Correlation between sarcopenia,sarcopenic obesity and osteoporosis in adults of Han nationality in Liaoning province / 解剖学报

Objective To understand the prevalence of sarcopenia,sarcopenic obesity and osteoporosis, and to analyze the influence of sarcopenia and sarcopenic obesity on osteoporosis. Methods After all the people signed the informed research agreement, the experimental subjects were selected from Han people over 20 years old in Liaoning region, and a total of 1266 cases were included. The distribution of muscle mass, fat mass and bone mineral density in different parts of adults were measured by bioelectrical impedance analyzer (BIA) and bone densitometer, and the correlation between sarcopenia and sarcopenic obesity and osteoporosis in adults was studied. Results With the increase of age, the muscle mass of limbs, trunk, total muscle mass and body weight of the Han adults in Liaoning showed a trend of increasing at first and then decreasing. There was no significant difference in the prevalence of sarcopenia and sarcopenic obesity between men and women, but there was a significant difference in the prevalence of osteoporosis between men and women. The prevalence of all three groups reached the peak in the age group above 60, and the difference was statistically significant.The risk factor for osteoporosis was sarcopenia and sarcopenic obesity. Conclusion Among adults of Han nationality in Liaoning, the prevalence of sarcopenic obesity,sarcopenia and osteoporosis is significantly different in age. Bone condition is affected by fat mass and muscle mass.

OCT parameters as a predictor of the efficacy of Ranibizumab in the treatment of macular edema secondary to central retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the correlation between optical coherence tomography(OCT)parameters and central retinal vein occlusion of macular edema secondary(CRVO-ME), and compare the clinical efficacy of ranibizumab combined with laser photocoagulation and ranibizumab alone in the treatment of CRVO-ME.METHODS:There were 43 case with 43 eyes of patients in CRVO-ME diagnosed in our hospital from January 2020 to December 2020 included in the present study and divided into two groups, namely A and B. Patients in group A were treated with ranibizumab combined with laser photocoagulation, while patients in group B were treated with ranibizumab alone. The structure of outer retina and “SAVE” scores were observed and estimated using OCT and fluorescein angiography(FFA)examination before and after the treatment at 1, 3, 6, 12mo, and then analyzed their correlation with best corrected visual acuity(BCVA, LogMAR). The BCVA, central macular thickness(CMT), intraocular pressure and average number of drug injections were also compared between the two groups before and after treatment.RESULTS:At 12mo after treatment, the BCVA in the OCT baseline external limiting membrane(ELM)intact group and baseline ellipsoid zone(EZ)intact group before and after treatment were significantly improved than those of the fracture group(0.47±0.16 vs 0.21±0.15, P=0.013; 0.44±0.20 vs 0.25±0.17, P=0.008). There was no statistically significant difference in BCVA changes between baseline RPE fracture group and RPE intact group(P>0.05). The number of patients with “S” and “A” at 1 score decreased significantly at 12mo after treatment in both groups, the BCVA of patients with “V” and “E” at 0 score before treatment was significantly improved than those patients at 1 score(all P<0.05). The BCVA and CMT of patients after treatment in groups A and B were both significant improved compared with before treatment(P<0.05). There were no significant differences in the BCVA and CMT in the number of drug injections between the two groups(P>0.05). In addition, there were no severe complications such as secondary glaucoma and endophthalmitis in both groups.CONCLUSION: Baseline status of ELM and EZ, presence or absence of vitreoretinal abnormalities(V), and focal leakage(E)could suggest the treatment efficacy of CRVO-ME. Ranibizumab in the treatment of CRVO-ME demonstrates prominent efficacy and great safety, and there was no better effect was observed when combined with laser photocoagulation.

