Objective: To compare efficacies and complications of total hip arthroplasty ( THA ) with subtrochanteric osteotomy for treating patients with Hartofilakidis types C1 and C2 developmental dyspla-sia of the hip ( DDH) .Methods:Retrospective analysis was performed in 32 patients with DDH who un-derwent THA.These patients were divided into two groups according to Hartofilakidis classification, 17 patients in type C1 and 15 in type C2.Their HSS and WOMAC scores, leg length discrepancy (LLD), hip joint image data and complications were evaluated.Results:HSS scores in type C1 was changed from preoperative 43.7 ±4.6 to postoperative 87.2 ±7.1 (P<0.001), together with WOMAC scores 43.6 ± 4.3 to 87.5 ±6.7 (P<0.001).HSS scores in type C2 was changed from preoperative 44.4 ±5.4 to postoperative 86.5 ±8.0 (P<0.001), together with WOMAC scores 44.1 ±4.1 to 86.7 ±8.1 (P<0.001).Four cases in type C2 and one case in type C1 presented intraoperative fracture which all healed during the postoperative follow-up.The postoperative X-ray films showed that the joint prosthesis location was satisfactory, the surrounding bone was not dissolved and the bone at femur osteotomy site healed with no infection.Conclusion:For unilateral high dislocation DDH patients, THA with femur osteotomy can be effective and safe.No significant differences were found between types C1 and C2, however intraoper-ative fracture in type C2 should be paid attention to.

Objective To study the Value of low dose CT scanning with gas-contrasted and low window level in diagnosing gastro-colon lesions.Methods 126 cases suspected with gastro-colon lesions were randomly devided into two groups,group A(69 cases) were scanned with conventional water-contrast or non-contrast and conventional expose dose,and with conventional window level,group B(57 cases) were scanned with gas-contrasted and low expose dose,and using low window level.The images were evaluated by 2 experienced radiologists,the results including doctor's self-confidence and diagnostic accurate rate in both group A and group B were compared based on the endoscopic results.Results The diagnostic self-confidence of radiologists and the accurate rate in evaluating the lesions in group B were obviously superior to group A.Conclusion CT scanning of gastro-colon with gas-contrasted,low expose dose and low window level is markedly superior to conventional one.

Objective To analyse CT signs of lumbar spinal degenerative diseases.Methods CT findings of lumbar spine in 1180 cases with degenerative disease lumbocrural pain were analysed.CT classification of degenerative disease of lumbar spine was carried out according to the lumbar structures in combination with clinical sign.Results Lumbar spinal degenerative disease could be classified into 6 types:intervertebral disc degeneration(degenerative rate 65.3%);lumbar vertebra degeneration(degenerative rate 48.1%);vertebra facet joint degeneration(degenerative rate 36.0%);ligment degeneration(degenerative rate 25.4%) ;degenerative stenosis of lumbar spinal canal(degenerative rate 44.0%);and degenerative lumbar spine unstability(degenerative rate 25.0%).The former 4 types were belonged to primary degeneration of lumbar spine,the latter 2 types were belonged to secondary degeneration of lumbar spine.Conclusion CT classification of lumbar spinal degenerative disease is helpful to clinic in diagnosis and therapy.

Objective To explore the effect of Latexin (Lxn) gene transfection on proliferation of CD13;MIAPaca-2 pancreatic cancer stem-like cells.Methods CD133+ MIAPaca-2 cells were isolated and sorted by magnetic activated cell sorting from pancreatic cancer MIAPaca-2 celt line.CD133+ MIAPaca-2 cells were cultured in serum-free medium and the capacity for proliferation,and tumorigenicity of CD133+ MIAPaca-2 cells was determined by the floating spheres test and tumor xenograft assays.The CD133+ MIAPaca-2 cells were transfected with Lxn plasmid (1,3,5 μg).After transfection,the protein and mRNA expression of Lxn in CD133+ and CD133+-MIAPaca-2 cells were detected by Western blotting and RT-PCR,respectively.Cell proliferation was assayed by CCK-8.Results CD133+ MIAPaca-2 cells were successfully isolated,and it grew into a ball-suspended way,the tumorigenicity rate in nude mice with subcutaneous injection 1 × 105 cancer cells was 100％.After Lxn plasmid transfection,the expression of Lxn in CD133+ MIAPaca-2 cells was increased in a dose dependent manner,the Lxn protein and mRNA expression of tumor cells transfected with 5 μg plasmid was 20.80 ±0.98,16.80± 2.73,which was significantly higher than that in non-transfected cells (1.02 ± 0.01,1.01 ± 0.01),and the difference between the two groups was statistically significant (P ＜ 0.05).After transfection,cellular proliferation activity also showed a transfection dose and culture time-dependent decrease,the inhibition rate of tumor cells transfected with 0.4 μg plasmid was 36.2％,which was significantly different from that in non-transfected cells (P ＜ 0.05).Conclusions CD133+ MIAPaca-2 pancreatic cancer cells have some characteristics of cancer stem cells.Lxn gene transfection can inhibit the proliferation of CD133+ MIAPaca-2 cells.

Objective To study the correlation of expression of DNA topoisomerase Ⅱ alpha (TOP2A)with expressions of human epidermal growth factor receptor 2 (HER2)and phosphatase and tensin homolog (PTEN)and gene mutation of phosphatidylinositol 3-kinase (PI3K)in breast cancer so as to provide reference for prognosis of the cancer and evaluation of drug efficiency.Methods This study enrolled totally 96 breast cancer patients. Tumor specimens were resected.The gene expressions of TOP2A,HER2 and PTEN were analyzed using branched DNA-liquid-chip,and PI3K gene mutation was detected by xTAG-liquid-chip.Correlations between gene expressions and gene mutation were further explored by Spearman correlation analysis so as to clarify the relationship between TOP2A and HER2 signaling pathway gene.Results Co-expression of TOP2A and HER2 was strong,and TOP2A tended to be highly expressed in the presence of high expression of HER2 (P =0.01).The expression of PTEN was not significantly correlated with the expression of TOP2A,whereas the mutation of PI3K had a positive association with the high expression of TOP2A (P =0.004).Conclusion Anthracycline drug resistance factor TOP2A may be related to the critical factors of HER2 signaling pathway,suggesting that HER2 expression and PI3K mutation may be key factors in regulation of TOP2A expression,which would provide important evidence for chemotherapeutic resistance.

Objective To explore the risk factors for clinical anastomotic leakage after resection of rectal cancer in China. Methods By meta-analysis we made a comprehensive analysis of the risk factors for clinical anastomotic leakage after resection of rectal cancer based on 19 articles published in China between January 1999 and January 2009. Results The anastomotic leakage rate was higher in the patients aged 60 years old and above than in those younger, with the combined odds ratio (OR) value being 0.50 (95% CI: 0.33-0.76) (P<0.01). The incidence rate was higher in the male patients than in the female ones, with the combined OR value being 2.17 (95% CI: 1.38-3.42) (P<0.01). The incidence rate in the patients with the distance of tumor from the lower margin to anal verge being 7cm and shorter was higher than that with longer distance, with the combined OR value being 1.79 (95% CI: 1.37-2.35) (P<0.01). The incidence rate in the patients who had received radiotherapy preoperatively was higher than that in those who had not, with the combined OR value of 3.66 (95% CI: 2.19-6.09) (P<0.01). The incidence rate in the patients who had received stapler anastomosis was higher than that in the patients who had received manual anastomosis, with the combined OR value being 0.70 (95% CI: 0.47-1.05), but there was no significant difference between them (P>0.05). The incidence rate was higher in the patients with diabetes mellitus than in the healthy ones, with the combined OR value being 3.16 (95% CI: 2.27-4.39) (P<0.01). The incidence rate was lower in the patients with Dukes A and B stages than in those with Dukes C and D stages, with the combined OR value being 0.61 (95% CI: 0.45-0.83) (P<0.01). The incidence rate in the patients with high malignance degree in clinicopathological types was higher than that with low malignance degree, with the combined OR value being 2.17 (95% CI: 1.38-3.42) (P<0.01). The incidence rate was lower in the patients who had received preventive colostomy than in those who had not, with the combined OR value being 0.39 (95% CI: 0.14-1.05), but there was no significant difference between them (P>0.05). The incidence rate was higher in the patients who had got selective operation than in those who had got emergency operation, with the combined OR value being 0.27 (95% CI: 0.13-0.56). Conclusion The risk factors of anastomotic leakage after resection of rectal cancer are as follows: 60 years old and above, male patients, diabetes mellitus, preoperative neo-adjuvant radiotherapy, the distance of tumor from the lower margin to the anal verge being shorter than 7cm, Dukes C and D stages, high malignance degree in clinicopathological types, and emergency operation.

