Objective To evaluate the application value of hip joint traction device in treating serious developmental dysplasia of the hip. Methods From April 2006 to October 2008, 6 cases Crowe Ⅳ hip dysplasia and 1 case dysplasia of acetabulum in coxa vara underwent arthroplasty. There were 2 males and 5 females with an average age of 30 years (range, 12-45). All patients were admitted to the hospital for the distraction, which was 1.0-2.0 cm on the first day and 1 mm/d thereafter, until slowly pulling femur head to the real acetabulum. Changing to the skin distraction with 3 kg, arthroplasty was performed after pin sites healing. Results Seven femur heads of 5 cases and two greater trochanters of 1 case were pulled into the real acetabulum, average distraction length was 4.45 cm, and average time was 43 d, no nerve injury and infection of pin sites. Soft tissue release and femur shortening were not required in arthroplasty. One case accelerated pulling speed to 1.25 mm/d when left femur head was distracted to 6.0 cm, so that the partial left deep peroneal nerve injury happened after 12 h. Ending distraction, bilateral THA was undergone by stages and femur shortening 3 cm in operation, nerve injury restored after half year. All patients were followed up for average 2.5 years (range, 1.5-3.0). In all patients, two limb lengths were equal, middle gluteal muscle myodynamia improved about 1-2 grades. The mean Harris hip score improved from 56.2 to 92.2 one year after operation. Conclusion The hip joint traction device could pulled femoral head to the real acetabulum rotating center, as a result, femur shortening and soft tissue release were not required while performing arthroplasty, and through which wound and operative time were decreased, middle gluteal muscle function was improved. However, we should strictly pulled the femur head at 1 mm/d to avoid nerve injury.

Objective To evaluate the efficacy and safety of methotrexate(MTX)on the hip involve ment in patients with ankylosing spondylitis(AS).Methods Among the AS patients with hip joint involvement admitted to the department from 1999—2002,50 patients were treated with sulfasalazine(SSZ)(control group, CG)and 48 MTX(observation group,OG).One kind of NSAIDs was taken by the patients in both groups as the basic therapy.The treatment was maintained in both groups after being discharged.Patients were followed-up for three years.The observation parameters included symptoms,signs,Bath AS disease activity index(BASDAI), Bath AS functional index(BASFI),hip joint function score,the CT staging of hip joint involvement,serum in- flammation markers,laboratory tests and side effects.The data were analyzed with SPSS10.0 statistics software. Results At the 1st,2nd and 3rd year,44,38 and 32 cases in the OG and 45,38 and 31 cases in the CG were followed up respectively.During the three-year follow-up period,the hip joint function score of the OG was significantly higher than that of the CG(P

Objective To observe the occurrence of the complication in patients under going interventional therapy for cardiovascular diseases and analyze its causes.Methods The data records of 1015 patients with interventional therapy for cardiovascular diseases in our hospital from October,2003 to October,2004(aged between 7 and 85 years,585 males and 430 females) were analyzed.Among them,520 patients received percutaneous transluminal coronary angioplasty and stent implantation,160 underwent radiofrequency catheter ablation,201 with permanent cardiac pacing,121 received blocking for congenital heart disease,10 received intraartery stent implantation and 29 with other interventional therapy.Results The complication occurred in 7.58% of 1015 patients.A higher incidence of hypotension and aberrant reflex has been reported(2.66% of all,mortality rate 0.39%).Conclusions Interventional therapy for cardiovascular diseases is an effective treatment with some risk.Serious pre-operational appraisal,enriching the experience of the doctors and strict post-operational monitoring may reduce the occurrence of the complication.

