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小切口撬拨复位锁定钢板外固定治疗跟骨关节内骨折

目的 总结采用小切口撬拨复位、锁定钢板外固定治疗有移位的跟骨关节内骨折的临床效果。 方法2006 年8 月－ 2007 年6 月，采用小切口撬拨复位、锁定钢板外固定术治疗13 例15 足跟骨关节内骨折。男9 例，女4 例；年龄16 ～ 81 岁，中位年龄37.6 岁。坠落伤9 例，交通伤4 例。左侧4 例，右侧7 例，双侧2 例。骨折根据Sanders 分型：Ⅱ型6 足，Ⅲ型9 足。患者伤后至手术时间2 ～ 6 d，平均3.6 d。术中对3 例骨缺损者植入同种异体骨3 g。 结果 术后2 周未发生皮肤坏死及其他并发症。术后10 d 2 例钉道有渗出，经换药后愈合。术后13 例均获随访，随访时间6 ～ 15个月，平均10.6 个月。患者骨折均愈合，愈合时间5 ～ 8 个月，平均6.7 个月。完全负重时间2 ～ 4 个月，平均3.2 个月。功能评价采用美国足踝协会的后足评分系统，优10 足，良3 足，可2 足，优良率86.7%。术后Bouml;hler 角（29.00 ± 0.42）°，与术前（4.82 ± 0.32）° 比较，差异有统计学意义（P lt; 0.05）。 结论 小切口撬拨复位、锁定钢板外固定治疗跟骨关节内骨折损伤小、促进骨折愈合；外置钢板可避免皮瓣坏死、钢板外露及发生骨髓炎等风险，是治疗跟骨关节内骨折的一种有效方法。

The characteristics of high-resolution magnetic resonance imaging with focal cortical dysplasia in children

ObjectiveTo discuss the 3D high resolution Magnetic resonance imaging (MRI) features of focal cortical dysplasia (FCD) in children.MethodsMRI data of 42 children with FCD confirmed by pathology, from April 2015 to June 2018, which were admitted to Qilu Children’s Hospital of Shandong University, were retrospectively analyzed. The following MRI signs were observed, blurring of junction of the gray matter-white matter, abnormality of structure with focal cortex (thick or thin), gray matter and white matter signal, white matter signal increased with T2WI/FLAIR, with or without transmantle sign (abnormal signal of white matter extending in the direction of ventricle), gray matter signal increased with T2WI/FLAIR, the abnormal sulci or gyri morphology and segmental and/or hypoplasia/atrophy of the lobes.ResultsAmong the 42 cases, 37 cases (88.1%) showed MRI positive signs, FCD typeⅠ accounted for 13 cases (35.1%), the main MRI features are focal blurring of junction in the gray matter-white matter, abnormality of structure with focal cortex in the corresponding part,and white matter signal increased with T2WI/FLAIR. FCD TypeⅡ accounted for 17 cases (45.9%), the MRI features are focal blurring of junction in the gray matter-white matter, abnormality of structure with focal cortex, white matter signal increased with T2WI/FLAIR, and transmantle sign. FCD TypeⅢ accounted for 7 cases (18.9%), among which hippocampal atrophy 2 cases (28.6%), dysembryoplastic neuroepithelial tumor (DNET) 2 cases (28.6%), section cell tumor 1 case (14.3%), softening lesion with gliosis 2 cases (28.6%).ConclusionThe 3D high-resolution MRI features of FCD in children are specific and could improve the detection rate of FCD lesions.

Radioactive Iodine-131 Treatment for Differentiated Thyroid Carcinoma

0.3—0.5mm小动脉套入法与间断缝合法的实验观察

锁骨钩钢板结合锚钉治疗肩锁关节脱位22例

上消化道多原发癌的诊治分析

目的 探讨上消化道多原发癌的诊断及手术治疗。方法 对48例诊断为上消化道多原发癌患者，42例按肿瘤不同的生长部位采取3种不同的手术方式，同时清扫颈、胸、腹三区域或胸、腹二区域淋巴结。结果 颈部淋巴结鳞癌转移13例；胸部淋巴结鳞癌转移21例，腺癌转移9例；腹部淋巴结鳞癌转移8例，腺癌转移25例。本组无手术死亡，均获得随访，存活5年8例，存活3年12例，存活1～2年10例，现有10例仍在随访中。结论 上消化道多原发癌以淋巴结转移为主，彻底的手术切除是患者获得长期生存的关键，颈、胸、腹三区域或胸、腹二区域淋巴结清扫极其重要。

改良AO克氏针张力带钢丝与聚髌器治疗髌骨骨折临床分析

视网膜静脉阻塞与眼压

小切口切开复位Herbert 螺钉内固定治疗有移位的锁骨中段骨折

目的 总结采用小切口切开复位Herbert 螺钉内固定治疗有移位的锁骨中段骨折临床效果。 方法 2008 年5 月－ 2010 年3 月，采用微创小切口切开复位Herbert 螺钉内固定治疗32 例有移位的锁骨中段骨折。男21 例,女11 例；年龄16 ～ 75 岁，中位年龄32.3 岁。交通事故伤18 例，摔伤9 例，重物砸伤5 例。左侧14 例，右侧18 例。其中横形骨折6 例，斜形骨折8 例，粉碎性骨折18 例。患者伤后至手术时间为18 ～ 42 h，平均26.4 h。 结果 术后32 例均获随访，随访时间13 ～ 18 个月，平均14.6 个月。32 例均获解剖复位，无成角、短缩或分离移位，内固定物无移位。术后6 ～ 8 周骨折均达临床愈合，无畸形或延迟愈合、骨不连等并发症发生。术后肩关节功能根据Neer 评分标准均获优。 结论 小切口切开复位Herbert 螺钉内固定治疗有移位的锁骨中段骨折损伤小，促进了骨折愈合，可避免锁骨下动、静脉及臂丛神经损伤、气胸等并发症及二次手术。

Comparison Study of Left Ventricular Function Assessment by 18F-FDG PET, Gated SPECT and 2D-Echocardiography in Patients with Myocardial Infarction

The aim of this study is to analyze the concordance between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO in patients with myocardial infarction. Sixty-four patients with coronary artery disease (CAD) and myocardial infarction were enrolled in the study.. Each patient underwent at least two of the above mentioned studies within 2 weeks. LVEF、 EDV and ESV values were analyzed with dedicated software. Statistical evaluation of correlation and agreement was carried out EDV was overestimated by 18F-FDG PET compared with GSPECT [(137.98±61.71) mL and (125.35±59.34) mL]; ESV was overestimated by 18F-FDG PET (85.89±55.21) mL and GSPECT (82.39±55.56) mL compared with ECHO (68.22±41.37) mL; EF was overestimated by 18F-FDG PET (41.96%±15.08%) and ECHO (52.18%±13.87%) compared with GSPECT (39.75%±15.64%), and EF was also overestimated by 18F-FDG PET compared with GSPECT. The results of linear regression analysis showed good correlation between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO (r=0.643-0.873, P=0.000). Bland-Altman analysis indicated that 18F-FDG PET correlated well with ECHO in the Left ventricular function parameters. While GSPECT correlated well with 18F-FDG PET in ESV, GSPECT had good correlation with Echo in respect of EDV and EF; whereas GSPECT had poor correlation with PET/ECHO in the remaining left ventricular function parameters. Therefore, the clinical physicians should decide whether they would use the method according to the patients' situation and diagnostic requirements.