[Objective]To compare the differences in using Ponseti method treating congenital clubfoot (CCF) patients older than six-month and younger than six-month of congenital clubfoot(CCF). [Method]Five hundreds and forty-four feet in 378 cases of CCF were treated with Ponseti method. According to the age differences, they were divided into older infancy group (﹥6 month, 227 feet in 157 cases and younger infancy group(≤6 month,317 feet in 221 cases). The deformation degree of CCF was evaluated by the Pirani scoring system. A scoring of 0-0.5 was regarded as being excellent. For each group, we evaluated the percentage of excellence result according to the Pirani score, the number of casts used, and the percentage of percutaneous achillotenotomy. The result was compared between the two groups. [Result]The excellence rate showed no significant differences between the two groups (P﹥0.05). Both the number of casts used and the percentage of percutaneous achillotenotomy in the younger infancy group were more than that in the older infancy group. There was obvious difference between the two groups (P

Objective To investigate the changes and clinical significance of serum prealbumin (PAB) and bilirubin in patients with coronary heart disease (CHD). Methods The levels of serum PAB and bilirubin were measured respectively in 234 patients with CHD (CHD group) and 77 patients with paroxysmal supraventricular tachycardia (PSVT, control group), and the former group was divided into stable angina pectoris (SAP) group with 80 patients,unstable angina pectoris (UAP) group with 84 patients and acute myocardial infarction (AMI) group with 70 patients,according to the chnical manifestation. Results The levels of total bilirubin (TBIL),direct bilirubin (DBIL) and indirect bilirubin (IBIL) in CHD group [ (11.8 ± 6.1 ), (4.8 ± 1.0) and (7.7 ± 2.7) μ mol/L] were significantly lower than those in control group [(14.6 ±5.6), (6.2 ±1.3) and (9.5 ±6.1)μmol/L] (P ＜0.05). The levels of TBIL, DBIL and IBIL decreased gradually from SAP group, UAP group to AMI group, but there was no significant difference among three groups (P ＞ 0.05 ). The levels of serum PAB in CHD group were also significantly lower than those in control group [(205.55 ±5.68) mg/L vs.(229.78 ± 9.62) mg/L] (P ＜ 0.05),and decreased gradually from SAP group,UAP group to AMI group [(215.73 ± 7.98), (214.12 ± 3.79) and (195.75 ± 7.07) mg/L],but there was no significant difference among three groups (P ＞ 0.05 ). Conclusion The levels of serum PAB and bilirubin are related to the severity of CHD, and can be used as important biochemical indicators in monitoring the attack and severity in patients with CHD.

Objective:To evaluate the effectiveness of Ponseti method in the treatment of congenital talipes equinovarus (CTE) in children older than 6 months. Methods: Ponseti method was used to treat 157 cases (227 feet) of CTE in children older than 6 months. All cases were classified by age and by the degree of deformity severity. The age group classification was: (1) Ⅰ Group (6 months to 12 months),113 feet in 81 cases; (2) ⅡGroup (1 to 3 years old), 78 feet in 52 cases; (3) Ⅲ Group (>3 years old), 36 feet in 24 cases. The degree of deformity of CTE was evaluated with Pirani scoring system. The cases were classified into three groups according to the deformity degree : (1) Mild Group (scoring 1-2. 5) , 85 feet in 56 cases; (2) Moderate Group (scoring 3-4. 5) , 104 feet in 71 cases; (3) Severe Group (scoring 5-6) , 38 feet in 30 cases. A Pirani score of 0-0. 5 is regarded as an excellent result. For each group, we evaluated the number of casts used, the percentage of excellent result according to the Pirani score, and the percentage of percutaneous achillotenotomy. The result was compared among different groups. Results: The overall percentage of excellent result among all cases was 96.92%. A-mong the age groups, the percentage of excellence was not statistically different between Ⅰ Group and Ⅱ Group (P>0. 05). The percentage of excellence was lower in the Ⅲ group than the other groups (P> 0. 01). Among the groups classified by deformity degree, the percentage of excellence was the lowest in severe group (P<0. 05), and the difference between the mild group and moderate group was not statistically different (P>0. 05). The number of casts used among different groups were different (P<0. 01). Among different groups, the percentages of percutaneous achillotenotomy were significantly different (P<0. 01). 209 feet in 148 caseswere followed up for average time duration of 3 years and 11 months. Re-lapse was observed in 40 feet in 29 cases. The percentages of relapse were not statistically different among different groups (P>0. 05). Conclusion: Using Ponseti method to treat CTE for children older than 6 months can achieve excellent results in this study.

