Objective To discuss the activity of Toxoplasma gondii and its impact on fetus during pregnancy.Methods Sixty -eight pregnant women whose IgG was positive and IgM was negative for anti - Toxoplasma gondii antibodies were chosen.Their serum and umbilical blood were tested for IgG,IgM,CAg (by ELISA) and DNA (by PCR) of Toxoplasma gondii.The infections of placental samples were tested by the direct smear,homogenate smear and PCR.Results There were 28 positive cases of Toxoplasma gondii IgG antibodies in cord blood,and the vertical transmission rate of IgG in placenta was 41.2%.There were 6 positive cases of Toxoplasma gondii DNA in cord blood,and the incidence of intrauterine infection was 8.8%.There were 9 positive cases of Toxoplasma gondii DNA in placental tissues,and the incidence of intrauterine infection was 13.2%.Conclusions Past Toxoplasma gondii infection during pregnancy may lead to vertical transmission between the mother and infant.

[Objective]To study the possibility of drug inhibition of wear particle induced osteolysis and aseptic prosthesis loosening in vivo.[Methods]4?8 mm transverse holes were made in femur condyle and tibia plateau of 12 adult rabbits bilaterally.One milligram of CoCr alloy(mean 5.38 ?m),Ti-6Al-4V(mean 3.21 ?m) and UHMWPE(12～200 ?m) particles were implanted into the holes separately.The animals were divided into 4 groups and each group had the same particles combination.Oral drug therapy twice a day was adopted with non-selective COX inhibitor(indomethacin,0.5 mg/kg BW),membrane Ca2+ channel inhibitor(nitrendipine,0.1 mg/kg BW),osteoclast inhibitor(alendronate sodium,0.1mg/kg BW) and blank control(0.9% saline) to the 4 groups separately and randomly according to the double blind principle,which started on the 2nd day postoperatively until 12 weeks at the time of sacrifice.Routine histological observation and calculation of the ratio of bone area(BA) to total tissue area(TTA) were done under the computerized analysis system.[Results]CoCr and Ti alloy particles could seldom be seen in the slices of the groups which showed normal cancellous bone.There were obvious macrophage infiltration and fibroblast proliferation round the particulate UHMWPE in the group of blank controls.It was similar in the groups of indomethacin and nitrendipine though the histological reaction was a little bit weaker and osteotoid tissue could occasionally be seen.UHMWPE particles were totally enclosed in the cancellous bone with little fibrous tissue proliferation in the group of alendronate sodium and the BA/TTA ratio was significantly higher than those at the other groups(P0.05).[Conclusion]This indicates the possibility of inhibition or prevention of osteolysis induced by wear particles by drug therapy especially when alendronate sodium is adopted,and it has significant clinical implications for controlling the most common cause of implant failure.

OBJECTIVE: To investigate the effects of herbs for replenishing yin to tonify kidney on testicular ultrastructural changes in rats with glucocorticoid-induced kidney deficiency. METHODS: Thirty rats were randomized into three groups: normal control group, untreated group and Erdi Biejia Decoction (EDBJD)-treated group. Kidney deficiency rat model was induced by glucocorticoid. Testicular structure and ultrastructure were observed under the light microscope and the transmission electron microscope. RESULTS: The light microscope revealed the decreased thickness of seminiferous epithelium layer, reduced number of spermatogenic cells, interstitial tissue edema, and a qualitative reduction in the number of interstitial cells and hematoxylin-eosin stained cytoplasm in the untreated group. The transmission electron microscope revealed loose structure of seminiferous epithelium, degenerative mitochondria, and increased amounts of lysosome, presence of numerous cytoplasmic vacuolation and chromatin in interstitial cell cytoplasm in the untreated group. The aggregates of heterochromatin around the nuclear membrane and the shrinkage of nucleus were also observed. Compared to the untreated group, these pathological changes were inconspicuous in EDBJD-treated group. CONCLUSION: EDBJD as replenishing yin to tonify kidney herbs can suppress glucocorticoid induced pathological changes in the testes of rats.

Objective To explore the effect of reducing sub-clinical infections of Toxoplasma gondii in newborn babies with preventive treatment. Methods Forty-four infected pregnant women were treated in different period and their umbilical blood and/or placenta of their newborn babies were tested for IgG, IgM, cAg and DNA of Toxoplasma gondii. Results The positive rate of Toxoplasma DNA in umbilical blood was 37.8%(14/37). The lowest rate was found in the preventive treatment group with a significant difference compared with the group of general treatment. Conclusion Preventive treatment can reduce sub-clinical infection rate of newborn babies effectively.

BACKGROUND:Three-dimensional finite element simulation has been widely used in biomechanics. However, there is little research in knee joint replacement. The study of femoral prosthesis is less.
OBJECTIVE:To analyze the optimal positioning parameters of knee replacement and femoral prosthesis implantation, and to verify the efficacy of Gemini-PS knee prosthesis in total knee arthroplasty.
METHODS: (1) Knee finite element model in total knee replacement was constructed. Orthogonal experiment was performed in femoral osteotomy positioning parameters. The shift amount A, external rotation degree B, and valgus degree C of femoral prosthesis were selected as the relevant factors for orthogonal experiment. Three values were taken for each parameter to establish orthogonal tables. Nine experimental combined knee replacement finite element models were created and analyzed with finite element. Analysis of variance and range analysis were used by optimization. (2) Totally 42 patients (47 knees) with knee osteoarthritis received total knee arthroplasty with Gemini-PS knee joint prosthesis. Knee joint function was evaluated after replacement with Hospital for Special Surgery knee score and American Knee Society knee score. Knee pain was assessed with Visual Analogue Scale score.
RESULTS AND CONCLUSION:(1) Minimal polyethylene substrate surface compressive stress peak was translation 0 mm, external rotation of 3°, valgus 6°; the peak stress was 15.9 MPa. Among the influential factors, the effects of internal and external translation were larger than that of external rotation angle, and greater than that of valgus angle. The optimal positioning parameter combination was pan 0 mm, external rotation 3°, valgus 6° by range analysis and variance analysis. Orthogonal experiment was valid by simulation. (2) 42 patients were folowed up for 12-36 months. One patient affected subcutaneous fat liquefaction of the lower segment of the incision. Hospital for Special Surgery knee score and American Knee Society knee score were significantly higher after implantation (P < 0.05). Visual Analogue Scale score was significantly lower after replacement (P < 0.05). X-ray films showed that osteolysis, dislocation or loosening was not found. The recovery of knee joint was good after operation. (3) These findings

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

BACKGROUND:The hidden blood loss, accounted for a fairly large proportion of perioperative blood loss in total hip replacement, can seriously affect the recovery of postoperative joint function, but the specific influential factors and mechanisms remain unknown at present. OBJECTIVE:To evaluate the relative influential factors for hidden blood loss after primary total hip arthroplasty by the blood loss condition, and to analyze the association between hidden blood loss and prognosis. METHODS:Clinical data of 110 patients who underwent primary total hip arthroplasty in the Liuzhou Worker’s Hospital between April 2011 and April 2013 were retrospectively analyzed. The hidden blood loss was calculated according to Ward and Gross formula. The effects of patient’s gender, age, body mass index, type of prosthesis, presence of internal diseases, and different causes of a disease on hidden blood loss after arthroplasty were analyzed. The patients were divided into the high blood loss group (≥ 480 mL) and the low blood loss group (<480 mL) according to the hidden blood loss. Al the patients were fol owed up for 1 year. The Harris hip score system was used to assess the recovery of hip joint function between the two groups. The correlation between hidden blood loss and the recovery of joint function was analyzed using Pearson’s correlation analysis RESULTS AND CONCLUSION:The total blood loss of primary total hip arthroplasty was (1 340±367) mL, and the hidden blood loss was (748±324) mL, and the percentage of hidden blood loss was 53.7%. The type of prosthesis, presence of internal diseases, and different causes of a disease were significantly associated with hidden blood loss after total hip arthroplasty (P<0.05). Gender, age, body mass index, and operation time were not significantly associated with hidden blood loss after total hip arthroplasty (P>0.05). The hidden blood loss was correlated with postoperative functional recovery (P=0.046). Results indicated that type of prosthesis, presence of internal diseases, and different causes of a disease are main influential factors for hidden blood loss after total hip arthroplasty. The hidden blood loss has some influence on the recovery of postoperative joint function.

Background and purpose:Hepatic epithelioid hemangioendothelioma (HEHE) is an extremely rare, vascularly original tumor, and would be misdiagnosed easily in the clinical and imaging characteristics. This study aimed to investigate the imaging features of HEHE and our experience in clinical diagnosis and treatment, and to provide important reference for the diagnosis and treatment of HEHE in the future.Methods:This study retrospectively analyzed clinical manifestations, imaging features, pathological characteristics and treatment effects of 5 HEHE cases confirmed by pathology at Department of Integrative Cancer, Fudan University Shanghai Cancer Center.Results:The ratio of male to female patients was 2 to 3. HEHE predominantly occurred in middle-aged female patients whose ages range from 26 to 65 (mean=45.6). Imaging features of HEHE included multifocal hepatic disease (n=2), systemic multi-center multi-tissue occurrence (n=3). The ultrasound images showed isoechoic or hypoechoic lesions with no obvious blood lfow signal in the lesions. CT plain scan showed isointensity or hypointensity, while MR unenhanced with hypointense T1 signal and hyperintense T2 signal. The density or signal was uneven. Contrast-enhanced CT and MR images showed “slow in slow out”, obvious and variable degrees of peripheral rim enhancement. High FDG uptake showed delayed imaging characteristics (PET/CT). DSA angiography showed the tumor blood vessels were slim. After transcatheter arterial chemoembolization (TACE) surgery, lipiodol deposition within the lesion was not ideal. Under the microscope, tumor cells showed epithelial differentiation; angiogenesis was also visible. Immunohistochemistry staining showed CD31 and CD34 positive in all the 5 cases. Two cases treated with TACE combined with high intensity focused ultrasound (HIFU) and/or radiofrequency ablation (RFA) had good result.Conclusion:The clinical and radio-logical characteristics of HEHE are distinctive. Currently, for patients with systemic multi-organizational multi-center lesions, TACE combined with HIFU and/or RFA might be the most effective treatment method.

Objective To evaluate the management of biliary complications (BC) following orthotopic liver transplantation (OLT). Methods From Feb 1999 to Feb 2004, 236 cases underwent OLT with end-to-end choledocho-choledochostomy. Biliary anastomosis was performed by intermittent suture with T tube placement in 96 cases, without T tube in 39 cases, by continuous suture in posterior wall and intermittent suture in anterior wall and without T tube in 101 cases. Results Thirty-two (13.3%) patients developed BC, with incidences in group 1, 2 and 3 of 17.7%, 15.4% and 7.9%, respectively. The incidence of hepatic hilar and/or intrahepatic bile duct strictures was 8.3%, 2.6% and 1.0%, respectively. BC incidence in group 3 significantly decreased. Twenty patients with biliary stricture underwent endoscopic and/or radiological interventions, and stricture resolution was achieved in 90% of patients with anastomotic strictures and 60% of patients with hepatic hilar and/or intrahepatic strictures. Conclusions Modified biliary tract reconstruction technique contributes to the decrease of BC. Endoscopic and/or radiological interventions should be used for non-ischemic anastomotic biliary strictures or simple hepatic hilar strictures.

Objective Rheumatoid arthritis (RA) is a typical type Ⅲ hypersensitivity with a large number of immune complexes (IC) and complement deposits in the synovial tissue , but its specific pathogenesis is not yet clear.This article was to explore the expression of the antigenic profile of serum ICs in RA.Methods ICs were isolated from the serum of 55 patients with RA (41 cases of anti-CCP antibody [+] and 14 cases of anti-CCP antibody [-]), 41 with systemic lupus erythematosus (SLE), and another 41 healthy controls by polyethylene glycol (PEG) precipitation, separated by immunoprecipitation, digested with trypsin in gel, and then subjected to mass spectrometry for identification.The levels of total proteins were compared among different groups using Vennny 2.1.0.The protein expression was considered to be up-regulated when the total protein level of the RA group was >2 times and down-regulated when it was <0.5 times that of the control.Further functional analysis was performed on the differential proteins in RA using the STRING software.Results Totally, 277 proteins were identified in the serum ICs of the RA patients, including 162 in the anti-CCP (+) and 248 in the anti-CCP (-) RA group.Compared with the SLE and healthy control groups, only 129 proteins were found in the RA patients, including 38 in the anti-CCP (+), 109 in the anti-CCP (-) RA group, and 18 in both the two groups.Among the proteins identified in the RA patients and healthy controls, 2 and 11 were up-regulated while 17 and 21 down-regulated in the anti-CCP (+) and anti-CCP (-) RA group, respectively.Conclusion More differentially expressed proteins were identified in the anti-CCP (-) than in the anti-CCP (+) RA patients.The identification of differentially expressed proteins provides a new idea and direction for the investigation of the pathogenesis and new biomarkers of RA.