Objective To analyze the image findings of renal tuberculosis and evaluate the merits and disad vantages of various imaging diagnostic methods, then choose the most sensitive one. Methods The KUB, IVP, AP and CT findings of 48 patients with renal tuberculosis which had been convinced by operations were evaluated and compared. Results The diagnosis rates of KUB and IVP were 41.7% (20/48), AP of 62.5 % (10/16), CT of 100 % (48/48). The characteristic findings of CT were multiple low density lesions, with "flower petals" shape gath-ered in sections. Conclusion CT has a great value for diagnosing renal tuberculosis.

Objective To analyze CT features of the pulmonary segment lesions.Methods The CT findings of 88 patients with pulmonary segment lesions were reviewed.The diseases included chronic pneumonitis(n=30),tuberculosis(n=24),lung cancer(n=34),all proved pathologically.Results Wedge-shape or cone-shape of lesions was demonstrated in most of cases.In chronic pneumonitis,the border of lesion was depression or straight without hilar mass and bronchus obstructed.Most lesion was isodensity and the air bronehogram could be found in some cases.In tuberculosis,the border was irregular or hazy with different density inside the lesion(cavity,calcification,bronchieetasis).Satellite-lesion and thickening of the pleura nearby were found commonly.In lung cancer,the hilar mass and pot obstructed bronchus were the characteristic,with the border evagination in some cases.According to the above,82% of the cases were diagnosed correctly.Conclusions Some relative specific CT manifestation existed in the pulmonary segment lesions caused by chronic pneumonitis,tuberculosis and lung cancer.But the CT of some patients were similar to each other,of which diagnosis must be based on pathology.

AlM:To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases ( 67 eyes ) wearing overnight orthokeatology were included as trial group, and 30 cases ( 60 eyes ) wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit:subgroup A(35 eyes,≤-3. 00D), B subgroup (32 eyes,>-3. 00D and ≤-6. 00D). ln the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology , with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. ln the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance ( ANOVA) was used to compare the differences among the groups. P<0. 05 was considered statistically significant.RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature ( including vertical curvature and horizontal curvature ) of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group (0.33±0.31)mm was lower than that of group A (0. 43±0. 25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth (2. 08 ± 0. 57) D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.CONCLUSlON: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.

Female ; Humans ; Medicine, Chinese Traditional ; methods ; Menstruation Disturbances ; pathology ; Polycystic Ovary Syndrome ; pathology ; therapy ; Uterus ; physiopathology

BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Objective To present the primary effectiveness and morbidity of metallic ureteral stent in treating the patients with malignant ureteral obstruction .Methods The retrospective study enrolled 11 patients received metallic ureteral stent placement because of malignant ureteral obstruction at our hospital between Jul.2012 and Jan.2014.Total of 16 stents were inserted including 5 bilateral stent insertion. There were 4 males and 7 females, with a mean age of 56 years (range 28 to 88 years).Mild to moderate hydronephrosis were identified by ultrasound and CTU in all patients , including 2 recurrent fever and 1 renal colic in affected side , however serum creatinine level is normal .There were 10 patients received stents insertion through cystoscopic or nephroscopic retrograde approach and 1 through nephroscopic antegrade approach,under superficial , spinal or intravenous anesthesia .Patients were scheduled for follow-up at 6 months intervals by KUB and ultrasound and would be examined ahead of time if there were any obstructive symptoms including recurrent fever or renal colic of the affected side .Outcomes and complications were observed during follow-up.Results In total,11 patients underwent 13 operations,including 2 by staging operations.Hydronephrosis , recurrent fever and renal colic were relieved in all patients after operation , showing 100%success rate.The mean follow-up was 9 months,in which,9 patients had not reached the scheduled time (1 year) while 2 patients exceed the time limit of stent exchange because of poor physical status.During the follow-up, 1 patient died of the progression of urothelial carcinoma .Nine stents of 5 patients keep alleviating the obstruction without hydronephrosis evaluated by ultrasonography .Stents failure occurred in 6 ureters of 5 patients, including 3 encrustation and 2 migration, presenting of progressive hydronephrosis and recurrent fever . Functional restoration was achieved in one of the encrusted stent undergoing ESWL .One stent with encrustation fail to be removed and a polymer double-J stent replacement in the same side was required for drainage .The other 3 nonfunctional stents were removed and replaced by polymer double-J stents.Conclusions Ureteral obstruction secondary to extrinsic compression contributing to relatively stable malignant tumor could be treated safely and sufficiently with the resonance metallic stent . Surveillance on schedule and regularly change within 1 year is critical to achieve successful outcomes .Tumor progression with ureteral invasion as while as encrustation can cause stent failure ,and in these cases the stent should be changed every 6 months or less.

The methods of diagnostic imaging for pulmonary embolism is diversified. However, the different characteristic features of diagnostic imaging and diagnostic accuracy impressive influenced the choice of selection by clinicians. Furthermore, the principle and indication of interventional therapy would have great impending force on the outcomings. This article presents a comprehension of diagnostic imagings and interventional therapy for pulmonary embolization.

Objective To evaluate the safety and effect of percutaneous fenestration of intimal flap(FIF) and endovascular stent(ES) placement for aortic dissection. Methods Male patient, 54 years old. DeBakey Ⅲb aortic dissection, tear of intimal flap situated at the beginning of desconding aorta, developed to abdominal aorta and right iliac artery. The true lumen was 3 mm at narrowest locatation. Through femoral artery approach, percutaneous fenestration of intimal flap and ES placement are operated and four ES were placed. Results The blood flow of aortic true lumen and branches were resumed. The true lumen raised to 12 3 mm at the narrowest locatation. The clinical symptoms vanished. Conclusion Percutaneous fenestration and ES placement for aortic dissection feature little injure, high safety and effecacy. So, It is the first choice for certain aortic dissection.

Adult ; Body Composition ; Exercise ; physiology ; Female ; Humans ; Lipids ; blood ; Obesity ; blood ; Young Adult

Objective To evaluate the interventional treatment of Budd-Chiari syndrome (BCS)with regard to different types of the disease.Methods One hundred and fifty-nine consecutive cases with BCS underwent interventional treatments with regard to different types of the diseases,including percutaneous angioplasty (PTA),transcatheter thrombolysis,endovascular stent implantation and modified transjugular intrahepatic portosystemic shunt(MTIPS).Among them,147 cases that underwent complete follow-up were enrolled in this study.Simple obstruction of HV,membranous obstruction of IVC,membranous obstruction of IVC combined with thrombosis in the distal lumen and segmental obstruction of IVC constituted 13.6/(20),66.0/(97),6.1/(9)and 14.3/(21/147),respectively.The technical success rate of each type Was determined.They were followed up for(67.3±9.0)months (16 h-104 months).Overall primary patency rote was evaluated.The late effect on liver function Was analyzed according to the Child-Push score.Results The primary patency rate of PTA was 65.6/ (86/131)and the secondary pateney rate was 96.9/(124/128).The primary patency rate of stent implantation was 78.9/(15/19)and the secondary patency rate Was 92.3/(24/26).One patient of type Ⅲa that received recanalization,catheter-directed thrombolysis and PTA in IVC died of hemoptysis 72 h after the procedtire.One patients of type I b who received MTIPS died of DIC 16 hrs after the procedure.And one patient of type Ⅳb who received MTIPS died of hver failure 13 months after the procedure.Twelve patients died in 7-79 months after the interventional procedure due to unrelated causes.At the end of follow-up,the liver function of the patients Was improved. Conclusions Optimal application of various vascular interventional techniques has a satisfactory primary and secondary patency rate and improves the long-term liver function.