Objective To investigate the influence of multi-drug resistant mycobacterium strain tuberculosis (MDR-TB) on the clinical outcomes and its countermeasures in the treatment of bone and joint tuberculosis. Methods From December 1993 to June 1999, 250 revised cases were admitted in our hospital, which were 143 males and 107 females aging from 2 to 72 years with an average of 25.44 years. The most of lesions were located at spine, then the hip, knee and small joints. The specimens were harvested via need biopsy or operation from the lesion. Specimens were examined by Bactec TB 460 to identify tuberculosis mycobacterium and non tuberculosis mycobacterium strain, and drugs-sensibility test to INH(0.2 ?g/ml), SM (6.0 ?g/ml), RFP (2.0 ?g/ml) and EMB (7.5 ?g/ml) respectively. Results Of 250 patients, Mycobacterium were positive in 48 by Bactec measurement, which were tuberculosis mycobacterium strain in 46 with 18.4% positive rate, and non tuberculosis mycobacterium strain in 2(1 mycobacterium avium intracellulare complex, the other unkown). Of the 46 positive specimens, 27 were sensitive to all of 4 drugs(58.7%), however, 3 were resistant to 1 drug(6.5%), 1 was resistant to 2 drugs(2.1%), 4 were resistant to 3 drugs (8.7%), and 11 were resistant to 4 drugs(24%). In 11 patients resistant to 4 drugs and 2 patients with non tuberculosis mycobacterium strain, 8 were complicated with sinuses after the first operation, in which 7 healed after 2 to 3 re-operations and 1 died of secondary infection. 1 M. avium intracellulare complex and 1 unidentified mycobacterium were multi-drug resistant strains( INH,RFP, SM, EMB) and found with poor clinical results.Conclusion Those cases with MDR-TB in lesions can influence the curative effect of bone and joint tuberculosis significantly. Based on the drug-sensibility, the chemotherapy regimen should be modified and individualized, and requires several operations to cure.

Objective To evaluate the value of multi-slice spiral CT(MSCT) post-processing technique in diagnosis of spinal injury. Methods CT materials in 44 cases of spinal injury were retrospectively analyzed,all case were scanning with 16-slice helical CT,the images were passing on an independent workstation for MPR and SVR technique,and compared with axial 2D imaging of CT . Results MPR and SVR images could show the fracture line and displacement of fractured osseous fragments and spatial relationship of structure clearly,MPR images could show small fracture line and dislocation of joint actually. Conclusion MPR and SVR images are important supplement to axial 2D images,the axial imaging combined with various reconstruction technique can provide the space structure of spinal injury ,and play an important role in selecting therapy project and evaluating prognosis.

Objective To evaluate the value of multi-slice spiral CT(MSCT)post-processing technique in diagnosis of small peripheral lung cancer .Methods CT materials with small peripheral lung cancer in 20 cases were retrospectively analyzed ,after 16-slice spiral CT scanning ,both plain and contrast ,and reconstructed using 1mm slice thickness ,the images were passing on an independent workstation for SSD and MPR technique .Results the images of SSD and MPR could reveal the relation between focus and surrounding organs in different dirctions,also revealed the features of pulmonary carcinoma stereos copically and directly,could show actually lobulated sign ,burr sign,pleural indentation sign and vessel convergence sign with small peripheral lung cancer ,the SSD imaging was superior in judging the presence of the lobulated sign .Conclusion It is very valuable for diagnosis of small peripheral lung cancer that application of SSD,MPR and two dimensional reconstruction。

Objective To evaluate the practical value of ERCP for etiologic diagnosis and treatment of postcholecystectomy syndrome(PCS).Methods A retrospective review of 116 cases of postcholecystectomy syndrome received ERCP in the recent four years in our hospital was undertaken.Of the116 cases,80 cases(68.97 %) had the indications for therapeutic ERCP and were treated by endoscopy.Results The bile duct was visualized in all of the 116 cases(100 %),and the pancreatic duct was visualized in 97 cases(83.62 %).The etiology of PCS was choledocholithiasis in 56 cases(48.28 %),diverticulum adjacent to duodenal papilla or papilla with in the diverticulm in 19 cases(16.37 %),residual of long cystic duct with stones in 15 cases(12.93 %),benign stenosis of terminal commom bile duct in 13 cases(11.20 %),sphincter of oddi dysfuction in 4 cases(3.45 %),tumour of doudenal papilla in 3 cases(2.59 %),stenosis of injured bile duct in 2 cases(1.73 %),sclerosing cholangitis in one case(0.86 %),cholangiocarcinoma in one case(0.86 %),remnant gallbladder with stones in one cases(0.86 %),and chronic pancreatic ductal lithiasis in one case(0.86 %).Fifty-seven cases were treated by EST stone extraction,20 cases by ERBD,23 cases by ENBD,1 case by EMBE,and 1 case by EPS extraction.In the 80 cases treated with endoscopy,75 cases were followed up for 3~12 months,with relief of symptons in 74 cases(98.67 %).Conclusions ERCP is the gold standard for etiologic diagnosis of PCS.PCS is an indication for therapy by ERCP.Therapeutic ERCP is the preferred treatment of PCS cases with an indication for endoscopic treatment.

[Objective] Introduce 1 case of adult onset stil ’s disease cured by Chinese traditional medicine plus acupuncture therapy.[Methods] With TCM treatment we started from relieving shaoyang disorder, clearing heat and expel ing superficial evils, differentiated the case Shaoyang syndrome, then made a prescription of Xiao Chai-hu Tang and Qing-hao Bie-jia Tang to balance qi movement ,clear heat and expel dampness;with acupuncture treatment we discharged heat and expel ed wind at acute phase, supplemented the center and boosted the energy at stable phase. With the combined therapy that reached a total function of expel ing damp and regulating qi movement. [Results] The patient ’s symptoms relieved and discharged, fol owed the case 2 months without recurrence. [Conclusion] Chinese traditional medicine plus acupuncture therapy can cure adult onset stil ’s disease effectively, it is worth clinical application.

Proteus syndrome is a rare complex disorder characterized by asymmetric and disproportionate overgrowth of multiple tissues,presence of cerebriform connective tissue nevi and epidermal nevi,vascular malformation and abnormality of fat tissues.In 2006,a patient with typical manifestation of Proteus syndrome was admitted to our hospital.By minimally invasive plastic surgery,we achieved good therapeutic results.

Objective To observe the effects of cryptotanshinone (CTS) on cytochrome P450 (CYP) isoforms in the rat liver microsomes. Method The rats were randomized into six groups according to the body weight, 3 rats in each group. CTS groups were treated with CTS at the doses of 20～540 mg/kg per day for 10 days, and the negative control group was treated with 10 mL/kg hydroxylpropyl-β-cyclodextrin solution. The positive group was injected with β-NF(80 mg/kg) intraperitoneally on the 7th day, and all the animals were sacrificed by decapitation on the 10th day after last dose. The liver was got out for the preparation of liver microsomes. The activities of six kinds of CYP isoforms were detected by cocktail in-vitro incubation method. Besides, the expression level of CYP isoforms mRNA and protein in rat liver was analyzed by reverse transcription polymerase chain reaction (RT-PCR) and western-blotting assay, respectively. Results CTS significantly increased the ac-tivity of CYP1A2 in a dose-dependent manner. In CTS groups at the dosages of 20～540 mg/kg, the activity of CYP1A2 was 60 %～430 % higher, CYP1A2 protein expression level was 130 %～320 % higher, and CYP1A2 mRNA expression level was 10 %～150 % higher than that of the negative control group. CTS had no effect on other kinds of CYP isoforms. Conclu-sion CTS can induce hepatic microsome CYP1A2 expression significantly, which indicates potential drug-drug interaction might occurred when CTS is co-administrated with those drugs metabolized by CYP1A2.

Objective To investigate the effects of radiotherapy combined with resveratrol( Res)on proliferation, invasion and apoptosis of hepatoma cell line Bel-7404. Methods Bel-7404 cell line was treated with Res(25 μmol·L-1 ) combined with radiotherapy,then divided into four groups( group 1:the control;group 2:radiation at dose of 2 Gy;group 3:radiation at dose of 4 Gy;group 4:radiation at dose of 6 Gy). Cell proliferation and invasion were detected by MTT assay. Cell apoptosis were observed by fluorescence microscopy. Expressions of MMP-2 and VEGF proteins were determined by Western blotting. Results Compared with the control group,cell proliferation and invasion were significantly inhibited,while cell apoptosis was increased in all radiation groups(P〈0. 05). Conclusion The sensitivity of hepatoma Bel-7404 cells to radiation can be enhanced by resveratrol. Radiation therapy combined with resveratrol can inhibit proliferation and invasion of hepatoma cells and increase the cell apoptosis,which may be related with the down-regulation of MMP-2 and VEGF proteins.

Objective To investigate the liver protective effects of Siphonostegia chinensis decoction in rats with liver fibrosis induced by carbon tetrachloride(CCl4).Methods A total of 120 male SD rats were randomly divided into six groups: a blank control group, a model group, a Siphonostegia chinensis decoction group, a Salvia miltiorrhiza decoction group, a Rhizoma polygoni cuspidati decoction group and a polyene phosphatidylcholine capsules group, with 20 rats in each group. The model of liver fibrosis in rats was induced by subcutaneous injection with CCl4, except the blank group. Except rats in the blank control group and the model group, the rats in the other four groups were treated with Siphonostegia chinensis decoction, Salvia miltiorrhiza decoction, Rhizoma polygoni cuspidati decoction and polyene phosphatidylcholine capsules(10 ml/kg). The serum level of tumor necrosis factor-α(TNF-α)was determined with enzyme-linked immunosorbent assay, the fibrosis stage assessment were determined by histopathological examination.Results Compared with the model group, Siphonostegia chinensis decoction group significantly reduced the stage of liver fibrosis(P<0.01)and there were no obvious difference in liver fibrosis stage among the Salvia miltiorrhiza decoction group, Rhizoma polygoni cuspidati decoction group and polyene phosphatidylcholine capsules group, and the Siphonostegia chinensis decoction group(allP>0.05).Compared with liver fibrosis model group(368.06±24.90)U/L, the serum level of TNF-α in the Siphonostegia chinensis decoction group(336.61± 20.20)U/L significantly reduced(P<0.01), and there were no obvious difference among the Siphonostegia chinensis decoction group, the Salvia miltiorrhiza decoction group(337.81±21.04)U/L, the Rhizoma polygoni cuspidati decoction group(338.95±24.43)U/L and the polyene phosphatidylcholine capsules group(337.11± 23.64) U/L(allP>0.05).Conclusion Siphonostegia chinensis decoction has certain liver protective effect in rats with liver fibrosis induced by CCl4.

Objective To objectively evaluate the intrusion effects on the maxillary incisors of implants versus conventional method(J-hook headgear ,utility arch) .Methods Such online databases as Cochrane library ,PubMed ,EMbase ,VIP ,Wanfang and CNKI were searched by randomized control test and prospective case controlled study about implants vs conventional anchorage for the maxillary incisor intrusion .After study selection ,assessment and data extraction conducted ,meta-analyses were performed by u-sing the RevMan 5 .1 software .Results Totally 11 studies were included ,6 studies involving 154 patients were included in the J-hook headgear group ,5 studies involving 127 patients were included in the utility arch group .The results of meta-analyses showed that :(1)Compared with the J-hook headgear ,implants had more decrement in the distance of upper center incisior cutting to palatal plane(P<0 .001) ,more decrement in overbite(P=0 .001) ,shorter treatment time (P<0 .001) ,less increase in SN-OP angle(P=0 .004) ,less decrement in distance of maxillary molar cusp to palatal plane (P=0 .020);There was no statistically significant differ-ence in overjet ,root resorption(P>0 .05) .(2)Compared with the utility arch ,implants had more decrement in the distance of the center of resistance of the upper incisor to palatal plane (P=0 .010) ,less increase in U6-PP angle (P<0 .001);There was no statis-tically significant difference in the distance of upper center incisior cutting to palatal plane ,U1-PP angle ,the distance of upper first Molar cutting to palatal plane ,sagittal position of the mesial tip of the upper first Molar ,overbite ,overjet ,course of treatment ,root resorption(P>0 .05) .Conclusion The implants anchorage intruded the maxillary incisor was better than conventional method (J-hook headgear ,utility arch) ,it has more incisor intrusion ,shorter treatment time and more comfortable for the patients ,there was no difference in root resorption between the two groups .