Objective To improve the diagnostic accuracy by analyzing the CT manifestations of ovarian cystadenoma .Methods The CT images of 57 patients with 62 ovarian cystadenomas proved by surgery and pathology were studied retrospectively . Results Of 62 ovarian cystadenomas, 26 cases with 31 tumors were serous,another 31 cases were mucinous . Unilocular and multilocular forms were seen respectively in 19(61.3%)and 12(38.7% ) of 31 serous cystadenomas, and in 3(9.7%)and 28(90.3%) of 31 mucinous cystadenomas.22 (71.0%) tumors were benign, and 9(29.0%)were of borderline and/or malignant transformation in 31 serous cystadenomas.23 (74.2%) tumors were benign, and 8 (25.8%) were of borderline and/or malignant transformation in 31 cases of mucinous cystadenomas.Benign cystadenomas were frequently round or oval cysts with thin regular wall and septa.Borderline or malignant transformation cystadenomas demonstrated predominately thick irregular wall or septa with projections.The overall preoperative accuracy of characterization was 48.4% in serous and 77.4% in mucinous cystadenomas.Conclusion Multilocular cystadenomas have the typical CT manifestations and CT is a high valuable procedure for imaging them, whereas unilocular cystadenomas, having similar CT findings with some other benign cystic lesions, are lack of enough characteristic features for CT correct characterization.

Objective To explore the surgical types in fractures of the proximal femur by internal fixation. Methods One hundred and three cases of femoral peritrochanteric fracture underwent operation were studied retrospectively. According to AO classification, the cases of each type were treated by four methods of internal fixation: the cannulated compression screw, dynamic hip screw (DHS), anatomical plate and proximal femoral nail (PFN). Results All patients were followed up from 6 to 40 months. All fractures were healed. Complications occurred in 9 patients, including aseptic necrosis of the femoral head in 2, coax magna in 7. According to Sanders standard of function of joint, the final effect was satisfactory. Conclusion It is important to select different surgical types according the different peritrochanteric fracture separately.

Population pharmacokinetics of vancomycin (VAN) in the Chinese patients was described by using nonlinear mixed-effects modeling (NONMEM). 619 VAN serum concentrations data from 260 patients including 177 males and 83 females were collected separately from two centers. A one-compartment model was used to describe this sparse data. No significant difference was observed between two center datasets by introducing SID covariate. The final model was as CL= (θ (base0+ θ(max) x(1 -e(-θ(Age)(Age/72) and V = θ x θ (Age)(Age/72). The creatinine clearance (CL(Cr)) and Age were identified as the most significant covariate in the final model. Typical values of clearance (CL) and volume of distribution (V) in the final model were 2.91 L x h(-1) and 54.76 L, respectively. Internal model validation by Bootstrap and NPDE were performed to evaluate the robustness and prediction of the final model. The median and 95% confidence intervals for the final model parameters were based on 1000 Bootstraps. External model evaluation was conducted using an independent dataset that consisted of 34 patients to predict model performance. Pharmacodynamic assessment for VAN by AUC (0-24 h) to MIC ratios of over 400 was considered to be the best to predict treatment outcomes for patients. AUC (0-24 h) was calculated by clearance based on the above population model. The results indicate that the conventional dosing regimen probably being suboptimal concentrations in aged patients. The approach via population pharmacokinetic of VAN combined with the relationship of MIC, Age, CL(Cr) and AUC(0-24 h)/MIC can predict the rational dose for attaining efficacy.

OBJECTIVE:To evaluate the efficacy and safety of the application of airway secretions expurgation cluster manage-ment in oxygen-driven aerosol inhalation. METHODS:280 patients with chronic obstructive pulmonary disease in the Respiratory Second Division of our hospital from Mar. 2012 to Dec. 2013 were randomly divided into group A,B,C and D,with 70 cases in each group.Group A and B were treated with compound isopropyl bromide 2 ml+nomal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalation for 7 days;group C and Dreceived Ambroxol hydrochloride injection 15 ml+normal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalatiom for 7 days. group A and C were treatment groups, group B and D were control groups. Two treatment groups inhaled compound medications while the application of airway secretions expurgation cluster management. Two control groups inhaled compound medications with single effective cough guidance. RE-SULTS:Compared with control groups,the patients in treatment groups eliminated more phlegm,had lower (PaCO2)and higher (PaO2),also had a shorter hospitalization period,with significant difference(P<0.05). CONCLUSIONS:Airway secretions expur-gation cluster management technology is a simple,safe and effective method,especially in patients with chronic obstructive pulmo-nary disease in oxygen-driven inhalation therapy.

OBJECTIVE:To study the feasibility of 10 kinds of culture media used in pharmaceutical microbial limit test stated in Chinese Pharmacopoeia(2010 edition)autoclaving at 121 ℃ for 15 min. METHODS:The performance(color,pH,sterility,the growth-promoting activity,antibacterial ability,indication)of 10 kinds of culture media including Modified Martin Broth medium were tested after autoclaving at 121 ℃ for 15 min or in the parameters from the product instructions according to GB4789.28-2013 and the requirements for quality control of culture media in Chinese Pharmacopoeia(2010 edition). The quality of the media were compared after autoclaved by different parameters. RESULTS:The quality of the media which were autoclaved at 121 ℃ for 15 min were equivalent with the media which were autoclaved by the parameters from the product instructions,and their quality met the requirements for quality control of media in Chinese Pharmacopoeia(2010 edition). CONCLUSIONS:The sterilization parame-ters of 10 kinds of media in Chinese Pharmacopoeia (2010 edition) can be adjusted to be autoclaved at 121 ℃ for 15 min,the quality of the media remain stable after autoclaving.

