Objective To explore the efficacy of orthosis in orthopaedic rehabilitation. MethodsFrom 1992 to 2006, 420 patients involved various orthopaedic disorders were managed with different orhtosis, the clinical date were analyzed retrospectively. ResultsAll patients who was managed with orthosis got an improved functional status and were satisfied with therapeutic effect.ConclusionOrthosis is valuable in assistant managing of bone and joint functional impairment.

Objective To explore the values of CT virtual gastroscopy (CTVG), three dimensional (3D) and axial imaging by multi slice spiral CT (MSCT) in the preoperative assessment of gastric carcinoma. Methods Fifty two patients with gastric carcinoma proven by means of biopsy underwent CTVG, 3D imaging using the surface shaded display (SSD) and Raysum, and axial imaging. MSCT was first performed after the ingestion of gas, and a second tri phase MSCT scan was performed after the ingestion of water. The results were compared with those of fibrous gastroscopy (FG) and surgical pathological findings. Results The detection rates of gastric lesions with CTVG, 3D and axial imaging by MSCT were 98.1%, 96.2%, and 96.2%, respectively. The accuracy of judging gross type of advanced gastric carcinoma using CTVG combined with 3D imaging, FG,and axial imaging was 92.5% , 82.5%, and 75.0%, respectively.Statistical difference existed in CTVG combined with 3D imaging and axial imaging (P

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

Objective To explore the quantitative characteristics of pancreatic ductal adenocarcinoma(PDAC) in single-source dual energy spectral CT imaging. Methods From January 2013 to December 2014, 113 patients underwent dual phase contrast-enhanced gemstone spectral imaging(GSI) on Discovery CT 750 HD. All diagnoses were pathologically confirmed by surgery or biopsy. The spectral HU curves of PDAC were observed, the monochromatic CT values, the effective atomic number(Zef ), the iodine concentration(IC), water concentration(WC), and the corresponding normalized values(normalized monochromatic CT values, normalized Zef , normalized IC, normalized WC)of the lesion and the pancreatic parenchyma in late arterial phase(AP) and portal venous phase(PP) were recorded . The measurements were performed three times repeatedly. Paired t test (normal distribution) or Wilcoxon test (non-normal distribution) were used for analyzing the differences between the two phases and between PDAC and pancreatic parenchyma. Results The monochromatic CT values of PDAC in AP were lower than in PP at each energy level and the difference was more marked at lower energy. The normalized monochromatic CT values increased with the increase of energy level in both AP and PP and the difference was more distinct at lower energy. The Zef , IC and normalized IC of PDAC all had significant differences(P<0.05), while the WC, normalized Zef , and normalized WC had no difference between AP and PP. The Zef and IC of pancreatic parenchyma had significant differences(P<0.05), while the WC had no difference between AP and PP. The differences of Zef , IC, and WC between PDAC and pancreatic parenchyma were significant in both two phases (P<0.05). Conclusions Dual phase CT spectral imaging showed characteristic quantitative parameters of pancreatic ductal adenocarcinoma. The monochromatic CT values, Zef , and iodine concentration of PDAC were lower than those of pancreatic parenchyma in both AP and PP. The monochromatic CT values, Zef , and iodine concentration of PDAC in late arterial phase were lower than those in portal venous phase. The differences were all more distinct at lower energy.

Objective To evaluate the efficacy and side effects of arsenic trioxide (ATO) combined with thalidomide in the treatment of relapsed/refractory multiple myeloma (MM). Methods 35 patients with relapsed/refractory MM were treated with ATO (10 mg/d) and Vit C (2 g/d) for 14 days,28 days per cycle.Meanwhile they were orally administered thalidomide 50 mg/d,and then one week later orally thalidomide was added to 100-150 mg/d. After 3 cycles of treatment, response and the side effects were evaluated. Patients responsed to the regimen were continued the treatment of thalidomide and were followed up to estimate the PFS. Responses were assessed according to the criteria of the EBMT.Adverse events were graded according to the criteria of the WHO.Results The overall response Was 71.43 ％ (25/35),CR 5.71％ (2/35),PR 34.29 ％ (12/35),MR 31.43 ％ (11/35).After a median follow-up of 11 months,the median PFS was 9 months.The major adverse reactions were digestive tract reaction,leukocytopenia,liver function damage,peripheral neuropathy.They were mild,and could be tolerated.Conclusions The combination of ATO and thalidomide is a feasible and active regimen in treatment of relapsed/refractory MM with better compliance in general.

Objective To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods From Feb.2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy,effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV( with 10 keV increment) in late arterial phase [(36±13)HU vs. (62±23)HU, (26 ±8)HU vs. (40±15)HU, and (19±6)HU vs. (27±10)HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [ (43 ± 14 )HU vs.(61 ±25)HU and (30 -10)HU vs. (40 ± 16)HU respectively], effective-Z (late arterial phase 7.80 ± 0. 16 vs. 8.05 ± 0. 21, and portal venous phase 7. 87 ± 0. 15 vs 8.02 ± 0. 22 ), concentration of calcium (water) [late arterial phase (5 ±3) g/L vs. (11 ±4) g/L, t= -3.836, P=0.001 and portal venous phase (7 ± 3 ) g/L vs. ( 10 ± 5 ) g/L, t = - 2.071, P = 0. 049 ] and iodine (water) [ late arterial phase (0.38 ±0.24) g/L vs. (0.78 ±0.32) g/L, t = -3.755, P=0.001 and portal venous phase (0.48 ± 0. 24) g/L vs. (0. 72 ± 0. 34 ) g/L, t = - 2. 161, P = 0. 041 ] were lower in serous oligocystic adenoma than those in mucinous cystic neoplasms. In discriminant analysis, multiple parameters [ age, symptom,tumor size, CT values on 40 keV to 50 keV, effective-Z, concentration of iodine (water) in late arterial phase and concentration of calcium (water) in portal venous phase] showed high accuracy (100%, 27/27 )of joint diagnosis between serous oligocystic adenoma (100%, 15/15 ) and mucinous cystic neoplasms (100%, 12/12). Conclusions The serous oligocystic adenoma and mucinous cystic neoplasms had distinct characteristic findings on CT spectral imaging. CT spectral imaging is highly accurate in the differential diagnosis between serous oligocystic adenoma and mucinous cystic neoplasms.

