BACKGROUND:Articular capsule ligaments can lead articular surface to move normally and limit the excessive movement, especially to prevent any non-physiological movement. They are the important structures for stabilizing hip joints. It was previously thought that articular capsule should be routinely resected in the total hip arthroplasty (THA). OBJECTIVE: This study was designed to investigate the effect of retaining articular capsule in THA through posterior approach on maintaining hip stability. DESIGN, TIME AND SETTING: This study, a retrospective case analysis, was performed on 61 patients with femoral neck fracture, who received treatment in the Department of Orthopedics, Xiangya Second Hospital of Central South between January 2005 and December 2006. PARTICIPANTS: Twenty-nine patients who underwent THA with retaining articular capsule from January to December 2006 were included as retaining group, and thirty-two patients who underwent THA with routine resection of partial articular capsule were included as routine group. The two groups were kept identical in case selection, prosthesis selection, post-surgery processing and operators. METHODS: Four holes were drilled on greater trochanter on the proximal femoral bone. The superior part of articular capsule valve was sutured to the superior part of original articular capsule using No.1-0 absorbing thread, then sutured to base of femoral neck in mattress manner, and the suture was not ligated. The inferior part of articular capsule valve was sutured to the inferior part of original articular capsule using another suture. And the suture passed through two bone holes on base of femoral neck. The lower limbs were externally rotated and the suture was ligated. Subsequently, the excised extortor was repaired. Prior to and subsequent to suture, hip was slowly bent for 90° and femur was internally rotated for45°to investigate the suture of articular capsule on strengthening articular stability. MAI OUTCOME MEASURES: Operation time, bleeding volume and hip dislocation after THA. RESULTS: The operation time and bleeding volume were lower in the retaining group than in the routine group (P < 0.05). After THA, hip dislocation did not occur in any patients in the retaining group but occur in 2 patients (6.2%) in the routine group. Statistical tests could not be performed due to less data, resulting in no statistical significance.CONCLUSION: There has been no precise conclusion about the effects of retaining articular capsule or not on hip stability.But retaining articular capsule shortens operation time, reduces intrao-perative bleeding, unable raise operation risk, and re-establishes hip soft tissue balance.

Objective To observe the effects of nerve impulses on the expression of carbonic anhydrase Ⅲ ( CAⅢ ) and its phosphatase activity, and to explore whether or not the cause of CAⅢ expressive decreased in skeletal muscles of myasthenia gravis( MG) is resulted from the obstruction of nerve impulse.Methods The motor nerves of extensor digitorum longus (EDL, mainly composed by fast fibers) and soleus (Sol, mainly composed by slow fibers) were cut off by operation of denervation.Levels and phosphatase activities of CAⅢ were analyzed at 7, 14, 28, and 56 d after denervation by Western blot and specific enzyme staining on the membrane following SDS-polyacrylamide gel electrophoresis, respectively.Results (1) Levels of CAⅢ in Sol of normal side (eg denervated contralateral) were much higher than that in EDL of normal side, and the levels in both Sol and EDL had an enhanced tendency with time (age) increase, especially for Sol.After denervation, the levels of CAⅢ in EDL were gradual increased, however, the level in Sol was 14 d after denervation as the boundary of ascension and then decline.( 2) The phosphatase activities of CAⅢ in Sol of normal sides were much higher than that in EDL of normal sides, and there were an enhanced tendency with time (age) increase in Sol, but no significant changes were found in EDL The enzyme activities in denervated Sol were lower(in the 14, 28, and 56 days after denervation: 14.39 ±1.93, 11.48 ±1.46, 9.04 ±1.46) much than their contralaterals(22.75 ± 1.80, 25.26 ±3.15, 25.82 ± 2.97; t = 0.002, 0.005, 0.002, all P ＜ 0.05), the enzyme activities in denervated EDL were also lower than their contralaterals, however, no significant differences were found.(3)It was consistent for CAⅢ levels and phosphatase activities in both Sol and EDL of normal sides.After denervation, however, the deviation of the CAⅢ levels and phosphatase activities happened, the levels of CAⅢ were increased, but the phosphatase activities were decreased.Conclusions The effect of nerve impulse transferring obstructed by denervation on CAⅢ expression of skeletal muscles is different from that by MG auto-antibody.The decrease of CAⅢ protein in the MG muscles may be not resulted from the nerve impulse transferring obstructed by MG auto-antibody.

[Summary] This review summarized the evolution of surgical timing and procedure skills of postnatal repair in the treatment of congenital diaphragmatic hernia ( CDH ) .Minimally invasive repair of diaphragmatic hernia was highlighted.The current status, difficulties, and future trends of surgical intervention for CDH were analyzed.

30%Horseradish Peroxidase was ingected into the nueleus lateralis dorsalis and nucleus lateralis posterior of thalamus. The result shows that thalamus has much more labeled cells than the cerebral. The midbrain has the leaet.We discussed the labeled cells of the cerebral cortex, putamencaudatus, nucleus reticular and ventral nucleus of thalamus, formatio retieaularis of midbrain.

