Objective To assess the feasibility and efficiency of pedal-plantar loop technique in the treatment of below-the-ankle arterial occlusion . Methods A retrospective analysis was undertaken on 12 cases ( 14 legs ) of below-the-ankle arterial occlusion.The pedal-plantar loop angioplasty was performed in all the cases .Balloon angioplasty was performed after traversing through the arterial obstruction sites using antegrade or retrograde technique .After 6 months of the surgery , the results of visual analogue scale , dorsal or plantar arterial pulse volume scores , ankle brachial index , TcPO2 , and healing of the ulcer were compared to preoperative measures. Results Technical success was achieved in 9 cases (11 legs).During follow-up, 1 patient died of cerebrovascular events 2 months after the therapy .The other 8 cases (10 legs) were followed up for 6 months and no one had recurrent ischemic symptoms . The results of visual analogue scale , ankle brachial index, and TcPO2 before the surgery were (5.68 ±1.09) points, 0.60 ±0.04, and (25.71 ±5.25) mm Hg, which were improved to (0.44 ±0.27) points, 0.87 ±0.05, and (35.90 ±5.28) mm Hg (P<0.05).Dorsal or plantar arterial pulse volume scores were also enhanced markedly (P=0.004).Complete ulcer healing was observed in 8 limbs.No related complication was observed in other patients after the surgery .One technical unsuccessful patient who suffered infection and severe rest pain was given leg amputation . Conclusion Pedal-plantar loop technique is an effective therapy for below-the-ankle arterial occlusion while long term follow-up data need to be collected .

BACKGROUND:Suitable stress signals such as extracorporeal shock wave (ESW) and parathyroid hormone can be involved in regulation of bone formation and metabolism.
OBJECTIVE:To investigate the effects of low-density ESW and low-dose intermittent recombinant human parathyroid hormone 1-34 (rhPTH1-34) on the proliferation and differentiation of osteoblasts from rats cultured in vitro.
METHODS:Osteoblasts from the skul of neonatal rats were cultured using col agenase digestion method. After 60-150 times of stimulations of 0.18 mJ/mm2 ESW, different patterns of rhPTH1-34 at 10-12-10-10 mol/L and ESW+intermittent rhPTH1-34 (10-11 mol/L), osteoblasts were col ected to observe cel proliferation by cel counting, MTT and flow cytometry analysis and to observe cel differentiation by measuring alkaline phosphatase and type I col agen expression.
RESULTS AND CONCLUSION:0.18 mJ/mm 2 ESW (60-150 times), intermittent rhPTH1-34 (10-11 and 10-10 mol/L) and ESW+intermittent rhPTH1-34 (10-11 mol/L) stimulations could al improve proliferation and differentiation of rat osteoblasts cultured in vitro (P<0.05). ESW (60-150 times)+intermittent rhPTH1-34 stimulation showed better effects than ESW and intermittent rhPTH1-34 alone (P<0.05). These findings indicate that the combination of suitable ESW stimulation and low-dose intermittent rhPTH1-34 stimulation can improve the proliferation and differentiation of rat osteoblasts significantly.

Objective To investigate the expression and significance of osteopontin (OPN) and monocyte chemoattractant protein-1 (MCP-1) in lipid -induced rat renal injury. Method Wistar rats were randomly divided into two groups: normal control rats (C group) and cholesterol fed rats (H group). Twelve weeks later, the 24h total urine protein amount, creatinine clearance rate and the levels of total serum cholesterol, LDL- cholesterol, HDL- cholesterol and triglycerides were measured. Kidney pathological changes were observed by HE and PAS statning. Immunohistochemitry were used to detect the expression of OPN, MCP-1 and ED1. Results Total serum cholesterol level, LDL-cholesterol level and 24h total urine protein amount in H group rats were higher than those in C group rats, and there were no significant difference between two groups in HDL-cholesterol and triglycerides level. Compared with C group rats, the expression of OPN and MCP-1 increased in cortical tubular epithelium of H group rats, and the number of ED1 + cells increased in tubulointerstitium as well. Either OPN or MCP-1 expression was positive correlation with the number of ED1 + cells. Conclusion The expression of OPN and MCP-1 in tubular epithelium increased in hypercholesterolemia rats, which might mediate M? infiltration into tubulointerstitium and lead to interstitial fibrosis.

AIM: To observe the therapeutic effect of hepatocyte growth promoting factor (PHGF) combined with transmetil in treatment of chronic severe hepatitis (CSF). METHODS: 120 patients were divided randomly into two groups: the combined treatment group and the routine group. All the patients received ordinary therapy, and 62 patients, based on the therapy, received PHGF combined with transmetil in the combined treatment group. RESULTS: Compared with the routine treatment group, the levels of total serum bilirubin and prothrombin time were decreased significantly (P

Objective To investigate the expression of osteopontin(OPN) and monocyte chemoattractant protein-1(MCP-1) and the effect of Irbersartan on them in diet-hypercholesterolemia rats. Methods Wistar rats were divided into three groups: normal control rats(C), cholesterol fed rats(H) and cholesterol fed rats treated with Irbesartan(50 mg ? kg -1 ? d -1 ). Twelve weeks later, we measured the 24 hours total urine protein, creatinine clearance and total serum cholesterol, LDL- cholesterol, HDL- cholesterol and triglycerides. Kidney pathology was observed. Immunohistochemistry was used to analyse the expression of OPN, MCP-1, ED1 +and their relationship. Results (1) Total serum cholesterol, LDL-cholesterol level and 24 h total urine protein in H group rats were higher than that in C group rats, there was no significant difference between two groups in HDL-cholesterol and triglycerides.(2) Compared with C group rats , the expression of OPN and MCP-1 increased in cortical tubular epithelium (2.34?0.25 vs 0.49?0.11; 1.93?0.21 vs 0.49?0.11, P

To investigate the prevalence of mental health problems in male violent offenders of Hunan and Sichuan Provinces; and to compare the types and severity of problems between the violent and nonviolent offenders.Methods:Ninety-one violent juvenile offenders and 64 nonviolent juvenile offenders in the juvenile detention centers of Hunan,and 81 violent juvenile offenders in the juvenile detention centers of Sichuan; 39 high school students from a middle school of Hunan Province and 49 from a middle school of Sichuan Province were investigated using the Investigation Screening Inventory for Child Mental Disorder and the Kiddy Schedule for Affective Diseases and Schizophrenia (K-SADS-PL),and classified according to the Diagnostic and Statistical Manual of Mental Disorders.Results:In the Hunan violent group,86.6％ met the criterion of conduct disorder (CD),17.6％ of substance abuse,9.9％ of substance dependence,while in the Hunan nonviolent group,75.0％ met the criterion of CD,and 11.7％ of substance abuse; these were all significantly higher than those of the control group (P＜0.05).In the Sichuan violent group,17.3％ met the criterion of attention deficit/hyperactivity disorder (ADHD),18.5％ of oppositional defiant disorder (ODD),69.1％of CD,and 22.2％ of substance abuse; these were all significantly higher than those of the Sichuan control group.Moreover,63.7％ of Hunan-violent,55.6％ of Sichuan-violent,and 45.0％ of Hunannonviolent offenders had a previous offence records.Conclusion:Mental and behavioral disorders among delinquent youth is becoming a serious problem,and there is an urgent need to develop and implement effective assessment and treatment approaches for juvenile offenders with the aim of reducing offence and recidivism in this population.

Objective To discuss the experience in the diagnosis, treatment, complications and follow up of carotid body tumor. Methods All the 25 cases were diagnosised by DSA and CTA. The tumor was resected under carotid adventitial plane in 18 cases, with external carotid artery resection in 4cases, and in 3 cases, internal carotid artery (ICA) and external carotid artery (ECA) were resected simultaneously in which internal carotid artery was reconstructed in two cases including using self vein bypass in one and anastomosis between ICA and ECA in the other. ICA was ligated in the third case. Results No cases died perioperatively. ALL CBTs were treated successfully. Horner syndrome and trachyphonia were relieved after operation. Postoperative trachyphonia, bucking and lingual paralysis developed in 3 cases, and in one case with vagus resection caused dyspnea tracheotomy was performed. The rate of nerves injuries was 12% but no semiplegia and aphasia occurred. Follow up period was from 4 to 90 months (average 44 ±6 months) for 21 cases. The trachyphonia and bucking were improved during follow up but the lingual paralysis persists, and tumor recurred in two cases with one dying. Conclusions CBT treatment should include active surgery, sufficient preoperative preparation and avoiding the postoperative nervous complications.

Objective To investigate the technical details and therapeutic effect in treating StarIdford B aortic dissection by endovaseular aortic repair(EVAR). Methods We retrospectively review 115 type B aortic dissection cases undergoing the procedure of mini-traumatic EVAR from November 1998 to February 2009.There were 71 male patients and 44 female patients with a mean age of55.7 years and follow up period from 7 to 83 months for 75 cases. Results The procedure Was technically successful in 113 cases and 122 stent grafts were placed with hybrid surgery being carried out in 3 cases of carotid artery bypass.Severe perioperative complications included subclavian steal syndrome in 4 eases,pulmonaryinfections in 3 cases.arterial embolism in 2 cases,acute cerebral infarction in 2 cases,kidney tailure in 2 cases.alimentary tract hemorrhage,graft infection,acute intestinal ischemia and type A dissection occurred in one each case respectively.Five cases died perioperatively.Among the 75 cases that were fouowed up,there were 9 eases with type I endoleak and at last 5 cases redid endovaacular repmr.2 cases with secondary type A dissection accepted graft replacement.There were 6 deaths during the follow-up period,4 dying of acute myocardial infarction(2 cases),cerebral hemorrhage(1 case),type A dlssection (1 case)respectively,the causes of other2 deaths were not confirmed. Conclusion EVAR was effective for Standford B aortic dissection as shown by midterm follow up.

Clinical data of 116 patients with implanted permanent dual catheters for hemodialysis,including 18 with infection and 98 non-infection, during January 2006 and July 2009 were retrospectively analyzed to study risk factors for catheter-related bacteremia (CRB). Duration of catheter implantation,primary disease, routine blood examinations and blood biochemical examination of the patients were analyzed between the two groups. COX proportional hazard regression analysis was performed for all predictor variables. Results showed that overall incidence of bacteremic episodes was 0. 314 per 1000 catheter-day.Compared to that in infection group, levels of hemoglobin, plasma albumin, peripheral lymphocyte count and ratio of CD4/CD8 in non-infection group were significantly higher ( all P ＜ 0. 05 ), and OR of CRB were 4. 011 (P =0. 0213) for diabetes mellitus and 7. 181 for hemoglobin level less than 80g/L (P = 0. 0020),respectively. It is suggested that improving nutrition status and correcting anemia for patients with hemodialysis are necessary to reduce CRB.

Objective To investigate the effects of total hip replacement (THR) and dynamic hip screw (DHS) to intertrochanteric fracture in the geriatric with serious osteoporosis. Methods The clinical data of 51 senile cases (age over 60 years) with serious osteoporosis (Singh index less than grade Ⅲ ) cured from January 2003 to March 2008 were retrospectively reviewed. Two different groups were randomly selected from all cases treated with THR and DHS. Nineteen cases of THR were selected in THR group, modified Gibson approach was taken to complete hip joint replacement Thirty-two cases of DHS were selected in DHS group,lateral hip approach was employed to complete DHS fixation. Mobilization by CPM from the 2nd day and weight burdening from 3rd to 7th day according to general physical condition after surgery were carried out in THR group, mobilization and weight bearing start according to different conditions from the 2nd to 10th week in DHS group. Results Among 51 cases, 47 cases had got follow-up for 5.0 -40.5 (28.1 ± 11.9) months. Nineteen cases in THR group had got follow-up, Harris hip score of 18 cases (94.7% ) were good or excellent, and the other 1 case was bad. Twenty-eight cases in DHS group had got follow-up. Harris hip score of 23 cases (82.1% ) were good or excellent, and the other 5 cases were bad. There was statistical significance between the two groups (P < 0.05 ) . The average periods to start partly weight bearing of THR group and DHS group were( 8.3 ±4.2) days and (43.6 ± 15.3) days respectively, there was statistical significance between the two groups (P< 0.05). Conclusion To the geriatric intertrochanteric fracture with serious osteoporosis, THR is a better choice than DHS, because THR has shorter recovery period before full weight bearing, higher hip functional outcome evaluated by Harris hip score, earlier recovery of mobilization and less complications related with long term bed-bound .