Objective: The clinical effects of rubbing therapy with ointment in treating patella strain were observed. Method: Forty-two cases of patella strain were treated by local rubbing with ointment and the changes of the clinical symptoms were observed. Results: After 3 courses of treatment, the total effective rate was 95.2%.Conclusion: It is indicated that rubbing therapy with ointment has good effects in the treatment of patella strain.

Objective:To establish an HPLC method for the simultaneous determination of minoxidil and tretinoin in compound minoxidil gel. Methods:A Shim-Pack VP-ODS C18(250 mm × 4. 6 mm,5 μm)column was used with the mobile phase of methanol and 2% acetic acid solution by gradient eleution . The detection wavelength was respectively set at 280 nm and 350 nm,and the flow rate was 1. 0 ml·min -1 . The column temperature was 35℃ and the injection volume was 10 μl. Results:Minoxidil and tretinoin had a good linear relationship within the range of 4. 0- 240. 0 μg·ml-1 and 0. 05- 3. 00 μg·ml-1(r =0. 999 6 and 0. 999 3),respectively. The average recovery was 99. 56%(RSD = 0. 42% ,n = 9)and 99. 36%(RSD = 0. 50% , n = 9),respectively. Conclusion:The established method is simple,and suitable for the simultaneous determination of the two constituents in compound minoxidil gel.

Objective To investigate two kinds of methods of lymph node dissection for early effects on the prognosis of the patients in the treatment of lung cancer by comparative study,and provide guidance for clinical treat-ment.Methods 98 cases of early stage lung cancer patients who were taken using elective surgery were selected in the study.According to the random number table,they were divided into two groups of 49 cases for each other.Sort of an odd number of patients in the observation group,and given systematic lymph node dissection (LND);sort of an even number of patients in the control group,which was systematically sampled lymph node dissection (LNS).After dissection from the relevant data,following -up of 5 -year survival,relapse rate,quality of life and other data for com-parison and statistical analysis were accessed.Results In the observation group,the number of lymphatic vessels in the cleaning,operation time,3 years,the survival rate of 5 years,2 years,3 years and 5 years recurrence rate and survival quality total score comparison is superior to the control group,with significant difference (P <0.05);The amount of bleeding,3 months and 2 years the survival rate,quality of life of each individual score data comparison of the two groups had no significant differences (all P >0.05);The nerve injury rate of the observation group was higher than the control group,there was significant difference (P <0.05).Conclusion Systematic lymph node dissection for treatment of early lung cancer has a thorough cleaning,operation time is short,the short -term survival rate is high,low recurrence rate,high quality of life and other advantages,and has the value of popularization.But there was the amount of bleeding,nerve injury and high rate of defects,it needs to be further perfected.

Objective To make a comparison between the outcome of modified Soave procedure and laparotomy on Hirschsprung disease(HD)in children.Method Chose the 21 eases who underwent transanal modified Soave procedure(modified Soave procedure group)and 25 eases had done by laparotomy (laparotomy group)from January 2001 to January 2007,clinical data of two groups were compared.Results Modified Soave procedure group showed lower level of IL-6 and CRP[(10.7±1.6)ng/L,(27.7±4.1)mg/L]on 48 h postoperation than laparotomy group[(22.0±2.3)ng/L,(73.7±15.0)mg/L](P ＜ 0.01).The mean operative time,hospital stay,the mean time of anal aerofluxus and the cost of hospitalization in modified Soave procedure group were much shorter than those in laparotomy group(P＜ 0.01).While the complication rate of two groups had no statistical difference.Moreover,there were no significant difference of rectal high pressure zone length and resting anal canal pressure between two groups at 1 year after operation.Conclusion Transanal modified Soave procedure for HD is a minimal invasive surgery,especially in young patients with short-segment type and common type of HD.

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underestimation.These lesions included 2 invasive ductal carcinomas,1 mucinous adenocarcinoma,2 DCIS and 1 blunt duct adenosis with ADH and focal cancerous,1 inflammatory breast cancer underwent chemotherapy.The sensitivity and specificity and accuracy of breast MRI were 95.83 ％ (115/120),72.73 ％ (88/121),84.23 ％ (203/241),respectively.MRI findings had no difference with respect to mammogram or ultrasound was 75.10 ％ (181/241).Conclusion MRI misdiagnosis and missed often occurs in smaller breast lesions,morphologic and hemodynamic malignant manifestation atypical,especially intraductal lesions.MRI diagnosis should be combined with physical examination,X-ray mammogram and ultrasound to improve diagnostic accuracy and reduce missed diagnosis.

Objective To explore the methods for early diagnosis and treatment of blunt pancreatic injury.Methods The clinical data of 32 patients with blunt pancreatic injury treated in our hospital from Janurery 2004 to Janurery 2009 were retrospectively analyzed.Results The conformity diagnosis rate of CT was 79.3%.Four cases received nonoperative treatment including 3 cases of grade I and 1 of grade II injury.A total of 28 cases with blunt pancreatic injury underwent operation: 5 grade I and 7 grade II cases underwent debridement and drainage;among the patients with grade Ⅲ injury,4 underwent distal pancreatectomy in combination with splenectomy,and 2 pancreatectomy with spleen preservation;amongst the 5 patients with grade Ⅳ injury,4 underwent Roux-en-Y pancreaticojejunostomy and 1 underwent distal pancreatectomy in combination with splenectomy;of the 5 patients with grade Ⅴ injury,1 case was operated on using duodenorrhaphy and diverticulization,2 underwent the Whipple′s procedare and 2 had damage control surgery.Three patients died of multiple organ failure,and complications occurred in 19(76.0%).Pancreatic fistula and pancreatic pseudocysts were the main complications.Conclusions In the absence of major pancreatic ductal injury,and the clinical conditions were stable,pancreatic injuries can be treated with nonoperative management.Operative treatment is suitable for severe blunt pancreatic injury.Appropriate operation,based on patient condition and the classification of pancrecatic trauma,is the key to increase the cure rate and decrease mortality rate.

Objective To evaluate the clinical effect of splenic internal jugular shunt for Budd Chiari Syndrome (BCS). Methods A retrospective analysis was made on the clinical data of 21 patients of BCS who underwent this operation. Results There was no death in 21 patients receiving this operation, The average post operative reduction of FPP was 0.97Kpa.2 suffered postoperative lung infection . Abdominal incision infection occurred in one patient. Tweenty cases were followed up for one month to forty five months. Lower extremity varicose veins and abdomen wall varicose veins basically disappeared a month postoperatively; ascites vanished completely 3 months postoperatively,and lower limb ulcer healed 6 months postoperatively. Seventeen patients followed by CDFI showed that no thrombus was found in their artificial vessel. Barium meal studies in 12 cases displayed that oesophageal varicose veins had basically disappeared during the follow up period. Conclusions Splenic jugular shunt bridged by artifical vessel is safe,effective and less traumatic for patients with type III and some patients with type II Budd Chiari syndrome. It is currently the best choice for treatment of BCS.

Objective To compare the efficacy and safety of icotinib therapy alone versus icotinib combined with thoracic radiotherapy for the treatment of advanced non-small cell lung cancer (NSCLC) patients with an activating epidermal growth factor receptor (EGFR) gene mutation.Methods A total of 83 patients with advanced NSCLC harboring an activating EGFR gene mutation was enrolled in this study.All the patients were randomly divided into 2 groups.Patients in group A (n =41) received thoracic radiotherapy (prescribed at 60-66 Gy) combined with icotinib (three times per day,125 mg once).Patients in group B (n =42) were given icotinib therapy alone (three times per day,125 mg once).Treatment was continued until disease progression or unacceptable toxicity or death.The primary end points were median progression-free survival (mPFS) and 12 month-PFS rate.The secondary end points included objective response rate (ORR),disease control rate (DCR) and adverse events.Results With a median follow-up of 18.2 months,mPFS was 15.2 months (95％ CI:12.2-17.4) in group A and 13.2 months (95％ CI:10.8-14.9) in group B (x2 =4.29,P=0.036).PFS rates of 12 months for group A and group B were 70.3％ and 61.2％,respectively.The ORR were 78.0％ vs.57.1％ (x2 =5.16,P =0.028),and the DCR were 95.1％ vs.92.9％ (P＞0.05) in groups A and group B,respectively.No grade 3-4 adverse events was observed in both groups except the rashes (4 cases in each group).Besides,10 patients had grade 1-2 radiation-related pneumonitis and 15 patients suffered grade 1-2 radiation-related oesophagitis in group A.Conclusions In advanced NSCLC patients with an activating EGFR gene mutation,the combination of thoracic radiotherapy and icotinib had achieved an improvement on ORR and PFS with good tolerance.Clinical trial registration Chinese clinical trial registry,ChiCTRINR-16010262.

Objective To study the clinical manifestation and MRI feature of toxic encephalopathy after inhaling caffeine and sodium benzoate. Methods Three patients with toxic encephalopathy induced by inhaling caffeine and sodium benzoate were observed clinically and with MRI. Results The 3 patients were male. They all had definite addiction histories (the time of addiction for 3 years to 7 years ). There were special language and retropulsive dystonia besides the common characteristics of toxic encephalopathy:reaction retardation and disturbance of intelligence. MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, and cerebellum hemisphere dentate nucleus. The clinical symptoms of 3 patients were significantly improved 40 days after the adrenocortical steroid and neurotrophic treatment. The mild mood disorder remained in case 1. Conclusion Clinical manifestation and MRI of toxic encephalopathy after inhaling caffeine and sodium benzoate are known, so we could diagnose the patients of the disease in time.

Objective To evaluate the diagnosis, treatment and prognosis of primary duodenal carcinoma. Methods The clinical data of 41 cases with primary duodenal carcinoma admired during 2000-2007 were analyzed retrospectively. Results Clinical manifestation was not specific, including abdominal pain, abdominal distention, jaundice, bowel obstruction or bleeding. The correct diagnosis rate of endoscopy, duodenography, ultrasound and CT was 86%, 90%, 20% and 33% respectively. 23 cases underwent pancreaticoduodenectomy, 6 cases received segmental duodenectomy, 9 cases received bypass operation and 3 cases underwent biopsy. Overall postoperative 5-year survival rate was 18%. Univariate analysis revealed that the operation types, tumor histology, depth of tumor invatian, lymphatic invasion correlated with prognosis. Multivariate analysis showed that only the operative types, depth of tumor invasion and lymphatic invasion were independent prognostic factors. Conclusions Duodenography and endoscopy are major methods for diagnosis of primary duodenal carcinoma. Pancreaticoduodenectomy is the choice of therapy for primary duodenal carcinoma.