Objective:To analyze the risk factors of acute renal injury (AKI) after coronary artery bypass grafting (CABG) in the elderly patients.Methods:A total of 423 patients aged over 60 years who underwent CABG in Linyi People′s Hospital from May 2014 to May 2010 were retrospectively analyzed. Patients were divided into AKI group and control group according to whether AKI occurred. The risk factors of AKI were analyzed by multivariate logistic regression.Results:Among the 423 patients, 62 cases(14.7%)developed postoperative acute kidney injury. Compared with the patients without AKI ( n=361), the proportions of patients with hypertension, heart function (NYHA) ≥ Ⅲ, atrial fibrillation and cardiopulmonary bypass were higher in AKI group, the proportion of patients using statins before operation was lower [71.0%(44/62) vs. 50.7%(183/361),χ 2 =8.75, P<0.01;38.77%(24/62) vs. 7.5%(27/361),χ 2 =48.67, P<0.01;16.1%(10/62) vs. 4.4%(16/361),χ 2 =12.55, P<0.01;51.6%(32/62) vs. 21.3%(77/361),χ 2 =25.37, P<0.01;59.7%(37/62) vs. 85.6%(309/361),χ 2=23.87, P<0.01]. Patients in AKI group had higher level of blood uric acid, urea nitrogen and creatinine [353.8(275.5, 462.5)μmol/L vs. 314.5(262.9, 383.6)μmol/L, Z=2.75, P=0.01;5.5(4.3, 8.2)mmol/L vs. 5.1(4.3, 6.4)mmol/L, Z=2.44, P＝0.02; 74.9(58.5, 92.7)μmol/L vs. 67.0(57.1, 76.3)μmol/L, Z=2.90, P=0.01];and longer operation time, more blood loss and blood vessel bridge than those in control group [(403.2±124.1) vs. (350.6±110.2), t =3.41, P<0.01;(4.0±0.9) vs. (3.7±0.8), t=2.83, P=0.01;(3.8±0.7) vs. (3.5±0.8), t=3.58, P<0.01]. The multivariate logistic regression analysis showed that preoperative cardiac function (NYHA)≥Ⅲ( OR=8.528,95% CI:3.734-19.477, P<0.01),hypertension( OR=6.455,95% CI:2.605-15.997, P<0.01),extracorporeal circulation( OR＝3.046,95% CI:1.190-7.795, P=0.02),diabetes mellitus( OR=2.294,95% CI:1.047-5.026, P=0.04),elevated serum uric acid level( OR=1.004,95% CI:1.000-1.008, P=0.03)were the independent risk factors for AKI. Statins is a protective factor for postoperative AKI( OR=0.366,95% CI:0.154-0.873, P=0.02). Conclusions:AKI is a common complication after CABG in elderly patients. Cardiac function(NYHA) ≥ Ⅲ,hypertension,extracorporeal circulation,diabetes mellitus,elevated serum uric acid level are risk factors and administration of stating is protective factor for the incidence of acute kidney injury in elderly patients after coronary artery bypass grafting.

Objective To investigate the differences in expression of Mohawk (MKX) transcription factors and collagen of types Ⅰ and Ⅲ in anterior cruciate ligament (ACL) gratis between 2 remodeling outcomes under arthroscopy.Methods Enrolled for this study were 17 patients who had undergone arthroscopic single-bundle ACL reconstruction with autogenous hamstring tendons and secondary arthroscopic exploration 48 to 131 months (average,83.1 months) after removal of tibial internal fixator at Department of Sports Medicine,The First Affiliated Hospital to Shenzhen University from March 2017 to December 2017.They were divided into a good remodeling group (11 cases) and a fair remodeling group (6 cases) according to the graft quality under arthroscopy (synovial and vascular coverage,and apparent tension,thickness and retear of the grafts).During the secondary arthroscopic procedures,biopsy of the central ACL grafts was performed.Moreover,normal ACL tissues were harvested from 8 contemporary controls of ＜ 60 years old who underwent total knee replacement.Immunohistochemical assay and quantificational real-time polymerase chain reaction were conducted to detect the expression of transcription factors and collagen of types Ⅰ and Ⅲ in all the samples.Results In the samples from good remodeling and control groups,there were abundant well-arranged collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells;in the fair remolding group,the collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells were much decreased in number and the fibers were not well arranged.The former 2 groups scored in immunohistochemical assay significantly higher than the latter one (P ＜ 0.05).qRT-PCR showed that the expression levels of MKX gene (0.44 ± 0.30),COL1A1 gene (0.52 ± 0.27) and COL3A1 gene (0.60 ± 0.22) in the fair remolding group were significantly lower than in the control group (1.00 ± 0.00,1.00 ± 0.00 and 1.00 ± 0.00) and than in the good remolding group (0.97 ± 0.67,0.99 ±0.38 and 1.00 ± 0.35) (P ＜ 0.05).Conclusion Good remodeling ACL grafts with histological maturation under arthroscopy are more similar to normal ACL than fair remodeling ACL grafts in expression of MKX transcription factors and collagen of types Ⅰ and Ⅲ.

OBJECTIVE: To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting. METHODS: A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively. RESULTS: In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane. CONCLUSION In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.
Adult ; Humans ; Shoulder ; Rotator Cuff/surgery* ; Arthroscopy/methods* ; Scapula/surgery* ; Shoulder Joint/surgery* ; Cadaver ; Joint Instability/surgery*