Objective To explore optimal puncture route and method for advance pierce accuracy when perform percutaneous vertebroplasty. Methods 248 cases (365 vertebrae )with osteoporotic vertebral body fractures in thoracic vertebral and lumbar vertebral were treated by percutaneous vertebroplasty. Total injured vertebraes were examined and measured puncture routes under CT before operation. Then according to measure route pierce and perform percutaneous vertebroplasty, when the pricker arrived preconceive place, take some radiographs obverse and side, after operation,scan injured vertebraes with CT again. Pierce accuracy was evaluated. Results 365 vertebrae were pierced successfully,the pierce successful rate was 100%. 324 vertebra piercing route were coincident with CT measure routes,coincident rate 88.8%. 41 vertebra piercing route weren' t coincident with CT measure routes, deflective rate was 11.2%. Conclusion CT measure puncture route and directing pierce was effective means when percutaneous vertebroplasty.

Objective:To research the value of diagnosis of traumatic rib fractures by multislice CT VRT and DR plain film. Methods: Seventy-two cases of traumatic rib fracture patients were diagnosed by DR film and multislice CT VRT. Results:Multiple rib fractures than single, most of them occurred in the 4-10 ribs and axillary segment, 97.2%of 16-slice spiral CT three-dimensional reconstruction of patients with rib fracture diagnosis rate significantly higher than DR plain film diagnosis rate 80.3%(x2=19.15, P<0.01), DR plain film missed rib fractures are mainly located in the costal cartilage (58.1%), 16-slice spiral CT reconstruction is still found 19 other fractures and lung complications 16cases. Conclusion:16-slice CT the thin layer VRT diagnosis of rib fractures greatly improves the diagnostic accuracy.

Objective To investigate the feasibility of abdominal aorta or common iliac artery occlusion by balloon catheter dilatation to decrease blood loss and promote operation safety during resection of sacral tumors and hip bone metastatic tumors. Methods From March 2003 to March 2005, 4 cases each of high level sacral tumors (3 of giant cell tumor and 1 of chordoma) and hip bone metastatic tumors (3 of lung cancer and 1 of osteosarcoma ) were resected after occlusion of the distal abdominal aorta or unilateral common iliac artery with balloon catheter dilatation in reducing intraoperative hemorrhage, the blocking time were 40 to 70 mins each with an interval of 15 to 20 mins. A balloon catheter was introduced through femoral artery at radiographic department one hour before the index operation. The balloon catheter was positioned proximal to the bifurcating of common iliac artery in lower abdominal aorta between superior mesenteric artery and renal artery confirmed by arteriography, or located in affected side common iliac artery. Results After the occlusion of abdominal aorta or unilateral common iliac artery, there was much less intraoperative hemorrhage (the amount of bleeding, 100 to 300 ml) and needed no hemostasis during the resection and curettage of the tumors. It possessed the similar effects as using the tourniquet in the operations of the extremities. The operating field was clean and the anatomic structures were exposed clearly. It was easy to define the boundary of the tumors and enable to perform complete tumor excisions and reduce contamination in the operative field. All the patients had smooth blood pressures during the operations. 1 case of sciatic nerve paralysis occurred in sacral giant cell tumor postoperation, but recovered 3 weeks later. Conclusion Occlusion of major blood supply arteries with balloon catheter dilatation can effectively reduce operative hemorrhage during the resection of sacral and hip tumors and it can promote the safety of the operations.

Objective Through retrospective analysis of the thoracotomy of pulmonary metastases form osteogenic sarcomas in order to explore the related factors of prognosis and to improve the outcome of treatment.Methods From October1980to March2003,32cases with pulmonary metastases from sarcoma of bone were reviewed.62of thoractomy were performed for the patients,61of which were accomplished in the department of orthopaedics,and58operations were performed by the authors.There were32males and10females aging from11to61years with an average of 22.1years.The primary tumors of the patients were25oateosarcomas,3chondrosarcomas,2juxtacortical osteogenic sarcomas,and1each of fibrosarcoma and Ewings sarcoma.Of 32cases,21(65.6%)were treated with limb salvage,and11(34.4%)by am puta-tion.According to Enneking system,there wereⅡB in26andⅢB in5.25(78.1%)cases were bi lateral multiple metastases,6(18.8%)cases were unilateral solitary metastasis,and1(3.1%)case was unilateral mul tiple metastases.Most of the procedures of operation were local resection of the tumor ;however,only5cases underwent lobectomy.Results The postoperative complications included1case of severe bleeding cured by exploratory thoracotomy,2cases of lethal infections,and1case of atelectasis.Of 32cases,11sur -vived with out tumor at final follow-up.In25osteosarcoms,16were dead,2were lost from the follow-up;7cases of the other18cases that bilateral resections performed,were alive without tumor (38.9%)with a me di an survival time of 7years and3months.1each of Ewings sarcoma,paraosteal osteosarcoma and,chon-drosarco ma survived without tumor for 22years and5months,19years and3months,and13years and3months respectively.Conclusion Thoracotomy of pulmonary metastases of osteogenic sarcomas is an ef-fective method to salvage the patients life.The procedure of metastasectomy is local resection.The results al-so suggest that newadjurant chemotherapy is a important way to effect the condition of pulmonary metastases of osteogenic sarcomas.

Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Objective To establish a method for the determination of eight heavy metal elements ofPb,Cd,As,Hg,Co,V,Se,Mo in iron dextran by inductively coupled plasma optical emission spectrometry (ICP-OES).Method Through selection of detection wavelengths,optimization of instrument parameters,correction of spectral interference,verification of ionization interference and investigation of suppression methods,the eight heavy metal elements were analyzed by ICP-OES.Results The recovery rate of the detected elements increased 5％ to 10％ by suppression of ionization interference.The accuracy of the method was good.The spiked recovery rates of the detected elements were from 95.7％ to 101.1％.The precision of the method were good (RSD ＜ 3.6％,n =6).The linearities of the detected elements were good,and the correlation coefficients were all greater than 0.999.The detection limits were from 0.15 to 8.09 ng/mL.The quantization limits were from 0.46 to 24.26 ng/mL.Conclusion The method was accurate,sensitivity,rapid and reliable,which can be applied to the determination of contents of eight heavy metal elements in iron dextran.

Objective To investigate the effect of levothyroxine(L-T4) intervention on premature delivery occurrence risk in early pregant women complicating subclinical hypothyroidism.Methods The databases of PubMed,EMBASE,EBSCO,Cochrane library,CBM and Wanfangdata were retrieved for collecting the related literatures on pregnancy complicating subclinical hypothyroidism published from January 1980 to March 2017.The undesirable studies were deleted according to the inclusion standard.The meta analysis was performed by using the RevMan5.3 software.Results (1) The 12 articles on premature delivery occurrence risk in pregnan women complicating subclinical hypothyroidism without intervention were included(accumulated 5 612 cases of samples and accumulated 368 cases of premature delivery),802 pregnant women received L-T4 intervention,the control group (4 810 cases) was the pregnant women of normal thyroid.The merged OR was 3.46,95%CI 2.64-4.54,P<0.05.(2) Twenty-one articles on premature delivery occurrence risk in pregnan women complicating subclinical hypothyroidism treated by L-T4 in meta analysis were included(accumulated 2561 cases of samples and accumulated 286 cases of premature delivery).The merged ORwas 5.37,95%CI 3.90-7.38,P<0.05).Conclusion Early pregnancy complicating subclinical hypothyroidism can increase the risk of preterm birth,whereas adopting the L-T4 intervention therapy can significantly reduce the risk of premature delivery occurrence.

Aim: This study was performed to: (i) determine the association of breast cancer with dense breasts, and (ii) determine the breast cancer association with early onset of menarche, nulliparity, late age at first childbirth, not breast-feeding, and family history of breast cancer. Methods: This was a retrospective hospital-based case-control study. The 231 cases were women diagnosed with breast cancer on histology during the study period from July 1998 to April 2005. The 231 controls were age-matched and randomly selected women who did not have breast cancer but had mammography performed during the same time interval. Tabar classification was used to classify the mammographic parenchymal pattern of the 462 samples. The same radiologist analysed the parenchymal pattern based on the craniocaudal and mediolateral oblique views. Statistical analysis was done using the SPSS package. Results: Majority of women with breast cancer (55%) had dense breasts (29% Type IB, 19% Type IC, 4% Type IV, 3% Type V). Majority of controls (58%) had dense breasts (22% Type IB, 26% Type IC, 6% Type IV, 4% Type V). The majority of women with breast cancer had menarche at 12 years or older (93%), were parous (89%), had the first childbirth before 35 years old (91%), had breast-fed (67%), and did not have family history of breast cancer (84%). For controls, the majority had menarche at 12 years or older (88%) were parous (87%), had the first childbirth before 35 years old (98%), had breast-fed (66%), and did not have family history of breast cancer (85%). All factors explored, including breast density, were not significantly associated with breast cancer. The odds ratio for breast cancer among those with dense breast compared to those with non-dense breast is 0.8 (95% CI=0.6, 1.2). Conclusion: This study found no association between breast cancer and dense breasts (p=0.398). There was also no association between breast cancer with early onset of menarche (p=0.174), nulliparity (p=0.448), older age at first childbirth (p=0.065), not breast-feeding (p=0.716) and family history of breast cancer (p=0.665).

Bilirubin ; Child ; Duodenogastric Reflux ; diagnosis ; Esophageal Diseases ; diagnosis ; Esophagus ; metabolism ; Gastroesophageal Reflux ; diagnosis ; Humans