Objective To discuss the diagnostic value of high frequency ultrasound on lesions of knee traumas.Methods Ninty-eight cases with post-traumatic knee injuries were examined by high frequency ultrasound,and the characteristics of changing ultrasonogram were observed and comparing with surgical results and MR.Results Of the 98 cases with post-traumatic knee injuries,there were 57 cases with effusion and hematocele in knee joint,among which there were 41 cases with collateral ligaments and meniscus injuries,the diagnostic coincidence rate was 93.3% in tendon tear and complete tendon fracture(compared with MR),91.7% in partial and complete muscle tear(compared with MR),67.7% and 71.4% in collateral ligaments and meniscus injuries(compared with surgical results).Conclusions High frequency ultrasound can be used as a conventional imaging examination method for post-traumatic knee injuries.

Clinical data of 15 patients with penetrating injury in the distal segment of the common bile duct during biliary tract exploration were retrospectively analyzed.Nine injuries were found during the surgical procedures and successfully treated with common bile duct T tube and peritoneal drainage before discharged from the hospital (mean hospitalization time 16 days).Six penetrating wounds were found post-operatively, and underwent another operation.Four patients were fully recovered at 8 to 12 weeks, and 2 died from multiple organ failure caused by infectious shock.Our investigation suggests that for the penetrating injury in the distal part of the common bile duct, early diagnosis, proper management and effective draining may improve the survival of the patients and avoid serious complications.

Objective To analyze of related factors in affecting condylar buttress plate (CBP) surgical treatment of distal femoral fractures.Methods One hundred patients with distal femoral fractures were grouped according to eight related factors (gender,age,fracture type,fracture classification,surgical time,reset quality,whether bone graft and plaster braking),respectively.Operative efficacy was scored by the Neer knee functional score table,and score ≥ 72 was excellent,while ＜ 72 was good.Eight related factors were carried out single factor analysis with x2 test to compare the operative efficacy of each group,then the related factors with single factor analysis result of P＜0.05 were put in Logistic multifactor regression analysis,in order to clarify the independent risk factors for CBP treatment of distal femoral fractures.Results There was no significant difference (P＞0.05) in the operative efficacy between male and female group,open fracture and closed fracture group.The difference between youth,middle-aged and elderly group,type A and type C fracture group was statistically significant (P＜0.05).The operative efficacy of patients got surgery within 7 d was obviously better than those who got surgery 7 d later (P＜0.05).The operative efficacy of patients who had no intraoperative bone graft was better than those who had bone graft (P＜0.05).The operative efficacy of satisfactory reset group and none plaster braking group was better than that of unsatisfied reset group and plaster braking group (P＜0.05),respectively.Conclusions Age,fracture type and reset quality are CBP therapy independent risk factors for the efficacy of operation for patients with distal femoral fractures,which will provide some reference for improving the operative efficacy of CBP operation in treatment of distal femoral fractures.

Objective:To investigate the effect of self fixing mesh with " Y-shaped" placement in laparoscopic transabdominal preperitoneal repair of female inguinal hernia.Methods:From February 2019 to September 2020, a total of 40 female patients who underwent TAPP (Keyhole method) in Shaanxi Provincial People′s Hospital were researched.Random number table method was used.According to different patch placement methods, the patients were divided into the self fixing mesh with " Y-shaped" placement group (21 cases) and with normal placement group (19 cases). The operative time, placement time, length of stay, Visual Analogue Scale (VAS), postoperative complication were compared between two groups.Results:All 40 patients completed TAPP, and all patients were followed up successfully, with a median follow-up time of 12.5 months.The operation time and patch placement time were (54.9±9.0) min and (10.8±2.5) min in the Y-shaped placement method group and (62.8±11.2) min and (20.3±3.5) min in the conventional placement method group, respectively; the differences between the two groups were statistically significant ( t=2.490, P=0.017; t=.925, P<0.001). There was no statistically significant difference between the two groups in length of stay, VAS score 1 day after surgery and postoperative complications(all P>0.05). Conclusion:In laparoscopic female inguinal hernia repair (keyhole method), the " Y" shape placement method can effectively shorten the time of self fixing patch placement, thus shorten the operation time, and does not increase the risk of complications.