Objective To identify the risk factors associated with overall survival (OS) for patients undergoing partial hepatectomy for colorectal liver metastases,and to assess the predictive values of five published scoring systems in an independent patient cohort for the purpose of external validation.Methods The clinical,pathologic,and complete follow-up data were prospectively collected from 303 consecutive patients who underwent primary hepatic resection for colorectal liver metastases at the Beijing Cancer Hospital from January 2000 to Aug 2014.The predictive values of the Nordlinger score,the Memorial Sloan-Kettering Cancer Center (MSKCC) score,the Iwatsuki score,the Basingstoke index,and the Konopke scoring system were assessed in this patient set.The clinical and pathologic parameters were further analyzed using univariate and multivariate analyses.Results The 1-,3-and 5-year overall survival were 89.2％,50.8％ and 38.6％,respectively.The median survival time was 37 months.Two risk factors were found to be independent predictors of poor overall survival:the N stage of the primary tumor,and a carcinoembyonic antigen level ＞ 30 μg/L.The MSKCC score had the best independent predictive power for survival when compared with the other 4 prognostic systems (C-index:0.903).Conclusion In our patient cohort,the MSKCC score was the best staging system in predicting survival.

Objective To compare the image quality and radiation dose of prospective electrocardiogram(ECG)-triggered high-pitch spiral scan,prospectively triggered sequential scan and retrospectively triggered spiral scanning mode by dual-source CT in the follow-up of coronary artery bypass graft(CABG).Methods Totally 90 patients with stable heart rate(≤65 beats per minute)after bypass surgery were randomized to undergo prospective high-pitch spiral scan in group A (n=30),prospective sequential scan in group B (n=30),and retrospective spiral scan in group C (n=30).The patency and image quality of the grafts were blindly evalua-ted by two independent readers.Moreover,radiation dose of the three modes were evaluated.Results Scanning time of group A was significantly shorter than that of group B and group C (P<0.05).The average image quality score had no significant difference among three groups(H=0.449,P=0.799).The effective radiation dose of group A,group B and group C were (2.64±1.21)mSv, (6.48±2.58)mSv and(18.95±7.16)mSv,which was significantly lower in group A(H=101.21,P=0.00).Conclusion In pa-tients with a stable HR of 65 beats per minute or less,high-pitch spiral CT scan provides similar image quality at lower radiation dose compared with sequential scan and retrospective spiral scan,which can be widely used as a non-invasive effective tool for the post-operative follow-up of CABG.

Objective To evaluate the correlation between postoperative complications and prognosis after radical hepatic resection for colorectal liver metastasis (CRLM).Methods We retrospectively summarized patients' clinicopathological data and postoperative complications.Postoperative complications were graded using Dindo-Clavien system of classification.Then we investigate the relation between these data and prognosis.Results One hundred and seventy-three patients were recruited.Postoperative complications developed in 59 (34.1％) cases.37 patients had minor complications and 22 patients had major complications.On univariate (x2 =8.106,P =0.004) and multivariate analysis (x2 =8.006,P =0.005),complication was an independent predictor of overall survival (OS).However,in a subgroup of patients with minor compications,morbidity was not associated with a significant reduction in both OS (x2 =3.199,P =0.074) and disease-free survival (x2 =1.313,P =0.252).Conclusions Postoperative complications are an independent factor for long-term outcomes after hepatic resection for CRLM.

Objective Bisegmentectomy Ⅶ-Ⅷ can be an alternative option for the tumor localized in segments Ⅶ and Ⅷ and infiltrating the main trunk of RHV instead of a right hemihepatectomy.This study was to evaluate the safety and practicability of the removal of segments Ⅶ and Ⅷ of the liver with the resection of the main trunk of RHV without vascular reconstruction.Method 13 consecutive patients underwent bisegmentectomy Ⅶ-Ⅷ with the resection of the RHV between Nov.2006 and Dec.2012 at Beijing Cancer Hospital 1st Department.of HPB Surgery.Results Bisegmentectomy Ⅶ-Ⅷ with the resection of the RHV was performed in all 13 patients successfully without the distal vein reconstruction.The duration of the operations was 90-215 min.Mean blood loss was estimated to be 200 ml (100-700 ml).Indications for a bisegmentectomy Ⅶ-Ⅷ included hepatocellular carcinoma in 6 cases,intrahepatic cholangiocarcinoma in one,liver metastasis in 4 and hepatic hemangioma in 2 as confirmed pathologically.All patients recovered without severe complications.The atrophy of segment Ⅵ due to the venous drainage obstacle was observed in 3 patients without the dysfunction of liver postoperatively.Conclusions It is safe and practicable to perform Ⅶ and Ⅷ bisegmentectomy with resection of the right hepatic vein without vascular reconstruction for liver tumors.