Treatment for developmental dislocation of hip differs due to various age and pathological alterations.The principle of management is early diagnosis and intervention.At present,although a lot of methods have emerged and their indications vary,the surgical reconstruction has received a good result as a main method of treating the disease.It is controversial about how to select technique and method.The aim of the treatment is to achieve concentric reduction of femoral head and acetabulum to restore anatomic structure of the hip and reconstruct joint function.This paper introduced the surgical intervention for developmental dislocation of hip,application of different implants(hip replacement and surface replacement) and treatment plans for different age groups in recent years.

Objective To investigate the roles of urotensin Ⅱ(U-Ⅱ) in rat with chronic obstructive pulmonary disease(COPD).Methods Male SD rats were randomly divided into chronic bronchitis group(group B),COPD group(group C),exsmoker group(group D) and control group(group A). The concentrations of U-Ⅱ in plasma,BALF and lung tissues were measured by RIA.Lung function and pathological analysis of lung specimens were performed.Results There was no significant difference of plasma U-Ⅱ levels among groups.The BALF levels of U-Ⅱ was 1.7,2.2,4.7,4.9 folds higher than plasma levels in group A,B,C and D respectively(all(P

The article suggests fully displaying the vital role of esthetic education and melting the esthetic education work in the process of management of medical students so as to comprehensively improve students' thinking and political quality,the professional ability,the technical culture quality and the psychological and physical quality,and at the same time formulate the target system of the comprehensive quality evaluation on students and create a good esthetic education environment.

Objective:To establish a real-time fluorescent quantitative PCR method for determining the BK virus(BKV) level in renal transplant recipients,and to evaluate its clinical application.Methods: Plasmids containing part of BKV VP1 gene conservative region were constructed as external standards,and a TaqMan probe technique was used to establish a quantitative method for determination of BKV.Urine and peripheral blood(PB) samples from 112 renal transplant recipients were assayed for BK virus levels,and the results were compared with those of 40 healthy controls.Results: The real-time fluorescent quantitative PCR assay established in this study had good sensitivity,specificity,and reproducibility.The minimal detectable level was 8?10~(2)copy/ml,intro-experiment variation was 0.54%-3.78%,and intra-experiment variation was 0.62%-4.58%.BKV was detected in 27.7% urine samples and 11.6% PB samples from patients.The median level of BKV in urine and PB were(8.2?)10~(4)copy/ml and 2.4?10~(3)copy/ml,respectively.BKV positive rate of 40 healthy population in urine and PB samples were 2.5% and 0%,respectively.The positive rate and level of BKV in renal transplant recipients were both significantly higher than those in normal cohort(both P

ObjectiveTo imitate the process of identifying episode separations,which helps to improve the methodology of control episode separations.Methods Abstracts of inpatient record on all patients discharged from the hospitals in Beijing in 2010 were drawn from Beijing Public Health Information Center.Risk-adjusted by Diagnosis Related Groups-Beijing version (BJ-DRGs),two-weeks readmission rate was calculated at the whole city and hospital levels respectively.Comparing the readmission rate between these two levels,“suspicious objects”of episode separations can be found.In turn,the episode separations can be identified by detail analysis of these suspicious objects.Results In 2010,there were 13 DRGs with readmission rate exceeding 10％.Take the cases of dementia and other chronic brain disorders for example,the readmission rate for this type of inpatients in hospital G was much higher than the average level of the whole city.After the detail analysis of hospital G,the episode separations were found.Conclusion It is an effective method to indentify episode separations that calculating readmission rate based on the DRG risk-adjustment and using city level readmission rate as bench-mark.

Objective To study the effect of early pulmonary surfactant (PS) treatment on oxygenation in neonates with acute respiratory distress syndrome (ARDS). Methods Clinical data of neonates with ARDS were retrospectively analyzed. All neonates with ARDS were divided into control group and treatment group. Neonates in treatment group were given PS at a dose of 70-100 mg/kg through the endotracheal tube. Results Among 64 neonates with ARDS, 18 neonates in treatment group were treated with PS, while other interventions were same with 46 neonates in control group. The PaO2/FiO2 and ventilation efifciency index were statistically higher in treatment group than those in control group at 6 h, 12 h, 24 h and 48 h (P<0.05). The oxygenation index and respiratory index were statistically lower in treatment group than those in control group at the same time points (P<0.05). Compared with control group, the treatment group also had a signiifcantly shorter duration of assisted ventilation and oxygen treatment (P<0.05). Conclusions Early treatment with PS in neonates with ARDS could improve the pulmonary compliance and oxygenation, and reduce the duration of assisted ventilation and oxygen treatment, and thus yield better prognosis.

Objective To study the oxygenation of the pulmonary surfactant replacement therapy for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in neonates.Methods Ninetyeight eligible neonates with ALI and ARDS were divided into two groups,treatment group (n =30) and control group(n =68).Thirty infants in treatment group were injected with pulmonary surfactant 70 ～ 100 mg/kg via tracheal intubation.The rest of the treatment measures were same in treatment and control group.Results There were no differences between the two groups in gender,gestational age,birth weight and ALI/ARDS.After the pulmonary surfactant replacement therapy for ALl and ARDS,the PaO2/FiO2 and ventilator efficiency index were higher in treatment group than that in control group at 6 h,12 h,24 h,48 h;the oxygenation index and respiratory index were shorter in treatment group than that in control group at the same time.The differences at all time points were statistically significant (P ＜ 0.05).The treatment group also had a significantly shorter duration of assisted ventilation[(66 ± 13) h vs (80 ± 18) h,(82 ±26) h vs (101 ±36) h] and oxygen treatment time [(86±13) h vs (104± 16) h,(103 ±25) h vs (125 ±29) h] (P ＜0.05).Conclusion The application of the pulmonary surfactant replacement treatment in neonates with ALI and ARDS could improve rapidly in dynamic compliance and oxygenation,decrease duration of assisted ventilation and supplemental oxygen administration,thus yield better prognosis.

Objective:To evaluate MRI manifesattions of intradural metastases of medulloblastomas.Methods:The clinical data and MRI of 6 cases with intradural metastasis of medulloblastomas were reviewed retrospectively.Results:21 masses were found in 6 cases,mostly in lumbar segment.Most of them were oblong or fusiform shagped.The size averaged 1.8 cm?2.3 cm.They had the similar signal intensity with those in brain,but hemorrhage,cyst and calcification were less common.Conclusion:MRI plays an importment role in diagnosis of intradural metastases of medulloblastomas. [

Objective To analyze the causes and results of treatment of periprosthetic femoral frac-tures after total hip arthroplasty and to explore the best operative methods for fractures. Methods 11 cases treated for periprosthetic femoral fracture after total hip arthroplasty were subjected to a retrospective fol-low-up study from December 1998 to March 2003. There were 8 men and 3 women, the mean age was 56 years (range, 43 to 75 years). There were 2 Vancouver A type fractures, 7 B2 type, 1 B3 type, 1 C type. 5 fractures were treated by nonoperative methods and other 6 by operative methods, including one fracture malunion treated initially by skin traction. There were 5 revisions using long stem supplemented with cortical allograft strut, including 4 uncemented stems with distal fixation and one cemented stem; the remaining one fracture treated by open reduction and internal fixation. Results None was lost for follow-up. The mean follow-up period was 25.6 months (range, 7 to 50 months). 9 fractures united at a mean of 4 months (range, 3 to 6 months). Nonunion was found in 2 fractures, both were treated nonoperatively. All the 6 fractures treated by operative methods united. Up to now, 7 stems were well-fixed, continuous radiolucent line was seen in one revision case, 3 stems were loosened. The function of the patients with well-fixed stems was bet-ter than those with loosened stems, the mean Harris score of the former was 91. All the cortical allograft struts were incorporated with host bone within one year. No strut fracture happened. Conclusion Type A fractures with well-fixed stems can be treated by nonoperative methods, while type B1 and type C fractures should be treated by open reduction and internal fixation, on condition there is no surgical contraindication. For fractures with loosened stems, use of an uncemented long stem with distal fixation supplemented with cortical allograft strut is the best choice.

To accelerate the identification of HLA-DPB1 matched marrow donors from unrelated population, a very simple HLA-DPB1 genotyping method called PCR-fingerprinting (PCRF) was developed according to the theory about homoduplex and heteroduplex formation from different PCR coding strands and non-coding ones. Unlike PCR-SSCP, strict laboratory condition is not needed in the PCRF. After denaturing at 94℃ for 2 min and cooling at 37℃ for 8 min, the PCR product was separated by 8% PAGE for 5 h and polymorphism band patterns would appear when the gel staining was completed with either EB or silver staining procedure. To confirm its reliability, 21 individuals from 9 family whose DPB1 genotypes assigned by PCR-RFLP were verified. It was found that there were 8 PCRF patterns corresponding to the 9 HLA-DPB1 genotypes from the 21 cases and the same DPB1 genotypes produced identical PCRF pattern except one pair.The factors on efficient separation of heteroduplexes and homoduplexes were also discussed.