Objective To study the CT and MRI features of the chordoma in the mobile spine.Methods The CT and MRI fea-tures were retrospectively analyzed in twenty-four cases of chordoma in the mobile spine.Results In all the twenty-four cases,bone lesions were solitary in eight cases and multiple in sixteen cases,mostly occurred in cervical,occasionally occurred in thoracic or lum-bar vertebra.Both vertebral body and part appendix were involved in all cases.CT imaging showed that all the lesions mainly mani-fested as osteolytic bone destruction,peripheral osteosclerosis and the cortical bone were incomplete.Soft-tissue mass involved para-vertebral and intraspinal.Five lesions appeared vertebrae compression.Eight lesions appeared intervertebral foramen expansion.Le-sions appeared honeycomb or annular enhancement after contrast media injection.Lesions were presented as heterogeneous slightly hypo-isointensity on T1 WI,hyperintensity on T2 WI.Low signal fibrous septa within the tumors were seen.Lesions appeared hon-eycomb enhancement after Gd-DTPA injection.Conclusion CT and MRI findings of chordoma in the mobile spine can be regarded as characteristic,which are helpful for clinical diagnosis.

OBJECTIVE: To study the inhibitory effect of Danggui Buxue Tang (DBT), a compound traditional Chinese herbal medicine for supplementing blood, on tumor growth in tumor-bearing mice after inoculation of EL-4 cells, and its immune mechanism as well as its synergic effect in reducing toxicity of cytoxan (CTX). METHODS: Experiment was carried out in tumor-bearing mice after inoculation of EL-4 cells. The mice were randomly divided into four groups after 7 days of the inoculation: untreated group, DBT-treated group [24 g/(kg x d)], CTX-treated group [7.5 mg/(kg x d)] and DBT plus CTX-treated group, with another ten normal mice as control. Inhibitory rate of tumor growth, survival time, immune function and variability of blood cells were measured in the mice during the experiment. RESULTS: After treatment of relevant interventions for 15 days, the tumor in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group grew slower than the untreated group (P<0.05). Murine survival time in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group was lengthened as compared with that in the untreated group (P<0.05). Compared with the untreated group, all kinds of immune indexes in the DBT-treated group and DBT plus CTX-treated group were significantly improved (P<0.05), while the immune indexes in the CTX-treated group were decreased (P<0.05). Compared with the CTX-treated group, all kinds of immune indexes in the DBT plus CTX-treated group were significantly improved (P<0.05). CONCLUSIONS: DBT can enhance the immune function in tumor-bearing mice and the inhibitory effect of DBT on tumor growth is related to the enhanced immune response. DBT can also increase the therapeutic effects and reduce the side effects of CTX.

Objective To investigate the method and effect of monosegment pedicle instrumentafinn on thoraeolumbar vertebral fracture.Methods Sixteen patients with thoracolumbar vertebral fractures treated by open reduction and monosegment pedicle instrumentation through posterior approach.Posterolateral bone grafting was done in all cases,9 cases were quite decompressed using laminectomy.The follow-up time Was 8-24 months.The spine radiographs and CT scan were taken pre-and post-operation.The parameters used for clinical evaluation were the Denis pain scale,neurological evaluation by the Frankel scale and bone graft healing evaluation by the Suk scale.Results All of the fractures were reduced satisfactorily during the follow-up.The height of the injured vertebral improved rate was 30.8%,kyphosis of the injured vertebral segment rectified obviously.There was no implant break,and no signs of losing were observed in any patient.Nine patients which had neurological deficiency had average improvement more than one degree by the Frankel scale.After operation the pain score was P1 in 14 patients and P2 in 2 patients.Condnsion For the appropriate patients with thoracolumbar vertebral fractures,open reduction and internal fixation of monosegment pedicle instrumentation through posterior approach is a safe and effective method.

Objective To explore the efficacy and safety of transcatheter intra-arterial hyperthermo-chemotherapy for advanced ovarian carcinoma. Methods 36 patients with unresectable or recurred ovarian carcinoma were divided into two groups randomly: treatment group(n=20) and control group(n=16). Transcatheter intra-arterial infusion warmed to 62 degree chemo-agents via the ovarian tumor supplied artery was performed in the treatment group while routine intraarterial chemotherapy was done in the control group. The CA125 level dynamic change, short-term efficacy and side effect after the interventional procedure were compared between two groups.Results The CA125 level decreased significantly in the treatment group more than that in the control group(?

ObjectiveTo evaluate the sufficiency of dialysis and nutri ti onal status of 44 end-stage renal disease (ESRD) with urea metabolic parameters such as TACurea,KT/V and PCR.MethodClinical data were collecte d and analyzed with statistic methods.ResultsTACurea and PCR w ere significantly lower in patients in insufficient dialysis group than those in sufficient dialysis group.There was no statistical difference between the two g roups in terms of KT/V.PCR was not influenced by KT/V in sufficient dialysis gro up,while it was significantly influenced by KT/V in insufficient dialysis group. ConclusionTACurea and PCR are significant indicators to assess whether the blood dialysis is sufficient or not in the long run.KT/V can direct ly indicate the effectiveness of single dialysis.Therefore,it is the best indica tor for adjusting the dialytic strategy.However,it is not important if the dialy sis is not sufficient.

Objective To investigate the CT and MRI features of Langerhans cell histiocytosis (LCH) with multiple spinal involvement.Methods The CT and MRI data of 13 patients with multiple LCH lesions in spine confirmed by pathology were retrospectively analyzed.All of 13 cases underwent CT examination (1 case underwent enhanced scanning) and 12 cases underwent MR examination (6 cases underwent enhanced scanning).Results In 13 cases,there were 8 cases of single central lesions invading the adjacent vertebrae and 5 cases of multiple central lesions.There were 19 core spinal lesions and 15 adjacent invading lesions in a total of 34 vertebrae lesions.Eighteen core lesions (18/19,94.74 ％) had different degrees and shape of vertebral compression.A total of 34 abnormal vertebrae were found in 13 cases by CT,which were manifested as osteolytic bone destruction.Eighteen cortical bones of 19 core vertebrae were incomplete,and a paravertebral soft-tissue masses were observed.There were 33 vertebrae lesions in 12 patients who underwent MR examination,including 18 core spinal lesions and 15 adjacent invading lesions.The lesions displayed equal,slightly lower or low signal on T1WI,slightly higher or high signal on T2WI and high signals on fat suppression sequences.A paravertebral soft-tissue masses were observed in 17 core spinal lesions (17/18,94.44％).Conclusion CT and MRI manifestations of spinal multiple LCH have certain characteristics.The level of diagnosis and differential diagnosis should be improved by deepen understanding of the disease image performance,but the diagnosis still depends on the pathology.

Objective To investigate the diagnosis of Crohn's disease(CD)in Ruijin hospital of School of Medicine of Shanghai Jiaotong University according to the criteria made by World Health Organization(WHO)and Chinese Medical Association.Methods The consecutive patients with CD diagnosed in Ruijin hospital between 1998 and 2007 were retrospectively analyzed.The clinical manifestation.endoscopic,radiologic and pathologic findings of all patients were re-evaluated accordingto the diagnostic criteria of CD proposed by WHO and Chinese Medical Association in 2007.The diagnostic level of CD was assessed.Results Only 5 and 10 patients were confirmed to be well consistent with the criteria of WHO and Chinese Medical Association,respectively.Two hundred and thirty-six patients were confirmed as suspected diagnosis to the criteria of Chinese Medical Association and 20 patients to WHO.The level of endoscopic diagnosis was raised,wherease the level ofpathologic diagnosis was decreased in recent years compared with that before 2004.Conclusion The pathologic diagnosis rate of CD is still at a low level.The current diagnostic level of CD is lagging behind the demand of the guidelines.

BACKGROUND:Bone loss to different degrees may appear within 1 year after hip replacement in the femoral or acetabular sides, and severely affect long-term stability of the prosthesis and bone strength. Thus, to reduce bone loss around the prosthesis stem after total hip replacement is significant to prolong the use time of the prosthesis and to prevent fractures surrounding the prosthesis.
OBJECTIVE:To observe the preventive effect of zoledronic acid on bone loss surrounding the prosthesis stem after hip replacement.
METHODS:A total of 80 patients after total hip replacement in the People’s Hospital of Shenxian from February 2011 to September 2014 were enrol ed in this study. They were divided into two groups (n=40). At 4 days after replacement, patients in the observation group received treatment with zoledronic acid, but those in the control group did not give zoledronic acid. The rest medication was identical between the two groups. Bone mineral density in the hip was measured before replacement and at 1 year after replacement in both groups. Serum calcium and
phosphorus levels and alkaline phosphatase activities were observed before replacement, 3 days and 1 year after medication in the two groups. Adverse reaction during medication was recorded in the observation group.
RESULTS AND CONCLUSION:The average bone mineral density was significantly decreased in both groups at 1 year after replacement, and significant differences were found as compared with before replacement (P<0.05). The average bone mineral density was significantly higher in the observation group than in the control group at 1 year after
replacement (P<0.05). Calcium and phosphorus levels were significantly diminished at 3 days after medication as compared with that before replacement (P<0.05). Calcium and phosphorus levels maintained at the level before replacement at 1 year after medication. Alkaline phosphatase activities were slightly reduced within a short time after replacement in both groups, but no significant difference was found as compared with before replacement (P>0.05). Alkaline phosphatase activities were low in the observation group at 1 year after medication, and significant difference was detected as compared with the control group and that before replacement (P<0.05). No significant difference in alkaline phosphatase activities was detectable in the control group between 1-year post medication and pre-replacement (P>0.05). Within two or three days after medication, nine patients suffered from varying degrees of muscle aches and fever in the observation group, and above symptoms were lessened after taking acetaminophen. These results verify that after total hip replacement, zoledronic acid injection can effectively prevent bone loss around the prosthesis in early stage after replacement, but fever symptoms may occur within a week after replacement. Thus, it is recommended that zoledronic acid injection can be given at 1 week after replacement. If fever and other symptoms appear, acetaminophen can be given.

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.

Objective To explore and use a simple effective technique for repairing whistling de-formities and similar defects of upper lip.Methods According to various degrees of the defect on the ver-milion,one or two lip flaps were designed.At the first,a horizontal incision was performed in the area of vermilion defect to make the wound as a recipient area,then one or two lip flaps were formed,which were vertical against horizontal incision and close to area of deformity.Lengths of the flap ranged from 0.6 to 1.4cm,widths of the flap ranged from 0.4~0.7cm,and maximum ratio of length to width was 3:1.At last,the lip flaps were rotated up to recipient area for repairing whistling deformities.Sometimes deform-ities of Cupid’s bow and white lip were repaired at the same time through making additional incision.Re-sults Follow-up for l to 15 months showed that 25 cases of operation were with satisfactory results,ver-milion deformities were repaired or acquired visible improvement without complications and without leav-ing clear incision scar at lip after operation from November 2002 to September 2004.Conclusion In gen-eral application of vertical lip flaps could achieve anticipatory objective for repairing the whistling deformi-ties on lip if there are sufficient membraneous tissue in donor area.This operation is simple,practical and satisfactory.