Objective To evaluate the value of CT guided branchofiberoscopic biopsy of carcinoma originating from small bronchiole. Methods The fiberbronchoscopic biopsy results of 33 cases under CT guidance were compared to the results of surgical pathology, including fiberbronchoscopic blind examination and CT guided percutaneous lung biopsy. Results The lesions occurred in 1 - 3 grade bronchus could be approached with fiberbronchoscopic biopsy under direct vision. CT guided fiberbronchoscopic biopsy had the benefit of getting more reliable, accurate samples simultaneously with less complications in the diagnosis of bron-chiolar lesions. It was more easy and having higher positive rate to diagnose the lesion of terminal bronchiole and alveoli by CT guided percutaneous lung biopsy. Conclusions CT guided fiberbronchoscopic biopsy can collect more wholesome pathologic specimen than other examinations for small lesions of bronchus. The comprehensive utilization of microscopy, brush biopsy and multiple sites biopsy can improve the accuracy.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurotoxicity Syndromes ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To explore the better diagnostic method for acute splenic arteral injury through comparative analysis of CT and DSA. Methods Fifty-seven patients with acute splenic injury were examined by CT and DSA,treated with splenic arterial embolization and then undertook follow up. Results CT examination possessed higher sensitivity and accuracy than DSA in demonstrating splenic parenchymal laceration,intrasplenic hematoma,subcapsuler hematoma,rupture of splenic capsule and combinated injury of intra-abdominal organs,especially in localizing splenic laceration.And there was a high significant difference statistically between the two kinds of examination(?~2=10.71,P

The latest literature concerning operative treatment for distal radius fracture was reviewed to find out the newest developments in this field.This paper summarizes bilateral internal fixation with combined palmar and dorsal incisions,dorsal open reduction and plate internal fixation,internal fixation with LCP(locking compression plate),dorsal Pi-plate internal fixation combined with external fixators,and arthroscopic treatment of distal radius fractures,for they are reported to have reached excellent or good results.The reports show that each subtype of distal radius fractures merits a unique approach,because distinct fracture patterns result from different mechanisms of injury.

Animals for model of osteoporosis involve rat, mouse, rabbit, beagle dog, minipig, sheep, etc. The types of model include aged related model, ovariectomized model, orchietomied model, drug treated model, abolition degeneration model, and dietary bone loss. The rat with ovariectomized model is used widely. Biochemical determination, bone mineral density measurement, bone histomorphorphormetry and bone biomechanics are used to judge the formation of experimental osteoporosis.

Objective To investigate the histologic basis of imaging manifestations on adrenal myelolipoma and evaluate the value of various imaging modalities in diagnosing the tumor.Methods The imaging manifestations and pathological features of 21 cases of adrenal myelolipoma proved by postsurgical pathology were retrospectively analysed.Results Histologically,the myelolipoma presented hematopoietic elements amidst fatty tissue and showed indefinite border.The myeloid tissue was well vascularized and were adherent closely to normal adrenal gland.Both CT and MRI detected a single mass with irregular plaque or streak of bone marrow tissues between fatty components.The capsule of the tumor was not apparent,but rarely it presented an irregular local “capsule”which was composed of adrenal tissue with compression surrounding the tumor.Enhanced-scan found foggy enhancement in fatty tissue and enhancement of bone marrow tissue which made myeloid plaque enlarged and the edge misted.Ultrasonography demonstrated highly echogenic fat-containing ball of adrenal,while intravenous urography only showed translocation and renal axis alteration of homolateral kidney.Conclusion CT scan appears to be the most accurate qualitative modality to demonstrate adrenal myelolipoma while coronal and sagittal section scanning on MRI can make its localization more exact.Ultrasonography is also an important way in detecting the mass whereas intravenous urography and abdominal plain film should not be used to be the qualitative criterion.

Objective To evaluate the comprehensive application of the CT guided transbronchial lung biopsy (CT TBLB) and CT guided percutaneous needle lung biopsy (CT_NLB) in pulmonary peripheral lesions.Methods According to the lesion location in lung field,51 patients were selected to CT TBLB and 46 patients to CT NLB.Results In the comprehensive application of the two lung biopsy methods,the comphensive biopsy success rate was 100%,pathological diagnostic positive rate 87.6% and diagnostic correct rate 97.9% (of them 100% in CT TBLB).The complications of pneumothorax and haemoptysis were decreased significantly.The positive rate and diagnostic correct rate seem higher,but there was no significant difference between the two methods (P

OBJECTIVETo discuss the curative effect of traditional treatment and combination therapy for senile hip fracture.

