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简介：GuidedbyTCMtreatmentonthebasisofsyndromedifferentiation,theauthorhastreated33casesofhysteromyoma,whicharedividedintostagnationofliver-qiandbloodstasis(SLQBS)type,andqi-deficiencyandbloodstasis(QDBS)type,byacupuncture-moxibus-tionandTuina.After3therapeuticcourses,thetotalef-fectiverateis81.8%.ThetherapeuticeffecthasnocloserelationshipwiththeTCMsyndromedifferentiation.

简介：AbstractBackground:Giant serpentine aneurysms (GSA) originate from saccular or spindle aneurysm, dissimilar from dissected aneurysm, that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel. The clinical and neuroradiologic characteristics are clarified and the mechanism of formation and the efficacy of double stent implantation in GSA are discussed.Case presentation:An 18-year-old man presented himself with a GSA arising from the internal cerebral artery (ICA). In addition, a mandibular aneurysm (MA) arose from the external cerebral artery (ECA). Success was achieved in treating GSA through endovascular treatment with double stents implanted in the parent artery, which were LEO stent and Tubridge flow diverter. After 1 year of follow-up, three-dimensional reconstruction of blood vessels revealed the disappearance of the serpentine access of GSA, which was found to be replaced with a roughly normal vascular structure.Conclusions:Double stent implantation has provided a feasible treatment option for giant serpentine internal carotid aneurysms and eliminated the possibility of causing collateral circulation occlusion. Therefore, it represents a simple and suitable treatment method for anatomical structure and operation.

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简介：OnMay8,2003,USPresidentBushsubmittedareportontheso-called“Tibetanissue”toCongressinaccordancewithForeignRelationsAuthorizationAct,2003.ThereportUSrecognitionofTibetaspartofChina,butdeclaredsupportforthe14thDalaiLamainhispursuitof

简介：OnJune22-30,aninvestigationgroupmadeupofVice-PresidentChenShiqiuandanumberofexecutivecouncilmembersoftheChinaSocietyforHumanRightsStudies,andexpertsandscholarsonhumanrights,conductedinvestigationinShanghaiandWuxi,ZhenjiangandChangzhouinJiang-

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简介：AbstractProsthetic infection is one of the severe postoperative complications of arthroplasty. Mixed bacterial-fungal prosthetic infection is rare but can be disastrous. This case was a 76-year-old female suffered from prosthetic infection following total hip replacement due to femoral neck fracture and underwent multiple debridements. The culture of periprosthetic tissue was bacteriologically sterile following the first debridement, while the Staphylococcus hominis was identified in the second debridement in the previous hospitalization where fungal infection had not been considered. Thus the pathogen spectrum of anti-infection therapy failed to contain fungus. Ultimately, the culture result of our sampled periprosthetic tissue during the third debridement was Candida albicans without bacterium in our hospital. The fungal prosthetic infection was successfully treated by a two-stage revision with antifungal drugs. Accurate diagnosis and standardized treatment is the key to the therapy of infection after hip arthroplasty, especially for mixed bacterial-fungal prosthetic infection.

简介：AbstractAnterior tibiofemoral dislocation after total knee arthroplasty is an extremely rare and serious event. Amongst English-published papers, we found only 15 relevant cases, 3 of which presented vascular complications. This manuscript aims to present a 77-year-old woman with a TC-Plus (Smith & Nephew) cruciate-retaining type in first time of knee prosthesis, who suffered an anterior tibiofemoral dislocation and were admitted to our hospital. The clinical management and outcome were evaluated. Furthermore, a review of literature was performed. We concluded that early detection and surgical intervention of vascular injury is the key in the survival of the limbs. If there is still knee instability after acute recovery, it seems that revision surgery with constrained total knee arthroplasty can bring about good clinical and functional results.

简介：AbstractPregnancy is rare and difficult in Sheehan syndrome patients. With the help of assisted reproductive technology, the patients even with panhypopituitarism can get pregnant again. Moreover, women with hypopituitarism have increased risk of pregnancy complications. Here we report a patient who suffered acute and severe Sheehan syndrome with panhypopituitarism and central diabetes insipidus got pregnant again by in vitro fertilization and embryo transfer. A regular and careful antenatal care was given by the cooperation between obstetricians and endocrinologists. Finally, she delivered a healthy female baby at 37+6weeks of gestation with Apgar scores of 10 and 10 at 1 and 5 minutes, respectively. The patient and her baby were doing well at postpartum follow-up. The related articles were also reviewed. This case report is aimed to help clinical practitioners to make better decisions on the management of Sheehan syndrome or other type of hypopituitarism during pregnancy.

简介：AbstractSevere acute pancreatitis is commonly associated with pancreatic and extrapancreatic necrosis (EPN). Progressive EPN leading to necrotizing fasciitis of the retroperitoneum and abdominal wall has been reported. However, extension of retroperitoneal necrosis to the scrotum causing Fournier’s gangrene is uncommon. We present a case of 39-year-old male admitted with severe acute pancreatitis requiring prolonged mechanical ventilation. He was managed with percutaneous drainage and culture specific antibiotics during the 1st month of hospital stay. During the 3rd month of hospital stay, the patient started developing pain and ulceration over the scrotum. He was diagnosed with Fournier’s gangrene based on clinical examination and was planned for debridement. During surgery, the track extending up to the deep inguinal ring was widened and drain was placed into the right lateral pelvic wall through the deep ring via a separate stab incision to reduce further scrotal wound contamination. The case highlights a rare but potentially fatal complication of Fournier’s gangrene following severe acute necrotizing pancreatitis and the importance of measures to prevent further contamination of scrotum after surgical debridement. Concomitant management of two potentially fatal conditions poses numerous challenges.

简介：AbstractPlacenta accreta spectrum (PAS) disorders are severe obstetric complications and can cause life-threatening hemorrhage, hysterectomy, or even death. PAS disorders in one of dichorionic diamniotic twins are rare to be seen in clinical practice and lack of standard management strategies. We reported a case of retained placenta creta after selective fetal reduction in one of dichorionic diamniotic twins. A 32-year-old woman with a history of cesarean section was diagnosed with placenta increta in one of dichorionic diamniotic twins at 16 weeks of gestation. After discussion, the couple required to be hospitalized for selective fetal reduction. She received selective termination by ultrasound-guided single fetal intracardiac injection of potassium chloride. The follow-up prenatal ultrasound examinations detected the placenta of the reduced fetus did not stop invade the myometrium of the uterus but developed from placenta increta to placenta percreta. The patient was diagnosed with placental percreta by prenatal ultrasound signs and surgical findings. The patient underwent scheduled cesarean delivery at 34+5 gestational weeks. The outcome of maternal and fetal was satisfactory for our elaborate operation and optimal management. PAS disorders are severe obstetric complications with an increasing incidence. Combined with twin pregnancy makes PAS disorders more intractable. We should learn that selective fetal reduction probably cannot solve it thoroughly. Intensive and standard management is essential to promote maternal and fetal outcomes.

简介：AbstractBackground:Myxofibrosarcoma (MFS), especially radiation-Induced MFS (RIMFS) in the head and neck, is an extremely rare malignant fibroblastic tumor. The diagnosis and treatment of MFS remain great challenges. In the present study, we presented one case of RIMFS. Combined with previous literature, the clinical features, essentials of diagnosis, and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity.Case presentation:We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after the first operation. The postoperative pathological diagnosis was high-grade MFS. The tumor relapsed 6 months later, and then, a planned extensive resection with negative surgical margins was carried out, followed by radiotherapy. No relapse occurred in a 12-month postoperative follow-up.Conclusions:Planned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck, so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.

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简介：ObjectivePorencephaliccystpresentingwithotologicinvolvementisuncommon.Onlyafewcaseshavebeenreported.Wereportararecaseofcerebrospinalfluid(CSF)otorrheacausedbyamassiveporencephaliccystencompassingthelefttemporalandoccipitallobes.TheCSFleakwasrepairedsuccessfullyusingatransmastoidapproachwithfacia,abdomenfatandfibringluetosealtheosseousdefectsinthesinoduralangle.AreviewoftheliteratureconcerningporencephaliccystandCSFotorrheaisalsopresented.

简介：以七星针进行叩刺患部，微量出血后，点燃艾条，对准患部约距皮肤2cm左右进行反复旋转施灸，治疗63例患者。3个疗程后，总有效率为100％。

简介：胫骨的高原不属于工会的Intraarticular是稀罕的。在文学，仅仅9个病人被发现为不属于工会的胫骨的高原和他们得到了改变结果的intraarticular被对待。与骨头grafting一起的内部固定在所有情况中作为标准治疗被做。我们对待intraarticular的4个不同侧面案例在我们由4个不同方法的机构不属于工会的胫骨的高原。我们与骨头接枝，有K钉子的arthrodesis和全部的膝代替一起与巴黎扔的、内部固定的灰浆对待这些案例。大小写1与当病人拒绝了外科，扔的巴黎(流行音乐)的灰浆被对待。破裂被统一，尽管有外翻足malalignment，病人充分对运动的完整的范围满意。大小写2与开的减小被管理与骨头grafting一起的内部固定。病人有一个好工会并且在膝关节得到了运动的完整的范围。大小写3由于她的老年与全部的膝关节造形术被对待并且得到了令人满意的结果。大小写4是一感染不属于工会。Arthrodesis被做，病人能与忍受independently.We的完整的重量走断定与骨头grafting一起的那内部固定不能在胫骨的高原不属于工会的intraarticular的所有情况中是合适的。不属于工会的、现在的状况的原因和膝关节的运动的范围都应该被考虑，治疗应该根据每种patient’s状况是individualised。

简介：手掌的perilunate破裂脱臼是极其稀罕的腕骨损害，但是与ipsilateral索引和中指的metacarpophalangeal关节脱臼联系从来没被报导过。我们报导跟随一处高精力的损伤的一个28岁的人的一个案例。在执行metacarpophalangeal关节损害的关上的减小以后，通过手掌的途径的手腕损害的开的减小被做，并且K电线固定被用来稳定舟骨破裂和lunotriquetral关节。在16月的后续时期以后，没有症状，手腕重获全套运动，并且折断的骨头在一个好位置被加强。