Objective To explore the application value of three osteotomy in the treatment of severe hallux valgus.Methods 25 patiens with severe hallux valgus who were treated were selected.The results of surgical treatment and postoperative complications were retrospectively analyzed,and preoperative and postoperative AOFAS score,HVA and IMA were comparatively analyzed.Results AOFAS hallux valgus feet with reference to evaluation standard,35 foot excellent prognosis was 94.3％.Postoperative AOFAS score(88.7±5.2) compared to the preoperative (41.7±8.4) was significantly higher(P＜0.05),while the postoperative HVA values(10.2 ±2.1)° and IMA value (7.4±1.3)° compared to preoperative(55.7±14.2)° and IMA values(22.7±4.8) ° were significantly lower(P＜0.05).35 feet,the inside of the front foot after the numbness in 8 feet,metatarsophalangeal joints slightly limited by 3 feet,while the remainder were serious complication.Conclusion Three osteotomy for severe hallux valgus had acute efficacy and fewer complications,which is worth dirtical application.

Objective To summarize cardiopulmonary bypass management in open heart surgery of children with congenital heart disease. Methods The clinical data of 80 children with age less than 4 years old underwent open heart surgery under cardiopulmonary bypass from January,2005 to January,2009 were retrospectively analyzed. Results The operations of all 80 cases were basically smoothly and no severe complications associated with extracorporeal circulation occurred. After cross-clamping releasing,automatically re-beating occurred in 75 cases,and 5 re-beat after electric shock. There was no postoperative death. Conclusions Open heart surgery under cardiopulmonary bypass is safe and efficacy in children with congenital heart disease.

Objective To investiGate the bioloGical effect of inhibitor of apoptosis proteins( Survivin) on esophaGeal cancer ECA-l09 cell line. Methods Survivin siRNA was transiently transfected into non small esophaGeal cancer ECA-l09 cell line by liposome-mediated method and the expression level of Survivin siRNA was detected by RT-PCR and western blot. MTT assay,cell apoptosis,cell cycle and western blot were conducted as to observe proliferation,apoptosis,cycle of cell and expression of Caspase-9. Results RT-PCR and Western blot showed that ECA-l09 cell transfected Survivin siRNA had a lower relative expressive content compared with untransfected Group( P <0. 05 ). MTT assay,cell apoptosis and cell cycles demonstrated that ECA-l09 cell transfected Survivin siRNA had a lower survival fraction,hiGher cell apoptosis,more percentaGe of the G2/M phases( P < 0. 05 ). Conclusion Survivin involve in the bioloGical processes of esophaGeal cancer cell proliferation,apoptosis,and cell cycle.

[Objective]To explore the surgical method and clinical effects for the treatment of old thoraco-lumbar vertebrral fracture with kyphosis and spinal cord injury[Method]Thirty-six patients with old thoraco-lumbar vertebral fracture with kyphosis and spinal cord injury from 1998 to 2003,all had undergone anterior decompression through posterior median approach.[Result]All patients were followed-up.Kyphosis was rectified well.The Frankle classification of all but 3 patients with complete paraplagia increased one or more degrees after operation.[Conclusion]Operation through posterior median approach can achieve anterior decompression effectively.

Objective To evaluate the effect of alcoholism history on the elderly patients’early cognitive function after lower abdominal or limbs surgery under general anesthesia through controlled clinical trials.Methods Sixty male patients aged 65-80 years of ASA grade Ⅰ or Ⅱ were selected un-dergoing lower abdominal or limbs surgery,30 cases with alcoholism history as alcohol group(group A),30 cases without alcoholism experience as control group (group C).All patients were anesthe-tized intravenously.The general data before and during operation,and the postoperative complications were recorded.The mini mental state examination(MMSE)was performed to assess the cognitive function 1d before and 1,7 d after surgery,then post-operative cognitive dysfunction(POCD)was compared between the two groups through analysis of the MMSE score.Results The MMSE score of 1,7 d after surgery in two groups was significantly lower than that of the preoperative(P < 0.05 ). Compared with the score 1 d after surgery,the score of 7 d post-operation was significantly higher in group A (P <0.05).The postoperative score in group A were significantly lower than that in group C 1,7 d after surgery (P <0.05).The incidence of POCD in group A were higher than that in group C 1,7 d after surgery (P <0.05 ).Conclusion Alcoholism history can increase the incidence of early cognitive dysfunction in elderly patients after general anesthesia.

BACKGROUND: Status epilepticus can result in neuronal injury.OBJECTIVE: To observe the mitochondrial ultrastructural damage and the changes of Fas, Bax and Caspase-3 expressions in hippocampal CA3 neurons of rats of different kindling, so as to provide theoretical evidence for the neuronal injury after epilepsy.DESIGN: A randomized c ntrol animal experiment.SETTINGS: Department of Neurology and Department of Anesthesiology,Qilu Hospital of Shandong University.MATERIALS: The experiments were carried out in the pathological laboratory of Shandong Academy of Medical Sciences between March and July2005. Totally 150 adult male SD rats of 260-300 g were provided by the experimental animal center of Shandong University (SCXK20030004), they were raised at room temperature and were free to the access of food and water.METHODS: The adult male Sprague Dawley (SD) rats were divided into intraperitoneal injection of kainic acid group and caudal venous injection of kainic acid group respectively ac cording to the method of random number table, and the rats were administrated by kainic acid injected intraperitoneally (12 mg/kg) and via caudal vein (10 mg/kg) respectively. Each group was divided into 5 subgroups, which were 3, 6, 24, 48 and 72 hours after status epilepticus groups respectively. Twelve successfully induced rats were selected from each subgroup, hippocampi were removed at different time points after the termination of status epilepticus, 2 were used for examination under electron microscope, 5 for the reverse transcription-polymerase chain reaction (RT-PCR) detection of Fas and Bax, and 5 for the immunohistochemical assay of Caspase-3. Another 12 rats were used as normal controls without any treatment. The materials were taken at24 hours after corresponding status epilepticus in the control group, and the specific distributions were the same as those in the subgroups. The mitochondrial structure was observed under electron microscope, the levels of Fas and Bax mRNA were detected with semi-quantitative RT-PCR, and the expression of Caspase-3 protein was determined with the immunohistochemical assay.MAIN OUTCOME MEASURES: ① Results of ultrathin section under transmission electron mcroscope; ② RT-PCR results; ③ Immunohistochemical results.RESULTS: Totally 132 rats were involved in the analysis of results. ①Mitochondrial structure under electron microscope: In the intraperitoneal injection group, the mitochondria swelled, and the neurons showed characters of apoptosis. In the caudal venous injection group, the mitochondria swelled, and accompanied by the membranous collapse, and the neurons manifested the necrosis. ② No expression of Fas and Bax was detected in the control group and caudal venous injection. In the intraperitoneal injection group, Fas expression appeared at 6 hours after status epilepticus, increased at 24 hours, reached the peak value at 48 hours, and lasted till 72 hours. ③ The Caspase-3 expressions began to increase 6 hours after status epilepticus in both the intraperitoneal injection group and caudal venous injection group(10.27±0.34, 15.21±0.34; P ＜ 0.001), and reached the peak values at 24 hours (25.36±0.47, 28.23±0.47; P ＜ 0.001); The higher expression of Caspase-3 lasted till 72 hours in the intraperitoneal injection group, but sharply decreased in the caudal venous injection group.CONCLUSION: Two different methods of administration result in different severity of mitochondrial damage and different expressions of Fas, Bax and Caspase-3, which further determines the molecular mechanisms of neuronal death.

Objective To investigate the applied value of combined flap that was anastomosed a set of blood vessels. Methods This team includs 26 cases, all cases were injured in traffic accident. The wound parts were knee, calf or ankle. All skin defaults was combined with osseous exposure, chronic inflammation and the wound area was huge. So all cases were terminal repair. After drastically debriding,the wound was repaired through transplanting combined flap that was anastomosed a set of blood vessels. The 6 types flaps were selected. It demonstrates signs of adequate circulation. Its longest was 70 cm, its largest was 42 cm x 42 cm. Results All flaps were alive, the wounds were closed up, the fractures were healed up, the feet or calves were reserved. All above was condition for function reservation. Conclusion THe applying of combined flap that anastomosed a set of blood vessels could substitutes the built-up flaps that was anastomosed a group of blood vessels. The procedure have spent smaller time, and have higher successful ratio. So it would be prone to applying and popularizing in clinical.

As a weapon of mass destruction ,the biological weapon , composed of biological warfare agents and their re-lease devices,is characterized by strong pathogenicity , large pollution areas, various routes of infection, low cost, user-friendliness and a large number of impact factors .Although the United Nations has banned the use of biological weapons , there are still some countries and regions that continue biological weapon researches .In addition, illegal use of biological warfare agents in the field of terrorism and non-military arena poses a serious threat to public safety .Early detection of bio-logical warfare agent use and determination of its type are crucial to biological weapon defense and epidemic control .There-fore, to enhance researches on rapid detection and early warning of biological warfare agents is of great significance .This paper reviews the main technologies currently applied to the field of biological warfare agent detection and their progress .

Objective To observe the efficacy ofHuayu Kangyou Formula combined with Western medicine for Hp-related peptic ulcer disease;To discuss the mechanism of action.Methods Totally 152 patients were randomly divided into treatment group and control group, 76 cases in each group. Control group was given standard triple therapy, while treatment group was givenHuayu Kangyou Formula based on the standard triple therapy. The treatment lasted for 6 weeks. The clincal symptom scores and gastroscopy were observed to evaluate the therapeutic effect, adverse reactions were recorded, and relapse of ulcer was followed-up.Results The total effective rates of clinical symptoms in the treatment group and the control group were 94.74% (72/76) and 84.21% (64/76), respectively;the excellent rates were 78.95% (60/76) and 55.26% (42/76), respectively;the incidences of adverse reactions were 5.26% (4/76) and 13.16% (10/76), respectively;the relapse rates after 1 year of follow-up visit were 13.63% (6/44) and 41.67% (10/24), respectively, with statistical significant difference between the two groups (P<0.05).ConclusionHuayu Kangyou Formula combined with Western medicine can effectively improve the efficacy of Hp-relative peptic ulcer disease, reduce adverse reaction rate and relapse rate.

Objective:To explore the degradation property of novel magnesium alloy stents in Bama mini-pig models of carotid artery stenosis, and evaluate the feasibility of observing their dynamic and continuous process by high-resolution C-arm CT.Methods:Twelve Bama mini-pigs were selected; carotid artery stenosis models were established by large balloon over-dilation and high-fat and high-salt diet in Bama pigs; 24 weeks after that, self-made braided degradable magnesium alloy stents were inserted into the carotid artery stenosis models (confirmed by DSA) by balloon dilation. Degrees of stent patency and in-stent restenosis were examined by DSA immediately after procedure and on the 30 th, 60 th and 90 th d of procedure. Four experimental pigs were sacrificed on the 30 th, 60 th and 90 th d of procedure, respectively; the degradation property of the novel magnesium alloy stents was observed according to results of high-resolution C-arm CT in the inserted-stent areas and staining results of specimens in the stenosis areas, and stent imaging features during degradation were summarized. Results:Twelve Bama mini-pig models of carotid artery stenosis were established and 12 magnesium alloy stents were successfully inserted with a technical success rate of 100%. Both immediate postoperative and follow-up angiography showed patency of the vascular lumens without obvious in-stent restenosis. High-resolution C-arm CT and pathological examination showed homogeneous stent lumens and clear delineation of the stent meshes, with slightly degraded stent on the 30 th d of procedure; the stent lumen was blurred and some magnesium alloy wires were fractured with developed degradation of the stent on the 60 th d of procedure; and the stent meshes and stent strut could not be visualized due to severe degradation of the stent on the 90 th d of procedure. Conclusion:Magnesium alloy degradable stent is almost completely degraded within 90 th d of procedure in Bama mini-pig models of carotid artery stenosis, and high-resolution C-arm CT can be used to dynamically monitor the degradation of the stent in vivo.