2.Curative effect analysis on proximal frmoral nail antirotation for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall.
Jie WEI ; De-an QIN ; Xiu-sheng GUO
China Journal of Orthopaedics and Traumatology 2015;28(6):572-575
OBJECTIVETo explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA).
METHODSFrom June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function.
RESULTSAll incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score.
CONCLUSIONPFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure stable fixation and earlier get out of bed.
Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies
7.Progress of molecular pathology in pediatric brain tumor.
Ya-jie WANG ; Yue-shan PIAO ; De-hong LU
Chinese Journal of Pathology 2011;40(3):206-208
Astrocytoma
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genetics
;
metabolism
;
pathology
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Brain Neoplasms
;
classification
;
genetics
;
metabolism
;
pathology
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Child
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Child, Preschool
;
Chromosomal Proteins, Non-Histone
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genetics
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metabolism
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Chromosome Deletion
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Cyclin-Dependent Kinase Inhibitor p16
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genetics
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metabolism
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DNA-Binding Proteins
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genetics
;
metabolism
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Ependymoma
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genetics
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metabolism
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pathology
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Hedgehog Proteins
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genetics
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metabolism
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Humans
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Medulloblastoma
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classification
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genetics
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metabolism
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pathology
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Proto-Oncogene Proteins B-raf
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genetics
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metabolism
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Rhabdoid Tumor
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genetics
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metabolism
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pathology
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SMARCB1 Protein
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Signal Transduction
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Transcription Factors
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genetics
;
metabolism
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Wnt Proteins
;
metabolism
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beta Catenin
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genetics
;
metabolism
10.Clinical signifcance of enhanced MRI in differentiating ben ign and malignant pancreatic neuroendocrine tumors
Xiuxiang LIU ; Jinayu LIU ; Gang CHENG ; Jie DE
Chinese Journal of Pancreatology 2016;16(6):378-382
Objective To determine the clinical value of contrast enhanced MRI in differentiating benign and malignant pancreatic endocrine tumors (PNETs).Methods MRI findings on 13 cases who were pathologically diagnosed as PNETs were retrospectively analyzed , including the tumor volume , border , MRI signal and adjacent organ involvement of Grade 1~3 tumors, and the sensitivity, specificity and accuracy of MRI for diagnosing PNETs were calculated .Results A total of 18 tumors were detected , including 12 benign (Grade 1) and 6 malignant (Grade 2~3) tumors.Eight Grade 1 tumors′(66.7%) maximal diameters were≤2 cm, while 100%(6 /6) Grade 2 ~3 tumors′maximal diameters were ≥2 cm.All of Grade 1 tumors (100%) had clear boundary , while 50%(2/4) Grade 2 and 100%(2/2) Grade 3 tumors had unclear boundary.Ten Grade 1 tumors (83.3%) had intratumoral homogeneous signal , while 100%(6/6) Grade 2~3 tumors had heterogeneous intratumoral signal .Two Grade 3tumors ( 100%) had organ infiltration and retroperitoneal lymph node metastasis .The sensitivity ,specificity and accuracy of MRI for differentiating benign and malignant PNETs were 833.%, 85.7%and 84.6%, respectively.Conclusi ons MRI had higher sensitivity, specificity and accuracy in differentiating benign and malignant PNETs , but it was still difficult to differentiate Grade 1 from Grade 2 tumors by MRI.Tumors size could not be considered to be a reliable indicator for differentiating benign and malignant PNETs .