageal fistulas were founded after operation; one case underwent debridement and orificium fistulae repair; one case only underwent debridement; one case underwent debridement and second-stage removal of hardware; and one case underwent debridement and second-stage removal of hardware and esophageal repair with sternocleidomastoid flap.Postoperative treatment included esophageal rest,enteral nutrition,wound drainage,and antibiotic administration.Methylene blue was used to evaluate status of orificium fistulae.Results All patients with esophageal fistula were cured 9 to 61 weeks after treatment,and oral intake was achieved.They were followed up for 6-48 months.There was no recurrence of esophageal fistula,cervical instability and infectious spondylitis in any ease.All patients were satisfied with swallowing function and outcome of cervical spine diseases.The Frankel grade was improved averagely one grade in patients with cervical injury,and the JOA score was improved from preoperative 9 points to postoperative 15 points in patients with cervical spondylosis.Conclusion Successful management of esophageal fistula caused by anterior cervical spinal surgery depends on primary closure of the perforation with or without muscle flaps,surgical drainage,esophageal rest and nutrition support,and removal of hardware if necessary.Prevention consists of the careful operation and gentle tissue handling.

Background and purpose: Lymph node (LN) metastasis of esophageal cancer of neck rate higher, but there is little bulk reports. This article aimed to analyze the characteristics of cervical lymph node metastasis (CLN) in thoracic esophageal squamous cell carcinoma (TE-SCC) and the clinical role. Methods:A total number of 1 131 TE-SCC patients underwent radical esophagectomy plus three-ifeld lymph node dissection at Fujian Provincial Tumor Hospital between Jan. 1993 to Dec. 2003, during which, 367 patients had pathological metastasis of CLN. Results:The metastatic rate of CLN was 33.2%for the entire group, 43.7%, 33.0%and 16.0%for the upper, middle and lower TE-SCC respectively. Single factor analysis showed that the metastatic rate of CLN was relevant with the tumor site, pathological differentiated degree, lesion length showed in X-ray, pT stage and the number of CLN (P<0.05). But multivariate regression analysis showed that the metastatic rate of CLN was just relevant with the tumor site, pT stage and the number of CLN (P<0.05). Metastasis of cervical paraesophageal lymph nodes was the most common, and Background and purpose: Lymph node (LN) metastasis of esophageal cancer of neck rate higher, but there is little bulk reports. This article aimed to analyze the characteristics of cervical lymph node metastasis (CLN) in thoracic esophageal squamous cell carcinoma (TE-SCC) and the clinical role. Methods:A total number of 1 131 TE-SCC patients underwent radical esophagectomy plus three-ifeld lymph node dissection at Fujian Provincial Tumor Hospital between Jan. 1993 to Dec. 2003, during which, 367 patients had pathological metastasis of CLN. Results:The metastatic rate of CLN was 33.2%for the entire group, 43.7%, 33.0%and 16.0%for the upper, middle and lower TE-SCC respectively. Single factor analysis showed that the metastatic rate of CLN was relevant with the tumor site, pathological differentiated degree, lesion length showed in X-ray, pT stage and the number of CLN (P<0.05). But multivariate regression analysis showed that the metastatic rate of CLN was just relevant with the tumor site, pT stage and the number of CLN (P<0.05). Metastasis of cervical paraesophageal lymph nodes was the most common, and supraclavicular lymph node metastasis was next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes were rare. The ratio of the number of CLN occupied the sum of the segmental CLN were 57.7%, 32.0%and 10.0%for the upper, middle and lower TE-SCC respectively (P<0.05). Right CLN of each segmental TE-SCC was more than left CLN. Conclusion:Independent factors on CLN in TE-SCC are the tumor site, pT stage and the number of CLN. Metastasis of cervical paraesophageal lymph nodes is the most common, and supraclavicular lymph node metastasis is next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes are rare.

Objective To describe the clinical and pathological features and survival of juvenile patients with pancreatic carcinoma ( age ≤ 40 years old ) and to explore whether pancreatic carcinoma in young patients was a particular subtype. Methods As a case control study, the clinical data and follow-up data of sporadic 29 cases diagnosed as juvenile pancreatic carcinoma in Ruijin hospital from January, 2000 to December, 2007 were analyzed and compared with randomly selected 89 cases of senile eases (age≥ 61 years old) with pancreatic carcinoma. Results The percentage of juvenile pancreatic carcinoma was 3.6% (29/811 ) and the male/female ratio was 2.5: 1. The incidence rate of abdominal pain was significantly higher in the juvenile patients than in the senile patients (72.4% vs 48.3% , P < 0.05 ) ;the incidence of malnutrition was significantly lower in juvenile patients than that in senile patients ( 13.8% vs 38.0%, P <0.05 ) ;and the rate of patients with advanced stage disease ( Ⅲ～Ⅳ ) was significantly higher in juvenile patients than in senile patients (69.0% vs 55. 1%, P < 0.05). The percentage of radical operation in juvenile patients was not statistically different from that in senile patients ( 34.5% vs 30.34%, P > 0.05 ), and analysis using the Kaplan-Meier method and log-rank test revealed no significant difference in overall survival between the two groups ( median survival time : 7.0 vs 8.0 months, P > 0.05 ). Conclusions The age onset of the pancreatic carcinoma tended to be younger. The predominant clinical manifestations of juvenile pancreatic carcinoma were abdominal pain or back pain. Juvenile pancreatic carcinoma may be a particular subtype of pancreatic cancer.

