Objective: High tibial osteotomy treated medial compartment serious osteoarthritis of the knee with varus deformity,and relieving arthritic pain,correcting deformity and normal femoraltibial axial alignment.Methods:From May 1992 to February 1998,18 cases(21 knees) were operated on,We chose fit patients and planed osteotomy angle.Results:All cases were followed up for an average 3.2 years,according to Coventry's rating system,81% of the whole series had a good or excellent results.Conclusion:It increases the medial joint space width and corrects femoraltibial axial alignment,allows for healing of the articular cartilage.Satisfactory results were obtained.

ObjectiveTo investigate the characteristics of three vaginal bacteria inspection methods of Amsel method,gram staining Nugent score method and bacterial vaginosis (BV) Blue methodMethods The leucorrhea specimen of 99 vaginal fluid abnormal patients were examined by Amsel method,gram staining Nugent score method and BV Blue method,then compared and analyzedResultsThe positive rate was 28.28％ (28/99) in Amsel method,47.47％(47/99) in gram staining Nugent score method and 16.16％ (16/99) in BV Blue method.There were significant differences among three methods(P＜ 0.01 ).The specificity and sensitivity of gram staining Nugent score method was higher.ConclusionThe three vaginal bacteria inspection methods have advantage and shortcoming individually,suspecting patients should be followed up to detect and diagnose in chnic,or detected by many methods.The specificity and sensitivity of gram staining Nugent score method is higher,but BV Blue method is simple,faster,which has higher value in detection and diagnosis in BV.

[Objective]To explore the change and its significance of the expression of basic fibroblastic growth factor(bFGF) and bone morphogenetic protein-2(BMP-2) of the local femoral head in nontraumatic osteonecrosis(NONFH). [Methods]Thirty samples of femoral heads of NONFH were collected as the experimental group and 10 fresh samples of femoral heads of femoral neck fracture as control group.The specimens were collected at the time of total articular replacement arthroplasty.The bone tissues from necrosis area and healthy area were made into general sections after immobility and decalcification.Pathological changes were exexamined by optical microscopy and the expression of bFGF and BMP-2 in femoral head was determined with in-situ hybridization technique.[Results]The organization structure of experimental group was disorganized,cracked,and the bone trabecula was rarefactive and non-intact.There were a great number of empty lacune in bone trabecula.The intensity and area of positive expression of bFGF and BMP-2 in femoral head of the experimental group were obviously lower than that of control group.The result had statistical significance(P

[Objective] To explore the curative effect of synthetic surgical therapy on severe flexion deformity knees.[Methods]There were 22 patients(35 knees)with flexion deformity knees who were treated by synthetic surgical therapy during March 1999 to February 2008.Evaluation with HSS scoring system at preoperative and postoperative period were made.[Results]All patients were followed up.The mean followed-up time was 3.1 years(range 13 months to 7 years).The mean HSS score of knee joint was 23.5 points at preoperative period(range-6 to 35)and it was 79.8 points at postoperative period(range 62~91).The result showed statistical significance(P

Objective To investigate the correlation between serum cystatin C(Cys-C)and renal function in patients with renal damage secondary to cirrhosis.Methods 129 patients with liver cirrhosis were selected,according to the measured glomerular filtration rate (GFR) as the gold standard for evaluation of renal function,patients were divided into group A(cirrhosis with normal renal function),group B(cirrhosis following renal insufficiency),group C (cirrhosis secondary to renal failure).The concentration of Cys-C was compared among three groups,and the serum creatinine(Scr),serum proteins ball micro β2 (β2-MG),creatinine clearance (Ccr) were detected.Results Cys-C,Scr,β2-MG,Ccr and other indicators of A,B,C three groups increased or decreased with the severity of impaired renal function(t =6.65,6.85,6.58,4.54,all P ＜ 0.05).The abnormal detection rates of Cys-C,Scr,Ccr,β2-MG in A group were 31.1％,11.1％,8.9％,26,7％,those in B group were 83.7％,30.2 ％,34.9％,46.5％,those in C group were 100.0％,85.4％,87.8％,95.1％.Conclusion Serum Cys-C concentration is a sensitive marker to evaluate glomerular filtration,it has accurate and reliable clinical significance in the early diagnosis of liver cirrhosis secondary to kidney damage.

Objective To investigate the accuracy of the new trauma scoring method:Glasgow coma score (GCS),age and systolic pressure score (GAP),in diagnosing patients' traumatic condition and predicting fatality rate in department of emergency.Methods The chnical data of 27 706 traumatic patients in department of emergency were collected.The observation was categorized into three kinds:death within 24 h after reaching department of emergency (24 h death);death from 24 h after reaching department of emergency to 7 d (death after 24 h);survival.On the basis of the trauma mechanism,GCS,age and systolic pressure score (MGAP),the GAP method was used for judging traumatic condition and predicting fatality rate of traumatic patients in department of emergency.The accuracy of GAP in predicting fatality rate was compared with revised trauma score (RTS),trauma and injury severity score (TRISS) and MGAP.The C-statistics method was used to calculate the accuracy in predicted the fatality rate.Results The C values (0.936 and 0.961) of GAP in predicting fatality rate after 24 h and in 24 h were higher than RTS (0.917 and 0.958) and MGAP (0.920 and 0.950),but slightly lower than TRISS (0.950 and 0.970).The traumatic condition in GAP was defined in this way:severity 3-10 scores,moderation 11-18 scores,and slightness 19-24 scores.Conclusions The GAP is simple,practical and accurate in diagnosing patients' traumatic condition and predicting their fatality rate.It is helpful in physicians' decision of a proper treatment plan.

From May, 2000 to June, 2001, 27 patients with Parkinson disease (PD), including 10 cases of rigidity, 13 cases of tremor, 4 cases of rigidity and tremor, were treated by microelectrode-guided technique. Among them, phlebotomy was carried out in 17 cases and thalamotomy in 10 cases. All the targets of lesion were anatomically located by using MR and neurophysiological signals on microelectrode. Our results showed that the efficiency of microelectrode-guided technique for treatment of PD was 98%. The postoperative unified parkinson disease rating scale were 12.3 +/- 9.1 and 13.2 +/- 8.9 respectively, which significantly improved as compared with those before operation. It was concluded that by recognizing special electrical signals in neurons microelectrode-guided neuropsychological techniques can locate target at cellular level, which overcomes the individual difference in anatomy and function, and allow more accuracy, safety and efficiency of operation. This is especially true of PD patients who fail to respond to medical treatment.
Magnetic Resonance Imaging ; *Microelectrodes ; Parkinson Disease/*surgery ; Stereotaxic Techniques ; Thalamus/surgery

Objective To assess the feasibility and efficacy of renal pelvis drainage and ureteral stent of laparoscopic pyeloplasty in treatment of ureteropelvic junction obstruction.Methods Eighteen patients(14 boys and 4girls) with ureteropelvic junction obstruction,the average patient age was 66 months (range 3-182 months),who underwent transabdominal laparoscopic Anderson-Hynes pyeloplasty in Capital Institute of Pediatrics from Aug.2011 to Oct.2012 were selected.The ureteral stent and renal pelvis drainage were installed during the performance of surgery.They were removed in 7 days and 9 days after operation respectively.Results Eighteen cases successfully underwent laparoscopic pyeloplasty,without conversion to open surgery.The mean operating time was 102.8 minutes (ranging between 90 and 150 minutes).Two cases had complications on postoperative day 3,one patients ureteral stent was inadver-tentely pulled out,another was removed because of blood clots.No patient had postoperative urinary leakage or anastomotic stenosis.Postoperative follow-up time was 6 months.The hydronephrosis vanished in 13 patients,reduced obvious ly in 5 patients as revealed by ultrasound examination.Conclusions Intraoperatively,renal pelvis drainage and ureteral stent for postoperative drainage is effective,and it is worthy of application in a large scale.Patients can avoid further anesthesia for removing stents and the complications of long-term indwelling stent tubes,and have an improved quality of life.

