Objective To evaluate the actual displacement of a femoral neck fracture following close reduction under the C-arm X-ray perspective.Methods From June, 2006 to June, 2009, we managed 12 patients with femoral neck fracture by open reduction and internal fixation.They were 8 males and 4 females, aged from 23 to 65 (average, 42.3) years old.We tried close reduction of their fractures under the C-arm X-ray perspective before a temporary fixation.Next we performed open reduction, readjusted the fracture ends, and placed internal fixation.The actual displacement of the fracture measured after open reduction was carefully compared with the close reduction under the X-ray perspective.Results A substantial displacement was found after open reduction in 7 patients who had achieved anatomic reduction under the X-ray perspective.In the other 5 patients who presented with a slight displacement after close reduction under X-ray perspective, the actual displacements were larger than the X-ray observations but completely reduced after open reduction.The actual measurements after open reduction were significantly larger (3.21 ± 0.96 mm on average) in the anteroposterior displacement ( t = 11.540, P = 0.000), but insignificantly larger (0.58 ±0.93 mm on average) in the superior-inferior displacement ( t = 2.184, P = 0.346) than those after close reduction.Conclusions In general, anatomic reduction can not be achieved for a femoral neck fracture under the C-arm X-ray perspective.Consequently, open reduction may be better than close reduction in the treatment of femoral neck fracture in that improper reduction can block blood supply to the femoral neck and dissection of the capsula articularis coxae can improve blood supply as well as help decompression.

Child, Preschool ; Histoplasmosis ; complications ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Mycobacterium Infections ; etiology

Objective To observe the differences of retinal vessel oxygen saturation between diabetic and healthy subjects.Methods Seventy-one diabetic patients and 91 healthy persons were included diabetes group and control group respectively.Oxygen saturation was measured in retinal blood vessels in two groups using retinal Oxymap.The oxygen saturation in retinal arteries and veins about 1.5-3.0 disc-diameter from center of optic disc was analyzed by instrumental software.Results Among 71 cases of diabetics,there was no significant difference in retinal oxygen saturation between male and female,among different ages and duration of disorder (all P ＞ 0.05).The retinal average arteriolar oxygen saturation in diabetes group was higher than that in control group (P =0.00).The diabetes group had the higher arteriolar oxygen saturation in all the quadrants,while only the superior temporal and inferior temporal showed significant difference statistically (all P ＜0.05).The retinal average venous oxygen saturation in diabetes group showed an upward trend although with no significance (P ＞0.05).Venous oxygen saturation in the diabetes group were higher in retinal superior temporal and inferior temporal quadrant and lower in retinal inferior nasal quadrant,there were significant statistical differences (all P ＜ 0.05).The retinal arterio-venous oxygen saturation differences in diabetes group was higher than that in control group,there was significant statistical difference (P =0.00).Conclusion There is significant difference in retinal vessel oxygen saturation between diabetics and healthy subjects.There are different degrees of changes in retinal oxygen saturation among different quadrants,indicating uneven distribution of retinal oxygen metabolism in each quadrant.

Objective To investigate the feasibility of magnetic resonance diffusion-weighted intravoxel incoherent motion (DW-IVIM)imaging and its reproducibility in normal liver.Methods Thirty-five young healthy volunteers underwent liver DW-IVIM ex-amination twice on a 1 .5 Tesla Philips MR scanner.Parameter maps of D,D* and f were generated by using a manufacturer-sup-plied software.Six Region-of-interests (ROIs)(3 ROIs in left and right liver lobe,respectively)were drawn on three consecutive middle slices,respectively.The average values of D,D* and f were measured and compared between the left and right liver lobe. The reproducibility of D,D* and f measurement were assessed with Bland-Altman method.Results The values of D,D* and f of left liver lobe [D(×10-3 mm2/s):1.250±0.210,D*(×10-3 mm2/s):101.906±15.063 ,f(%):22.954±5.268]were statistically higher than those of right liver lobe[D(×10-3 mm2/s):1.039±0.124,D*(×10-3 mm2/s):100.127±20.757,f(%),18.317± 3.671](D,f,P<0.001,D*,P<0.232-0.605),however ,their reproducibility of left liver lobe [limit of agreement(LOA):22.55%,51.05%,39.3%,respectively]were lower than those of right liver lobe (LOA:20.3%,39.25%,33.9%).The D values had the best reproducibility in both the left and right liver lobe.Conclusion The liver DW-IVIM is feasible.The values of D,D*and f in left liver lobe were higher that those in right liver lobe but with worse reproducibility of measurement.The D value was most reproducible in both liver lobes.

Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.

Objective To explore the relationship between cat fur or dog fur allergens and clinical presentation, as well as allergenic cross-reactivity between cat fur or dog fur allergens and other allergens. Methods Totally 548 children with allergic disorders were assayed with 13 international standard allergen agents by means of SPT. The results were denominated according to the size of skin areola or welt, reference histamine as positive, isotonic Na chloride as negative. Results In 143 children with cat fur allergenic SPT position, 98 cases were boys and 45 cases were girls with an average age of 5. 84 years. In 96 children with dog fur allergenic SPT positive,60 cases were boys and 36 cases were girls with an average age of 6.06 years. The most had occurred in summer. Of them,a large number of cases presented asthma,secondly presented mild cough. Besides, the cross- reactivity of cat fur and dog fur allergenic SPT positive in 64 cases with acarid was most common, followed by latex, which exceeded animal protein, while the cross - reactivity of mold, plant farina and chomophyte allergens were rare. Conclusions About 20% children with allergic disorders are cat fur or dog fur allergenic SPT positive. Cat fur or dog fur allergenic SPT positive results are significantly correlative to age and season, however they are not relative.to sex. Cat fur or dog fur allergens exist correlations with other allergens.

