Objective To evaluate the relationship between transverse process fractures of lumbar spine and blunt abdominal trauma.Methods 169 cases of blunt abdominal trauma were reviewed.Number and type of lumbar transverse process fractures associated intra-abdominal injuries were recorded.Results 148 fractures in 81 cases showed transverse process fractures on CT (single fractures in 43,multiple fractures in 38).Of them,the fractures were at right-sided in 28 patients,left-sided in 33 and bilateral in 20.Transverse process fractures of L 1 vertebra were most common(n=60).Transverse process fractures were associated with abdominal trauma in 15 cases (18%), both was statistically significant (?

Objective To analyze the cost-benefit of large-scale medical instruments and provide the reference for medical instruments' purchasing.Methods The application of classical economic model,on the basis of cost-benefit analysis model of the practice of hospital's medical instruments,the evaluation system was established.Results The combination of practical work in hospital radiology department,recruitment evaluation of mathematic model is verified repeatedly by obtained dates;the magnetic resonance,the evaluations of CT economic benefit and overall efficiency of division are fulfilled.Conclusion This system can effectively evaluate the cost-benefit of large-scale medical instruments.

Objective To compare the efficacy of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) on polycystic kidney disease (PKD) patients with end-stage renal disease (ESRD). Methods Retrospective analysis was made on 29 patients with PKD who carded out dialysis therapy for over 3 months in our department from January 2001 to December 2007. They were divided into the CAPD group (10 cases, 34.5%) and HD group (19 cases, 65.5%). Ten cases of non-PKD CAPD patients were randomly selected as the control, who matched the CAPD group in terms of age and gender. The patient information was recorded, such as general data, initial dialysis data, comphcations, survival time, quit of dialysis or death, etc. Kaplan-Meier method and Log-rank test were adopted to analyze the survival rate. Results The survival rates of 1-, 3- and 5-year for the CAPD group were 90%, 75% and 25% respectively, while for the HD group were 94.4%, 67.6%, and 48.3%, and for the control were 83.3%, 44.4% and 22.2% respectively, with no significant differences among 3 groups (P>0.05). group and the control were quite similar. The incidence of peritonitis for the CAPD group (0.62 times/patient year) was similar to that for the control (0.30 times/patient year)(P>0.05). The duration of the lust peritonitis[(23.5±4.0) months vs (20.0±15.8) months] and the catheter exit-site infection (0 time vs 1 time) for two groups were similar as well (P>0.05). One patient had hernia in CAPD group and no patient in control group had hernia. The incidence of peritoneal dialysate leakage was similar between these two groups. In the HD group, two patients (10.5%) had cerebral hemorrhage resulting in death, and 10 patients (52.6%) had cystic hemorrhage, 5 out of whom underwent operation due to repeated cystic hemorrhage and 2 cases received unilateral nephrectomy because of severe hemorrhage. No patient in CAPD group had cerebral hemorrhage but 1 patient (10%) had cystic hemorrhage and recovered after conservative treatment. The hemorrhage complication incidence of CAPD group was significantly lower than that of HD group (P<0.05). Conclusions The prognosis and complication incidence in PKD and non-PKD patients treated with CAPD are similar. The prognosis of PKD patients treated with CAPD or HD is also similar, and the risk of hemorrhage complications of PKD patients treated with CAPD may be decreased compared with those treated with HD. PKD patients can choose HD or PD as the initial therapy of ESRD unless existence of hernia or intolerance. PKD is not the contraindication of PD.

Objective To compare the efficacy between the two-cuff swan neck catheter and the Tenckhoff catheter in continuous ambulatory peritoneal dialysis (CAPD) patients prospectively. Methods One hundred and ten patients with end-stage renal disease (ESRD) were selected as candidates, who received catheter implantation and CAPD therapy for the first time. Patients were divided into group A (swan neck catheter group) and group B (Tenckhoff catheter group), 55 patients for each group. Catheters of beth groups had a straight end and were implanted by routine surgical procedure. One-year follow-up was performed and information was recorded such as complications, survival time, quit of dialysis, death, etc. Survival analysis was carried out by Kaplan-Meier method and Log-Rank tests. Results At the end of follow-up, 17 patients died, 3 received renal transplantation, 8 were transferred to hemodialysis, 3 went to other hospitals, and 79 patients (71.8%) remained in our department for CAPD. Twenty-six patients of both groups had peritonitis with a total of 35 occurrences. The total incidence of peritonitis was 0.32 times/patient year, with the detailed figure of 0.35 times/patient year for group A and 0.29 times/patient year for group B respectively (P0.05). The time interval between the catheter implanting and the onset of peritonitis was (30±29) weeks and (29±24) weeks for group A and group B respectively (P0.05). The risk of developing peritonitis in both groups was 26.97% within 1 year. Tunnel infection occurred in 2 patients and exit-site infections in 9 patients of two groups. The incidence of tunnel plus exit-site infections was 0.1 times/patient year. Incidence of tunnel infection and the exit-site infection for group A was lower than that of group B (0 vs 0.036 times/patient year and 0.06 times/patient year vs 0.11 times/patient year respectively). However, the difference was not significant (P0.05). Mechanical complications of catheter (catheter migration, omcntum wrapping, leakage of peritoneal dialysates, slip out of outer cuff), incidence of inguinal hernia and bellyache between two groups were not significantly different (P0.05). There were 4 cases of catheter drawing in each group. Both two groups had the same 12-month technical survival rate as 92.73%. Of 17 dead cases, 7 were in group A and 10 in group B (P0.05). The main death causes were cardiocerebral events (47.1%) and infections (23.5%). The 12-month survival rate was 86.34% for group A and 80.68% for group B (P0.05). Conclusions There are no significant differences of infection, mechanical complications, technical survival rate and patients' survival rate between two groups. The efficacy of swan-neck catheter is similar to Tenckhoff catheter in CAPD patients.

Objective To analyze the histological changes of bone diseases and to investigate the noninvasive measurements for diagnosing renal osteodystrophy (ROD) in maintenance dialysis patients . Methods Ninety-one patients were selected to receive bone biopsy . The bone samples were stained with HE, toluidine blue and Masson, and were examined with light microscopy . The levels of immunoreactive parathyroid hormone (iPTH), osteoprotegerin (OPG),sRANKL and osteocalcin (OCN) were determined in the patients enrolled from 2004 to 2006 . The level of iPTH was measured by radioimmunoassay . OPG and sRANKL were measured by ELISA,and OCN was measured by chemiluminescence . Results The incidence of ROD in the maintenance patients was 100% . According to the histological appearance, 50 cases (54 .9%) were high turnover bone disease (secondary hyperparathyroid bone disease), 9 cases (9 .9%) were low turnover bone diseases(osteomalacia and adynamic bone disease), and 32 cases(35 .2% ) were mixed bone disease . The level of iPTH in patients with ROD was significantly increased compared with healthy controls . It was the lowest in low turnover bone diseases . There was no difference among three types of ROD . OPG level was significantly increased compared with healthy controls [(2176 .58±1576 .08) pmol/L vs (1310 .46±1254 .00) pmol/L, P＜0 .05] . The level in high turnover bone diseases was higher than that of the healthy controls [(2261 .85±1712 .22) pmol/L vs (1310 .46±1254 .00) pmol/L, P＜0 .05] . There was no difference among three types of ROD .sRANKL level in high turnover bone disease was significantly increased compared with healthy controls [(0 .328±0 .524)pmol/L vs (0 .084±0 .190) pmol/L, P＜0 .05] . OCN level was also higher than that of the healthy controls (P＜0 .05), and the OCN level in low turnover ROD was the lowest among three types of ROD . OCN level in mixed ROD was dramatically increased as compared to low turnover ROD [(226 .633±66 .455) pmol/L vs (193 .03±104 .269) pmol/L, P ＜0 .05] .Conclusions The histological changes of bone disease can be indicated by iPTH level, but the types of ROD can not be distinguished according to iPTH level neither be differentiated by the levels of OPG, sRANKL and OCN . Bone histomorphometry is still the golden standard for diagnosing renal osteodystrophy .

Objective:To study the relationship between CYP4F2 gene polymorphism and coronary heart disease (CHD) in Mongolia patients ,and investigate clinical characteristics of these patients . Methods:All subjects received questionnaire . Gene amplification and genotyping were performed in 234 Mongolian CHD patients (CHD group) and 221 non-CHD pa‐tients (normal control group) using high temperature ligase detection reaction technique .The relationship between Mongo‐lian CHD and CYP4F2 gene polymorphisms of two single nucleotide polymorphism (SNP) sites (rs1558139 ,rs2108622) was analyzed .Results:Compared with normal control group ,there were significant rise in percentages of male (41.18% vs . 67.95% ) ,smoking history (32.13% vs .41.88% ) ,body mass index [BMI ,(21.66 ± 4.53 ) kg/m2 vs .(25.34 ± 5.37 ) kg/m2 ] and triglyceride level [ (1.66 ± 0.90) mmol/L vs .(1.92 ± 1.38) mmol/L] ,and significant reduction in level of high density lipoprotein cholesterol [ (1.18 ± 0.28) mmol/L vs .(1.07 ± 0.29) mmol/L] in CHD group , P<0.05 or <0.01.There were no significant difference in genotype and allele frequencies of rs 1558139 and rs2108622 between two groups . Conclusion:Clinical characteristics of Mongolian CHD patients include high male percentage ,smoking history ,high body mass index and high triglyceride level .CYP4F2 gene polymorphisms of rs1558139 and rs2108622 are not related to coronary heart disease in Mongolian patients .

