Objective To explore the clinical effect of inverted L-shaped incision combined with medial canthal tendon plication for moderate and severe epicanthus correction.Methods Improved method of inverted L-shaped incision combined with medial canthal tendon plication were performed in 42 cases of moderate and severe epicanthus.The epicanthus covered more than 50％ lacrimal caruncle with single-fold eyelids or unconspicuous double-fold eyelids.Among them,40 cases received doubleeyelid plasty simultaneously.Results The follow-up time of 38 cases ranged from 6 to 24 months.37 cases received double-eyelid plasty simultaneously.All the patients obtained satisfactory results aesthetically,the contours of two eyelid fissures and the double-eyelid radian looked more natural postoperatively.There was no reoccurrence of epicanthus.Mild scar proliferation was observed in all of the patients in the early 1-2 months of postoperative period and then would fade within three months.Conclusions It is effective to correct epicanthus by improved method of inverted L-shaped incision combined with medial canthal tendon placation.

Objective To investigate the value of 99Tcm-MDP imaging for the differential diagnosis between infection and aseptic loosening after total hip arthroplasty.Methods During February 2008 to August 2011,74 patients (32 males,42 females,average age (64.3±11.2) years) with hip pain after arthroplasty underwent 3-phase (blood flow,blood pool and bone phases) 99Tcm-MDP imaging.All patients had measurements of serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).Joint infection was defined as either increased peri-prosthetic soft tissue activity during perfusion and blood pool phases or increased peri-prosthetic bone activity during uptake phase,or positive in all 3 phases.Aseptic loosening was defined as having negative 99Tcm-MDP in all 3 phases.Clinical diagnosis was chosen as the gold standard.The blood flow-pool imaging was compared with the serum examinations.x2 test was used for statistical analysis.Results There were 74 symptomatic joints in 74 patients,including 24 joint infections and 50 aseptic loosening.For the detection of peri-prosthetic infection,combined perfusion-blood-pool phase was more accurate than bone uptake phase (90.5％ (67/74) vs 55.4％ (41/74) ;x2=23.159,P＜0.001),with the sensitivity of 91.7％ (22/24)vs 70.8％ (17/24) and specificity of 90.0％ (45/50) vs 48.0％ (24/50),respectively.The blood flow-pool imaging was also more accurate than CRP (73.0％ (54/74) ;x2 =7.656,P＜0.05) and ESR (71.6％ (53/74) ; x2 =8.633,P＜0.05),respectively.Conclusion 99Tcm-MDP perfusion/blood flow-pool imaging is an accurate modality for differentiating peri-prosthetic infection from aseptic loosening in patients with hip pain after arthroplasty.

0.05) for children and young people, showing irrelevancy to age. Conclusions The X ray SRS is effective and safe for cerebral AVM, it gives high obliteration rate for AVM of volume

Purpose To study clinical pathological characteristics,margin status and its influencing factors in different type of facial basal cell carcinoma (BCC).Methods The histopathological features,margin status of the first frozen section and influencing factors was retrospectively analyzed,with review of the relevant literature.The primary outcome variable was the rate of initially positive frozen section margins.Multivariable Logistic regression was used to study histologic subtype,surgical margins,tumor size,location and other factors influence on the rate of initially positive frozen section margins.Results The pathological subtype is the major risk factor,the infiltrative (OR =4.463,95％ CI =1.919-10.380,P ＜0.05) and morpheaform (OR=5.018,95％CI=2.025-16.623,P＜0.05) had higher risk on positive surgical margin compared with the nodular.The rate of initially positive frozen section margins of nodular and superficial BCC at different margins were observed but the difference were not significant (P ＞ 0.05).Conclusion The pathological subtype is the major risk factor.Surgical excision with a 3 mm margin can achieve ideal results for nodular and superficial BCC in facial area.

