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 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 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 discuss the application of Chinese version of Speech intelligibility rating (SIR) in e-valuating the speech intelligibility of Chinese children with hearing disorder ,and analyze its scorer reliability .Meth-ods 50 children with cochlear implants or hearing aids were interviewed using SRI Chinese version .Each child was rated by a parent and a speech and language therapist .The reliability of scores was analyzed with Spearman correla-tion coefficient ,Kendall's coefficient of concordance and Kappa coefficient .Results The complete agreement was foud in 34 cases(68% ) ,with a disagreement of one category in 14 cases(28% ) ,and a disagreement of 2 categories was found in 2 cases (4% ) .Spearman correlation coefficient was 0 .885 ,Kendall's coefficient of concordance was 0 .801 ,Kappa coeffi-cient was 0 .593 ,the result was statistically significant (P<0 .001) .Conclusion SRI Chinese version has good reliability and is helpful in evaluating Chinese speech producing ability of children with hearing disorder in everyday life .

Objective:To investigate the effect of human interferon-α-2b(IFN-α-2b) in the treatment of endometriosis by detecting the levels of CA125 and endometrial antibody(EMAb). Methods: Forty-five cases with endometriosis were divided into three groups. Fifteen cases in test group (operation+IFN-α-2b), 20 cases in control group A (operation+Diphereline), 10 cases in control group B(only operation). The blood serum level of CA125 was detected by microparticle enzyme immunochemiluminescent at pre-operation, the first month, second month and third month of the post-operation; and the EMAb level was measured by enzyme linked immunosorbent assay (ELISA). The follow-up of patients was carried out after operation to evaluate the clinical appearances and record the adverse effects of the human IFN-α-2b. Results: Compared with pre-operation, the levels of CA125 and EMAb were obviously degraded in the first to third months after surgery in test group and control group A(P < 0.05). There were no significant difference in the levels of CA125 and EMAb were at pre-operation,the first month,second month and third month of the post-operation between the test group and control group A(P > 0.05). There were no significant difference in the levels of CA125 and EMAb at pre-operation between the test group and control group B(P > 0.05). However, the level of EMAb was lower the first month after operation in the test group than that of control group B. In the follow-up, the adverse effects of the human interferon-α-2b were observed including low-grade fever, articular muscle soreness and gastrointestinal tract complaints. These appearances completely disappeared after drug withdrawal. It had less impact on the menstruation. Conclusion: The levels of CA125 and EMAb were similar in treatment of endometriosis with human IFN-α-2b and with Diphereline. Both of the treatments are better than the pure surgery. It has less impact on the menstruation and can avoid menostasia.

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

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.