Objective To analyze the possible reasons of failed surgical treatment of acetabular fractures. Methods Various methods were used for positive patient identification, including according to Matta's X-ray assessment and Merle d'Aubigne & Postel hip function score of clinical standards for classification of acetabular fracture reduction surgery were not satisfied or not carried out a reduction and fixation,the clinical evaluation of hip joint as a "bad", occurrence of femoral head subluxation or dislocation, femoral head necrosis and other serious complications. From February 2000 to February 2008, 22 patients including 14 males and 8 females with an average age of 38.6 years (range, 18-72 years) were considered as failed cases. Results 45.5% of these cases were posterior wall fractures which were not given any fixation, 27.3% of them were posterior column fractures which were not fixed, 13.6% of them whose reduction and fixation of anterior wall fractures were not satisfied, and 9.1% of them were anterior column fractures which needed fixation. One case should take open reduction and iternal fixation instead of THA. The rate of misdiagnosis and mistaken diagnosis were 90% if only X-ray evaluation was made and this rate decreased to 8.3% if computed tomography was taken. The rate of wrong selection of operative approach was 100% in 10 cases of misdiagnosis, and which was 58.3% in 12 cases of correct diagnosis. In the 5 patients with correct diagnosis and selection of operative approach, the reasons of failed surgical treatment were due to imperfect surgical skills in 3 cases, and inappropriate fixation patterns in 2 cases. Conclusion The causes of the failure of surgical treatment for acetabular fracture might include preoperative missed diagnosis and misdiagnose, inappropriate approach, and an unreasonable internal fixation with unskillful technique.

Objective To explore the dose of template-assisted ¹⁹²Ir source hypofractionated stereotactic brachytherapy (SABT) for peripheral lung cancer. Methods We retrospectively analyzed the dose parameters of GTV and OARs of 28 peripheral lung cancer patients treated with template-assisted ¹⁹²Ir-source hypofractionated SABT, and compared the dose parameters between SABT with virtual SBRT. Results The D_mean and V₁₅₀ for the GTV in the SABT plan were significantly higher than those in the SBRT plan (all P < 0.01). For OARs, all dosimetric parameters in the SABT plan were significantly lower than those in the SBRT plan (all P < 0.01), except for the D_1000cm³ and D_1500cm³ for the lung (P > 0.05). Conclusion Template-assisted ¹⁹²Ir source hypofractionated SABT ensures high dose in the gross tumor volume and reduces the dose in organs at risk in the treatment of peripheral lung cancer.

Objective To study the effects of poly lacticoglycolic acid(PLGA) ultrasound contrast agent on tumor lymph node imaging and its mechanism.Methods PLGA ultrasound contrast agent was made by double emulsion method; VX2 tumor cells were harvested from carrier rabbits and inoculated in the thigh of healthy New Zealand White rabbits. Implants were allowed to grow for 14 to 18 days before imaging. Popliteal lymph nodes were imaged as the injection sites were massaged. And macrophages were used to investigate the mechanism for lymph node enhancement. Results PLGA ultrasound contrast agent had a tight size distribution. Tumor lymph node was significantly enhanced by PLGA ultrasound contrast agent. Macrophages experiment showed that macrophages could phagocyte lots of PLGA ultrasound contrast agents.Conclusions PLGA ultrasound contrast agent is good for lymph node imaging. The possible mechanism for lymph node enhancement is that macrophages in lymph node can phagocyte lots of PLGA contrast agents, which causes the concentration of PLGA contrast agent in lymph node.

Objective The aim of this study is to analyze the clinical characteristics,diagnosis,treatment and prognosis factors of primary retroperitoneal liposarcoma.Methods We retrospectively analyzed 44 patients diagnosed with primary retroperitoneal liposarcoma that confirmed by pathology from Jan 2008 to Jun 2018 at the Department of General Surgery,Shengjing Hospital,China Medical University.Results The 44 patients consist of 19 males and 25 females.the clinical manifestations were abdominal mass,abdominal distension and abdominal pain.Asymptomatic patients were mainly found through physical examination.The main preoperative examination method was CT,and its accuracy rate was 75％.The most common pathological type was well-differentiated liposarcoma.The recurrence rate is 82％,and 24 (55％) patients died from tumor recurrence,2 patients died of other unrelated diseases.Conclusions Primary retroperitoneal liposarcoma is difficult to be diagnosed at early stage.CT is the main examination method.Complete surgical resection is the main treatment for primary or recurrent patients.This disease is prone to relapse and the prognosis is poor.

Mesh-related visceral complications caused by mesh erosion after tension-free inguinal hernia repair are one kind of rare long-term complications, but they are easily neglected. Interval time from initial hernia repair to mesh-related visceral complications by preperitoneal and laparoscopic repair is short. Rutkow and transabdominal preperitoneal repair have the highest reported rate. Lichtenstein has the longest interval time and the lowest reported rate. The most frequently eroded organs are sigmoid colon, bladder and small intestine. The common clinical manifestations of sigmoid colon erosion are hematochezia, abdominal wall fistula and colitis, hematuria and recurrent urinary tract infection in bladder erosion cases, intestinal obstruction and abdominal wall fistula in intestinal erosion case, sigmoid-bladder fistula and intestinal-bladder fistula in multiple organ erosion cases. Resection or repair of corresponding organs with mesh removal have good efficacies in most patients. The authors summarize and analyze researches on mesh-related visceral complications after tension-free inguinal hernia repair from 1994 to 2021, review their advances, in order to raise awareness of such complications in clinicians.