Objective To evaluate the potential high risk factors of femoral head necrosis after femoral neck surgery in adult patients. Methods From January 2009 to October 2014,390 patients with femoral neck fractures in our hospital were treated with multiple hollow compression screws. All patients were followed up for 12 to 60 months. Then retrospectively analyzed the incidence rates of femoral head nec-rosis and the clinical data about age,gender,fracture side,Garden index,fracture shift condition,internal medicine complications,whether to do lower limb preoperative traction,restoration method,postoperative load time and whether take out hollow compression screw internal fixa-tion,so as to explore the higher risk factors for femoral head necrosis. Results Among the 390 cases,352 cases got followed up. There were 45 cases of them ended with nonunionand 49 cases ended with femoral head necrosis. The univariate regression analysis results showed that the age,fracture shift condition,internal medicine complications,postoperative load time and Garden index,whether take out internal fixation were risk factors for femoral head necrosis (P<0. 05). The multi-factor results showed that aged from 40 to 60 years old,transfered fracture, seriously complications,time of loading less than 3 mouths,Ⅲ and Ⅳ Garden index,take out internal fixation were the high risk factors for femoral head necrosis (P<0. 05). Conclusion Patients who aged from 40 to 60 years old and having transfered fracture,seriously complica-tion,early weight bearing,high Garden index and internal fixation take-out would increase the risk of femoral head necrosis.

Objective To investigate the clinical characteristics and management of congenital hypertrophic pyloric stenosis (CHPS) associated with intestinal malrotation (IM) in infants.Methods The clinical data of 6 cases with CHPS and IM admitted in our hospital from Jan 2003 to Dec 2009 were reviewed,including clinical presentation,symptoms and information of imageology.Results Through barium meal examination and sonography,4 cases were diagnosed CHPS and IM,pyloromyotomy and Ladd's procedure were performed;two cases were diagnosed CHPS,only pyloromyotomy was done,secondary operation was performed for recrudescence of vomiting.All the cases were followed up for 1 to 3 years with good prognosis.Conclusion The etiology of CHPS with IM isn't clear.The diagnosis of IM may be delayed because the symptoms of IM can be masked by that of CHPS.It is helpful for diagnosis of this disease to have barium meal and sonography examination.Good prognosis will be achieved if prompt preoperative diagnosis and operation can be done.

AIM This study was undertaken to investigate the protective effect against ConcanavalinA (ConA) or BCG+LPS induced liver injury in mice by FTY720 and possible mechanisms. METHODS The serum ALT and its AST level changes were measured in two kinds of immunological liver injury models. The serum IFN ? and IL 4 changes were determined by ELISA and tested the effect of FTY720 on lymphocyte proliferation. RESULTS FTY720 dose dependently reduced serum ALT, AST levels in ConA or BCG+LPS induced liver injury in mice. It was also found that FTY720 decreases serum IFN ? and IL 4 levels during liver injury. The results also proved that FTY720 was able to inhibit lymphocyte proliferation. CONCLUSION Pretreatment with FTY720 could protect the mice from immunological liver injury. The possible mechanisms of its action are related to inhibiting lymphocyte proliferation and cytokines production.

AIM:To study the effects of lipopolysaccharide(LPS), interleukin-6(IL-6)and tumor necrosis factor ? (TNF?) on tissue factor(TF) expression of astrocytes. METHODS:Astrocytes were identified with anti-glial fibrillary acidic protein antibody. The TF activity of cell lysate was measured with one stage clotting assay. RESULTS:TF activity of astrocytes of LPS,IL-6,TNF? groups were obviously higher than that of the control group( P

Objectives To detect the expression of human leukocyte antigen-G (HLA-G) in tissues from pregnant women with preeclampsia and discuss the relationship between HLA-G and preeclampsia.Methods Pregnant women with preeclampsia in Maternal and Child Health Hospital of Shaanxi Province from March 2009 to December 2009 were included.Eight were included into mild preeclampsia groups and 22 were included into severe preeclampsia group.And 30 age-matched normal pregnancies were referred as the control group.All women in the three groups received cesarean section.The soluble HLA-G (sHLA-G)levels in peripheral blood,umbilical blood and amniotic fluid were examined by ELISA ; the expressions of HLA-G protein in placenta,fetal membrane and umbilical cord were examined by western blot.Results ( 1 ) The sHLA-G levels in peripheral blood,umbilical blood and amniotic fluid in each group.The sHLA-G levels in peripheral blood in mild and severe preeclampsia group were (50 + 14) and (30+6) μg/L respectively,and the sHLA-G levels in umbilical blood were (34 ± 10) and (26 ±8)μg/L respectively.All were significantly lower than those in the control group ( P ＜ 0.01 ),which were (100 ± 16) and (70±9) μg/L respectively.There was also statistical difference between mild and severe preeclampsia group (P ＜0.01 ).Although the sHLA-G level in umbilical blood of severe preeclampsia group was lower than that in mild preeclampsia group,there was no statistical difference ( P＞0.05 ).The sHLA-G levels in amniotic fluid in mild and severe preeclampsia groups were (26±7 ) and (25 ± 5 ) μg/L respectively,which were lower than that in the control group (27±6) μg/L,but the differences were not significant ( P＞0.05 ).There was no statistical difference between mild and severe preeclampsia groups ( P＞0.05 ).(2) The expression levels of HLA-G protein in placenta,fetal membrane and umbilical cord in each group.The expression levels of HLA-G in placenta and fetal membrane in the control group were 1.59 ± 0.36 and 0.42 ± 0.09 respectively.The expression of HLA-G in placenta was significantly higher than that in fetal membrane ( P＜0.05 ).The expression level of HLA-G in umbilical cord in the control group was 0.24±0.17,statistically different from those in placenta and fetal membrane,respectively (P＜0.01 ).The expression levels of HLA-G in placenta in mild and severe preeclampsia groups were 0.78 + 0.21 and 0.29 ± 0.17 respectively,significantly different from the control group ( P ＜ 0.01 ).There was no expression of HLA-G in fetal membrane and umbilical cord in mild and severe preeclampsia groups.Conclusions The expressions of HLA-G in the peripheral blood,umbilical blood and placenta in women with preeclampsia are significantly lower than those in normal pregnant women.The abnormal expression of HLA-G might be associated with the pathogenesis of preeclampsia.

Objecfive To investigate the association between bacteriology of airway secretions in acute onset chronic respiratory failure (ACRF) and its clinical prognosis.Methods The bacterial flora and antibiotic resistance in the airway secretions from 44 patients with 49 cases of ACRF were studied,the associations between bacteriology,antibiotic resistance and annual ACRF hospital admission frequency (ACRF≥2 or ACRF<2),its mortality were also explored.Results Positive rate of culture in airway secretions was 63.3%.Untraditional pathogens such as Pseudomonas Aeruginosa accounted for 80.7%.The bacterial yield of patients with ACRF≥2 was twice as that with ACRF<2 (P<0.01).Of the identified bacteria,61.3% displayed antibioticresistance,and there was signifi-cant prolongation of ventilation and hospitalization and increase of mortality in patients with antibiotic resistance(P<0.05).Conclusion There is a predominance of untraditional pathogens such as Pseudomonas Aeruginosa in bacteria from airway secretions of ACRF patients,positive yield and percentage of untraditional pathogens increased with the severity of chronic respiratory failure,infections caused by antibiotic-resistant strains led to higher mortality in ACRF.

Objective:To explore the role of reactive oxygen species(ROS,i.e,H_2O_2 and O_2-) in regulation of respiratory rhythm in the medial area of nucleus retrofacialis(mNRF).Methods: Medullary slices of neonatal SD rats,including hypoglossal nerve(Ⅻn) and mNRF,were made according to Suzue's method.Simultaneous recording of the Ⅻn respiratory rhythmic activity(RRA) with suction electrode and the respiratory neuronal discharge were performed with whole cell patch in the mNRF on the brainstem slice in vitro.The effect of t-butyl hydroperoxide(tBHP) and ?-lipoic acid(?-LA) on the respiratory pacemaker neurons and respiratory rhythm in the mNRF were observed.Results: tBHP significantly decreased respiratory cycle(RC) and increased respiratory amplitude;?-LA significantly increased RC and decreased its amplitude.Meanwhile,?-LA significantly prolonged the action potential of the respiratory cadmium-insensitive pacemaker neurons and reduced its amplitude,but it had no significant effect on the cadmium-sensitive respiratory pacemaker neurons.Voltage steps and ramps showed that ?-LA inhibited both the transient and persistent sodium current of cadmium-insensitive pacemaker neurons.Conclusion: ROS has an excitatory effect on the respiratory rhythm and the cadmium-insensitive respiratory pacemaker neurons through modulating sodium current.

Objective To discuss the effect of the combination detection of cardiac troponin I (cTnI) and homocysteine(Hcy) for increasing the diagnosis and treatment offects of non-ST elevation myocardial infarction (NSTEMI) .Methods The levels of cTnI and Hcy were detected in 47 patients with NSTEMI(NSTEMI group) before and after therapy and 63 healthy individuals(control group) .The detection results were performed the statistical analysis for verifying their value to judge the diagnostic and treatment effect of NSTEMI .Results The levels of cTnI and Hcy were (2 .37 ± 0 .65)ng/mL and(19 .23 ± 2 .94)μmol/L in the NSTEMI group ,which were significantly higher than(0 .33 ± 0 .14)ng/mL and(10 .62 ± 3 .27)μmol/L in the control group ,the differences showing statistical significance (P< 0 .05);the sensitivities of single cTnI and Hcy were 95 .74% and 85 .11% respectively ,and their specificities were 85 .71% and 90 .48% respectively ;the sensitivity and sepecificity of cTnI and Hcy combination detection were risen to 97 .87% and 98 .41% respectively ;after therapy ,the cTnI and Hcy levels in the NSTEMI group were significantly lowered and close to the normal levels .Conclusion The combination detection of cTnI and Hcy can not only be used for the diagno-sis of NSTEMI ,but also has the important significance to the judgment of the therapeutical effect of NSTEMI .

Objective To analyze the changes of clinical and pathological features in the patients of IgA nephropathy with anemia.Methods Four hundred and nine patients of IgA nephropathy diagnosed by renal biopsy were classified into two groups:IgA nephropathy with nonanemia (group 1) and IgA nephropathy with anemia (group 2).Changes were studied retrospectively between the groups.Results Serum hemoglobin level was correlated with the clinical parameters of IgA nephropathy.Companed to group 1,changes in group 2 were as followed:serum creatinine increased,eGFR decreased,proteinuria increased; the global sclerosis,segmental sclerosis,crescents and tubulointerstitial lesions worsened.The glomerular and tubulointerstitial lesions were negatively correlated with serum hemoglobin and eGFR,but positively correlated with serum uric acid and proteinuria (P＜0.05).Multivariate Logistic regression analysis revealed that anemia was an independent risk factor for the tubulointerstitial lesion.Conclusion Clinical feature and pathological damages in the patients of IgA nephropathy with anemia are more serious than those with non-anemia.