Objective To investigate the diagnostic value of CT-guided craniocerebral puncture biopsy, and to discuss its clinical safety. Methods During the period from April 2013 to June 2014 at authors’ hospital CT-guided craniocerebral puncture biopsy was carried out in 23 patients. All patients had clinical symptoms or signs of nervous system. Imaging examination revealed that all patients had intracranial space-occupying lesions. CT-guided craniocerebral puncture biopsy was performed to make pathological or bacteriological examinations. The results were statistically analyzed. Results In this group of patients, definite pathological diagnosis was made in 19 cases, biopsy positive diagnosis rate of biopsy was 82.6% (19/23), among them oncology-pathological diagnosis was obtained in 14 cases (60.9%), mainly including glioma, non-Hodgkin lymphoma, dysembryoplastic neuroepithelial tumor, choroid plexus papillary tumor, epidermoid cyst, etc. Non-neoplastic lesion was confirmed in 5 cases (21.7%), including suppurated meningitis, cerebral gliosis hyperplasia, cerebral telangiectasis, etc. Small amount of subdural hemorrhage was observed in one case (4.3%). No severe complications, such as intracranial infection or epilepsy, occurred in all patients. Conclusion CT-guided craniocerebral puncture biopsy is minimally-invasive with fewer complications, it can provide definite diagnosis for intracranial lesions, therefore, this technique has a broad development prospect in clinical practice.

Objective To evaluate the feasibility and clinical effectiveness of arthroscopic femoral osteoplasty for cam-type femoroacetabular impingenent(FAI).Methods From October 2007 to April 2009,31 patients with cam-type FAI underwent hip arthroscopy,including 12 males and 19 females with an average age of 34.1 years(range,18-45).Physical examination,X-ray,3D-CT scans were carried out preoperatively to make the definite diagnosis.All patients were treated with hip arthroscopic debridement and femoral osteoplasty.The patients were followed-up at 1 month,3 months,6 months,1 year,and every year post operation.Outcomes were measured with pain visual analogue scale(VAS),ROM of hip,impingement tests,α angle and modified Harris hip score at final follow-up.Results All patients were followed up for average 22.7 months(range,18-36).At final follow-up,impingement tests among all patients were negative,the range of flexion increased from 101.0°±14.2° to 121.0°±11.7°,the range of internal rotation in a position of 90° flexion increased from 5.0°±9.8° to 30.1°±12.7°,α angle decreased from 74.2°±10.7° preoperatively to 44.7°±8.3°,VAS pain score decreased from 6.1±1.1 preoperatively to 0.9±0.7,modified Harris hip score improved from 41.2±5.7 preoperatively to 73.6±4.1,all differences were statistically significant.Conclusion Arthroscopic femoral osteoplasty for cam-type FAI can win the satisfactory achievements for complete excision of bony prominence at anterior-lateral femoral head-neck junction,restoration of the femoral offset,significant relief of clinical symptoms and improvement of hip range of motion.

Objective To compare the clinical results of anterior cruciate ligament(ACL)reconstruction using anterior tibial muscle tendons allograft and hamstring tendons autograft.Methods According to the graft used for ACL reconstruction,60 patients with chronic ruptures of ACL were divided into group A(30 patients,using anterior tibial muscle tendons allograft)and group B(30 patients,using semitendinosus and gracilis tendons autograft).The average follow-up periods after surgery were 29.4 and 31.6 months respectively.Lysholm,Tegner,IKDC clinical rating scales and KT2000 were used for evaluation pre-and post-operation.The muscle strength of the extension,flexion,internal rotation and external rotation of knees was evaluated by the isokinetic tester.Results There were statistically significant differences in Lysholm,Tegner,IKDC clinical rating scales and KT2000 results between pre-and postoperation(P<0.01).However,there were no statistically significant differences between group A and group B after operation(P>0.05).The Isokinetic muscle strength tester showed that the knee muscle strength of the internal rotation and flexion were decreased post-operative in group B,rather than group A,which showed no significant differences between pre-and post.operation(P<0.05).Conclusion For ACL reconstruction under arthroscopy,anterior tibial muscle tendons allograft was a favorable substitute for autograft materials for its convenience,satisfactory clinical effect and less complications.

Objective To explore the clinical value of CT for guiding interventional therapy of Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction.Methods A total of 329 consecutive BCS patients with IVC obstruction underwent endovascular treatment.All the patients underwent CT examination prior to endovascular treatment,and the data were retrospectively reviewed.The accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of CT were compared with results of DSA.Results DSA showed partial obstructive IVC in 108 BCS patients and complete obstructive IVC in 221 patients.CT demonstrated partially obstructive IVC in 99 patients and completely obstructive IVC in 230 patients.CT revealed 15 false-negative and 6 false-positive results.CT diagnosis of puncture or not yielded an accuracy of 94.19％,sensitivity of 97.29％,specificity of 86.11％,PPV of 93.49％ and NPV of 93.94 ％ for detection of BCS with partial IVC obstruction,while CT-based interventional treatment plan yield an accuracy of 97.55 ％,sensitivity of 100 ％,specificity of 92.52 ％,PPV of 96.49 ％ and NPVof 100％.Conclusion CT can provide high diagnostic accuracy and sensitivity for BCS patients with obstructed IVC,therefore being helpful to planning interventional treatment of BCS.