Objective To study the effects of sulodexide on renal NF-κB activation and monocyte chemotactic protein 1 (MCP-1) expression in diabetic rats and elucidate the possible mechanism of sulodexide in preventing diabetic nephropathy (DN). Methods Wistar rats were fed with high-sucrose-high-fat diet and injected with a low dose of STZ (streptozotocin,35 mg/kg) into abdominal cavity to induce diabetes.DM rats were randomly divided into non-treated group of treatment,blood glucose (BG),triglyceride (TG),cholesterol,serum creatinine (Scr),urea nitrogen (BUN),24 h urinary albumin excretion (UAE) were measured.HE staining was performed in renal tissues for light microscopy examination of mean glomerular volume (MGV).MCP-1 expression was detected by immunohistochemical method.NF-κB activation was determined by Western blot. Results Compared with NC group,DM group and DMS group had significant elevated BG,TG and TC levels (all P＜0.01).There were no significant differences of BG,TG or TC levels between DM group and DMS group.Compared with NC group,DM group and DMS group had significant increased Scr,BUN,UAE levels (all P＜0.01).Scr,BUN,UAE levels were significantly lower in DMS group than those in DM group [(39.1±0.88) μmol/L vs (41.0±2.16) μmol/L,(9.12±1.06) mmol/L vs (9.87±0.19) mmol/L； (19.92±0.96) mg/24 h vs (25.99±0.52)mg/24 h,all P＜0.05].Compared with NC group,the MGV of DM group was significantly increased [(7.47±1.11)×105 μm3 vs (4.22±1.09)×105 μm3,P＜0.01].Compared with DM group,the MGA of DMS group was significantly reduced [(6.64±0.71)×105 μm3 vs (7.47±1.11)×105 μm3,P＜0.05],but was still increased compared with that of NC group (P＜0.01).Compared with NC group,the MCP-1 expression of DM group was significantly higher [(12.17±1.94)/HPF vs (1.19±0.70)/HPF,P＜0.01].MCP-1 expression in DSM group was significantly lower than that of DM group [(9.22± 1.61)/HPF vs (12.17±1.94)/HPF,P＜0.01],but still higher than that of control group (P＜0.01).Compared with NC group,the NF-κB activity was significantly higher in DM group [(0.89±0.07) vs (0.24±0.03),P＜0.01].Compared with DM group,NF-κB activity of DMS group was significantly lower [(0.27±0.01) vs (0.89±0.07),P＜0.01].There was no significant difference of NF-κB activity between DMS group and NC group. Conclusion Sulodexide has protective effects on diabetic nephropathy,and one of the mechanisms may involve the inhibition of NF-κB activation as well as the suppression of MCP-I expression.

Objective To evaluate the clinical efficacy and safety of insulin enteric-coated soft capsules in patients with type 2 diabetes mellitus. Methods Totally 260 patients were enrolled in this multi-center,randomized, open, parallel-controlled clinical trial. Patients were orally administered with the capsule (capsule group, n = 135) or subcutaneously injected with insulin (control group, n = 125)one hour before the breakfast and supper time for 12 weeks. Results In the capsule group, the glyeosylated hemoglobin A1 c (HbA1 c)and fasting/postprandial blood glucoses were significantly decreased. In terms of the proportions of subjects achieving HbA1c goals using American Diabetes Association standard (HbA1c ≤7.0%)and International Diabetes Federation standard (HbA1c≤6.5%), they were 38.9% and 21.4% in capsule group and were 45.1% and 30. 2% in control group (P = 0. 323; P = 0. 109). The incidences of adverse reactions were not significantly different between these two groups (P = 0. 618). The satisfaction score was significantly higher in capsule group than in control group (P = 0. 000). Conclusion The insulin enteric-coated soft capsule has similar effectiveness and safety with insulin injections, and meanwhile is more popular among subjects.

Objective To investigate the clinical,genetic and neuroimaging features by reporting a family with dyssynergia cerebellaris myoclonica. Methods The proband was examined clinically by neuroimaging,electromyography ( EEG),skin and muscles pathology and hematology.The patients with the illness in the family were followed up and the pedigree was drawn.Results There were 6 patients with dyssynergia cerebellaris myoclonica of the 27 family members in the family.All patients had disproportionate myoclonus,epilepsy,progressive cerebellar ataxia performance. Proband brain MRI showed cerebral atrophy.Cerebellar and cortical atrophy were more serious than other parts.There were long T,and long T2 signals in the white matter,high signal in T2FLAIR.EEG showed bursts of spike-low wave,polyspilke-low waves and polyspike waves distributing in the whole brain.Pathology of the skin and muscles was normal.Conclusions Dyssynergia cerebellaris myoclonica is an autosomal dominant disease,characterised by myoclonus,progressive cerebellar ataxia and epilepsy.Brain MRI shows cerebral cortical and cerebellar atrophy,abnormal signal in white matter.EEG showes spike and ware wave.The diagnosis is mainly based on family history,typical clinical manifestations,brain MRI and EEG changes.

Objective To investigate obstructive sleep apnea syndrome (OSAS) in patients with aortic dissection (AD). Methods Questionnaire analysis was applied to patients with or without AD according to Berlin questionnaire. Questionnaires were collected and common characters and related symptoms were compared between the two groups. Further comparison on related symptoms was made between the AD group and hypertensive patients in the control group. Results Totally 70 questionnaires were collected with 33 for the AD group (29 males and 4 females) and 37 for the control (29 males and 8 females). The average age (P ＜0.05) was 50.9 years for the AD group (range 32 to 70) and 53.4 years for the control (range 25 to 83). Snoring occurred in 29 AD patients (87. 88% ) and in 22 control patients (59. 46% ) (P ＜ 0. 05 ). Snoring everyday occurred in 19 AD patients (57. 58% ) and in 12 controls (32.43%) (P ＜0.05). Loud snoring was reported from 23 AD patients (69.70%) and 10 controls (27.03%) (P ＜0. 05). Apnea occurred in 15 AD patients (45. 45% ) and 8 controls (21.62%) ( P ＜0. 05). Apnea nearly everyday occurred in 9 AD patients ( 27.27% ) and 5 controls ( 13. 51% ) ( P ＜0. 05). Fatigue after sleep occurred in 23 AD patients (69. 70% ) and 15 controls (40. 54% ) (P ＜0. 05).Fatigue nearly everyday after sleep occurred in 10 AD patients (30. 30% ) and 6 controls ( 16. 22% ) ( P ＜0. 05). Hypertension was found in 28 AD patients ( 84. 85% ) and 20 controls ( 54. 05% ) ( P ＜ 0. 05 ).The average age of hypertensive control were 62 ± 16, greater than that of AD group (P ＜0. 05). In the 20 hypertensive control patients, loud snoring in 7 (35%), lessen than that of AD group (P ＜0.05).Compared with hypertensive controls, AD patients had greater body length ( P ＜ 0. 05 ) and lesser waist-tohip ration (P ＜ 0. 05 ). Conclusions Compared with normal control, OSAS is more common in AD patients.

