Objective To study X-ray and clinical diagnosis of multiple myeloma(M M).Methods X-ray findings in 16 cases with M M were retrospectively analyzed.Results The main manifestations on X-ray were:normal in 3;osteoporosis in 8;osteolytic destrucion in 12;osteosclerosis in 1 and mass of soft tissue in 6.Conclusion The diagnosis of M M is mainly depended on clinical and X-ray findings,puncture of bone marrow is of diagnostic value,the differential diagnosis is still necessary.

Adult ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Female ; Hemophilia A ; drug therapy ; Humans ; Rituximab

Esophageal and Gastric Varices ; complications ; prevention & control ; surgery ; Gastrointestinal Hemorrhage ; complications ; prevention & control ; surgery ; Humans

Objective To summarize the clinical experience of endovascular intervention for intra-cranial aneurysms, especially in the respect of the technique and management of intra-operative complications. Method The clinical data of 60 patients with intra-cranial aneurysms treated with endovascular intervention in the past 3 years were analyzed. The relevant literature especially with regard to the practical technique described was reviewed so as to potentiall minimize and properly manage the intra-operative complications. Results A total of 69 sacciform aneurysms and one dissecting aneurysm located at left vertebral artery (VA) were detected by using digital subtraction angiography (DSA) in 60 patients. There were 65 saccular aneurysms obliterated with constructive approach, and five of them treated with stent-assisted technique and four of them treated with ballon-assisted technique. The VA dissecting aneurysm was obliterated with coils by deconstructive approach with complete occlusion of its parent vessel. There were a total of 53 complete occlusions of aneurysms accounted for 76.81% of 69 sacciform aneurysms in 51 patients ( 85 % ) and eight subtotal occlusion of aneurysms (95 % ～ 99 % occlusion) accounted for 13.56% of total sacciform aneurysms in five patients (8.47%) and four incomplete occlusion of aneurysms ( ＜ 95% occlusion) accounted for 6.78% of total sacciform aneurysms in three patients (5.08%), and one was failure in operation. The rupture of aneurysms occurred during operation in4 patients (6.78%). Two senile patients suffered from intra-opeartive symptomatic thromboembolisn. One patient had stent shifting and spring coil dislocated and moved into the M3 segment of the ipsilateral MCA. Vasospasm occurred in 15 patients during operation, and most of them received endovascular intervention 3 days after the initial ictus. The rate of good recovery was 93.3% at discharge from hospital (the modified Rankin Scales, mRS＜ 2). There were 55 patients followed up for up 24 months after discharge, and excellent recovery rate was found in 51 patients ( mRS ＜ 2), and 3 died.During the follow-up period, no aneurismal recanalization or rupture was noticed in all patients. Conclusions The endovascular intervention is a safe and effective approach to the intra = cranial aneurysms. Advances in the skill of technique and proper management will decrease the complications during operation and improve the prognosis of patients.

Objective To investigate cranial decompression under temporal muscle in very-low position with large bone flap combined with mild hypothermia for severe cranial trauma.Methods 88 severe brain injury patients (GCS ≤ 8 ) were randomly divided into two groups,mild hypothermia group( n =48) and non-mild hypothermia group ( n =40),both presented with cranial decompression under temporal muscle in very-low position with large bone flap.Data of patients,GCS increment,rate of brain cistern display,rate of pupil shrink and therapeutic effect were ananlyzed.Results The treatment group showed better effect compared with the oontrol group(P＜0.05).Condusion The therapy of cranial decompression under teniporal muscle in very-low position with large bone flap combined with mild hypothennia showed the advantage of depressing intracranial pressure,reducing crerebral edema and improving the therapeutic effect of severe brain injury patients.

Endoscopy ; Equipment Failure ; Female ; Foreign Bodies ; surgery ; Humans ; Intubation, Intratracheal ; instrumentation ; Middle Aged ; Trachea

Gastroesophageal reflux (GER) was very common among preterm infants, which could cause several complications and severely affects the prognosis. The standardization of diagnosis and treatment of gastroesophageal reflux was very important for preterm infants. Due to less adverse reactions, nonpharmacological therapy was the most advisable choice in preterm infants with GER. In this paper, nonpharmacological therapies including body positioning, feeding frequency and modality, changing food patterns, gastric tube, and nonnutritive sucking were reviewed. Body positioning was the safest and most effective nonpharmacological therapy. Other nonpharmacological strategies such as changes of feeding frequency and modality might also be useful. The role of some strategies was still controversial, thereby needing to be further investigated. Selection of what kind of specific nonpharmacological therapy should be based on the specific conditions.