0.01). Among the groups classified by deformity degree,the percentage of excellence was the lowest in severe group (P0.05). The number of casts used among different groups were different (P0.05). Conclusion:Using Ponseti method to treat CTE for children older than 6 months can achieve excellent results in this study.

Objective To discuss the feasibility of ultrasound in evaluating the effect of closed reduction with cast fixation on developmental dislocation of the hip.Methods Seventy-three cases with unilateral DDH treated by closed reduction with cast fixation under frog position were detected by ultrasound on the medial cross-section of the hips.The position relation between femoral head and acetabulum of the hips were demonstrated,the relevant parameters (the vertical distance between the femoral head and the central line through pubic symphysis) were measured and compared with the contralateral side to understand the situation of the femoral head.Results The contour of the femoral head and the ossification center can be visually displayed,the relative position relation of the femoral head and acetabulum can be demonstrated on the medial cross-section of the hip under frog position by ultrasound to judge the status of closed reduction.The measurement of the ultrasonic parameters can provide quantitative indicator for the status of reduction.Conclusions Ultrasound can be viewed as the first imaging tool to evaluate the effect of closed reduction with cast fixation on developmental dislocation of the hip for it is simple,intuitive and no radiation injury.

Objective To investigate collagen metabolism in stress urinary incontinence(SUI) so as to determine the alteration that contributes to SUI.Methods Biopsy specimens of vaginal wall tissue from 24 women with stress urinary incontinence were collected,with matched specimens from 24 female patients without SUI.Immunohistochenical technique were applied to detect the expression of MMP-1 and TIMP-1.Results SUI group demonstrated a significant increase in MMP-1 expression and a decrease in TIMP-1 expression,with significant difference with control group.Conclusion Patients with SUI were in the predominant status of collagen breakdown,which may contribute to the pathogenesis of SUI.

Objective To investigate the relationship between IgG antibody titer in pregnant women with maternal-fetal ABO blood incompatibility and hemolytic disease of fetuses and newborns.Methods From January 31 2009 to January 31 2010,1269 singleton pregnant women who were suspected to have maternal fetal ABO blood incompatibility in Department of Obstetrics and Gynecology,Southwest Hospital,Third Military University were collected.Anti-A or anti-B IgG titers of them were detected at 28-30 gestational age,and umbilical cord blood were taken when delivery and hemolytic disease of the newborn serological test were done to diagnose hemolytic disease of the newborn (HDN).The relationship between the titers and incidence of fetal or neonatal hemolytic disease was retrospectively analyzed by Kendall tau rank correlation.Results No IgG of anti-A or anti-B in serum were found in 58.4％ (741/1269) pregnant women,while the antibody titer of 5.1％ (65/1269) pregnant women were more than or equal to 1 ∶ 128.When they were tested again at 36 gestational week,the titer of 17 cases increased twice but lower than 1 ∶ 512.No signs of intrauterine hemolysis,such as edema,ascites and pleural effusion,were found.Three hundred and eighty neonates (29.9％,380/1269) were diagnosed as HDN.Among which,12 cases (3.2％,12/380) showed mild anemia and (or) jaundice within 24 hours after delivery.There was positive correlation between incidence of neonatal hemolysis and antibody titer(Tb=-0.293,P＜0.01).The incidence of HDN increased from 85.4％ (35/41) in women with antibody titer of 1 ∶ 128 to 5/5 inwomen with antibody titer at 1 ∶ 512 (x2=108.906,P＜0.01).Among 380 HDN neonates,322 cases were transferred to neonatal intensive care unit for phototherapy based comprehensive therapy,and two underwent exchange transfusion.All patients were cured.Conclusions The intrauterine hemolysis incidence of patients with suspected maternal-fetal ABO blood incompatibility is very low,and no special care is required during pregnancy.Anti-A or anti-B tests during pregnancy is helpful in early diagnosis and management of HDN.

Objective To establish a co-culture system between mesenchymal stem cells (MSCs) and smooth muscle cells (SMCs) in vitro, and study the influence of SMCs on the differentiation of bone marrow MSCs (BMSCs) into SMCs in the co-culture system. Methods Density gradient centrifugation was used to separate and culture BMSCs, and collagenase digestion was employed to separate and culture bladder smooth muscle cells(BSMCs). Then the 2 types of cells were identified respectively. Then the cells were divided into 4 groups, BMSCs culture group (positive control), BSMCs cells culture group (negative control), BMSCs and BSMCs co-culture groups with contact or non-contact. The expression of ?-smooth muscle actin (?-SMA) and calponin were detected by immunofluorescence staining. Western blot analysis was employed to determine protein expression of calponin. Results In contact co-culture group, the positive rate of CD90 abd CD44 were 99.78% and 60.27% respectively in BMSCs, while only 0.21% for CD45. Western blotting showed that BMSCs expressed little calponin, but those contacting with BSMCs had an increasingly stronger expression of calponin with the elapse of contact culture time, while there was no significant change in its expression in BMSCs with contact. Immunofluorescence staining indicated that part of BMSCs were calponin positive at the 8th day after culture, but no positive cell was observed in non-contact culture group and BMSCs culture group. Conclusion The contact between BSMCs and BMSCs can promote the differentiation of BMSCs into SMCs.

Objective To study the effects of muscular trumatic fluid on the biological properties of muscle-derived stem cells (MDSCs) in rats.Methods MDSCs were isolated and purified by the preplate technique,muscle injury was made for the extraction of muscular traumatic fluid.Bradford colorimetric was used to detect the protein content in the muscular traumatic fluid,and the fluid with the highest protein was used to co-culture with MDSCs.Methyl thiazolyl tetrazolium (MTT) assay and wound model of monolayer of cells were used to observe the effects of wound fluids on the proliferation and mobility of MDSCs.The expressions of α-SMA and Vimentin were tested by immunohistochemistry and Western blot technique.Results MTT assay showed that wound fluid with concentration of 10% could most significantly increase the proliferation of MDSCs.The increased expressions of α-SMA and Vimentin were found in MDSCs after cultrue with muscular traumatic fluid in vitro,and the time-dependent relation exists.Conclusions Wound environment can directly participate in the muscle regeneration by inducing the proliferation,mobility of MDSCs;on the other hand,MDSCs can differentiate into fibrotic cells under stimulation of muscular traumatic fluid.

OBJECTIVE:To study the effect of penehyclidine on the level of cytokines in infants with congenital heart disease undergoing cardiopulmonary bypass(CPB).METHODS:A total of 60 children with congenital heart disease(CHD)were divided into three groups:Group P1(intramuscularly injected with penehyclidine before operation),Group P2(intramuscularly injected with penehyclidine before and after operation),and Group C(intramuscularly injected with atropine before operation).The levels of cytokine were determined at different time.Postoperative salivary secretion and X-ray of chest were observed.RESULTS:After CPB,the levels of the inflammatory cytokine in all the three groups were significantly higher,with those in Group P1 and P2 significantly lower than in Group C(P