OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

The incidence of breast tumors has increasing trend year by year recently.Ultrasound has become a main means of screening and diagnosis in breast tumors for its lack of radiation,harmlessness to op- erator and patient,convenience and repeatrbility.Grey-scale uhrasonography,color doppler flow imaging,col- or doppler energy contrast enhanced ultrasonogrphy,3-D ultrasonography,elastomography,ultrasound-guided biopsy are main methods for both detection and differentiation in breast tumors.The purpose of this paper is to review the applications of these techniques in breast tumors diagnosis.

OBJECTIVETo investigate the typical features of contrast-enhanced ultrasound imaging in malignant lymphoma after treatment with integrated Chinese and Western medicine.

METHODSTen patients with malignant lymphoma after different treatment cycles were examined with contrast-enhanced sonography, including 21 lymphnodes (in the neck, space of iliac blood vessels, retroperitoneum) and 7 spleen infiltrations.

RESULTSThe blood flow pattern distribution in lymph node before freatment was significantly different from that after trentment showed either by color Doppler flow imaging (CDFI) or by contrast-enhanced ultrasound (CEUS, P < 0.05), and the difference in splenic lesion was shown by CEUS (P < 0.05).

CONCLUSIONContrast-enhanced ultrasound imaging is a valuable tool for the follow-ups of malignant lymphoma after chemotherapy and guiding subsequent treatment.

Contrast Media ; Humans ; Integrative Medicine ; Lymphoma ; diagnostic imaging ; therapy ; Medicine, Chinese Traditional ; Ultrasonography, Doppler, Color

Environmental Pollution ; prevention & control ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Iatrogenic Disease ; prevention & control ; Medical Laboratory Personnel ; psychology

AIM: To analyze the clinical feature and treatment of endogenous endophthalmitis caused by liver abscess. METHODS: A total of 9 eyes (7 cases) with endogenous endophthalmitis caused by liver abscess in our hospital from 2005 to 2010 were analyzed retrospectively. Microorganism was cultivated with blood or vitreous in all patients.4 eyes were performed vitrectomy. 2 eyes were injected antibiotics in vitreous cavity. 3 eyes were only treated with antibiotics.RESULTS: Two cases (2 eyes) were diagnosed with endophthalmitis firstly, then found liver abscess; 4 eyes were with diabetes mellitus, and 1 eye with abnormal glucose tolerance. Cultivation of microorganism was positive in 6 eyes (67%), including Pneumonia cray-research, Candida albicans and Escherichia coli. 5 eyes had useful vision after treatment, 1 eye had light perception,3 eyes became blindness. CONCLUSION: As an ocular emergency, endogenous endophthalmitis caused by liver abscess can severely damage visual function. Timely consultation, early diagnosis, proper systemic and topical anti-infective and anti-inflammatory treatment are the most effective methods for controlling infection. Vitrectomy with intravitreal antibiotics plays an important role in preserving useful vision function in patients.

Background Studieshowed thaDelta-like ligand 4 (Dll4) participatein the deveopmenof retinal celland angiogenesis.The Dll4-Notch pathway and vasculaendothelial growth facto(VEGF) are thoughto be critical mediatorof neovascularization undehypoxiconditions.The relationship between Dll4 and VEGF inovery cleaand furtheresearch ineeded.Objective Thistudy wato observe the inhibition of Dll4 on experimental retinal neovascularization and VEGF expression.MethodThe retinal neovascularization animal model wainduced by oxygen-induced retinopathy (OIR) in 5-day-old SPF SD ratby rearing the new postnatal ratwith the motherattogethein closed box with oxygen level a(80±2) ％ till 12-day-old.The ratwere then raised in normal aifo5 days.Aftethat,2.5μl (0.5 μg) of Dll4 monoclonal antibody wainjected into the mid-vitreoucavity in the righeye(Dll4 injected group) and PBwaused in the same way in the fellow eye(PBcontrol group) in the 12-day-old rats.Retinawere isolated in the 17-day-old rats,and retinal vasculamorphology waexamined by adenosine diphosphatease (ADPase) staining of retinal flatmounts,and the endotheliocyte nuclei above the internal limiting membrane were counted in the retinal tissue-slices.Reverse transcription PC(RT-PCR) waused to detecthe mRNexpression level of Dll4,VEGF,VEGF receptor-1 (VEGFR-1),VEGFR-2 and neuropilin-1 mRNin the retinas.Statistical analysiwaperformed by the paired t-test.The care and use of the animalcomplied with the Guidance Suggestion issued by the Ministry of Science and Technology of Chinin 2006.ResultThe Dll4 mRNexpression in the retin(Dll4 mRNA/β-actin mRNA) wa0.22± 0.06 and 0.98 ± 0.13 in the Dll4 injected group and the PBcontrol group,respectively,with statistically significandifference (=21.839,P =0.000).No significandifferencewere found in the expression of the VEGF mRNA,VEGFR-1 mRNand VEGFR-2 mRNin the retinabetween the two group(t=0.463,P=0.649;=1.687,P=0.109;=-1.674,P=0.111).Compared with the PBcontrol group,the expression of neuropilin-1 mRNwasignificantly elevated in the Dll4-injected group (0.73±0.08 vs.0.64±0.07) (t=-2.677,P=0.015).ADPase staining showed thathere were much more new blood vesselin the Dll4 injected group than those of the PBcontrol group.The numbeof nuclei structurally adjacento the vitreal side of the internal limiting membrane wa(63.6± 11.6)/slide in the Dll4 injected group,which wamore than thaof the PBcontrol group a(35.1±5.2)/slide (=-7.879,P =0.000).ConclusionDll4 playan essential role in the procesof pathological angiogenesiin the retina.Dll4 ithoughto be feedback regulatoof VEGFR,which participatein the procesof restraining pathological vasculogenesis.

