ObjectiveTo evaluate clinical outcomes of thoracic endovascular aortic repair (TEVAR)for the treatment of Stanford type B aortic dissection (AD)and descending aortic aneurysm. MethodsClinical data of 20 patients with Stanford type B AD or descending aortic aneurysm who underwent TEVAR in West China Hospital from March to June 2013 were retrospectively analyzed. There were 19 male and 1 female patients with their age of 41-76 (58.3±10.2)years. Clinical outcomes were analyzed. ResultsAmong the 20 patients, 18 patients were successfully discharged, 1 patient refused further postoperative treatment and was discharged, and 1 patient died postoperatively. Sixteen patients (88.9%)were followed up for over 3 months. In all the patients during follow-up, true lumen diameter recovered within the scope of intravascular stents, and there was thrombosis in false lumen or aneurysm lumen. ConclusionTEVAR provides a new choice with significant advantages for the treatment of Stanford type B AD, especially for the elderly and patients with concomitant serious diseases, so it is worthy of clinical application.
ObjectiveTo investigate the reasons for failure to treat thoracolumbar tuberculosis by anterior internal fixation and its countermeasures. MethodsA total of 485 patients with thoracolumbar spinal tuberculosis underwent anterior focus clearance and fixation from January 2005 to January 2012. Eighteen of them failed with a rate of 3.71%. Screws were pulled out in two patients. Vertebra cutted by screws occurred in three patients. In another three patients, screws dropped into the intervertebral disc. Tuberculosis relapsed in 10 patients (5 accompanied with spinal deformity, 2 with pure malunion, 2 with abscess formation, and 1 with sequestra). Twelve of the patients underwent two-stage posterior pedicle screw internal fixation and anterior focus clearance and autogenous bone grafts fusion. Four were treated by shifting antituberculosis drugs and staying in bed. Two were cured by multiple abscesses puncture and antituberculosis injection. ResultsThese patients were followed up for 15~30 months. Twelve cases of spinal tuberculosis were completely cured and 6 cases of them got clinical cure. However, 3 cases of them had scoliosis deformity followed and 1 had kyphosis. No tuberculosis relapse, cold abscess or sinus formation, or pedicle screw internal fixation failure occurred again. ConclusionAlthough there are many complications of anterior internal fixation for spinal tuberculosis, anterior internal fixation is still a perfect choice if we can make an appropriate choice of operation and strengthen the management after operation.
ObjectiveTo investigate the correlation of X-ray repair cross-complementing gene 1 (XRCC1-Arg399Gln, Arg280His, and Arg194Trp) polymorphisms and susceptibility to gastric cancer. MethodsOne hundred and twenty patients with gastric cancer were included in study group, 120 healthy volunteers were included in control group. The DNA was extracted from peripheral blood. Arg399Gln, Arg280His, and Arg194Trp gene polymorphisms were detected and analyzed using polymerase chain reaction-restriction fragment length polymorphism technique, and the susceptibility between different genotypes and gastric cancer was compared in two groups. ResultsThe age, gender, smoking, drinking, diet, and other common characteristics of exposure factors had no significant differences in two groups (P > 0.05). The mutation locus genotype frequencies of Arg399Gln and Arg280His had no significant differences between two groups (P > 0.05). However, the mutation locus genotype frequencies of Arg/Trp, Trp/Trp, and Arg/Trp+Trp/Trp were higher and the mutation locus genotype frequency of Arg/Arg was lower in the study group as compared with the control group (P < 0.05). ConclusionThe preliminary results from this study shows that XRCC1 Arg399Gln and Arg280His polymorphisms are not correlated with susceptibility to gastric cancer; However, Arg194Trp polymorphism is correlated with susceptibility to gastric cancer.
ObjectiveTo investigate the curative effects of capecitabine and hessaitin combined with whole brain radiotherapy for treatment the HER2 positive breast cancer with brain metastasis. MethodsThe clinical data of 60 cases HER2-positive breast cancer patients with brain metastasis in our hospital in January 2004 to January 2012 were retrospectively analyzed.The 32 cases of observe group were treated by using capecitabine and herceptin combined with whole brain radiotherapy, and the 28 cases of control group were treated by using capecitabine and cisplatin combined with whole brain radiotherapy.The disease control rate, toxicity rate, and survival rate were evaluated. ResultsCompared with the control group, the disease control rate, toxicity rate, and survival rate were all better in observe group (P < 0.05). ConclusionThe capecitabine and hessaitin combined with whole brain radiotherapy for treating patients with HER 2 positive brest cancer transferred to brain are effect and safe.
For tooth segmentation problem on the three-dimensional computed tomography (CT) volume data, this paper proposes a regional adaptive deformable model for tooth structure measurement of CT images. The proposed method combines the automatic thresholding segmentation, CV active contour model, and graph-cut. Firstly, we achieved the segmentation and location of dental crowns by automatic thresholding segmentation. And then by using the above segmentation result as the initial contour, we utilized active contour method to slice gradually the segment of remaining tooth. By incorporating active contour and graph-cut then, we realized the accurate segmentation for tooth root, which is the most difficult to be segmented. The experimental results showed that the proposed tooth structure measurement accurately and automatically segmented dental crowns from CT data, and then rapidly and accurately segmented the tooth neck and tooth root. The structure of tooth could be effectively segmented from CT data by using the proposed method. Experimental results indicated that the proposed method was rather robust and accurate, and could effectively assist the doctor for diagnosis in clinical treatment.
ObjectiveTo investigate the clinical characteristics of primary mass of the hepatoduodenal ligament (HDL) and present some thoughts in the diagnosis and treatment of this disease. MethodsSixteen consecutive patients diagnosed as having a primary mass of the HDL in the West China Hospital of Sichuan University from September 2004 to May 2013 were retrospectively investigated. ResultsThe symptoms and blood testing both lacked specificity. In this group, fourteen patients were examined by ultrasound and fifteen by contrast-enhanced computed tomography, with 3/14 (21.43%) and 5/15(33.33%) respectively defining the location of the lesions and characteristic of benign/malignant. When combining the ultrasound and contrast-enhanced computed tomography, six of twelve(50.00%) defined the location and characteristic of benign/malignant. When combined with contrast-enhanced magnetic resonance, ten of sixteen (62.5%) defined the location and characteristic of benign/malignant. All cases underwent abdominal exploration, 11 cases (68.8%) were porformed mass resected, 2 cases(12.5%) were porformed the simple HDL mass biopsy combined with biliary drainage with T tube, 1 case(6.2%) was porformed drainage for abscess of HDL, and 2 cases(12.5%) were porformed simple frozen biopsy. All cases recovered and discharged. ConclusionsThe diagnosis of a primary mass of the HDL is difficult. The united usage of multiple imageological examinations can increase the accuracy rate of the noninvasive preoperative diagnosis. Surgery and other active treatment can produce good prognosis.
ObjectiveTo compare the effectiveness of short segmental pedicle screw fixation with and without fusion in the treatment of thoracolumbar burst fracture. MethodsA retrospective analysis was made on the clinical data of 57 patients with single segment thoracolumbar burst fractures, who accorded with the inclusion criteria between February 2012 and February 2014. The patients underwent posterior short segmental pedicle screw fixation with fusion in 27 cases (fusion group) and without fusion in 30 cases (non-fusion group). There was no significant difference in gender, age, cause of injury, time between injury and admission, fracture segment and classification, and neurologic function America Spinal Injury Association (ASIA) classification between 2 groups, which had the comparability (P > 0.05). The operative time, blood loss, and hospitalization days were compared between 2 groups. The height of the injured vertebra, the kyphotic angle, and the range of motion (ROM) were measured on the X-ray film. The functional outcomes were evaluated by using the Greenough low-back outcome score and the visual analogue scale (VAS) for back pain. The neurologic functional recovery was assessed by ASIA grade. ResultsThe operative time was significantly shortened and the blood loss was significantly reduced in the non-fusion group when compared with the fusion group (P < 0.05), but no significant difference was found in hospitalization days between 2 groups (P > 0.05). The patients were followed up for 2.0-3.5 years (mean, 3.17 years) in the fusion group and for 2-4 years (mean, 3.23 years) in the non-fusion group. X-ray films showed that 2 cases failed bone graft fusion, the fusion time was 12-17 weeks (mean, 15.6 weeks) in the other 25 cases. Complication occurred in 2 cases of the fusion group (1 case of incision deep infection and 1 case of hematoma at iliac bone donor site) and in 1 case of the non-fusion group (fat liquefaction); primary healing of incision was obtained in the others. The Cobb angle, the height of injured vertebrae showed no significant difference between 2 groups at pre-operation, immediate after operation, and last follow-up (P > 0.05). The ROM of injured vertebrae showed no significant difference between 2 groups at 1 year after operation (before implants were removed) (P > 0.05). The implants were removed at 1 year after operation in all cases of the non-fusion group, and in 11 cases of the fusion group. At last follow-up, the ROM of injured vertebrae in the non-fusion group was significantly higher than that in the fusion group (P < 0.05), but no significant difference was found in Greenough low-back outcome score, VAS score, and ASIA grade between 2 groups (P > 0.05). ConclusionFusion is not necessary when thoracolumbar burst fracture is treated by posterior short segmental pedicle screw fixation, which can preserve regional segmental motion, shorten the operative time, decrease blood loss, and eliminate bone graft donor site complications.