[Objective]To refine operative indications of rotating hinge prostheses and report the medium term results of these implants,and to analyze the reasons for postoperative complications.[Method]From 1999 to 2007,42 Endo-Model(Link) rotating hinge prostheses were used in 34 patients.The cases were all gonarthrosis with severe genu varus,genu valgus or flexion contracture.Bone defect or instability was found in these cases before operation.The mean follow-up was 6.4 years(2.3-10.4 years).[Result]One case of deep infection,and one periprosthetic fracture were noted.And 3 cases of patella subluxation or tilt were detected by postoperative X-ray.All patients had excellent pain relief and restoration of walking capability.The average HSS score improved from 40.5 points to 89 points after surgery.[Conclusion]Besides being used in revision surgery,rotating hinge prostheses are indicated in primary arthroplasties for patients with severe ligament laxity,substantial deformity or bone losses.With appropriate indication selection and accurate operative skill,satisfactory medium term result can be obtained.

Highly active adherent LAK cells (A-LAK) with monocytes depleted by phenylalahine methyl ester (PME) were cultured from peripheral blood lymphocytes of patients with hepatocellular carcinoma (HCC). Results showed that A-LAK cells cultured in about 14 days had expanded better and faster than that of nonadherent LAK cells (NA-LAK) with their greatest expansion varied from 23 to 243 fold .A-LAK cells showed a trend of increase in TH cell subgroup and decrease in Ts cell sub-group as well as significant difference of TH/TS ratio. The IL-2R expression increased from 34.1%to 64.3%. A-LAK cells had a higher cytotoxicity (64.6%)than that of NA-LAK cells (42.8%).Further clinical application of A-LAK cells may improve biotherapeutic effect on HCC patients compared with that of NA-LAK cells .

Objective To study the epidemiology of breast diseases based on a vast amount of data collected from a number of hospitals. Methods The pathological data of breast diseases collected from 14 hospitals were statistically analyzed. Grouping was made according to the patients′ age, i.e. every 10 years from 0 to 69 as a group, and the patients aged 70 and over as another group. A database was established using software SPSS (10.0). A statistical analysis was made on the types of breast diseases, the incidence was calculated, and curves were plotted up based on the types of disease and the contribution of patients′ age in different hospitals. Results A total of 35948 cases, including 46 diseases of breast diseases, were analyzed. The common diseases were fibroadenoma, carcinoma, adenosis, hyperplasia of male breast, cystic hyperplasia and accessory-breast, which made up 37.99%, 21.49%, 20.60%, 4.54%, 3.60% and 2.80%, respectively, of the total cases analyzed. Conclusion The number of patients suffering from breast diseases is proportional to the size of the hospital. It has been found that different pathology of the breast had its peak preponderant age of discovery. In all the cases analyzed, tumors were found in 23 167 cases, accounting for 64.45% of all patients, among which benign and malignant lesions constituted 66.13% and 33.74%, respectively. Fibroadenoma was the predominant tumor among benign tumors (89.14%), while the breast cancer constituted 98.82% of malignant tumors. The incidences of the both types of tumor, were similar in different hospitals. No significant difference was found on the peak ages of different breast diseases among the hospitals. 12 781 cases of nontumorous lesions accounting for 35.55% for all the cases showed marked differences in age distribution among hospitals, implying that there were different diagnostic criteria for such lesions.

Aqueous extract of Dracocephalum tanguticum Maxim. (DtM ),when given ig or ip to experimental hypoxia mice,markedly increased their tolerance to normobaric and hypobaric hypoxia. Erythrocyte superoxide dismutasc (SOD ) activity of mice or rats determined at high altitude (animaquing mountain 4700 m above sea level ) showed an elevated dismutation activity of peroxide anions. At an experimentally simulatcd altitude of 6000 m above sea level,determunation of MDA, Hb and Hct showed an obvious reduction of all the abnormally elevated criteria. It is suggested that the antihypoxia activity of DTM may be partly due to its free radical scavenging activity

Objective To construct human PLAGL2 siRNA expression DNA plasmid and study the interfering effect on gene expression in H441 cells. Methods H441 cells were transfected with PLAGL2 siRNA expression DNA plasmid with Fu-gene6. Real time PCR and Western blot were employed to detect the interfering effect on the expression of PLAGL2.SP-CSP-B mRNA and protein in wildtype and PLAGL2 siRNA expression DNA plasmid transfected H441 cells respectively. Results Real time PCR revealed that,as compared with wildtype H441 cells, the expression level of PLAGL2 mRNA in PLAGL2 siRNA plasmid transfected H441 cells was significantly reduced(P<0. 05) ,but that of SP-C mRNA in PLAGL2 siRNA plasmid transfected H441 cells was significantly increased(P<0. 05). Western blot showed that,as compared with wildtype H441 cells, the expression level of PLAGL2 protein in PLAGL2 siRNA DNA plasmid transfected H441 cells was significantly reduced(P< 0. 05). Conclusion Human PLAGL2 siRNA expression DNA plasmid was constructed successfully,and its transfection into the H441 cells could effectively inhibit the PLAGL2 expression,and simultaneously promote the expression of SP-C.

