Severe clubfoot has complicated clinical features.Conventional surgical management could hardly get satisfactory results,always with serious trauma,and even smaller foot.This paper summarizes the characteristics of clubfoot in details and its relative assessment standard,principles and advantages of Ilizarov's technique,design of the apparatus and correction procedures.Combination of this and traditional technique and reasonable osteotomy method are also analyzed,complications are discussed for prevention.

Four diterpenoid alkaloids were isolated from Aeonitum longtounens T. L. Ming grown in Lijiang of Yunnan Province, for the first time. They were identified as foresaconitine, chasmaconitine, delsoline and delcosine by Physical contants and spectral data.

The present paper reports the distribution of ALADH phenotypes in 170 Chinese peoples living in Nanjing area by means of the mixed starch get electrophoresis. The gene frequencies are ALADH~1=0. 359, ALADH~2=0.641, which are compared with the gene frequencies of some other countries.

Objective To define the risk period of acute pancreafifis-associated lung injury (APALI) by aserial study including a dynamic changes in total water content of lung, ultrastructure and number of type Ⅱ alveo-lar epithelial, and reactive oxygen metabolisms (ROMs) of lung tissue in mice with severe acute pancreatits (SAP)and a clinical analysis of APALI patients. Method ICR mice were selected to establish SAP model. The animalsreceived 7 intraperitoneal injections of caerulein (50 μg/kg body weight) at hourly intervals followed by intraperi-toueal injection of lipopolysaccharide (15 mg/kg body weight). The total water content, uhrastrueture and numberof type Ⅱ alveolar epithelial cells, and ROMs of lung tissue were detected before (0 h) and 6 hours, 12 hours,lday, 4 days and 7 days after SAP model establishment, respectively. In addition, 215 patients with APALI (PaO2< 60 mmHg) collected from the First Affiliated Hospital of Zhejiaug University between January 1998 and Decem-ber 2006 were analyzed. Statistical analysis were performed by using F-test. P-values less than 0.05 were regardedas statistically significant. Results The total water content and ultrastructure mitochondria and lamellar bodies intype Ⅱ alveolar epithelial cells of lung in SAP mice were significantly altered at 12 hours after SAP model estab-lishment, and reached maximum at 1 to 4 days later. A decrease in number of type Ⅱ alveolar epithelial cells andincrease in ROMs reached a maximum at 1 day after SAP model establishment. Furthermore, the results of clinicalstudy showed that the lung injury occurred at (3.1435±1.0199) days after SAP. The data were almost consistentwith the resalts from SAP model. Conclusions The risk period of APALI occurres between the 1st day and the4th day during the course of SAP.

[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.

[Objective]To explore the methods and effect of using Ilizarov'techniques for correcting severe flexion contracture of the knee joint.[Method]According to Ilizarov's tension-stress principle and its applying technique,the knee joint distraction apparatus was designed and fixed individually.The joint hinges of the apparatus on the two sides were consistent with the rotational center of the knee joint.Joint distraction of 5 to 10 mm was initially performed and followed by gradual correction of the knee joint flexion contracture at an average rate of 1 mm per day at the level of the knee joint by turning the nuts on the distraction rods at 3～4 rounds per day,with the distraction rate modified according to the patient's tolerance.Regular x-ray exams should be carried out to prevent knee joint dislocation and compression of the articular cartilage.The final requirement of correcting the soft tissue flexion deformity of the knee joint was to overcorrect the joint deformity into 5～10 degrees of hyperextension.As for the joint flexion with anterior bowing deformity of the distal femur,the degree of correcting the knee joint flexion contracture should deduce the degree of the bony deformity.The frame was left on for an additional 2 to 4 weeks.When the frame was removed,the knee joint was immediately casted in full extension for 3 to 4 weeks followed by the range of motion exercise on CPM to regain the knee motion and a long-leg brace was provided simultaneously to maintain the correction for 3 months.Secondary osteotomy was performed on anterior bowing deformity of the distal fermur in 8 patients.[Result]More than 30 degrees of severe flexion contracture of knee joint (mean?sd 58.50?21.28?) in 49 patients (52 knees ) were corrected to an average of 4.12?4.61 degrees after treatment.40 joints of 38 cases were followed for an average of 6.8 months,in which 28 joints maintain the postoperative effect.,while 12 joints had partial relapse of 9.30??8.24?.[Conclusion]Ilizarov's technique for correcting severe flexion contracture of the knee joint,can have satisfactory effect with little complications.It is mini-invasive,reliable and safe.

Objective To explore the application of the Ilizarov's principle on tension-stress in correction of adult severe talipes equinovarus. Methods From January 1996 to February 2003, 12 patients (13 feet) were corrected with this method, which involved 9 males and 3 females, whose average age was 26 years old (ranged from 20-36 years). The left foot was afflicted in 4 patients, and the right foot in 7, both side in 1. Among these patients, 3 were congenital, 6 were caused by the poliomyelitis, 1 by trauma, 1 by complication from encephalitic paralysis and 1 by radiotherapy for the cavernous hemangioma of the leg. The Ilizarov distraction apparatus of the ankle and foot joint were equipped in terms of the diseases preoperatively. During the operation, the release of the postero-medial soft tissue and the limited osteotomy of triple joints of the clubfoot were performed. According to the principles of Ilizarov, the wires were inserted and the fixator installed, the distraction devices of the ankle and foot joint which had corrective function in three-dimensional directions were applied to the tibia and foot, the telescopic rods on the apparatus were rotated one week after the operation. The deformity of talipes equinovarus, internal rotation and the drooping of the forefoot were gradually corrected, and the patients could bear weight and walked on the deformity foot during the course of distractive correction. Results All the 12 patients were available at follow-up with a mean duration of 15 months (ranged from 7 months to 4 years). There was no recurrence of the deformity and the feet function was good while walking on full weight-bearing. The mean duration of traction was 71 days. 10 patients (11 feet) could gain 0? in full weight-bearing, 2 patients preserved the drooping feet deformity at 15?-20? (because of shortness in the lower extremety). None of the complications occurred postoperatively, such as infection in the incision or pin tract, necrosis of the flap, neurovascular injury and nonunion. Conclusion Utilizing Ilizarov's principle on tension-stress to correct severe adult talipes equinovarus is a safe, minimally invasive and effective method.

In order to arouse the working enthusiasm of the entire staff and give expression to the value of labor and skills, our hospital has implemented reform in the distribution system. Bonus given to clinical departments is linked both to the amount and quality of work and to economic profits; bonus to medico technical departments is given by means of deducting a percentage from the income and expenditure surplus in a way of progressive decrease; bonus given to functional departments is equivalent to 90% of the average bonus given to medical service departments; and bonus to logistical service departments is given, if possible, by the piece and mark. As a result of the reform, the distribution system has become more rational, the working enthusiasm and efficiency of the staff have been enhanced, operational income and income structure have improved, and social benefits bave been raised, with the satisfaction rate reaching over 90%. Of course, there still exist some difficulties in the reform.

ObjectiveTo evaluate surgical management of femoral pseudoaneurysm caused by injection of addictive drugs.MethedsData of 18 cases were reviewed and analysed retrospectively.13 patients underwent primary expanded polytetrafluoroethylene(ePTFE) external iliofemoral bypass (end to side) grafting. Postoperative anastomotic burst and bleeding in one of the 3 patients undergoing saphenous vein autotransplant in situ was successfully treated by ePTFE grafting. Results All of the grafts were patent as demonstrated by postoperative color Dopler ultrasonography. Although 2 patients had their femoral arteries ligated, limbs of all the 18 patients were salvaged.ConclusionsWhen a suitable saphenous vein is not available for autotransplantation, an artificial vessel grafting is still an effective procedure for managing femoral artery false aneurysm.During operation thorough debridement and avoidance of artificial vessel contamination are the most important factors for preventing infective complications of the graft.

We retrospectively analyzed 218 allergen skin prick tests ( SPT ) of the patients with chronic sinusitis with or without nasal polyps( CRSwNP/CRSsNP) before the operation. The proportions of positive SPT in CRSwNP and CRSsNP were compared respectively. The distributions of allergens were the same in all groups. The positive rate of SPT in CRSwNP was higher than that in CRSsNP, with statistical significance(P<0. 05). The positive rate of SPT in CRSsNP was higher than that of the control group, without statistical significance. The recurrence rate in CRSwNP was higher than that in CRSsNP, with statistical significance. The recurrence rate in the allergen-positive patients was higher than the allergen-negative patients, with statistical significance.