Adult ; Aneurysm, Dissecting ; Carotid Artery, Common ; Humans ; Male

[Objective]To investigate surgical strategy of lowest instrumented vertebrae(LIV)selection of anterior correction for adolescent idiopathic scoliosis,and to discuss correlation of lowest instrumented vertebrae and trunk balance.[Method]Twenty-eight patients with thoracolumbar/lumbar adolescent idiopathic scoliosis(Lenke 5 type)were treated by anterior correction and fusion with mean 1.5-year follow-up.Specific radiographic parameters such as LIV and fusion levels,disc wedging,LIV obliquity,global coronal balance were observed respectively,and correlation of disc wedging and these parameters was analyzed.[Result]The preoperative disc angle was(2.96??1.43?)and postoperative was(-3.60??1.75?).The postoperative disc wedging was most correlated with LIV obliquity.Trunk balance and LIV-CSVL distance,fusion segments,LIV obliquity were significant correlated.[Conclusion]Selection of LIV was correlated with various radiographic parameters.Short fusion was inappropriate in such conditions:big disc angle of lower end vertebrae between superior vertebrae,fewer vertebra between certain vertebrae and apex vertebrae,long distance from certain vertebrae to CSVL and lager obliquity of the vertebrae.Disc wedging distal to LIV tent to occur postoperatively if parallel disc was not involved.

Objective To present the surgical results of severe scoliosis treated with one stage anterior release and posterior instrumentation. Methods 36 patients of severe scoliosis received one stage anterior release and posterior correction during July 1997 to January 2003. There were 9 males and 27 females with an average age of 17.2 years, including 33 idiopathic scoliosis and 3 neurofibromatosis scoliosis. The Cobb's angles of scoliosis were from 85? to 116? with a mean of 96.2?. 18 cases were found with single thoracic curve, 7 cases double thoracic and lumbar curves, 6 cases thoracolumbar curve, 4 cases lumbar curve, and 1 case double thoracic and lumbar curves with associated lumbar curve. 20 cases had abnormal sagittal profile. Three-dimensional instrumentations such as CD (4 cases), CD-Horizon (5 cases), TSRH (10 cases) or Isola (17 cases) were used in posterior procedure after anterior release under the same anesthesia. 31 cases of this group received thoracoplasty. Results The coronal correction was achieved 48.5% on average. The sagittal profile of the spine was distinctly ameliorated. The sagittal balance was restored or maintained in 80.6% of the patients. There were no severe neurological complications, hook displacement, rod breaking and deep infection at follow-up. One case of traumatic pleurisy occurred after surgery and one pseudarthrosis at 2 years later. One patient demonstrated imbalance 11 months after surgery. Two patients presented loss of correction more than 10? at one year follow-up (5.2? on average). Conclusion The result of one stage posterior correction associated with anterior release in treatment of severe scoliosis is satisfactory. Appropriate selection of cases, detailed assessment, SEP monitoring and wake-up test during surgery are helpful to reduce severe complications. The long term results need to be followed-up.

OBJECTIVE To analyze the characters of hospital infection among deceased inpatients.METHODS The inpatients who died in hospital from Jan 2004 to Dec 2005 were analyzed retrospectively.RESULTS The infection rate of deceased inpatients was 40.11%,and the location majored in respiratory tract,urinary system and digestive tract.The infection rate was apparently higher among the cases more than 60 years old,and those with hematological disease,circulatory disease and nervous system disease.The hospital infection rate was related with long hospitalization and had seasonal fluctuation.CONCLUSIONS The high hospital infection rate among deceased pabients may be related with the seriously underlying diseases, aging,drug abuse and invasive therapy.

Antidiuretic Hormone Receptor Antagonists ; Heart Failure ; drug therapy ; Humans

Carcinoma, Papillary ; diagnosis ; pathology ; Female ; Humans ; Jugular Veins ; pathology ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; pathology

Objective To study the diagnostic value of serum α-L-fueosidase (AFU), transforming growth factor alpha(TGF-α)and ferritin (Fer) in primary hepatic carcinoma (PHC). Methods AFU and Fer in the serum were studied in 36 patients with benign hepatism and 56 patients with low concentration AFP of PHC hepatic carcinoma by automatic biochemistry analyzer Roche Modular. ELISA was used to assay the degree of TGF-α The sensitivity and specificity of AFU, TGF-α and Fer for low expression AFP of PHC were evaluated by ROC curve. Results The serum AFU, Fer and TGF-α levels were all significant difference in the patients than those in controls (P <0.05). The area under ROC curve of these indexes in descending order was AFU (0.707), TGF-α (0.677) and Fer (0.592). The diagnostic sensitivity of Fer was lower than AFU and TGF-α in diagnosis of AFP lowly expression PHC. The ratio showed AFU better than TGF-α The diagnostic specificity of AFU (64 %) was higher than that of TGF-α (61%) when TGF-α and AFU was at the same diagnostic sensitivity (64 %). Conclusion AFU is more valuable than Fer and TGF-α for negative or AFP lowly expression PHC, meanwhile it has much more accuracy.

Objective To investigate the clinical, histopathological and immunopathological charac teristics of erythema annulare centrifugum (EAC). Methods A retrospective study was performed on 54 cases of EAC collected from 2001 to 2005. Information was gathered about patients' sex, age, disease course, distribution and morphology of eruptions, symptoms, complications. Also, the findings of histopathology and direct immunofluorescence examination in some patients were evaluated. Remits EAC most commonly occurred on the lower limb, and was usually complicated by various diseases among which mycosis predominated. Histological examination revealed compact lymphocyte infiltration in dermal vessels in 32 of these 54 patients. Direct immunofluorescence showed the deposition of IgG, lgM, or C3 on the walls of small vessels in 6 of 12 tissue samples tested. Conclusions EAC is a multifactorial disease, and it seems that the infiltration of lymphocytes and deposition of circulatory immune complex on small blood vessels in dermis may play important roles in its pathogenesis.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

Adolescent ; Adult ; Bundle of His ; pathology ; physiopathology ; Child ; Female ; Humans ; Male ; Purkinje Fibers ; pathology ; physiopathology ; Tachycardia, Ventricular ; pathology ; physiopathology