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 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 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 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.

Acute-On-Chronic Liver Failure ; complications ; virology ; Adult ; DNA Mutational Analysis ; Female ; Genetic Variation ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; virology ; Humans ; Male ; Middle Aged

Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6,vitamin B12 and folic acid at pretherapy and post-treatment.Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group(intervention group,60 cases and 60 cases of non-intervention group),while 120 youth volunteers with the same period and age without neurological diseases as a control group.Both groups patients were detected for hyperhomocysteinaemia,folic acid and vitamin B12.The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6,vitamin B12 and folic acid on this basis.The hyperhomocysteinaemia,folic acid and vitamin B12 were detected repetitively after four weeks.Results Compared with control group,the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly ((10.2 ± 3.1) μmmol/L vs.(21.3 ± 4.5) μmmol/L,P ＜ 0.05).The hyperhomocysteinaemia,folic acid and vitamin B12 had no significant differences between intervention group and non-intervention group (P ＞ 0.05).After replenished vitamin B6,vitamin B12 and folic acid,the hyperhomocysteinaemia had decreased significantly ((10.5 ± 3.0) μmnol/L) in intervention group.Folic acid ((6.5±2.8)μg/L) and vitamin B12(450.2±155.6) ng/L) had increased significantly(P＜0.05).Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth.It is that hyperhomocysteinaemia decreased by replenished vitamin B6,vitamin B12 and folic acid which make for prognosis in ischemic cerebral apoplexy for the youth.

Objective To investigate the effect of Glycyrrhizin combined with puerarin on serum Leptin and insulin resistance in non-alcoholic fatty liver disease(NAFLD) patients.Methods One hundred and twenty patients with NAFLD were randomized into 4 groups,which were control group,compound Glycyrrhizin group,puerarin group,combined group,and each group was 30 cases.Patients in control group were received the regular liver protecting therapy including vitamins,amino acids,glucurolactone,in compound Glycyrrhizin group were given 60 ml compound glycyrrhizin solution (iv),in puerarin group were given puerarin at dose of 400 mg by intravenous infusion,and in combined group were given both compound glycyrrhizin and puerarin combination.All treatment period was 4 weeks.The levels of serum serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total cholesterol (TC),triglyceride (TG),leptin (LP),fasting blood glucose (FBG) and insulin(INS) were measured,and the insulin resistance index(IRI) was calculated.The liver CT image of patients were performed by Germany Siemens dual source CT instrument.Results The levels of serum ALT,AST,TC,TG,LP and IRI in control group at before and after treatment were ((83.08 ± 115.68) U/L vs.(43.32 ±11.72) U/L,(52.12±15.62) U/Lvs.(36.08 ±7.28) U/L,(6.20±1.30) mmol/Lvs.(5.60 ±0.70) mmol/L,(2.70 ±0.50) mmol/L vs.(2.10 ±0.40) mmol/L,(14.63 ±3.26) μg/L vs.(7.61 ± 2.46) μg/L,(7.9 ± 1.8) vs.(7.0 ± 1.2)),and the difference were statistically significant (t =12.828,4.244,16.648,21.442,3.341,16.152 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and IRI in compound glycyrrhizin group after treatment were ((43.28 ± 11.06) U/L,(37.28 ± 7.22) U/L,(5.70± 0.80) mmol/L,(2.20 ± 0.50) mmol/L,(7.89 ± 2.26) μg/L,(7.1 ± 1.6) respectively,significant different from before treatment ((83.06 ± 14.38) U/L,(51.68 ± 15.48) U/L,(6.30 ± 1.50) mmol/L,(2.60 ± 0.40) mmol/L,(15.13 ± 3.87) μg/L,(7.8 ± 2.2) respectively,t =8.893,4.225,16.520,24.708,6.353,21.137 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI in puerarin group after treatment were (44.26 ± 9.68) U/L,(36.86 ± 6.88) U/L,(5.60 ± 0.70) mmol/L,(2.26 ± 0.48) mmol/L,(6.89 ± 2.18) μg/L,(7.0 ± 1.8) respectively,significant different from that before treatment ((82.68±14.36) U/L,(50.06±15.23) U/L,(6.20±1.60) mmol/L,(2.70±0.52) mmol/L,(15.68 ±3.26)μg/L,(7.7 ±2.8) respectively,t =7.087,8.138,18.159,7.244,7.470,32.283 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI in combined treatment group after treatment were (22.28 ± 9.38)U/L,(28.48 ± 9.06) U/L,(5.00 ± 0.60) mmol/L,(1.70 ± 0.40) mmol/L,(4.63 ± 2.36) μg/L,(6.20± 1.6) respectively,significantly different from that before treatment ((84.62 ± 14.88) U/L,(49.12 ± 16.56)U/L,(5.70 ± 1.60) mmol/L,(2.78 ± 0.50) mmol/L,(14.78 ± 3.68) μg/L,(7.6 ± 2.1),t =14.255,11.272,8.371,9.941,8.102,37.626,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI of patient were no significant difference before treatment,but after treatment,these indexes in combined therapy group were the lowest among 4 groups (P ＜ 0.05).And there were no significant difference among control group,compound glycyrrhizin group,puerarin group (P ＞ 0.05).Conclusion Compound glycyrrhizin combined with puerarin is proved to be an effect treatment method for NAFLD through decreasing serum leptin,improving insulin resistance.

Objective To establish the sulfur mustard (SM ) induced tracheal injury model in rat and to investigate its mecha-nism .Methods Male rats (SD) were anesthetized and intra-tracheally intubated .The SM group was intra-tracheally injected by 2 mg/kg of diluted SM ,while the propylene glycol control group only by 0 .1mL of propylene glycol and the normal control group had no any treatment .The tissue and blood samples were taken for conducting the HE and immunohistochemical staining and measuring serum enzymes and andinflammatory factors .Results In the SM group ,a large number of lymphocytes infiltration in submucosa were observed;the positive expression of caspase-3 and caspase-9 were observed in epithelium and submucosa ;serum levels of TNF-α,IL-1β,IL-6 reached the peak in 24 h;serum levels of LDH ,GP ,BARS reached the peak in 6h ,so did GGT in 24 h .In the propyl-ene glycol control group and the normal control group ,lymphocytes ,macrophages and neutrophils were rare in submucosa .Conclu-sion The mechanism of SM (2 mg/kg) induced acute tracheal injury involves the inflammatory reaction ,apoptosis and oxidative stress ,moreover the lesion degree has the correlation with time .

Objective To observe the efficacy of Sorafenib in preventing and treating tumor recurrence after liver transplantation for patients with primary hepatic carcinoma beyond Milan criteria.Methods From March 2008 to June 2010,30 patients of liver transplantation with primary hepatic carcinoma exceeding Milan criteria were randomized into 2 groups,each group of 15 cases.Beginning one month posttransplantatoin patients in the experimental group received oral administration of Sorafenib (400 mg bid),while those in the control group received Capecitabine ( 1500 mg bid) for 14 days every 4 weeks.Drug was withdrawn in patients without recurrence in 18 months after transplantation,recurrent patients maintained the original dose until they were not suitable for the medication.Results The 1 year recurrence rate in experimental group was 53.3％,that in control group was 86.6％ ( x2 =3.968,P ＜ 0.05).The 1 year survival rate in experimental group was 93.3％,that in the control group was 46.6％( x2 =7.777,P ＜ 0.05 ).The mean survival time of patients in experimental group was (24.6 ± 1.7 ) months (7 - 28 months),that in the control group was ( 16.4 ± 2.7 ) months ( 5 - 34 months ) ( x2 =7.154,P ＜ 0.05).Most adverse reactions in both groups were of grade Ⅰ - Ⅱ.The incidence of diarrhea and handfoot syndrome in experimental group is higher than that in control group.Conclusions Using Sorafenib for patients with primary hepatic carcinoma exceeding Milan criteria after liver transplantation may reduce carcinoma recurrence rate,and prolong patients' survival time.