Objective To discuss effect on prevention of postpartum hemorrhage of caesarean section by us- ing calcium gluconate combined with oxytocin and misoprostol.Methods 385 cases of caesarean section were select- ed and randomized into O(Oxytocin) group and OM(Oxytocin+ Misoprostol) group and COM (Calcium gluconate+ Oxytocin+Misoprostol)group.Results The mean operative blood loss in O group and OM group and COM group were (300?50.24)ml,(220?30.83) ml,(150?45.52) ml.The amount of the mean operative blood loss of COM group was significantly lower than those of O group and OM group(P＜0.05).The amount of bleeding of 2 hours after delivery in O group and OM group and COM group were (400?45.52)ml,(260?60.43)mi and(210?50.54) ml.The amount of bleeding of COM group was significantly lower than those of O group and OM group (P＜0.05).Conclusion The prevention by used calcium gluconate combined with oxytocin and misoprostol is efficient in reducing the amount of postpartum hemorrhage of caesarean section.The operation of medicine is easy and safe and economic.

Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage.Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting,and adjacent expander implantation in the early stage and expanded flap transposition in the second stage.Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean,(19.4±12.2) years],with average 15 months follow-up (range,3-67 months).The average expansion time was 74.3 days (range,53-96 days).The total of 18 patients with 22 expanders were treated with satisfactory results.All the flaps survived and the skin color,texture and contour well matched to those of the peripheral tissue.Only one complication of infection happened in the 18 cases (5.56％) and total 22 expanders (4.55％),which was similar to the rate reported in the literature.There were no any other complications related to the expander.Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face,which can not only achieve satisfactory color,unbulky and well matched texture similar to normal,but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion.

Objective To evaluate the efficacy and superiority of intracardiac noncontact catheter mapping system for mapping and ablation of complicated arrhythmia.Methods 12 patients(9 males and 3 females,aged between 28 and 76 years) were included in this study.The characteristics of electrophysiological examination were as follows one was idiopathic ecotopic beats originated in right ventricular outflow tract(RVOT),two cases with idiopathic left ventricular tachycardia(ILVT),one atrial tachycardia(AT) of left atrium,two AT originated in right atrium,six atrial fibrillation(Afi) of left atrium.Among them,4 cases failed with conventional electrophysiological examination and radio frequency ablation(RFA),1 patient was reported recurrence.All patients were introduced 64 non-contact unipolar electrodes and ablation catheter to the same chamber via formal veins,reconstructed three-dimension geometry configuration,isopotential maps and analyzed the foci of reentrant activation and critical isthmus,then ablated the interested sites guided by noncontact mapping system.Results One idiopathic ectopic beat originated in RVOT near septum received segmental ablation.Two ILVT substrates located at left posterior-mid septum and left-posterior septum underwent segmental ablation.One AT of left atrium(LA) originated in right inferior pulmonary vein(RIPV) was given linear ablation between RIPV and mitral.One of the two AT from right atrium(RA) mapped the earliest activation in orifice of inferior cava vein and was given cricoid ablation;another AT originated in posterior wall of superior cava vein across crista terminal received linear lesion.One of the six Afi cases triggered by left atrial ectopic beats was given linear lesion between left superior pulmonary vein(LSPV) and right superior pulmonary vein(RSPV) during sinus rhythm;the other five cases mapped the reentrant origin site of Afi during persistent Afi rhythm received the catheter linear ablation,and the ablation lines respectively were created between RSPV and RIPV,LSPV and left inferior pulmonary vein(LIPV),LSPV and RSPV,LIPV and mitral isthmus.All patients succeeded and no obvious complication observed in operation and postoperation.None recurred during 2~26 month follow-up period.Conclusions It is safe and effective of intracardiac noncontact catheter mapping system for endocardium mapping and ablation of arrhythmia,especially for the clarity of electrophysiological mechanism of complicated arrhythmia and guiding RAF,which has potential clinical values.