Objective To evaluate the effect of X-ray stereotactic radiotherapy(SRT)with two different methods in curing brain metastases.Methods 41 patients with brain metastases were treated by SRT,including 24 cases by SRT and 17 cases by SRT combined whole brain irradiation.78 lesions in 41 patients fall into two groups:small tumor(3 cm).All patients were followed for 2～19 months after treatment by CT scan.The effect,recurrent and complication were discussed.Results Following SRT,the effect rate was 92.9% in SRT group and 93.7% in SRT combined whole brain irradiation group.The effect rate was 97.4% for small lesions while 90% large lesions.The recurrent rate was much higher in SRT(17%) than that in SRT combined whole brain irradiation group(5.9%),the difference was statistically significant(?

Objective:Setting up a queuing simulation model to study the allocation and usage of MRI in certain regional hospital in East China. To find out the causes and put forward suggestions. Methods: Statistical method was used for statistical analysis of MRI inspection time. Queuing simulation model was used to analyzing MRI allocation and used in 7 top hospitals. The waiting queue length, average queue length, sojourn time and waiting time was calculated.Results: The average MRI examination waiting time of the 7 top hospitals in the whole region is 0.403 h. The waiting time of 2 hospitals is more than 40 min while which is less than 20 min in 3 hospitals. The equipment utilization rate is higher in 2 hospitals (vacancy rate is 11.9%-16.4%) while which is lower in 2 other hospitals (vacancy rate is 52.3%-58.9%).Conclusion: The problem of health allocations of resources could be solved by establishing regional MRI examination center radiation regional around.

Objective To explore a new surgical treatment for severe inverted nipple and to reduce the possibility of recurrence. Methods Two opposite long six-side polygon de-epithelialized areas were designed within the range of areola on both sides of the nipple. The four sides in lateral portion were dissected and two wedge-shaped dermal and glandular tissue flaps were created, completely releasing the contractive fiber causing nipple retraction while reserving breast ducts. The flaps were reversed 180 degrees through the tunnel bilateral sides of breast ducts to support the nipple. It was tracted for 3-4 weeks by series 7 needle penetrating the nipple basis. Results All the 14 patients were followed up for 3-18 months, and they were satisfied with the appearance and the aesthesia of the nipple and no recurrence was observed, breast-feed function reserved in 2 cases after childbirth. Conclusions This operation is easy to perform with satisfying aesthetic outcome and breast-feed function remaining.It is an ideal method for correcting serious inverted nipple.

Objective To evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.

Objective:To observe the clinical efficacy of warm needling moxibustion plus tuina in treating knee osteoarthritis (KOA) due to cold-dampness blocking collaterals.
Methods:Forty-eight KOA patients were randomized into 2 groups by their visiting sequence, 24 cases in each group. The treatment group was intervened by warm needling moxibustion plus tuina, while the control group was treated with acupuncture plus tuina. The two groups were both treated once a day, 30 min for each session, 10 d as a treatment course, totally for 3 treatment courses. The visual analogue scale (VAS) and Lysholm knee scoring scale (LKSS) were observed before and after the treatment to evaluate the clinical efficacy.
Results:After 3 treatment courses, the VAS and LKSS scores were significantly changed in the two groups (P<0.01), and the between-group differences were also statistically significant (P<0.01). The markedly-effective rate was 83.3% in the treatment group versus 66.7% in the control group, and the difference was statistically significant (P<0.05).
Conclusion:Warm needling moxibustion plus tuina can produce a more significant efficacy than acupuncture plus tuina in treating KOA due to cold-dampness blocking collaterals.

Objective: To investigate the curative efficiency of traditional Chinese medicine Niaoduqing(尿毒清) in treatment of critically ill patients with renal failure(RF).Methods: Forty-six serious patients with RF in emergency intensive care unit(EICU) were treated with western medicine.Additionally,(Niaoduqing) was used orally or via nasal tube 30 g/d for 9 days.The parameters including blood urea nitrogen(BUN),creatinine(Cr),pH,anion gap(AG),red blood cell(RBC),hemoglobin(Hb) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) were recorded 3,5,7 and 9 days after treatment.Then the changes of the indexes before and after the treatment were analyzed.Results: There were obvious differences in renal function 9 days after treatment compared with that before treatment.BUN and Cr significantly(decreased),and RBC increased.AG and APACHEⅡdecreased significantly(all P