Objective To study the side-effects of immunosuppressant cyclosporine A (CsA) on the circulatory system of rabbit and the mechanism of its toxicity. Methods Eighteen male New Zealand white rabbits were randomly divided into three groups. CsA were administered intravenously in 5mg?kg~ -1?d~ -1 to group A and in 15mg?kg~ -1?d~ -1 to group B for consecutively 21 days, meanwhile, as a control, an equal amount of saline was given to group C. Ultrasound and physiometry instrument were used to assess the experimental results. Results No changes were found in the dimension of any cardiac chamber in both groups A and B, obvious thickening occurred in the interventricular septum and the posterior wall of the left ventricular, pericardial effusion appeared and the weight of cardiac muscle increased significantly, and the diastolic and systolic blood pressure in ascending aorta decreased in groups A and B compared to group C. Also, the systolic pressure in left ventricular decreased while the diastolic pressure increased significantly in groups A and B. Conclusion Large dose of CsA has strong toxic effects on cardiac muscles, and can cause cardiac malfunction.

Objective To discuss the ultrasonographic features of immunosuppressants induced hepatotoxicosis after renal allograft. Methods The pre operative and postoperative ultrasonographic features of liver and gallbladder (GB) of 29 renal transplantation patients with clinical hepatotoxicity, after the use of CsA as the main immunosuppressive agent, were evaluated. Results Out of the 29 patients, 23 exhibited enhanced liver echo and 6 patients had features of fatty liver. The thickness of gallbladder wall was around 0.3cm in 21 patients. The morbidity rate of hepatotoxicity was 69% (20/29) in three months. Conclusion The main ultrasonographic features of immunosuppresive agent induced hepatotoxicity were enhanced liver echo, thickened gallbladder wall and unclear echo from GB. These findings provided important subsidiary diagnostic signs for hepatotoxicosis, especially three months after renal allograft. At this time, not only the allograft renal should be examined, but also the liver and gallbladder should be scrutinized with ultrasound. The ultrasonographic changes together with the clinical laboratory data could serve as a guidance for the administration of immunosuppressive drugs.

Objective To explore the risk factors of collapse of osteonecro si s of the femoral head (ONFH) with a retrospective study, and put forward a treat ment protocol according to this study results. Methods From October 1993 to Apri l 2000, 40 cases (56 hips) were followed-up. The term of follow-up ranged from 1 2 to 68 months (average 29.2 months). The age of patients was from 16 to 60 year s old (average 36.8 years old). Preoperatively, the AP and frog view X-ray film, coronal and sagittal MRI were taken. The staging of ONFH proposed by ARCO was a dopted. Clinically the Harris score was used to assess the clinical outcome. The patients were divided into three groups: 1) Non-operative: 10 cases (14 hips), stage Ⅰin 7 hips(ⅠA 4,ⅠC 3),stageⅡin 7 hips (ⅡA 1,ⅡB 3,ⅡC 3); 2) Core dec ompression with vascularized iliac bone graft (VICBG): 18 cases (24 hips ), stag eⅠin 6 hips (ⅠB 4,ⅠC 2), stageⅡin 16 hips (ⅡA 4,ⅡB 8,ⅡC 4), stageⅢ in 2 hips (ⅢA); 3) Transtrochanteric rotational osteotomy(TRO): 12 cases (18 hips), stageⅡin 1 hip (ⅡC), stageⅢ in 17 hips (ⅢA 8, ⅢB 7,ⅢC 2). Harris score was 46 to 82 (mean 62.9). Results Collapse of the femoral head occurred in 9 hips a mong the 14 hips in the nonoperative group, in 10 hips among the 24 hips in the VICBG group. In TRO group, further deterioration was prevented in all but one hi p. Whether theres surgical intervention or not, no collapse occurred in both s tageⅠA and ⅡA, collapse occurred in both stage ⅠB and ⅡB was 7 hips among 15 hips (46.7%), 13 hips progressed into collapse of the femoral head with ⅠC and ⅡC (100%). The Harris score was 47 to 93(mean 77.4) postoperatively. Conclusio n With MR imaging, it is possible to predict the possibility of collapse of ONFH . The lower risk is below 30 percent of necrotic area, the higher risk is 30 to 60 percent of necrotic area, and the higherest risk is beyond 60 percent of necr otic area. The best results can be obtained if selection of treatment individual ly according to ARCO stage, patient age and necrotic extent.

Objective To explore the indication, to describe the key of operative technique in detail and to summarize the early results in mini-incision and minimally invasive surgery (MIS) total hip arthroplasty (THA) for hip disorders. Methods From Mar. 2003 to Mar. 2005, 43 patients (49 hips) were performed with MIS THA. The mean age of patients was 53.2 years ranging from 22 to 79 years. There were 22 males and 21 females. The average body mass index (BMI) was 23.4 ranging from 17.1 to 30.2. Using the modified postero-lateral approach, MIS THA was performed with cementless prostheses. For comparison, 35 patients (43 hips) were performed with standard THA at the same period. The age and BMI of patients in both groups were similar, but the pattern of disorders was different. The comparative items included preoperative bleeding, operative time, incisional length, postoperative functional recovery, and prosthetic position. Results 31 patients (MIS THA) and 25 patients (standard THA) were followed from 6 to 24 months (mean 13.1 months). No complications occurred in MIS THA. Dislocation appeared in one patient with standard THA at the two days after operation. The length of incision was 9.3 cm (range, 8.7 to 10.5 cm) in MIS group and 16.8 cm (range, 14 to 20 cm) in standard THA group. The difference was significant statistically (P

[Objective]To explore the correlation between anticardiolipin antibodies and post-SARS patients with osteonecrosis,investigate the etiology of post-SARS osteonecrosis,and select the sensitive molecular symbols for early diagnosis and distinguish the high risk population.[Method]The studied subjects were divided into two groups.Sixty-two post-SARS patients with osteonecrosis was one group,and 52 matched healthy people was as normal controlled group.Empty stomach blood samples from cubital veins were collected from both groups.IgA,IgG and IgM of anticardiolipin antibodies types were examined by ELISA.[Result]Twenty-one of 62 post-SARS osteonecrosis patients were tested at least one type of anticardiolipin antibodies positive,among them,with IgA(11.33?11.209)APL,IgG(5.127?5.927)GPL,IGM(17.821?10.606)MPL.Four of 52 control group persons were detected positive,with IGA(10.702?3.126)APL,IgG(5.184?4.780)GPL,IgM(14.684?5.516)MPL.There were significant differences between two groups,while,there were no difference in prothrombin time(PT),thrombin time(TT),prothrombin activity(PTA)and international normalized ratio(INR).[Conclusion]The study indicates an increased positive incidence of anticardiolipin antibodies in post-SARS patients with osteonecrosis.This has reflected that anticardiolipin antibodies may play a role in osteonecrosis.

Objective To investigate the effect mechanism of sanguinarine on the proliferation,apoptosis,invasion and migration abilities of cervical cancer cells.Methods MTT,flow cytometer,cell scratch test and Transwell chamber assay were respectively used to detect the cellular proliferation,apoptosis,migration and invasion abilities after sanguinarine action.The expression levels of E-Cadherin,PTEN,β-catenin and MMP2 protein of cervical cancer cells after sanguinarine action were detected by Western blot.Results 0.6,0.8 μmol/L sanguinarine had the inhibitory effect on the proliferation of cervical cancer cells.After 0.8μmol/L sanguinarine action for 48 h,cervical cancer HeLa and Siha cells apoptosis rate were up to (45.68± 2.26)％ and(31.89 ± 3.80)％ respectively.0.8 μmol/L sanguinarine action for 3 h,cervical cancer cells HeLa and Siha adhesion rates were only (67.45 ± 2.13)％and(73.59± 2.61)％.0.8 mol/L sanguinarine action for 16 h,the invasion numbers of cervical cancer Hela and Siha cell were (39.64 ±1.98) and (43.87 ± 2.83) respectively.The expression amount of E-Cadherin and PTEN in cervical cancer cells after sanguinarine action was increased,while the expression amount of E-Cadherin and PTEN was weakened.Conclusion Sanguinarine has the proliferation inhibiting and apoptosis promoting effect on cervical cancer cells,its mechanism may be related to adhesion protein E-Cadherin,β-catenin and PTEN,MMP2.

ObjectiveTo evaluate the effectiveness of mesenchymal stem cell (MSC) in osteonecrosis of the femoral head defect(ONFH) repair. MethodsAniaml model of ONFH defect were established with rabbits, which were divided into 3 groups,group A did not infill anything as control, nano Hydroxyapatite/collagen(nHAC) as group B,nHAC+MSC as group C.Histology change were investigated 4,8,12 weeks after operation respectively.Results groups B and C were different with group A. The difference between groups A and C was more significant. ConclusionMesenchymal stem cell has a strong activity of osteoconduction,it has a value in repairing the bone defect of ONFH and the treatment of ONFH.

ObjectiveTo study the value of strain ratio from longitudinal section and cross section in differential diagnosis of benign and malignant thyroid nodules using ultrasonic elastography.MethodsA total of 118 patients with 153 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the strain ratio from longitudinal section and cross section. Receiver operating characteristic (ROC) curves were used to evaluate the value of elastography. The nodules are divided into two groups, group one included nodules which were near the isthmus and group two included other nodules. Diagnostic results were compared with pathological results.ResultsThe area under the ROC curve (AUC) of the strain ratios for differentiating benign and malignant thyroid nodules were 0.906 and 0.844. There was no statistical difference (Z=1.542,P>0.05). The best diagnostic cut-off points of the strain ratios were 3.65 and 3.58. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 81.2%, 80.8%, 81.0%, 87.2% and 71.2% and those of strain ratio from cross section were 77.2%, 76.9%, 77.1%, 84.4% and 63.4%. In group one, the AUC were 0.903 and 0.830. There was no statistical difference (Z=1.125,P>0.05). The best diagnostic cut-off points were 3.30 and 3.28. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 86.2%, 68.8%, 80.0%, 83.3% and 73.3% and those of strain ratio from cross section were 78.6%, 58.8%, 71.1%, 75.9% and 62.5%. In group two, the AUC were 0.906 and 0.852. There was no statistical difference (Z=0.936,P>0.05). The best diagnostic cut-off points were 3.33 and 3.71. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 90.1%, 75.7%, 85.2%, 87.7% and 80.0% and those of strain ratio from cross section were 84.7%, 70.3%, 80.6%, 83.6% and 72.2%. ConclusionReal-time ultrasonic elastography is helpful to the differential diagnosis of thyroid nodules, but there is no statistical difference between the strain ratio from longitudinal section and cross section.

Objective To explore the relationship between the osteonecrotic volume (lesion size), angle and the index of necrotic extent on the femoral head. Methods Fifty-one hips in 39 patients with non-traumatic avascular osteonecrosis on the femoral head were divided into 12 equal segments from the head to the neck junction (a turning point of the spherical curve of the head) with whole hip displacement, each with 30 degrees on a coronal plane of weight-bearing surface. The osteonecrotic angle of the arc of each necrotic segment from the center of the femoral head was measured at the point of one- to 12-o'clock on imaging of two dimensional reconstruction of computerized tomography (CT) scans and anteroposterior and lateral radiographs. Necrotic volume on each segment of the femoral head was calculated with fluid displacement method. The index of osteonecrotic extent on the femoral head was calculated using direct anatomical measurements. Results Osteoneerotic volume on the femoral head at the point of 12- to one-o'clock on coronal plane was (74. 5 ± 7.4)% of the sphere equivalent of the whole femoral head, which was positively correlated to its necrotic angle [ (41.9±8. 3) degrees] at the point of one-o'clock on the plane, with a coefficient of correlation of 0. 843, and that at the point of one- to two-o'clock on the plane was (73.7 ±0. 4) %, which was positively correlated to its necrotic angle [ (41.9 ± 1.8) degrees] at the point of two-o'clock, with a coefficient of correlation of 0. 543. Osteonecrotic volume on the point of 11- to 12-o'cleck was (83.6±8.6)%, and the necrotic angle at the point of 12-o'clock was (44. 9±3.9) degrees, which were positively correlated each other, with a coefficient of correlation of 0. 701 (P <0. 01 ). Osteonecrotic volume on the femoral head was positively correlated to its necrotic angle , modified index of necrotic extent, index of necrotic extent and Kerboul conjugated necrotic angle, with coefficients of correlation of 0. 798, 0. 701, 0. 377 and 0. 398 ( P < 0. 01 ), respectively, at the point of one o' clock. Conclusions Measurements of osteonecrotic volume was positively correlated to the index of necrotic extent and necrotic angle on the femoral head, respectively. Necrotic angle on the plane at 30-degree of the trochanter on the femoral head can well reflect its necrotic volume.

Objective To evaluate the early and middle-term results of in-situ single-screw fixation and subtrochanteric osteotomy of femur with external fixator for slipped capital femoral epiphysis(SCFE).Methods From June 1998 to July 2008, eleven patients (12 hips) with SCFE were treated, including 7males (8 hips) and 4 females (4 hips) with an average age of 14.3 years (range, 9-18). The average BMI was 31.1 g/m2. According to the Southwick measurement, mild (＜30°) in 6 cases (7 hips), moderate (30°-50°) in 2 cases (2 hips), and severe (＞50°) in 3 cases (3 hips). All the mild and moderate cases were undergone insitu single screw fixation, and three severe cases were performed subtrochanteric osteotomy of femur with external fixator. All the cases were evaluated at 3 months, 6 months and every year postoperatively. Results All the cases were followed up for average 5.6 years (range, 2-12). The Harris hip score increased from mean 74.8 points preoperatively to 90.6 points postoperatively, with 10 hips excellent, 1 hip good, 1 hip fair and 0 hip poor. The excellent and good rate was 91.7% (11/12). The X-ray showed the epiphyseal closure in in-situ single screw fixation cases, and no further increase in epiphyseal-shaft angle. Partial reduction of slipped epiphysis with normal joint spaces was observed in subtrochanteric osteotomy of femur with external fixator cases. Conclusion In-situ single screw fixation provides a surgical treatment option to treat mild and moderate SCFE with satisfactory clinical outcome, and profit to the prevention further slip. Subtrochanteric osteotomy of femur with external fixator is suitable for severe SCFE with late deformity. The realignment procedure can correct deformity and postpone or avoid the occurrence of osteoarthritis.