Objective: To observe the curative effects of high tibial osteotomy with slotting plate for the treatment of osteoarthritis of the knee with genu varum.Methods:The general status of all patients were comprehensively evaluated.Their weight bearing lines of lower limbs were measured at standing positions in order to determine the angles of corrective osteotomy with high tibial osteotomy.Results:Evaluation was done according to the criterions made by Dou Baoxin 85.8% of curative effects were excellent and good,The ideal tibiofemoral angles were 170°～172° degree.Conclusion:With slotting plate fixation to correct the weight bearing line of lower limbs,with advantages of reasonable operative method,easy mastering of the angles of correction,and firm fixation and high union rate,is the best method to treat the osteoarthritis of the knee with genu varum.

Effect of lithium salt(Li)administnation to caudate-putamen nucleus (CPN) on pain response in the rat was studied by chronic cannula implantation and direct injection of drugs into the brain structurementioned above. The results were as follows:( 1 ) The injection of Li into anterior part of the head of CPN of rats produced significantly the analgesic effect that could be antagonized by naloxone, atropine,phento-lamine.propranolol, lysergic acid diethylamide and bicuculline, but not by haloperidol.(2) The injection of Li into central part of the head of CPN of rats did not produce analgesic effect.The results above showed that microinjection of Li into different parts of the head of CPN could give rise to different effects on pain response and the analgesic effect of Li could be related to metabolic changes of endogenous opioid peptides, acetylcholine, noradrenaline, gama aminobutyric acid and 5-hydroXytryptamin aad mediated by their receptors respectively

The morphological changes of the humerus and femur were examined in 52 sports- men (30 weight-lifters-static type of movement and 22 runners—dynamic type of move- ment).The results were as follows: 1.In the humerus of the weight-lifters the thickness of the wall of bone was very much increased as compared with that of the runners and,as a result,the transverse diameter of the shaft enlarged and the cavity diminished. 2.In the femur,however,no such changes were observed in both types of exercise. On the contrary,there is some indication that the femur of the runners increased in longitudinal direction. 3.In the weight-lifters,the thickness of the wall of the bone was not only shown in the shaft,but also in the metaphyses where it ended as a sickle in the longitudinal section.On the other hand,that of the runners gradually pointed out. 4.The bony prominences of the humerus of the weight-lifters were very much marked and its internal bony lamellae were clearly visible.

For a period of 3 months,an experimental exercise under the influence of dynamic and static factors was given to 3 groups (15 each) of mice.The histological changes of the extensor muscle of the post extremities of these mice were examined by the Bielschowsky-Gros and H.E.methods.The result,as compared with that of the control group,was summarized as follows: 1.The structural changes of the muscle fibers differ in different groups under the influence of different mechanical factors,for instance,under the influence of static factors either the muscle fibers as a whole or their nuclei were enlarged mainly along the trans- verse diameter. 2.The increase in number of nuclei of the muscle was observed in the experi- mental animals among which the dynamic type was most conspicuous.This increase was not only related to the character of mechanical factors,but also the intensity of the muscular activity. 3.Under mechanical factors,the nuclei of the muscles were increased both in number and in size.Under the influence of dynamic factors,the nuclei increased pre- dominantly in length (long type nuclei) while under the influence of static factor,its in- crease was mainly along the transverse direction.In the latter the transverse diameter of the long type nuclei was also wider and tends to become oval in shape.It is,therefore, assumed that the type and number of the nuclei of the muscle cells depend upon the func- tional activity of the organ and the character of the force acting upon it. 4.After a long period of exercise,either by means of dynamic or static factor, a large number of annular nuclei was found in the muscles.This phenomenum has not been reported in the literature.

Fifteen mice, were divided into 3 groups, each was trained to adopt a particularfunctional state of muscular activity for a long term. The histological changes of theirmotor end-plates were examined by means of the Bielschowsky-Gros and the Ranvier'sgold chloride techniques. The results were summarized as follows: 1. It was found that, by increasing the dynamic or static functional activity of mus-cles of the mice, the motor end-plates were enlarged in size and their nuclei were in-creased in number, as compared with those of the control group. 2. The size of the nuclei of the end-plates of both experimental groups was notequally affected, e.g., the nuclei in the static group were larger, while those in the dyna-mic group were comparatively smaller. 3. Under the influence of the dynamic or static muscular exercise, the end-platesincreased in their sizes, more so in the static than in the dynamic group, while the controlgroup remained to be the smallest. The diameter had a tendency to increase along thelong axis in the dynamic group, and along the transverse axis in the static group; hencethe end plate appeared to be oblong in the former and oval in the latter group. 4. After a long term of muscular exercise, whether dynamic or static in nature, thenerve fibers supplying the end-plates increased in thickness and degree of complexity oframification. There were some unidentified cells with annular nucleus in the vicinity ofthe end-plate. 5. Mechanism of the changes of the motor end-plates was discussed in the light offunctional morphology.