Detecting Manic State of Bipolar Disorder Based on Support Vector Machine and Gaussian Mixture Model Using Spontaneous Speech

OBJECTIVE: This study was aimed to compare the accuracy of Support Vector Machine (SVM) and Gaussian Mixture Model (GMM) in the detection of manic state of bipolar disorders (BD) of single patients and multiple patients. METHODS: 21 hospitalized BD patients (14 females, average age 34.5±15.3) were recruited after admission. Spontaneous speech was collected through a preloaded smartphone. Firstly, speech features [pitch, formants, mel-frequency cepstrum coefficients (MFCC), linear prediction cepstral coefficient (LPCC), gamma-tone frequency cepstral coefficients (GFCC) etc.] were preprocessed and extracted. Then, speech features were selected using the features of between-class variance and within-class variance. The manic state of patients was then detected by SVM and GMM methods. RESULTS: LPCC demonstrated the best discrimination efficiency. The accuracy of manic state detection for single patients was much better using SVM method than GMM method. The detection accuracy for multiple patients was higher using GMM method than SVM method. CONCLUSION: SVM provided an appropriate tool for detecting manic state for single patients, whereas GMM worked better for multiple patients’ manic state detection. Both of them could help doctors and patients for better diagnosis and mood state monitoring in different situations.

Assessment of 64-slice spiral computed tomography angiography with image fusion for perigastric arteries anatomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical significance of 64-multislice spiral computed tomography angiography(MSCTA) with image fusion for the anatomy of perigastric arteries.</p><p><b>METHODS</b>A total of 53 patients underwent abdominal 64-MSCTA, among whom 26 patients with gastric cancer underwent gastrectomy. Using volume rendering techniques, computed tomography angiography(CTA) of perigastric arteries and the stomach were reconstructed respectively, and then the images were fused together. The branching pattern of the celiac trunk and the origins and courses along the stomach of the 10 perigastric arteries were assessed. The accuracy, sensitivity, and specificity of 64-MSCTA were determined based on intraoperative findings.</p><p><b>RESULTS</b>CTA clearly showed the celiac trunk. The most common branching pattern of the celiac trunk was Michels type I( in 46 patients(86.8%). The anatomy of perigastric arteries and stomach could be clearly demonstrated from any angle according to image fusion. The left gastric artery and the right gastroepiploic artery were shown in 100%, the left gastroepiploic artery 94.3%(50/53), the right gastric artery 83.0%(44/53), short gastric artery 58.5%(31/53), posterior gastric artery 49.1%(26/53), the replaced left hepatic artery 15.1%(8/53). The accessory left hepatic artery, accessory left gastric artery and replaced right hepatic artery were all identified in 7.5%(4/53) patients. The accuracy of preoperative CTA in term of correctly identifying perigastric arteries ranged from 84.6% to 100%, the sensitivity 82.6% to 100%, and the specificity was 100% for all the perigastric arteries.</p><p><b>CONCLUSIONS</b>64-MSCTA can clearly reveal individual perigastric arteries. The anatomy of the stomach and perigastric arteries can be shown in vivo by fused image, and can provide guidance for gastrectomy.</p>

Modified culotte stenting for treatment of complex coronary bifurcation lesions: immediate and 9-month outcomes in a pilot study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The optimal stenting strategy for the treatment of coronary bifurcation lesions (CBLs) remains uncertain. The present study observed technical feasibility and reliability, 9-month clinical and angiographic outcomes of the modified culotte stenting (MCS) in the treatment of CBLs with drug-eluting stents.</p><p><b>METHODS</b>A total of 34 consecutive patients with CBLs that required stenting the parent vessel (PV), the main branch (MB) and the side branch (SB) were included. All patients were first assigned to receive MCS for CBL interventions (per MCS), and might be switched to receive the double-kissing-crush stenting (DKS) in case of temporally acute branch occlusion (per protocol).</p><p><b>RESULTS</b>The immediate angiographic or procedural success was achieved in 33/34 (97%) lesions (patients) per MCS, 34/34 (100%) lesions (patients) per protocol with 100% successful final balloon kissing. The long-term clinical success at 9 months was 94% per MCS and 94% per protocol, only 2 patients had reoccurrence of angina but none of them needed target lesion revascularization. There were no procedure-related biomarker elevation, no in-stent thrombosis peri-procedurally and at 9-month follow-up. Quantitative coronary angiography data at 9 months showed that in-stent (6%) or in-segment (6%) binary stenosis was infrequent, and minimal lumen diameter was significantly reduced but late lumen loss was acceptable with only (0.10 ± 0.14) mm for PV, (0.21 ± 0.23) mm for MB and (0.27 ± 0.32) mm for SB.</p><p><b>CONCLUSIONS</b>MCS for treatment of CBLs that required dual-stent implantation was technically easier and safer, readily to complete final balloon kissing, and was associated with high immediate success and optimal 9-month outcomes.</p>

Application of monitoring phosphocreatine kinase continuously and dynamically in early diagnosis of compartment syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To determine the efficacy of phosphocreatine kinase in the early diagnosis of compartment syndrome.</p><p><b>METHODS</b>Forty patients with compartment syndrome of limbs were reviewed from 2005 to 2008 including 34 males and 6 females with an average age of (37.03 +/- 13.02) years. Monitoring phosphocreatine kinase continuously and dynamically after injured 2, 24 hours, 1, 2, 3 and 4 weeks later. The concentration of CK were measured by using Japanese Olympus automatic biochemistry analysator. The muscle preparations from affected extremity were taken after operation and 1, 2, 3 weeks later for biopsy.</p><p><b>RESULTS</b>Two hours later after injury, the contents of CK increased sharply and the contents of CK were about 20 times more than the nomal. Twenty-four hours later, the contents of CK reached its maximum,the contents of CK were about 42 times more than the nomal. One week later, the contents of CK recovered to normal level. Pathological changes of muscle were irreversible.</p><p><b>CONCLUSION</b>The change of the contents of CK can reflect the progression of disease objectively. If it increased sharply, the chance of compartment syndrome was high. Monitored it dynamicly and continuously can provide assistant for early diagnosis of compartment syndrome and evaluating pathogenetic condition.</p>

Comparison of long-term clinical outcome between transcatheter Amplatzer occlusion and surgical closure of isolated patent ductus arteriosus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transcatheter Amplatzer occlusion of patent ductus artertiosus (PDA) has emerged as a minimally invasive alternative to surgical closure. The goal of this study was to compare long-term clinical outcomes between two procedures, especially on chronic residual shunt, late or very late procedure-related complications, and regression of pulmonary hypertension and left ventricular dilation.</p><p><b>METHODS</b>A total 255 patients having isolated PDA with a minimal diameter of >or= 4 mm treated from January 2000 to July 2003 were included in this study and have been followed up until July 2008. The patients were assigned to either the device or surgical closure group according to the patients' and/or their parents' preference. Baseline physical exams, chest roentgenography, electrocardiography, and echocardiography were performed preprocedure and at each follow-up.</p><p><b>RESULTS</b>Seventy-two patients accepted the transcatheter procedure (Group-TC) and 183 underwent surgical operation (Group-SO) for PDA closure, both groups were similar in their demographics and preoperative clinical characteristics. There were no cardiac deaths and late complications such as infectious endocarditis and Amplatzer duct occluder (ADO) dislodge in either group. More acute procedure-related complications were recorded in Group-SO (13.7%) compared with Group-TC (1.4%) (P = 0.004). The recovery time was (8.7 +/- 2.3) days for the Group-SO and (1.3 +/- 0.5) days for the Group-TC (P < 0.001). The survival freedom from persistent residual shunt, defined as residual shunt that can not resolve automatically, was 91.3% for Group-SO and 98.6% for Group-TC (P = 0.037 by Log-rank test). There was no significant difference in regression of pulmonary hypertension and left ventricular dilation; neither survival freedom from pulmonary hypertension nor abnormal left ventricular end-diastolic volume index were significantly different between the surgical group and the Amplatzer group.</p><p><b>CONCLUSIONS</b>Our study confirmed the long-term safety and efficacy of transcatheter Amplatzer occlusion. In comparison to the time-proven surgical closure, transcatheter Amplatzer occlusion was less invasive and associated with fewer complications and residual shunt, and as effective in the regression of pulmonary hypertension and left ventricular dilation.</p>

Arthroscopic release to treat subtalar stiffness after calcaneal fracture / 中华外科杂志

<p><b>OBJECTIVE</b>To report the results of arthroscopic release to treat subtalar stiffness after calcaneal fractures.</p><p><b>METHODS</b>From September 2004 to December 2006, 10 cases of subtalar stiffness were treated. There were 8 male and 2 female cases, with an average age of 36 years old (ranging from 18 to 48). All, but 2 cases, had single subtalar involvement. The routine triple portals (lateral, anterolateral, posterolateral portals) were applied with the patient placed in the lateral decubitus position. The anterior capsule, lateral gap, calcaneofibular ligament, posterior capsule together with the posteromedial corner of the subtalar joint were released step by step under arthroscopic control. Finally, manual release was performed.</p><p><b>RESULTS</b>All cases were followed-up for 12 to 36 months (mean, 24.5 months). According to the AOFAS hindfoot activity rating scale, 10 cases were rated as Grade III, 2 as Grade II before the surgery. Nine cases were improved to Grade I, 3 to Grade II at the last follow-up after the surgery. AOFAS hindfoot scores were significantly improved from 71.4 before the surgery to 90.6 at the last follow-up (P < 0.01). All cases returned to the previous work at an average of 1.8 months (range, 1 to 3 months) after the surgery.</p><p><b>CONCLUSION</b>Arthroscopic release to treat subtalar stiffness after calcaneal fracture has such advantages as minimally-invasiveness, simplicity and effectiveness.</p>

Surface-replacement total hip arthroplasty in the treatment of the femoral head osteonecrosis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the outcome and indication of surface-replacement total hip arthroplasty in the treatment of the femoral head osteonecrosis.</p><p><b>METHODS</b>The clinical data of 17 patients (21 hips) with femoral head osteonecrosis were reviewed. Among which, 10 cases were male and 7 cases were female, the average age was 36 years old (ranging from 25 to 51 years). There were 8 hips at Ficat stage III and 10 hips at Ficat stage IV. The 17 patients (21 hips) underwent surface-replacement total hip arthroplasty. Gibson posterolateral incision was used and non-cemented prosthesis was implanted. For prosthetic femoral head fixation, a guide pin was inserted into the capital center. After hollow boring hit drilling, a guide pole was inserted, and redundancy of femoral head was rasped off with cutterbar. The bone cement was painted on the femoral head and prosthesis, and the prosthesis was planted into the central axis hole of neck of femur until bone cement solidification. The therapeutic effects were evaluated by Harris hip score and statistical analysis was made. The X-ray was rechecked regularly.</p><p><b>RESULTS</b>The mean duration of follow-up was 32 months (18 to 42 months). The average Harris hip score was improved significantly from preoperative 35.30 +/- 5.23 to postoperative 90.47 +/- 3.14, and the excellent and good rate was 90.5%. There were high statistical differences between preoperative and postoperative Harris score (P < 0.01). The X-ray showed radiolucent line around acetabular prostheses in two patients but without prostheses loosening.</p><p><b>CONCLUSION</b>Surface-replacement total hip arthroplasty is a satisfactory way for the treatment of femoral head osteonecrosis in the middle-late phase, which can help reconstructing normal joint biomechanics and load transmission,improving joint stability and postponing THA without affecting later rebuilding, as well as some advantages such as decreasing surgical wound, convenient and low infection rate. Its indication is Ficat stage III and part Ficat stage IV femur head necrosis with less destroyed neck of femur,especially for young patients having a large amount of activity.</p>

Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As a kind of sirolimus-eluting stent (SES) made in China, Firebird SES is more effective than bare metal stent (BMS) and not inferior to Cypher SES for short coronary lesions in terms of reduction of restenosis and revascularization. However, Firebird SES does not show any benefits in patients with a very long coronary lesion (VLCL). The present study was undertaken to evaluate the safety and efficacy of Firebird SES for VLCL by comparison of Cypher SES and BMS.</p><p><b>METHODS</b>In this prospective, nonrandomized and comparative study, eligible patients with de novo coronary lesion (> or = 30 mm) between January 2005 and June 2006 were allocated into Firebird SES group, Cypher SES group or BMS group. They were subjected to an angiographic follow-up of 6 months and a clinical follow-up of 12 months. The primary endpoints constitute the in-stent and in-segment restenosis rates at 6 months. The secondary endpoint was defined as a major adverse cardiovascular event (MACE) that was a 12-month combined endpoint of all-cause deaths, reinfarction or in-stent thrombosis, and target-lesion revascularization. The 12-month in-stent thrombosis was also evaluated to address the safety of Firebird SES implantation exceptionally.</p><p><b>RESULTS</b>A total of 468 patients were assessed for eligibility. Of 113 patients who were finally included according to the prior inclusion and exclusion criteria, 39 (41 lesions) were treated with Firebird SES, 37 (39 lesions) with Cypher SES, and 37 (37 lesions) with BMS. There were no significant differences in the baseline characteristics between the three groups; but there were longer lesions, more frequent use of overlapping stent in the Firebird SES group and the Cypher SES group. Angiographic follow-up showed that the rates of binary stenosis were similar between the Firebird SES group and the Cypher SES group (in-segment: 14.6% vs 12.8%, relative risk (RR) 1.14, P = 0.81; in-stent: 9.8% vs 10.3%, RR 0.95, P = 0.94), and significantly lower than those in the BMS group (in-segment: vs. 36.1%, RR 0.41 or 0.36, P = 0.04 or 0.03, respectively; in-stent: vs 30.6%, RR 0.32 or 0.34, P = 0.03 or 0.04, respectively). The total MACE rate up to 12 months was also similar in both SES groups (7.7% vs 5.4%, P = 1.000), and significantly lower than that in the BMS group (27.0%, P = 0.034 or 0.024, respectively). The in-stent thrombosis rate in the follow-up period was 2.6% in the Firebird SES group, not higher in the Cypher SES and BMS groups (2.7% and 2.7%, respectively, P = 1.000).</p><p><b>CONCLUSIONS</b>In the treatment of VLCL, Firebird SES would be safer and more effective than BMS. Firebird SES may be not inferior to Cypher SES in terms of restenosis and MACE.</p>

Experimental study about the dorsal approach to arthroscopic lateral release in hallux valgus surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To study the availability and method of the dorsal approach to arthroscopic lateral release in hallux valgus (HAV) surgery.</p><p><b>METHODS</b>Ten fresh foot specimens with ankle preserved were included. Lateral capsule and the oblique head of hallucis adductus muscle were released using blade under arthroscopic visualization. Inspection was made for the relationship of the dorsal portals and the surrounding nerves, vessels and tendons. The ranges of release were also recorded. Five cases underwent the dorsal approach to arthroscopic lateral release in hallux valgus surgery. All patients were female, and the average age was 30 years old. The average hallux valgus angle was 30 degrees.</p><p><b>RESULTS</b>The proximal portal was in close proximity to the extensor hallucis brevis tendon at a distance of 0 - 3 mm (average 1.5 mm) and was at a distance of 1 - 4 mm to the extensor hallucis longus tendon (average 2.4 mm). The distal portal was in close proximity to the first dorsal digital artery and nerve which were vulnerable to injury due to the short distance of 1 - 3 mm (average 1.4 mm). Among the 6 normal feet, metatarsal sesamoid ligament (MSL) was totally released in 1 specimens, and was partially released (70%) in 1 specimen, while in the other 4 HAV feet, 2 specimens had MSL totally released, 1 specimen partially released (50%). The 5 patients were all followed up with the average of 9 months. And the angle of hallux valgus was improved to 7 degrees (range from 4 degrees - 9 degrees).</p><p><b>CONCLUSIONS</b>Dorsal approach to do arthroscopic lateral release in HAV is available. The advantages are small incisions, clear arthroscopic visualization, higher flexibility to release the lateral structures, less possibility of avascular necrosis of the metatarsal head as a result of no vessel injury.</p>

Establishment of arthroscopic trans-septal approach and its clinical application / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the method and result of arthroscopic trans-septal approach (ATS).</p><p><b>METHODS</b>Ten fresh cadaveric knees were prepared for anatomical study about the posterior septum, and 65 posterior compartment arthroscopy of the knees were performed to view the structure of the posterior septum. The initial diagnosis included: rheumatoid arthritis, pigmented villonodular synovitis, osteoarthritis, loose body or foreign body in the posterior compartment, posterior cruciate ligament (PCL) injury or avulsion fracture, posterior horn tear of meniscus, undiagnosed swollen knee with pain and effusion, osteochondritis dissecans, pyogenic arthritis, gout. From January 2002 to June 2005, 22 cases of ATS were applied. Anterolateral portal was initially created, followed by posterolateral portal under the viewing of arthroscopy which was located at the anterolateral portal. Anteromedial and posteromedial portals were also created using the same technique. Arthroscopy was then transferred to the posteromedial portal, and blade was introduced from the anteromedial portal to gradually remove the synovium covering PCL. Arthroscopy was relocated to the anteromedial portal, Wissinger rod was introduced from the posteromedial portal and pointed to the posterior septum adjacent to the posterior edge of the midportion of PCL. The Wissinger rod was pushed carefully to pierce through the posterior septum under the sight of arthroscopy which was located at the posterolateral portal. ATS was finally created.</p><p><b>RESULTS</b>The posterior septum was in the middle of posterior compartment of the knee, which was film screen-like at the sagittal plane and sandwich-like at the transverse plane. The synovium covered the posterior septum at arthroscopic inspection. Twenty-two cases of ATS were successfully created, amounting to 34% (22/65) of all cases at the same period which had received the arthroscopy of posterior compartments of the knees. Synovectomy of the posterior compartments of the knees was performed in 7 cases, loose body removal was in 6 cases, PCL reconstruction was in 4 cases, reduction and fixation of PCL avulsion fracture was in 2 cases. Chondroplasty, inflammatory synovectomy, and meniscectomy were performed accordingly in 6 osteoarthritis cases. No vascular or nervous injury was encountered. At an average of 20 months follow-up (range, 4 to 45 months), 9 cases still had mild knee pain or swelling, 2 cases had severe pain and were recommended for total knee replacement, the other 11 cases had no recurrence of knee pain or swelling.</p><p><b>CONCLUSIONS</b>ATS has no blind area under arthroscopic vision and facilitate trans-septal operation. It is a safe and effective method to treat the diseases of the posterior compartment of the knee. The direction of inside to outside to create ATS is comparatively reliable, and PCL could be identified as an interior landmark during the passage of Wissinger rod through posterior septum to create ATS.</p>

Sagittal mobility study on the first tarsometatarsal joint in hallux valgus patients and its clinical values / 中华外科杂志

<p><b>OBJECTIVE</b>To study sagittal mobility about the FTJ (first tarsometatarsal joint) and its relationship with the pathophysiology and treatment of hallux valgus patients.</p><p><b>METHODS</b>According to Lee's method, FTJ sagittal mobility of 300 normal feet and 200 hallux valgus was measured, and its correlative factors were statistically analysed.</p><p><b>RESULTS</b>FTJ sagittal mobility of 300 normal feet was 8.4 degrees +/- 2.3 degrees , and that of 200 hallux valgus was 11.7 degrees +/- 3.2 degrees , the difference was significant. The normal range of FTJ sagittal mobility was less than 13 degrees . The sagittal overmotion of FTJ had relation to the anatomical configuration of FTJ (P < 0.05), intercuneiform splitting (P < 0.01), transferred pain under the second metatarsal head (P < 0.01), and FTJ osteoarthritis (P < 0.01) had no relation to HVA (hallux valgus angle), IMA (intermetatarsal angle), second metatarsus medial diaphyseal cortex hypertrophy (P > 0.05).</p><p><b>CONCLUSION</b>Lee's method is convenient and accurate. Both HVA and IMA can not represent the sagittal mobility measurement of FTJ, which should be routinely evaluated, especially for hallux valgus patients with type I FTJ. Lapidus procedure should be considered for patients with larger FTJ in combination with transferred pain under the second metatarsal head, intercuneiform splitting, FTJ osteoarthritis.</p>

Anatomical study about the posterior coaxial portals via posterior tibial tendon sheath for ankle arthroscopy / 中华外科杂志

<p><b>OBJECTIVE</b>To conduct the anatomical study about the posterior coaxial portals via posterior tibial tendon (PTT) sheath for ankle arthroscopy.</p><p><b>METHODS</b>Coaxial portals were established in 20 ankles by K-wires which were left in place for distance measurement between them and the posterior nerves, tendons and vessels. Ankle arthroscopy was performed in 5 fresh ankles using 2.7 mm 300 arthroscopy with the same portals as mentioned above. The maximum visible scope were recorded and the distance between the arthroscopy and the posterior nerves, tendons and vessels was also measured.</p><p><b>RESULTS</b>The medial portal was located 5 - 12 mm (average, 8 mm) above the tip of medial malleolus, and the lateral portal was located 8 - 24 mm (average, 15 mm) above the tip of lateral malleolus. The coaxial portals, which traversed the PTT sheath and passed posterior to the fibular, not only separated the arthroscopy and instrument from the posterior nerves, tendons and vessels by posterior capsule but also enlarged their distance. The medial and lateral malleolus articular gap, the posterior capsule could be viewed by these portals with as much as 1/2 - 2/3 posterior articular surface of talus. Not only the tibiotalar articular gap but also the dynamic movement between the mortise and the talus were clearly observed. Arthroscopic operation could be performed by instrument through the posterolateral portal.</p><p><b>CONCLUSIONS</b>The posterior coaxial portals via PTT sheath for ankle arthroscopy have such advantages as easy maneuverability, superior safety, clear vision and larger operation field under arthroscopy.</p>

The comparison between the therapeutic effect of the combination of ~(99m)Tc-methnetium methylene diphosphonate and colloidal chromic phosphate phosphonium-32 and each treatment alone in rats with adjuvant arthritis / 中华风湿病学杂志

Objective To compare the therapeutic effect of the combination of ~(99m)Tc-methnetium methylene diphosphunate and colloidal chromic,phosphate ~(32)p with the monotherapies in rats with adjuvant arthritis(AA).Methods In this study,50 Sprague-Dawley rats were randomly divided into five groups with 10 rats in each:normal control group(arthritis induced and treated with the same volume of normal saline via the same administration route),AA control group(arthritis induced with adjuvant and treated with normal sa- line),~(32)p colloid group(arthritis induced with adjuvant and treated with single intra-articular injection of col- luidal chromic phosphate ~(32)p 0.74 MBq and intra-peritoneal injection of normal saline every other clay),~(99m)Tc- MDP group(arthritis induced with adjuvant and treated with intra-peritoneal injection of ~(99m)Tc-MDP 2.5?10~(-3)?g/kg every other day and single intra-articular injection of normal saline),combination group(arthritis in- duced with adjuvant and treated with the combination of the two drugs).The diameter of the left hind ankle, serum levels of turnout necrosis factor(TNF)and interleukin-1?(IL-1?),and the pathological changes of an- kle joints were tested at different time points.Results The diameter of the left hind ankle at week 4 was smaller in the combination group than that of the ~(32)p colloid treatment alone group [(7.11?0.34)mm vs(7.57?0.29)mm,P

Correlation between CT perfusion and vascular endothelial growth factor in neoplasm of head and neck / 中华放射学杂志

Objective To investigate the correlation between the CT perfusion and microvessel density (MVD),expression of vascular endothelial growth factor(VEGF)in neoplasm of head and neck.Methods Eighty-eight lesions of head and neck were scanned by spiral CT.The largest axial surface of the mass was searched on unenhanced imaging,and at this level the dynamic contrast enhanced scan series was acquired.Time-density curves (TDC)were created from circular or oval regions of the interest drawn over the mass,target artery by Toshiba Xpress/SX spiral CT with perfusion functional software.The parameters were measured including:peak height (PH ),peak time (PT ),mean transit time (MTT), contrast enhancement ratio(RPH),and perfusion flow (PF).Histopathological slides of 35 masses were carefully prepared for the anti-CD34 and VEGF immunohistochemical staining and tumor microvessel density and calculation of VEGF expression scores.The parameters of CT perfusion were correlatively study with MVD and VEGF.Results(1)The TDC of CT perfusion imaging could be classified into 3 types.The TDC of 53/77 (68.9% )malignant tumors presented the type with rapid ascending and rapid descending after injecting contrast.The TDC of 6/9 malignant lymphomas showed low platform curve。(2)The PF median of thyroid carcinoma was 82.2(41.0,183.4)ml?min~(-1)?100 g~(-1).There was significantly difference in the parameters of CT perfusion among thyroid carcinoma and squamaous cell cancer (Median 23.8 (7.0, 108.4)ml?min~(-1)?100 g~(-1))and lymphomas (Median 24.5(13.2,78.6)ml?min~(-1)?100 g~(-1)).(3) MVD in benign tumors was (44.7?3.4),and in malignant tumors,it is (49.6?14.8 ).There was no significantly difference in MVD between benign and malignant tumors.High VEGF expression was found in 15 malignant tumors and 1 benign tumors,low VEGF expression was found in 9 malignant tumors and 10 benign tumors.(4)There were no significantly difference in VEGF expression and MVD.There was good correlation between MVD (M 40.0 )and PH (M 26.9 ),RPH (M 14.5 ),PF (M 46.8 )(r = 0.35,45.49, 0.41 ).There was correlation between VEGF(M 4.0)and MTT(M 16.7 )(r = -0.41 ).Conclusion The TDC and CT perfusion could be helpful to differentiate benign from malignant tumors. CT peffusion in neoplasm of head and neck is correlated with MVD and VEGF,and may reflect MVD and expression of VEGF.