Objective To research the influence kidney-yang deficiency on rat' s gastric antrum and small intestinal mucosa tissue microstructure' s change.Methods The rats were cut off bilateral adrenal three-quarters to establish the model rats with deficiency of kidney-yang,which were randomly divided into a model group and a Shenfu decoction group at 4 weeks after operation.The sham operation group was the same as model group except without cutting rats bilateral adrenal and setting as a control group.The Shenfu decoction group was given suspension liquid of Shenfu decoetion by lavage,and both the control group and model group were given physiological saline of the same capacity for 4 weeks.Each rat gastric antrum and small intestinal mucosa's organization structure by conventional HE slice was observed.Results ① The sham operation group rats' gastric and intestinal mucosa were pink,shiny and elastic by macroscopic observation.Compared with the sham operation group,the gastric and intestinal mucosa of the model group became thinner,dimmer and less elastic.Compared with the model group,the gastric and intestinal mucosa of the Shenfu decoction group were a bit thicker,shinier and more elastic.② The results of the light microscope showed that:The gastric antrum and intestinal mucosa's tissue structure were normal.Compared with the sham operation group,the antrum mucosa tissue's cell gap of the model group became larger,besides the mucous glands had different degrees of alignment disorders,and a large number of vacuolar degeneration Appeared.The intestinal mucosa tissue villus edge was irregular,partial shedding of the epithelium fell offand deleted.Compared with the model group,the antrum mucosa tissue's cell gap of the Shenfu decoction group became smaller,the mucous glands cells arranged more regular,and the vacuolar degeneration had reduced.The intestinal mucosa tissue villus edge was more regular,and intestinal mucosal epithelial tissue was more complete.Conclusion The pathological changes were emerged in kidney-yang deficiency rat models.

Objective To investigate the rehabilitation prognoses of children with traumatic brain injury (TBI).MethodsA retrospective analysis was made in 64 children who had been admitted for rehabilitation.Their clinical information,rehabilitation protocols,recovery of consciousness and ability in the activities of daily living (ADL) were analyzed. ResultsThe children's injuries were severe-42.19％ had consciousness disorders,but 80％ of them recovered consciousness after rehabilitation.Their limb motor dysfunction was dominated by hemiplegia (51.67％).For 65.63％ of the patients rehabilitation was initiated within one month after injury.The average length of stay in rehabilitation was 33.09 ± 25.96 days.Those with consciousness disorders stayed significantly longer than those without.The main treatments were hyperbaric oxygen therapy,exercise and neurotrophic drugs (the ratios were 95.31％,89.06％ and 82.81％ respectively).After the first course of inpatient rehabilitation,the conscious ness recovery rate was 81.48％ and ADL ability improved significantly.The total effectiveness rate was 90.63％.Univariate and multivariate analyses showed that the factors most strongly correlated with effective rehabilitation were age at injury and the rehabilitation intervention time.ConclusionThe results suggest that a general hospital should focus on early (acute and subacute phase) rehabilitation.So developing the rehabilitation network system is necessary and urgent.Rehabilitative therapy is very helpful in TBI cases.Being older at the time of injury and earlier rehabilitation intervention predict better short term outcomes.It is necessary to build and improve on a more standardized and systemic rehabilitation and assessment system for pediatric TBI.

Objective To study the value of carotid plaque magnetic resonance imaging (MRI) in pre-operation assessment in the elderly patients with carotid atherosclerosis and explore the possibility of minimizing the contrast weightings to gain sweeptime. Methods Totally 70 elderly patients with cerebral ischemia (average age of 68.8 years) underwent carotid MRI and digital subtraction angiography (DSA) due to the appearance of carotid plaque detected by ultrasound. Carotid plaque MRI was acquired with 3.0T MR scanner and 8 channel surface coil. The standard carotid plague MRI program included pre-and post-contrast T1 weighted imaging (T1WI), T2 weighted imaging, proton density weighted imaging and 3D time of flight MR angiography (3D TOF MRA). All these program were divided into two combinations: the 5-sequence MRI (all the sequences) and 2-sequence MRI (T1WI and TOF MRA). Digital subtraction angiography (DSA) in coronal and lateral views of carotid artery was performed with GE Advantx LCN+. The software SPSS 13.0 was used to statistically analyze the difference between MRI and DSA, and that of two sequence combinations was used in the detection of luminal stenosis and fibrous cap (FC) rupture. Results Totally 135 arteries were analyzed while 3 arteries in one patient were excluded due to the poor quality image and stent placement. The degree of luminal stenosis were (38.3±31.0)% and (38.5±30.9)%, respectively, detected by the two MRI sequence-combination with no significant difference (t=2.447, P＞0.05) and was (35.1±31.8)% by DSA. There was a good concordance between MRI and DSA in luminal stenosis detection (Kappa value: 0.773). No statistical difference was found between two MR sequence combinations in detecting FC rupture (both in 36 vessels). DSA detected FC rupture of 16 vessels, showing remarkably difference contrast to MRI(χ2=12.0, P＜0.01). Conclusions MRI can accurately detect the luminal stenosis and FC rupture. The short time scanning resulting from sequence optimization could make MRI much more suitable than DSA to do the pre-operation assessment for senile carotid atherosclerotic patients.