Objective To evaluate the therapeutic effects of pingyangmycin in treatment of body surface hemangioma in children.Methods The clinical data of 1 658 children patients with hemangioma on body surface in which pingyangmycin was injected between January 1997 and January 2008 were analyzed retrospectively.Results All 1 658 patients were observed for 6-12 months,with average of 10.83 months.The total effective rate was 97.09%.Compared among different types of hemangioma,total effective rate had significant difference(?2=203.12,P

Cochlear Implantation ; methods ; Fractures, Bone ; surgery ; Humans ; Temporal Bone ; injuries ; surgery ; Temporomandibular Joint ; surgery

Objective To investigate the clinical features and surgical management of patients with blunt multiple severe injuries. Methods 165 patients whth the injury severity score (ISS) over 16 were reviewed between 1988 and 1998. Results 47 cases (28.5%) had 3 or more injury sites, and 63 cases had multiple intraabdominal organ trauma. Abdominal trauma was evaluated by abdominocentesis in 143 cases, by US in 65 and CT in 47. All had positive values over 90%. Missed diagnosis of intraabdominal injury occurred in 21 cases (12 7%). The total mortality rate was 17 6% (29 cases). The average ISS for the died was 41 6 and 24 8 for the survivors ( t =15 21, P

Objective To investigate the application of improving prolene hernia system(PHS) tensionfree repair for inguinal hernia under ultrasound-guided local nerve block anesthesia.Methods Retrospective analysis the clinical data of 40 patients with improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia from January 2013 to January 2014 in Gulou Hospital of Nanjing University.Results In group of ultrasound-guided local nerve block anesthesia , the average anesthesia time was (8.9 ± 1.5) min, the time to get out of bed was (5.6 ± 1.1) h, the length of stay was (2.9 ± 0.7) d,There were (12.4 4± 2.2) min, (10.2 ± 1.6) h and (3.7 ±± 0.7) d in general anesthesia group, and significant difference(P ＜0.05), the average operation time of two groups were (22.6 ± 2.0) min, (22.1 ± 2.4) min,the average duration of postoperative analgesia was (6.4 ± 1.6) h, (6.1 4± 1.5) h, and no significant difference (P ＞ 0.05).Conclusions Improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia is simple , easy and safe to be performed with mild pain, faster recovery and less bleeding.It is worthy of popularization and application.

Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.

Objective To evaluate surgical treatment of infected femoral artery pseudoaneurysm.Methods The data on surgical treatment of 45 patients with infected femoral artery pseudoaneurysm admitted from January 2003 to June 2008 were analyzed retrospectively.Fourty-three patients underwent operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis.Two patients were unavoidable to undergo removing of infected femoral artery pseudoaneurysm and ligating the proximal and distal artery of pseudoaneurysm because of severe infection and large volume.Results The patients were followed up from 3 to 12 months(mean 7.82 months).The limbs of all the patients underwent bypass graft with vascular prosthesis were salvaged successfully,patients of which had secondary wound healing and had not intermittent lameness.One of two patients performed ligation of artery was salvaged successfully but had severe intermittent lameness,another patient underwent high amputation above knee because of ischemic gangrene.ConclusionFor infected femoral artery pseudoaneurysm,the operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis is effective and safe.