Objective To report clinical and laboratory features of a rare case who was primary myelofibrosis (PMF) with positive JAK2 V617F terminating in T-acute lymphoblastic leukemia (T-ALL).Methods A rare case of PMF terminating in ALL was found, the quantity and quality of JAK2 gene mutation were defined by PCR methods, collected the clinical dates. Results The JAK2 V617F gene mutations were all positive pre and post-blast, the mutant rates respectively were 71.21% and 83.56 %. The interval from PMF to leukemia was 22 months, and from leukemia to death was 27 days. Conclusion PMF with positive JAK2 V617F terminating in ALL is a rare case, clinical prognosis is poor and survival time is short.

Objective To investigate the relationships between serum concentration of RBP-4 and inflammatory factors,insulin resistance in patients with gestational diabetes mellitus.Methods20 patients newly diagnosed with impaired glucose tolerance (IGT),27 patients newly diagnosed with gestational diabetes mellitus(GDM) and 50 subjects with normal glucose tolerance(NGT) were enrolled in this cross-sectional study.Additionally,another subset analysis was performed,subjects were divided on the basis of BMI into normal weight (NW) and overweight or obesity (OW/OB).Serum RBP-4 was measured with ELISA;serum concentrations of hs-CRP,free fatty acids (FFA),triglyeride(TG),total cholesterol (TC) and insulin were measured in fasting status.Insulin resistance was assessed by HOMA-IR.ResultsLn(HOMA-IR) and the concentrations of FFA,ln(hs-CRP) in IGT or in GDM were significantly higher than that of NGT(P＜0.05).In the group of OW/OB,FFA[(0.90±0.31)mmol/L vs (0.71±0.28)mmol/L,t＝2.73,P＜0.05)],ln(hs-CRP)(0.62±1.00 vs -0.17±1.07,t＝2.90,P＜0.05),ln(HOMA-IR),lnRBP(0.56±0.27 vs 0.30±0.14,t＝2.86,P＜0.05)were significantly higher than that of NW.In the group of GDM,lnRBP-4 showed a positive relationship with FFA (r＝0.231,P＜0.05)and ln(hs-CRP) (r＝0.237,P＜0.05).There was a positive relationship between lnRBP-4 and FFA(r＝0.371,P＜0.05) or ln(hs-CRP)(r＝0.247,P＜0.05) in the group of OW/OB,but no association in the group of NGT,IGT or NW.There was no relationship between lnRBP-4 and ln(HOMA-IR) in IGT,GDM and NW,while in the group of NGT and OW/OB,lnRBP-4 showed a positive relationship with ln(HOMA-IR) (r＝0.276,0.290,P＜0.05).In a multiple linear regression analysis,ln(hs-CRP),FFA or ln(HOMA-IR) was not the independent factor of lnRBP-4 in any group.ConclusionsIn patients with gestational diabetes mellitus,lnRBP-4 may be a new marker of inflammation.

ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.

Objective To report the anatomical study and clinical application of the free peroneal perforator-based sural neurofasciocutaneous flap. Methods Latex injection studies were performed on 10 adult cadaveric lower limbs. The presence, prevalence, and location of the peronel perforators that were suitable for vascular anastomosis were documented. From April 2007 to January 2010, 6 patients with large soft tissue defects in the upper limb underwent the reconstructive procedures with the free peroneal perforatorbased sural neurofasciocutaneous flap transfers. 4 patients were men and 2 were women, with the age ranging from 19 to 60 years. The causes of the injury included 4 motor vehicle accidents, and 2 massive machinery trauma. The area of the flap ranged from 16 cm × 8 cm to 30 cm × 10 cm, and the length of the perforator pedicle was 4 cm to 6 cm. Results A mean of 5.3 perforating vessels of the peroneal artery was noted in the specimen. The peroneal perforator that located at the junction of the middle and lower thirds of the fibula was found suitable for microsurgery, with the external diameter and the length being (1.21 ± 0.13)mm and (4.6 ± 0.8)cm respectively. All the 6 flaps survived completely without necrosis. No severe venous congestion was observed. All the patients were satisfied with the aesthetic outcome postoperatively at 3 to 12 months'follow-up. There were no major donor site complications. Conclusion The free sural neurofasciocutaneous flap based on a single peroneal perforator is an excellent tool for reconstruction of extensive soft tissue defects in the upper limb.

Objective To design and investigate the clinical effects of parallel double venous pots hemodialysis tubing set in patients with heparin-free hemodialysis.Methods Totally 120 patients who received hemodialysis therapy in our hospital from May,2014 to June,2016 were randomly divided into the experimental group (n=60) and the control group(n=60) via random number table.The experimental group received self-designed parallel double venous pots dialysis tubing set,while the control group received the normal dialysis tubing set.The number of preventive replacement of dialyzer and tubing set during heparin-free dialysis,the number of discarded tubing set due to coagulation and the time frame for the first tubing set were recoded from two groups.Results There were statistically significant differences in the number of discarded tubing set due to coagulation and the time frame for the first tubing between two groups(P＜0.05).Conclusion Parallel double venous pots dialysis tubing set can reduce the number of discarded tubing set due to coagulation,prolong the time frame for the first tubing.