BACKGROUND:The effects of artificial joint replacement, osteotomy and reconstruction in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult are not very satisfied. OBJECTIVE:To evaluate the effect of artificial total hip arthroplasty and hip-self procedure in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult patients. METHODS:Twenty-three adult patients with Crown Ⅳ-type congenital dislocation of hip were treated with artificial total hip arthroplasty and hip-self procedure. There were 2 males and 21 females with an average age of (24.26±3.56) years ranging 20 to 35 years. The effect was evaluated according to the Harrris evaluation standard, and the statistical analysis was performed. RESULTS AND CONCLUSION:Al of the patients were fol owed-up for 12-60 months, averaged of (26.60±13.16) months. Statistical comparison with the SPSS 19.0 system showed there was significant difference of the Harrris scores between preoperation and postoperation period (P<0.05). The artificial total hip arthroplasty and hip-self procedure can be used to reconstruct the normal function of hip joint, relieve pain and increase the joint stability, which is considered as the best method for the treatment of Crown Ⅳ-type congenital dislocation of hip in adult.

Objective To investigate the concentration of monocyte chemoattractant protein-1 (MCP-1) and interleukin-18 (IL-18) in the urinary of children with primary nephrotic syndrome(PNS) at different time points,and to explore their correlation with occurrence,development,progression,and prognosis of PNS.Methods A total of 65 pediatric cases from our hospital was enrolled in this study,and was divided into three groups based on the retrospective the follow-up results including steroid-sensitive NS (SSNS) (n =35),steroid-resistant NS (SRNS) (n =15),and frequent-relapse NS (FRNS) (n =15) groups.Another 20 healthy children served as normal controls.Peripheral blood samples and urine specimen were collected at three time points (without glucocorticoids,treatment after 8 weeks,and treatment after 16 weeks or recurrence).The levels of MCP-1 and IL-18 in the urine were assayed by enzyme-linked immunosorbent assay (ELISA).The levels of blood urea nitrogen,creatinine,and 24-hour urinary protein excretion were assayed by full-automatic biochemical study appliance.Results (1)In SSNS group,the levels of urinary IL-18 before treatment and treated for 8 weeks were higher than the normal control group [before treatment:(160.30 ±27.29) pg/ml; treated for 8 weeks:(157.62 ±26.85) pg/ml; normal control group:(70.88 ± 14.43) pg/ul].However,after treated for 16 weeks,the levels of urinary MCP-1 and IL-18 were markedly decreased compared with that of control group and those before treatment and treated for 8 weeks [treated for 16 weeks:(20.98 ±4.53) pg/ml,and (79.09 ±7.23) pg/ml,P ＜0.05].(2)In SRNS group,the levels of urinary MCP-1 and IL-18 before treatment were remarkably higher than that of control group and that of SSNS group before treatment[SSNS group before treatment:(76.84 ± 5.58) pg/ml,and (252.37 ± 25.34)pg/ml,P ＜0.05],but no significant difference was found when it was compared with that treated for 8 weeks [treated for 8 weeks:(72.32 ±4.30) pg/ml,and (243.70 ±35.43) pg/ml,P ＞0.05] ; However,its level was markedly decreased after treated with immunosuppressants of CTX for 16 weeks when it was compared with those before treatment and treated for 8 weeks[treated for 16 weeks:(34.03 ± 2.56) pg/ ml,and (114.42 ± 21.33)pg/ml,P ＜ 0.05].(3)In FRNS group,the levels of urinary MCP-1 and IL-18 were no remarkable difference between control and SSNS groups [before treatment:(30.43 ± 4.61) pg/ml,and (156.65 ± 34.39)pg/ml; treated for 8 weeks:(29.41 ± 4.76) pg/ml,and (152.21 ± 34.73) pg/ml,P ＞ 0.05],but its level was markedly lower than SRNS group (P ＜ 0.05).When it was recurred,the levels of urinary MCP-1 and IL-18 were significantly increased compared with before treatment and treated for 8 weeks[recurred:(72.92 ±3.01)pg/ml,and (224.33 ±26.07)pg/ml,P ＜0.05].(4)No correlation was found between the levels of MCP-1 and IL-18 and the levels of blood urea nitrogen and creatinine (P ＞0.05).Positive correlation was found between the levels of MCP-1 and IL-18 and the 24-hour urinary protein excretion (r =0.706,0.556,P ＜0.01).There's a correlation between urinary MCP-1 and IL-18 (r =0.811,P ＜ 0.01).Conclusions For children with PNS,the detection of urinary MCP-1 and IL-1 8 contributed to the early prediction of children'sensitivity on glucocorticoid.The elevated levels of urinary MCP-1 and IL-18 in combination with clinical symptoms and proteinuria can be used as an important noninvasive marker to monitor PNS recurrence.

Objective To comprehend the clinical characteristics and treatment of AIDS patients,and provide the basic information for prompt diagnosis of AIDS cases.Methods To analyze the clinical data of 15 AIDS patients identified by western blot test.Results 80\^0% of the AIDS patients acquired HIV through sexual contact,and the common clinical menifestations of them were loss of weight(80\^0%),fever(73\^3%),pneumonia(66\^7%)and diarrhea(26\^7%).The duration from emerging clinical symptoms to definitive diagnosis among them was long.The patients were more frequently accompanied by co infection with various pathogens.The efficacy of solely using anti bacterium therapy was usually poor,and all around treatment was effective(66\^7%).Conclusion Physicians should be alert of the occurrence of AIDS.Anti HIV antibody should be promptly tested for patients of repeating fever,chronic cough and long term diarrhea.The rapid and correct diagnosis and all around treatment are the key of ameliorating state of an illness.

Objective To investigate the change in heat shock protein 70(HSP7O) in the brain tissue of fetal and newborn rats after prenatal hypoxic adaptation and the possible mechanism of the protective effect. Methods Twenty-two 22d pregnant Wistar rats were randomly divided into two groups: GroupⅠ(hypoxic adaptation group) and group Ⅱ(control group). The animals in group Ⅰ were placed in a tightly closed hypoxic adaptation chamber, of which the oxygen and carbon dioxide concentrations were monitored. The pregnant rats were taken out and exposed to fresh air for 5 mm when the 02 % in the chamber was reduced to 15 %, then the pregnant rats were placed back in the chamber and the above process was repeated once. The animals were then left for their natural labor. In control group the pregnant rats underwent the same process but the chamber was not tightly closed(O2 %= 21 %). Prenatal rats were delivered by cesarean section at lb. 3h, 8h, 24h, 48h, 72h, 120h and 168h after hypoxic adaptation and decapitated and brain was removed. Seven newborn rats from each group were decapitated and brain was removed for determination of HSP70 expression with immunohistochimical technique. Results No HSP7O expression was observed in the brain tissue of normal prenatal and newborn rats. HSP70 was observed in the different regions of hippocampus and cortex from 8h to 168h after hypoxic adaptation. Strongest HSP70 expression was observed in hippocampus CAl . Conclusions HSP70 plays a role in the formation of prenatal hypoxic adaptation.

0 05) The maternal plasma CGRP level was significantly higher(P

Objective To examine whether the prenatal hypoxia adaptation has any protective effect on the brain of the newborn rat Methods 12 22 day pregnant Wistar rats were randomly divided into 2 groups: the control group and the treated group In the treated group the pregnant rats were placed in a tightly closed hypoxia adaptation chamber When the O 2% in the chamber dropped to 15%, the rat was taken out to breathe fresh air for 5 min then put back in the chamber This process was repeated until its natural delivery In control the chamber was not tightly closed (O 2%=21%) 40 newborn rats weighing 6 8g were selected and subjected to brain ischemia and hypoxia, Left common carotid artrey was ligated under ether anesthesia 2h after recovery from surgery the newborn rats were placed in hypoxia chamber (T=36℃?1℃,O 2%=9%)for 1 5h 24h later they were sacrificed and brain was removed for microscopic examination (optical and electron) and flow cytometry measurement Results In the treated group most newborns were normal There were a few apoptosis cells in early stage The rate of apoptosis was 2 9%, necrosis cells could hardly be seen In the control group, although most neurons were also normal but there were apoptosis cells in early, middle and late stage and even necrosis cells The rate of apoptosis was 9 51%, which was significantly different from that in the treated group Conclusions Prenatal hypoxia adaptation has protective effect on the brain of newborn rat

ve To determine the most approprite hypoxic concentration and duration for prenatal hypoxic adaptation animal experiment by exposing pregnant rats to the hypoxic air of different oxygen concentration.Methods Full-term pregnant rats( gestation time 22 days) were placed in an airtight cabin specially designed for hypoxic adaptation experiment. The rats were divided into 7 groups. The Q2 concentration in the airtight cabin was decreased from 21% (group Ⅰ as control) to 18% (group Ⅱ), 17% (group Ⅲ), 16% (group Ⅳ), 15% (group Ⅴ), 14% (group Ⅵ) and 13% (group Ⅶ) respectively. The animals were exposed to short duration of hypoxic air twice with a break of 5min breathing fresh air. The duration of the first hypoxic episode lasted 10 min (group Ⅰ ) , 5 min (group Ⅱ), 7.5min (group Ⅲ), 9.83 min (group Ⅳ), 11.5 min (group Ⅴ), 13.17 min (group Ⅵ) and 14 min (group Ⅶ) respectively. The second hypoxic episode lasted 10min, 9.33 min, 11 min, 15.17 min, 13.33 min, 17 min and 18 min respectively. Ten newborn rats (1 day after birth) randomly selected from each group were placed in a 100ml airtight bottle and the duration from the start to the time when the newborn rat stopped breathing was recorded as hypoxia surviving time. Another 10 newborn rats randomly selected from each group were decapitated and brain was removed for light and electron microscopic examination to determine the degree of neuronal damages. Results In group Ⅰ-Ⅴ the newborn rats were normal (pink skin color and good extremity movement) . In group VI 10/55 (18%) newborn rats were cyanotic with diminished extremity movement, the others were normal. In group VIII 11/52(21% ) newborn rats died, 14/ 52(27%) were cyanotic with diminished extremity movement. Neuronal damages could be seen in cyanoticnewborn rats including decreased number, swelling, apoptosis of neurons and expanded mitochondria. The hypoxia surviving time was significantly longer in group Ⅳ, Ⅴ and Ⅵ than that in control group. Conclusions Hypoxic air containing 15% O2 is appropriate for animal experiment of prenatal hypoxic adaptation. It is better to divide prenatal hypoxia into two episodes lasting 11.5 min and 13.33 min with a break of 5 min between them when animals breathe fresh air.

Objective To investigate the mechanism involved in the brain protection afforded by prenatal hypoxic adaptation by determining the quantitative variation in bcl-2 and bax mRNA expression.Methods Twenty-four Wistar pregnant (22d pregnant) rat were randomly divided into two groups: group I (hypoxia group) and group *** ( control group) . In group Ⅰ the pregnant rats were placed in an airtight cabin specially designed for hypoxic adaptation. When O2 % in the cabin decreased to 15%, the animals were taken out breathing fresh air for 5min and then placed back in the cabin and underwent another episode of hypoxia. In group Ⅱ the animals were placed in the cabin which was not tightly closed and underwent no hypoxia. 7 fetal or newborn rats were taken at 1st, 3rd, 24th, 48th, 72nd, 120th, and 168th h after prenatal hypoxic adaptation from each group and their brains removed for determination of bcl-2 mRNA and bax mRNA. Results In control group the expression of bcl-2 and bax were observed in the brain tissue of normal fetal or newborn rats from the 22nd day in the uterus to the 7th day postpartum during which there were no significant changes in bcl-2 gene expression while bax gene expression gradually decreased with time ( the decrease was of no statistical significance) . In hypoxia group bax gene expression decreased at 8th h after hypoxic adaptation and reached the bottom at 24th h which persisted until 120th h; while bcl-2 gene expression started increasing at 24th h after hypoxic adaptation and persisted until 72nd h. The bcl-2/bax ratio also started increasing at 8th h after hypoxic adaptation and peaked at 24th h and persisted until 72nd h. Conclusions In the brain tissue of fetal and newborn rats which have undergone prenatal hypoxic adaptation, bcl-2 gene expression is elevated, bax gene expression decreases and bcl-2/bax ratio increases. These changes are time -dependent.

Objective To investigate the effect of propofol on the expression of c-fos protein and c-fos mRNA in hippocampus during global cerebral ischemia-reperfusion in rats. Methods Forty male Wistar rats weighing 250-320 g were randomly allocated to one of five groups: group A received sham operation ( n = 8); group B received ischemia-reperfusion (I-R n = 8); group C received intraperitoneal propofol 50 mg?kg-1(C1 n = 8) or 100 mg@kg-1(C2 n = 8) or 150 mg2kg-1(C3 n = 8) 10 min before I-R. The animals were anesthetized with intraperitoneal pentobarbital 40 mg?kg-1.Vertebral arteries were surgically exposed and permanently occluded by coagulation. Bilateral common carotid arteries were exposed. 4-0 silk suture was placed around the arteries. Global cerebral ischemia was induced by lighting the suture for 10 min which was then loosened for reperfusion. At the end of 60 min reperfusion the animals were decapitated on ice and brain was immediately removed. Different brain tissues were either kept in liquid nitrogen ( - 80℃) or fixed in 10% formalin. The changes in c-fos protein in brain was evaluated by immuno-histochemical methods and c-fos mRNA expression in hippocampus was detected using semiquantitative RT-PCR technique.Results The c-fos expression was minimal in sham operation group. I-R induced significant increase in the expression of c-fos protein and c-fos mRNA and propofol significantly inhibited the increase in c-fos expression induced by I-R. The levels of c-fos expression were higher in group C1 than that in group C2 (P 0.05) . Conclusion The study shows that propofol can significantly inhibit expression of c-fos protein and c-fos mRNA induced by global cerebral I-R.

Objective: This study was to observe the changes of IL-6 gene expression in acute repetitive hypoxia. Method: When the ratio of living cells was more than 95%, nerve cells cultured were passed through with mixed gases of 95% N_2+5%CO_2 for 3 min followed by another gases mixture of 95% O2+5% CO_2 for 10 min. After repeated the experiment as above, the alteration in the expression of IL-6 gene was measured using the RT-PCR method. The prod ucts of PCR were analyzed with computer Gel imaging and image analysis instrument. Result: After the first hypoxia IL-6 gene expression enhanced, and after the second hypoxia, it was still stronger than baseline although it declined slightly. There was no significant RNA disintegration. Conclusion:The IL-6 involves in the cellular defense in hypoxia adaptation.