Objective To introduce a new technique of talocalcaneal joint fusion with trephine and evaluate its clinical effects. Methods From June 1997 to October 2001, 18 cases complained of pain, weakness, limited range of motion and tenderness of ankle were treated with subtalar joint fusion. Of 18 cases, there were 12 males and 6 females with an average age of 47 years (range, 35 to 59 years). The lesions of subtalar joint were identified as traumatic osteoarthritis in 8, degenerative osteoarthritis in 5, congenital bone bridge in 2, rheumatoid arthritis in 2 and refractory inflammation of tarsal sinus. The AP and lateral view X-ray films were taken to measure the width and length of sutalar joint and talocalcaneal angle so as to choose the trephine of appropriate diameter (?11.5 mm, 12 mm, 13 mm )and guide the direction and length of osteotomy. Posterolateral approach was used in 14, and anterolateral approach in 4 depending on the location of lesion at subtalar joint. The trephine was inserted into subtalar joint slowly, the bone block inside the trephine was removed, rotated to 90?, then reimplanted in situ in 14 cases; Autograft of iliac crest was harvested and implanted by trephine in 4. Results All of the affected feet were immobilized with a cast postoperatively for 12 to 16 weeks. The patients were followed up for an average of 25 months ranging from 5 months to 4 years. All the wounds healed well at 2 weeks, the callus appeared at 4 weeks, and the bony fusion was obtained at 16 weeks displayed by postoperative X-ray films. The scores of ankle pain by VAS measurement were improved from preoperative 83.8 to postoperative 32.5. There were no severe complications, only 1 case suffered from dropping foot and recovered 10 months later, and 1 case complained of discomfort of foot. Conclusion Subtalar joint fusion with trephination is an effective procedure with many advantages such as: minimal invasive surgery, easy to perform, higher fusion rate and preserving mechanical stability of hind foot.

OBJECTIVE:To investigate the effects of Yiqi huayu granules on gastrointestinal motility of gastrointestinal motili-ty disorder model mice and blood rheology of acute blood stasis model rats,and to provide experimental evidence for clinical use of it. METHODS:50 ICR mice were randomly divided into normal group,model group,mosapride group(positive control chemi-cal drug,0.003 g/kg),Muxiang shunqi pills group(positive control TCM,0.36 g/kg)and Yiqi huayu granules group(2.4 g/kg), with 10 mice in each group. Treatment groups were given relevant medicine solution intragastrically,once a day,for a week;nor-mal group and model group were given normal saline intragastrically. Those groups fasted for 24 h after last medication,and then were given above medicine intragastrically;1 h later,they were given atropine sulfate intragastrically to induce gastrointestinal mo-tility disorder model except for normal control group. The stomach residue rate and intestinal propulsive rate of mice were mea-sured. 60 SD rats were randomly divided into normal group,model group,Compound danshen tablet group(positive control,1.0 g/kg)and Yiqi huayu granules high-dose,medium-dose and low-dose groups(2.4,1.2,0.6 g/kg),with 10 rats in each group. Nor-mal group and model group were given normal saline intragastrically,and treatment groups were given relevant medicine,once a day,for a week. 1 h after last medication,those groups were given adrenaline intraperitoneally+aqua astricta. to induce acute blood stasis model except for normal group. The whole blood viscosity(high-shearing,middle-shearing,low-shearing),plasma viscosity, 1,3,5 min platelet aggregation rate ,hematocrit and maximal platelet aggregation rate were all detected in rats. RESULTS:Com-pared with normal group,stomach residue rate of mice in model group was increased significantly(P<0.01),while intestinal pro-pulsive rate was decreased significantly(P<0.01). The whole blood viscosity(high-shearing,middle-shearing,low-shearing),plas-ma viscosity,hematocrit,1,3,5 min platelet aggregation rate and maximal platelet aggregation rate of rats were all increased sig-nificantly in model group (P<0.01). Compared with model group,above indexes of mice/rats were all improved significantly in treatment groups(P<0.05 or P<0.01). CONCLUSIONS:Yiqi huayu granules can significantly promote the function of gastrointes-tinal peristalsis and anticoagulation.

Objective To evaluate the multi-spiral CT(MSCT)imaging features and classification of renal pelvis carcinoma.Meth-ods 76 patients of renal pelvis carcinoma proved pathologically were analyzed retrospectively,and divided into different types ac-cording to the MSCT features.The MSCT differences for different types were analyzed.Results Most of the tumors showed iso-density or slight hyperdensity (95%)on un-enhanced images,and persistent mild-to-moderate enhancement (91%)in enhanced im-ages.All cases were divided into three types:pelvic mass type in 30 cases (39%),substance invasion type in 25 cases (33%),wall thickening type in 21 cases (28%).All cases were also divided into two types:substance invasion type(25 cases,33%)and renal pelvis type(5 1 cases,67%).The occurrence rate of local low enhancement,whole kidney low enhancement,hydronephrosis,lymph node metastasis and vein tumor thrombus were 80%,20%,48%,52%,1 6% in substance invasion type cases,and 4%,42%, 75%,4%,6% in the renal pelvis type cases,respectivily.Conclusion MSCT multiphase enhancement scanning shows important valuation in the diagnosis and classification of renal pelvis carcinoma.Obvious differences of CT features are showed for different types.The diagnosis accuracy may be improved by the knowledge of substance invasion type.

Objective To discuss the methods of specification and quantification of thinking process of syndrome differentiation and treatment of old and famous TCM practitioners; To inherit the clinical experience and ideas of TCM practitioners more effectively. Methods Based on one typical case of Professor Lv Renhe treating chronic nephritis, indexing the prescriptions with TCM Subject Headings thesaurus and analyzing them with “Chinese medicine prescription intelligence analysis system” (“CPIAS” for short), relative dose, comprehensive property, comprehensive taste, comprehensive channel tropism, and prescription efficacy were under quantitative analysis. Results The typical case included two prescriptions of initial diagnosis and six diagnosis. CPIAS quantitative analysis showed that relative dose, comprehensive property, comprehensive taste, comprehensive channel tropism, and prescription efficacy were in accordance with syndrome differentiation and treatment of Professor Lv Renhe for chronic nephritis. Conclusion This method has guiding significance for studying and inheriting the speculative regularities and academic thoughts of Professor Lv Renhe.

Objective To evaluate the clinical effect of talonavicular arthrodesis and the influence of adjacent joints use trephine percutaneous osteotomy in the treatment of talonavicular arthralgia.Methods From June 1999 to June 2009,24 patients were performed talonavicular arthrodesis due to a variety of painful disorder of talonavicular joint with trephine percutaneous osteotomy.There were 13 males and 11 females,with an average age of 45 years(range,37-72 years).The indications for the procedure included 15cases with posttraumatic arthritis,6 cases with rheumatoid arthritis,and 3 cases with degenerative arthritis.AOFAS system and visual analogue scale(VAS)were used to evaluate the change of function and arthralgia.Graves score system was used to evaluate the influence of adjacent joints.Results All patients were followed up 10-120 months,with the mean of 48 months.Only one case suffered skin brim necrosis of incision and got delayed healing after 3 weeks.The average AOFAS ankle-hind foot score improved from 45.2 points preoperatively to 84.5 points postoperatively.The excellent and good rate was 87.5%.VAS pain scores decreased from 8.1 to 2.4 postoperatively.Twenty-three patients were satisfied and one dissatisfied with the results.Postoperative radiology showed the union evidence in 23 patients at 6 months postoperatively(successful fusion rate of 95.8%).One joint nonunion occurred and required revision arthrodesis with iliac crest bone graft.There was an increase of Ⅰ grade in arthritic scores for 8 cases and Ⅱ grade for 1 case.Conclusion Talonavicular arthrodesis with trephine percutaneous osteotomy has the advantages of low trauma,high successful fusion rate and can acquire satisfactory clinical effect in the treatment of painful malalignment of talonavicular joints.

Objective To evaluate the effect of dexmedetomidine on autophagy in the hippocampal neurons of rats with traumatic brain injury (TBI).Methods Adult male Sprague-Dawley rats,aged 12-16 weeks,weighing 340-370 g,were randomly divided into 3 groups (n=80 each) using a random number table:sham operation group (group S),traumatic brain injury group (group TBI) and dexmedetomidine group (group Dex).The rats were subjected to a diffuse cortical impact injury caused by a modified weight-drop device to induce TBI.Dexmedetomidine 15 μg/kg was injected intravenously immediately after TBI in Dex group.At 24 and 48 h after TBI,neurological deficit score (NDS) was assessed,Morris water maze test was performed,and brains were removed for detection of brain water content in the brain tissue.At 6,12,24 and 48 h after TBI,the expression of hippocampal LC3]Ⅱ was determined using Western blot analysis.Results Compared with group S,brain water content and NDS were significantly increased at 24 and 48 h after TBI,the escape latency was prolonged,and the expression of hippocampal LC3 Ⅱ was upregulated at 6,12,24 and 48 h after TBI in TBI group.Compared with TBI group,brain water content and NDS were significantly decreased at 24 and 48 h after TBI,the escape latency was shortened,and the expression of hippocampal LC3 Ⅱ was down-regulated at 6,12,24 and 48 h after TBI in Dex group.Conclusion The mechanism by which dexmedetomidine reduces TBI is related to inhibition of autophagy in the hippocampal neurons of rats.

BACKGROUND:Stem celltumorigenicity is a practical issue concerning stability in the clinical application of stem cells. Therefore, it is particularly important to clear whether stem cells have tumorigenic ability or not. Nude mice occupy an increasingly important position in oncology, immunology, and safety evaluation of drugs and biological products.
OBJECTIVE:To observe the tumorigenicity of neural stem cells and mesenchymal stem cells in Balb/c nude immunodeficient mice.
METHODS:Balb/c nude mice were randomly divided into control group, negative group, positive group, neural stem cellgroup and mesenchymal stem cellgroup. HepG-2 cells, RPE cells, passage 4 neural stem cells and mesenchymal stem cells were injected subcutaneously into nude mice from different groups, respectively. After 12 weeks of injection, anatomical observation was performed to detect the tumor formation in the transplantation site. Meanwhile, soft agar colony formation assay was applied to investigate neural stem celland mesenchymal stem cellclone in vitro.
RESULTS AND CONCLUSION:After 12 weeks of injection, the tumorigenicity study results showed that no tumor developed in the transplantation site in the control group, negative group, neural stem cellgroup and mesenchymal stem cellgroup. Histopathologic examinations also showed no abnormality in these groups. Soft agar colony formation assay showed in soft agar resistance medium, neural stem cells and mesenchymal stem cells did not exhibit clone ability. These findings indicate that neural stem cells and mesenchymal stem cells undergoing short-term passages have no tumorigenic growth.

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare type of bile duct tumors with different classification criteria and has a better prognosis than cholangiocarcinoma. Clinicians lack the awareness of this disease due to its low incidence rate. This article reviews recent research advances in the etiology and pathogenesis, pathological characteristics, clinical features, differential diagnosis, treatment and prognosis of IPNB, in order to improve the clinical diagnosis and treatment of IPNB.

Objective To explore the expressions of miR-221 and miR-222 in papillary thyroid carcinoma (PTC),and relativi-ties with clinical pathological features.Methods Samples from patients of PCT (43 cases),nodular golter(21 cases),and para-carcinoma thyroid tissues(14 cases),78 cases in total (from 06/2015 to 05/2016,Shaanxi Provincial People’s Hospital) were collected.Real time-PCR tests were carried out,then analyzed in relation to clinical pathology features,and statistical a-nalysis was used to evaluate the results.Results The expressions of miR-221 and miR-222 were significantly higher in PTC (11.54±3.37,10.67±2.45)than in nodular golter (3.21±1.12,2.89±1.23)and normal thyroid tissue (2.02±0.76, 1.98±0.34)(t=3.62,3.25;3.27,3.01,all P<0.05),which were significantly related with Regional lymph node metasta-sis,tumor invasion coated,distant metastasis and clinical stage (P<0.05),while not related with the gender,age,or size of the tumor of the patients (P>0.05),and no differences were found in nodular golter and in normal thyroid tissue (t=0.91, 0.79,P>0.05).Conclusion miR-221 and miR-222 could be considered as a specific molecular marker of PTC,may play an important role in the diagnosis and treatment on PTC.

Objective:To investigate the diagnosis and treatment of intravenous leiomyomatosis involving the heart.Methods:From March 2009 to December 2018, 5 patients with intravenous leiomyomatosis with cardiac involvement were collected from The First Hospital of Lanzhou University.All patients were admitted to the hospital as space occupying lesions of right atrium.The relevant data such as echocardiography, CT and MRI were recorded.The preoperative diagnosis, surgical methods and therapeutic effect of the patients were analyzed and summarized.Results:All the 5 patients were female with an average age of (45.8±2.2) years old.Their clinical manifestations were chest tightness and shortness of breath.Three patients had a history of giant hysteromyoma.Echocardiography was performed in all patients, and 3 of them obviously extended to the inferior chamber.Cardiopulmonary bypass was established and thoracoabdominal incision was performed, and the tumors were completely resected in 5 patients, and the origin of tumors was consistent with the result of MRI in 3 cases.The tumor originated from the right uterine vein in 3 cases, and 2 cases originated from the right ovarian vein and was intubated in the femoral vein.The operation was smooth and the postoperative recovery was good.All patients were discharged smoothly.No tumor recurrence was found in pelvic cavity, inferior vena cava and heart after 1 year follow-up.Conclusion:Venous leiomyomatosis involving the heart is rare and easy to be misdiagnosed.Most of them are diagnosed as right atrial space occupying lesions.The diagnosis can be improved by echocardiography, CT and MRI before operation.The operation mode should be adjusted according to the intraoperative findings and different origins, and the tumor should be completely removed as far as possible, and combined with gynecology consultation if necessary.The short-term follow-up showed good prognosis.