Clinical significance of low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion as a squamous abnormality category in cervical cytopathology / 肿瘤

Objective: To examine the histological outcomes and the predictive value of clinical risks in women with liquid-based Papanicolaou tests (PTs) interpreted as "low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion" (LSIL-H) in comparison with the 2001 Bethesda System (TBS 2001) cytologic categories of low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and atypical squamous cells, cannot rule out a high grade lesion (ASC-H). Methods: The PTs which diagnosed as squamous cell abnormalities, including atypical squamous cells of undetermined significance (ASC-US), LSIL, ASC-H and HSIL, were reviewed by two pathologists who were blinded to the histology results. The diagnose of histology was used as gold standard, and the prevalence of high-risk human papillomavirus (HR-HPV) was examined. Results: Of 49 000 PTs, 88 (0.17%) were rediagnosed as LSIL-H. Before rediagnosed as LSIL-H, these 88 cases were diagnosed as ASC-US (19.32%, 17/88), LSIL (43.18%, 38/88), ASC-H (34.09%, 30/88) and HSIL (3.41%, 3/88). Women who diagnosed as LSIL-H had a higher incidence of cervical intraepithelial neoplasia 2 (CIN-2) /-3 or more severe lesion (CIN-3+) than that in women who diagnosed as LSIL ( P<0.01), but the incidences in these two groups were both lower than that in women who diagnosed as HSIL ( P<0.01). The difference of CIN-2/-3 incidence between LSIL-H and ASC-H was not significant. Conclusion: The similarity of histologic follow-up results between LSIL-H and ASC-H suggested that the similar management decisions should be made for women who were diagnosed as LSIL-H or ASC-H.

Lateral minimally invasive approach reduction and internal fixation with hollow screws for displaced intra-articular calcaneal fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the operative treatment of displaced intra-articular calcaneal fracture by lateral minimally invasive approach reduction and internal fixation.</p><p><b>METHODS</b>During January 2006 to September 2009, 30 cases (31 feet) of displaced intra-articular calcaneal fracture were treated by open reduction and hollow screws internal fixation through lateral minimally invasive approach from the fibular tip to the basement of the fourth metatarsal foot (Sanders II in 21 feet, Sanders III in 8 feet, Sanders IV in 2 feet), including 23 males and 7 females with an average age of 36.5 years ranging from 18 to 60 years.</p><p><b>RESULTS</b>The 31 feet of 30 patients were followed-up for from 3 to 24 months (14 months in average). There was no soft tissue complications such as infected incision, skin necrosis, poor wound healing, and sural nerve injury. X-ray films of 25 feet after the operations showed well reduction of articular surface and satisfactory shape on calcaneal; 6 feet showed roughly normal shape. Based on the Maryland grading system, 6 feet were excellent, 20 feet good and 5 feet fair.</p><p><b>CONCLUSION</b>The lateral minimally invasive approach is a good option for calcaneal fracture of Sanders II and III, because of its less damages to soft tissue and fewer complications. It could also provide excellent exposure of articular surface.</p>

Multi-slice CT Reconstruction in the Diagnosis of Intracranial Foreign Bodies / 中国康复理论与实践

@#ObjectiveTo evaluate the role of multi-slice CT(MSCT) reconstruction in the diagnosis of intracranial foreign bodies.MethodsMSCT scans were performed in 16 patients with intracranial foreign bodies. The volumetric data were reconstructed in the workstation. 5 patients were detected by CT angiography (CTA) examination. Imaging results were then compared with findings found during surgery.Results11 foreign bodies located in one brain lobe, 3 passed two brain lobes, 2 located in ventricle. Among them, 6 cases were closed to parietal including 2 cases closed to cerebral arterial circle. 14 patients were operated and extirpated 18 foreign bodies. Compared with surgical findings, the orientative accuracy of reconstruction imaging was 100%, qualitative accuracy was 85.7%.ConclusionMSCT reconstruction may display the intracranial foreign bodies from multi-angles. It is propitious to know the characteristics, location and whole shape of the foreign bodies for the surgeon before the operation, accordingly to make a best operation project.