Objective To evaluate the significance of CT assessment for extraarticular anatomy in treatment of displaced intraarticular calcaneal fractures.Methods(1)Measurement of normal calcaneum 40 pieces of adult calcaneum specimen were measured,items of measurement included height of culmination of posterior facet and tuberosity,width of posterior edge of sustentaculum and tuberosity.(2)CT measurement of calcaneum.Transverse(axial)and coronal CT scanning were obtained from 20 feet with displaced intraarticular calcaneal and 20 normal feet as control.Following items were measured in CT scanning:the height of culmination of posterior facet and tuberosity,the coronal talocalcaneal angle,in coronal scanning,the width of posterior edge of sustentaculum and tuberosity,the axial calcaneocuboid angle,in axial scanning.Results(1)Measurement of height of calcaneum height of culmination of posterior facet and tuberosity of calcaneal specimen were(43.07?2.85)mm and(44.69?3.67)mm respectively,and these two items from CT scanning of normal feet were(42.84?1.66)mm,(43.40? 3.01)nun,and from CT scanning of feet with calcaneal fractures were(34.76?3.24)mm,(40.41? 3.69)mm.There was a statistically significant different between these two items for normal calcaneal specimen and for CT scanning of feet with ealcaneal fractures(P

Objective: To investigate the influencing factors for myopia among primary and secondary school students in Suzhou, so as to provide basis for myopia prevention and control. Methods: The students in Grade 4-12 were recruited by stratified cluster random sampling method. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time were collected through the questionnaire of National Surveillance Program of Influencing Factors for Common Diseases and Health in Students. Uncorrected visual acuity and cycloplegic refraction were tested. Multivariate logistic regression analysis was performed to explore myopia-related factors. Results: A total of 990 questionnaires were distributed, and 882 valid questionnaires were recovered, with an effective rate of 89.09%. The prevalence rate of myopia was 78.23% ( 690 cases ). Multivariate logistic regression analysis showed that females ( OR=1.703, 95%CI: 1.173-2.474 ) , middle school students ( OR:5.597-11.949, 95%CI: 3.573-28.349 ) , both parents＇myopia ( OR=2.445, 95%CI: 1.597-3.742 ) , video display terminal time over 3 hours per day ( OR=2.026, 95%CI: 1.235-3.325 ) were risk factors for myopia; outdoor activity time over 2 hours per day ( OR: 0.493-0.510, 95%CI: 0.273-0.943 ) was a protective factor for myopia. Conclusion The prevalence of myopia among primary and secondary school students in Suzhou is 78.23%. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time are influencing factors for myopia.

Objective To define the exposure extent of the ventral part of the clivus under the extended endoscopic endonasal approach,important anatomical landmarks and the distance between each other via this approach.Methods Twenty formalin-fixed intact adult human head-neck specimens,in which only the arteries was injected with red latex,were longitudinally and coronally dissected to evaluate the surgical key steps and the advantages and limitations via extended endoscopic endonasal approach and selected measurements were obtained.Five fresh and intact head-neck specimens were used to perform analogical operation via the extended endoscopic endonasai approach to the ventral part of the clivus.The surgical exposure of main landmarks in the clivus was extended under endoscope and microscope,and the interactions and distances between the landmarks were studied.ResultsAnatomic landmarks of the approach included the middle turbinate,the choana narium,the Eustachian tube ostium,and the nasopharynx mucosa,the aperture of sphenoidal sinus,the longus capitis,the longus colli,the basion,the internal carotid artery and the sphenopalatine artery.The distances between the anterior nasal spine and both the pharyngeal tubercle and the basion were (78.23±2.58) mm and (89.60±2.52) mm,respectively.The shortest distance exposuring ventral region of clivus completely should be (89.60+2.52) mm.The exposure in the inferior wall of sphenoid sinus and the lower clivus was limited by pterygoid canal and foramen lacerum,and the average distances from the median line to them were (9.22±0.52) mm and (9.70±0.70) mm,respectively; no significant difference between the left and right was found (P>0.05).Conclusion knowing the anatomical structure,understanding its connection with the brain tissue and its exposure extent of the ventral part of the clivus are the major problems that need to be solved in the extended endoscopic endonasal approach.

OBJECTIVETo explore regional anatomy of fasciae and spaces related to laparoscopic right hemicolectomy (LRC).

METHODSSeven cadavers and 49 patients undergoing LRC for cancer were observed. Computed tomography (CT) images of patients and healthy individuals were reviewed.

RESULTSBetween ascending mesocolon and prerenal fascia (PRF), there was a right retrocolic space (RRCS), which communicated in all directions. Anterior, posterior, medial, lateral, cranial, and caudal boundaries of the RRCS were ascending mesocolon, PRF, superior mesenteric vein, peritoneal reflexion at right paracolic sulcus, inferior margin of transverse part of duodenum, and inferior margin of the mesentery root, respectively. Between transverse mesocolon and pancreas and duodenum, there was a transverse retrocolic space (TRCS), which was bounded cranially by root of transverse mesocolon. On CT images of healthy individuals, PRF was noted as slender line of middle density, continuing to transverse fascia, and the retrocolic spaces were unidentifiable. For patients with right colon cancer, PRF and right retrocolic space might be easier to be identified.

