[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 describe the imaging appearances of mesenteric cavernous hemolymphangioma.Methods The ultrasonography(USG) and CT findings of 5 patients with mesenteric cavernous hemolymphangioma confirmed by operation and pathology were analyzed retrospectively.Results The tumors were reticulate hypoechoic masses on USG,the insides of them were of abundant red or blue blood flows signal on colour Doppler flow imaging(CDFI).On CT,the masses appeared as heterogeneous density with irregular margins and multiple round-like iso-or low dense cystoid foci with asymmetric thickness walls around the lesions.Conclusion The application of CT combined with USG may improve the diagnostic accuracy of mesenteric cavernous hemolymphangioma.

BACKGROUND:At present, many researches have shown that tacrolimus has protecting effect on peripheral nerves,however,whether tacrolimus has a similar effect on central neural system has not been known yet.OBJECTIVE:To investigate the effect of tacrolimus on neural behaviors and memory by observing the neural behaviors and detecting the expression of synaptophysin in cortex,hippocampus and basipodite.DESIGN:Parallel and before and post contrast study.SETTING:Department of neurosurgery, affiliated hospital of the two medical universities.MATERIALS:The experiment was carried out in the Laboratory of Department Neurosurgery,Shanghai Changzheng Hospital in November 2002.Twenty-four qualified Sprague-Dawley rats supplied by Shanghai Experimental Animal Center of medical institution of Fudan University,with body mass of 180-220 g,were randomly divided into three groups:control, injury and treatment,with 8 rats in each group.INTERVENTIONS:Anesthesia was induced by administration of sodium pentobarbital(with the concentration of 20 g/L,40 mg/kg) twenty-four hours before the operation.The coup energy was 151.95-172.21 kPa that was equal to medium injury. The control rats did not receive the coup. Tacrolimus was given to the treatment group in the dosage of 1 mg/kg body weight by intraperitoneal injection at 5 minutes post trauma. The drug was given once physiological saline. Before and post trauma (on the third and seventh day)all rats Accepted Beam Walking Test,Beam Balance Test and Memory Test,respectively. One week after trauma,all rats' heads was removed and the brain was taken out within seconds.The hippocampus,cortex and basipodite of the traumatic hemisphere were kept in methanal with the concentration of 4 percent. Immunohistochemistry and image analysis system were used to study the expression of synaptophysin in cortex,hippocampus and basipodite of the traumatic hemisphere.MAIN OUTCOME MEASURES: ①The performance records of neural behaviors and memory of the three groups. ②Results of the expression of synaptophysin in cortex, hippocampus and basipodite of the three groups.③Apoptotic cellscalculation of synaptophysin in cortex,hippocampus and basipodite.RESULTS:Totally 24 rats entered the final analysis. ①On the third day and the seventh day,the scores recorded in Walking Test and Balance Test of the treatment group were less than those in the injury group[Walking Test: (7.5±2.5) s,(5.5±2.1) s,(10.5±2.5) s,(8.2±2.5) s. Balance Test:(3.4±0.5)score,(2.5±0.2) score,(5.7±0.2) score,(5.0±0.5) score,P ＜ 0.05-0.01].But the scores recorded in memory test of the treatment group were still more than those in the control group,memory test[(4.9±1.7) s,(6.2±2.3) s,(4.0±1.5) s,(4.4±2.6) s,P ＜ 0.05-0.01]. ②The expression of synaptophysin in cortex,hippocampus and basipodite in the treatment group was still more than that in the injury group(140.36±3.87, 45.52±2.16,31.67±2.35,96.25±2.85,24.35±2.47,20.49±2.08,P ＜ 0.01);The expression of synaptophysin control group was especially more than that in treatment group (162.24±3.52,50.58±2.31,42.69±2.53, P ＜ 0.01).Apoptotic cells calculation of cortex,hippoeampus and basipodite in treatment group was far less than those in injury group,(10.37±2.12)%,(18.39±2.87)%, (12.78±2.45)%,(21.14±4.85)%,(38.57±3.78)%, (21.18±4.59)%,P ＜ 0.01].And apoptotic cells calculation in injury group was more than those in control group [(3.85±2.56)%,(4.96±2.15)%, (3.52±2.17)%,P ＜ 0.01].CONCLUSION:Tacrolimus can facilitate the expression of synaptophysin,refrain from calcineurin involving in the process of transcription-dependent and nontranscription-dependent apoptosis,and can also contribute to the recovery of memory and neural behaviors post trauma.

To promote acupuncture practice, the general situation of acupuncture in treating leucopenia between 1949-2004 were analyzed on the basis of Chinese Modern Acupuncture Database. From 1981, references of acupuncture treating leucopenia increased annually and steadily.In clinic, hydroacupuncture, needling, and moxibustion are widely used, and the selected acupoints are those of Bladder Meridian of Foot Taiyang and Governor Vessel. Acupuncture-moxibustion have a good therapeutic effects on leucopenia.

Objective To analyze the risk factors of esophageal and gastric variceal bleeding (EGVB) in patients with cirrhosis.Methods A retrospective study was conducted in 638 hospitalized patients with cirrhosis from 2002 to 2009,who were divided into study group as having EGVB (n =286) and control group as not having EGVB (n =352).Differences between 2 groups were analyzed with univariate analysis and multivariate logistic regression.Results Child-pugh classification,serum albumin,prothrombin time,portal vein diameter and spleen thickness were significantly different between 2 groups (P ＜ 0.05).Univariate analysis showed that serum albumin(OR =0.944,P =0.000),prothrombin time (OR =1.067,P =0.007),portal vein diameter (OR =3.423,P =0.007) and spleen thickness (OR =1.276,P =0.007) were correlated with EGVB.Multivariate logistic regression analysis showed that serum albumin (OR =0.936,P =0.000),portal vein diameter (OR =4.098,P =0.013) and spleen thickness (OR =1.275,P =0.000) were independent risk factors for EGVB in patients with cirrhosis.Conclusion Low serum albumin level,increased portal vein diameter and spleen thickness are the risk factors for EGVB in patients with cirrhosis,which can be important predictors.To some extent,increasing serum albumin might reduce the risk of EGVB.

Objective To investigate the clinical effectiveness and safety of Chinese medicine fumigation-washing therapy in treating talipes equinus denervated ulcer induced by tethered cord syndrome(TCS) . Methods A total of 21 qualified patients were randomized into fumigation-washing group (N=12) and antibiotics group (N=9). Patients of fumigation-washing group were given fumigation-washing therapy with the self-prescribed Chinese medicine, and antibiotics group was given intravenous dripping of sensitive antibiotics. The treatment lasted for 7 continuous days. The clinical efficiency of the two groups was evaluated after treatment, and the period of preparing for surgery was recorded. The changes of ulcer area and ulcer surface exudate volume in the two groups were observed before and after treatment. And the changes in blood routine examination, hepatic and renal function, and immune function of the fumigation-washing group were monitored. Results(1) The total effective rate of fumigation-washing group was 83.3％, and that of the antibiotics group was 77.8％, the difference being insignificant (P>0.05). (2) The ulcer area and ulcer surface exudate volume in both groups were significantly decreased after treatment (P<0.05 compared with those before treatment), and the decrease in the fumigation-washing group was superior to that of the antibiotics group(P < 0.05).(3) The period of preparing for surgery in the fumigation-washing group was(7.75 ± 1.71)d, shorter than(11.56 ± 4.39) d in the antibiotics group, the difference being significant(P < 0.05).(4) There were no statistically significant differences in the hepatic and renal function, and immunoglobulin and complement levels in the fumigation-washing group before and after treatment (P > 0.05). (5) The average daily hospitalization fee in the fumigation-washing group was (47.98 ± 5.17) yuan, less than (227.88 ± 43.24) yuan in the antibiotics group, and the difference was significant between the two groups (P < 0.05). Conclusion Chinese medicine fumigation-washing therapy is effective, safe and practical in treating talipes equinus denervated ulcer induced by TCS, and the therapy has the advantages of decreasing exudation, promoting ulcer healing, reducing hospitalization fee, shortening the period of preparing for surgery, and decreasing the incidence of infection.

Objective To evaluate the quality of pooled platelets leukocytes reduced after filtering out leukocytes using two man-ufacturers of leucocyte filters for pooled platelets and improving the preparation method.Methods Pooled platelets was prepared from 400 mL fresh whole blood by buffy coats(BC)method,after 1 6 h,(22±2)℃ holding period,pooled six bags of ABO-matched buffy coats.and then filtered with two manufacturers of leucocyte filter,divided into the control group and the experimental group. Before and after filtering,the numbers of platelet and leukocyte,pH,hypotonic shock response(HSR),platelet aggregation and CD62p expression were detected.Results Before filtering leukocytes,the platelet quality of two groups achieved the requirements of Chinese standards.The numbers of platelet and leukocyte,pH,CD62p expression(%)and platelet aggregation showed no signifi-cant difference between two groups(P >0.05).However,After filtering,the pH,platelet aggregation and the platelet recovery,the experimental group and the control group,were (6.53±0.60)vs(7.00±0.06)、(5.5±3.8)% vs (77.4±14.7)%,(86.8±4.3)%vs (90.6±2.7)%,showed significant differences (P <0.05);but the residual leukocytes,HSR and CD62p expression respectively were (3.00±4.00)×10 6/ bag vs (2.00±3.00)×10 6/ bag,(2.40±0.90)% vs (2.00±0.80)%,(7.30±5.90)% vs (5.60 ±3. 70)%,there were no significant differences(P >0.05).Conclusion The quality of pooled platelets leukocytes is reduced,after filte-ring out leukocytes with two manufacturers of leucocyte filters and improving the preparation method,achieves the requirements of Chinese standards.However,the leukocyte filters of experimental group might have influence on platelet aggregation and pH.

ObjectiveTo assess the balance between regulatory T (Treg) cells and T helper 17 (Th17) cells in patients with serofast syphilis.MethodsBlood samples were collected from 26 patients with serofast syphilis and 23 normal human controls.Flow cytometry was performed to determine the proportion of Treg and Th17 cells in peripheral blood and to quantify the expression of specific transcription factors Foxp3 and ROR-γt in CD4+ T cells of these subjects.Correlation analysis was carried out.ResultsThe proportion of Treg cells in CD4+ T cells in the patients with serofast syphilis was 33.28％ ± 11.84％,significantly higher than that in the normal controls(22.13％ ± 7.79％,P ＜ 0.01 ),while the proportion of Th17 cells was significantly lower in the patients than in the normal controls(3.17％ ± 2.32％ vs.8.87％ ± 2.00％,P ＜ 0.01 ).Enhanced expression of Foxp3 and attenuated expression of ROR-γt were observed in CD4+ T cells from the patients compared with the controls(2994.86 ± 1099.18 vs.2539.72 ± 1086.96,P ＜ 0.05; 1473.12 ± 752.20 vs.1778.34 ± 388.13,P ＜0.05).There was a negative correlation between the expression of Foxp3 and ROR-γt in CD4+ T cells from all the subjects (r =-0.481,P ＜ 0.01 ).ConclusionThe Treg/Th17 cell balance is abnormal in peripheral blood of patients with serofast syphilis.

Objective To investigate the relationship between the 6-Keto-PGF1α,TXB2 and the endotheliosis and thrombosis of the new endomembrance on the prostheses seeded by CD34 stem cells.Method Twelve dogs were evenly divided into two groups; ePTFE prostheses and weaved Dacron prostheses implanted into the abdominal aorta(AA) and inferior vena cava (IVC).in each group, 4 dogs were implanted by prostheses seeded by CD34+ stem cells, 2 dogs were implanted prostheses treated by autogenous blood only as control.The peripheral blood was collected in preoperative and 3 ,7,14,30,60 days postoperation.light and electron microscopy were applied to observe the endotheliosis and thrombosis of the new endomembrance when harvesting all the prostheses in the 60 days.Result The platelet, 6-Keto-PG F1α,TXB2 and P/T in experimental group was significantly different compared with control group.The new endomembrane in control group was significantly thickener than the experimental group.Conclusions CD34+ stem cell inhibits PGF1α and P/T ratio decrease, restrains TXB2 and platelet excessively rise, prevents intimal hyperplasia and thrombosis in a CD34+ stem cells seeded blood vessel prostheses.

Objectives To evaluate modified transthoracic esophageal transection (modified Walker's procedure) for management of postoperative rebleeding of portal hypertension.Methods Since 1983,we adopted modified Walker's operation to make low esophageal transection and transect intraabdominal recurrent varix of the coronary vein in the treatment of esophageal variceal rebleeding in portal hypertensive patients who had received previous surgeries aiming at portal hypertension.Results In 53 cases of postoperative rebleeding of portal hypertension,49 cases underwent elective operation with no mortality,4 cases received emergency surgery,one died post-operatively due to hepatic failure.The postoperative control rate of recurrent bleeding was 100％,and the overall postoperative mortality was 2％.The longest postoperative survival time was 24 years,and the 5-year survival rate was 77％.There were no postoperative recurrent hemorrhage and hepatic encephalopathy.Conclusions Modified transthoracic esophageal transection (modified Walker's procedure) is easy to perform,good at saving operative time,with a reliable immediate hemostatic effect and long-term control of variceal hemorrhage,hence is a effective remedy operative method for postoperative rebleeding of portal hypertensive patients after failed previous operations.