Objective To investigate the key procedures of the acute traumatic intracranial hematoma com-bined with herniation and the prognosis factors. Methods 45 cases of acute traumatic intraeranial hematoma com-bined with herniation from February 1997 to June 2008 were admitted in our hospital. Timely establishment of effec-tive ventilation and circulation and pre-operative examination were done to all the eases. Craniotomy hematoma clean was performed in 8 cases, hematoma clean and decompressive craniectomy was canducted in 33 cases and 4 cases were not operatively treated. Results 26 eases (58%) were cured,and 19 cases (42%) died. Conclusions The key procedures of the acute tranmatie intraeranial hematoma combined with herniation is timely establishment of ef-fective ventilation and circulation, and that is effective method to prevent secondary brain injury ; removing hematoma as soon as possible,and lifting the oppression of the brain stem are the keys to rescue patients. Prognosis is closely related to the degree of primary brain injury, eonseious level before operation and the time of herniation appearance.

This paper is dedicated to evaluate the thermal behavior of skin surface embedded with tumor tissue through construction of three-dimensional heat transfer model of the human body. It was found that the far-infrared imaging equipment could not yet get the accurate results for diagnosis of tumors developed in early stage or located deeply in the human body, because of limited resolution and accuracy in the current system. Conceptual experiments with a thermal imaging system under various cooling levels were performed to confirm this issue. A dual cooling cavity was proposed to realize ultra-low-temperature so as to improve the cooling of the current infrared equipment and thereby to enhance its image precision and accuracy. This study is expected to be of significant reference value for realizing an early diagnosis of cancers through medical image.
Diagnostic Imaging ; methods ; Early Detection of Cancer ; methods ; Early Diagnosis ; Infrared Rays ; Neoplasms ; diagnosis

Objective Objective To verify the accuracy of dose calculation and the precision of beam modeling in a Pinnacle three-dimension treatment planning system(TPS).Methods Based on the photon beam model data of a Varian 600C Linac,output factor verification and 12 tests were carried out ac- cording to the recommendation of Netherlands Commission on Radiation Dosimetry(NCS).The results of ion chamber measurement and TPS calculation at selected points were compared.Deviation and confidence limit were used to evaluate dose calculation accuracy.Results The Pinnacle TPS had a high precision of dose calculation when compared with the measurement data.Deviation of calculated output factors was＜1% on all opening patrols,and was＜3% on wedged portal except one with the size of 15 cm?40 cm and angled 60?.The results of 12 tests were in accordance with the criteria of NCS recommendation,with maximum av- erage deviation＜1%.The overall accuracy is better than those of other TPS reported in the literature. Conclusions Dose verification is a prerequisite before a three-dimension treatment planning system is used in the clinical practice.Pinnacle treatment planning system installed in our institute is reasonably acceptable and satisfactory.

Objective To evaluate the changes of left ventricular(LV) 3-dimension peak displacement (3D-D) during different cardiac pacing patterns. To provide a reliable mechanical data base for the optimization cardiac pacing. Methods Cardiac pacings in open-chest Beagle canine models( n = 10) were performed using three patterns[I, e. , right ventricular apical pacing (RVA-P), LV lateral pacing (LVL-P)and LV apical pacing(LVA-P)],3D full volumetric real-time imaging were acquired in a completed cardiac cycle. The 3D-D,3D-D peak time (3D-DTc) and the standard deviation of TC(3D-DTSD) were calculated and analyzed in different pacing patterns for difference and spatial correlationship. Results ① The 3D-D of LVL-P and LVA-P state decreased compared with BASE and RVA-P state, there were significant 3D-D difference of mid anterior,mid anteriorspetal, mid interior,mid posterior, mid lateral between LVL-P and BASE, RVA-P patterns( P ＜0.05). There were significant 3D-D difference of mid anterior,mid lateral,mid posterior between LVA-P and RVA-P patterns groups( P ＜0.05). There were significant 3D-D difference of all segments in apical level between LVL-P,LVA-P and BASE, RVA-P states( P ＜0.05). ② Corrected by the heart rate,the 3D-DTC of different cardiac pacing patterns were shorter than BASE state. ③ There were no significant 3D-DTSD difference between different cardiac pacings and BASE patterns. There were significant 3D-DTSD difference between RVA-P and LVA-P patterns (P ＜ 0.05). Conclusions LV mechanical activation and synchronization could be maintained during RVA-P rather than LVA-P and LVL-P. Echocardiographic study of left ventricular 3D-D can actually reveal myocardial mechanical state during different cardiac pacings and BASE patterns.

OBJECTIVETo compare two different procedures of colostomy in the laparoscopic- assisted abdominoperineal resection(LAPR), and to reduce the related complications of colostomy.

METHODSSixty- three cases with anorectal cancer undergone LAPR from June 2001 to December 2005 were registered and followed up. Circular stapler anastomosis with sigmoid colon and abdominal skin were applied on 61 cases of the colostomy, and 2 cases were hand sutured. All patients were assigned to group A and B. Thirty- seven cases received the procedure of colostomy through the rectus abdominis peritoneally in group A,other 26 cases through extraperitoneal tunnel and the rectus abdominis in group B.

RESULTSDescending colon, sigmoid colon and rectum were dissected using laparoscopic instruments in 63 cases. No conversion to open procedure and no operative death occurred in two groups of patients. There was no significant difference between two groups in mean operation time, but significant differences were found in the time of return of bowl function[A group (2.4 +/- 1.1)d vs B group (1.9 +/- 0.8)d,P < 0.05], duration of postoperative hospital stay [A group (19.9 +/- 7.8)d vs B group (14.5 +/- 3.9)d,P < 0.01] and stoma related complications(A group 29.4% vs B group 4.0%,P < 0.05). Postoperative hospital stay were shorter, and less colostomy related complications were found in group B.

CONCLUSIONColostomy through extraperitoneal tunnel and the rectus abdominis is a better procedure in LAPR, which can reduce the related complications of colostomy and shorten postoperative hospital stay.

Abdominal Cavity ; surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Colostomy ; methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Staging ; Peritoneum ; surgery ; Rectal Neoplasms ; pathology ; surgery

To study the alteration of the cell cycle during the differentiation of human myeloid leukemia cell line HL-60 induced with all trans-retinoic acid (RA), the flow cytometry was used to assay the various phases of cell cycle in HL-60 cells treated with RA. The results showed: (1) S + G(2)/M phase proportion kept relative invariability during the 48 hours incubation of HL-60 cells with RA, however, the proportion alteration of S-phase cells was associated with the RA concentrations. At 10(-6) mol/L RA, the proportion of S-phase cells appeared a temporarily increasing peak followed by persistent decrease of S-phase proportion. At 10(-5) mol/L RA, S-phase cell proportion only appeared the persistent decreasing tendency. (2) Re-culture of HL-60 cells without RA showed the decrease of S + G(2)/M and S-phase cells was associated with the increase of differentiated cells, but not all HL-60 cells were triggered into differentiation at the same time. Once the cells start to differentiate, even if there is no RA presence, the HL-60 cells were still differentiated until maturation. In conclusion, HL-60 cells are able to differentate and maturate after exposure to RA for a period of time. S-phase proportion is related to the concentrations of RA. Once the cells start to differentiate, even if there is no RA presence, the HL-60 cells still differentiatiated until maturation.

BACKGROUNDAccurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy (NAC) include physical examination (PE), ultrasound (US), and magnetic resonance imaging (MRI). The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer.

METHODSAccording to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination.

RESULTSOf the 64 patients who received NAC, the pathologic complete response (pCR) was shown in 13 of 64 patients (20%). The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively.

CONCLUSIONSCompared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; drug therapy ; pathology ; Chemotherapy, Adjuvant ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Physical Examination ; Ultrasonography

OBJECTIVETo analyze the clinical characteristics of living-related kidney transplantation (LRKT).

METHODSFrom January, 2004 to December, 2008, 175 LRKT were performed including 63 cases (36%) of parent-child relations and 49 cases (28%) of sibling relations between the recipients and donors. Out of 175 donors, 52 were 50 years old or above, 4 had microscopic hematuria (including 2 with also hypertension), 2 had kidney stone, and 2 had high body mass index (BMI). Zero-point graft biopsy was performed in 59 donors, and abnormalities were found in 15 of them. The recipients were at the age of 33-/+10.5 years, and the primary diseases are mainly dominant glomerular nephritis (72.6%, 127/175), and with a few cases of diabetes (4%, 7/175) and hypertensive nephropathy (4%, 7/175).

RESULTSSerum creatinine of the donors was 102-/+22.5 micromol/L at 7 days postoperatively, and 92-/+19.1 micromol/L at one month. One recipient died of severe pulmonary infection. Two recipients underwent graft nephrectomy due to anastomotic stenosis with concomitant acute graft rejection and renal arterial embolism. The one-year survival rates of the patients and grafts were 99.3% and 98.2%, respectively. The incident rates of accelerated rejection and acute rejection were 1.1% and 14.9%, respectively. Other complications included impaired liver function (22.3%), infection (9.7%) and leucopenia (4.6%). The renal arterial stenosis occurred in 2.3% (4/175) of the recipients.

CONCLUSIONSThe recipients of living-related and cadaveric kidney transplant have different primary kidney disease spectrums. Differential diagnosis and treatment of acute rejection and renal artery or anastomotic stenosis can be of vital importance. Marginal donor kidneys with appropriate inclusion criteria can be safely used for transplantation. With good short-term patient and graft survival, LRKT needs further study to evaluate its long-term effect.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Family ; Female ; Glomerulonephritis ; surgery ; Graft Rejection ; epidemiology ; Humans ; Kidney Transplantation ; adverse effects ; Living Donors ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo explore and evaluate the application of epiglottis with sternohyoid muscle in the surgery for laryngeal cancer.

METHODSTwo fifty patients with laryngeal cancer were treated by partial laryngectomy and the laryngeal defects were reconstructed by epiglottic flap and sternohyoid muscle fascia flap. The staging of tumors: T2N0M0 23 cases, T3N1M0 14 cases, T3N2M0 13 cases. All of them received post radical radiotherapy with average 60 Gy. The patients were followed up for 3 to 5 years. Thirty patients underwent neck dissection.

RESULTSThe three and five years survival rates were 90% and 80% respectively. The total cases eat breath pronounced well. The decannulation rate was 96%.

CONCLUSIONAfter partial laryngectomy in laryngeal cancer epiglottic flap and sternohyoid muscle fascia flap were performed reconstruction of laryngeal function.

Aged ; Carcinoma, Squamous Cell ; surgery ; Epiglottis ; transplantation ; Female ; Humans ; Hyoid Bone ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Sternum ; Surgical Flaps

OBJECTIVETo assess the results of multi-technique with intact canal and scute rebuild operation for middle ear cholesteatoma.

METHODSAnalysis of 113 cases (males 60, females 53, with mean 42.7 years old), of which with double ears of 11 cases, and totally 124 ears (11 ears for one review, an ear for third time review, and totally 137 operations) was retrospectively performed. Ten cases less than 19 years old were operated from September 2001 to January 2006 for middle ear cholesteatoma as well as ossiculoplasty with intact canal and scute rebuild etc multi-technique. All cases were followed up for a mean (36.58 +/- 20.47) months.

RESULTSThere were 118 ears (95.2%) without cholesteatoma recurrence. Six ears were found cholesteatoma recurrence. Other 6 post-operation ears with drum re-perforation and hearing drop were re-operated. The pre-operation air-bone gap (ABG, average of 0.5, 1, 2 kHz) of 124 ears, with in initial 112 ears, was (33. 61 +/- 12.35) dB, while that of post-operation ABG was (13.58 +/- 9. 27) dB, by partnership t test, t = 18.35, P < 0.01. The pre-operation ABG in reviewed 12 ears at the first pre-operation was (38.83 +/- 12.43) dB, but post-operation ABG (10.38 +/- 8.99) dB, by partnership t test, t = 5.38, P = 0.00022. The ABG closure to within 20 dB was tested in 100 ears while ABG over 20 dB but air conduct (AC) in 40 dB was in 6 ears, and then as succeed was in 106 ears (85.5%). ABG closure within 10 dB was in 50 ears and though ABG over 10 dB but ABG reduced over 30 dB was in 9 ears (59/124, 47.6%) as which as best result. Bone conduct (BC) threshold was tested of 21 ears (16.93%) with raise 1-9 dB, of 42 ears (33.9%) with no change and of 61 ears (49.2%) with descend 1-28 dB. Of 10 cases less than 19 years old post-operation ABG was (8.80 +/- 5.27) dB, which indicated that all cases was as succeed.

CONCLUSIONSUsing intact canal and scute rebuild etc multi-technique a normal canal, hearing improvement and very low recurrent could be gained for middle ear cholesteatoma, especially in juvenile and children. The multi-technique should be almost no damage for hearing bone conduct.

Adolescent ; Adult ; Aged ; Child ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Middle Aged ; Otologic Surgical Procedures ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult