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Objective:To investigate the clinical efficacy of early versus delayed open reduction and internal fixation in the treatment of tibial pilon fracture. Methods:Sixty patients with tibial pilon fractures admitted to Zhejiang Veteran Hospital from May 2018 to May 2021 were included in this study. They were randomly divided into a control group and a study group ( n = 30/group) using the coin-tossing method. Patients in the control group underwent early reduction and internal fixation within 3 days after injury. Patients in the study group underwent delayed reduction and internal fixation during 7-14 days after injury. The time to bone fracture healing and the time to independent weight-bearing walking were recorded. At 3 and 6 months after surgery, the American Orthopedic Foot and Ankle Society score, Visual Analogue Scale score, clinical efficacy, and incidence of complications were compared between the two groups. Results:The time to bone fracture healing and the time to independent weight-bearing walking in the study group were (8.23 ± 0.63) weeks and (11.77 ± 0.82) weeks, respectively, which were significantly shorter than (9.57 ± 0.86) weeks and (13.40 ± 0.93) weeks in the control group ( t = 6.87, 7.21, both P < 0.001). At 3 months after surgery, American Orthopedic Foot and Ankle Society score in the study group was significantly higher than that in the control group, and the Visual Analogue Scale score in the study group was significantly lower than that in the control group ( t = 6.69, 5.16, both P < 0.001). Overall excellent and good rate of clinical efficacy in the study group was significantly higher than that in the control group (86.6% vs. 63.3%, χ2 = 4.35, P = 0.037). At 6 months after surgery, there were no significant differences in American Orthopedic Foot and Ankle Society score and Visual Analogue Scale score between the two groups ( t = 0.96, 1.12, P = 0.339, 0.267). At 6 months after surgery, there was no significant difference in the overall excellent and good rate of clinical efficacy between the study and control groups (96.6% vs. 90.0%, χ2 = 0.26, P = 0.605). The incidence of complications in the study group was significantly lower than that in the control group (3.3% vs. 26.6%, χ2 = 4.70, P = 0.030). Conclusion:Delayed open reduction and internal fixation after reducing injury to the soft tissue of the affected limbs can effectively shorten the rehabilitation cycle of tibial pilon fracture, increase short-term efficacy, and decrease the risk of postoperative complications.
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Objective:To evaluate the value of time-signal intensity curve (TIC) combined with apparent diffusion coefficient (ADC) obtained with 1.5T magnetic resonance imaging in the evaluation of anal fistula activity.Methods:The clinical, imaging, and pathological data of 71 patients with pathologically confirmed anal fistula who received treatment in Ningbo Yinzhou No.2 Hospital from June 2018 to February 2020 were retrospectively analyzed. These patients were divided into active phase group ( n = 42) and remission phase group ( n = 29) according to surgical findings and pathological tissue composition. Pearson's chi-square test was used to analyze TIC types. The ADC value was compared between the two groups. Results:TIC types: In the active phase group, the percentage of patients with type I curve (rising enhancement pattern) and type III curve (washout pattern) was 47.6% (20/42) and 35.7% (15/42) respectively, which were significantly higher than that of patients with type III curve [plateau pattern; 16.7% (7/42)], χ2 = 9.22, 3.94, both P < 0.05). In the remission phase group, the percentage of patients with type I and II curves was 34.5% (10/29) and 55.2% (16/29) respectively, which were significantly higher than that of patients with type III curve [10.3% (3/29), χ2 = 4.86, 13.23, both P < 0.05]. ADC value: ADC value in the active phase group was significantly lower than that in the remission phase group [(0.932 ± 0.074) × 10 -3 mm 2/s vs. (1.164 ± 0.061) × 10 -3 mm 2/s, t = -13.87, P < 0.001). Conclusion:TIC combined with ADC value can effectively evaluate anal fistula activity. It can be used as a routine method for preoperative evaluation and postoperative follow-up for patients with anal fistula.
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Objective To study the quantification method based on Hankel matrix,the water suppression method and the metabolite imaging method for magnetic resonance spectroscopic imaging (MRSI) data.Methods Impact of Hankel data matrix on quantification MRSI methods were analyzed to obtain the most efficient Hankel matrix structure.The maximum amplitude method of the water signal peak was proposed for MRSI data water suppression.The interested metabolites information was extracted from MRSI data,and then metabolite image was obtained through bilinear interpolation algorithm.Results The minimum amplitude error and the minimum frequency error were acquired when columns number was 3/4 sampling points.The amplitude,frequency and the damping factor of the simulation data accuracy was 96.94％,99.72％ and 95.55％ respectively.Hankel lanczos with partial reorthogonalization singular value decomposition (HLSVDPRO) method with 3/4 sampling points was used to form Hankel matrices.The speed of quantification decreased with the increase of sampling points.The error of quantification parameter reached minimum when the number of sampling points was 512.The water suppression degree of simulation data was 99.55％ with the maximum amplitude water suppression method.Conclusions The accuracy and the speed of the quantification are promoted with an optimized Hankel matrix structure for the MRSI quantization method.The optimal length of sampling points is 512.The maximum amplitude method can suppress water perfectly.Doctors can detect the presence of tumor regions in human body at the (super) early stage by metabolite information images.
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Objective To estimate the radiation dose and cancer risk of thyroid for children who underwent head CT or chest CT scans.Methods The parameters used in the CT scans were accessed from the DICOM files through PACS used DCMTK software, then the thyroid radiation dose was estimated with the CT-Expo(C) software and the cancer risk induced by CT scan was projected based on BEIR Ⅱ model combined with the Chinese cancer incidence and lifetime table in 2008.Results CT parameters used for different ages were roughly the same, the thyroid equivalent dose for head CT ranged from 1.2-2.0 mGy, the highest thyroid cancer risk occurs for newborn girls, about 9.6/100 thousand population;while for chest CT the thyroid equivalent dose ranged from 8.1 to 38.0 mGy, the highest thyroid cancer risk was also for newborn girls, about 244.7/100 thousand population.The radiation dose and cancer risk for thyroid decreased with the increased age.Conclusions The radiation dose for thyroid from chest CT was relatively higher than head CT, especially for newborn babies;therefore more protection should be given to the thyroid and other radio-sensitive organs during CT scanning.
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Objective To ascertain the frequency distribution of CT examinations in children.Method A wide range of information was collected through the radiology information system (RIS),including ID,sex,birth date,examination time,the examined part of body and other relevant ones related to children who underwent CT examinations between Jan 1,2012 and Dec 31,2012.The SAS software was used for data processing and statistical analysis.Results A total of 1 542 children underwent 1 670 examinations,of which 67％ were male.Head CT examination was the most frequent,accounting for 71.9％ of all CT examinations,and followed by the abdomen/pelvis examinations.The number of examinations of children undergoing the repetitive examination accounted for 6.4％; 51.7％ of the examinations was for trauma.The positive rate of CT examination was 51％,dependent upon the age and examined body parts to some extent.The younger patients had lower positive rate,and the positive rate of head CT examination was lower than those in other parts.Conclusions To reduce the possible cancer risk to be induced by the ionizing radiation from CT,justification of CT examination should be considered for children.
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Objective To observe the clinical effect of Chuanxiong-Chatiao San in treatment hemicrania. Methods All patients were randomly recruited into a control group (75cases) and a treatment group (78 cases). The control group was treated with Gastrodin injection, Ligustrazine injection and Mailuoning injection; on this basis, the treatment group was treated with Chuanxiong-Chatiao powder. Both groups were treated for 14 days with a 7 days interval. Results The excellent rate and effective rate were 91.03% and 96.08% in the treatment group respectively; and 70.66% and 94.67% in the control group respectively. The difference between the two groups was significant (χ2= 12.7143,P<0.01) . Conclusion Chuanxiong-Chatiao powder combined with western medicine is effective in treating hemicrania.
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Objective To explore the diagnosis and therapies of the lateral patellar compression syndrome.Methods This group included 21 cases(30 knees) of lateral patellar compression syndrome,with the average 45 years old(2 males and 19 females of 36～58 years old).All of the patients had obvious Clinical sings and symptoms,whose auxiliary examination was negative.It was almost as same as the Merchant classificasion of the lateral patellar compression syndrome.We adopt the lateral retinaculum release and debridement cartilage defects and drilling.Results All of the definitely diagnosised patients were reviewed with an average of 4 years follow-up visiting(range from 0.5 to 15 years) after operation.The rate of fineness is 96.7% in accordance with Ye Qibin's synthesis estimation for the ailing knee.Conclusion The lateral patellar compression syndrome is a common disease.The lateral retinaculum release and debridement cartilage defects and drilling is a good therapy with minor injury and significant effects for the severe or recurrent attacking lateral patellar compression syndrome.