[Objective]To evaluate the application value of minimally invasive release operation about congenital vertical talus(CVT).[Method]All operation were operated with single method by author.Firstly,Achilles tendon,capsulotomy of the ankle and subtalar joint were released through a small straight posterior inside of Achilles tendon end point.Secondly,astragaloscaphoid and subtalar front joint were released bluntly through a straight posterior incision.Thirdly,based on circs subtalar joint were released through calcaneocuboid articulation outside foot.Then one K-wire were passed through the body of talus from its axis,and passed through instep after reposition of astragaloscaphoid joint.Two K-wires was passed through calcaneus to talus from planta.[Result]Eight cases were available for follow-up from 17 to 36 months(mean,28 months),follow-up results was evaluated by using a version of Adelaar and Kodros score,there were excellent result in 1 foot,good in 5,fair in 2.The presence of hindfoot valgus and forefoot abduce were noted in one foot,forefoot pronation was appeared in one foot.Two parameters-talar and calcaneus axis-first metalarsal base angles,calcaneus talus angles of eutopic and lateral radiograph were basally normal.[Conclusion]Operative reduction has been advocated as the only effective treatment for CVT,it is the best choice to use minimally invasive release operation for infant.

[Objective]To analyze reason of congenital infantile coxa vara to be misdiagnosed as infantile dislocation of hip joint.[Method]There were 6 patients(6 hip join)congenital infantile coxa vara being misdiagnosed as infantile dislocation of hip join in 54 patients(73 hip join)and treated by expectant treatment as infantile dislocation of hip join.The curative effect of 6 patients were not good,after serious medical examination,careful reading image data,paying attention to curative effect,6 patients were confirmed to be diagnosed as infantile dislocation of hip join and not infantile dislocation of hip join.[Result]The features for diagaosis of congenital infantile coxa vara were:the big greater trochanter of femur and its position moving up,short spacious neck of femur,spacious medial blank in hip joint,superposed neck of femur and lesser trochanter of femur,praeter propter exponent of acetabulum,acceptable succession of Shenton’s line,enlarged angle of femoral head epiphysis,late center of ossification,incorporated abnormity such as breves femoral bone,bowing of femoral bone,abortive clavicle and bones of cranium,equines.[Conclusion]The second center of ossification of femoral head is appeared 6～9 monthes after birth,and it is difficult to discriminate congenital infantile coxa vara and infantile dislocation of hip join before this.Early to realize symptom,physical sign and character of image of congenital infantile coxa vara is significant for correct diagnosis and can avoid misdiagnosis and mistreatment.

Objective:To investigate the localization and identification value of high frequency ultrasound in displaying connection nerves of SNT, and to improve the accuracy of ultrasound diagnosis.Methods: Retrospective analysis the results of high frequency ultrasound to 49 cases proved by pathology annually patients (54 tumors, 54 connection nerves), and compared with the results of pathological diagnosis, evaluating the accuracy of high frequency ultrasound in displaying connection nerves. Results: The longitudinal section appearance of tumor connection nerve showed hypoechoic band and parallel fine belt-like structure surrounded by hyperechoic lines, it was enlarged gradually and became triangular close to the tumor. To the distribution of sex, age and course of the disease, the rates of high frequency ultrasound in displaying connection nerves were no significant difference (x2=0.083,x2=0.454,x2=1.277;P>0.05). The rate of high frequency ultrasound in displaying connection nerves of SNT was 94.4%, compared with the results of pathological diagnosis, the distribution ratio and the rate of high frequency ultrasound in displaying connection nerves showed no significant difference(x2=0.015,P>0.05).Conclusion: When using high frequency ultrasound observed connection nerves of SNT, there were obvious image characteristics, and the rate of high frequency ultrasound in displaying connection nerves of SNT was high, it would be a better value to diagnostic SNT.