OBJECTIVE To investigate the genotype characteristics of extended-spectrum ?-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae and drug resistance condition in Tianjin.METHODS A total of 218 strains of ESBLs-producing E.coli and K.pneumoniae were isolated from clinic.The drug-resistant CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV,OXA-1,OXA-2 and OXA-10 were tested by SYBR GREEN Ⅰ real-time fluorescent quantitative Polymerase chain reaction(PCR).RESULTS Among 109 strains of ESBLs-producing E.coli,the drug resistance of genotypes CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV and OXA-1 was 32.1%,0.9%,0.9%,33.9%,73.4%,27.5% and 15.6%,respectively.The strains with more than two genes were 66.1%.The positive rate of CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,TEM,SHV,OXA-1 and OXA-10 was 49.5%,2.8%,1.8%,22.9%,78.9%,76.1%,33.0% and 0.9%,respectively.The strains with more than two genes were 82.2%.The strains were highly sensitive to imipenem.CONCLUSIONS Most of the genotypes of ESBLs-producing E.coli and K.pneumoniae in Tianjin are SHV,TEM,CTX-M-1 and CTX-M-9.The rate of OXA are increasing,and the drug resistance genes of K.pneumoniae from different hospitals are different.

Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.

Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.

Objective To assess the value of C-reactive protein(CRP) for the prognosis of acute pulmonary embolism (PE). Methods 56 acute pulmonary embolism patients, confirmed by spiral computed tomography (sCT), magnetic resonance imaging(MRI), or pulmonary angiography (CTPA). CRP as well as electrocardiogram (ECG), echocardiography(UCG), blood gas analysis, were taken after admission. Results Among these patients,24 cases with higher CRP(≥10 mg/L),were diagnosed as massive (50.0%), sub-massive PE(45.8%), mini-massive (4.2%) or died(25.0%). 24 cases (100.0%) showed right heart dysfunction and 24 cases showed pulmonary hy-pertension on UCG, right ventricular 20 (83.8%) on ECG, 22 cases (91.7%) showed hypoxemia. 8 cases (33.3%) had syncope,and 9 cases (37.5%) had cardiogenic shock. CRP was lower than 10 mg/L in 32 patients, among whom,3 cases (9.4%) were with massive PE,6 cases (18.8%) were with sub-massive PE,23(71.8%) were with small PE,1 cases(6.3%) died. 13 (40.6%) had right heart dysfunction and 16(50.6%) had pulmona-ry hypertension on UCG, right ventricular on ECG in 15 cases (46.9%), hypoxemia in 11 cases (34.4%), syncope in 2 cases (6.3%), cardiogenic shock in 4 cases (12.5%). The occurrence of massive PE, mortality (P<0.01) and sub-massive PE (P<0.05)were statistically different between the groups with higher CRP and the groups with lower CRP. The ratio of right heart dysfunction, pulmonary hypertension, right ventricular overloading, hypoxemia had statistical significance (P<0.01). There was statistical significance in the occurrence of syncope, cardiogenic shock (P<0.05). Conclusions CRP can be used as a parameter for PE, and can be used to stratify risk levels for severi-ty and assess the effectiveness of treatment.

Objective To explore the mechanism of blood-stage treatment in patients with psoriasis vulgaris through studying the level change of IFN-?, IL-4, IL-10 and IL-17 in patients with blood-stage treatment during activity and quiescence period separately. Methods 20 patients with psoriasis vulgaris in active stage(blood heat syndrome)and 20 patients with psoriasis vulgaris in resting stage(blood stasis syndrome) were recruitedto observe the treatment effects by the PASI score,and to observe thechange of IFN-?, IL-4, IL-10, IL-17 before and after treatment in the serum by ELISA. Results The PASI scores of two groups were both significantly decreased after treatment (blood heat syndrome group t=6.685, P<0.01;blood stasis syndrome group t=4.959, P<0.01). The levels of cytokines were significantly different between patients in the periods of activity and quiescence. Onvarying degrees, the levels of cytokines of two groups were improved after treatment. The levels of cytokines IFN-?, IL-17 in blood heat group significantly decreased(t=3.024, P<0.01;t=2.543, P<0.05). The levels of cytokines IL-17 drop but the levels of cytokines IL-4 raised in blood stasis group,that were significantly differentwith the levels before treatment(t=2.417, P<0.05; t=2.547, P<0.05). Conclusion The levels of INF-?, IL-4, IL-10 and IL-17 could be effectively modulated with blood-stage treatment in treating psoriasis vulgaris.

Objective To investigate medical students' cognitive status and attitude toward urban-rural integration and to find the influencing factors in an aim to provide information for the process of urban and rural integration.Methods Sampling survey was conducted among the junior students who were major in eight-year clinical medicine,five-year clinical medicine and nursing (undergraduate) with self-made questionnaire.The data entry was done by 19.0 SPSS software and descriptive statistical analysis and ONE-WAY ANOVA were used to do statistical analysis.Results Students who didn't know urban-rural integration accounted for 53.2％,while 80.7％ students supported urban-rural integration.Students' major and residence were two influencing factors of working in the countryside.Conclusion Measures should be taken to raise students' awareness of urban-rural integration based.Targeted measures should be adopted based on students' majors and residences.