Objective To analyze operation resection of craniopharyngioma operation experience,and to evaluation of therapeutic effect of operation.Methods Clinical data of 26 cases patient of craniopharyngioma treated by craniotomy from July 2008 to July 2013 in the Department of Neurosurgery of the People's Hospital of Xinjiang Uygur Autonomous Region for microsurgical operation resection were retrospectively analyzed.The main clinical manifestations, imaging features, the selection of operation treatment and operation approach, extent ofsection of tumor after operation, the occurrence of complications and follow up outcome were analyzed.Results Six cases with brain frontal botton+longitudinal fissure+brain endplate approach,4 cases with brain frontal botton approach, 5 cases with cerebral longitudinal fissure + callosum approach, 11 cases with pterion approach.Total removal was achieved in 19 cases, subtotal resection in 6 cases, most resection in 1 cases.Bilateral olfactory nerve in 22 cases of complete retention, unilateral olfactory nerve stretch mutilation in 4 cases,20 cases of pituitary stalk were identified, and 1 cases of anterior communicans anterior rupture give electrocoagulation cut.Enamel cell type in 23 cases, squamous epithehal cells type 3 cases.Postoperative diabetes insipidus 18 cases, electrolyte disturbances 16 cases, pituitary function decline 5 cases, secondary brain edema 2 cases, 1 case of postoperative epilepsy, 1 cases of death.The pursuit of total was diabetes insipidus factors(x2 =4.807, P =0.046), 5 cases of recurrence, 3 cases go again operztion treatment, 2 cases for the gamma knife treatment, the tumor recurrence rate of total removal lower subtotal resection and most resection (Z =-3.718 P=0.000).The tumor recurrence rate of puget tumor grade level 2 higher than puget tumor grade level 0 and puget tumor grade level 1 (Z =-3.124 P =0.000).The quality of life score (KPS) more than 70 points in 15 cases,60-70 points in 8 cases, ≤60 points in 2 cases.Conclusion Craniopharyngioma preferred operation treatment.Evaluation of preoperative imaging and operation approach is the key to successful operation.The correct operation of the surgery and treatment strategies, advantageous to resection tumor, effective prevention of postoperative complications.Postoperative residual tumor is the main cause of recurrence of craniopharyngioma.Recurrence of craniopharyngioma treatment should individualized therapy after weigh the advantages and disadvantages.

Objective To investigate the possible association of circulating components of GH-IGFs-IGFBPs system with the GHR-exon 3 genotype in idiopathic short stature (ISS) children. Methods Genomic DNA was extracted and isolat-ed from peripheral leukocytes in 108 ISS children. GHR-exon 3 polymorphism was analyzed with multiplex poly-merase chain reactions (PCR) assay. According to the results of genotype, ISS children were divided into GHRfl group and GHRd 3 group. The height and weight were recorded in two groups. The body mass index (BMI) and BMI standard deviation score (SDS) were measured. The serum levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, IGF-1 SDS and IGFBP3 SDS were calculated. GH stimulation test was used to measure the serum GH peak value. Fifty-five ISS chil-dren were treated with recombine human GH [0.15 IU/(kg·d)] for three months to analyse the association of IGF-1 response of GH treatment and genotypes. Results There were 63 GHRfl and 45 GHRd3 in 108 ISS children. There were no signifi-cant differences in BMI, IGF-1, IGFBP3, GH peak, IGF-1 SDS and IGFBP3 SDS between two groups (P>0.05). Multiple stepwise regression analysis showed that age, IGFBP3, lg (BMI) and lg (GH peak) were influencing factors of lgIGF-1 (P<0.05). In 55 ISS children treated with rhGH, there were 34 cases of GHRd3. The differences of △IGF-1 and △IGF-1 SDS were higher in GHRd3 group than those of GHRfl group (n=21). Conclusion The GH sensitivity may be a risk factor in ISS children, which may not be related with GHR polymorphism.

Objective To determine the value of MR in the diagnosis of the medial and lateral meniscal posterior root tears.Methods One hundred and twenty one patients underwent arthroscopy and MR of knee examinations were retrospectively reviewed,and all of them did not have the history of knee surgery before the MR examination.MR images were double-blinded,independently,retrospectively scored by radiology residency (doctor 1) and attending radiologist (doctor 2).The likelihood of the meniscus posterior root tear was scored on basis of arthroscopic findings constituted the gold standard.Sensitivity,specificity and accuracy of MR diagnosis of the lateral and medial meniscus posterior root tear by two physicians were calculated,and the consistency of diagnosis results by two physicians was evaluated using the Kappa statistics.Reasons leading to misdiagnosis or missed diagnosis were discussed.Results Thirty three of the 121 patients were diagnosed with meniscus posterior root tears by arthroscopy,including 14 cases of lateral tears and 19 cases of medial tears.The sensitivity,specificity and accuracy in the diagnosis of posterior lateral meniscus root tears (PLMRT) for doctor 1 were 71.4％ (10/14),82.2％ (88/107) and 81.0％ (98/121),respectively,and for doctor 2 were 71.4％ (10/14),86.0％ (92/107) and 84.3％ (102/121).The sensitivity,specificity and accuracy in the diagnosis of posterior medial meniscus root tears (PMMRT) for doctor 1 were 100.0％ (19/19),88.2％ (90/102) and 90.1％ (109/121),respectively,and for doctor 2 were 100.0％ (19/19),95.1％ (97/102) and 95.9％ (116/121),respectively.The Kappa statistics for PLMRT and PMMRT were 0.67 and 0.81,respectively,demonstrating a good interobserver agreement (P＜0.05).The misdiagnosed cases of the PMMRT were 12 for doctor 1 and 5 for doctor 2.There were 4 cases being commonly misdiagnosed by the two doctors,and there were no any missed cases in this study.For the PLMRT,the misdiagnosed cases were 19 for doctor 1 and 15 for doctor 2.Eleven cases were misdiagnosed and 4 were missed by the two physicians.Conclusion MR is a reliable diagnostic tool for detecting posterior root tears of the medial and lateral meniscus.