BACKGROUND:For treatment of central nervous system diseases, neural stem cel s (NSCs) or bone marrow stromal stem cel s (BMSCs) can be transplanted into the brain, but there are less reports to compare the effects of two kinds of stem cel transplantation. OBJECTIVE:To explore the effect of midbrain NSCs and BMSCs on the behavior and brain morphology of rats with Parkinson’s disease. METHODS:Fifty-eight Sprague-Dawley rats were enrol ed to establish Parkinson’s disease models, and then randomly divided into three groups, which were treated with 5μL midbrain NSCs (n=20), 5μL BMSCs (n=20) and 5μL normal saline (n=18) via two coordinate points of the right striatum at 3 weeks after modeling, respectively. At 5 months after transplantation, the rats underwent intraperitoneal injection of apomorphine to observe behavioral changes, and then, the striatum was taken for immunohistochemistry staining. RESULTS AND CONCLUSION:The number of rotations was reduced significantly in the BMSCs and midbrain NSCs groups at 5 months after transplantation (P<0.05), which was significantly lower than that in the normal saline group (P<0.05). However, there was no significant difference between the BMSCs and NSCs groups (P>0.05). In the BMSCs group, BrdU/Nestin positive cel s were seen in the brain stratium at 1 week after transplantation;BrdU/GFAP and BrdU/NSE positive cel s as wel as TH positive cel s rather than BrdU/TH positive cel s were found in the brain stratium at 1 month after transplantation;after that, the number of BrdU/Nestin positive cel s was reduced gradual y and disappeared ultimately, but there were stil a certain number of BrdU/GFAP and BrdU/NSE positive cel s, especial y the former ones. Meanwhile, the NSCs group also had a similar situation, but no double-labeled cel s were in the normal saline group. These findings indicate that midbrain NSCs and BMSCs transplantation can both improve the behavior of Parkinson’s disease rats, and differentiate into neurons, astrocytes and dopaminergic neurons.

Objective To explore the clinical efficacy of low-dose cytarabine and harringtonine (LD-HA) regimen in the induction therapy of acute myeloid leukemia (AML) except M3. Methods 52 AML patients who received LD-HA were analyzed retrospectively. The patients were graded according to molecular biological and cytogenetic risk degree. The clinical efficacy, toxicity of LD-HA and long-term survival followed-up were compared with those of idarubicin and cytarabine (IA) regimen in 49 patients. Results After one cycle, the overall remission (OR) rates of LD-HA group and IA group were 71.2%(37/52) [CR rate 50.0%(26/52), PR rate 21.2%(11/52)] and 53.1%(26/49) [CR rate 44.9%(22/49), PR rate 8.2%(4/49)], respectively, with no statistical significance of OR between the two groups (P= 0.068). OR rates were not statistically significant in either low-risk group or intermediate-risk group between LD-HA group and IA group (P> 0.05), but OR of high-risk group in LD-HA was much higher than that in IA group [100 % (11/11) vs 66.7 % (12/18), P<0.05]. Cardiac toxicity and bone marrow suppression in LD-HA group were much milder than those in IA group. The patients unfit for standard chemotherapy could tolerate to LD-HA regimen. Conclusions LD-HA regimen as induction for high risk AML patients can improve the OR rate, and reduce the side effects, which is beneficial for high-risk AML patients.

[Objective] To investigate the diagnosis and treatment of congenital oblique talus in clinical practice.[Methods]Clinical situation of thirty-one patients displayed tarsoptosis and pas valgus,collapse in medial longitudinal instep,and with no talipes calcaneus,no contraction of tendon and no rigidity.All instep of the patients were restored to normal by chirismus.The X-ray of normotopia showed that axial ray of talus was declivent to wall and was angulated with No.1 metatarsal bones.The X-ray of lateral position showed that semiluxation of articulatio talonavicularis was noted,and axial ray of talus and No.1 metatarsal bones was not normal.The X-ray of lateral position of maximal plant flex and entropion showed that axial ray of talus and No.1 metatarsal bones was normal.Twenty-seven cases were cured by manipulation,4 cases were cured by operation,31 cases were cured by orthopaedic orthosis.[Results]All cases were curative during a follow-up of 12 to 24 months(mean,10 months).All outline forms of feet were good and no valgus calcaneus was found,the medial longitudinal instep were restored,the function of ankle and toes was normal,and the pedal force of enstrophe with ecstrophy was balance.The X-ray of normotopia showed that the angle of axial ray of talus to No.1 metatarsal bones was normal in 26 cases and ≤10? in 5 cases.Kite's angle was normal in 29 cases and ≤20? in 2 cases.The X-ray of lateral position showed that articulatio talonavicularis was good in 29 cases and ≤25? of talus to calcaneus in 6 cases.[Conclusion]Congenital oblique talus in infants can be cured by manipulation or operation.The prognosis is good.

Objective To study the effect of hypothemah on the early inflammatory reaction in acute lung injury induced by intestinal ischemia-repeffusion(IlR)in rabbits.Method Seventy-two healthy rabbits provided by Peking Union Medical Colege Hospital Anhnal center were randomly divided into four groups(n=18 pergroup):(1)normothermia control group (rectal temperature 37-38 C;sham group);(2)normothermia IlR group(rectal temperature 37-38 C);(3)mild hypothermia HR group(rectal temperature 32-35℃);and (4)moderate hypothermia IIR group(rectal temperature 28-31.9C).Acute lung injury was induced by claIllp.ithe superiornteric artery(SMA)for 1 hour and declamping the SMA for 6 hours.Hypothermia WaS induced by surface cooling.Before and 2.4 and 6 hours after IIR,the Olasmlevels o,IL-,IL-6 and IL10 were measured.All rabbits were killed 6 hours after IIR and water content in lung tissue Wttk'assessed.Iaght mieropic examination was performed tbr morphological assessment of the hmg.The data were analyzed by AN()VA.Statistical significance wag dned as a P of<0.05.Results In the IIR groups,the plasma levels ofTHE-a.IL-l,IL-6 and IL-10 and lung water were increased.There Was evidence of acute lung injury from morphologi-cal assessment of the lung.The acute lung injury induced by IIR was improved by hypethennia.Mild hypothermia Was similar to moderate hypothermia for the treatment of acute lung injury induced by IIR.ConclusiotMild hy-pothermia and moderate hypothermia Can significantly improve acute lung injury induced by IIR in rabbits.Mild hypothea had similar efficacy to moderate hypothermia for the treatment of acute lung injury induced by IIR.

Objective To evaluate the intervention effect of atorvastatin on the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease. Methods One hundred and eighteen patients who undertook intracavitary therapy (including Balloon dilation, Stent implantation and endarterectomy, Stent implantation and thrombectomy) in our hospital from January 2008 to January 2010 were divided into two groups randomly,60 cases into the control group,and 58 cases into the atorvastatin group whom were orally medicated with Atorvastatin 20 mg once daily. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower limb artery of two groups were observed and recorded before treatment and at 4 weeks, 12 weeks, 24 weeks after treatment. Results Success rates of intracavitary therapy were 98. 33% (59/60) and 100. 00% (58/58) in the control and atorvastatin group respectively. The patency rate decreased in different degree with time in both groups,which decreased more significantly in the control group but remained relatively stable in the atorvastatin group. By follow up we found that the patency rate in the control group was significantly lower than that of in the Atorvastatin group(77. 96% vs 94. 82% ,P ＜ 0. 01 )at 24 weeks. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower extremity artery of control group increased in different degrees, but with no statistical significance (P＞ 0. 05 ), while these indices began to decrease in atorvastatin group after 4 weeks of medication and were significantly lower than the control group ( P ＜ 0.01 ). Conclusions Atorvastatin has effect on preventing the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease.

Objective To study the diagnostic value of computer tomography(CT),magnetic resonance cholangiopancreatography (MRCP),ultrasonography combined with serum CA19-9 and CEA for periampullary carcinomas.Methods We analyd the imaging findings and laboratory testings of 87 patients with periampullary carcinomas which were confirmed by surgical or biopsy specimen of ERCP.Results ①CT or MRCP was better than US in diagnosing periampullary carcinomas.② There was significant differences in serum CEA between four categories of periampullary carcinomas (x2 =9.97,P ＜ 0.05),while the serum CA19-9 had no statistical difference.③CT,MRCP,US combined with serum CA19-9 and CEA improved the diagnostic accuracy of the periampullary carcinomas.Conclusion CT,MRCP,US combined with serum CA19-9 and CEA can improve the early diagnosis of periampullary carcinomas and help for clinical treatment plan.

BACKGROUNDS: At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios. METHODS: We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups. RESULTS: The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8%, [11/141] P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50). CONCLUSIONS Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
Administration, Intravaginal ; Catheters ; Dinoprostone/therapeutic use* ; Female ; Fetal Weight ; Humans ; Infant, Newborn ; Labor, Induced/methods* ; Nuchal Cord ; Oligohydramnios ; Oxytocics ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies