Objective To observe the clinical effects of coronoid process of ulna osteotomy and bilateral anatomic locking plate on humerus condyle comminuted fracture in the elderly.Methods 17 elderly patients with humerus condyle comminuted fracture were collected in department of orthopaedics in our hospital from July 2005 to December 2013 and graded into C2 (6 cases) and C3 (11 cases) according to the standard of the American society for the prevention of bone trauma.All patients were treated by coronoid process of ulna osteotomy and bilateral anatomic locking plate and accessed by Mayo elbow performance score (MEPS) at the last follow-up.Results Postoperative incision in all patients were healed,and X-ray showed fracture healing occurred at 10 to 24 weeks after coronoid process of ulna osteotomy (average of 14 weeks).No iatrogenic ulnar nerve injury and nonunion were found at the follow-up.The MEPS were excellent in 13 cases,well in 3 cases,ordinary in 1 case,and the excellent and good rate was 94.1％.Conclusions Coronoid process of ulna osteotomy and bilateral anatomic locking plate in the treatment of humerus condyle comminuted fracture in the elderly have good clinical effects with many advantages such as exposure clearly,early elbow joint function exercise and avoiding the aggravation of elbow joint osteoarthritis.

Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods

Objective To evaluate the improvement of cone beam CT (CBCT) image quality by using bewtie filter (F_1) and water calibration. Methods First the multi-level gain calibration of the detector panel with the method of Cal_2 calibration was performed, and the CT images of CATPHAN503 with F_0 and bowtic filter were collected, respectively. Then the detector panel using water calibration kit was calibrated, and images were acquired again. Finally, the change of image quality after using F_1 and (or) water calibration method was observed. The observed indexes included low contrast visibility, spatial uniformity, ring artifact, spatial resolution and geometric accuracy. Results Comparing with the traditional combination of F_0 filter and Cal_2 calibration, the combination of bowtie filter F_1 and water calibration improves low contrast visibility by 13.71%, and spatial uniformity by 54. 42%. Water calibration removes ring artifacts effectively. However, none of them improves spatial resolution and geometric accuracy. Conclusions The combination of F_1 and water calibration improves CBCT image quality effectively. This improvement is aid to the registration of CBCT images and localization images.

Objective To discuss the feasibility of TIPS in the treatment of complicated Budd Chiari syndrome(BCS) and to evaluate its clinical effect. Methods Five patients (male/female=4/1) aged from 30 to 35(mean 33 years). Four of 5 patients with varied degree of esophago gastric varies had the history of upper gastrointestinal bleeding and two had obvious ascites. We punctured the stenotic or occluded hepatic vein into the branch of portal vein in liver parenchyma. Balloon catheter expanding and installing were followed by the gastric coronary vein embolization. Results Successful operation were obtained in all 5 patients. The mean portal vein pressure dropped from(4.7?1.3)kPa before operation to(3.5?1.5)kPa after TIPS. One patient died in 24 hours after an emergency TIPS. One patient died of liver function failure three weeks later. In the mean 64 months′ follow up, 2 of the remaining 3 patients received angiography examination and were demonstrated stenosis at the end of hepatic vein. Both patients were treated with re intervention successfully. Conclusion TIPS was a safe, effective, and feasible method in the treatment of patients with complicated BCS with portal hypertension.

Objective To study the correlations between MR imaging and histological classification of intracranial meningiomas.Methods MR imaging findings of 128 cases of intracranial meningiomas proved by operation and pathology were analyzed retrospectively.Results On T 1-weighted images,29(49%) meningothelial meningiomas were hypointense, 11(19%) were slightly hypointense and 17(29%) were isointense, while fibrours meningiomas were respectively in 23(59%),5(13%) and 9(23%). On T 2-weighted images, 34(58%) meningothelial meningiomas were hyperintense, 15(25%) were slightly hyperintense and 10(17%) were isointense, while fibrours meningiomas were in 2(5%),8(20.5%) and 11(28%) respectively. Most of the intracranial meningiomas such as meningothelial, fibrours and transitional were iso- and hypo-intense to the cortex on T 1-weighted imaging. On T 2-weighted imaging, meningothelial, angiomatous and transitional were hyperintense or slightly hyperintense, while fibrous tended to be hypointense or slightly hypointense. Conclusion The signals of meningiomas of different histologic type on T 1-weighted images are no significant different.On T 2-weighted images,there are significant correlation between signal intensity and tumor histology.

Apoptosis ; Blood Platelets ; cytology ; Humans

Adult ; Aged ; Aged, 80 and over ; Biliary Tract Neoplasms ; complications ; Cholangitis ; etiology ; Cholestasis ; etiology ; therapy ; Drainage ; adverse effects ; Female ; Hepatic Encephalopathy ; etiology ; Humans ; Intraoperative Period ; Jaundice, Obstructive ; etiology ; therapy ; Liver Neoplasms ; complications ; Male ; Middle Aged ; Pancreatitis ; etiology ; Stents ; adverse effects

Objective To establish the proper review rules for the microscopic screening of urine samples tested by automatic urinalysis work station.Methods A total of 3 154 random urine samples were enrolled to establish and validate review rules .All the samples were collected from the inpatients and outpatients of Shanghai First People′s Hospital from March to May 2013 and tested by urinalysis work station.Three thousands one hundred and fifty four urine samples were firstly tested by urinalysis work station,including both urine dry chemical analyzer and urine sediments analyzer .Then each urine sample was examined microscopically by two technicians-in-charge using double-blind method.The average results from the two technicians were used as review results .Compared with review results ,the review rules were set up.According to different test methods by automatic urinalysis work station , four microscopic review protocols were defined:(1)Protocol 1:based on chemistry results only ,microscopy review was performed when any of WBC,RBC,PRO and NIT was positive;(2)Protocol 2:based on urine sedimental analysis only ,microscopy review was performed when any of WBC ,RBC and CAST count was over upper limit of the reference range;(3)Protocol 3:if any of BLD ,RBC,LEU,WBC was different between two systems ,or quantitative results had two or more than two gradient differences ,microscopy review was performed;(4) Protoco1 4:if any of BLD, RBC,LEU ,WBC was different between two systems , or CAST was over upper limit of the reference range , or alarm appeared , microscopic review was performed .400 randomly selected urine samples were tested to validate the review rules .Omission diagnostic rate and review rate were used to evaluate the rules .Results According to the review rules,the positive samples rate was 43.47%(1 371/3 154) and the negative rate was 56.53%( 1 783/3 154 );Positive samples were composed of RBC ( 55.58%) , WBC ( 59.66%) and CAST(6.42%).The review rates of four protocols were 44.48%(1 403/3 154),45.69%(1 441/3 154), 26.09%(823/3 154),28.95%(913/3 154),respectively.The false negative rates (omission diagnostic rates)were 7.13%(225/3 154),4.53%(143/3 154),2.73%(86/3 154) and 1.02%(32/3 154), respectively .Protocol 4 was selected as an ideal plan.Additional 400 urine samples were tested using protocol 4 in order to confirm the review rule.The review rate, false negative rate were 26.25%(105/400), 0.75%( 3/400 ), respectively.After image review revised, the review rate was 14.50%(58/400).Conclusion This study formulates that the automatic urine analysis workstation review rules have clinical maneuverability and validity.