Objective To compare open versus closed reduction in treatment of children with displaced femoral neck fracture whose reduction is delayed by more than 24 hours.Methods We retrospectively reviewed 51 children who had been treated at our department for femoral neck fracture between May 2005 and May 2012 after their reduction had been delayed for more than 24 hours.They were 37 boys and 14 girls,1.7 to 15.5 years of age (average,9.1 years).According to Delbet's classification,27 cases belonged to type Ⅱ,18 to type Ⅲ,and 6 to type Ⅳ.Of them,18 underwent closed reduction and 33 open reduction.Their complications were recorded in detail.Their therapeutic results were evaluated according to Ratliff's criteria and compared between the 2 methods of reduction.Results The 51 children were followed up for an average of 36.7 months (range,from 17 to 61 months).Anatomic reduction was achieved in 6 cases in the closed reduction group (33.3％) and 29 cases in the open reduction group (87.9％),respectively.All fractures healed after an average of 10.9 weeks (range,from 9 to 13 weeks),with one exception of nonunion in the closed reduction group.The incidence of femoral head necrosis in the closed reduction group (27.8％,5/18) was significantly higher than that in the open reduction group (15.2％,5/33) (P ＜ 0.05).According to the Ratliff's evaluation at the final follow-ups,the good to excellent rate in the closed reduction group(66.7％,12/18) was significantly lower than that in the open reduction group (84.8％,28/33) (P ＜0.05).Coxa vara occurred in 3 children in the closed reduction group but in none in the open reduction group.Conclusion Open reduction with internal fixation may lead to better outcomes than closed reduction in the treatment of children with displaced femoral neck fracture whose reduction is delayed by more than 24 hours,probably because open reduction can result in better reduction quality.

Objective To investigate the diagnosis/misdiagnosis reason/treatment of residual gallbladder stone with choledocholithiasis.Methods The clinical data of 34 patients with residual gallbladder,16 cases of them suffered from choledocholithiasis additionally were retrospective analyzed.Results 14 cases were treated by residual cholecystectomy +choledochotomy +T -tube drainage,2 cases were were treated by choledochotomy + T -tube drainage.Preoperative misdiagnosis of residual gallstones rate was 56.3% (9 /16 ),7 cases were found residual gallstones during operation.The other 2 cases were misdiagnosed residual gallstones.The rate of intraoperative and postoperative misdiagnosis was 12.5% (2 /16 ).18 cases with residual gallstones,16 cases underwent residual cholecystectomy,2 cases who were suspected with choledocholithiasis underwent residual cholecystectomy +choledo-chotomy,T -tube drainage.18 cases had no preoperative and postoperative misdiagnosis.Conclusion The clinical symptom of residual gallbladder stone with choledocholithiasis was similar to residual gallstones,often characterized by upper abdominal pain,fever,chills,jaundice,abdominal distension and other symptoms.It is difficult for preoperative imageological diagnosis that less than 3 cm residual gallbladder and small stones.When choledocholithiasis at the same time,needing more intraoperative careful dissect cystic duct and common bile duct,completes the cystic duct and common bile duct exploration,reducing misdiagnose residual gallstones.

Objective To analyze and evaluate the image quality and the impact factors of CT virtual endoscopy (CTVE) in the application of various body parts. Methods CTVE images from 143 patients were classified into 2 types according to the chosen threshold: low attenuation lumen (including natural air filled and artificially air filled lumina) and high attenuation lumen. A 4 point scale was used to evaluate the differences of diagnostic confidence, artifacts, and overall image quality rating between both kinds of lumina. Results There was no statistically significant differences in diagnostic confidence of CTVE images among 3 kinds of lumina, but the image quality of CTVE of natural air filled lumen was better than that of artificially air filled lumen ( P 0.05). There was a significant difference in artifact rating of CTVE images among three kinds of lumina with the most artifacts seen on images of high attenuation lumen. Common artifacts observed on the CTVE images were attributed to patient motion artifacts such as respiration, inappropriate choice of spiral CT scanning parameters, and improper modification of thresholds. Conclusion The threshold setting was one of the most important factors impacting the image quality of CTVE images, and most artifacts seen on the CTVE images were easily recognized on the basis of their characteristic appearance, and did not influence the diagnostic information heavily.

0.05), but the lesion detection sensitivity of SSD and Raysum display were lower than that of UGI(? 2=4.17,7.11, and 5.14,4.17, P0.05). Excess fluid remained in the stomach and patient respiratory movement during breath holds were the reasons causing severe artifacts (6.1%) that influenced the diagnostic evaluation. Conclusion The performance of CTVG was equivalent to UGI in the detection of advanced gastric carcinoma and superior to UGI in the Borrmann′s classification. CTVG has potential in the detection of early gastric carcinoma. The value of SSD and Raysum display was limited in the evaluation of gastric carcinoma when used alone clinically.