BACKGROUND:Developmental dislocation of the hip is a type of adult hip dysplasia, including Crowe III and IV type; the type of dislocation of the hip is a severe prognosis. Total hip replacement is clinicaly used for the complex reconstruction of acetabulum. For injured acetabulum, autologous bone graft is effective to reconstruct acetabulum structure, provides good coverage and stability for the acetabulum. Postoperative combination with effective exercise can ensure the recovery of acetabulum function. OBJECTIVE:To analyze the correlation of prosthesis position selection during total hip replacement with clinical short- and middle-term effects of Crowel III and Crowel IV hip dislocation. METHODS:Clinical data of 28 cases of dysplasia and dislocation of the hip joint combined with severe osteoarthritis, who were treated in the Department of Joint Surgery, the Second Affiliated Hospital, Inner Mongolia Medical University from December 2011 to December 2012, were retrospectively analyzed. Al patients received total hip replacement. Implant was biological artificial total hip joint prosthesis. During 2-year folow-up, patients were rechecked by imaging regularly to analyze the imaging changes of acetabulum prosthesis position and bone graft fusion. Harris hip score was used to assess the recovery of hip function. The correlation of prosthesis position and short- and middle-term effects was analyzed. RESULTS AND CONCLUSION: The filing rate of medulary cavity of prosthesis was above 75%. The initial position was fixed and stable. The stability rate of femur-prosthesis interface reached 100%. Compared with pre-replacement, hip function was significantly improved at 6 months post surgery (t=25.55, 9.07;P < 0.05). These results indicate that total hip replacement for Crowel III and Crowel IV hip dislocation can effectively reconstruct the acetabulum, recover hip function, and stabilize prosthesis. Total hip replacement is characterized by good filing rate, high stability of femoral prosthesis interface, and stable initial fixation. The clinical repair effect is strongly associated with the position of the prosthesis.

The understanding of anatomical structures and their adjacent relationship is the founda-tion and key to the development of surgical skills and clinical thinking. In clinical teaching for residents and graduate students , we took the advantage of donor operations in organ transplantation and showed abdominal anal operations anatomical features and relationships through different view angles and compre-hensive ways. This new teaching approach was designed in accordance with processes of organ donation, procurement and back-table operation. The main contents included anatomy of abdominal wall layers, rela-tionships among abdominal organs, locations and courses of important structure, as well as medical human-istic education. In the context of organ donation becoming more and more popular and standardized after the cardiac death of Chinese citizens, this teaching approach is worth exploring.

Objective To study the effect of serf-designed multi-organ preservation solution(SMO)on cold-stored rat liver.Methods The rat livers were preserved with SMO solution(group A,n=15),UW solution(group B,n=15)and HC-A solution(group C,n=15),respectively.The livers were transplanted orthotopically after 6-,12-,24-hour preservation.The changes of liver function at hour 12 after transplantation were detected and conditions of the survived rats at day 14 after transplantation were observed.Results There was no morphological change of the livers in group A within 24 houm.The total bilimbin,alaninetransaminase,and hyaluronic acid increased in group A and B as the preservation time increased,but the levels of the 3 indexes of group A were significant lower than those in group C(F=49.027,70.280,34.349,71.532,446.544,303.408,P＜0.05).No rat djed in group A 14 days after liver transplantation.Conclusions SMO and UW solution have similar effect on protecting the liver.and the protective effect of the 2 solutioas was better than that of HC-A solution.

Objective To evaluate the role of Lactobacillus plantarum (LP) in the treatment of colitis in interleukin (IL)-10 knockout (IL-10-/-) mice and to explore its possible mechanisms.Methods Eight weeks old female wildtype (WT) mice and IL-10-/- mice, twenty mice of each type,were randomly assigned to four groups, WT group, WT+ LP group, IL-10-/- group and IL-I0-/- +LP group. The WT and IL-10-/- mice were gavaged with 0.5 ml saline, WT+Lp and IL-10-/- +Lp groups were gavaged with Lp 0.02 g (0.5 ml) ,took Lp 1 × 109 cfu everyday,continued for 4 weeks and then the experiment finished. The fresh mice faeces was collected once every week before (week 0) and during the experiment. The mice were executed at the end of experiments, the change of mice weight Was recorded, the length and the wet weight of colon were measured, fresh colon tissue specimens were taken for biological slices and proinflammatory cytokines TNF-a and IFN-γ were measured in colon mucosa. The fresh faeces were selectively cultured. The colonization of Lp in normal and colitis mice and its regulation role in intestinal flora were observed. Results Compared with WT mice, IL-10-/- mice demonstrated severe diarrhea, significantly decreased in body weight (P ＜0.05)and serious malnutrition. After Lp treatment, diarrhea relieved in IL-10-/- mice and the body weight increased significantly (P＜0.05). Pathological examination suggested that 100％ of IL-10-/-mice had intestinal inflammation, however after Lp treatment intestinal inflammation improved significantly. Mucosal ulcer, epithelial hyperplasia, the infiltration of neutrophils and lymphocytes in the lamina propria were also significantly reduced.The histopathological score was significantly lowered (P＜0.01). After Lp treatment, colon wet weight and the ratio of wet weight to length of IL-10-/- mice changed significantly (P＜0.01). Colon edema and thickening improved remarkably. The TNF-a and IFN-γ concentration of colon in IL-10-/- mice were 377.4±84.4 μg/g and 602.6±108.1 μg/g,which increased obviously than WT group (139.2 ± 32. 7 μg/g and 173.0± 52.4 μg/g, P＜0.05). After treated with Lp for four weeks, the TNF-α and IFN-γ concentration of colon in IL-10-/-+Lp group mice were 207.2±65.7 μg/g and 442.1 ± 138.4 μg/g, both were lower than that of IL-10-/- group mice (P＜0.05). The intestinal flora was disrupted in IL-10-/- mice. Conclusion Lp can effectively reduce intestinal inflammation in IL-10-/- mice, which take certain part in treatment in colitis. This treatment effect is associated with intestinal flora regulation and the inhibition of proinflammation cytokines expression.

Objective To investigate the expressions of toll-like receptor 4 mRNA and nuclear factor-κB (TLR4-NF-κB) mRNA in lung tissue of rats with acute paraquat poisoning.Methods Thirty male SD rats were randomly divided into two groups,namely normal saline group (NS group,n =6) and the PQ groups (n =24).The rats of PQ group were administered with 20 mg/kg PQ by intraperitoneal injection to establish the models of PQ induced lung injury.The saline was administered once instead in normal saline group.The rats of PQ group were sacrificed separately at 6 h,12 h,24 h,48 h and 72 hours after modeling,while at 6 hours the rats of normal saline group was sacrificed.The expressions of TLR4 mRNA,NF-κB mRNA,and the levels of tumor necrosis factor-α and interleukin-6 in lung (serum) of rats were detected.Meanwhile,pathological changes of the lung tissue were examined under optical microscope.Results There were no histopathological changes such as alveolar edema,hemorrhage and inflammatory cell infiltration found in NS group other than in PQ group.At the 72 h,the expressions of TLR4 mRNA (9.61 ±0.21),NF-κB mRNA (5.62 ± 0.24),and the levels of TNF-α (153.08 ± 5.02) pg/ml,and interleukin-6 (230.08 ± 10.64) pg/mL in lung tissue of rats were significantly higher in PQ group than those in control group (P ＜ 0.01).Conclusions In rats after PQ poisoning,the expressions of TLR4 mRNA,NF-κB mRNA,and the levels of TNF-αand IL-6 were higher than those in normal rats,and the TLR4-NF-κB pathway could play an important role in lung injury of rats with PQ poisoning.

Objective To investigate the suitable mode of cognitive-behavioral therapy for lung transplant recipients during waiting for lung and evaluate the effect to improve patients' physical and mental state.Methods 50 cases were randomly divided into the experimental group and the control group,each group with 25 cases.The control group received conventional treatment.The experimental group received cognitive-behavioral therapy in addition to conventional treatment.SAS and vital signs were measured in the two groups on admission,2 weeks and 4 weeks after admission.Results The SAS score of the experimental group was lower than the control group 2 weeks and 4 weeks after admission and SAS score decreased as the intervention extended.The SBp of the experimental group was lower than the control group 4 weeks after admission.There was no significant difference of DBp between two groups.The heart rate of the experimental group was lower than the control group 4 weeks after admission.The heart rate of the experimental group was lower on 2 weeks and 4 weeks after admission than on admission.4weeks after admission,the respiratory rate of the experimental group was lower than the control group and on admission.Conclusions Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness.

Objective To investigate the prevention and treatment of acute renal failure (ARF) following orthotopic liver transplantation(OLT).MethodsClinical data of 51 patients who underwent liver transplantion consecutively between October 2001 and April 2003 were analyzed retrospectively. Results Preoperatively 9 out of 51 patients had suffered renal dysfunction (Cr≥132 ?mol/L or BUN≥18 ?mol/L), ARF developed in 7 cases within one week postoperatively. Kidney function recovered to normal in 6 cases in 3 to 6 days after administration of vasoactive drugs (dopamine) and daclizumab (Zenapax). One patient failing to response needed hemodialysis for 11 days before his kidney finally functioned. Conclusions The etiology of ARF following OLT is multifactorial, with preoperative, intraoperative and postoperative factors being involved. Individually applied immunosuppressant, improving renal perfusion, and hemodialysis were important for the recovery of kidney function.

OBJECTIVE Toexplorethecredibityoftwoimprovedmodelsofsyntheticvascular dementia(VD)rats.METHODS OneimprovedmodelofVDratswasestablishedbyligatuingthebilat-eral common carotid artery twice at 3 d (improved 2-VO),while the other was established by blocking the middle cerebral artery on the left side by separating pterygopalatine arteria (i mproved MCAO/R). The learning and me mory ability was determined by escape latency in Morris water maze directional navi-gation test and cross-over ti mes in target areas in spatial probe test and the search strategy.The organi-zational structure in CA1 area of the hippocampus was observed and analyzed under a microscope after HEstaining.RESULTS Thelearningandmemoryabilitydecreasedsignificantlyin2modelgroupsat 20 d after the operation.The escape latency was much longer in improved 2-VO group and improved MCAO/R group than that in sham group(P<0.05)especially in improved 2-VO group.41 d after the operation,no difference between MCAO/R and sham group (P <0.05 ).The differences between improved 2-VO group and sham group remained significant(P<0.01 ),and difference between improved 2-VO group and improved MCAO/R group was significant(P<0.01 )at 41 d.The cross-over times in the target area in spatial probe test decreased more significantly in 2 model groups than in sham group. 41 d after the operation,improved MCAO/R group was not different from sham group(P<0.05). Search strategy results showed that swimming trajectory in the improved 2-VO groupwas mostly edge and random type,but was of tendency type and straight type in the improved MCAO/R group.In the organization structure of hippopal CA1 area of rats,the nu mber of cells was reduced,their arrange ment was sparse and chaotic,the morphology of cells was inco mplete,the structure of cells was abnormal, cytoplasmwasscarce,andnucleoliwereinconspicuous.CONCLUSION TwoimprovedVDmodelscan lead to behavior and pathological changes in rats.The i mproved 2-VO model,si mple and stable,is suitable for drug efficacy research.The improved MCAO/R model is the ideal short-term efficacy study.

Background and purpose:In 2013, the ofifcial journal of European Society of Radiotherapy &Oncology (ESTRO) -Radiotherapy & Oncology published the updated version of Consensus Guidelines of Delineation of the neck node levels for head and neck tumors, which contributed to the standardization of description of neck nodal metastasis, as well as reduction of treatment variations from various institutions. This study applied this updated guidelines to analyze the patterns of lymph node metastasis of nasopharyngeal carcinoma and explore the prognostic value of the radiologic characteristics of nodes, in order to provide evidence for future revision of N staging system. Methods:A total of 656 patients from Jan. 2009 to Dec. 2010 were retrospectively recruited to analysis. All were pathologically diagnosed as non-metastatic nasopharyngeal carcinoma, treated with intensity-modulated radiotherapy. All patients received a pretreatment MRI scan. We retrospectively reviewed the MRI imaging of 656 patients and mapped the lymph node metastasis using the 2013 International Consensus Guidelines.Results:Median follow-up was 46.9 months. Four-year local recurrence-free survival, nodal recurrence-free survival, distant metastasis-free survival, disease-free survival and overall survival was 91.3%, 95.1%, 87.7%, 78.5% and 92.8%, respectively. The most common metastatic node levels were levelⅡ (76.2%) and levelⅦa (65.1%), followed by levelⅢ (50.4%),Ⅴa(17.5%) andⅣa (11.7%). There was a very low incidence of node skipping (1.0%). Cervical nodal necrosis was observed in 46.4%of patients with positive nodes and extracapsular spread was noted in 74.4% of them. Univariate analysis showed that bilateral nodal involvement, greatest dimension of positive nodes (≥6 cm), central nodal necrosis, T stage and N stage were prognostic factors for disease-free survival and distant metastasis-free survival (P<0.05). Extracapsular spread showed a trend to correlate with poor distant metastasis-free survival (P=0.060). The involvement of lower neck levels (below the caudal border of cricoid cartilage) did not have a signiifcant impact on disease-free survival and distant metastasis-free survival. In multivariate analysis, T stage and greatest dimension of nodes (≥6 cm) were independent prognostic factors for distant metastasis-free survival (P<0.05). T stage, greatest dimension of nodes (≥6 cm) and central nodal necrosis were independent prognostic factors of disease-free survival (P<0.05).Conclusion:This study demonstrates the patterns of lymph node metastasis of nasopharyngeal carcinoma based on 2013 International Consensus Guidelines. Bilateral nodal involvement, greatest dimension of positive nodes and central nodal necrosis had prognostic values on disease-free survival and distant metastasis-free survival. In our study, the involvement of lower neck levels was not proved to be a prognostic factor for disease-free survival and distant metastasis-free survival.

BACKGROUND:Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function.
OBJECTIVE:To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures.
METHODS:The surgical efficacy of 12 cases of complicated proximal humerus fractures who had al received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation.
RESULTS AND CONCLUSION:Al the patients were fol owed up for 18 months in average (6 to 48 months). Based on Neer scoring, excellent was in 10 cases, good in one case, fair in one case. The excellent rate was 92%. During the fol ow-up period, prosthesis location was good and there were no complications, such as periarticular fractures, nerve injury, infection, dislocation or looseness. Attention should be paid for the effective restoration of shoulder cuff and the correct reconstruction of the large and smal nodules in semi-shoulder arthroplasty. Besides, it also should be combined with the early and standard functional exercises. The clinical effect of semi-shoulder arthroplasty is satisfactory and it is an effective way to treat complicated proximal humerus fractures.