Objective:To improve the prediction of the resectability of esophageal carcinoma by computed tomography.Methods:Eighty-five esoghageal carcinoma cases diagnosed by conventional upper GI tract radiography were enrolled.Three CT signs i.e. angularity,triangular area,and angularity combined with posture were used to observe and to determine the >45。Results:The prediction of resectability by CT were accurate which was confirmed by surgical interventions.Conclusion:Determination of the triangular fat pad between the aorta and the tumor lesion by Ct is reliable and practical in the predication of resectability in the patients with esophageal carcinoma.

BACKGROUND: Based on previous studies, the combination of basic fibroblast growth factor (bFGF) with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament (ACL) graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex (MHC) through the treatment of allogenous tendon by freeze. The freeze. dried tendon showed advantages including prolonged storage time. availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE: To observe histologically the effect of exogenous application or bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING: Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital. Fourth Military Medical University of Chinese PLA between June 2006 and June 2007.MATERIALS: Fourteen dogs were used in the experiment. METHODS: Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF(100 u g/L)was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL. While only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES: Twelve of them were randomly divided into 6 groups according to the 6 time points,i,e.,1,2,3,4,5,6 weeks after surgery(2 dogs in each group).The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS: Neovascularization occurred at the 2nd to 3rd weeks and reached the peak at the 4th to 5th weeks postoperatively at the experimental sides. By contrast. The neovascularization occurred at the 4th to 5th weeks postoperatively at the control sides. Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION: The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.

Objective To evaluate the predicting value of the marker of endothelial injury: plasma matrix metalloproteinase-9( MMP-9) and high sensitivity C-reactive protein( hsCRP) level on the progression of acute anterior circulating territory infarction progressing to malignant middle cerebral artery infarction (m-MCAI). Methods 90 patients with acute anterior circulating territory infarction, in which 46 patients progressed to m-MCAI, were collected and sampled consecutively. The plasma MMP-9 and hsCRP of all patients were determined by ELISA and immunotur-bidimetry,respectively,at admission. And the clinical characters and cranial CT features of the patients were analyzed. Results At admission,the plasma MMP-9 level in the patients with m-MCAI(242.0 ±58.0)ng/ml was significantly higher than that in the patients with non m-MCAI( 169.0 ± 50.0) ng/ml( P < 0. 01) ,the plasma hsCRP level in the patients with m-MCAI(6.25 ±1.2) ng/ml was significantly higher than that in the patients with non m-MCAI( 1.55 ± 0.9) mg/ml( P <0. 01).Conclusion The increased level of plasma MMP-9 and hsCRP could be predictors for the m-MCAI proceeding.

Objective:To investigate the clinical efficacy of posterolateral locking plate in the treatment of large posterior malle-olar fracture .Methods :From January 2010 to June 2012 ,23 patients with large posterior malleolar fractures were treated by posterolateral locking plate ,including 15 males and 8 females ,all of whom aged from 32 to 78 years with an average age of 43 .7 years .The average time from injury to operation was 7 .3 days ,which ranged from 5 to 12 days .Calcaneal traction fixa-tion or plaster was performed on the injured limb before operation .Once that swelling reduced ,all patients were treated by posterolateral locking plate and were assessed with the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS) .Results:The follow-up time was from 14 to 22 months ,with an average period of 17 .4 months . 23 patients resulted in bone healing ,without loosen or breakage of internal fixation .As the X-ray pictures showed ,fracture healing time after operation ranged from 11 to 21 weeks ,which was 14 .7 weeks on average ,and full weight bearing time was from 15 to 25 weeks ,which was 17 .1 weeks on average .The AOFAS scores ranged from 73 to 94 points with an average of 83 .4 points at the 12th month after operation .One patient had superficial wound infection at the 7th day after operation and was healed by sensitive antibiotics and changing fresh dressing .Conclusions :Posterolateral locking plate could be a good method for the treatment of posterior malleolar fracture because effective redution and proper fixation could be obtained through straight access .

