OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groups:TUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.

Objective To investigate the value of ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and computered tomography(CT) in the diagnosis of lung cancer.Methods The ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and CT were performed in 50 patients with lung neoplasm confirmed by pathology.Results There was not significant difference in the sensitivity of three imaging examination methods.The specificity of ~(99m)Tc-HL91 hypoxia imaging was obviously higher than that of ~(99m)Tc-MIBI tumoraffin and CT.The accuracy of ~(99m)Tc-HL91 hypoxia imaging was higher than that of ~(99m)Tc-MIBI tumoraffin,and had not significance difference with that of CT.The sensitivity,specificity and accuracy of the combination of three imaging examination methods in the diagnosis of lung cancer were 96.9%,100% and 98%,respectively.Conclusion The ~(99m)Tc-HL91 hypoxia imaging is valuable in diagnosing lung cancer and the diagnostic accuracy may be further improved with the combination of ~(99m)Tc-MIBI tumoraffin and CT.

Objective To analyze the curative effects in hyperthyroidism radioiodine treatment which using different methods to measure thyroid weight in order to calculate therapeutic dose.Methods 265 hyperthyroidism underwent radioiodine treatment,then they were divided into 4 groups.Calculating therapeutic dose was done according to SPECT tomography,nuclear plane imaging,ultrasonography and palpation to measure thyroid weight.We Compared and analyzed the curative effects after 6 months.Results The curative effects of 4 groups had obviously difference(P

Objective To investigate the clinical value of 99m Tc-HL91 hypoxia imaging in the diagnosis and treatment of lung cancer. Methods 99m Tc-HL91 hypoxia imaging was performed in 72 patients with primary lung cancer. The qualitative analysis and semi-quantitative analysis of the early and delayed images were also performed. 65 patients underwent chemotherapy were divided into 2 groups by the T/N value of delayed images, and the curative efficacy in both the two groups was compared. Results The sensitivity of 99m Tc-HL91 hypoxia imaging for diagnosing lung cancer was 86 1% in early imaging and 98 6% in delayed imaging. The results of semi-quantitative analysis in different pathological types of lung cancer hadn’t obvious difference. The curative efficacy of the patients with low uptake was better than that of the patients with high uptake in 65 patients underwent chemotherapy, difference of which had significant(P

Objective To compare the diagnostic efficiency of superb microvascular imaging (SMI) and contrast-enhanced ultrasonographic microvascular imaging (MVI) for differentiating breast lesions.Methods One hundred and sixteen patients with 116 breast lesions were first examined by grayscale ultrasound.Then SMI and MVI were performed on all patients.Microvascular architectures of breast lesions were depicted by both methods.The lesions were evaluated based on their microvascular architectures.The diagnostic efficacy of both methods were compared.Results The diagnostic sensitivity,specificity,and accuracy of SMI and MVI were 79.24％,90.48 ％,85.35％ and 88.68％,87.30％,87.93％,respectively.The areas under the curve of SMI and MVI were 0.888 and 0.926.The diagnostic values of SMI and MVI were not statistically different (P =0.212).Conclusions SMI can detect tiny vessels and depict microvascular architecture of breast lesions as MVI do,which is beneficial for breast tumor differentiation.The diagnostic efficacy of SMI is almost the same as MVI.

Humans ; Accidents, Traffic ; Colon, Sigmoid ; Forensic Medicine ; Autopsy ; Abdominal Injuries ; Thoracic Injuries ; Rupture

Objective To evaluate the efficacy ofintravitreal injection (IVI) ofexpansile gas alone to treat idiopathic full-thickness macular hole (FTMH).Methods This is a prospective interventional case series.Twenty FTMH patients (26 eyes) who underwent IVI with expansile gas alone were enrolled in this study.There were 5 males (5 eyes) and 21 females (21 eyes),with the mean age of (59 ± 12) years.All patients received the best corrected visual acuity (BCVA),slit lamp microscope,indirect ophthalmoscopy,fundus color photography and three-dimensional optical coherence tomography (OCT) examinations.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution visual acuity.The diameters of macular holes and the interface between vitreous and macular were observed by OCT (Topcon,OCT-2000).Based on the diameter,the holes were classified as small FTMH (equal or lesser than 250 μm),medium FTMH (more than 250 μm but equal or lesser than 400 μm) and large FTMH (more than 400 μm).The mean BCVA was 0.85 ± 0.29.There were 7,10 and 9 eyes with small,medium and large FTMH.There were 10 eyes with vitreous-macular traction (VMT).All the eyes received IVI of 0.2 ml C3F8 followed facedown positioning for 7-14 days.The follow-up ranged from 1 to 23 months.The BCVA,FTMH closure and complications were observed.If holes failed to close at 1 month after IVI,vitrectomy combined with internal limiting membrane (ILM) peeling and C3F8 tamponade would be performed for these eyes.Results FTMHs was able to close in 17/26 eyes (65.4％) had hole closure,failed to close in 9/26 eyes (34.6％).All 10 eyes with VMT achieved vitreous-macula separation after IVI of gas.The eyes failed in the closure initially with IVI of gas alone,all succeed with hole closure after vitrectomy combined with ILM peeling and C3F8 tamponade.The closure rate of small (6 eyes),medium (8 eyes) and large FTMH (3 eyes) was 85.7％,80.0％ and 33.3％ respectively.The diameter of FTMHs in holes-closure eyes and failed-closure eyes was (307.8 ± 122.8),(431.6± 128.4) μm respectively,the difference was significant (t=-2.407,P=0.024).VMT was found in 6 eyes and 4 eyes in holes-closure group and failed-closure group,respectively,the difference was significant (t=-2.196,P=0.038).The mean preoperative BCVA was 0.51 ±0.36.There was a significant difference between pre-and postoperative BCVA (t=4.758,P＜ 0.05).Two eyes developed local retinal detachment,which achieved hole closure and retinal reattachment after vitrectomy.Conclusion IVI of expansile gas alone is an effective way in treating FTMH with a diameter smaller than 400 μm and with VMT before surgery.

Objective To discuss the outcomes of the clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy. Methods 75 patients (11％) with CIRF among 655 who underwent initial MPCNL from January 2008 to December 2010 were diagnosed by CT scan.Clinical data of 68 patients (39 male and 29 female) were analyzed retrospectively.Previous open surgery hadbeen performed in 13 and ESWL in 20 cases.The median residual fragment size was 1.8 mm.The anatomical distribution of CIRF was 9 at upper pole,14 at middle,34 at lower,9 at renal ureteropelvic junction and 2 at upper and lower pole.Stone analysis showed 40 cases of calcium oxalate calculi,15 of calcium oxalate calculi mixed with carbonate calculi,2 calcium oxalate calculi mixed with uric acid,3 calcium oxalate calculi mixed with struuvite stone,3 struuvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Mean follow up was 23 months (12-36).Follow-up consisted of physical examination,serum routine,urine routine and CT imaging. Results 14(21％) patients (3 upper pole,1 middle pole,4 lower pole and 6 ureteropelvic junction) had symptomatic episodes,including 9 hematuria,2 renal colic pain,5 lower urinary tract symptoms,12 with size of CIRF ＞ 4 rmm.8 patients required surgical procedures.5 patients (1 middle,2 upper pole and 2 renal pelvis) underwent ESWL.3 patients with ureteral CIRF were performed ureteroscopic lithotripsy.The CIRF were clear after surgeries.4 paticnts with CIRF ＞ 4 mm did not have symptoms.These patients were recommended to conservational treatments.2 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.27％ (3/11)CIRF located in upper pole had symptom,compared with 4％ (1/14) in middle pole,11％ (4/36) in lower pole and 67％ (6/9) in ureteropelvic junction. Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or SWL are more likely to get CIRF.Medium-term follow-up of CIRF revealed that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Objective To observe dynamically osteopontin(OPN) expression in the renal tubules of streptozotocin(STZ) induced diabetic rats, and to explore the relationship between OPN and angiotensinⅡ(AngⅡ), nuclear transcription factor-?B(NF-?B), and renal injuries. Methods Male SD rats were injected with STZ to induce diabetes mellitus, which were randomly divided into 5 groups and meanwhile there were other 5 age-matched normal control groups. Immunohistochemistry was employed to observe the expression of OPN, AngⅡ, NF-?B and fibronectin(FN) in renal tubules. The OPN and I-?B protein in renal cortex was detected by Western blot methods. Blood glucose, serum creatinine and 24 h urine protein were examined. The renal morphology was checked through light microscopy.Results The AngⅡand NF-?B expression from DM day 3, OPN expression from day7, FN from week 2 in renal cortex or tubules was increased as compared with control groups, while I-?B protein in renal cortex was gradually decreased since day 3. In DM week 4, there were positive correlations between OPN and AngⅡ, NF-?B, FN and 24 h urine protein. Conclusion An increase of OPN expression in the renal tubules of diabetic rats may be regulated by AngⅡ and NF-?B, and therefore participates the injury mechanisms of renal tubulo-intestitium.