Objective:To compare clinical features of patients with pyogenic liver abscesses with and without septated lobulations.Methods:Patients diagnosed to have pyogenic liver abscesses who were treated in our hospital from January 2011 to March 2021 were enrolled into this retrospective study. There were 203 males and 132 females, with age of (56±14) years old. The patients were divided into two groups by findings on computed tomography and ultrasound into the septated lobulation group ( n=68) and the non-septated lobulation group ( n=267). The clinical data of these patients were compared. Results:In the septated lobulation group, the neutrophil count was 9.17(5.97, 12.33)×10 9/L and the TBil was 17.65(11.92, 27.84) μmol/L. These were significantly higher than the corresponding figures of 7.81(5.42, 10.81)×10 9/L, 12.90(9.00, 19.68) μmol/L, respectively in the non-septated lobulation group ( P<0.05). The difference in the maximum diameters of the septated lobulation group was also significantly larger than the non-septated lobulation group ( P=0.032). Additionally, pus culture showed the proportion of Klebsiella pneumoniae positive patients in the septated lobulation group was significantly higher than that in the non-septated lobulation group [41.18% (28/68) vs. 25.84% (69/267), P=0.013]. The use of fluoroquinolones in patients in the septated lobulation group was higher than that in the non-septated lobulation group [20.59% (14/68) vs. 10.11% (27/267), χ 2=5.54, P=0.019]. Conclusion:Compared to patients without septated lobulations, those with septated lobulations had a larger diameter of abscesses, a higher positive rate of Klebsiella pneumoniae on pus culture and a higher proportion of patients receiving fluoroquinolones.

Objective To investigate the regulatory role of HK2 in the metastasis of hepatocellular carcinoma ( HCC) . Methods The protein expressions of HK2 in 73 HCC tumor tissues and paired adjacent non?tumor tissues were evaluated by using immunohistochemical analysis. The scratch wound healing assay and Transwell assay had been used to analyze the migration and invasion of HCC cells with HK2 knockdown. Expressions of epithelial?to?mesenchymal transition ( EMT) markers, such as E?cadherin, ZO?1, N?cadherin and vimentin,in HCC cells with HK2 knockdown were determined by qRT?PCR and Western blot analysis. Results The expression levels of HK2 in tumor tissues and adjacent non?tumor tissues were 5.39±3.40 and 2.16±1.55, respectively. The protein expression of HK2 was significantly higher in tumor tissues compared with adjacent non?tumor tissues of HCC (P<0.05). Knockdown of HK2 in HCC cells decreased the cell motility from 1.00±0.54 to 0.56±0.09 (P<0.05), andknockdown of HK2 in HCC cells decreased the number of invaded cells form 345±42 to 215±34 (P<0.05). The expression of epithelial markers ZO?1 and E?cadherin were up?regulated, while mesenchymal markers vimentin and N?cadherin were down?regulated in HCC cells when HK2 was knockeddown. Conclusions HK2 is up?regulated in HCC and promotes cell motility by stimulating EMT.

Objective To investigate the regulatory role of HK2 in the metastasis of hepatocellular carcinoma ( HCC) . Methods The protein expressions of HK2 in 73 HCC tumor tissues and paired adjacent non?tumor tissues were evaluated by using immunohistochemical analysis. The scratch wound healing assay and Transwell assay had been used to analyze the migration and invasion of HCC cells with HK2 knockdown. Expressions of epithelial?to?mesenchymal transition ( EMT) markers, such as E?cadherin, ZO?1, N?cadherin and vimentin,in HCC cells with HK2 knockdown were determined by qRT?PCR and Western blot analysis. Results The expression levels of HK2 in tumor tissues and adjacent non?tumor tissues were 5.39±3.40 and 2.16±1.55, respectively. The protein expression of HK2 was significantly higher in tumor tissues compared with adjacent non?tumor tissues of HCC (P<0.05). Knockdown of HK2 in HCC cells decreased the cell motility from 1.00±0.54 to 0.56±0.09 (P<0.05), andknockdown of HK2 in HCC cells decreased the number of invaded cells form 345±42 to 215±34 (P<0.05). The expression of epithelial markers ZO?1 and E?cadherin were up?regulated, while mesenchymal markers vimentin and N?cadherin were down?regulated in HCC cells when HK2 was knockeddown. Conclusions HK2 is up?regulated in HCC and promotes cell motility by stimulating EMT.