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD2 Antigens ; metabolism ; Child, Preschool ; Chromosome Breakage ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Ki-1 Antigen ; metabolism ; Lymphoma, Large-Cell, Anaplastic ; drug therapy ; metabolism ; pathology ; Mucin-1 ; metabolism ; Prednisone ; therapeutic use ; Receptor Protein-Tyrosine Kinases ; genetics ; metabolism ; Vincristine ; therapeutic use

OBJECTIVETo establish a guinea pig model of tympanosclerosis and investigate the development and progression of tympanosclerosis in the tympanic membranes and middle ear mucosa.

METHODSTwenty-one healthy guinea pigs were subjected inoculation of 1x10(8)/L Staphylococcus aureus into the left middle ear cavities under general anaesthesia, with the right ears as the control, to establish models of chronic purulent otitis media. The animals were sacrificed by decapitation after 1, 3 and 6 months after model establishment for histological examination of the middle ear mucosa.

RESULTSThe histological changes of tympanosclerosis occurred in some of the animals 3 months after model establishment, and the extent of calcium deposition and fibrosis across the mucosa were positively correlated with the duration of chronic purulent otitis media.

CONCLUSIONTympanosclerosis may occur in some guinea pigs after inoculation of Staphylococcus aureus into the middle ear cavity, and this model can be useful for study of tympanosclerosis.

Animals ; Disease Models, Animal ; Ear, Middle ; microbiology ; pathology ; Guinea Pigs ; Otitis Media with Effusion ; microbiology ; pathology ; Sclerosis ; microbiology ; pathology ; Staphylococcal Infections ; pathology ; Tympanic Membrane ; microbiology ; pathology

OBJECTIVETo analyze clinical pure tone test data in patients with Meniere disease and study the changes in the audiometic curve configuration.

METHODSA retrospective analysis was conducted of the pure tone test data in 75 cases (82 ears) from 1984 to 2008. The audiometic curve configuration was divided into 6 categories to analyze the relationship between the main curve types and the clinical stages. RESULTS The most common audiogram was the peak type (46.34%), followed by the falling type (19.51%) and the mountain type (12.19%), and the dip type was relatively rare (2.43%). No significant differences were found in the rate of peak audiograms between the clinical stages. The common audiogram peak frequency occurred at 2 kHz (47.39%). The top curve of 1-2 kHz had the largest proportion in mountain type audiograms (70%, 7/10 ears).

CONCLUSIONThe peak type and mountain type configuration are one of the audiological characteristics of Meniere disease, especially for 2 kHz peak, which may serve as the diagnostic features of Meniere disease in the vertigo patients on their first visit.

Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; methods ; Female ; Hearing Loss, Sensorineural ; diagnosis ; etiology ; Humans ; Male ; Meniere Disease ; complications ; physiopathology ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo compare the influences of stapedectomy and small fenestra stapedotomy on the hearing of guinea pigs.

METHODSTwenty-four (48 ears) guinea pigs were randomized equally into two groups, and the left ears were subjected to stapedectomy and total stapes replacement with a prosthesis, or sham operation (12 ears) to expose the footplate of the stapes and the round window. Each guinea pig was tested by ABR perioperatively. Four guinea pigs were chosen randomly from each group and decapitated for morphological examination by light microscopy and scanning electron microscopy after ABR test.

RESULTSIn the sham operation group, the post-operative latencies of each wave, the intervals and the hearing threshold exhibited no significant changes other than prolonged latency of wave I. In stapedectomy group, the hearing threshold increased to 23.75-/+3.77 dBSPL 1 h after operation with significantly prolonged post-operative latencies of all the waves and intervals but for III-IV interval, which was shortened. The latencies of each wave (especially waves I and III) in the stapedectomy group were increased by a greater magnitude than those in the sham operation group, but the intervals were comparable between the two groups. No significant difference was noted in the parameters of ABR either 1 h or 1 day after the operation between the two groups, in which the architecture of cochleas remained intact with similar number of spiral ganglion cells. The stereocilia of the outer hearing cells (OHC) were normal in the sham operation group while in stapedectomy group, slight stereocilia disorder occurred but became normal 1 day after operation. No obvious changes were found in the stereocilia of the inner hearing cell (IHC) in either groups.

CONCLUSIONStapedectomy can induce mild hearing loss without seriously damaging the function of the cochlea in guinea pigs.

Animals ; Auditory Threshold ; physiology ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Guinea Pigs ; Hair Cells, Auditory ; cytology ; Hearing ; physiology ; Male ; Round Window, Ear ; cytology ; physiology ; surgery ; Stapes Surgery ; adverse effects ; Time Factors