Objective To investigate the potential values of magnetic resonance elastography (MRE)for evaluating the brain tumor consistency in vivo.Methods Fourteen patients with known solid brain tumor(5 male,9 female;age range:16-63 years)underwent brain MRE studies.Informed consent was obtained from all patients.A dedicated external force actuator for brain MRE study Was developed.The actuator was fixed to the head coil.During scan.one side of the actuator was attached to the patients'head.Low frequency oscillation Was produced by the actuator and caused shear waves propagating into brain tissue.The pulse sequence used in the study Writs phase-contrast gradient-echo sequence.Phase images of the brain were obtained and the shear waves within the brain were directly imaged.Phase images were processed with local frequency estimation (LFE) technique to obtain the elasticity image.Consistency of brain tumors Was evaluated at surgery and Was classified as soft,intermediate,or hard with comparison to the white matter of the brain.Correspondence of MRE evaluation with operative results was studied.Results The elastic modulus of the tumor Was lower than that of white matter in 1 patient,higher inll patients,and similar in 2 patients.At surgery,the tumor manifested a soft consistency in I patient,hard consistency in 11 patients,intermediate consistency in 2 patients.The elasticity of tumors in 14 patients evaluated by MRE was correlated with the tumor consistency on the operation.Conclusion MRE Can noninvasively display the elasticity of brain tumors in vivo,and evaluate the brain tumor consistency before operation.

Objective To explore whether the use of spatiotemporal image correlation (STIC) can supply additional information with respect to conventional fetal echocardiography in the prenatal diagnosis of total anomalous pulmonary venous connection(TAPVC).Methods Twenty-five cases diagnosed as TAPVC received fetal echocardiography examination.Four-dimensional volumes from 19 cases of suspected TAPVC were compared to conventional echocardiography.Echocardiographic characteristics were compared with the results of postnatal work-up and pathology.Results TAPVC was found in 25 cases by fetal echocardiography,four cases were isolated TAPVC,21 TAPVC had associated cardiac anomalies.Among them,nine cases were supracardiac types,six cases were infracardiac types,nine cases were intracardiac types and one was indefinite.Three true positivecases of TAPVC were confirmed after birth.Twenty-two choose to terminate pregnancy,9 of which refused to autopsy,and 10 true positive cases of TAPVC were confirmed at autopsy while 3 were considered false-positive cases.4D ultrasound with STIC clearly visualized the anomalous PV confluence and/or the draining vertical vein in all nineteen cases examined.Conclusions STIC may be proposed to identify abnormal venous drainage at the screening level,thus supplying additional information over that provided by 2D fetal echocardiography.

Objective To investigate the changes and correlation of mitral valve coaptation length index CLI and coaptation area index CAI after mitral valvuloplasty MVP Methods A total of 30 subjects undergoing MVP for mitral regurgitation MR were studied Coaptation length CL CLI coaptation area CA and CAI were determined before and after surgery by 2-dimensional transoesophageal echocardiography 2D-TEE and 3-dimensional transoesophageal echocardiography 3D-TEE Results Compared with preoperative measurements CL CLI CA and CAI were significantly increased in postoperative studies CL 4 7±0 7 mm vs 9 4± 1 1 mm CLI 9 1 ±3 3 vs 38 5 ±4 1 CA 148 9 ± 65 3 mm 2 vs 371 9 ± 144 3 mm 2 CAI 9 3 ±3 1 vs 35 9 ± 7 5 all P < 0 05 CLI was significantly correlated with CAI both preoperatively r = 0 770 P < 0 01 and postoperatively r = 0 771 P <0 01 Furthermore CLI and CAI were significantly negative correlated with the degree of MR r =-0 897 P <0 01 r =-0 886 P <0 01 Conclusions Coaptation variables increased significantly in subjects after MVP CLI by 2D-TEE was related to CAI by 3D-TEE and both were useful for the assessment of mitral valve coaptation But CLI by 2D-TEE was more simple and feasible in clinic.