Background: and Purpose Patients with aortic disease might have an increased risk of intracranial aneurysm (IA). We conducted this research to assess the prevalence of IA in patients with aortopathy, considering the impact of gender, age, and cardiovascular risk factors. Methods: We searched PubMed and Scopus from inception to August 2019 for epidemiological studies reporting the prevalence of IA in patients with aortopathy. Random-effect meta-analyses were performed to calculate the overall prevalence, and the effect of risk factors on the prevalence was also evaluated. Anatomical location of IAs in patients suffered from distinct aortic disease was extracted and further analyzed. Results: Thirteen cross-sectional studies involving 4,041 participants were included in this systematic review. We reported an estimated prevalence of 12% (95% confidence interval [CI], 9% to 14%) of IA in patients with aortopathy. The pooled prevalence of IA in patients with bicuspid aortic valve, coarctation of the aorta, aortic aneurysm, and aortic dissection was 8% (95% CI, 6% to 10%), 10% (95% CI, 7% to 14%), 12% (95% CI, 9% to 15%), and 23% (95% CI, 12% to 34%), respectively. Gender (female) and smoking are risk factors related to an increased risk of IA. The anatomical distribution of IAs was heterogeneously between participants with different aortic disease. Conclusions According to current epidemiological evidence, the prevalence of IA in patients with aortic disease is quadrupled compared to that in the general population, which suggests that an early IA screening should be considered among patients with aortic disease for timely diagnosis and treatment of IA.

OBJECTIVE:To evaluate therapeutic efficacy of Shengxuening tablets in the treatment of iron-deficiency anemia during pregnancy,so as to provide evidence for clinical decisions. METHODS:Retrieved from CNKI,Wanfang,VIP and PubMed,clinical randomized controlled trials(RCTs)about Shengxuening tablets in the treatment of iron-deficiency anemia during pregnancy were collected during 2008-2018. After screening literatures and extracted information, the literature quality was evaluated by using improved Jadad scale. Meta-analyses was performed by using Stata 12.0 software. RESULTS:A total of 11 RCTs were included,inulving 1 617 patients. Total response rate of Shengxuening tablets was significantly higher than those of ferrous sulfate [OR＝8.73,95%CI(2.964,25.69),P＜0.05],ferrous succinate [OR＝1.86,95%CI(1.04,3.33),P＜0.05] and dietory conditioning [OR＝3.43,95%CI(2.08,5.66),P＜0.05],with statistical significance. CONCLUSIONS:Therapeutic efficacy of Shengxuening tablets is significantly better than that of routine iron supplements in the treatment of iron-deficiency anemia during pregnancy.

Objective:To compare the curative effect and cost of domestic and imported covered stents in the treatment of non-complex Stanford type B aortic dissection.Methods:A retrospective case-control study was used to analyze the clinical data of 93 patients with non-complex Stanford B aortic dissection who underwent thoracic endovascular aortic repair (TEVAR) in Taizhou Second People's Hospital from September 2016 to September 2021.Ninty-three patients were divided into two groups according to the use of different covered stents during the operation, of which 47 patients were treated with domestic covered stents (observation group) and 46 patients were treated with imported covered stents (control group). Overall response rate, rate of complication, treatment cost and cost-effectiveness ratio of the two groups were compared and sensitivity analysis was performed in the two groups.The measurement datas conforming to the normal distribution were expressed as mean ± standard deviation( ± s), and the inter-group comparison was conducted by t test.The comparison of counting datas between groups was conducted by Chi-square test or Fisher exact probability method. Results:The overall response rate of the observation group and the control group were 93.62% and 97.83%, with no significant difference ( P>0.05); The incidence of complications was 6.38% and 2.17%, with no significant difference ( P>0.05). The cost of covered stent [(62 155.49±10 231.08) yuan] and the total cost of treatment [(95 063.66±20 042.34) yuan] in the observation group were lower than those in the control group [(93 825.37±16 577.04) yuan and (126 035.89±26 186.18) yuan]( P<0.05). There was no significant difference in other direct costs between the observation group [(32 908.17±9 811.26) yuan] and the control group [(32 210.52±9 609.14) yuan] ( P >0.05). The cost-effectiveness ratio of the observation group and the control group were 1 015.42 and 1 288.31, and the incremental cost-effectiveness ratio of the control group was 7 356.82. After the cost-effectiveness sensitivity analysis and adjusting the cost of the covered stent to decrease by 10% of the two groups, the cost-effectiveness ratio of the observation group and the control group were 949.03 and 1 192.41, and the incremental cost-effectiveness ratio of control group was 6 604.61. Conclusions:Both domestic and imported covered stents are effective in the treatment of non-complex Stanford type B aortic dissection with fewer complications. Compared with the imported covered stent, the domestic covered stent has lower treatment cost and more advantages of cost-effectiveness, which is more in line with diagnosis related groups reform.