Objective To Summarize experence of Dynamic Hip Screw for the treatment of femoral intertrochanteric fracture. Methods 54 cases with femoral intertrochanteric fracture were treated by DHS internal fixation. Results All patients were followed up for 4～36 months with an average of 7 months. Satisfactory effect was obtained. Conclusions The recovery of intact posterointernal cortex of femoral intertrochante, the standard postiton of fixation of DHS and an incarease in postoperative functional exercise are the key to obtain a satisfactory therapeutic effect.

Objective To evaluate the effect of vitreoretinal surgery with lens sparing technique in treating the detachment with giant retinal tear(GRT) associated with proliferative vitreoretinopathy(PVR). Methods Thirty one consecutive eyes with GRT underwent vitrectomy were analysed retrospectively. Operative techniques included peeling of pre retinal membrane, injection of perfluorodecalin liquid, retinotomy and retinectomy,endolaser,and silicon oil or C 2F 6 gas tamponade. Lens sparing vitrectomy was performed in 28 phakic eyes. Follow up period ranged from 11 to 34 months. Results Anatomic retinal attachment was achieved intraoeratively in 29 eyes. In 16 eyes of 28 eyes with postoperative cataract formation,3 eyes underwent cataract surgery with or without intraocular lens implantation. The corrected final visual acuity ranged from 0.4 to 0.01. Conclusion Most phakic eyes of retinal detachment with GRT PVR can be successfully operated on with an outcome of improving the visual acuity by using techniques of lens sparing vitrectomy, perfluorodecalin liquid and silcone oil tamponade.

Objective To establish a new allele specific PCR method for GPT typing: and study GPT polymorphism by FLDAS-PCR and PCR-RFLP. Method 248 unrelated individuals of Han were genotyped using FLDAS-PCR and PCR-RFLP. Results Three genotypes were identified with DP of 0.631 in Han population. Typing results by FLDAS-PCR were completely consistent with those by PCR-RFLP. The allele frequencies were GPT * 1 = 0.5423 and GPT * 2 = 0.4577. The population data fitted the Hardy-Weinberg law. Conclusion GPT-FLDAS-PCR and GPT-RFLP method is useful for forensic identification.

OBJECTIVE To investigate the distribution scope of the pan-drug resistant bacteria in the SICU patients including their producing environment and high risk factors in these two years and to approach its prevention and treatment policy. METHODS The distribution scope and the high risk factors of the pan-drug resistant bacteria in SICU were reviewed and analyzed from Jan 2005 to Jan 2007.RESULTS There were 11 cases in the period from Jan 2005 to Jan 2006; and was only 1 case from Jan 2006 to Jan 2007. CONCLUSIONS To establish the drug resistance monitoring system, attach great importance to isolation and education, to monitor the original region of the pan-drug resistant bacteria, and to adopt the comprehensive antibiotic policy to control the drug resistant bacteria. Among them, the early effective isolation of high risk patients may be very effective to reduce the producing and developing of the pan-drug resistant bacteria.

Objective To investigate multi-slice spiral CT (MSCT) and MRI features of stasis cirrhosis and the diagnostic value of MSCT and MRI. Methods MSCT and MRI findings of 35 patients with stasis cirrhosis were studied. The size of liver and spleen, the diameter of hepatic vein (HV), enhancement pattern of liver parenchyma, contrast medium reflux in inferior vena cava (IVC) and (or) HV, ascites, number of varices and correlated abnormalities were reviewed. Results The volume index of liver and spleen of 35 patients was 4 434.95 cm3 and 621.92 cm3 respectively. The mean diameter of HV of 27 patients (77.1%) was 3.61 cm and HV of other 8 patients (22.9%) were too small to show. Number of patients showed waves of borderline, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, varices and ascites was 5 (14.3%), 29 (82.9%), 20 (57.1%), 16 (45.7%), and 6 (17.1%), respectively. Correlated abnormalities included cardiac enlargement 4 cases (11.4%), pericardium thickening 11 cases (31.4%), and pericardial effusion 2 cases (5.7%). Conclusions Stasis cirrhosis mainly demonstrate liver enlargement, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, and slight portal hypertension. MSCT and MRI play invaluable roles in diagnosis, differential diagnosis and etiological diagnosis of stasis cirrhosis.

BackgroundThe morphological examination of macular disease is very important information for the early diagnosis.Spectral domain optical coherence tomography (SD-OCT) is a gold criteria in the diagnosis of macular diseases,but its clinical application is limited in the eyes with refractive medium opacity.The resolution ratio of conventional B-scan sonography is unsatisfactory.20 MHz B-scan sonography may be a new approach to maculopathy.ObjectiveThis study was to evaluate the clinical value of 20 MHz B-scan ultrasound by comparing morphological changes of different maculopathies observed by 20 MHz ultrasound and spectral-domain OCT.MethodsA prospective study was designed.51 eyes of 51 patients with macular diseases who were determined by Tianjin Medical University Eye Center were enrolled in this study.Spectral-domain OCT was used to image the macular area,and then the 20 MHz B-scan ultrasound was used to examine the same eye to assess the value of 20 MHz B-scan ultrasound diagnosis.The macular diseases were typed according to the OCT manifestation.The characteristics of 20 MHz ultrasound for the same maculopathy were analyzed.All the patients subscribe the informed consent before the study.ResultsIn 10 eyes with macular hole determined by spectral-domain OCT,shallow dome-shaped lesion with central hollow was exhibited on the ultrasound image.The macular edema,retinal neuroepithelium layer detachment and retinoschisis were found in 16 eyes,6 eyes and 4 eyes by spectral-domain OCT,but the 20 M Hz B-Scan ultrasound presented with the focal belt-shaped elevation with non-echo zone below.In contrast,in 15 eyes of retinal pigment epithelium detachment in OCT,spectral-domain OCT showed stronger and thicker belt-shaped echo.Conclusions20 MHz B-scan ultrasound has certain value in the diagnosis and differentiation for several common maculopathies.Although it is not accurate as OCT in recognizing diseases,it could play an important role in refractive media opacity eye.

Objective: To study the expressions of mitochondrial protein (MAB1273), Bcl-2, and Bax in renal cell carcinoma and to investigate their role in the tumorigenesis. Methods: The expressions of mitochondrial protein, Bcl-2 and Bax were detected by immunohistochemistry SP method in 9 tissue samples of renal on-cocytoma, 6 samples of chromophobe carcinoma, 23 samples of clear cell carcinoma and 12 samples of normal renal tissue. Results: The expression of MAB1273 in renal oncocytoma, chromophobe carcinoma and clear cell carcinoma was much higher than that in normal renal tissue (P=0.006). No significant difference was found in MAB1273 expression among the three types of renal carcinoma. The expression of Bcl-2 was higher in the renal carcinoma groups than in the normal renal tissue group, with a significant difference (P=0.008). The expression of Bax was not different among all of the groups (P=0.057). Rank correlation analysis showed a positive correlation between MAB1273 and Bcl-2 expression (r=0.341, P=0.015). The expression of Bcl-2 was negatively correlated with Bax expression (r= -0.287, P=0.043). Conclusion: Overexpression of mitochondrial protein and Bcl-2 and underexpression of Bax may play a part in the genesis of renal oncocytoma, chromophobe carcinoma and the clear cell carcinoma, indicating that overexpression of MAB1273 may be correlated with apoptosis of renal cell carcinoma cells.

OBJECTIVE To summarize the clinical characteristics,diagnositic and therapeutic strategies of severe cytomegaloviral (CMV) pneumonia after kidney transplantation. METHODS To analyze retrospectively pertinent clinical information of 6 cases of severe cytomegaloviral pneumonia after kidney transplantation, including developing process of disease, clinical manifestation of pre-and post-hospitalization ,various assistant examination,therapeutic procedures and prognosis. RESULTS 6 cases had similar characters of episode as follows:CMV pneumonia occurred after 1～3 months after kidney transplantation. Major clinical symptoms included fever, coughing,few sputum without obvious manifestation of breathholding.Peripheral white blood cell was normal or less than normal range, serum CMVpp65 was finally positive during hospital stay. Radiological image of the lung presented inflammatory infiltration and obvious interstitial lesion after 7～10 days of fever, which went worse rapidly. Renal function descended with deterioration of pulmonary infection. All of patients had been treated with multiple antibiotics,glucocorticoid and mechanical ventilation, Etiological diagnosis of the 3th～6th cases were earlier than 1th～2th cases , the 3th～6th cases who finally survived were treated with longer and higher doses of antivirus and glucocorticoid, than 1th～2th cases who died of refractory hypoxemia and acute renal failure during hospital stay. CONCLUSIONS Severe cytomegaloviral pneumonia had similar clinical characteristics of episode. early diagnosis of etiology,continuous application of antivirus and glucocorticoid were crucial for Severe cytomegaloviral pneumonia after kidney transplantation.

Objective To investigated the potential influences of poly(lactic-co-glycolicacid)(PLGA)scaffold as a platform on the differentiation of mouse bone-marrow stem cells to islet-like cells.Methods Mouse bonemarrow stem cells were grown and differentiated in culture with or without PLGA scaffold,and cell morphology and functions were compared within these groups.Results The PLGA scaffold showed fine biological compatibility.Differentiated islet-like cells were dithizone (DTZ) positive,insulin and C-peptide double positive,glucagon positive and somatostatin positive in both groups.Under electron microscope there were ultrastructures similar to that of islet β cells in cells of both groups.Cells with PLGA scaffold secreted more insulin under high level glucose stimulation (P＜0.01).Conclusions PLGA scaffold was biologically compatible and improved function of the differentiated islet-like cells.

Objective To investigate the mult-slice spiral CT(MSCT)imaging manifestations of bowel wall thickening due to nontumorous causes,and to address the value of MSCT scanning in assessing nontumorous bowel wall thickening.MethodsThe MSCT findings of 284 patients with bowel wall thickening due to nontumorous causes confirmed by surgery,biopsy,or clinical follow-up were retrospectively analyzed.The location,range,symmetric or asymmetric,degree,attenuation,presence or absence of enhancement and associated perienteric abnormalities of thickened bowel wall were involved.ResultsAll nontumorous disease caused bowel wall thickening include liver cirrhosis(109 cases),acute pancreatitis(54 cases),bowel obstruction(36 cases),inflammatory bowel disease(14 cases),ischemic bowel disease(12 cases),radiation enterocolitis(13 cases),tuberculosis(12 cases),immune reaction(10 cases),infective enteritis(3 cases),acute appendicitis(3 cases),hypoproteinemia(5 cases),non-common disease(8 cases)and normal variants(5 cases).The attenuation pattern of the thickened bowel wall include high attenuation(1 case),iso-attenuation(144 cases),low attenuation(127 cases),fat deposition(5 cases)and pneumatosis(7 cases).The enhancement pattern of the thickened bowel wall included gentle enhancement(249 cases),notable enhancement(32 cases)and unenhancement(3 cases).Degree of bowel wall thickening included mild thinckening(279 cases)and marked thickening(5 cases).The range of bowel wall thickening was focal(8 cases),segmental(64 cases)and diffuse(212 cases).The associated perienteric abnormalities of thickened bowel wall included swelling of fat(218 cases),ascites(189 cases),lymphadenopathy(5 cases),peirenteirc abscess(2 cases),mesenteric vascular lesion(25 cases)and involvement of solid abdominal organs(169 cases).ConclusionMSCT has an invaluable role in the diagnostic evaluation of nontumorous bowel wall thickening.A wide variety of nontumorous diseases may manifest with bowel wall thickening at MSCT.Paying attention to the characteristics of thickening of bowel wall will benefit the diagnosis and differential diagnosis of various intestinal diseases.