Objective To compare and determine the reproducibility of apparent diffusion coefficient (ADC)values of the normal liver parenchyma in respiratory-triggered,breath-hold,and free-breathing diffusion weighted magnetic resonance imaging (DWI). Methods 11 volunteers did three times of breath-hold (excitation number is 1,at the end of the expiration,thickness/gapping=5 mm/1 mm), respiratory-triggered (excitation number is 2,at the end of the expiration,thickness/gapping=5 mm/1 mm),free-breathing (excitation number is 4,thickness/gapping=5 mm/1 mm)and for a total of nine axial liver DWI,the gradient factor was 800 s/mm2 .Then they were all coronally reconstructed (thickness/gapping=8 mm/1 mm).The nonparametric test was used to compare all axial and coronally reconstructed liver ADC values;and the Bland-Altman method was used to evaluate the ADC values’repeatability in coronally reconstructed images.Results The breath-hold DWI’s mean ADC value was (1.09±0.07)×10-3 mm2/s significantly lower than the respiratory-triggered DWI(1.16± 0.09)×10-3 mm2/s and the free-breathing DWI(1.19±0.10)×10-3 mm2/s(P<0.005),the axial and coronal images’results were similar.The ADC values’average difference and scope of consistency of coronal image were (-0.09 to -0.01±0.09 to 0.48)for breath-hold DWI,(-0.04 to 0.01±0.11 to 0.17)for respiratory-triggered DWI,(-0.07 to -0.02±0.11 to 0.18)for free-breathing DWI,respectively.Conclusion The breath-hold DWI’s ADC value of normal liver parenchyma is lower than the respiratory-triggered and free-breathing DWI,and showed more poorer repeatability.It is suggested that the measurement of ADC values of the liver parenchyma should be done within the respiratory-triggered or free-breathing DWI.

0.05).The effective rates of Somatostatin and Octreotide were 89.29% and 82.14%;the time averages for hemostasia were (15.67?7.34)hrs and (17.22?9.38)hrs respectively;the cost-effectiveness ratios were 51.54 and 65.94 respectively.For all-in cost of a therapeutic course,Octreotide group exceeded 814.34 yuans compared to Somatostatin group.The cost-effective ratios showed that the all-in costs of Somatostatin and Octreotide groups were 51.54 yuans and 65.94 yuans respectively in increase of 1% of effective rate with a difference of 14.4 yuans.CONCLUSION:Somatostatin is cheaper in cost and better in cost-effective ratio in comparison with Octreotide.

Juvenile retinoschisis (RS or XLRS,MIM#312700)is a rare X-linked inherited disorder,mainly affects bilateral retina,and is characterized by cartwheel-like changes of the macular region of the retina and schisis or splitting within the inner retinal layers,leading to visual deterioration.The electroretinogram is beneficial in the diagnosis of juvenile retinoschisis.The a-wave can be of normal or nearly normal amplitude in this disorder,whereas the amplitude of the b-wave is appreciably reduced,giving a decrease in the proportion of b/a.The responsible gene,XLRSl,maps to Xp22 and was identified by positional cloning.This paper makes a brief review about the latest XLRS research of pathogenesis,animal experiments,clinical therapy,and 25 references are cited.

Corticosteroid-induced glaucoma (CIG) is a form of open angle glaucoma associated with both topical and systemic administration of corticosteroids. Here we described the clinical findings in a patient with severe glaucoma and posterior subcapsular cataract (PSC) after topical administration of corticosteroid eye drops. We concluded corticosteroid eye drop was an effective medicine for inflammation of the eyes; however,prolonged use could cause severe vision loss as a result of intractable corticosteroid-induced glaucoma and cataract.

[Objective]To discuss the fractures classification,operative route,internal fixation and operative therapeutic effection of acetabular fractures.[Method]Thirty-four cases of acetabulum fractures and femoral head dislocation were involved from November 2001 to August 2006 in our hospital throught operative treatment.The classification according of AO system:type A fractures 24 cases,type B 10 cases.Applicated Kocher-Langenbeck operative route was applied in 20 cases,Gibson route 2cases,illioinguinal route 4 cases and anteriorcombined posterior route 4 cases.Thirty-two cases were adopted reconstruction plates and screws and 2 cases steel-wire cerclage to fix fracture.All patients were followed up.[Result]Acorrding to evaluation system of AAOS:excellent in 12 cases,good in 12 cases,fair in 4 cases,poor in 6 cases.Total exellence rate were 71%.[Conclusion]Combinate full-scale imageology information,correct classification of fracture according of AO,reasonable surgical approach and fixation,correct subtle technique during the operation and effective fracture resetting are keys to improve the effect of acetabular fractures.

Objective To study the influence of Dahuang granule on the level of motilin in plasma and gastrin in serum of patients with severe acute pancreatitis (SAP). Methods Sixty-four patients with SAP were divided into Dahuang granule group (32 cases) and control group (32 cases), treated with Dahuang granule and routine therapy respectively. The level of motilin in plasma and gastrin in serum of the two groups were detected by radioimmunoassay method. Results After treated for one week, the level of motilin in Dahuang granule group was significantly higher than that in the control group (P

Objective Our purpose was to report Initial clinical application experience and assess the immediate and short-term effect of transcatheter closure secundum atrial septal defects (ASD) using Amplatzer atrial septal ocluder.Methods Procedures were perfomed under fluoroscopy and transesophageal echocardiography monitoring. Nine patients (3 male, 6 female) underwent attempted transcatheter closure of a ASD using the Amplatzer atrial septal ocluder device with 10F, 11F or 12F long sheath at a mediant age of 33.0?5.2 years (range 8 to 52 years) and weighed 22 kg or more. Other congenital cardiac anomanies which require surgery were excluded. The mediant diameter of ASD at its narrowest segement were mensureted with the balloon catheters was 23.3?6.2 mm (ranger 11 to 30 mm). Systolic pressures of pulmonary arteries were 24.4?5.5 mm Hg (24-46 mm Hg) with catheterization mensuration. After the procedure, TEE were perfomed immediately to find whether there any residual shunt retained. Follow-up evaluation was color flow mapping at 24 h, 1, 3 and 6-months after closure. Results Nine patients had successful device placement. Transesophageal echocardiography showed that 8 patients had complete immediate closure and one had a small residual shunt after the operation, and could get up in the next day. The complication of cerebral throumbus embolism occurred in one woman patient during the procedure. She accepted immediately thrombolysis therapy with urokinase and recovered after several days. Conclusion Transcatheter closure of secondum ASD using Amplatzer atrial septal occluder device is an effctive nonsurgical therapy method. The operation has specialities of simple, safe with a high succes rate of placement and a fine occlusion effect. Further clinical trias are underway.

Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; methods

Objective To evaluate the mid-term effect of total hip arthroplasty (THA) after failed internal fixation of intertrochanteric fracture.Methods Twenty-one patients treated with THA due to failed internal fixation of intertrochanteric fracture from January 2007 to December 2010 were studied retrospectively.There were 10 males and 11 females,at mean age of 71.7 years (range,66-79 years).Sixteen patients were treated with dynamic hip screws/dynamic condyle screws (DHS/DCS),3 proximal femoral nails,2 hollow screws.Mean interval from internal fixation to THA was 29 months (range,10-79 months).Causes for the failed internal fixation were loosening,cutting,and breakage of screws which generated fracture displacement or nonunion in 19 patients and femoral head necrosis in 2 patients.All patients received THA with uncemented acetabulum cups and proximally long-stemmed,porous-coated titanium femoral components including AML stems for 5 patients and Solution stems for 16 patients.Moreover,greater trochanteric fracture was fixed by Luke wire.Harris hip score were measured before operation and at final follow-up.Radiographs were performed before operation,at 3,6 and 12 months after operation,and at final follow-up to assess the fracture restoration,healing,prosthesis initial fixation,and mid-term survival condition.Results One patient was died due to pulmonary infection 1.5 years after operation.Two patients were lost to follow-up and 18 patients were followed up for 3-5 years (mean,3.9 years).At final follow-up,13 patients regained the ability to walk independently,4 needed support of a cane,1 needed assistance of a walker.There were no signs of loosening,subsidence or rupture of the prosthesis.Mean Harris hip score increased from 25.3 points preoperatively to 80.6 points at final follow-up; the score was excellent in 11 patients,good in 6,good in 1,with the excellent and good rate of 94％.Conclusion THA can improve hip function,patients' quality of life and midterm outcome in salvage of failed internal fixation of intertrochanteric fractures.

BACKGROUND: Tibia open fracture is a common disease, and intramedullary fixation has become the first choice, but the high risk of postoperative infection limits its clinical application.OBJECTIVE: To investigate the early prevention effect of vancomycin-hydroxyapatite (VCM-HA) coated titanium intramedullary nail in a rabbit model of open femoral fracture combined with wound infection.METHODS: Titanium intramedullary nails coated with three different concentrations of VCM-HA were prepared using biomimetic deposition, and subsequently in vitro bacteriostasis experiment was performed. Forty healthy male New Zealand white rabbits were selected and the model of mid-femur open fracture with wound infection was prepared. The rabbit models were then divided into ordinary intramedullary nail, low-, middle- and high-concentration VCM-HA coated intramedullary nail groups (n=10 per group). The wound appearance of the animals was dynamically observed. The body mass, anal temperature, white blood cells and C-reactive protein contents in the venous blood were monitored. The pathological examination of the soft tissue around the fracture and injured limb X-ray were conducted regularly.RESULTS AND CONCLUSION: The prepared VCM-HA coated titanium intramedullary nail exerted obvious antibacterial effects in vitro. The anal temperature in the ordinary nail group was significantly higher than that in the other three groups at 3 days after modeling (P < 0.05). The white blood cells and C-reactive protein contents in the venous blood in the VCM-HA groups were significantly lower than those in the ordinary nail group at 3, 7, 14 and 28 days after modeling (P < 0.05). The hematoxylin-eosin staining of the peripheral tissues displayed the inflammatory response in the VCM-HA groups was milder than that in the ordinary nail group at each time point after modeling. The injured limb X-ray displayed that the callus grew slowly accompanied with sequestration in the ordinary nail group, while the callus growth in the VCM-HA groups was significantly better than that in the ordinary nail group. To conclude, the VCM-HA coated intramedullary nail can effectively reduce postoperative infection in an animal model of open femoral fracture combined with wound infection.