[Objective]To analyze the causes for postoperative incisal effuscin following posterior lumbar spinal surgery, to study a protocl for classification of effusion and afford according treatments.[Method]1186 cases of posterior lumbar spinal surgery were completed in the hospital from june 2001 to june 2005,877 operations with instrumentation, Il09 oprations with non-instrumentation, to compare the rate of incisal effusion between the two groups. The patients of incisal effusion were divided into three types:Type Ⅰ:the causes are ascertained, 28 cases: Type Ⅱ: infection, 11 cases; Type Ⅲ:the causes are uncertain, 14 cases o Patients of type Ⅰ were received puncturation, etiological treatment, nutrient therapy. Patients oftype II were received invisal drainaga,debridement, surgical irrigation and culture-directed antibiotic. Patients of type Ⅲ were received puncturation, and prophylactic antibiotics. [Result]The occurrences of incisal effuson were higher in instrumental group (4.33%)thannon-instrumental group(1.35%),P

[Objective]To explore the diagnosis and surgical procedure of soft tissue tumors!in the wrist.[Method]A retrospective study was conducted to evaluate surgical excision of 132 cases of wrist soft tissue tumors in our hospital from jan 2003 to jun 2004.The preoperative diagnosis was compared with pathologic diagnosis and surgical complications was analyzed.[Result]Totally 132 cases included 110 ganglion and 22 non-ganglion were related to 11 disease.The correct rate of preoperative diagnosis was 86.4%(ganglion 95.5%,non-ganglion 40.9%).All cases were recieved surgical excision and were followed up 2 years except 5 cases,123 cases were cured,3 cases were recurrence and 1 died.Complications were seen in 2 dorsal cases and 6 volar cases.[Conclusion]Soft tissue tumors in the wrist are related to much broader spectrum of diseases.On cureing ganglion it is important to master surgical indications and crucial points of operation procedure for different sites.Because histological features of non-ganglion is difficult to determine,surgical treatment should be adviced for initial choise.

Objective: To explore the influence factors of the degenerate oligonucleotide primered PCR(DOP-PCR). Methods: Genome DNA template from the mouse single oocyte or liver tissue were used to perform DOP-PCR. DOP-PCR was carried out with templates of different origin, different gradient dilution, with or without low melting point gel purified to wipe off the small fragment that might interfere with the following analysis, and then PCR of gene FTCD and CBS were carried out to evaluate the influence of these factors on the amplification efficiency and specificity. Results: Compared with genome DNA template from mouse liver, the template from single oocyte had the same efficiency and specificity but a minor yield and different gradient dilution of DNA template had no effect on the efficiency and specificity. Furthermore, there was a higher specificity in the low melting point gel-purified DOP-PCR product than in untreated ones. Conclusion: We have got a satisfactory result and increased specificity from DOP-PCR product purified with the low melting point gel. Single oocyte of mice could be used for further investigation of special genes detection by DOP-PCR and of an optimization in the yield of the products.

Objective To investigate the optimization of therapeutic regimen through the adjustment of the minimum sub-field area in intensity-modulated radiotherapy (IMRT) for cervical cancer,under the premise of no influence on the dose to target volume or organs at risk.Methods A total of 12 patients with pathologically confirmed cervical cancer were enrolled,and the prescribed dose to the planning target volume (PTV) was 50 Gy in 25 fractions.The Pinnacle 8.0m treatment planning system was used for all patients,and 16 IMRT plans were developed for each patient,with the application of 9 evenly distributed fixed incidence directions (0°,40°,80°,120°,160°,200°,240°,280°,and 320°),a minimum sub-field number of 80,and a minimum sub-field hop count (MU) of 5 MU.The range of sub-field area was 2-81 cm2.Direct machine parameter optimization was used for inverse-planned optimization calculation,and all the plans met the requirements of the clinical prescribed dose.The dose-volume histogram was used to evaluate the dose distribution in target volume and organs at risk.Results With the sub-field area increasing from 2 cm2 to 81cm2,the total hop count of IMRT plan was reduced from (1405±170) MU to (490±47) MU (P=0.000),and when the sub-field area increased above 6 cm×6 cm,the total hop count was reduced significantly (P=0.000).In the IMRT plan with a minimum sub-field area of 2-49 cm2,there was no significant difference in dose between the target volume and the organs at risk (P＞0.05).The dose to the rectum,the bladder,and both femoral heads showed no significant differences across the IMRT plans with different minimum sub-field areas (P＞0.05).Conclusions When the Pinnacle 8.0m treatment planning system is used to develop IMRT plans for cervical cancer,the requirements for clinical dose can still be met with a minimum sub-field area reaching 7 cm×7 cm,and there are significant reductions in sub-field hop count and total hop count.

Objective To evaluate the change of left atrial(LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation using real-time tri-plane echocardiography (RT-3PE) as well as quantitative tissue velocity imaging (QTVI).Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter (LADap),LA mediolateral diameter (LADml) and LA superior-infra diameter (LADsi),early and late diastolic transmitral flow velocity and ratio (E,A and E/A),the peak velocity of pulmonary vein and ratio (S,D,Ar,S/D),the maximum volume of the left atrium (LAVmax),the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram(LAVp),the minimum volume of the left atrium (LAVmin),LA passive emptying fraction (LAPEF),LA active emptying fraction (LAAEF),LA total emptying fraction (LATEF),LA expansion index (LAexpI),average peak velocity of six wall of the left atrium (Vs,Ve,Va).Results After 3,6 months,LADap decreased significantly(P ＜ 0.05) ;3 months of follow up,peak A increased,E/A ratio decreased (P ＜0.05);6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased(P ＜0.05) ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased (P ＜0.05);6 months of follow up,LA volume decreased,LAAEF and LATEF increased (P ＜0.05);3,6 months of follow up,the average Va increased(P ＜0.05).Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.

To evaluate the treatment effect of the late avascular necrosis of femoral head with concentrated autologous bone marrow and impaction autologous bone graft. The clinical data of 35 patients with late avascular necrosis of femoral head treated with the above methods was analyzed retrospectively with the University of Pennsylvania staging system, and evaluated with Harris hip score system. Among the 35 patients, there were 8 at stage Ⅲ, 23 at stage Ⅳ and 4 at stage Ⅴ. The preoperative Harris hip scores ranged from 43-72 with the average scores of 49. The patients were followed up for at least one year with the mean time of 2 years and 3 months. Two patients (preoperative at stage Ⅴ) had received total hip replacement duo to severe pain and ostarthritis. The imageology in 5 patients showed that the femoral head appearance collapsed little compared with that before operation, but their subjective feelings were well. All the femoral heads of left patients remained the shape after operation, complains of pain disappeared or lessened. The overall successful rate was 94% (33/35). In Harris scale, there was 1 patient with 92 scores, 17 with 80-89 scores, 3 with 70-79 scores and 2 patients

Objective To summarize the clinical effects of one stop hybrid approach for treating the tetralogy of fallot complicated with aorta pulmonary collateral arteries. Methods From Janu 2008 to June 2013, 79 cases of tetralogy of fallot were complicated with aorta pulmonary collateral arteries with mean age (5.4±3.9) years and weight (18.2±5.7) kg. All patients were diagnosed by echocardiography examination and accepted 64-row CT for demonstration of no dysplasia in pulmonary ressels, McGoon index was (1.7±0.6) and Nakata index was (176.7±7.3). 76 cases had aorta pulmonary collateral arteries for preliminary screening, and accepted cardiovascular angiography before operation. 3 cases were misdiagnosed before surgery and were confirmed by cardiovascular angiography after operation. Results There were 4 deceased cases with an operative mortality of 5.1%. 1 case died of lung infection and 3 cases died of refractory heart failure. In all aorta pulmonary collateral arteries, the smallest diameter was 2.5 mm, the largest was 9.4 mm, average (5.3±2.1) mm. 2 to 21 coils were implanted in respective case with an average of 10.2 coils per case. The maximum number of coils implanted in 1 single ressel was 9. The average number of ressels occluded was 3.7 (range from 1 to 11 ressels) in each case. One case received second closure due to re-open of collateral arteries on neo-vasculanigation. 14 cases had lung infection and 3 cases had pulmonary edema post operation. 75 cases were followed up for 3-72 months. 4 cases with post operative heart function of NYHA gradeⅢtoⅣand all other cases with gradeⅡon higher. Conclusions Peri-operative hybrid management for aorta-pulmonary collateral arteries can increase the operative success rates and reduce complications.

Objective To explore the feasibility of “double low ”(low tube voltage and low contrast agent concentration)imaging technology of dual-source computed tomography (DSCT)in coronary angiography for low-weight patients.Methods 60 patients (BMI≤25 kg/m2 )who underwent coronary CT angiography (CCTA)on DSCT scanner were divided randomly into 2 groups:group A was “double low”group (n = 30,tube voltage = 80 kVp,using sinogram affirmed iterative reconstruction technology and 270 mg I/mL concentration of contrast agent);Group B was conventional group (n=30,tube voltage=120 kVp,using filtered back projection technology and 350 mg I/mL concentration of contrast agent).Adaptive cardiosequence prospective ECG-gated technology (CorAdSeq)was applied in both the groups,The collecting phase was 65%-75% RR interval (when heart rate<70 beats per mi-nute)or 40%-50% RR interval (when heart rate≥70 beats per minute).Subjective and objective methods were applied to evaluate the image quality.The image quality and.radiation dose were compared between the “double low”group and the conventional group by using SPSS 1 9.0 software.The differences between measurement data were analyzed by using independent samples t-test.Results The effective dose with size specific dose estimates (EDssde)of group A(1.22±0.31)mGy/cm was significantly lower than that of group B (3.44±0.80)mGy/cm with P <0.001.Contrast-noise ratio,signal-noise ratio and CT value of group A were signifi-cantly higher than those of group B (all P <0.05 ).Conclusion Compared with conventional DSCT coronary angiography,“double low”DSCT coronary scanning proposal for low-weight patients can significantly reduce the radiation dose and the amount of contrast agent,and the image quality can meet the needs of clinical diagnosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Face ; Female ; Humans ; Injections ; Melanosis ; drug therapy ; therapy ; Middle Aged ; Young Adult