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The history,hardware,imaging principle and technical characteristics of dual-energy CT machine were described.The causes,clinical diagnosis and treatment of urinary calculi were analyzed.Dual-energy CT had its technical characteristics,clinical significance,advantages and practicality expounded in detail when used to determine the components of urinary calculi.
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Objective To investigate short-term clinical effect of anterolateral minimally invasive approach of total hip replacement.Methods A total of 35 patients treated by total hip replacement was divided into A and B groups.Group A used anterolateral minimally invasive approach,and group B used standard posterior Moore approach.The clinical data of operation time,amount of bleeding,blood transfusion volume,component position,Harris hip score,and complications of two groups were statistically compared.Results In terms of operation time,group A had certain disadvantages than group B.No significant difference was found between two groups in terms of operation time,annount of bleeding,blood transfusion volume,component position,Harris hip score,and complications.Conclusions In total hip replacement,anterolateral minimally invasive approach was safe and effective compared to standard posterior Moore approach.Doctors should choose their familiar surgical approach in operation.
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The suitable distribution regions of medicinal clematis armandii in Sichuan province were extracted based on the suitable requirements of clematis armandii,comprehensive analysis and quantification on environmental indicators suitable forclematis armandii,following remote sensing (RS) and GIS spatial analysis,spatial database building and other technologies,extracted land use information.The results showed that regions suitable forclematis armandii were Gulin county,Xuyong county,Baoxing county and Tianquan county and other areas in Sichuan province.Among them,Gulin county and Xuyong county were the main distributed regions,which accounted for 23.2% and 25.4% of the total area,respectively.Through the comparison with the Chinese Materia Medica (CMM) Resource Database,this research result was basically coincided with census data from the Third National CMM.It also showed that RS and GIS technology were suitable for the investigation of suitable area of clematis armandii scientifically and feasibly.It improved the rational use of clematis armandii.It provided supporting information for rational planting of clematis armandii.It also of fered references for monitoring other wild herbs.
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Objective To observe the effect and complications of Hoffmann Ⅱ metal external fixator in the treatment of open fractures of tibia and fibula. Methods 40 patients with open fractures of fibula received fracture reduction and fixation with HoffmannⅡmetal exter-nal fixing frame by C arm X-ray machine,who were followed up for 12 months,and the efficacy and the incidence rate were observed. Results Among the 40 cases,27 cases (67. 5%) were recovered,11 cases(27. 5%) were delayed healing,2 cases(5%) did not heal. 11 cases (27. 5%) with the pin loosening,8 cases (20%) with pin tract infection,7 cases (17. 5%) with the pin tract aseptic,1 cases (2. 5%) with infection of bone,1 cases (2. 5%) with knee flexion and extension slight abnormality. Conclusion Hoffmann Ⅱ metal external fixator in the treatment of open fractures of tibia and fibula has certain advantages,and the curative effect is exact,but there are still complications,we should pay attention to prevention to avoid adverse consequences.
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Objective: To explore the relationship between atrial MMP-9 with its inhibitor (TIMP-1), anti-apoptosis gene (BCL-2) with apoptosis gene (BAX) and the aging with atrial remodeling in experimental dog model during atrial ifbrillation (AF), in order to better deal with the aging caused AF. Methods: The experimental dogs were divided into 4 groups: ①Adult with sinus rhythm (ASR) group, ②Elder with sinus rhythm (ESR) group and③Adult with AF (AAF) group,④Elder with AF (EAF) group. n=7 in each group. Chronic AF model was induced by rapid and persistent atrial pacing. The mRNA and protein expressions of MMP-9, TIMP-1 and BCL-2, BAX were measured by real time quantitative RT-PCR and Western blot analysis. The cellular ultra structural remodeling was examined by optical/electron microscopy, and the apoptosis index was determined by TUNEL method, Results: Compared with adult dogs, the elder dogs showed obviously increased expressions of MMP-9, BAX, and decreased expressions of TIMP-1, BCL-2, all P of MMP-9, BAX, all P Conclusion: The abnormal expressions of MMP-9/TIMP-1 and BCL-2/BAX might be one of the molecular mechanisms for aging caused AF in experimental dog model.
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Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.
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Objective To investigate epidemiological characteristics in hospitalized adolescents and children who suffered from traffic injuries,such as source and location of an accident,the victim's gender arid age,and the site of injury.Methods The chosen subjects were 163 hospitalized children aged 1 to 18 years old,who were admitted to general hospitals in Shanghai in the years of 2004 to 2005 as a result of traffic injuries.Descriptive statistics and analysis were used to interpret the data.Results Children of immigrant workers and suburban residents were the main victims ;the main cause of injury was the collision between the motor vehicle and the pedestrian;this type of traffic injury was the most prevalent among children between 5 to 9 years old;and the locations of the injury was most commonly found in the head,the face, and the extremities.Conclusions From this statistical evidence,it could be concluded that it would be worthwhile for the government to pay more attention to children of immigrants and suburban residents to effectively educate them about traffic safety and knowledge,tt is also advisable to improve the safety protection and post - traffic injury care of children passengers.
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Objective To analyze inducing factors of acute left heart failure(AHF) of emergency case.Methods According to different age and gender,the inducing factors of AHF of 211 patients were retrospectively analyzed.Results Infection(42.99%) was the most important inducing factors of AHF in all the four age-groups,but as for patients elder 80,the arrhythmias was also play an important part in inducing factors of AHF.The difference of inducing factors was found among the four age-groups.but the difference of inducing factors was not found between the two gender-groups. Conclusion Since the most important inducing factors of AHF of emergency case was infection,anti-infectives is important for preventing and controlling AHF.
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Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder carcinoma,and the effective measures of prevention of the misdiagnosis.Methods We retrospectively analyzed the clinicalrecords of 52 cases with primary gallbladder carcinoma that had been treated in our hospital in 10 years,and analyzed the causes of misdiagnosis.Results Nineteen cases were diagnosed preoperatively(36.5%),while 33 cases were misdiagnosed before operation(63.5%),including misdiagnsed as cholecystolithiasisin 13 cases,gallbladder polyps in 8cases,atrophic cholecystitis in 4cases,hepatic hilar cholangiocarcinoma in 3 cases,tumor of liver in 4 cases,and Mirizzi syndrome in 1 case.There were 29 casesdiagnosed during operation(55.8%),and 4 cases misdiagnosed intratoperatively(7.7%).Misdiagnosiswas due to several reasons:complicated with other gallbladder disease,lack of distinctive clinical features of gallbladder carcinoma,over dependence on imaging methods,and not doing fast frozen section duringoperation in dubious cases.Conclusions In suspected cases with high risk of gallbladder cancer,imagingstudies should be performed,and,if necessary,invasive studies and even exploratory laparotomy should be done.Also,intraoperative rapid frozen section can result in early discovery and treatment,and is conducive to improvement of prognosis of gallbladder carcinoma.
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Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.
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The out-patient and emergency department is the window of a hospital open to the society,also is the most direct social image of the hospital.So,we must insist on the moral principle of the "ten needs" in the work of the out-patient and emergency department in order to establish a healthy and harmonious physician-patient relationship.The "Ten needs" includes a proper attitude,a sincere communication,a quick response,a correct diagnosis,a flexible treatment,a reasonable prescription,a steady action to the emergency,a well nursing,complex skills and a standard management.