Purpose To investigate the effect of two different 1.5T MRI scanners on the apparent diffusion coefficient (ADC) measurement and its reproducibility in diffusion weighted imaging (DWI) of the liver. Materials and Methods Two groups of volunteers (33 people in each group) underwent liver DWI examination twice by using the same DWI sequence with b value of 0 and 800 s/mm2 on different MRI scanners (1.5T Siemens Espree and 1.5T Philips Achieva). On ADC maps, two region of interests were placed on three central slices of the left and right liver lobes, respectively. The ADC measurements of six region of interests on left and right liver lobes were averaged to represent the mean ADC values of the left and right liver lobe, respectively. The reproducibility of the ADC measurements was assessed by Bland-Altman method. Results The ADC values of the left and right liver lobes measured on Siemens MRI scanner were significantly higher than those on Philips MRI scanner (t=2.045-2.713, P<0.05); on both scanners, the ADC values of the left liver lobe were significantly higher than those of the right liver lobe (t=-10.561--7.263, P<0.001). The Bland-Altman results showed that the reproducibility of ADC measurement was similar on both MRI scanners, and both displayed higher reproducibility of right liver lobe than that of left liver lobe (on Siemens MRI scanner: the agreement were 16.65% and 7.55% for the left and right liver lobe, respectively;and on Philips MRI scanner:16.30%and 7.85%, respectively. Conclusion Different MRI scanners may have influence on ADC values, but does not affect its reproducibility. Therefore, when ADC values obtained on different MR scanners are compared in clinical analysis, this influence should be considered.

?AlM: To analyze the result of ultrasound biomicroscopy ( UBM ) of patients with rhegmatogenous retinal detachment ( RRD ) who need to perform pars plana vitrectomy ( PPV ) to explore the value of clinical application of UBM at preoperation.
?METHODS:Patients who underwent PPV for RRD in our hospital from January to December 2014 were selected. The preoperative results of UBM were recorded and the positive findings of UBM were analyzed, the value of preoperative application of UBM was investigated.
?RESULTS:Totally 356 cases (357 eyes) of patients with RRD were received PPV. All patients were examined by UBM, 122 eyes ( 34. 17%) were positive, 56 eyes were ciliochoroidal detachment, 28 eyes were narrow anterior chamber angle, 6 eyes were chamber angle-closure, 28 eyes were ciliary body cyst, 4 eyes were iris cyst, 11 eyes were anterior proliferative vitreoretinopathy, 1 eye was retinal cyst. There were 12 eyes existing two lesions at the same times. ln this study, patients with choroidal detachment was detected by UBM in 56 eyes, the positive rate was 15. 7%, while 25 eyes was detected by B -ultrasonography, the positive was 7. 0%. The difference was statistical significant(χ2=13. 382, P<0. 05).
?CONCLUSlON: The patients with RRD have underwent PPV for the condition of illness, preoperative UBM can be examined to detect the condition of anterior chamber angle, iris, ciliary and anterior choroid, which is significant for comprehensively understanding the preoperative condition of patients, estimating the difficulty of the operation, and guiding operation and the postoperative follow-up.

Objective To investigate the value of urine L-type fatty acid-binding protein (uL-FABP) and uric neutrophil gelatinase-associated lipocalin (uNGAL), and predict the value of poor outcomes (injury progression,dialysis,or death within 7 days ) in critically ill patients with early acute kidney injury (AKI) at time of nephropathy consultation. Methods One hundred and twenty-five patients with evidence of the AKIN criteria stage1 AKI were enrolled in this study. At time of nephropathy consultation , urinary samples were collected. The levels of uL-FABP and uNGAL were measured. Each marker was assessed for its predictive value using an area under the receiver operator characteristic curves (ROC-AUC) to predict AKI prognosis. Results Twenty-eight patients developed poor outcome. It was 0.81 in ROC-AUC in uL-FABP , in,which it could be improved to 0.83 when combined with APACHEⅡscore (0.75 in ROC-AUC). The ROC-AUC of uNGAL was 0.66, in which it could not impove its predictive power significantly when combined with APACHEⅡscore. Conclusion Among critically ill patients with early AKI , uL-FABP provided an independent and prognostic power when combined with APACHEⅡscore and the level of uL-FABP at time of nephropathy consultation helps to predict clinical outcome in critically ill patients with early AKI.

Objective To evaluate the clinical features of POEMS syndrome. Methods The clinical materials of 4 patients with POEMS syndrome were analysed retrospectively. Results All 4 patients presented polyneuropathy, abnormal globulinemia and endocrinopathy. All were treated with corticoid, cyclophosphamide and thalidomide. Some patients were treated with human immunoglobulin. Conclusion POEMS syndrome was a rare disease with involvement of multiorgan which result in difficult diagnosis. So for suspected cases, a necessary examination to avoid misdiagnosis should be given.