Objective To investigate the clinical significance of serum D-dimer in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods 98 patients with COPD were selected as the research objects,including 38 patients with stable COPD and 60 patients with AECOPD.At the same time,fifty healthy subjects were enrolled in this study as healthy control group.The arterial blood gas(pH,PaCO2,PaO2,PaO2/FiO2),pulmonary function(FVC％,FEV1％,FEV1/FVC) were detected,plasma D-D were measured by immunoturbidimetry with fully automated biochemical analyzer.Results The PaCO2 of the stable COPD group and the AECOPD group were (45.30 ± 3.18) mmHg and (51.44 ± 5.12) mmHg,which were significantly higher than that of the healthy control group[(39.45 ± 4.05) mmHg] (t =4.414,7.556,all P ＜ 0.01).Tthe PaO2,PaO2/FiO2,FVC％ and FEV1/FVC were significantly lower than those of the healthy control group (t =3.618,7.702,21.433,26.316,4.323,8.302,5.112,10.384,4.191,9.511,all P ＜ 0.01).The PaCO2 of AECOPD group was significantly higher than that of the stable COPD group(t =4.331,P ＜ 0.05),while the PaO2,PaO2/FiO2,FVC％,FEV1 ％ and FEV1/FVC were significantl) lower than those of the stable COPD group(t =5.702,4.652,3.773,6.241,5.806,all P ＜ 0.05).The serum DD of the healthy control group was (0.33 ± 0.05) mg/L,which of the stable COPD group was (0.77 ± 0.08) mg/L,which of the AECOPD group was (1.58 ±0.10)mg/L,and the difference of the these groups was statistically significant(F =14.667,P ＜ 0.01).The plasma D-D of the stable COPD group and the AECOPD group were significantly higher than that of the healthy control group (t =4.667,13.224,all P ＜ 0.05).The plasma DD of the AECOPD group was significantly higher than that of the stable COPD group (t =9.471,P ＜ 0.05).There were positively correlation betweem D-D and PaCO2 (r =0.661,P ＜ 0.05),and there were negatively correlation betweem D-D and PaO2/FiO2 and FEV1/FVC(r =-0.964,-0.589,all P＜0.05).Conclusion D-dimer is correlated with arterial blood gas and lung function.D-dimer test can help to evaluate the stage and severity of COPD accurately,which is helpful for effective treatment.

Objective　To measure the levels of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in synovial fluid and plasma of patients with RA and investigate its clinical significance.Methods　By using ELISA sandwich method,the levels of uPA and uPAR in plasma from 46 patients with RA and 8 with osteoarthritis (OA) were measured.Those in synovial fluid (SF) from 14 patients with RA,and plasma from 12 healthy subjects were measured as controls.Results　The concentration of uPA and uPAR in SF from patients was significant higher than that in their plasma (P＜0.001,P＜0.01),and the concentration of uPA and uPAR in plasma of RA was also much higher than that in plasma of OA patients (P＜0.05,P＜0.000 1) and healthy subjects (P＜0.000 1,P＜0.001).There was no significance between plasma levels of RF＋ and RF－ in RA patients.The concentration of uPA and uPAR of plasma in RA correlated positively with CRP,RF and the number of swelling joints.Conclusion　The levels of uPA and uPAR in SF and plasma are useful parameters for monitoring disease activity of RA.These findings suggest that the uPA and uPAR genes may play an important role via proteolytic damage of the extracellular matrix during the development of RA.

Male breast cancer is rare,it mainly caused by the interaction of the genetic factors,hormone levels,way of life,and the environment.Its clinical manifestations are indolent tumors.The diagnosis method includes clinical medical examination and imaging examination,and pathology examination.The treatment is in reference to the female breast cancer treatment model,including surgery,chemoradiotherapy and endocrine therapy.Tumor size and axillary lymph nodes involvement are independent predictors of overall survival.

Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

BACKGROUND:Core decompression with bone implantation in treatment of early avascular necrosis of femoral head may provide insufficient support for subchondral bone and increase the risk of fracture and col apse. Tantalum rod implantation can not only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head.
OBJECTIVE:To evaluate the efficacy of core decompression, core decompression with bone implantation and core decompression with tantalum rod implantation in treating early-stage avascular necrosis of femoral head. METHODS:A total of 24 cases (28 hips) who suffered from ARCO I/II avascular necrosis of femoral head were treated with core decompression with bone implantation, and 25 cases (29 hips) who suffered from ARCO I/II avascular necrosis of femoral head were treated with core decompression with tantalum rod implantation. Al the subjects were fol owed up for 24 months. The efficacy of two different surgical methods was evaluated before and after treatment by observing the changes in Harris scores.
RESULTS AND CONCLUSION:Al involved patients were fol owed up. Harris score of core decompression with bone implantation group were increased 4.93 points at 6 months after surgery;Harris score of core decompression with tantalum rod implantation group were increased 6.89 points at 6 months after surgery. There were significant differences between two groups before and after surgery (P<0.05). After 12 months, Harris scores in the two groups were both significantly increased and the scores of core decompression with tantalum rod implantation group was higher than that of core decompression with bone implantation group (P<0.05). The overal fine/excellent rate of core decompression with tantalum rod implantation group was 83%, which was better than core decompression with bone implantation group (75%). After 24 months, X-ray score of core decompression with tantalum rod implantation group was significantly higher than core decompression with bone implantation group (P<0.05). Comparing with core decompression with bone implantation, core decompression with tantalum rod implantation can better prevent femoral head col apse, improve hip function and delay the process of osteonecrosis of the femoral head.