Persistent pulmonary hypertension of newborn (PPHN) is a clinical syndrome,characterized by pulmonary arterial pressure elevated relative to systemic blood pressure,leading to extrapulmonary right-to-left shunting of blood across the ductus arteriosus and foramen ovale,causing severe hypoxemia.Pulmonary vascular remodeling is pathognomonic of hypoxia-induced PPHN.The regulatory mechanism and cell composition of vascular wall were dysfunction,which led to vascular wall thickened.The review focus on three aspects,such as endothelial cells,smooth muscle cells,and adventitial cells,described the relation and the possible mechanisms between hypoxia-induced PPHN and pulmonary vascular remodeling.

Objective To explore the X ray imaging of the common complications after total hip replacement (THR), in order to improve the diagnosis and differential diagnosis of the complications of THR. Methods Forty six cases were revised because of the complications of THR. The value of X ray in the diagnosis of complications was assessed by observing the radiography and comparing with surgical results. Results In these cases, after revision, 34 cases had aseptic loosening of femoral component, 13 cases had aseptic loosening of acetabular component, presenting on radiographs as the lucent zone alone the component, which was ≥2 mm in width and had the same contour as the component. 4 cases had septic loosening of femoral and (or) acetabular component, presenting on radiographs as the lucent zone alone the component, and bone destruction and sinus were also observed. The lucent zone was also ≥3 mm, but had the different contour of the component. Both kinds of loosening may accompany with migration of the component or not. 6 cases had dislocation of femoral head, presenting on radiographs as the head lying out of acetabulum in 2 cases, central migrating of the head in 2 cases, and asymmetrical position of the head in acetabulum in 2 cases. Conclusion The lucent zone and component migration had the important diagnostic value of loosening, the contour of lucent zone and sinus could help to make the differential diagnosis of aseptic and septic loosening. Asymmetrical position of the head in acetabulum and the head lying out of acetabulum were the signs of dislocation.

Objective To summarize the imaging features of the thoracic canal stenosis caused by ossification of ligamentum flavum, and to evaluate its clinical results of a novel decompression of total laminotomy and autografting in-situ. Methods 31 patients underwent total laminotomy, autografting in-situ and decompression to treat the ossification of thoracic ligamentum flavum. In the study, there were 18 males and 13 females; the average age was 45.7 years (rang, 26 to 73). 3 patients were associated with cervical stenosis, 5 with lumbar stenosis, and 2 with both cervical and lumbar stenosis. 9 were associated with anterior compression by thoracic disc herniation or OPLL. The vertebrae affected were 1 level in 3 patients, 2 levels in 12, 3 levels in 11 and more than 4 levels in 5. 23 affected segments were located at the upper thoracic spine(T1-T4), 19 at the mid-thoracic spine(T5-T8) and 52 at lower-thoracic spine(T9-T12). All the patients underwent total laminotomy and autografting in-situ, 9 patients with thoracic disc herniation or OPLL received discectomy and internal fixation at one stage. The postoperative outcomes were evaluated according to Epstein criteria. Results The patients were followed up 6 to 63 months (mean, 15 months). The clinical outcomes were excellent in 14 cases, good in 7 cases, and fair in 3 cases, and the excellent and good rate was 87.5%. One case experienced neurological complication with Frankel C grade improved to Frankel D grade treated with neurotrophic drug and hyperbaric oxygen and to Frankel E grade at 5 months after operation. 2 presented with lower limb intravenous thrombosis, and CSF leakage happened in 1 case and cured with re-operation. The osteotomy of total laminotomy was bony healed at average of 5.5 months, and there was not new formed ossification anterior to re-implanted vertebral lamina and spinal cord compression. Conclusion MRI combined with CT scanning is a most useful imaging modality for the diagnosis of ossification of thoracic ligamentum flavum. The novel surgical procedure designed by the authors is safe and effective in treating ossification of thoracic ligamentum flavum.

Objective To study the relationship between overweight, obesity and blood pressure among children living in urban Beijing. Methods A total of 4 267 pupils aged 9～10 years were randomly selected. Overweight and obesity were defined by age and sex specific BMI classification reference for Chinese children. Hypertension was defined by age, sex and height specific reference for US children. Results The prevalence of overweight and obesity in boys was 19.4% and 21.2%, in girls was 10.9% and 12.1%, respectively. Mean levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) have significant different between all study group. The total prevalence of high blood pressure (HBP) was 16.1% for boys and 15.2% for girls, while it was 36.4% and 41.3% among obese boys and girls, respectively. The prevalence of high systolic blood pressure (HSBP), high diastolic blood pressure (HDBP)and HBP gradually increased as weight increased. Compared with the normal weight group, OR(95%CI) for HBP of overweight and obese children were 2.6 (2.1～3.3) and 5.8 (4.7～7.0), respectively. Conclusion Obesity is positive correlation with hypertension in children aged 9～10years of Beijing, and the risk of hypertension was increased with their body weight.

OBJECTIVEThis study aims to survey the cognition and acceptance of implant dentures among Chengdu residents in 2005 and 2013 and to comparatively analyze the differences and influencing factors.

METHODSA questionnaire was designed for this study. Its main content included basic demographics of respondents (gender, age, cultural level, and income level), cognition level of implant dentures (concept and main characteristics of implant dentures), main concern of respondents regarding implant dentures and medical institutions, and acceptance level of the price of implant dentures, among others. The sampling survey was carried out among Chengdu residents in 2005 and 2013 using the designed questionnaire. The results were then statistically analyzed.

RESULTSUp to 908 valid questionnaires in 2005 and 905 valid questionnaires in 2013 were obtained. The level of cognition of implant dentures was higher in 2013 than in 2005, and the correlation between cognition and cultural level and that between cognition and income level were both positive. However, the correlation between cognition and age was negative. The success rate for implant dentures and medical treatment technology of medical institutions were the factors that the respondents were mainly concerned with. The main methods for disseminating information on implant dentures were the internet, television, newspapers, magazines, and introduction by friends.

CONCLUSIONWith the development of the society's economy and the improvement of culture and income level of Chengdu residents, the cognition and acceptance level of implant dentures have gradualy increased. Meanwhile, health education and medical technology still need to be strengthened.

ObjectiveTo analyze the correlations between bone mineral density and biochemistry data of health checkup receivers.MethodsA total of 3025 sets of medical measurements,including blood glucose,lipid profiles,blood uric acid,blood pressure and bone mineral density,were collected from January 2008 to November 2010 in Medical Examination Center of Peking Union Medical College Hospital.Bone mineral density of lumbar vertebra 1 - 4 (L1-4) and hip were recorded.Linear correlation analysis was used to investigate the correlation between bone mineral density and other factors. Results In multiple regression analysis,age,body weight,and alkaline phosphatase level were found to be related to male hip bone mineral density; age,body weight,alkaline phosphatase,and glutamyltranspetidase level were related to male L2-4 bone mineral density; age,body weight,alkaline phosphatase,and glutamyltranspetidase level were indicated to be related to female hip bone mineral density; age,body weight,alkaline phosphatase,and the ratio of neutrophile granulocyte were related to female L2-4 bone mineral density.ConclusionIn thisstudygroup, bodyweightwaspositivelycorrelatedwithbonemineraldensity, although alkalinephosphatase was negatively associated with bone mineral density.The role of blood glucose and lipid in the regulation of bone mineral density remains inconclusive.

Objective To explore the effect of gene mutations of epidermal growth factor receptor ( EGFR) on targeting therapy of advanced non-small cell lung cancer (NSCLC). Methods The 139 hospitalized patients who had been treated at least once with platinum-based chemotherapy and had tumor progression or recurrence after the last chemotherapy between December 2005 and December 2009, underwent EGFR gene test extracted from the pathological tissues. Based on the results of the test, the patients were divided into three groups: EGFR mutation per os (p.o.)Gefitinib (MPG) group, wild-type EGFR per os (p. o. ) Gefitinib (WpG) group and wild-type EGFR post-docetaxel chemotherapy (WpD) group. Clinical characteristics, pathology, treatment efficacy,survival time, performance status (PS) score, adverse reaction and quality of life of patients in the three groups were assessed. Results The EGFR mutation rate were higher in female, patients with adenocarcinoma and non-smokers than in male, smokers and those without adenocarcinoma. There were significant differences in median progression-free survival and median survival time among the three groups, which were 2.8 and 8. 9 months in MpG group, 2.0 and 7.1 months in WpG group,2.5 and 7. 8 months in WpD group(H=11. 198, 16. 991 ,all P＜0.01). The changes of PS score were significantly different between MpG group and WpG group (96. 8% vs. 62. 0%, x2 = 12. 583 ,P＜0. 01 ). However, there was no difference in changes of PS score between WpG group and WpD group (62. 0% vs. 66. 0%, x2 =0. 878,P＞0. 05). Conclusions The gene mutation of epidermal growth factor receptor may be served as an important indicator of advanced non-small cell cancer therapy.

ObjectiveTo improve the visualization of anteromedial and posterolateral bundles of anterior cruciate ligament (ACL) and investigate the optimal MRI plane for the bundles at a 3.0 T MR scanner.MethodsMR images of 149 knee joints were reviewed retrospectively.Display rates of AMB,PLB and their different parts (the top portion,the middle portion and the low portion) on MR different planes including axial,sagittal and coronal planes were analyzed and their differences were compared with the x2 section method.ResultsThere was no statistical difference in the display rates of two bundles of ACL between axial plane ( 115/149,77.2％ ) and coronal plane (103/149,69.1％ ) (x2 =2.4606,P ＞0.0125 ).Statistical differences were found between axial and sagittal plane,coronal plane and sagittal plane (21/149,14.1％ ) ( x2 =119.5138,92.8695 respectively,P ＜0.0125 ).There was a statistical difference for the top portion of ACL between axial plane ( 104/149,69.8％ ) and coronal plane,sagittal (0/149,0)and coronal planes ( 7/149,4.7％ ) ( x2 =135.081,159.7526 respectively,P ＜ 0.0125 ),between sagittal and coronal planes (x2 =7.1684,P ＜ 0.0125 ).For the middle portion of ACL,there was no statistical difference between axial plane ( 108/149,72.5％ ) and coronal plane (94/149,63.1％ ) (x2 =3.0120,P ＞ 0.0125 ),while statistical differences were found between axial and sagittal plane,coronal planes and sagittal plane ( 10/149,6.7％ ) ( x2 =134.7454,104.2173 respectively,P ＜ 0.0125 ).For the low portion of ACL,there was no statistical difference between axial plane ( 103/149,69.1％ ) and coronal plane (101/149,73.8％ ) (x2 =0.8065,P ＞0.0125),while statistical differences were detected between axial and sagittal plane,coronal planes and sagittal plane ( 18/149,12.1％ ) ( x2 =100.5300,115.9132,P ＜ 0.0125 ). The different parts of ACL displayed low intensity on different MR planes and normal morphology.ConclusionsACL can be displayed on conventional MR planes at a 3.0 T MR scanner to some extent.Axial and coronal planes might be the optimal MRI planes for ACL and its two bundles.

Objective To observe the application of endoscopy combined with 125I seed implantation in the pancreatic cancer palliative surgery in elderly patients.Methods A total of 78 elderly patients with pancreatic cancer who can not be treated with radical operation were divided into observation group and control group (n=39 each group).All patients were treated with stent intervention.Patients in the ation group were treated with 125I seed implantation guided by CT or ultrasonangraphy additionally.The clinical symptoms were compared between groups.The survival time and complications of the patients were recorded during the follow-up.Results The clinical symptoms of patients in both two groups were greatly improved (x2 =0.06,P＞0.05).Compared with the control group,the pain remission was better and the incidence of pain caused by pancreatic cancer was lower in the observation group (46.2％ vs.76.9％,x2 =7.80,P＜0.05).There was a significant difference in the average of survival time between the observation group and control group [(13.7±3.4) months vs.(8.4±3.8) months,t=3.73,P＜0.01],but no statistical difference was found in the long-term survival rate between groups.There was no significant difference in the incidence of complications between the two groups (10.3％ vs.7.7％,x2=0.15,P＞0.05).Conclusions Endoscopy combined with 125Ⅰ seed implantation is an effective treatment for elderly patients with advanced pancreatic cancer,which can effectively relieve the clinical symptoms,proiong the survival time,reduce the pain and complications.

To study factors related to visual field damage in Possner- Schlossman Syndrome(PSS) .Methods 145 cases of PSS and 166 cases of promary open angle glaucoma(POAG)were followed up with tonometer and perimeter. Results①Prevalence of visual field damageamong PSS and POAG cases were 35.43% and 93.42% respectively;72.11% of the visual field damage in the PSS group was of early stage,while 78.92% of that in the POAG group was of middle or late stage.②Compared with PSS cases with no visual field damage,the damaged cases were older;their course of the disease was longer;the average IOP between crises was higher;more cases were involved binocularly;more cases demonstrated abnormal diurnal and nocturnal IOP varianle or no crossover phenomenon. ③Systematic examination was given to 26 PSS cases with visual field damage and among them, 11 cases were confirmed to be complicated with POAG. Conclusion①Although the incidence of visual field damage done by PSS is much smaller and the symptoms slighter than those done by POAG,the prognosis of PSS is by no means optimistic. ②Coses at more advanced age, with longer course, with higher IOP between crises, with binocular involvement or without IOP crossover phenomenon are at a higher risk of visual field damage. ③Serious damage can be done by PSS itself.