[Objective]To analyze the causes of perioperative periprothetic fracture with hip arthroplasty and discuss the prevention and treatment of the fracture.[Method]18 of 640 THR cases occurred femoral fracture from July 1995 to August 2006,11 with intraoperative fracture and 7 with postoperative fracture,12 were and 6 female,the mean age 68 years(range:51 to 79 years).According to AAOS'standard,18 cases were divided into 6 types:1 of I type,6 of II type,4 of III type,4 of IVa type,2 of IVb type,1 of V type and 2 of VI type.10 of 11 cases of intraoprative fracture were operated immediately with internal fixation,and one of II type was treated with conservative method.4 of 7 cases of postoperative fracture were operated with open reduction and internal fixation in two weeks,2 cases with loosen stem were operated by revision hip,and one of V type was treated with conservative method because of other disease.[Result]The mean followed up perioid were 15.2 months(rang:6 to 42 months),15 fractures united,2 delayed united and 1 dead after 8 months postoperatively.The average scores were 80 according to Harris'standard(range:67 to 92).[Conclusion]Violence、abnormal of femur cannal、osteoprosis and bigger prothesis are the main causes of intraoperatively peri-prothetic femur fracture after THA,and loosening、 osteoperosis and outside injury are the main causes of postoperatively periprothetic femoral fracture,different treatment should be used according to the different types.

[Objective]To study the reason of loosening prothesis by observing the interface membranes harvested during the hip revision operation.[Method]Thirty eight specimens of interface membranes around the loosening prothesis were harvested from thirty eight patients who underwent the revision of total hip replacement.All the specimens were underwent outer observation,light and scanning electronic microscopic observation.[Result]All the gap of the loosening prothesis were filled with interface membranes with different thickness.A large number of the foreign pelletand bone pieces were found under scanning electronic microscope.[Conclusion]Interface membranes growed and filled in the gap between the loosening prothesis and bone(or bone cement).The wear debris stimulated the interface membrane to release bone resorption factors which caused the prothesis loosening,and the more loosening,the more large gap appeared,and the more resorption factors released from the interface membranes due to the debris stimulating,which formed vicious circle.Cutting the link of the circle could decrease the loosening rates.

0.05),but the integrated arthoplasty group had significant differences from the other two groups(P

It is an essential educational goal to strength experimental teaching and improving the practical skill of medical postgraduate students in medical colleges and universities.We made anexploration and practice on how to improve the practical skill and innovative ability of postgraduate students in medical immunology experimental teaching.The article points out that optimizing the design of experimental course,innovating the teaching methods,standard appraised of experiment and improving the quality of teacher are the efficient ways to enhance the practical skill of postgraduate students.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.

Immunology teaching course includes both basic immunology and clinical im-munology.This paper points out the problems of teaching and knowledge integration between the basic immunology and clinical immunology and suggests that teaching team should include the basic immunology and clinical immunology related content clinical experts to promote teaching quality.

Objective: To study the expression of PDCD5 mRNA and its significance in esophageal cancer in Xinjiang Kazakh and Han nationality. Methods: RT-PCR was used to detect the mRNA of PDCD5 in 40 cases of esophageal cancer (18 cases of Kazakh, 22 cases of Han). Results: The positive rate of PDCD5 mRNA expression in 40 samples of esopha-geal cancer tissue, adjacent tissue, and normal tissue was 80.0% (32/40), 80.0% (32/40) and 87.5% (35/40), respectively, with no significant difference (P>0.05). The Ods of cancer tissues, adjacent tissues, and normal tissues were 0.7644± 0.1444, 0.9341 ±0.1631 and 1.8703±0.4767, respectively. The expression of PDCD5 was significantly increased in cancer tissues compared with that in normal tissues (P<0.05). The expression level of PDCD5 mRNA was not significantly correlat-ed with the degree of differentiation and lymph node metastasis. Conclusion: No significant difference was found in PDCD5 mRNA expression in esophageal cancer between Xinjiang kazakh and Han nationality (P>0.05). The expression of PDCD5 is not correlated with the degree of differentiation, depth of invasion or lymph node metastasis. Detection of PDCD5 mRNA expression in esophageal cancer tissues may provide valuable information for patient prognosis.

ObjectiveTo explore the expression of MRP1 and CD34 in colorectal carcinoma tissue and the relationship with clinicopathological factors.MethodsImmunohistochemical streptavidin-perosidase method was used to examine the expression of MRP1 and CD34 in 53 cases with colorectal carcinoma and normal colorectal tissue.The correlation between the levels of MRP1and CD34 expression and clinicopathological factors were analyzed.ResultsThe positive expression rates of MRP1 in the carcinoma group and normal colorectal tissue group were 49.1％ and 15.1％ respectively,and there was a significant difference of the positive expression between the two groups( x2 =14.029,P ＜ 0.01 ).The expression of MRP1 had no correlation with the degree of differentiation,the depth of invasion,the metastasis of lymph node and all the other clinicopathological factors ( P ＞ 0.05 ).CD34 value in the carcinoma group and normal colorectal tissue group were ( 35.63 ± 12.23 ) MVD/HP and ( 6.12 ± 0.97) MVD/HP,respectively,and there was a significant difference between the two groups (t =17.565,P ＜ 0.01 ).CD34 was not correlated with age,sex,tumor size,localization of the primary tumor ( P ＞ 0.05 ),but correlated with Dukes staging,lymph node metastasis,differentiation of the tumor,depth of invasion( all P ＜ 0.05).ConclusionThe overexpression of MRP1 and CD34 protein may involve in colorectal carcinogenesis;MRP1 may involve in the primary multidrug resistance in colorectal carcinoma.; CD34 may involve in the colorectal carcinoma invasion and metastasis.Investigating the expression of MRP1 and CD34 in colorectal carcinoma simultaneously can provide new referential indexes for the treatment and prognosis of colorectal carcinoma.

Objective Objectives: To introduce the technique of performing minimally invasive concomitant Cox Maze Ⅳ ablation procedure entirely by bipolar clamp through right lateral minithoracotomy for patients with atrial fibrillation(AF) associated with mitral valve diseases.Methods Sixty nine patients with mitral valve disease and long-standing persistent AF received minimally invasive Cox Maze Ⅳ ablation procedure combined with mitral valve surgery from June 2012 to January 2015.The etiology of mitral valve disease was rheumatic(41 cases) and degenerative(28 cases).Age at operation ranged from 52 to 71 years.There were 43 males and 26 females.AF duration ranged from 1.5 years to 13 years.Diameter of the left atrium ranged from 42 to 60 mm.Diameter of the left ventricle ranged from 43 to 66 mm.Left ventricle ejection fraction (LVEF) ranged from 0.45 to 0.67.Concomitant Maze Ⅳ ablation procedure was performed through right lateral minithoracotomy entirely by bipolar radiofrequency clamp.Results All patients successfully underwent this minimally invasive concomitant Maze Ⅳ ablation procedure and mitral valve surgery.The mean cardiopulmonary bypass time was(130.3 ± 17.7) minutes.The mean aortic crossclamp time was(91.8 ± 12.7) minutes.No patient needed conversion to sternotomy during the surgery.There was no early death or pacemaker implantation in the perioperation.The average length of hospital stay was(9.8 ± 3.3) days.At discharge, 65 patients(65/69, 94.2％) maintained sinus rhythm.At a mean follow-up time of(21.0 ± 8.6) months, sinus rhythm was restored in 62 patients(62/69, 89.9％).Cumulative maintenance of normal sinus rhythm without AF recurrence at 2 years postoperatively was(85.1 ± 5.8)％.Conclusion The minimally invasive concomitant Maze Ⅳ ablation procedure performed entirely by bipolar clamp through right lateral minithoracotomy was a safe, feasible, and effective technique for patients with AF associated with mitral valve diseases.