Objective To investigate the clinical characteristics and chronological change of ulcerative colitis(UC) in the Chinese PLA General Hospital in near 16 years. Methods Patients diagnosed with UC during the period from 1994 to 2009 in the Chinese PLA General Hospital were registered and their clinical profiles were analyzed. Results From 1994 to 2009, of 525 patients diagnosed with UC, with a median onset age of 42 years. The predominant form of UC was extensive colitis, which affected almost 33.3% (175/525), left-sided colitis was present in 21.3% (112/525) and rectum was present in 12.4%(65/525). The chronic relapsing type of UC was the most common (69.0%, 362/525 ), followed by the initial onset type (18. 1%, 95/525 ), chronic continuous type with intermittent exacerbations (9.7%,51/525), and acute fulminant type (3. 2%, 17/525 ). Two hundred and twenty-one patients (42. 1%,221/525) were graded as mild, 162 (30.9% , 162/525) as moderate, and 142(27.0%, 142/525) as severe UC. The proportion of mild colitis and rectum was significantly higher in patients with an onset age of over 60 years, compared with those with an onset age of less than 30 years( P ＜0. 05 ). The proportion of UC patients with old age onset ( P ＜ 0. 05 ), male sex ( P ＜ 0. 01 ), mild colitis ( P ＜ 0. 01 ), rectum ( P ＜0. 01 ) , relapse-free type ( P ＜ 0. 01 ) demonstrated a chronological increase from 1994 to 2009.Conclusions The distinctive clinical features and chronological change were seen in UC patients in recent years. Compare to those with an onset at less than 30 years, the proportion of mild colitis and rectum was significantly larger in patients with an onset at over 60 years of age, and the proportion of UC patients with old age onset, male sex, mild colitis, rectum, relapse type were less.

Objective:To investigate the immune response after injecting polysaccharide nucleic acid of Bacillus Calmette-Guerin(BCG-PSN)under the mucous membrane of bladder in rabbits and to search for the most suitable dose of BCG-PSN.Methods:The rabbits were randomly divided into 5 groups:high dose(0.35 mg/ml)BCG-PSN group,mid- dle dose(0.175 mg/ml)BCG-PSN group,low dose(0.0875 mg/ml)BCG-PSN group,BCG(0.35 mg/ml)control group and BCG-PSN(0.35 mg/ml)intra-bladder perfusion control group.T lymphocyte subsets(CD4~+,CD8~+)in the peripheral blood were determined by flow cytometry before and 1 week,2 weeks,1 month and 3 months after the treatment; the levels of IL-2,TNF-?,and IFN-?of peripheral blood were determined by enzyme-linked immunosorbent assay;H-E and Masson staining was used for the pathological examination of the bladder.Results:(1)BCG-PSN injection increased the number of CD4~+ and CD8~+ T lymphocytes in a time- and dose-dependent manner,with the peak numbers appeared 2 weeks after BCG-PSN injection;the numbers restored to the normal levels 3 months after BCG-PSN injection.BCG control group had a similar changing pattern to the BCG-PSN injection group.The number of CD4~+ T cells BCG-PSN perfusion group was significantly lower than that in the high-dose BCG-PSN injection group(P

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.

Starting from the thinking characteristics of TCM in the holistic approach of syndrome and process of syndrome differentiation, the problems in the criteria of syndrome diagnosis was analyzed, combining with the outcome of investigation on macrocosmic diagnosis of syndrome carried on twice by expert group nationwide in China, a concept for designing basic framework of standard for macrocosmic diagnosis of syndrome was advocated in this study. In order to recognize and master fully the standard, the following items would be the contents of the framework: give a standardized term of each syndrome; the basic clinical features of a syndrome; the qualitative parameters which could be used to distinguish the nature of a syndrome, and indexes to be used to judge the affected location of a syndrome during identifying process for a syndrome; the order of pertinent indexes with their given score, and the threshold for quantitative diagnosis. It is considered that the above framework defined the sufficient criteria which is constructed on the bases of the approaches with integrated qualitative and quantitative methods. It may enable the syndrome differentiation to access the real world of a patient to be used appropriately this framework.
Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; standards ; Syndrome ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis