Objecfive To identify what factors contribute to the occurrence of avascular necrosis (AVN) of the femoral head after pediatric femoral neck fractures. Methods A series of 33 pediatric femoral neck fractures who had been admitted to our institution between June 1994 and April 2006 were retrospectively reviewed. There were 1 case of type Ⅰ,15 type Ⅱ,14 type Ⅲ and 2 type IV according to Delbet classification. The mean age at injury was 10.7(3.7 to 14.1) years, and the mean follow-up was 3.4(1 to 12.2)years. All patients were followed up until union was achieved. AVN occurred in 16 cases, including 8 cases of Ratliff type Ⅰ,3 of Ratliff type Ⅱ,4 of Ratliff type Ⅲ and 1 unclassified. Age at injury, fracture type, degree of displacement, quality of reduction and type of fixation were calculated and analyzed with respect to AVN. Results AVN occurred in 4 cases (36.4%)under 10 years old and in 12 cases (54.5%)10 years old or more. Eight cases (53.3%)of AVN occurred in Delbet type Ⅱ and 6 cases (42.9%) of AVN occurred in type Ⅲ.One case (25.0%)of AVN occurred in non-displaced group and 14 cases(53.8%)in displaced group. Ten cases(50.O%)of AVN occurred in the group whose reduction quality was satisfactory and 6 cases(66.7%)in unsatisfactory reduction group. Thirteen cases (48.1%)of AVN occurred in the unstable fixation group and 2 cases (50.0%)in the stable fixation group. Conclusion Fracture type, degree of displacement, quality of reduction and age at injury can affect the occurrence of AVN of the femoral head after pediatric femoral neck fractures.

Objective To investigate the curative effects of curcumin(CUR)or dexamethasone (DXM)on ischemia-reperfusion injury(IRI)of rat lung grafts.Methods Male SD rats were randomly divided 4 groups:CUR group(CUR was administered intraperitoneally to both donors and recipients at 3 h prior to operation);DXM group(DXM was administered intraperitoneally at 30 min prior to operation);vehicle group(Animals were injected with the DMSO to both donors and recipients at 3 h prior to operation);sham group(Time-matched control animals underwent the same surgery,except that no graft was implanted).Six animals were sacrificed at different reperfusion periods of 2 h and 24 h,respectively.Oxygenation indexes(PO_2/FiO_2),lung injury scores,wet/dry ratio(W/D)and myeloperoxidase(MPO)activity in the transplanted lung were measured.Malondialdehyde(MDA), total anti-oxidative capacity(TAOC),tumor necrosis factor(TNF)-?and interleukin(IL)-6 in the transplanted lung and serum were determined.Results The levels of LPV PO_2/FiO_2 were significant- ly higher in the CUR and DXM groups than in the vehicle groups both 2 and 24 h after reperfusion,re- spectively(P

Objective To evaluate the value of CYRTA21-1,CEA and SPECT in diagnosis of bone metastasis in lung cancer.Methods 216 patients with lung cancer were examined by radionuclide bone imaging and serum CYFRA21-1,CEA.20 patients with benign lung disease were also studied.Results 121 of the 216 lung cancer patients were confirmed bone metastasis including 101 multi-metastasis and 20 singu- lar-metastasis. The positive rate was 56.02 %.The serum CYFR21-1,CEA level and positive rate of lung cancer patients with bone metastasis were obviously higher than those of patients without bone metastasis or with benign lung disease.The level of serum CYFR21-1,CEA had significant difference(P

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.

Objective To analyze the causes of time consumption in CT enhancement scanning (CTES) and CT angiography (CTA) examinations in order to optimize the procedures, and help to save time and medical costs for patients. Methods A total of 2328 outpatients and 1402 inpatients to take CTES and CTA examinations were randomly selected as the normal control group, and another 2085 outpatients and 793 inpatients who underwent the optimized procedures were randomly selected as the experimental group. The problems of time consumption and patients'satisfaction degree were analyzed. Results The major causes for time consumption in CTES and CTA examinations included taking wrong contrast medicine, forgetting to take contrast medicine, having no auxiliary examination results, waiting in the wrong line, and opening the cap of contrast medicine. The time spent for checkup for inpatients and outpatients in the control and experimental groups was (119.8±15.6) minutes and (31.5±8.6 ) minutes vs (55.2 ± 10.6) minutes and (8.4 ±2.1) minutes. The satisfaction degree of inpatients and outpatients in the control and experimental groups were 90.16%(1264/1402) and 88.66%(2064/2328) vs 98.49%(781/793) and 97.94%(2042/2085). The experimental group spent shorter time and had higher satisfaction degree than those in the control group, and the differences were statistical significantly, tinpatient=34.96, P<0.01, toutpatient=12.03, P<0.01;χ2inpatient=55.20, P<0.01,χ2outpatient=146.27, P<0.01. Conclusions After the procedures of CTES and CTA examinations are optimized, the checkup time is significantly shortened, and patients' satisfaction degree is remarkably improved.

MTT Colorimetric method is usually applied for measuring the living animal cell number. By changing the reaction temperature and the reaction time as well as the colorimetric wavelength, the improved MTT colorimetric method was established to count the living bacterial cell number. This new method was used to measure the living cell concentration in the process for culturing bacteria PBW1. The results measured by the improved MIT colorimetric method and dilute plate method are similar. Compared with other methods including the dilute plate method, the improved MTT colorimetric method has many advantages such as accuracy, quickness.

Objective:To explore the influence of low-iodine diet on the expression of homeobox gene NKX-2.2 in rat cerebrum tissue,and to explain the possible molecular mechanism of cerebrum development retardation caused by low-iodine.Methods:Female Wistar rats were randomly divided into two groups:Low-iodine group and control group,both fed with low-iodine feed,given the deionized water and KIO3 solution respectively,they were drawn from the 16-day pregnancy,new-born and 20th days old low-iodine and normal age offspring after three months,and detect the content of NKX-2.2 mRNA in the cerebrum tissue by Real-time fluorescence quantitative PCR techniques.Results:The thyroid hormone levels of low-iodine group in serum were significantly lower than the control group(P

Objective To summarize the management of scrotal gangrene.Methods Totally,14 male patients (mean age,48 years;age range,27-74 years) with scrotal gangrene were treated from August 2003 to June 2005.Among these patients,scrotal gangrene was complicated by perianal and penile gangrene in 2 cases;by perianal,penile and inguinal gangrene in 10 cases;by perianal,penile,inguinal gangrene and abdominal subcutaneous gangrene in 2 cases.Three cases had concomitantly necrosis of the penis;and 5 ca- ses,orchitis.Bacterial cultures were performed in all 14 cases with the positive results.All patients underwent surgical treatment,including PhaseⅠincisions,aggressive debridement,drainage,irrigation,and scrotoplas- ty.After operation they received antibiotic therapy and supporting treatment.Three cases of penile necrosis underwent complete penis amputation and transplanting the urethra before the anus.Five cases of orchitis un- derwent unilateral orchiectomy.Two cases of abdominal gangrene underwent surgical subcutaneous treatment, including incision,aggressive debridement,drainage,and irrigation.Results Twelve cases undergoing scrotoplasty achieved PhaseⅠhealing.Two cases undergoing urethral fistulation recovered well.Ten cases of penile skin gangrene received penile dermatoplasty 1 month later,and then recovered.Two cases who had al- ready had AIDS died 2 or 3 d after operation.Conclusions The management of scrotal gangrene primarily consists of early and aggressive debridement,antibiotic therapy and supporting treatment.The PhaseⅠde- bridement and scrotoplasty as well as drainage are effective for the treatment of scrotal gangrene.

Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P

The traditional Chinese medicine (Tripterygium wilfordiiHook.f.,TWH) has been clinically used to treat primary and secondary renal diseases and proteinuria for nearly 40 years.However,there is a rare literature about the effect of triptolide (the main active ingredient of TWH) on the expression of oxidative carbonyl protein (OCP) in diabetic nephropathy (DN).This study aimed to provide experimental evidence for triptolide treatment on DN through its effect on the expression of OCP,in order to investigate the effects of triptolide on the expression of OCP in rats with DN.Sixty SD rats were randomly divided into five groups:control group,high-dose triptolide (Th) group,low-dose triptolide (T1) group,DN model group,and positive control (benazepril) group.The DN model was established using streptozotocin.Urinary protein excretion,fasting blood glucose (FBG),superoxide dismutase (SOD) in renal homogenate,malondialdehyde (MDA) in renal homogenate and renal nitrotyrosine by immunohistochemistry,and the expression of OCP by oxyblotimmune blotting were detected.In the DN model group,rat urinary protein excretion and renal MDA were significantly increased,while renal SOD significantly decreased and nitrotyrosine expression was obviously upregulated in the kidney.After triptolide treatment,24-h urinary protein excretion (61.96±19.00 vs.18.32±4.78 mg/day,P＜0.001),renal MDA (8.09±0.79 vs.5.45±0.68 nmol/L,P＜0.001),and nitrotyrosine expression were decreased.Furthermore,renal OCP significantly decreased,while renal SOD (82.50±19.10 vs.124.00±20.52 U/L,P＜0.001) was elevated.This study revealed that triptolide can down-regulate the expression of OCP in the renal cortex of DN rats.