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Objective To investigate the clinical efficacy of open reduction and internal fixation with dynamic anterior plate-screw system for quadrilateral area ( DAPSQ ) in the treatment of elderly patients with acetabular fracture involving medial displacement of the quadrilateral surface. Methods Between January 2007 and December 2014, a series of 18 senile patients with acetabular fractures involving medial displace-ment of the quadrilateral surface were treated at our department. They were 13 men 5 women, with a mean age 67. 8 years ( range, from 61 to 78 years ) . By the Judet-Letournel classification, there were 4 anterior column fractures, 5 anterior column plus posterior hemitransverse fractures, 8 double column fractures and one T-shaped fracture. The delay from injury to surgery averaged 6. 5 days. All were treated with the technique of DAPSQ. Screw internal fixation of the quadrilateral area followed plate moulding via a single ilioinguinal ap-proach. Fixation with lag screws for the posterior column was added if necessary. Results The 18 pa-tients were followed up for 12 to 35 months ( mean, 26 months ) . By the Matta criteria for fracture reduction, 9 cases were rated as excellent, 6 as good and 3 as poor. Bone healing was achieved within 2 to 4 months( mean, 3. 5 months ) . By the modified Merle d'Aubigné & Postel criteria, the affected hips scored 9 to 18 points ( mean, 16. 3 points ) at the final follow-ups, giving 7 excellent, 7 good, 2 fair and 2 poor cases. By the Harris evaluation, the affected hips scored 58 to 98 points ( mean, 87. 6 points ) , giving 7 excellent, 8 good, one fair and 2 poor cases. The postoperative complications included urinary tract infection in one, lesion of lateral femoral cutaneous nerve in one, heterotopic ossification ( Brooker Grade Ⅰ) in one, and traumatic osteoarthritis in 5 cases 2 of whom had to receive total hip arthroplasty. Conclusion The technique of DAPSQ is suitable for the treatment of acetabular fractures involving medial displacement of the quadrilateral surface in elderly patients, because it can provide and maintain stable fixation of the fracture in the quadri-lateral area and preserve hip joint function, leading to fine outcomes.
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Objective To investigate the high risk factors of fat embolism syndrome (FES) in multiple trauma patients combined with femoral shaft fractures.Methods A case series retrospective study was employed to evaluate 36 patients with FES after multiple fractures of femoral shaft fracture admitted from January 2010 to December 2015,including 30 males and six females aged 18-52 years (mean,36.2 years).According to whether the patients were combined with other parts injuries such as in chest,abdomen and brain,the patients can be divided into two groups,namely,Group A (9 cases) were simple femoral fractures patients with multiple fractures,and Group B (27 cases) were femoral shaft fracture associated with other parts of the fracture or splanchnocoele injury or craniocerebral injury.The quantitative assessment was used by revised trauma severity score (RISS) and the types of the femoral shaft fracture were classified by AO.The relationship of RISS range and types of femoral shaft fractures were evaluated.Results RISS was over 11 points in all cases.Among them,the RISS range of Group A patients was from 11 to 18 points (mean,13 points),with type C in AO classification accounting for 67％ and type B for 33％.The RISS range of Group B patients was from 18 to 25 points (mean,21 points),with type C in AO classification accounting for 78％ and type B for 19％.FES occurrence was positively correlated with the RISS (r =0.684,P ＜ 0.01),with type C the most common classification.Conclusions Clinical doctors should raise vigilance and take the following indicators as high risk factors for FES,ie,the multiple trauma patients combined with femoral shaft fractures plus RISS over 11 points,the multiple trauma patients combined with other parts of the fractures or splanchnocoele injury or craniocerebral injury plus RISS over 18 points,mainly type C femoral shaft fracture.
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Advanced gastric cancer without distant metastasis remains a potentially curable disease, but the prognosis is poor in this condition because of the high unresectability rate at presentation and the high recurrence rate after radical surgery. Administration of neoadjuvant chemotherapy has several potential benefits for advanced gastric cancer. This treatment can decrease tumor stage and improve R0 resection rate. Neoadjuvant chemotherapy has higher patient tolerability and a higher rate of chemotherapy completion than adjuvant chemotherapy. In vivo drug sensitivity tests can also be conducted to avoid unnecessary surgeries. Although high-intensi-ty chemotherapy results in a high overall response rate, a few advanced gastric patients can achieve a pathologically complete re-sponse. However, no standardized treatment has been achieved. This article introduces five cases of advanced gastric cancer treated with neoadjuvant chemotherapy in the Affiliated Tumor Hospital of Guangxi Medical University. The five cases achieved a pathological complete response. This article also aims to explore the clinicopathological characteristics of these patients, proper cooperative treat-ment practices, and prognostic factors for the benefit of future patients.
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Based on the breast ultrasound database of West China Hospital from January 1, 2002 to December 31, 2007, a study of data mining techniques for utilizing the diagnostic information of breast ultrasound and breast pathology was carried out. An innovative computerized retrieval system was invented. With the visual user interface of the system, the data of benignancy or malignancy diagnosed by ultrasound and pathologic examination, and the data on the diagnostic correlation of ultrasound and pathology were obtained, respectively. The qualities of data mining were 99. 98%-100%. By means of the retrieval system, the users can secure numerous data from the breast ultrasound database rapidly and accurately; so it contributes to the rational utilization of information from medical database for serving various medical studies. This method may also be helpful for doctors to utilize ultrasound database in other fields.
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Female , Humans , Breast Neoplasms , Diagnostic Imaging , Pathology , Data Mining , Databases, Factual , Information Storage and Retrieval , Methods , Medical Records Systems, Computerized , UltrasonographyABSTRACT
Background and purpose:The prognosis in patients with early breast cancer(EBC) was poorly defined by clinical and histopathological features.There were more than 200 genes that might be correlated with development,progression,recurrence and prognosis of breast cancer in the published literature.This study evaluated the prognosis of patients with EBC at molecule level according to the protein expressions of 16 selecting genes(HER2,ER,PR,BCL2,Ki-67,BMYB,Cyclin B1,STK15,MMP11,BAG1,NM23,PTEN,P53,P27,VEGF,PCN A).Methods:The immunohistochemical method was used to detect the protein expressions of these genes in 76 patients with EBC and the statistical analysis was performed by COX proportional hazards model.Results:COX proportional hazard model revealed that BCL2,VEGF and STK15 were independent prognostic factors for patients with EBC.A formula of PI was set up according the three genes.The predictive outcomes with PI were compared with the actual follow-up outcomes in 48 patients with EBC.As a result,the predictive accuracy of good and bad prognosis was 86.67% and 91.67%,respectively.Conclusion:A formula of PI derived from protein expressions of the 16 genes correlated with breast cancer was ultimately set up and might be used to predict the outcomes of the patients with EBC.