Objective To evaluate the safety and efficacy of laparoscopic common bile duct exploration (LCBDE) in the treatment of bile duct calculi. Methods Clinical data of 236 patients with bile duct calculi in Shaanxi Provincial People's Hospital between September 2012 and March 2015 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 98 males and 138 females, aged from 15-95 with a median of 58 years old. Laparoscopic surgery was performed via four-port approach. The anterior wall of common bile duct was cut in a length of 0.5 to 1.5 cm below the junction of cystic duct and common bile duct. Calculi were removed with a choledochoscope under laparoscope. After the calculi were removed completely, incision of the common bile duct was primarily sutured with 4-0 absorbable thread or a T tube was placed for drainage. Results LCBDE was performed successfully on 233 patients, with a rate of conversion to open laparotomy 1.3%(3/236), including 1 case was converted to laparotomic radical cholecystectomy for gallbladder carcinoma, 2 cases receiving laparotomic hepaticojejunostomy for hilar bile duct stricture. 225 cases underwent common bile duct exploration, 8 cases underwent cystic duct exploration. 161 cases underwent primary suture of common bile duct, and 72 cases received placement of T tube. The calculi incarcerated in the lower end of common bile duct or deep located at intrahepatic bile duct in 16 cases were removed completely after lithotripsy under a choledochoscope. The median length of operation was 95(60-225) min, the intraoperative blood loss was 60(20-250) ml, and the postoperative length of stay was 6.5(4.0-15.0) d. No perioperative death was observed, and the incidence of postoperative complications was 6.9%(16/233), including 9 cases of bile leakage, 3 cases of residual calculi, 3 cases of mild pancreatitis and 1 case of peritoneal effusion. The patients were followed up for 10-40 months, and no recurrent calculi or biliary stricture occurred. Conclusions LCBDE is a safe and effective minimally invasive surgical treatment for patients with bile duct calculi, which is characterized by less trauma, rapid recovery and less complications.

Objective To study the application value of multi-parameter imaging of Revolution energy spectrum CT in identifying the tumor-lung interface between central lung cancer and accompanying atelectasis.Methods The spectral CT imaging data of 73 patients with central lung cancer and accompanying atelectasis confirmed by pathology were collected.The polychromatic image,the best monochromatic image,the best monochromatic image combined with iodine concentration map and the effective atomic number(Eff-Z)of the tumor-lung interface in the arterial,venous and delayed phases were compared,and the CT value,iodine concentration(IC)value,Eff-Z and the slope of energy spectrum curve(λHU)of tumors and atelectasis in the venous phase were also compared.Results(1)On tri-phase CT,the subjective score of the tumor-lung interface in the venous phase was the highest.(2)There were differences among the subjective scores of tumor-lung interface on polychromatic image,best monochromatic image,best monochromatic image com-bined with iodine concentration map and Eff-Z on tri-phasic enhanced CT.The subjective score of the best monochromatic image combined with iodine concentration map was the highest,followed by the best monochromatic image.(3)There were significant differences in CT values,IC values,Eff-Z and λHU between tumors and atelectasis in venous phase,with the highest difference of IC value.Conclusion Revolution energy spectrum CT can identify the tumor-lung interface between central lung cancer and accompanying ate-lectasis through multi-parameter imaging,which may provide helpful information for the diagnosis and therapeutic evaluation of the disease.

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies