Objective: To study the treatment method of apoplectic joint contracture. Method: Fifty-two cases were treated with acupuncture plus cupping and thirty cases were treated with acupuncture alone as the control group. Result and conclusion: The effective rate of the former and later were 100% and 93.3% respectively,combined treatment of acupuncture and cupping was superior to acupuncture alone (P＜0.05).

Objective To investigate MRI value in diagnosing and differential diagnosing intrahepatic peripheral cholangiocarcinoma(IHPCC).Methods Twelve cases with IHPCC proved by pathology underwent plain MRI,and contrast-enhanced MR imaging including arterial,portal and delayed phase.MRI features were analyzed.Results All of 17 leisons in 12 cases,12 lesions exhibited hyperintensity at edge and hypointensity at center on T2WI,5 appeared as hyperintensity.2 lesions showed no enhancement and 15 lesions were circular enhancement in arterial phase,all of 17 lesions showed gradual fill in the center of lesions.The diagnostic accuracy was 100%.Conclusion MRI plays an important role in detecting and diagnosing IHPCC.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective To explore the thoracic and diaphragmatic complications of treating hepatic malignant tumor using thermal ablation techniques.Methods The patients received thermal ablations were involved as subjects from January 2002 to December 2013.The thoracic and diaphragmatic complications of treating hepatic malignant tumor with percutaneous thermal ablation were retrospectively analyzed.Results A total of 1 520 patients with 2 789 hepatic tumors [average largest diameter of tumor (2.30 ± 1 .03)cm] underwent 2 066 thermal ablation treatments.Five hundred and six radiofrequency ablation (RFA)and 1 560 microwave ablation procedures were performed,respectively.The complete ablation rate was 96.8%(2 701/2 789)at 1 month after treatment.The major thoracic and diaphragmatic complication rates were 0.8%(1 7/2 066 ),meanwhile the minor complication rates were 6.5% (134/2 066 ).Conclusions The thoracic and diaphragmatic complication rate of percutaneous thermal ablation is low in the treatment of hepatic malignant tumors.However,the major complications may cause serious consequences.Therefore, the patients of diaphragm-abutting liver tumors are fully assessed before thermal ablation treatments,and relevant prevention measures are completed.Open or laparoscope is used to assist thermal ablation treatment when necessary.

Objective To investigate the reasons of complications after ultrasound-guided PTBD and explore measures for their management. Methods The clinical data of 753 patients with obstructive jaundice treated with ultrasound-guided PTBD in our hospital from January 2001 to June 2008were retrospectively analyzed. Results The 753 patients received a total of 791 treatments of PTBD.The occurring rates of severe, common, and long-term complications were 1.14 % (9/791), 11.88 %(94/791 ) and 4.3% (9/791), respectively. Only 1 patient died of manipulation-related complications.Conclusion Ultrasound-guided PTBD is an effective method for treatment of obstructive jaundice.

BACKGROUND:In mass spectrometry analysis, the same protein in different samples labeled with isobaric tags for relative and absolute quantitation presents the same mass-to-charge ratio, while in the tandem mass spectrometry analysis, the ion signal shows different mass-to-charge ratio (114-121). Thus the quantitative information of the related proteins can be obtained. OBJECTIVE:To establish the protein spectrum of spinal cord tissue differences proteins after acute spinal cord injury, and to explore the spinal differential protein expression on the molecular level using isobaric tags for relative and absolute quantitation combined with LC-MS/MS mass spectrometry technique. METHODS:Eight Sprague Dawley rats were selected to establish the acute spinal cord injury models using Al en’s method. The rats were randomly divided into 0 hour spinal cord injury group and 8 hours spinal cord injury group, four rats in each group. The spinal cord tissues were col ected after injury, and the spinal cord tissue differences proteins were analyzed with isobaric tags for relative and absolute quantitation technique after acute spinal cord injury. RESULTS AND CONCLUSION:Total y 220 differential y expressed proteins were identified in this research, the number of up-regulation proteins was 116 and the number of down-regulation proteins was 104. There were 12 differential proteins related to neural regeneration, and among the 12 proteins, there were seven up-regulation proteins and five down-regulation proteins. The various identified differential proteins and significantly expressed nerve growth factors in this experiment can be used as the biomarkers of acute spinal cord injury or used as the strong evidence for the clinical management and monitoring of the injury process and target therapy of acute spinal cord injury, as wel as the effect evaluation.

Objective To explore the clinical value of intraoperative ultrasound (IOUS) in liver resection with radiofrequency-assisted technique.Methods Thirty-two patients underwent hepatic resection with radiofrequency-assisted technique by IOUS-guidance.The use of IOUS before,during and after resection were analyzed.Results All patients were completed hepatic resection by IOUS-guidance successfully.All lesions were resected drastically,and the reserved blood vessel and biliary duct were not injured.The mean transaction time was (53.6 ± 28.4) minutes and the mean blood loss during resection was (115.3 ± 118.5)ml.No patient needed blood transfusion.Nine patients developed postoperative complications including 3 bile leaks,1 lymph leak and 6 pleural effusions.There were no cases of postoperative haemorrhage,liver failure or wound infection.The mean postoperative stay was (20.5 ± 16.8) days.Conclusions The hepatectomy with radiofrequency-assisted technique can be guided by IOUS accurately.As IOUS-guidance,the lesions are resected drastically and liver tissue is reserved farthest,and the injury of blood vessel and biliary duct is avoided.IOUS is significant value in liver resection with radiofrequency-assisted technique.

Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.

BACKGROUND:Isobaric tags for relative and absolute quantitation (iTRAQ) mass spectrometry technology studys the information of relevant protein according to the ion signal shows different mass-to-charge ratio in the tandem mass spectrometry analysis. OBJECTIVE:To establish the protein spectrum of differential proteins in cerebrospinal fluid of acute spinal cord injury rat model, study the secondary injury mechanism and find an effective method of treating acute spinal cord injury from molecular level. METHODS:Acute spinal cord injury was produced in Sprague-Dawley rats and iTRAQ technology was applied to analyze the differential proteins in cerebrospinal fluid of acute spinal cord injury rat model. RESULTS AND CONCLUSION:Total 722 proteins have been identified in this study, including 107 differentialy expressed proteins, 63 downregulated proteins and 44 upregulated proteins. There were 19 proteins related to neurogenesis, including 14 up-regulation proteins and 5 down-regulation proteins. Seven proteins contributed to the regulation of neurogenesis. The differential proteins and growth factor identified in this study can be taken as the biomarkers of acute spinal cord injury or indicators of clinical monitoring of the progression, target treatment and efficacy assessment after acute spinal cord injury.

Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.