CONCLUSIONSThe RRCS and the TRCS are natural surgical spaces. The PRF is natural surgical plane in LRC for cancer.

Adult ; Colectomy ; methods ; Colon ; anatomy & histology ; pathology ; Colonic Neoplasms ; pathology ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the correlation of pathology, bone morphogentic protein (BMP) expression, CT value with the ossification of thoracic ligamentum flavum (TOLF) to afford the evidence to choose appropriate treatment methods.

METHODSTwenty-three patients aged 35 - 65 years old had TOLF in my hospital as case. Their courses of disease were 2 months to 9 years. The values of blood calcium, blood phosphorus and AKP in them were normal. The 5 peoples aged 21 - 35 years old who presented fracture of thoracic but not the ligamentum flavum ossification were selected as control. We excluded those who have DISH, ankylosing spondylitis, fluorosis and other disease related with TOLF. The lesion locus were scanned and mensurated by CT. The pathology characteristics were classified into immature ossification and mature ossification by general observation, histology examination. BMP were measured by the immunohistochemical (IHC) staining techniques.

RESULTSThe CT value was significantly higher in the case group (547.2 +/- 131.4) than controlled group (137.7 +/- 10.6) (t = 6.922, P = 0.000). Further, the CT value in the mature ossification (702.9 +/- 17.7) was significantly higher than the immature (480.5 +/- 180.2) (t = 5.623, P = 0.000). In addition, BMP both expressed negative in the mature ossification and the controlled group, but positive in the immature ossification. BMP expression was significantly different between the immature ossification and the mature (chi2 = 70.000, P = 0.000).

CONCLUSIONSThe CT values, pathological types and BMP expression results are similar to evaluate the ossification degrees of ligamentum flavum, and then could be indirectly judged the maturation degrees of TOLF by CT to confirm the treatment methods before operation.

Adult ; Bone Morphogenetic Proteins ; metabolism ; Case-Control Studies ; Female ; Humans ; Immunohistochemistry ; Ligamentum Flavum ; diagnostic imaging ; metabolism ; pathology ; Male ; Middle Aged ; Ossification, Heterotopic ; diagnostic imaging ; metabolism ; pathology ; Thoracic Vertebrae ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo assess the different causes of thoracic ossification of the ligamentum flavum (TOLF).

METHODSFrom July 1989 to November 2005, 142 cases were diagnosed the TOLF, in which 121 were operated. The lesions were classified into three types on the basis of the clinical result: (1) In such primary group (Group 1, 90 cases), without incorporation disease and Ca, P and AKP was all normal; (2) In systemic ossified TOLF group (Group 2, 30 cases), 6 cases ankylosing spondylitis, 3 cases DISH, 10 cases fluorosis, 11 cases OPLL; (3) In local spine disease group (Group 3, 22 cases), 5 cases fracture in spine, 4 cases spine TB, 13 cases posterior marginal intraosseous cartilaginous node. Such clinical feature was analysed, moreover surveyed the thoracic kyphosis angle, upper thoracic kyphosis angle, lower thoracic kyphosis angle and the vertebra body wedge change. The effect was assessed using Epstein Scale.

RESULTS(1) In Group 1, the mainly type was connected type (67/90, 74%). The ossified ligamentum flavum was mainly located at the lower thoracic and thoracic-lumber levels. The local type was less. In Group 2, the mainly type was connected type (21/30, 70%). The local type was none. The lesions figure was the most. In Group 3, the local type was the most (18/22, 82%). (2) In Group 1, the ossified ligamentum flavum was mainly located at the upper and lower thoracic levels (225/486, 47%). In Group 2, mainly located at the whole thoracic, some include cervix and lumber. In Group 3, mainly location was related with the location of primary disease. (3) In group 1, the curve was normal in 81% (73/90) of cases. In Group 2, the curve was abnormal in 87% (26/30) of cases. In Group 3, the curve was normal in the 82% (18/22) of cases.

CONCLUSIONSThe TOLF relates with systemic ossify disease, the change of load on the spine, aging and so on. It should be classified according to its causes.

Adult ; Aged ; Female ; Humans ; Ligamentum Flavum ; pathology ; Male ; Middle Aged ; Ossification, Heterotopic ; classification ; etiology ; pathology ; Retrospective Studies ; Thoracic Vertebrae

OBJECTIVETo investigate the effect of rhein on the development of hepatic fibrosis.

METHODSThe animal models were made with carbon tetrachloride (CCl(4)) mixed with vegetable oil (3/2, v/v), which was injected subcutaneously twice a week for 6 weeks, and with 5% ethanol for free drinking water. At the same time, Rhein was administrated at the dose of 25 mg/kg or 100 mg/kg once a day for 6 weeks. The changes of both biochemical markers, such as the levels of alanine aminotransferase (ALT), hyaluronic acid (HA), procollagen type III (PCIII) in serum and SOD, malondialdehyde (MDA) in liver, and related histopathological parametres were determined.

RESULTSCompared with the model group, there were three kinds of changes in the larger quantity of rhein treated group. (1) The levels of ALT, HA, PCIII in serum and MDA in liver homogenate were decreased significantly (from 150 U/L +/- 16 U/L to 78 U/L +/- 18 U/L, 321 microg/L +/- 97 microg/L to 217 microg/L +/- 75 microg/L, 31 microg/L +/- 14 microg/L to 16 microg/L +/- 6 microg/L and 3.67 nmol/mg +/- 0.68 nmol/mg to 1.88 nmol/mg +/- 0.34 nmol/mg, respectively, t > or 2.977, P<0.01). However the level of SOD in liver was increased (from 62.45 NU/mg +/- 8.74 NU/mg to 91.26 NU/mg +/- 14.04 NU/mg, t=4.453, P<0.01). (2) The expressions of transforming growth factor beta 1 (TGF-beta 1) and alpha-smooth muscle actin (alpha-SMA) in liver were markedly reduced (P<0.05 and P<0.01). (3) The collagen staining positive area was decreased and the grade of fibrosis was reduced significantly in liver (P<0.05 and P<0.01).

CONCLUSIONRhein can protect hepatocyte from injury and prevent the progress of hepatic fibrosis in rats, which may associate with that rhein plays a role in antioxidation, anti-inflammation, inhibiting the expression of TGF-beta1 and suppressing the activation of hepatic stellate cells (HSCs).

Animals ; Anthraquinones ; pharmacology ; therapeutic use ; Anti-Inflammatory Agents ; pharmacology ; Antioxidants ; pharmacology ; Collagen ; analysis ; Liver ; drug effects ; pathology ; Liver Cirrhosis, Experimental ; drug therapy ; metabolism ; pathology ; Male ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; antagonists & inhibitors ; Transforming Growth Factor beta1

OBJECTIVETo explore the feasibility of using an intracavitary convex array probe for detecting the distal extracranial internal carotid artery (ICA) by transoral carotid ultrasonography (TOCU).

METHODSForty patients underwent examinations with bilateral ICA inspected with an intracavitary convex array probe by TOCU to observe the internal diameter, visible length, peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI).

RESULTSEight of the 40 patients were excluded from the observation for the presence of carotid plaques. The examination was terminated in two patients due to sensitive throat and severe pharyngeal reflex. The rest of the patients completed the examination of the internal diameter, visible length, PSV, EDV and RI, which showed no statistically significant differences among them (P>0.05).

CONCLUSIONUsing intracavitary convex array probe, the distal extracranial ICA disease can be diagnosed with higher accuracy.

Adult ; Aged ; Carotid Artery, Internal ; diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Middle Aged ; Mouth ; diagnostic imaging ; Ultrasonography, Doppler, Duplex ; methods

OBJECTIVETo explore the regional anatomy of the rectum including the perirectal fasciae and spaces.

METHODSTwenty-one cadavers (15 males and 6 females) were embalmed and their vessels were visualized by injection with color dye. From the cadavers, 30 hemipelvis and 6 three-quarter pelvis were harvested. The perirectal fasciae and spaces and the pelvic autonomic nerves were dissected and examined.

RESULTSThree tissue layers were dissected from the inside to the periphery including the proper rectal fascia enveloping the mesorectum, the presacral fascia, and the piriformis fascia fused with the sacral periosteum. The mesorectum comprised 2 parts with the classical posterolateral fat covered by the proper rectal fascia posteriorly and the anterior fat covered by the posterior layer of Denonvilliers fascia anteriorly. Extending anteriorly to the anterior layer of Denonvilliers fascia, the presacral fascia bisected the space between the mesorectum and the piriformis fascia into the retrorectal space and the presacral space. The retrorectal space extended cranially to the left retrocolic space, anterior to the space between the 2 layers of Denonvilliers fascia(prerectal space).

CONCLUSIONSFrom the inside to the periphery, the proper rectal fascia, the presacral fascia, and the muscular fascia are distributed in an annular pattern around the mesorectum. The presacral fascia divides the perirectal space into 2 annular parts, the central retrorectal space and the peripheral presacral space. The retrorectal space is the ideal surgical plane for total mesorectal excision.

Adult ; Aged ; Cadaver ; Fascia ; anatomy & histology ; Female ; Humans ; Male ; Mesocolon ; anatomy & histology ; surgery ; Middle Aged ; Pelvis ; anatomy & histology ; Rectum ; anatomy & histology

OBJECTIVETo investigate the hereditary tendency of varicocele.

METHODSWe included in this study 112 varicocele patients, 117 direct male relatives of the patients, and 100 healthy men as controls. We compared the incidence of varicocele tween the direct relative group and the control group.

RESULTSThe direct male relatives of the varicocele patients had a significantly higher incidence of varicocele than the healthy controls (36.8% vs 17%, P < 0.05).

CONCLUSIONThe increased incidence of varicocele in the direct male relatives of the patients indicated a hereditary tendency of the disease.

Adolescent ; Adult ; Case-Control Studies ; Humans ; Infertility, Male ; Male ; Middle Aged ; Pedigree ; Varicocele ; epidemiology ; genetics ; Young Adult