BACKGROUND:There is no consensus on the choice of anatomic plate or dynamic hip screw for the treatment of intertrochanteric fracture. Current research is limited to smal-sample studies, and it is difficult to carry out a large-sample multicenter analysis. OBJECTIVE:To carry out Meta-analysis about the literature on anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures, in order to evaluate the efficacy of anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures. METHODS:The PubMed database (1995-2013), EMCC database (1995-2013), CBM database (1995-2013), CNKI database (1995-2013), VIP database (1989-2013) and Wanfang database (1995-2013) were searched by computer to col ect the control ed trials of anatomic plate versus dynamic hip screw for the treatment of intertrochanteric fractures. Then, the retrieved studies were screened according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated to extract useful y data, and Meta-analysis was performed by using the RevMan5.0 software. RESULTS AND CONCLUSION:A total of 19 control ed trials were included with a total of 1 730 cases. Among them, 764 cases were belonged to the anatomic plate group, and dynamic hip screw group included 966 cases. The Meta-analysis results indicated that there were no statistical y significant differences in fracture healing time, prognosis excellent and good rate and postoperative complications between two groups (P=0.34, 0.58, 0.80);the operative time, intraoperative blood loss and postoperative drainage volume in the anatomic plate group were lower than those in the dynamic hip screw group (P<0.000 01). The results indicate that anatomic plate and dynamic hip screw have the similar clinical efficacy for the treatment of intertrochanteric fractures, but the anatomical plate has relatively simple operation and less bleeding. Due to the poor quality of the included literatures and high bias occur and influence the effect, so more wel-designed multi-center randomized control ed trials should be performed to provide high-quality evidence.

Objective: To evaluate the repair method and its curative effects on defects and joint instability in elderly patients with recurrent soft tissue sarcoma around the knee after wide excision. Methods:Our study included 6 elderly patients with limb sal-vage and effective preoperative chemotherapy. These patients underwent extended resections, including internal or lateral articular cap-sule and collateral ligament excisions. Owing to polyleptic soft-tissue sarcoma around the knee, formed soft-tissue defects, and joint in-stability, collateral ligament and/or partial articular capsule was reconstructed using #5 Ethibond sutures. Simultaneously, soft-tissue de-fects around the knee were repaired by composite-wide pedicled fasciocutaneous flaps or medial head of gastrocnemius muscle flaps of the leg. The maximum flexion angles of the knee (MFKs) were observed and statistically tested before and during surgery, with a fol-low-up period of 6 months. Results: The immediate stability of the joints and complete coverage of the soft tissue defects were achieved during the surgery. The MFKs during preoperative treatment, intraoperative treatment, and six-month follow-up were 115.0° ± 7.8°, 101.7° ± 9.3°, and 104.8° ± 10.2°, respectively, with significant differences between the preoperative and intraoperative MFKs (t=2.68, P<0.05). By contrast, no difference existed between the intraoperative and six-month follow-up MFKs (t=0.55, P>0.05). Conclu-sion:This repair method can be applied to elderly patients with polyleptic soft tissue sarcoma around the knee by using simple, fast, and reliable surgical techniques for the reconstruction, stability, and repair of soft tissue defects in the knee joint.

Objective To evaluate the diagnostic value of digital subtraction angiography (DSA) of intracranial meningioma.Methods DSA was performed in 115 cases with meningioma. The branches of the external carotid artery were embolized in 76 cases. Results The blood supply of the meningioma located at the relatively superficial cerebrum are mainly arising from the middle meningeal artery of the internal maxillary artery and those located at the skull base are mainly from the ophthalmic artery and the cerebral segment of the internal carotid artery. The possible dangerous anastomoses between the extermal and internal carotid arteries and the vertebrobasilar arteries may exist.Conclusions To have a good knowledge of the charactereristics of digital subtraction angiography of meningioma is crucial for endovascular embolization and operation of meningioma.

To study the clinical characteristics and surgical treatment of congenital scoliosis with diastematomyelia, four patients were found to have scoliosis with diastematomyelia by CT and MRI.The first step of surgery was to excise the osteal compartion in spinal cord, the second step was the posterior scoliosis correction and fusion after two weeks. All the patients had successful surgery. The body height of the patients increased 4 75cm and the Cobb angle deceased 43? in average. No complication was found in the nervous system. This method is very effective, and is worth popularizing its application.

Arteriovenous Fistula ; therapy ; Child ; Embolization, Therapeutic ; Humans ; Male ; Pulmonary Artery ; abnormalities ; Pulmonary Veins ; abnormalities

Objective To assess the effect of family doctor team care on morbidity of disabled elderly in home care.Methods Eighty six disabled elderly patients with home care in Shanghai Xujiahui community were enrolled from February 2014 to January 2015.The patients were randomly divided into intervention group and control group with 43 cases in each.In intervention group,the family doctor team provided long-term,comprehensive and integrated care,and in control group the conventional home care was provided.The rates of morbidity and readmission to hospital were documented during the 3,6 and 12 monthfollow-up,and compared between two groups.Results The incidence rates of bedsore,pneumonia and deep vein thrombosis in intervention group was significantly lower than those in control group [after 6 months:4.9％ (2/41) vs.28.9％(11/38),x2 =8.311;2.4％ (1/41) vs.21.1％ (8/38),x2 =6.769;2.4％ (1/41) vs.15.8％ (6/38),x2 =4.353,respectively;after 12 months:2.4％ (1/41) vs.42.1％ (16/38),x2 =18.374;4.9％ (2/41)vs.28.9％ (11/38),x2 =8.311;7.3％ (3/41)vs.28.9％ (11/38),x2 =6.328,respectively;all P ＜0.05].The number of cases with bedsore healing(6/7 vs.0,x2 =18.555)and pneumonia recovery[5/6 vs.4.3％ (1/23),x2 =18.092] was significantly more and that with pneumonia deterioration (0 vs.52.2％ (12/23),x2 =5.340)was significantly less in intervention group than those in control group (all P ＜ 0.05).More cases with deep vein thrombosis improved(1/3 vs.0,x2 =3.949) and less cases with deep vein thrombosis deteriorated(0 vs.8/11,x2 =5.091) in intervention group than those in control group (P ＜ 0.05).And both the readmission rate for home care patients [2.4％ (1/41) vs.36.8％ (14/38),x2 =15.175] and for patients with complications [1/12 vs.43.8％ (14/38),x2 =4.872] was much lower in intervention group than that in control group (both P ＜ 0.05).Conclusion The family doctor team care can reduce the risk of complications and readmission to hospital,and also can improve the quality of life of home care disabled elderly,as well as reduce the burden of family and society.

Objective To investigate the effect of multidisciplinary intervenient on survival of patients with malignant tumor. Methods Six hundred and thirty-nine malignant tumor patients were randomly assigned to the intervenient and the control group. A total of 584 completed the follow-up study. The intervenient group received comprehensive treatment for 2 years,while the control group was in a process of self-rehabilitation. The 2-year survival rate was compared between the groups by using Cox proportional hazard model. Results The 2-year survival rate was 94. 74% (108/114) or 80. 67% (121/150) in II stage patients of the intervenient or control group, respectively ( P < 0. 01 ) . The 2-year survival rate was 88. 03% (163/177) or 82. 8% (184/222) in early and medium stage patients of the intervenient or control group,respectively(P <0. 01). Conclusion The multidisciplinary intervenient may help to improve the 2 year survival of early or moderate stage malignant tumors.

ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.

Objective To investigate the CT features of pulmonary sarcoidosis.Methods Ninety patients with histologically proved pulmonary sarcoidosis were retrospectively studied by using CT scans and clinical recording.Results The main CT findings of pulmonary sarcoidosis were nodules which were seen in 69 cases(76.7%),and the nodules mostly distributed around the bronchovascular bundle(n=37, 41.1%).Other abnormalities included consolidation(n=31,34.4%),ground-grass(n=39,43.3 %), thickening of bronchovascular bundle(n=30,33.3%),interlobular septal lines(n=58,64.4%), fibrosis(n=17,18.9%)including bronchial distortion(n=8,8.9%),linear shadow(n=5,5.6%), and honeycombing shadow(n=4,4.4%),air-trapping(n=3,5.3%),bronchial straitness(n=8, 8.9%),pleural thickening(n=42,46.7%),and hilar and mediastinal adenopathy(n=76,84.4%). Two or more abnormal findings co-existed in 83 cases.The pulmonary lesions co-existed with hilar and mediastinal adenopathy in 76 cases.The nodules(n=25),consolidation(n=9),ground-grass(n=11), thickening of bronehovascular bundle(n=10)were improved after therapy.Ten cases of the interlobular septal(10/22),0 of bronchial distortion(0/4),1 case of diffuse linear(1/3),and 0 case of honeycombing(0/2)were improved.Conclusion CT manifestations of pulmonary sarcoidosis are varied, but has some specific radiographic features.A correct diagnosis can be made.combined with hilar and mediastinal adenopathy.

Abstract: Objective　To investigate the clinical characteristics of silicosis complicated with active pulmonary tuberculosis. Methods A retrospective analysis of 36 patients with silicotuberculosis and 100 patients with active pulmonary tuberculosis was performed from January 2018 to December 2021 at Beijing Chest Hospital，Capital Medical University. The patients were confirmed by etiology or pathology. The patients with silicotuberculosis were designed to observation group and the patients with active pulmonary tuberculosis were designed to control group. The enumeration data were expressed as percentage and were treated with the chi-square test and the nonnormal distribution data is expressed as M(P25, P75). The difference was significant with P<0.05. Results　In the observation group, there were 7 cases (19.4%) of silicosis in stage Ⅰ, 14 cases (38.9%) in stage Ⅱ and 15 cases (41.7%) in stage Ⅲ. 25 cases (69.4%, χ2=17.099) had a course of TB more than 12 months. 32 cases (88.9%, χ2=16.722) with cough, expectoration and dyspnea as the main symptoms. 32 cases (88.9%, χ2=16.722) had nodular lesions, and 30 cases (83.3%, χ2=19.900) had mediastinal and hilar lymphadenopathy as the main imaging manifestations on chest CT. 17 cases (47.2%, χ2=7.481) were misdiagnosed. Compared with the control group, the difference was significant in these aspects (P<0.05). 27 cases in the observation group were followed up, 1 case died after 5 months of treatment. The negative conversion time of Mycobacteria growth indicator tube (MGIT) liquid culture in sputum was within 2 months in 17 cases (65.4%), between 2 and 12 months in 5 cases (19.2%) and over 12 months in 4 cases (15.4%), and a significant difference was observed comparing with the control group (P<0.05). Conclusions　The patients with silicotuberculosis are mainly in stage Ⅱ and stage Ⅲ with long duration of TB, cough, expectoration and dyspnea as the main symptoms. Chest CT shows that nodules, mediastinal and hilar lymphadenopathy are the main imaging manifestations. And the silicotuberculosis was easily misdiagnosed. At the same time, screening for latent tuberculosis infection in silicosis patients indispensable due to the poor prognosis of anti-tuberculosis treatment.