METHODSUsing prospective methods to choose 300 cases of elderly patients with hip fractures from February 2011 to December 2012, which were randomly divided into comprehensive treatment group and conventional treatment group. After screening, 148 case were in comprehensive treatment group,including 62 males and 86 females with an average age of (78.76 +/- 7.32) years old ranging from 60 to 88; 45 cases were intertrochanteric fracture of femur, 103 cases were fracture of neck of femur; Singh index > or = IV in 74 cases, < IV in 74 cases;preoperative Harris score was 39.90 +/- 2.28. There were 146 cases in conventional treatment group,including 60 males and 86 females with an average age of (80.00 +/- 7.06) years old ranging from 66 to 96; 50 cases were intertrochanteric fracture of femur, 96 cases were fracture of neck of femur; Singh index > or = IV in 75 cases, < IV in 71 cases; preoperative Harris score was 40.10 +/- 2.81. Preoperative general situation,leaving bed time and hospital stay, the incidence of postoperative 12 weeks Singh index > or = IV and DPD/Cr value, Harris score at 12 months after operation and the incidence of fracture again of two groups were observed and compared.

RESULTSIn comprehensive treatment group 140 patients were followed up for 12 to 18 months with an anverage of 14.80 +/- 1.85. In conventional treatment group 132 patients were followed up for 12 to 14 months with an average of 12.75 +/- 0.79. There were no significant differences in age, gender, the classification of fracture, preoperative Harris hip score, preoperative Singh index > or = IV level and DPD/Cr value between the two groups (P > 0.05). Comprehensive treatment group had shorter leaving bed time and hospital stay, smaller postoperative 12 weeks DPD/Cr value and higher postoperative Harris score, higher incidence of postoperative 12 weeks Singh index > or = IV level, lower incidence of fracture again than conventional treatment group, there was statistically significant difference between two groups (P < 0.05).

CONCLUSIONFor the anti-osteoporosis effect, the comprehensive treatment group has more advantage than traditional treatment group in elderly hip fracture, which can further improve the elderly hip fracture treatment and provide the reference of evidence-based medicine cooperate with rehabilitation department.

Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Hip Fractures ; surgery ; Humans ; Incidence ; Length of Stay ; Male ; Postoperative Complications ; epidemiology ; Prospective Studies

BACKGROUND: It has been reported that a combination of estrogen and progestin has a protective synergistic effect on osteoporosis with only little side effects.OBJECTIVE: This study was designed to investigate the effect of a combination of norethisterone and ethinyl estradiol (EE) on bone mass in ovariectomized rats.DESIGN: This study was a randomized controlled experiment.SETTING:It was conducted at the Department of Pharmacology of Guangdong Medical University.MATERIALS: Twenty-four specific pathogen free (SPF) unmated SD rats were selected, aging 4 and half months and weighing 230±15 g.METHODS: The experiment was conducted in the Department of Pharmacology of Guangdong Medical College from May to November 2002.These rats were randomly divided into 3 groups: pseudo-operation group, ovariectomy group and compound norethisterone group, each containing 8 rats. For the former two groups, ethanol solution (volume fraction=0.056), at a dose of 5 mL/(kg.d), was administered by gavage. While for compound norethisterone group, 60μg/(kg·d) norethisterone and 3.5μg/(kg·d) EE were given by gavage (according to the dosage for human, which was 20-35 μg EE combined with norethisterone). Duration of treatment was 90 days for all the animals. Then their tibias were removed. Employing a fullyautomatic imaging analysis system, osteoclasts and the relevant dynamic and static parameters reflecting secondary trabeculaes formation region in proximal tibias were measured. Respectively, the humeral samples were removed and employing the palsma emission spectrograph of full-spectrum direct reading, calcium content and hydroxyproline content in bone samples were measured. Meanwhile, urine calcium and hydroxyproline concentrations were examined as well.MAIN OUTCOME MEASURES: ①The trabecular area (Th. Ar), trabecular thickness (TbkTh), trabecular number (Tb.N) and trabecular separation (Tb. Sp) and the changes in static parareters of perimeters of osteoclasts were investigated. Variance in percent labeled perimeter (L. Pm ％), mineral apposition rate (MAR) and bone formation rate (BFR/BV) were also calculated. ②Changes in serum alkaline phosphatase (AKP), calcium and hydroxyproline contents in bone and urine were all measured.RESULTS: All the 24 rats entered the analysis procedure. Compared to pseudo-operation group, for the ovariectomy group, Tb. Ar and Tb.N decreased, Tb. Sp increased and osteoclast perimeter significantly increased (P＜0.01). Addtionally, the bone formation markers increased apparently with an increase in L. Pm ％ and MAR (P＜0.05) and a significant increase in BFR/BV (P＜0.01). Compared with the ovariectomy group, for the compound norethisterone group,the bone mass and the Tb.N increased, marked by an increase of 82％ in Tb. Ar and an increase of 83％ in Tb.N (P＜0.05), and the Tb.Sp decreased, marked by a decrease of 51％ (P＜0.05). Meanwhile, there was a decrease of 52.5％ in osteoblast perimeter (P＜0.01), an increase in organic bone matrix and a decrease in urine hydroxyproline (P＜0.05).CONCLUSION: A combination of estrogen and progestin has a protective synergistic effect on ovariectomized rats with osteoporosis, and it is capable of increasing the organic bone matrix without significant inhibitory effects on bone formation. The experimental dosage of the compound was calculated according to the clinical dosage, 20-35 μg estrogen combined with a progestin, which will yield optimal protective effects on bone sometimes.