Objective:To investigate the clinical efficacy and prognosis of simultaneous resection of synchronous colorectal liver metastasis in patients admitted in different phases.Methods:The retrospective cohort study was conducted. The clinicopathological data of 346 patients who underwent simultaneous resection of synchronous colorectal liver metastasis in the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2000 to April 2021 were collected. There were 217 males and 129 females, aged (58±12)years. Patients under-went simultaneous resection of synchronous colorectal liver metastasis. Observation indicators: (1) clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (2) surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (3) analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Follow-up was conducted using telephone interview or outpatient examination to detect survival of patients. The follow-up was performed once every 3 months, including blood routine test, liver and kidney function test, car-cinoembryonic antigen (CEA) test, CA19-9 test, abdominal B-ultrasound examination, and once every 6 months, including chest computed tomography (CT) plain scan, liver magnetic resonance imaging (MRI) and/or CT enhanced scan, abdominal or pelvic MRI and/or CT enhanced scan, within postoperative 2 year. The follow-up was performed once every 6?12 months within postoperative 2?5 years including above reexaminations. Electronic colonoscopy was performed once a year after operation. The follow-up was up to November 12, 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distuibution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used to conduct survival analysis. Results:(1) Clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 59 cases underwent simultaneous resection within 2000?2010 and 287 cases underwent simultaneous resection within 2011?2021. The gender (males and females), cases with or without fundamental diseases, cases with the number of lymph nodes harvested in primary lesion as <12 or ≥12, the tumor diameter of primary lesion, the tumor diameter of liver metastasis lesion, the number of liver metastasis lesions, cases with or without preoperative treatment, cases with or without postoperative treatment, cases with adjuvant therapy as perioperative treatment, surgery or other treatment were 47, 12, 36, 23, 19, 40, (5.5±2.4)cm, (2.1±0.7)cm, 1.6±0.5, 59, 0, 16, 16, 0, 16, 43 in patients admitted in 2000?2010, respectively. The above indicators in patients admitted in 2011?2021 were 170, 117, 121, 166, 58, 229, (4.2±2.0)cm, (3.0±2.0)cm, 1.9±1.4, 208, 79, 34, 235, 74, 29, 184, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=8.73, 7.02, 4.07, t= 4.40, ?6.04, ?3.10, χ2=21.05, 28.82, 26.68, P<0.05). (2) Surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Cases with surgical methods as complete open surgery or laparoscopy combined with open surgery, the operation time, time to postoperative initial liquid food intake, cases with or without postoperative complications, cases with postoperative duration of hospital stay as ≤10 days or >10 days were 58, 1, (281±57)minutes, (5±1)days, 33, 26, 14, 45 in patients admitted in 2000?2010, respec-tively. The above indicators in patients admitted in 2011?2021 were 140, 147, (261±82)minutes, (3±1)days, 233, 54, 198, 89, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=49.04, t=2.24, 7.53, χ2=17.56, 26.02, P<0.05). There was no death in the 346 patients. (3) Analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 295 cases were followed up for 47(range, 1?108)months. Of the 29 patients admitted in 2000?2010 who were followed up, there were 27 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2000?2010 were 18.0 months (95% confidence interval as 12.7?23.3 months), 82.8%, 11.5%, 3.8%, 53.6%, 8.3%, 4.2%, respec-tively. Of the 266 patients admitted in 2011?2021 who were followed up, there were 109 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2011?2021 were 54.0 months (95% confidence interval as 38.1?70.4 months), 93.3%, 61.8%, 47.0%, 68.2%, 33.7%, 28.3%, respectively. There were significant differences in overall survival rate and disease free survival rate between patients admitted in 2000?2010 and 2011?2021 ( χ2=47.57, 9.17, P<0.05). Conclusions:With the increase of the operation volume of simultaneous resection of synchronous colorectal liver metastasis, the operation time, time to postoperative initial liquid food intake, postoperative duration of hospital stay and postoperative complications have significantly decreased, while the overall survival rate and disease free survival rate have significantly increased.