Objective To explore the regulation and effect factors of arsenic expose and arsenic methylation level, then to provide a reference for study the function of arsenic metabolism in a arsenic poisoning process. Methods A meta-analysis was performed by two researchers. Twenty-five papers satisfying our priori eligibility criteria were included by searching Cochrane library, Pubmed, Springer, Embase and China National Knowledge Infrastructure. Based on the results of heterogeneity, a random or fixed effects model was chosen for the meta-analysis. Results The results showed that the following arsenic metabolites increased (all P<0.01) following arsenic exposure: inorganic arsenic [iAs; standardized mean difference (SMD): 1.07; 95% confidence interval (CI):0.61 - 1.53)], monomethyl arsenic (MMA; SMD: 1.10; 95% CI: 0.81 - 1.40), dimethyl arsenic (DMA; SMD: 2.50;95%CI:1.50-3.69), and total arsenic (TAs, SMD:3.10;95%CI:2.13-4.07). Additionally, the percentages of iAs (iAs%; SMD: 1.00; 95% CI: 0.60 - 1.40) and MMA (MMA%; SMD: 0.49; 95% CI: 0.21 - 0.77) also increased, while the percentage of DMA (DMA%; SMD: - 0.55; 95% CI: - 0.80 - - 0.31) decreased (P<0.01). The primary methylation index (PMI; SMD: - 0.57; 95% CI: - 0.94 - - 0.20), and secondary methylation index (SMI;SMD: - 0.27; 95% CI: - 0.46 - - 0.09) decreased (all P< 0.01). Compared to female, male had higher MMA%(SMD:0.44;95%CI:0.35-0.52), lower DMA%(SMD:-0.33;95%CI:-0.38--0.28) and SMI (SMD:-0.36;95%CI:-0.53--0.19). The smoker had higher MMA%(SMD: 0.22; 95%CI: 0.07 - 0.37) and lower DMA%(SMD:-0.16;95%CI: - 0.26 - - 0.05). The drinker had higher MMA% (SMD: 0.17; 95% CI: 0.07 - 0.27) and lower DMA%(SMD:-0.24;95%CI:-0.39--0.10). The older people had higher MMA%(SMD:-0.23;95%CI:-0.40--0.06). In addition, the body mass index may influence the percentages of MMA (SMD: - 0.18; 95% CI: - 0.31 - - 0.04, P < 0.01). Conclusion Arsenic exposure, smoking, drinking, and older age can reduce the capacity of arsenic methylation. Arsenic methylation is more efficient in women than in men.

Objective To investigate the therapeutic effect of modified transperitoneal laparoscopic dismembered pyeloplasty in children with with ureteropelvic junction obstruction (UPJO).Methods The clinical data of 27 children with UPJO treated with transperitoneal laparoscopic dismembered pyeloplasty were analyzed retrospectively.The age ranged from 5 to 104 months (mean,37 months).All cases were diagnosed by ultrasonography,IVU,CT and/or renal radionuclide scanning.The antero-posterior pelvic diameter was more than 3 cm by ultrasound in all cases.Indications of surgery were as followings:symptoms of upper abdominal pain or low back pain and/or split renal function ＜40％ and/or progressive dilatation.Modified transperitoneal laparoscopic dismembered pyeloplasty was performed.Double hitch stitches were transfixed at the top of pelvis and ureter to be anastomosed,and a 6 F urethral catheter was inserted as a ureteral stent percutaneously through the puncture hole and was removed 7-9 days postoperatively without double-J stent.Results All operations were completed laparoscopically without conversion to open surgery.The mean operative time was 118 min (range,85 to 176),the mean blood loss was 16 ml (range,10 to 30) and the mean postoperative hospital stay was 10.5 days (range 9 to 13).The perinephric urine drainage occurred in 2 patients with about 200 ml/d,and reduced to 6 ml/d and 4 ml/d 5 to 6 days after operation.During the follow-up period for 12 to 36 months(mean,22 months) in 27 cases,there was no stricture at UPJ and the hydronephrosis reduced significantly or disappeared.Conclusion Laparoscopic dismembered pyeloplasty with double hitch stitches and an ordinary urethral catheter as an ureteral stent is an easy method with high successful rate and less operative time,which avoids reoperation to remove the double-J stent and is worthy of clinical popularization.